Moore Robert Y, Whone Alan L, Brooks David J
Division of Neuroscience and MRC Clinical Sciences Centre, Faculty of Medicine, Cyclotron Building, Imperial College, Hammersmith Hospital, London W12 ONN, UK.
Neurobiol Dis. 2008 Mar;29(3):381-90. doi: 10.1016/j.nbd.2007.09.004. Epub 2007 Sep 26.
The early motor manifestations of Parkinson's disease (PD) reflect degeneration of nigrostriatal dopamine neurons projecting to the caudal putamen. However, extrastriatal dopamine and other monoamine systems are also involved, particularly in later disease. We used (18)F-dopa PET in a cross-sectional study to characterize extrastriatal monoamine neuronal dysfunction in PD. 16 Controls and 41 patients underwent investigation. We found that (18)F-dopa uptake was decreased in cortical motor areas, particularly the motor cortex, even in early disease. Frontal association areas were also affected in later disease but limbic areas were spared except for hypothalamus. The substantia nigra, midbrain raphe and locus coeruleus showed normal or increased (18)F-dopa uptake until PD was advanced, indicating compensatory responses in intact monoamine neuron perikarya. The red nucleus, subthalamus, ventral thalamus and pineal gland were also eventually involved. These findings provide a further basis for understanding the complex pathophysiology of PD in vivo and complement pathological studies.
帕金森病（PD）的早期运动表现反映了投射至尾侧壳核的黑质纹状体多巴胺神经元的变性。然而，纹状体以外的多巴胺和其他单胺能系统也参与其中，尤其是在疾病后期。我们在一项横断面研究中使用（18）F-多巴PET来表征PD中纹状体以外单胺能神经元功能障碍。16名对照者和41名患者接受了检查。我们发现，即使在疾病早期，皮质运动区，特别是运动皮层的（18）F-多巴摄取也会减少。额叶联合区在疾病后期也会受到影响，但除下丘脑外，边缘系统区域未受影响。直到PD晚期，黑质、中脑缝际核和蓝斑的（18）F-多巴摄取仍正常或增加，表明完整的单胺能神经元胞体存在代偿反应。红核、下丘脑、腹侧丘脑和松果体最终也会受累。这些发现为在体内理解PD复杂的病理生理学提供了进一步的依据，并补充了病理学研究。
