Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan; School of Medicine, Medical College, China Medical University, Taichung, Taiwan.
Psychiatry Clin Neurosci. 2014 Sep;68(9):692-700. doi: 10.1111/pcn.12175. Epub 2014 Apr 14.
We have previously found that sarcosine, a glycine transporter I inhibitor, can improve the psychiatric symptoms of schizophrenia. In this study, we aimed to investigate whether the agent can also ameliorate neuropsychiatric symptoms of Parkinson's disease (PD) patients with dementia.
An 8-week, double-blind, placebo-controlled trial was conducted in patients who had PD with dementia (PD-D). Neuropsychiatric manifestations were measured before and at week 2 (V1), week 4 (V2) and week 8 (V3) after treatment. Linear regression with the generalized estimating equations was applied for data analysis.
Fifteen patients were randomized into a sarcosine group; the other 15 into a placebo group. The generalized estimating equations model revealed significant differences in Hamilton Depression Rating Scale score (P = 0.049) at V1 and Neuropsychiatry Inventory (P = 0.039) at V2 between the treatment and placebo groups. By excluding the advanced patients from analysis, there were significant differences in Unified Parkinson's Disease Rating Scale V2 (P = 0.004) and V3 (P = 0.040), Hamilton Depression Rating Scale V1 (P = 0.014) and V2 (P = 0.047), Neuropsychiatry Inventory V1 (P = 0.002) and V2 (P < 0.001) and Behavior Pathology in Alzheimer's Disease Rating Scale V2 (P = 0.025) in favor of sarcosine.
Sarcosine temporally improved depression and neuropsychiatric symptoms in PD-D patients without exacerbating the motor or cognitive features; the beneficial effects were more prominent in patients with mild-moderate severity. Enhancement of N-methyl-D-aspartate receptor-glycine cascade may lead to a novel path for the management of PD-D.
我们之前发现肌氨酸，一种甘氨酸转运体 I 抑制剂，可以改善精神分裂症的精神症状。在这项研究中，我们旨在研究该药物是否还可以改善伴有痴呆的帕金森病（PD）患者的神经精神症状。
对患有痴呆的 PD 患者（PD-D）进行了 8 周的双盲、安慰剂对照试验。在治疗前（V1）和第 2 周（V2）、第 4 周（V2）和第 8 周（V3）后测量神经精神表现。采用广义估计方程线性回归进行数据分析。
15 名患者被随机分配到肌氨酸组，另 15 名患者被分配到安慰剂组。广义估计方程模型显示，在 V1 时 Hamilton 抑郁评定量表评分（P=0.049）和在 V2 时神经精神病学问卷（P=0.039）两组间存在显著差异。排除病情较重的患者进行分析，在 V2（P=0.004）和 V3（P=0.040）时统一帕金森病评定量表、V1（P=0.014）和 V2（P=0.047）时 Hamilton 抑郁评定量表、V1（P=0.002）和 V2（P<0.001）时神经精神病学问卷以及 V2（P=0.025）时行为病理学阿尔茨海默病评定量表方面，肌氨酸组均有显著差异。
肌氨酸可暂时改善 PD-D 患者的抑郁和神经精神症状，而不会加重运动或认知功能；在病情较轻中度的患者中，疗效更为显著。增强 N-甲基-D-天冬氨酸受体-甘氨酸级联反应可能为 PD-D 的治疗提供新的途径。
