Research On The Cerebral Neurotransmitter In Parkinson's Disease With Encephalofluctuography Technology And Related Factors In Parkinson's Disease With Depression

Part OneResearch on the changes of cerebral neurotransmitter in patients with Parkinson's diseaseObjectives:To study the changes in the levels of neurotransmitter in brain in patients with Parkinson's disease(PD)by using encephalofluctuography technology,and observe the correlation between the levels of neurotransmitter and the Unified Parkinson' s Disease Rating Scale(UPDRS)score,the Hoehn and Yahr(H & Y)stage and duration of PD.Methods:The changes of neurotransmitter were observed by using encephalofluctuography technology in 48 normal control cases and sixty-one cases of PD patients which came from the General Hospital of Chinese PLA during the period from August 2007 to December 2007. The patients were assessed by the sub scaleⅡ,ⅢandⅤof the UPDRS and self-designed register form.The changes of neurotransmitter were observed forty-eight hours after medication withdrawl and 1.5 hours after medicating benserazide.SPSS 13.0 statistical software was used for data statistic analyses.Results:1.Among the 61 cases of PD,the frequency spectrum of 5-hydroxytryptamine,acetylcholine,norepinephrine,dopamine, aminobutyric acid and glutamic acid were 20.38±5.44,16.61±5.96, 11.48±4.83,4.39±2.31,7.13±3.76 and 5.12±3.97,respectively, while the control group,the value were 22.13±5.40,17.44±5.25, 12.71±6.09,7.35±2.74,5.81±3.29 and 4.75±3.44 respectively.The level of dopamine between two groups was significantly different by statistical analysis(P＜0.01)).2.The level of dopamine of PD patients was negatively correlated with the UPDRS score and the H & Y stage(r=-0.317,P=0.013;r=-0.430, P=0.001).While the level of dopamine had not the correlation with the duration of PD(r=0.000,P=0.997).3.The levels of dopamine and 5-hydroxytryptamine in PD patients increased 1.5 hours after medicating Benserazide as compared with that forty-eight hours after medication withdrawl.Before taking medicine, the value of dopamine and 5-hydroxytryptamine were 4.38±2.10 and 19.81±4.81,respectively,while after medicating Benserazide,were 9.95±3.94 and 21.98±6.79,respectively.But the difference of dopamine was statistically significant(P＜0.01).Conclusions:The level of dopamine decreases obviously in brain of the PD patients,and it is negatively correlated with the UPDRS score and the H & Y stage.After medicating Benserazide,the level of dopamine increases.The changes of neurotransmitter in brain could provide useful value for the early diagnosis and therapy of PD by using encephalofluctuography technology. Part TwoResearch on the cerebral neurotransmitter and related factors in Parkinson's disease with depressionObjectives:To survey the incidence and the related factors in Parkinson's disease with depression(PDD)and explore the changes of neurotransmitter in brain in patients with PDD by using encephalofluctuography technology.Methods:70 patients with Parkinson's disease and 20 normal control cases were investigated,all of them were assessed by self-rating depression scale(SDS).All patients were assessed by self - designed register form and the sub scaleⅡ,ⅢandⅤof the UPDRS.The levels of neurotransmitter were observed by using encephalofluctuography technology in patients with PD and normal controls.A stepwise multiple regression analysis and partial correlation analysis were carried out to test the association between dependent variable SDS score and the independent variables including age,gender,education level,age of onset,duration,clinical classification,UPDRSⅡscore,UPDRSⅢscore and H & Y stage.Results:1.Depression occurred in 30 of all 70 patients and the total incidence rate was 42.9%.The minor,moderate and major incidence was 22.9%, 17.1%and 2.9%respectively.2.There were no significant difference in depressed group and non-depressed group about age and age of onset(P＞0.05).The UPDRSⅡ,Ⅲscores of depressed group were higher than that of non-depressed group(P＜0.01).The occurrence rate of depression in 1.0～2.5 stage group and 3 stage and above group were 37.3%and 72.7%,there were statistical difference in two groups(P＜0.05).The incidence of depression was high in the patients beyond 5 years' duration and of the prime type of rigidity(P＜0.05).3.Through stepwise multiple regression analysis and partial correlation analysis,we found that UPDRSⅡscore,gender and clinical classification were associated with the level of depression,while age, duration,UPDRSⅢscore and H & Y stage were not.4.The frequency spectrum of norepinephrine,dopamine and 5-hydroxytryptamine in depressed group were 10.65±4.52,4.30±1.92 and 21.70±5.36,while in normal control group,were 14.30±6.47, 7.35±2.94 and 22.40±5.92.The levels of norepinephrine and dopamine between two groups were different by statistical analysis(t=2.069, p=0.045;t=3.881,p=0.0004).Conclusions:Depression is a very common complication in PD.The occurrence of depression could be correlated with gender,clinical classification and stage of patient' s activity of daily living.PDD seems to have a multifactorial etiology.In addition to the social psychic factor to disability,the occurrence of PDD are mainly due to the underlying neuropathological and neurobiochemical changes.The levels of norepinephrine,5-hydroxytryptamine and dopamine are lower in PDD than normal controls by using encephalofluctuography technology.PDD is associated with decrease in NE,5-HT and DA,which might be the neurobiochemical bases for the occurrence of depression in PD.