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正电子发射断层扫描在帕金森病中的应用:对冲动性的深入了解。

Positron emission tomography in Parkinson's disease: insights into impulsivity.

机构信息

a Department of Neurology , Vanderbilt University Medical Center , Nashville , TN , USA.

出版信息

Int Rev Psychiatry. 2017 Dec;29(6):618-627. doi: 10.1080/09540261.2017.1398139. Epub 2017 Dec 5.

Abstract

This study reviews previous studies that employ positron emission tomography (PET) imaging assessments in Parkinson's disease (PD) patients with and without Impulsive Compulsive Behaviours (ICB). This begins with a summary of the potential benefits and limitations of commonly utilized ligands, specifically D receptor and dopamine transporter ligands. Since previous findings emphasize the role of the ventral striatum in the manifestation of ICBs, this study attempts to relate these imaging findings to changes in behaviour, especially emphasizing work performed in substance abuse and addiction. Next, it reviews how increasing disease duration in PD can influence dopamine receptor expression, with an emphasis on differential striatal and extra-striatal changes that occur along the course of PD. Finally, it focuses on how extra-striatal changes, particularly in the orbitofrontal cortex, amygdala, and anterior cingulate, may influence the proficiency of behavioural regulation in PD. The discussion emphasizes the interaction of disease and medication effects on network-wide changes that occur in PD, and how these changes may result in behavioural dysregulation.

摘要

本研究回顾了既往使用正电子发射断层扫描(PET)成像评估伴有和不伴有冲动强迫行为(ICB)的帕金森病(PD)患者的研究。首先总结了常用配体(D 受体和多巴胺转运体配体)的潜在优势和局限性。由于既往研究强调了腹侧纹状体在 ICB 表现中的作用,因此本研究试图将这些影像学发现与行为变化相关联,尤其强调了在物质滥用和成瘾领域的研究。接下来,本研究回顾了 PD 中疾病持续时间的增加如何影响多巴胺受体表达,重点关注 PD 病程中发生的纹状体和纹状体外差异变化。最后,本研究集中探讨了纹状体外变化,特别是眶额皮质、杏仁核和前扣带回,如何影响 PD 患者的行为调节能力。讨论强调了疾病和药物对 PD 中发生的全网络变化的相互作用,以及这些变化如何导致行为失调。

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