Stain-Malmgren R, Kjellman B F, Aberg-Wistedt A
Department of Psychiatry, Institution of Clinical Science, Karolinska Institute, St. Göran's Hospital, Stockholm, Sweden.
Psychiatry Res. 1998 May 8;78(3):163-72. doi: 10.1016/s0165-1781(98)00017-1.
We investigated platelet 14C-serotonin uptake and platelet [3H]LSD and [3H]paroxetine binding in 11 patients with seasonal affective disorder (SAD). Patients were reinvestigated after light therapy, applied at 07.00-09.00 h for 10 consecutive days. The degree of depression was rated before and after light therapy using the Comprehensive Psychopathological Rating Scale (CPRS). Baseline data in patients were compared with data from a control group consisting of 11 age- and sex-matched healthy volunteers. Seven patients responded to light therapy with a > 50% reduction in CPRS scores. In non-responders, the reduction in CPRS was 24.7 +/- 5.5%. There was a significant inverse correlation (P = 0.014) between Km for platelet 14C-serotonin uptake and CPRS scores. Patients had significantly higher Bmax for platelet [3H]LSD binding (P = 0.04) and significantly lower Bmax for platelet [3H]paroxetine binding (P = 0.016). There was a strong, multiple correlation between Bmax for [3H]LSD, as the dependent variable, and Km, Vmax and Bmax for [3H]paroxetine binding in patients (P < 0.0001) but not in controls. Responders to light therapy had significantly higher Km (P = 0.023) and significantly lower Bmax for [3H]paroxetine binding (P = 0.028) than non-responders. Bmax for [3H]paroxetine binding increased significantly to normal levels after light therapy. The results indicate that SAD is associated with aberrations in the serotonin uptake mechanism. The enhanced 5-HT2-receptor density may reflect a consequential up-regulation.
我们研究了11例季节性情感障碍（SAD）患者的血小板14C-血清素摄取以及血小板[3H]麦角酸二乙酰胺（LSD）和[3H]帕罗西汀结合情况。患者在每天07:00 - 09:00接受连续10天的光照疗法后再次接受检查。使用综合精神病理学评定量表（CPRS）在光照疗法前后对抑郁程度进行评分。将患者的基线数据与由11名年龄和性别匹配的健康志愿者组成的对照组数据进行比较。7例患者对光照疗法有反应，CPRS评分降低超过50%。无反应者的CPRS评分降低了24.7±5.5%。血小板14C-血清素摄取的米氏常数（Km）与CPRS评分之间存在显著负相关（P = 0.014）。患者血小板[3H]LSD结合的最大结合容量（Bmax）显著更高（P = 0.04），而血小板[3H]帕罗西汀结合的Bmax显著更低（P = 0.016）。以[3H]LSD的Bmax为因变量，患者中[3H]LSD的Bmax与[3H]帕罗西汀结合的Km、最大反应速度（Vmax）和Bmax之间存在强多重相关性（P < 0.0001），但在对照组中不存在。光照疗法的反应者比无反应者具有显著更高的Km（P = 0.023）和显著更低的[3H]帕罗西汀结合Bmax（P = 0.028）。光照疗法后，[3H]帕罗西汀结合的Bmax显著增加至正常水平。结果表明，季节性情感障碍与血清素摄取机制异常有关。5-羟色胺2（5-HT2）受体密度的增加可能反映了相应的上调。
