Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Neurobiol Dis. 2019 Dec;132:104563. doi: 10.1016/j.nbd.2019.104563. Epub 2019 Aug 1.
Depression can occur before the onset of motor symptoms in Parkinson's disease (PD) patients. The pathophysiology of depression in PD involves various brain regions and relevant functional circuits. This study investigated whether there exist distinctive patterns of presynaptic monoamine transporter densities in the basal ganglia depending on the degree of depression in patients with PD. A total of 123 early and drug-naïve PD patients were enrolled. Their affective status was evaluated by the Montgomery-Asberg Depression Rating Scale (MADRS), and subjects were subgrouped into one of the following three groups according to their MADRS scores: no depression, mild depression, and moderate-to-severe depression. All patients underwent positron emission tomography (PET) using F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane. The PET images were normalized, and differences in the regional standardized uptake value ratios (SUVRs) for each side of the caudate, putamen, globus pallidus, thalamus, and ventral striatum were analyzed and compared between the three groups. A trend analysis was performed across the groups to discern any associations between SUVR values of the basal ganglia and depression severity. The SUVR values of the caudate, anterior caudate nuclei, and ventral striatum declined as MADRS increased. The SUVR values of the striatum showed an inverse dose-dependent trend of antero- and ventroposterior gradient across the groups. This result indirectly revealed the involvement of the associative and limbic circuitry of the brain that are modulated by monoamines in early PD with depression. This might suggest an in vivo causal relationship between the ventral striatum, caudate and depression.
抑郁可发生在帕金森病 (PD) 患者出现运动症状之前。PD 患者抑郁的病理生理学涉及到各种大脑区域和相关的功能回路。本研究旨在探讨 PD 患者的基底神经节中是否存在与抑郁严重程度相关的、独特的突触前单胺转运体密度模式。共纳入 123 例早期未经药物治疗的 PD 患者。采用蒙哥马利-阿斯伯格抑郁评定量表 (MADRS) 评估患者的情感状态，根据 MADRS 评分将患者分为以下三组：无抑郁、轻度抑郁和中重度抑郁。所有患者均接受 F-N-(3-氟丙基)-2β-碳乙氧基-3β-(4-碘苯基)去甲托烷正电子发射断层扫描 (PET)。对 PET 图像进行标准化，并对三组之间双侧尾状核、壳核、苍白球、丘脑和腹侧纹状体的区域标准化摄取值比 (SUVR) 进行分析和比较。对各组进行趋势分析，以辨别基底节区 SUVR 值与抑郁严重程度之间的任何关联。随着 MADRS 的增加，尾状核、前尾状核和腹侧纹状体的 SUVR 值降低。纹状体的 SUVR 值呈前向后梯度的逆剂量依赖性趋势。这一结果间接揭示了在伴有抑郁的早期 PD 中，大脑的联合和边缘回路受到单胺类物质的调节。这可能提示腹侧纹状体、尾状核与抑郁之间存在一种体内因果关系。
