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帕金森病中的情绪障碍:从前驱起源到动物模型的应用

Mood disturbances in Parkinson's disease: From prodromal origins to application of animal models.

作者信息

Hayley S, Vahid-Ansari F, Sun H, Albert P R

机构信息

Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Ottawa Hospital Research Institute (Neuroscience), University of Ottawa, Canada.

Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Ottawa Hospital Research Institute (Neuroscience), University of Ottawa, Canada.

出版信息

Neurobiol Dis. 2023 Jun 1;181:106115. doi: 10.1016/j.nbd.2023.106115. Epub 2023 Apr 8.

Abstract

Parkinson's disease (PD) is a complex illness with a constellation of environmental insults and genetic vulnerabilities being implicated. Strikingly, many studies only focus on the cardinal motor symptoms of the disease and fail to appreciate the major non-motor features which typically occur early in the disease process and are debilitating. Common comorbid psychiatric features, notably clinical depression, as well as anxiety and sleep disorders are thought to emerge before the onset of prominent motor deficits. In this review, we will delve into the prodromal stage of PD and how early neuropsychiatric pathology might unfold, followed by later motor disturbances. It is also of interest to discuss how animal models of PD capture the complexity of the illness, including depressive-like characteristics along with motor impairment. It remains to be determined how the underlying PD disease processes contributes to such comorbidity. But some of the environmental toxicants and microbial pathogens implicated in PD might instigate pro-inflammatory effects favoring α-synuclein accumulation and damage to brainstem neurons fueling the evolution of mood disturbances. We posit that comprehensive animal-based research approaches are needed to capture the complexity and time-dependent nature of the primary and co-morbid symptoms. This will allow for the possibility of early intervention with more novel and targeted treatments that fit with not only individual patient variability, but also with changes that occur over time with the evolution of the disease.

摘要

帕金森病(PD)是一种复杂的疾病,涉及一系列环境损伤和遗传易感性。引人注目的是,许多研究仅关注该疾病的主要运动症状,而未能认识到通常在疾病过程早期出现且使人衰弱的主要非运动特征。常见的共病精神特征,尤其是临床抑郁症,以及焦虑和睡眠障碍被认为在明显的运动缺陷出现之前就已出现。在这篇综述中,我们将深入探讨帕金森病的前驱期以及早期神经精神病理学可能如何发展,随后是后期的运动障碍。讨论帕金森病动物模型如何捕捉该疾病的复杂性,包括抑郁样特征以及运动障碍,也很有意义。帕金森病的潜在疾病过程如何导致这种共病仍有待确定。但一些与帕金森病相关的环境毒物和微生物病原体可能会引发促炎作用,有利于α-突触核蛋白的积累和对脑干神经元的损伤,从而推动情绪障碍的发展。我们认为需要基于动物的综合研究方法来捕捉主要症状和共病症状的复杂性以及时间依赖性。这将使早期干预成为可能,采用更新颖、更有针对性的治疗方法,这些方法不仅适合个体患者的差异,也适合随着疾病发展而随时间发生的变化。

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