非痴呆帕金森病伴视幻觉患者血清素-2A受体与认知功能的关系
The Relationship Between Serotonin-2A Receptor and Cognitive Functions in Nondemented Parkinson's Disease Patients with Visual Hallucinations.
作者信息
Cho Sang Soo, Strafella Antonio P, Duff-Canning Sarah, Zurowski Mateusz, Vijverman Anne-Catherine, Bruno Veronica, Aquino Camila C, Criaud Marion, Rusjan Pablo M, Houle Sylvain, Fox Susan H
机构信息
Division of Brain, Imaging and Behavior-Systems Neuroscience Krembil Research Institute University Health Network University of Toronto Toronto Ontario Canada.
Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada.
出版信息
Mov Disord Clin Pract. 2017 Jan 23;4(5):698-709. doi: 10.1002/mdc3.12466. eCollection 2017 Sep-Oct.
BACKGROUND
There is growing evidence that the serotonergic system, in particular serotonin 2A receptors, is involved in neuropsychiatric symptoms in Parkinson's disease (PD), including cognitive processing and visual hallucinations. However, the relationship between serotonin 2A receptor availability, visual hallucinations, and cognitive profile is unknown. The objective of this study was to investigate the level of serotonin 2A receptor availability in brain regions affected by visual hallucinations and to test the association with cognitive/behavioral changes in patients who have PD with visual hallucinations.
METHODS
Nondemented patients who had PD with (n = 11) and without (n = 8) visual hallucinations and age-matched controls (n = 10) were recruited. All participants completed neuropsychological testing, which consisted of visuoperceptual, executive, memory, language, and frontal-behavioral function. Positron emission tomography scans using [F]setoperone, a serotonin 2A antagonist radioligand, were acquired in patients with PD, and a parametric binding potential map of [F]setoperone was calculated with the simplified reference tissue model using the cerebellum as a reference.
RESULTS
Patients who had PD with visual hallucinations exhibited significantly lower scores on measures of executive and visuoperceptual functions compared with age-matched controls. These changes were paralleled by decreased [F]setoperone binding in the right insula, bilateral dorsolateral prefrontal cortex, right orbitofrontal cortex, right middle temporal gyrus, and right fusiform gyrus. The psychometric correlation analysis revealed significant relationships among tests associated with visuoperceptual function, memory and learning, and serotonin 2A binding in different prefrontal and ventral visual stream regions. There was also reduced serotonin 2A receptor binding in patients who had PD with depression.
CONCLUSIONS
These findings support a complex interaction between serotonin 2A receptor function and cognitive processing in patients who have PD with visual hallucinations.
背景
越来越多的证据表明，血清素能系统，尤其是血清素2A受体，参与帕金森病（PD）的神经精神症状，包括认知加工和视幻觉。然而，血清素2A受体可用性、视幻觉和认知概况之间的关系尚不清楚。本研究的目的是调查受视幻觉影响的脑区中血清素2A受体的可用性水平，并测试其与有视幻觉的PD患者认知/行为变化的相关性。
方法
招募了有（n = 11）和无（n = 8）视幻觉的非痴呆PD患者以及年龄匹配的对照组（n = 10）。所有参与者都完成了神经心理学测试，包括视觉感知、执行、记忆、语言和额叶行为功能测试。使用血清素2A拮抗剂放射性配体[F]司托哌隆对PD患者进行正电子发射断层扫描，并使用小脑作为参考，通过简化参考组织模型计算[F]司托哌隆的参数化结合潜能图。
结果
与年龄匹配的对照组相比，有视幻觉的PD患者在执行功能和视觉感知功能测试中的得分显著更低。这些变化伴随着右侧脑岛、双侧背外侧前额叶皮质、右侧眶额皮质、右侧颞中回和右侧梭状回中[F]司托哌隆结合减少。心理测量相关性分析显示，与视觉感知功能、记忆和学习相关的测试与不同前额叶和腹侧视觉流区域的血清素2A结合之间存在显著关系。有抑郁症的PD患者中血清素2A受体结合也减少。
结论
这些发现支持了有视幻觉的PD患者血清素2A受体功能与认知加工之间存在复杂的相互作用。
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