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Lamotrigine--antiparkinsonian activity by blockade of glutamate release? 拉莫三嗪:阻断谷氨酸释放的抗帕金森活性?
F Zipp, H Baas, P A Fischer

Recent experiments provide evidence that the NMDA-antagonist MK-801 has a locomotor-stimulating effect in monoamine-depleted rodents. These findings are based upon a hypothetical pathway-circuit including the basal ganglia as a model reflecting hypo- and hyperkinetic movement disorders. We have treated 5 patients suffering from Parkinson's disease with the antiepileptic drug "lamotrigine" which does not appear to be an NMDA-antagonist but acts functionally as a glutamate antagonist by inhibition of presynaptic glutamate release.

最近的实验证明,nmda拮抗剂MK-801在单胺耗竭的啮齿动物中具有运动刺激作用。这些发现是基于一个假设的通路回路,包括基底节区作为一个反映低运动障碍和高运动障碍的模型。我们用抗癫痫药物“拉莫三嗪”治疗了5例帕金森病患者,该药物似乎不是nmda拮抗剂,而是通过抑制突触前谷氨酸释放而发挥谷氨酸拮抗剂的功能。
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引用次数: 42
Rotations induced by L-dopa in parkinsonian rats are reduced by an ingestion of amino acids. 左旋多巴诱导的帕金森大鼠的旋转通过摄入氨基酸而减少。
E Mizuta, S Kuno

We studied the effect of amino acid load on L-dopa-induced rotational behavior in rats with unilateral lesion of the nigrostriatal pathway. Pretreatment of rats with an ingestion of high concentration of amino acids significantly reduced the number of rotations induced by subcutaneously injected L-dopa. These results provide the experimental basis for clinical observations that dietary protein affects the response to L-dopa in parkinsonian patients.

我们研究了氨基酸负荷对左旋多巴诱导的单侧黑质纹状体通路损伤大鼠旋转行为的影响。预处理大鼠摄入高浓度氨基酸后,皮下注射左旋多巴诱导的旋转次数明显减少。这些结果为临床观察膳食蛋白质对帕金森病患者左旋多巴反应的影响提供了实验依据。
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引用次数: 2
Circadian secretion pattern of melatonin in de novo parkinsonian patients: evidence for phase-shifting properties of l-dopa. 新生帕金森患者褪黑激素的昼夜节律分泌模式:左旋多巴相移特性的证据。
E Fertl, E Auff, A Doppelbauer, F Waldhauser

Aim of this study was the characterization of the circadian melatonin profile in de novo Parkinson patients (N = 9, age 60.0 +/- 3.2 years, mean +/- SEM) and the comparison of these profiles with those of controls and Parkinson patients treated with l-dopa/decarboxylase inhibitor (l-dopa/DCI). We collected 14 venous blood samples during a period of 24 hours and measured the serum melatonin levels by a radioimmuno assay. De novo Parkinson patients displayed the nocturnal melatonin peak (acrophase) at the same time as controls and significantly later than l-dopa/DCI treated patients (1:54 +/- 15.6 min [average clock time +/- SEM in minutes] vs. 1:45 +/- 15.6 min vs. 0:13 +/- 40.8 min). The amount of secreted melatonin did not differ among the three groups. Stage and duration of Parkinson's disease did not correlate with the amount of secreted melatonin. Patients of the tremor subgroup, however, secreted more melatonin than patients presenting only with rigidity and akinesia. The phase advance in Parkinson patients treated with l-dopa/DCI is possibly due to a central nervous dopaminergic effect elicited by l-dopa administration and not inherent to Parkinson's disease per se.

本研究的目的是表征新生帕金森患者(N = 9,年龄60.0±3.2岁,平均±SEM)的昼夜褪黑激素特征,并将这些特征与对照组和接受左旋多巴/脱羧酶抑制剂(l-dopa/DCI)治疗的帕金森患者进行比较。我们在24小时内收集了14份静脉血样本,并通过放射免疫测定法测量了血清褪黑素水平。帕金森患者出现夜间褪黑激素高峰(峰期)的时间与对照组相同,明显晚于左旋多巴/DCI治疗的患者(1:54 +/- 15.6分钟[平均时钟时间+/- SEM以分钟计],1:45 +/- 15.6分钟,0:13 +/- 40.8分钟)。褪黑素的分泌量在三组之间没有差异。帕金森病的分期和病程与褪黑激素的分泌量无关。然而,震颤亚组患者分泌的褪黑素比仅表现为僵硬和运动障碍的患者多。帕金森患者接受左旋多巴/DCI治疗的期提前可能是由于左旋多巴引起的中枢神经多巴胺能作用,而不是帕金森病本身所固有的。
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引用次数: 103
The effects of L-threo-3,4-dihydroxyphenylserine on the total norepinephrine and dopamine concentrations in the cerebrospinal fluid and freezing gait in parkinsonian patients. l -threo-3,4-二羟基苯基丝氨酸对帕金森病患者脑脊液总去甲肾上腺素和多巴胺浓度及冻结步态的影响。
H Tohgi, T Abe, S Takahashi

