Tong Qing, Zhang Li, Yuan Yongsheng, Jiang Siming, Zhang Rui, Xu Qinrong, Ding Jian, Li Daqian, Zhou Xiaobin, Zhang Kezhong
Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Neurosurgery, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210029, China.
Parkinsonism Relat Disord. 2015 Aug;21(8):882-7. doi: 10.1016/j.parkreldis.2015.05.016. Epub 2015 May 27.
Accumulating evidence suggests that serotonergic system may be implicated in the pathophysiology of Parkinson's disease (PD), and particularly in nonmotor symptoms such as depression, fatigue, sleep disorders, sensory and autonomic dysfunction. This study aimed to evaluate plasma levels of serotonin (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) in PD patients, and investigate their associations with nonmotor symptoms.
Eighty-two PD patients and sixty-four controls underwent a series of clinical assessments, including Hamilton Depression Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Visual Analog Scale for Pain, and Scale for Outcomes in PD for Autonomic Symptoms. Plasma 5-HT and 5-HIAA levels were measured by HPLC-ECD.
PD patients exhibited worse performance on nonmotor symptom scales (all P-values <0.001) and presented lower plasma levels of 5-HT (P < 0.001) and 5-HIAA (P < 0.001) than control individuals. Within the PD group, decreased concentrations of plasma 5-HT and 5-HIAA were correlated with more severe depression (r = -0.447, P < 0.001; r = -0.407, P < 0.001, respectively) and pain (r = -0.485, P < 0.001; r = -0.416, P < 0.001, respectively). After performing multiple linear regression, plasma 5-HT (P = 0.01) and 5-HIAA (P = 0.006) remained significantly associated with depression.
Our results suggest that serotonergic dysfunction might exist in PD, and specifically correlated with depression and pain in PD. Plasma levels of 5-HT and 5-HIAA may be considered as peripheral markers for depression in PD.
越来越多的证据表明，血清素能系统可能与帕金森病（PD）的病理生理学有关，尤其是与抑郁、疲劳、睡眠障碍、感觉和自主神经功能障碍等非运动症状有关。本研究旨在评估PD患者血浆中血清素（5-HT）及其代谢产物5-羟吲哚乙酸（5-HIAA）的水平，并探讨它们与非运动症状的相关性。
82例PD患者和64例对照者接受了一系列临床评估，包括汉密尔顿抑郁量表、疲劳严重程度量表、匹兹堡睡眠质量指数、视觉模拟疼痛量表和PD自主神经症状结局量表。采用高效液相色谱-电化学检测法测定血浆5-HT和5-HIAA水平。
与对照组相比，PD患者在非运动症状量表上表现更差（所有P值<0.001），血浆5-HT（P<0.001）和5-HIAA（P<0.001）水平更低。在PD组中，血浆5-HT和5-HIAA浓度降低与更严重的抑郁（分别为r=-0.447，P<0.001；r=-0.407，P<0.001）和疼痛（分别为r=-0.485，P<0.001；r=-0.416，P<0.001）相关。进行多元线性回归后，血浆5-HT（P=0.01）和5-HIAA（P=0.006）仍与抑郁显著相关。
我们的结果表明，PD患者可能存在血清素能功能障碍，且与PD中的抑郁和疼痛具体相关。血浆5-HT和5-HIAA水平可被视为PD中抑郁的外周标志物。
