Smit M, Bartels A L, van Faassen M, Kuiper A, Niezen-Koning K E, Kema I P, Dierckx R A, de Koning T J, Tijssen M A
University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands.
University of Groningen, University Medical Center Groningen, Department of Neurology, PO Box 30.001, 9700, RB Groningen, The Netherlands; Ommelander Hospital Group, Department of Neurology, PO Box 30.000, 9930 RA Delfzijl, The Netherlands.
Neurosci Biobehav Rev. 2016 Jun;65:264-75. doi: 10.1016/j.neubiorev.2016.03.015. Epub 2016 Apr 9.
Dystonia is a hyperkinetic movement disorder characterized by sustained or intermittent muscle contractions. Emerging data describe high prevalences of non-motor symptoms, including psychiatric co-morbidity, as part of the phenotype of dystonia. Basal ganglia serotonin and serotonin-dopamine interactions gain attention, as imbalances are known to be involved in extrapyramidal movement and psychiatric disorders. We systematically reviewed the literature for human and animal studies relating to serotonin and its role in dystonia. An association between dystonia and the serotonergic system was reported with decreased levels of 5-hydroxyindolacetic acid, the main metabolite of serotonin. A relation between dystonia and drugs affecting the serotonergic system was described in 89 cases in 49 papers. Psychiatric co-morbidity was frequently described, but likely underestimated as it was not systematically examined. Currently, there are no good (pharmaco)therapeutic options for most forms of dystonia or associated non-motor symptoms. Further research using selective serotonergic drugs in appropriate models of dystonia is required to establish the role of the serotonergic system in dystonia and to guide us to new therapeutic strategies.
肌张力障碍是一种运动亢进性运动障碍，其特征为肌肉持续或间歇性收缩。新出现的数据表明，非运动症状（包括精神共病）在肌张力障碍的表型中普遍存在。基底神经节5-羟色胺及其与多巴胺的相互作用受到关注，因为已知失衡与锥体外系运动及精神障碍有关。我们系统回顾了有关5-羟色胺及其在肌张力障碍中作用的人类和动物研究文献。有报道称肌张力障碍与5-羟色胺能系统之间存在关联，5-羟色胺的主要代谢产物5-羟吲哚乙酸水平降低。49篇论文中的89例描述了肌张力障碍与影响5-羟色胺能系统的药物之间的关系。精神共病经常被提及，但由于未进行系统检查，可能被低估。目前，对于大多数形式的肌张力障碍或相关非运动症状，尚无良好的（药物）治疗选择。需要在合适的肌张力障碍模型中使用选择性5-羟色胺能药物进行进一步研究，以确定5-羟色胺能系统在肌张力障碍中的作用，并为我们指引新的治疗策略。
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