We studied the effects of L-threo-DOPS (L-DOPS) on the concentrations of total (conjugated and unconjugated) dopamine (DA) and norepinephrine (NE) in the cerebrospinal fluid (CSF) of parkinsonian patients with freezing phenomenon. The NE concentration increased remarkably and dose-dependently after administration of L-DOPS in both L-dopa/carbidopa-pretreated and untreated patients. The DA concentration also increased mildly but significantly in L-dopa/carbidopa-untreated patients. Freezing phenomenon improved in 6 out of 8 patients at Hoehn and Yahr's stage III, and 1 out of 5 patients at stage IV. These results indicate that L-DOPS administration increases the NE concentration dose-dependently, and is effective for freezing of gait of moderate severity.

本实验研究了l -三苯基多巴胺(L-DOPS)对帕金森病患者脑脊液(CSF)中总(偶联和非偶联)多巴胺(DA)和去甲肾上腺素(NE)浓度的影响。在左旋多巴/卡比多巴预处理和未治疗的患者中,给予左旋dops后NE浓度显著增加且呈剂量依赖性。未经左旋多巴/卡比多巴治疗的患者DA浓度也轻微但显著升高。8例Hoehn和Yahr期患者中有6例冻结现象改善,4期患者中有1例冻结现象改善。这些结果表明,L-DOPS使NE浓度呈剂量依赖性增加,对中等严重程度的步态冻结有效。
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引用次数: 64
Substance P receptors are differentially affected in Parkinson's and Alzheimer's disease. P物质受体在帕金森病和阿尔茨海默病中受到不同的影响。
L Rioux, J N Joyce

We have quantified by receptor autoradiography the number of NK1 receptors, using [125I] Bolton-Hunter labeled substance P, in striatum and pallidum (internal (GPi) or external (GPe) segment) of patients suffering from Alzheimer's (AD) and Parkinson's disease (PD). When compared to non-neurologic controls, a significant increase in the number of NK1 sites has been observed in the striatum of PD patients. No significant differences were observed for the GPi and GPe. We observed no significant differences from controls in the number of NK1 sites in the striatum and pallidum of AD cases. However, the number of NK1 sites in the striatum of AD patients was significantly lower than that of PD patients. These results show that the expression of NK1 receptors in the basal ganglia is affected in PD.

我们使用[125I] Bolton-Hunter标记物质P,通过受体放射自显影法定量测定了阿尔茨海默病(AD)和帕金森病(PD)患者纹状体和白质(内部(GPi)或外部(GPe)段)中NK1受体的数量。与非神经系统对照相比,PD患者纹状体中NK1位点的数量显著增加。GPi和GPe无显著差异。我们观察到AD病例中纹状体和苍白质中NK1位点的数量与对照组没有显著差异。然而,AD患者纹状体中NK1位点的数量明显低于PD患者。这些结果表明,PD患者基底神经节中NK1受体的表达受到影响。
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引用次数: 18
Effects of monoamine oxidase inhibition by selegiline on concentrations of noradrenaline and monoamine metabolites in CSF of patients with Alzheimer's disease. selegiline抑制单胺氧化酶对阿尔茨海默病患者脑脊液去甲肾上腺素和单胺代谢物浓度的影响
E H Heinonen, M Savijärvi, M Kotila, A Hajba, M Scheinin

