电刺激小脑顶核对帕金森病患者脑脊液中单胺类递质含量的影响  

Effect of Fastigial Nucleus Electrical Stimulation on Monoamine Transmitters in Spinal Cord Fluid of Parkinson's Disease

作　　者：赵振强[1] 蔡美华[1] 陈志斌[1] 胡兰[2] 王埮[1] 彭忠勇 

机构地区：[1]海南医学院附属医院神经内科,海南海口市570102 [2]海南医学院附属医院检验科,海南海口市570102 [3]贵阳市第二人民医院神经内二科,贵州贵阳市550005

出　　处：《中国康复理论与实践》2010年第9期853-855,共3页Chinese Journal of Rehabilitation Theory and Practice

基　　金：海南医学院苗圃基金(2004114)

摘　　要：目的探讨电刺激小脑顶核(FNS)对帕金森病患者的运动症状、抑郁症状及脑脊液中单胺类递质含量的影响。方法将65例伴随抑郁症状的帕金森病(PD)患者随机分为刺激组(FNS+美多巴组)、对照组(单纯美多巴组)。刺激组35例患者予以FNS治疗,每次通电30min,每日治疗1次,连续治疗30d,同时按常规服用美多巴;对照组30例,单纯服用多巴胺治疗。所有患者治疗期间美多巴用量不变。于治疗前、后予以改良Webster量表、汉密尔顿抑郁分级量表(HAMD)评分;同时通过高效液相色谱分析患者脑脊液中单胺类递质含量的变化。结果治疗后,刺激组运动症状有所改善,抑郁症状减轻,Webster和HAMD评分均减少(P<0.05),脑脊液中5-羟色胺(5-HT)含量增加,去甲肾上腺素和多巴胺无明显变化。对照组运动和抑郁症状则无明显改变,脑脊液中单胺类递质含量无明显变化。结论 FNS治疗在减轻PD患者运动症状的同时也能改善抑郁状态,其作用机理可能于中枢神经保护和促进5-HT的释放有关。Objective To study the therapeutic effects of cerebellar fastigial nucleus electrical stimulation（FNS）on motor and depression symptoms and monoamine neurotransmitters in the spinal cord fluid of patients with Parkinson＇s disease（PD）.Methods65 patients with idiopathic Parkinson＇s disease following depression were divided into stimulation group（FNS＋Madopar,n=35）and control group（Madopar,n=30）.The stimulation group took Modopar,and treated with FNS,30 miniutes once a day for 30 days.The control group took Modopar only.Madopar dose has no change during the treatment.The patients were evaluated by Webster Parkinson＇s Disease Evaluation Form,and Hamilton Depression Scale（HAMD）before and after FNS treatment.The loading of monoamine neurotransmitters was measured by high performance liquid chromatography-electrochemical process.ResultsAfter the treatment,the stimulation group improved in clinical feature and depression,scored significantly lower on Webster and HAMD than the control group（P〈0.05）;the loading of 5-hydroxytryptamine（5-HT）in spinal cord fluid increased;however noradrenalin and dopamine had no different.But there was no significant change in the symptoms and the loading of monoamine neurotransmitters in the control group.ConclusionFNS is efficient to relieve the motor and depression symptoms of PD,which possible mechamism might be central neuroprotection and the release of 5-HT by FNS induction.

关 键 词：帕金森病 小脑顶核 单胺类递质 

分 类 号：R742.5[医药卫生—神经病学与精神病学]