MRC Clinical Sciences Centre and Centre for Neuroscience, Faculty of Medicine, Imperial CollegeLondon, UK.
Neurology. 2010 Nov 23;75(21):1920-7. doi: 10.1212/WNL.0b013e3181feb2ab.
Depression associated with Parkinson disease (PD) has a different symptom profile to endogenous depression. The etiology of depression in PD remains uncertain though abnormal serotonergic neurotransmission could play a role.
To assess with PET serotonergic function via in vivo serotonin transporter (5-HTT) availability in antidepressant-naive patients with PD.
Thirty-four patients with PD and 10 healthy matched control subjects had a clinical battery of tests including the patient-report Beck Depression Inventory-II (BDI-II), the clinician-report Hamilton Rating Scale for Depression (HRSD), and the structured clinical interview for DSM-IV Axis I Disorders (SCID-I). They underwent ¹¹C-DASB PET, a selective in vivo marker of 5-HTT binding in humans.
BDI-II scores correlated with HRSD scores. Ten of 34 patients with PD (29.4%) had BDI-II and HRSD scores above the discriminative cutoff for PD depression though only half of these patients could be classed on SCID-I criteria as having an anxiety/mood disorder. Patients with PD with the highest scores for depression symptoms showed significantly raised ¹¹C-DASB binding in amygdala, hypothalamus, caudal raphe nuclei, and posterior cingulate cortex compared to low score cases, while ¹¹C-DASB binding values in other regions were similarly decreased in depressed and nondepressed patients with PD compared to healthy controls.
Depressive symptoms in antidepressant-naive patients with PD correlate with relatively higher 5-HTT binding in raphe nuclei and limbic structures possibly reflecting lower extracellular serotonin levels. Our data are compatible with a key role of abnormal serotonergic neurotransmission contributing to the pathophysiology of PD depression and justify the use of agents acting on 5-HTT.
帕金森病（PD）相关的抑郁症与内源性抑郁症的症状谱不同。尽管异常的 5-羟色胺能神经传递可能起作用，但 PD 中抑郁症的病因仍不确定。
通过评估抗抑郁药初治的 PD 患者体内 5-羟色胺转运体（5-HTT）的可用性来评估 PD 患者的 5-羟色胺能功能。
34 例 PD 患者和 10 例健康匹配的对照者进行了一系列临床测试，包括患者报告的贝克抑郁量表第二版（BDI-II）、临床医生报告的汉密尔顿抑郁量表（HRSD）和 DSM-IV 轴 I 障碍的结构化临床访谈（SCID-I）。他们接受了 ¹¹C-DASB PET 检查，这是一种用于检测人类 5-HTT 结合的选择性体内标志物。
BDI-II 评分与 HRSD 评分相关。34 例 PD 患者中有 10 例（29.4%）BDI-II 和 HRSD 评分高于 PD 抑郁的鉴别临界值，但只有一半的患者根据 SCID-I 标准可归类为焦虑/情绪障碍。抑郁症状评分最高的 PD 患者与评分较低的病例相比，在杏仁核、下丘脑、尾状核和后扣带回皮质中显示出明显升高的 ¹¹C-DASB 结合，而在抑郁和非抑郁的 PD 患者中，其他区域的 ¹¹C-DASB 结合值与健康对照组相比均降低。
抗抑郁药初治的 PD 患者的抑郁症状与中缝核和边缘结构中相对较高的 5-HTT 结合相关，这可能反映了细胞外 5-羟色胺水平较低。我们的数据与异常 5-羟色胺能神经传递在 PD 抑郁的病理生理学中起关键作用的观点一致，并证明了使用作用于 5-HTT 的药物的合理性。