A double-blind, cross-over trial with 12 patients with Alzheimer's disease (AD) was carried out primarily to test the suitability of this design in the investigation of the clinical effects of selegiline (10 mg/day) in AD. Cerebrospinal fluid (CSF) samples for the determination of concentrations of noradrenaline (NA) and several monoamine metabolites were collected at baseline and at the end of both four-week treatment periods (placebo and selegiline). The severity of dementia was assessed using Ferm's and Gottfries-Bråne-Steen (GBS) dementia scales. The concentrations of the dopamine metabolite, 3,4-dihydroxyphenylacetic acid (DOPAC) and the NA metabolites, 3,4-dihydroxyphenylglycol (DHPG), and 3-methoxy-4-hydroxyphenyl glycol (MHPG) decreased significantly during selegiline treatment. There was a clear trend of reduction in concentrations of homovanillic acid (HVA) during selegiline treatment, whereas the concentrations of NA, 5-hydroxyindoleacetic acid (5-HIAA), and tryptophan did not differ significantly. The study design was not suitable for the analysis of the clinical results as there was a significant carry-over effect in both scales. As only the first period data could be used in the analysis, there were no significant differences in the scores of Ferm's or GBS scales, but clear positive trends could be detected in favour of selegiline.

对12例阿尔茨海默病(AD)患者进行了双盲交叉试验,主要是为了检验该设计在研究塞来吉兰(10mg /d)治疗AD的临床效果中的适用性。在基线和四周治疗期(安慰剂和斯来吉兰)结束时收集脑脊液(CSF)样本,用于测定去甲肾上腺素(NA)和几种单胺代谢物的浓度。使用Ferm's和gottfries - br ne- steen (GBS)痴呆量表评估痴呆的严重程度。多巴胺代谢物3,4-二羟基苯基乙酸(DOPAC)和NA代谢物3,4-二羟基苯基乙二醇(DHPG)和3-甲氧基-4-羟基苯基乙二醇(MHPG)浓度在selegiline治疗期间显著降低。selegiline处理期间,高香草酸(HVA)浓度有明显降低的趋势,而NA、5-羟基吲哚乙酸(5-HIAA)和色氨酸的浓度差异不显著。该研究设计不适合分析临床结果,因为两个量表都存在显著的结转效应。由于只能使用第一期数据进行分析,因此Ferm's或GBS量表的得分没有显着差异,但可以发现明显的有利于selegiline的积极趋势。
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引用次数: 21
The effect of age on concentrations of monoamines, amino acids, and their related substances in the cerebrospinal fluid. 年龄对脑脊液中单胺、氨基酸及其相关物质浓度的影响。
H Tohgi, S Takahashi, T Abe

We studied age-related changes in the concentrations of monoamines, amino acids, and their related substances in the cerebrospinal fluid on 144 neurologically normal subjects. The concentrations of tyrosine, 3-O-methyldopa, dopamine (total), norepinephrine (total), homovanillic acid, p-hydroxyphenylacetic acid, and 5-hydroxytryptophan increased significantly with age (p < 0.05), and the concentration of 3.4-dihydroxyphenylacetic acid displayed a non-significant trend to decrease, whereas concentrations of other monoamine precursors and metabolites were unchanged. We found the significant positive correlations between the concentrations of HVA and 5-HIAA (p < 0.001), between tyrosine and tryptophan (p < 0.001), and between tyrosine and 3-O-methyldopa (p < 0.001). The concentrations of asparagine, glycine, taurine, and alanine increased significantly with age (p < 0.05), while glutamine, arginine, and threonine concentrations did not change with age. The aspartate, glutamate, and GABA concentrations displayed the non-significant trends to decrease in the elderly subjects. The concentrations of aspartate, glutamate, and GABA had mutually significant positive correlations (p < 0.05), but had significant negative correlations with the concentrations of some neutral amino acids. The urate and xanthine concentrations increased significantly with age (p < 0.01). These findings suggest that the concentrations of monoamine and amino acid transmitters and their related compounds in the cerebrospinal fluid reflect age-related changes in the synthesis, release, and reuptake mechanisms of the transmitters and their transport mechanisms across the blood-brain barrier.

