Mironova Yu S, Zhukova N G, Zhukova I A, Alifirova V M, Izhboldina O P, Latypova A V
Siberian State Medical University, Tomsk, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(5):138-142. doi: 10.17116/jnevro201811851138.
Clinical variants of Parkinson's disease (PD) are not restricted to motor symptoms but include a wide spectrum of different non-motor symptoms: cognitive, psychotic, autonomic and sensory. These non-motor symptoms often occur long before classical motor features. Associated pathologic changes can now be identified at earliest stages using neuroimaging, pathomorphological and genetic studies. Therefore, PD is currently considered as a multifactorial, heterogenic systemic disease associated with involvement of multiple neurotransmitter systems. This leads to understanding that not only dopaminergic but also other neurotransmitter systems, including glutamatergic system, are involved in the pathogenesis of PD. This article aimed at investigating a role of glutamatergic system in the initiation of neurodegenerative process. The role of glutamate as a neurotransmitter and a neurotoxin in the pathogenesis of PD and progression of its clinical manifestations is discussed. The authors suggest that research into glutamate excitotoxicity in PD patients might allow the improvement of treatment tactics and correction of pathogenetic therapy.
帕金森病（PD）的临床变体不仅限于运动症状，还包括广泛的不同非运动症状：认知、精神、自主神经和感觉症状。这些非运动症状往往早在典型运动特征出现之前就已出现。现在，使用神经影像学、病理形态学和遗传学研究可以在最早阶段识别相关的病理变化。因此，PD目前被认为是一种与多个神经递质系统受累相关的多因素、异质性全身性疾病。这使得人们认识到，不仅多巴胺能系统，而且包括谷氨酸能系统在内的其他神经递质系统都参与了PD的发病机制。本文旨在研究谷氨酸能系统在神经退行性过程起始中的作用。讨论了谷氨酸作为神经递质和神经毒素在PD发病机制及其临床表现进展中的作用。作者认为，对PD患者谷氨酸兴奋性毒性的研究可能有助于改善治疗策略并纠正病因治疗。
