Section of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
J Neurol. 2010 Apr;257(4):524-32. doi: 10.1007/s00415-009-5353-6. Epub 2009 Oct 21.
The biochemical basis of major depression (MD) in Parkinson's disease (PD) is largely unknown. To increase our understanding of MD in PD patients, the levels of monoamine metabolites (HVA, 5-HIAA and MHPG), BDNF, orexin-A, IL-6 and corticosterone were examined in cerebrospinal fluid. The analyses were performed in MD patients with (n = 11) and without (n = 12) PD at baseline and after 12 weeks' of treatment with the antidepressant citalopram, and in patients with solely PD (n = 14) at baseline and after 12 weeks. The major findings were that PD patients with MD had significantly lower baseline levels of MHPG, corticosterone and IL-6 when compared to patients with solely MD. In response to citalopram treatment, patients with solely MD exhibited an expected decrease in 5-HIAA and MHPG levels which was not found in PD patients with MD. Moreover, the levels of BDNF and IL-6 were lower in PD patients with MD compared with patients with solely MD after treatment with citalopram. Thus, the biochemical basis and the response to citalopram differ between PD patients with MD and patients with solely MD.
帕金森病(PD)中重度抑郁症(MD)的生化基础在很大程度上尚不清楚。为了增加我们对 PD 患者 MD 的理解,我们检查了脑脊液中单胺代谢产物(HVA、5-HIAA 和 MHPG)、BDNF、食欲素-A、IL-6 和皮质酮的水平。在基线时和使用抗抑郁药西酞普兰治疗 12 周后,对 MD 患者(n = 11)和无 PD 的 MD 患者(n = 12)进行了分析,并在基线时和 12 周后对仅患有 PD 的患者(n = 14)进行了分析。主要发现是,与单纯 MD 患者相比,患有 MD 的 PD 患者的 MHPG、皮质酮和 IL-6 水平在基线时明显较低。在西酞普兰治疗后,单纯 MD 患者的 5-HIAA 和 MHPG 水平预计会下降,但 MD 合并 PD 的患者并未出现这种情况。此外,与单纯 MD 患者相比,西酞普兰治疗后 MD 合并 PD 的患者的 BDNF 和 IL-6 水平更低。因此,MD 合并 PD 的患者和单纯 MD 的患者之间的生化基础和对西酞普兰的反应存在差异。