我们研究了144名神经正常受试者脑脊液中单胺、氨基酸及其相关物质浓度的年龄相关性变化。酪氨酸、3- o -甲基多巴、多巴胺(总)、去甲肾上腺素(总)、同香草酸、对羟基苯基乙酸和5-羟色氨酸的浓度随年龄的增长而显著升高(p < 0.05), 3.4-二羟基苯基乙酸的浓度呈不显著下降趋势,其他单胺前体和代谢物的浓度没有变化。我们发现HVA和5-HIAA浓度、酪氨酸和色氨酸浓度、酪氨酸和3- o -甲基多巴浓度之间存在显著正相关(p < 0.001)。天冬酰胺、甘氨酸、牛磺酸和丙氨酸的浓度随年龄的增长而显著升高(p < 0.05),谷氨酰胺、精氨酸和苏氨酸的浓度不随年龄的增长而变化。在老年受试者中,天冬氨酸、谷氨酸和GABA浓度呈非显著性下降趋势。天冬氨酸、谷氨酸和GABA浓度呈显著正相关(p < 0.05),与部分中性氨基酸浓度呈显著负相关(p < 0.05)。尿酸盐和黄嘌呤浓度随年龄的增长而显著升高(p < 0.01)。这些发现表明,脑脊液中单胺和氨基酸递质及其相关化合物的浓度反映了递质合成、释放和再摄取机制及其跨血脑屏障运输机制的年龄相关变化。
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引用次数: 28
Insulin-like growth factors and insulin-like growth factor binding proteins in cerebrospinal fluid and serum of patients with dementia of the Alzheimer type. 阿尔茨海默型痴呆患者脑脊液和血清中胰岛素样生长因子及胰岛素样生长因子结合蛋白的研究
A Tham, A Nordberg, F E Grissom, C Carlsson-Skwirut, M Viitanen, V R Sara

After acid gel-chromatography cerebrospinal fluid and serum levels of immunoreactive insulin-like growth factor 1 and 2 (IGF-1 and IGF-2) were determined in patients with dementia of the Alzheimer type (AD) and in healthy subjects. The AD CSF levels of immunoreactive IGF-1 did not differ from the subjects but the levels of immunoreactive IGF-2 was significantly elevated in both serum and CSF in the AD patient group. Additionally immunoreactive IGF-1 in AD serum was found to be significantly elevated. To characterize the CSF IGF binding protein activity (IGFBP), ligand blotting was performed on whole CSF from AD patients and subjects. The results demonstrate two major forms of IGFBP in CSF with approximate molecular weights of 33 KDa and 30 KDa. The two IGFBP forms are suggested to represent IGFBP-2 and IGFBP-6. A highly significant increase in both the IGFBPs was observed in the CSF of the AD patients compared to the healthy subjects.

经酸凝胶色谱法测定了阿尔茨海默型痴呆(AD)患者和健康受试者脑脊液和血清中免疫反应性胰岛素样生长因子1和2 (IGF-1和IGF-2)的水平。AD患者血清和脑脊液中免疫反应性IGF-1的水平与受试者没有差异,但免疫反应性IGF-2的水平在AD患者组中均显著升高。此外,AD血清中免疫反应性IGF-1明显升高。为了表征脑脊液IGF结合蛋白活性(IGFBP),对AD患者和受试者的整个脑脊液进行了配体印迹。结果表明,CSF中存在两种主要形式的IGFBP,分子量约为33 KDa和30 KDa。建议这两种IGFBP形式分别代表IGFBP-2和IGFBP-6。与健康受试者相比,阿尔茨海默病患者脑脊液中两种igfbp均显著升高。
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引用次数: 145
Effect of repeated electroconvulsive shock on striatal L-dopa and dopamine metabolism: an in vivo study. 反复电休克对纹状体左旋多巴和多巴胺代谢的影响:一项体内研究。
T Brannan, J Martínez-Tica, M D Yahr

A course of treatments with electroconvulsive shock (ECS) has been reported to reestablish L-dopa efficacy in patients with advanced Parkinson's disease. We wished to determine if ECS could modify L-dopa and dopamine metabolism in an animal model of Parkinson's disease. Therefore, we administered repeated ECS (8 ECS at 48 hr intervals) to rats with partial destruction of the nigrostriatal dopamine pathway and used the cerebral microdialysis technique to monitor extracellular concentrations of dopamine and dopamine metabolites (DOPAC and HVA) in the corpus striatum. The control group of animals received sham-ECS treatments. Basal dopamine levels were decreased by 20% in animals receiving repeated-ECS versus sham-ECS. DOPAC levels, on the other hand, were increased by 84% in animals receiving repeated-ECS. HVA levels were equal in the two groups. Following L-dopa administration, dopamine and HVA levels increased equally in control animals and animals which had previously received repeated-ECS. DOPAC concentrations were uniformly greater in rats receiving repeated-ECS. When ECS was administered acutely, dopamine levels increased 390% and returned to baseline values in 75 minutes, DOPAC and HVA were unchanged, and 5HIAA levels decreased 30%. We conclude that 1) acute ECS administration produces a transient, marked release of striatal dopamine and 2) repeated ECS can reset the level of basal dopamine release, a finding compatible with ECS-induced dopamine receptor supersensitivity, and 3) neither single nor repeated administration of ECS has a major effect on the formation of dopamine or HVA from exogenously administered L-dopa although there was a strong tendency for increased DOPAC formation. ECS may exert its putative antiparkinsonian effect by enhancing dopamine receptor sensitivity.

