Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy.
Eur J Nucl Med Mol Imaging. 2012 Dec;39(12):1937-48. doi: 10.1007/s00259-012-2232-7. Epub 2012 Sep 14.
Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of (123)I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity.
Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific (123)I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects.
As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and (123)I-FP-CIT uptake ratios in healthy subjects.
We found association between presynaptic dopaminergic function and affective symptoms in different movement disorders. Interestingly, the inverse correlation was present in each group of patients, supporting the fascinating perspective that common subcortical substrates may be involved in both anxiety and depression dimensions and movement disorders.
精神症状常发生于运动障碍患者中。它们不仅仅是对慢性残疾的一种反应，更可能是由于潜在运动障碍的心理社会因素和生化功能障碍的综合作用。我们通过（123）I-FP-CIT SPECT 评估了多巴胺转运体（DAT）的可用性，并对帕金森病、原发性肌张力障碍和原发性震颤患者的运动和精神特征进行了评估，探索了 SPECT 结果与症状严重程度之间的关系。
研究纳入了 21 例帕金森病患者、14 例原发性肌张力障碍患者和 15 例原发性震颤患者。使用汉密尔顿抑郁量表评估抑郁症状严重程度，汉密尔顿焦虑量表评估焦虑水平，Snaith-Hamilton 愉悦量表评估愉悦感损害程度。基于 ROI 分析，计算尾状核和壳核的特异性（123）I-FP-CIT 结合。对照组包括 17 名健康受试者。
正如预期的那样，帕金森病患者的 DAT 可用性显著降低，而原发性震颤和肌张力障碍患者的 DAT 可用性与对照组无差异。在帕金森病患者中，发现抑郁症状严重程度与左侧尾状核 DAT 可用性呈负相关（r = -0.63，p = 0.002）。在原发性震颤患者中，焦虑症状水平与左侧尾状核 DAT 可用性呈负相关（r = -0.69，p = 0.004）。在肌张力障碍患者中，焦虑和抑郁症状的严重程度与左侧壳核 DAT 可用性呈负相关（r = -0.71，p = 0.004，r = -0.75，p = 0.002）。在健康受试者中，心理计量评分与（123）I-FP-CIT 摄取比值之间无相关性。
我们发现不同运动障碍患者的突触前多巴胺能功能与情感症状之间存在关联。有趣的是，在每个患者组中均存在负相关，这支持了一个引人入胜的观点，即共同的皮质下基质可能涉及焦虑和抑郁维度以及运动障碍。
