Psychiatry & Neurology, Robert Wood Johnson Medical School, D207A, 671 Hoes Lane, Piscataway, NJ 08854, USA.
Psychosomatics. 2010 Nov-Dec;51(6):474-9. doi: 10.1176/appi.psy.51.6.474.
BACKGROUND: Parkinson's disease (PD) affects patients' lives with more than just physical impairment. Many of the non-motor aspects of PD, such as cognitive impairment, depression, and sleep disturbances, are common and are associated with a variety of poor outcomes. However, at present, the pathophysiology and clinical management of these symptoms are poorly understood. OBJECTIVE: The authors sought to determine the associations between various illness-associated cytokines, cortisol, and the non-motor symptoms of PD. METHOD: The authors examined a panel of cytokines (IL-1β, IL-6, IL-10, TNF-α) and cortisol in a cohort of 52 PD patients with depression. RESULTS: There were a number of significant correlations between the non-motor symptoms and TNF-α. Specifically, the authors found that TNF-α (but not IL-1β, IL-6, IL-10, or cortisol) was significantly correlated with measures of cognition, depression, and disability. In regression analyses accounting for all variables, TNF-α was consistently significant in explaining variance in cognition, depression, sleep, and disability. CONCLUSION: These data are consistent with a growing body of literature that implicates inflammatory cytokines in neural and behavioral processes and further suggests that TNF-α may be involved in the production and/or maintenance of non-motor symptoms in PD.
背景:帕金森病(PD)不仅会导致患者身体机能受损,还会对其生活造成诸多影响。许多非运动方面的 PD 症状,如认知障碍、抑郁和睡眠障碍,都很常见,并与各种不良后果相关。然而,目前这些症状的病理生理学和临床管理仍知之甚少。
目的:作者旨在确定各种与疾病相关的细胞因子、皮质醇与 PD 非运动症状之间的相关性。
方法:作者在一组 52 名患有抑郁症的 PD 患者中检查了细胞因子(IL-1β、IL-6、IL-10、TNF-α)和皮质醇的情况。
结果:非运动症状与 TNF-α 之间存在许多显著相关性。具体而言,作者发现 TNF-α(而不是 IL-1β、IL-6、IL-10 或皮质醇)与认知、抑郁和残疾的测量值显著相关。在考虑所有变量的回归分析中,TNF-α 在解释认知、抑郁、睡眠和残疾的变化方面始终具有显著意义。
结论:这些数据与越来越多的文献一致,这些文献表明炎症细胞因子与神经和行为过程有关,并进一步表明 TNF-α 可能参与 PD 中非运动症状的产生和/或维持。
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