Sandyk R
Department of Neuroscience, Touro College, Dix Hills, NY 11746, USA.
Int J Neurosci. 1997 Nov;92(1-2):63-72. doi: 10.3109/00207459708986390.
A 52 year old fully medicated physician with juvenile onset Parkinsonism experienced 4 years ago severe "on-off" fluctuations in motor disability and debilitating speech impairment with severe stuttering which occurred predominantly during "on-off" periods. His speech impairment improved 20%-30% when sertraline (75 mg/day), a serotonin reuptake inhibitor, was added to his dopaminergic medications which included levodopa, amantadine, selegiline and pergolide mesylate. A more dramatic and consistent improvement in his speech occurred over the past 4 years during which time the patient received, on a fairly regular basis, weekly transcranial treatments with AC pulsed electromagnetic fields (EMFs) of picotesla flux density. Recurrence of speech impairment was observed on several occasions when regular treatments with EMFs were temporarily discontinued. These findings demonstrate that AC pulsed applications of picotesla flux density EMFs may offer a nonpharmacologic approach to the management of speech disturbances in Parkinsonism. Furthermore, this case implicates cerebral serotonergic deficiency in the pathogenesis of Parkinsonian speech impairment which affects more than 50% of patients. It is believed that pulsed applications of EMFs improved this patient's speech impairment through the facilitation of serotonergic transmission which may have occurred in part through a synergistic interaction with sertraline.
一名52岁的患有青少年型帕金森病的内科医生，已接受全面药物治疗。4年前，他出现了严重的运动功能“开-关”波动，以及严重的言语障碍和口吃，这些症状主要出现在“开-关”期。当在他的多巴胺能药物（包括左旋多巴、金刚烷胺、司来吉兰和甲磺酸培高利特）中添加5-羟色胺再摄取抑制剂舍曲林（75毫克/天）后，他的言语障碍改善了20%-30%。在过去4年里，患者定期每周接受皮特斯拉通量密度的交变电流脉冲电磁场（EMF）经颅治疗，其言语障碍有了更显著且持续的改善。当暂时停止定期的电磁场治疗时，多次观察到言语障碍复发。这些发现表明，皮特斯拉通量密度的交变电流脉冲电磁场应用可能为帕金森病言语障碍的治疗提供一种非药物方法。此外，该病例表明大脑5-羟色胺能缺乏在影响超过50%患者的帕金森病言语障碍发病机制中起作用。据信，电磁场的脉冲应用通过促进5-羟色胺能传递改善了该患者的言语障碍，这可能部分是通过与舍曲林的协同相互作用实现的。
