Faculté de Médecine Lyon Sud Charles Mérieux, Université Lyon 1, Université de Lyon, Lyon, France; Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; Equipe physiopathologie des Ganglions de la base, Institut des Sciences Cognitives Marc Jeannerot, Centre de Neurosciences Cognitives, UMR 5229, CNRS, Bron, France; Université Lyon 1, Univ de Lyon, Bron, France.
Service de Pharmacologie Clinique, Faculté de médecine, CHU, Toulouse, France; Service de Neurologie B8, Hôpital Pierre Paul Riquet, CHU, Toulouse, France; ToNIC, Toulouse Neuroimaging Center, University of Toulouse, Toulouse, France.
Int Rev Neurobiol. 2018;141:275-303. doi: 10.1016/bs.irn.2018.07.029. Epub 2018 Aug 13.
Opioid receptors are localized throughout peripheral and central nervous system and interact with endogenous opioid peptides and drugs including heroin, synthetic opioids, and pain relievers (codeine, morphine). If several opioid PET tracers exist for preclinical studies, only a few have been used in human. Some tracers are selective for one subtype of opioid receptors (e.g., [C]CAF (carfentanil) for μ receptor) while others are not ([C]DPN (diprenorphine)). As shown by imaging studies, the opioid system is involved in pain processing, but also in addiction, neuropsychiatric manifestations (harm avoidance, sadness, novelty seeking behavior), feeding and food disorders and, finally, movement disorders and levodopa-induced dyskinesias. However, no imaging study has analyzed the potential dysfunction of opioid system in pain manifestations in Parkinson's disease. In addition, the involvement of opioid system in impulse control disorders and neuropsychiatric manifestations has never been studied in Parkinson's disease. Thus, there is an urgent need to understand the impact of opioid system dysfunctions in Parkinson's disease.
阿片受体定位于外周和中枢神经系统，并与内源性阿片肽和药物相互作用，包括海洛因、合成阿片类药物和止痛药（可待因、吗啡）。如果有几种阿片类 PET 示踪剂可用于临床前研究，那么只有少数几种在人类中使用。一些示踪剂对一种阿片受体亚型具有选择性（例如，[C]CAF（卡芬太尼）对 μ 受体），而另一些则没有（[C]DPN（地芬诺啡））。正如影像学研究所示，阿片系统参与疼痛处理，但也参与成瘾、神经精神表现（回避、悲伤、寻求新奇行为）、摄食和饮食障碍，最后还参与运动障碍和左旋多巴诱导的运动障碍。然而，尚无影像学研究分析阿片系统在帕金森病疼痛表现中的潜在功能障碍。此外，阿片系统在帕金森病冲动控制障碍和神经精神表现中的作用从未被研究过。因此，迫切需要了解阿片系统功能障碍对帕金森病的影响。
