Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.
Neurodegeneration Imaging Group, Department of Basic & Clinical Neuroscience, King's College London, London, United Kingdom.
Int Rev Neurobiol. 2018;141:173-210. doi: 10.1016/bs.irn.2018.08.002. Epub 2018 Sep 6.
In the last decades, the main focus of molecular imaging of Parkinson's disease has been on non-dopaminergic systems involved in the disease alongside the pathognomonic dopaminergic changes. Molecular imaging can detect, in vivo, both presynaptic and postsynaptic serotonergic changes in the brain and has played a key role in elucidating the pathophysiology of the serotonergic system in Parkinson's disease. Alterations in the serotonergic system may happen very early in the course of the disease and have shown a leading role in the development of tremor and dyskinesias, and in several non-motor symptoms, including sleep, cognitive and neuropsychiatric disturbances. These studies increasingly recognize that the regional topography of serotonergic brain areas associates with specific dysfunctions. In parallel with this trend, more recent molecular serotonergic imaging approaches are investigating serotonergic modulatory treatment and their contributions to the improvement of cognitive functions. In this review, we discussed post-mortem, preclinical and imaging evidence of serotonergic system changes in Parkinson's disease, and described how disease-specific serotonergic changes are relevant for motor and non-motor symptoms and complications. Future directions of serotonergic imaging have been also described alongside with the novel findings on the role of serotonergic system in asymptomatic LRRK2 carriers.
在过去几十年中，帕金森病的分子成像主要集中在与疾病相关的非多巴胺能系统以及标志性的多巴胺能变化上。分子成像可以在体内检测到大脑中突触前和突触后 5-羟色胺能的变化，并且在阐明帕金森病中 5-羟色胺能系统的病理生理学方面发挥了关键作用。5-羟色胺能系统的改变可能在疾病的早期就已经发生，并且在震颤和运动障碍的发展以及包括睡眠、认知和神经精神障碍在内的几种非运动症状中发挥了主导作用。这些研究越来越认识到，5-羟色胺能脑区的区域拓扑与特定的功能障碍有关。随着这一趋势的发展，最近的分子 5-羟色胺能成像方法正在研究 5-羟色胺能调节治疗及其对认知功能改善的作用。在这篇综述中，我们讨论了帕金森病中 5-羟色胺能系统变化的尸检、临床前和影像学证据，并描述了特定于疾病的 5-羟色胺能变化如何与运动和非运动症状以及并发症相关。还描述了 5-羟色胺能成像的未来方向以及 5-羟色胺能系统在无症状 LRRK2 携带者中的作用的新发现。