据报道,一个疗程的电休克(ECS)治疗可以重建左旋多巴对晚期帕金森病患者的疗效。我们希望确定ECS是否可以改变帕金森病动物模型中的左旋多巴和多巴胺代谢。因此,我们对黑质纹状体多巴胺通路部分破坏的大鼠进行重复ECS(8次ECS,间隔48小时),并使用脑微透析技术监测纹状体中多巴胺和多巴胺代谢物(DOPAC和HVA)的细胞外浓度。对照组动物接受假ecs治疗。与假ecs相比,重复ecs动物的基础多巴胺水平下降了20%。另一方面,在接受重复ecs的动物中,DOPAC水平增加了84%。两组HVA水平相等。在给予左旋多巴后,对照动物和先前接受重复ecs的动物的多巴胺和HVA水平增加相同。接受重复ecs的大鼠DOPAC浓度均较高。当急性给予ECS时,多巴胺水平增加390%并在75分钟内恢复到基线值,DOPAC和HVA保持不变,5HIAA水平下降30%。我们得出的结论是:1)急性ECS会产生短暂的纹状体多巴胺的显著释放;2)重复ECS可以重置基底多巴胺的释放水平,这与ECS诱导的多巴胺受体超敏感性相一致;3)单次或多次ECS对外源性左旋多巴的多巴胺或HVA的形成都没有重大影响,尽管DOPAC的形成有强烈的增加趋势。ECS可能通过增强多巴胺受体的敏感性来发挥其抗帕金森病的作用。
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引用次数: 8
Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters. 帕金森病中营养不良发生率的增加及其与临床疾病参数的关系
H S Markus, A M Tomkins, G M Stern

An anthropometric study was performed in 95 subjects (53 male, 42 female) with Parkinson's disease. Weight, height, triceps and biceps skin-fold thicknesses, and mid-arm circumference were recorded. A high incidence of undernutrition was found (23.6% of males and 22.5% of females, as defined by recent British guidelines). A subgroup of severely disabled patients with Parkinson's disease had a significantly lower mean body mass index than a similarly disabled control group with chronic pyramidal upper motor neuron lesions (males 20.6 v 23.2 kg/m2 p < 0.05; females 20.6 v 26.6 kg/m2 p < 0.01), suggesting that the undernutrition is not due to chronic illness or immobility alone. Correlation between anthropometric indices and clinical features of disease demonstrated that the presence of moderate or severe dyskinetic movements was the clinical parameter most strongly related to undernutrition. The reduction in anthropometric indices was most marked for skin fold thickness (related to percentage body fat) and least for arm muscle circumference (related to lean body mass); therefore the weight loss seen in Parkinson's disease is primarily due to fat loss rather than muscle loss.

对95名帕金森病患者(53名男性,42名女性)进行了人体测量学研究。记录体重、身高、肱三头肌和肱二头肌皮肤褶皱厚度、臂中围。营养不良的发生率很高(23.6%的男性和22.5%的女性,根据最近英国指南的定义)。重度残疾帕金森病患者亚组的平均体重指数明显低于慢性锥体上运动神经元病变的类似残疾对照组(男性20.6 v 23.2 kg/m2 p < 0.05;雌性20.6 vs 26.6 kg/m2 (p < 0.01),表明营养不良不仅仅是由于慢性疾病或不活动所致。人体测量指标与疾病临床特征之间的相关性表明,中度或重度运动障碍是与营养不良最密切相关的临床参数。皮肤褶皱厚度(与体脂百分比相关)的人体测量指数下降最为明显,手臂肌肉周长(与瘦体重相关)的人体测量指数下降最少;因此,帕金森氏症患者的体重减轻主要是由于脂肪的减少而不是肌肉的减少。
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引用次数: 97
期刊
Journal of Neural Transmission - Parkinson's Disease and Dementia Section
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