Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Lyon, France.
Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de neurologie C, Centre Expert Parkinson, Lyon, France.
Curr Neurol Neurosci Rep. 2017 Aug 18;17(10):76. doi: 10.1007/s11910-017-0788-0.
Apathy, depression, and anxiety are among the most important non-motor signs of Parkinson's disease (PD). This may be encountered at early stages of illness and represent a major source of burden. Understanding their pathophysiology is a major prerequisite for efficient therapeutic strategies. Anatomical and metabolic imaging studies have enabled a breakthrough by demonstrating that widespread abnormalities within the limbic circuits notably the orbitofrontal and anterior cingulate cortices, amygdala, thalamus, and ventral striatum are involved in the pathophysiology of depression, anxiety, and apathy in PD. Functional imaging has further shown that mesolimbic dopaminergic but also serotonergic lesions play a major role in the mechanisms of these three neuropsychiatric manifestations, which has direct therapeutic implications.
淡漠、抑郁和焦虑是帕金森病（PD）最重要的非运动症状之一。这些症状可能在疾病的早期出现，并成为主要的负担来源。了解其病理生理学是制定有效治疗策略的主要前提。解剖和代谢成像研究取得了突破，表明边缘回路（尤其是眶额皮质和前扣带皮质、杏仁核、丘脑和腹侧纹状体）的广泛异常与 PD 患者的抑郁、焦虑和淡漠的病理生理学有关。功能成像进一步表明，中脑边缘多巴胺能和 5-羟色胺能神经损伤在这三种神经精神表现的机制中起主要作用，这具有直接的治疗意义。
