Behavioral Neuroscience Program, Department of Psychology, State University of New York at Binghamton, 4400 Vestal Parkway East, Binghamton, NY 13902, USA.
Neurosci Biobehav Rev. 2011 Jan;35(3):556-64. doi: 10.1016/j.neubiorev.2010.06.007. Epub 2010 Jul 6.
Though the most recognizable symptoms of Parkinson's disease (PD) are motor-related, many patients also suffer from debilitating affective symptoms that deleteriously influence quality of life. Dopamine (DA) loss is likely involved in the onset of depression and anxiety in PD. However, these symptoms are not reliably improved by DA replacement therapy with l-3,4-dihydroxyphenylalanine (l-DOPA). In fact, preclinical and clinical evidence suggests that l-DOPA treatment may worsen affect. Though the neurobiological mechanisms remain unclear, recent research contends that l-DOPA further perturbs the function of the norepinephrine and serotonin systems, already affected by PD pathology, which have been intimately linked to the development and expression of anxiety and depression. As such, this review provides an overview of the clinical characteristics of affective disorders in PD, examines the utility of animal models for the study of anxiety and depression in PD, and finally, discusses potential mechanisms by which DA loss and subsequent l-DOPA therapy influence monoamine function and concomitant affective symptoms.
尽管帕金森病（PD）最明显的症状与运动有关，但许多患者还患有使人虚弱的情感症状，这些症状对生活质量有不良影响。多巴胺（DA）的缺失可能与 PD 患者的抑郁和焦虑的发生有关。然而，用 l-3,4-二羟基苯丙氨酸（l-DOPA）进行 DA 替代治疗并不能可靠地改善这些症状。事实上，临床前和临床证据表明，l-DOPA 治疗可能会加重影响。尽管神经生物学机制尚不清楚，但最近的研究认为，l-DOPA 进一步扰乱了去甲肾上腺素和血清素系统的功能，这些系统已经受到 PD 病理的影响，而去甲肾上腺素和血清素系统与焦虑和抑郁的发生和表达密切相关。因此，本综述概述了 PD 中情感障碍的临床特征，检查了动物模型在研究 PD 中焦虑和抑郁的效用，最后讨论了 DA 缺失和随后的 l-DOPA 治疗如何影响单胺功能和伴随的情感症状的潜在机制。
