Movement Disorders Research Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
J Neurol Sci. 2012 Jan 15;312(1-2):191-3. doi: 10.1016/j.jns.2011.08.014. Epub 2011 Aug 27.
Dopamine dysregulation syndrome is a complication of the dopaminergic treatment for Parkinson's disease, probably related to sensitization of the mesolimbic dopamine system. The relationship between dopamine dysregulation syndrome and deep brain stimulation of the subthalamic nucleus remains unclear. We report three patients with Parkinson's disease who developed de novo dopamine dysregulation syndrome after deep brain stimulation of the subthalamic nucleus. We hypothesized that the combined effect of dopaminergic replacement therapy and deep brain stimulation on the limbic territory of the subthalamic nucleus could have precipitated the dopamine dysregulation syndrome in these patients, by inducing hyperstimulation of the mesolimbic dopamine system. The outcome of postoperative dopamine dysregulation syndrome is poor despite deep brain stimulation adjustments, attempts to reduce the dose of dopaminergic drugs and the addition of quetiapine or antidepressants.
多巴胺失调综合征是一种与中脑边缘多巴胺系统敏感化相关的帕金森病多巴胺能治疗的并发症。多巴胺失调综合征与丘脑底核深部脑刺激之间的关系尚不清楚。我们报告了 3 例帕金森病患者，他们在接受丘脑底核深部脑刺激后出现新发的多巴胺失调综合征。我们假设，多巴胺能替代疗法和深部脑刺激对丘脑底核边缘区域的联合作用可能通过诱导中脑边缘多巴胺系统的过度刺激，引发了这些患者的多巴胺失调综合征。尽管进行了深部脑刺激调整、尝试减少多巴胺能药物剂量以及添加喹硫平和/或抗抑郁药，术后多巴胺失调综合征的结局仍较差。
