Service de Psychiatrie, Pole des Neurosciences Cliniques, CHU de Nice, France.
J Neurol Sci. 2011 Nov 15;310(1-2):58-60. doi: 10.1016/j.jns.2011.07.006. Epub 2011 Aug 9.
Though the core symptoms of Parkinson's disease (PD) are motor-related, a majority of patients also have neuropsychiatric symptoms concerning mood, behavior and cognition. Apathy and depression are considered among the most frequent ones, and have a negative impact on global functioning and quality of life. Recent neuroimaging studies have provided specific findings related with these symptoms. Depression in PD has been specifically associated with morphological and functional changes in prefrontal cortex, cingulate and thalamus, as with 5-HT transmission reduction in posterior cingulated and amygdala-hippocampus complex. Apathy has received less attention, but has been related with gray matter volume reductions or functional deficits in many regions, as anterior and posterior cingulate and dorsolateral or inferior frontal gyrus. Some of these deficits may be also related with a more pronounced reduction in striatal dopamine transmission. As neuroimaging studies give more arguments to the mechanisms of these symptoms, they also stimulate research for a better individualization of specific affective dimensions in Parkinson's disease.
虽然帕金森病（PD）的核心症状与运动有关，但大多数患者也存在情绪、行为和认知相关的神经精神症状。淡漠和抑郁被认为是最常见的症状之一，对整体功能和生活质量有负面影响。最近的神经影像学研究提供了与这些症状相关的具体发现。PD 中的抑郁与前额叶皮层、扣带回和丘脑的形态和功能变化有关，与后扣带回和杏仁核-海马复合体中 5-HT 传递减少有关。淡漠受到的关注较少，但与许多区域的灰质体积减少或功能缺陷有关，如前扣带回和后扣带回以及额下回和额中回。这些缺陷中的一些也可能与纹状体多巴胺传递的更明显减少有关。随着神经影像学研究为这些症状的机制提供了更多的论据，它们也刺激了对帕金森病中特定情感维度进行更好个体化研究的发展。
