Bonanno Lilla, Ciurleo Rosella, Marino Silvia, Ruvolo Claudio, Morabito Rosa, Bramanti Alessia, Corallo Francesco
Neuroimaging Laboratory, IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy.
Department of Medicine Surgery and Dentistry 'Salerno Medical School', University of Salerno, 84084 Fisciano, Italy.
J Clin Med. 2022 Mar 30;11(7):1931. doi: 10.3390/jcm11071931.
Parkinson's Disease (PD) is the most common neurodegenerative movement disorder whose treatment is symptomatic. No suitable methods for assessing the effects of dopaminergic drugs on disease progression in clinical trials have yet been provided. The aim of this longitudinal study is to evaluate the influence of rasagiline and selegiline on neurometabolic profile in de novo PD patients by using Proton Magnetic Resonance Spectroscopy (H-MRS). We enrolled de novo PD patients who were divided into two groups of 20 patients each, according to the dopaminergic treatment prescribed at the baseline visit (rasagiline or selegiline). At the baseline visit and after 12 months, all patients underwent neurological evaluation as well as H-MRS. Forty healthy controls (HC) underwent H-MRS at baseline and after 12 months. PD patients, compared to HC, showed significantly lower concentrations of NAA in the motor cortex, while the Cho levels showed a decreasing trend. After 12 months of therapy, the H-MRS study revealed that rasagiline and selegiline in a similar way were able to restore the NAA levels to values similar to those of HC. In addition, this neurometabolic change showed a correlation with UPDRS-III scores. This is the first longitudinal study that provides preliminary evidence that H-MRS may be a suitable method to evaluate objectively the influence of MAO-B inhibitors on the neurometabolic profile of PD patients. These results could open a new scenario on the hypothesis of a drug-induced slowing effect of PD progression.
帕金森病（PD）是最常见的神经退行性运动障碍，其治疗以对症治疗为主。目前尚无适用于评估多巴胺能药物对临床试验中疾病进展影响的方法。这项纵向研究的目的是通过使用质子磁共振波谱（H-MRS）评估雷沙吉兰和司来吉兰对初发帕金森病患者神经代谢谱的影响。我们纳入了初发帕金森病患者，根据基线访视时开具的多巴胺能治疗方案（雷沙吉兰或司来吉兰）将他们分为两组，每组20例患者。在基线访视时和12个月后，所有患者均接受了神经学评估以及H-MRS检查。40名健康对照者（HC）在基线时和12个月后接受了H-MRS检查。与健康对照者相比，帕金森病患者运动皮层中的NAA浓度显著降低，而Cho水平呈下降趋势。治疗12个月后，H-MRS研究显示雷沙吉兰和司来吉兰以相似的方式能够将NAA水平恢复至与健康对照者相似的值。此外，这种神经代谢变化与统一帕金森病评定量表第三部分（UPDRS-III）评分相关。这是第一项纵向研究，提供了初步证据表明H-MRS可能是客观评估单胺氧化酶B（MAO-B）抑制剂对帕金森病患者神经代谢谱影响的合适方法。这些结果可能为药物诱导的帕金森病进展减缓效应这一假说开辟新的前景。
