Jeong Eun Hye, Lee Jae Yong, Song Yoo Sung
Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, Republic of Korea.
Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
J Neuroimaging. 2025 Jan-Feb;35(1):e70014. doi: 10.1111/jon.70014.
We investigated the relationship between serotonergic and dopaminergic specific binding transporter ratios (SBRs) over 4 years in Parkinson's disease (PD) patients. We assessed serotonergic innervation's potential compensatory role for dopaminergic denervation, association with PD symptoms, and involvement in the development of levodopa-induced dyskinesia (LID).
SBRs of the midbrain and striatum were evaluated from [I-123] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane SPECT images at baseline and after 4 years. Correlations between SBRs and PD symptoms were analyzed, alongside interval changes.
Study included 177 PD patients (110 males, 67 females; mean age 61.0 ± 9.0 years). Significant worsening was observed in Hoehn and Yahr staging and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II and III scores over 4 years (p < 0.05, p < 0.001, and p < 0.001, respectively). SBRs of the caudate, putamen, and midbrain declined significantly (p < 0.001). Midbrain and striatal SBRs correlated significantly at both baseline and 4-year follow-up (p < 0.0001). Striatal SBRs correlated significantly with MDS-UPDRS II and III scores at both time points, while midbrain SBRs correlated with changes in MDS-UPDRS III scores over the 4 years (p < 0.01). Putamen and midbrain SBRs at 4 years were significantly lower in patients who developed LID compared to those who did not (p < 0.05).
The study demonstrates correlations between midbrain and putamen SBRs and MDS-UPDRS scores over 4 years in PD patients. Midbrain serotonin dysfunction may contribute to the development of LID.
我们研究了帕金森病（PD）患者4年期间血清素能和多巴胺能特异性结合转运体比率（SBRs）之间的关系。我们评估了血清素能神经支配对多巴胺能去神经支配的潜在代偿作用、与PD症状的关联以及在左旋多巴诱导的异动症（LID）发生中的作用。
在基线和4年后，从[I-123]N-ω-氟丙基-2β-甲氧基羰基-3β-（4-碘苯基）降冰片烷SPECT图像评估中脑和纹状体的SBRs。分析SBRs与PD症状之间的相关性以及间隔变化。
研究纳入177例PD患者（男性110例，女性67例；平均年龄61.0±9.0岁）。4年期间，Hoehn和Yahr分期以及运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第二部分和第三部分评分显著恶化（分别为p<0.05、p<0.001和p<0.001）。尾状核、壳核和中脑的SBRs显著下降（p<0.001）。中脑和纹状体的SBRs在基线和4年随访时均显著相关（p<0.0001）。纹状体SBRs在两个时间点均与MDS-UPDRS II和III评分显著相关，而中脑SBRs与4年期间MDS-UPDRS III评分的变化相关（p<0.01）。与未发生LID的患者相比，发生LID的患者4年时壳核和中脑的SBRs显著更低（p<0.05）。
该研究证明了PD患者4年期间中脑和壳核SBRs与MDS-UPDRS评分之间的相关性。中脑血清素功能障碍可能导致LID的发生。
