| The causes of dizziness is complexed, and anxiety, depression and other mood disorders inwhich occupies an important position. Studies suggest that central serotonergic system the keyfactors in etiology anxiety disorders and depression. So the genes that code for proterns involvedin regulation of serotonin sunthesis, release, uptake and metabolism, are major candidate genesin association studies of areanxiety disorders and depression. The 5-hydroxytrypaminetransporter (5-HTT) is the major determinant of serotonin reuptake following release at synapsesand it is a target for Selective serotonin reuptake inhibitors (SSRIs) antidepressant treatments.Scientists have found that the serotonin transporter-linked polymorpic region (5-HTTLPR)polymorphism of human 5-HTT gene can regulate the transcriptional activity of the gene, andmay be one of good candidate genes of anxiety disorders and depression. whether 5-HTTLPR iscandidate genes of chronic subjective dizziness? How is efficacy of the selective 5-HT reuptakeinhibitor in treatment of chronic subjective dizziness, the relevant literature rarely reported.Therefore, this study will be divided into two parts.Part I An association study of 5-HTT gene polymorphism and Chronic SubjectiveDizzinessObjective: To explore the association between the chronic subjective dizziness and5-HTTLPR and provide theoretical basis for clarigying the etiology of chronic subjectivedizziness. Methods: With polymerase chain reaction-restriction fraction length polymorphismtechnique, 5-HTTPLR were determined in 60 patients with chronic subjective dizzines and 40control subjects; Results: 1. the two alleles of 375 (S) and 419 (L) were observed. Theregenetypes distribution found were SS, LS and LL. 2. A group of patients with SS genotypesignificantly higher than the control group(48.3%:22.5%, x2= 6.947, P = 0.039), LL genotypewas significantly lower than the control group (16.7%:30.0%). 3. A group of patients with Sallele frequency significantly higher than those in the control group (65.1%:46.3%, x2= 6.732, P= 0.01), L allele frequency was significantly lower than the control group (34.9%: 53.8%).Conclusions: There was an association between 5-HTTLPR and chronic subjective dizziness,the presence of 5-HTTLPR allele S may increase the risk for chronic subjective dizziness, andpeople with SS genetype had more risk for chronic subjective dizziness. allele L may beprotection gene of chronic subjectivity dizzy. Part II The observation of SSRIs effiency in treatment of chronic subjective dizzinessObjective: To investigate the paroxetine in the treatment of chronic subjective dizzinessefficacy. Methods: 60 cases of chronic subjective dizziness were divided into two groups,integrated treatment group received Paroxetine (Seroxat 20 ~ 40mg / d), the control groupreceived conventional medical treatment, both groups with supportive psychotherapy, thetreatment period of 8 weeks. Before treatment, 2, 4 and 8 weeks after treatment, HamiltonDepression Scale respectively (HAMD), Hamilton Anxiety Scale (HAMA), 90 SymptomChecklist (SCL-90) and vertigo function level questionnaire score. Results: 1. Finally 33patients completed the experiment, which combines integrated the treatment group in 12 cases,control treatment 21 cases. 33 patients with chronic subjectivity dizziness before treatment,vertigo function level questionnaire, HAMD, HAMA score and the SCL-90 part of the factorscores are significantly higher than the norm, with significant difference (P<0.05). 2. After 8weeks of integrated treatment group HAMD, HAMA and SCL-90 score was significantly lowerthan the control group, the difference was significant (P<0.05). Conclusion: Patients withChronic subjective dizziness is the prevalence of emotional problems, and paroxetine(SSRI) forthe treatment of patients with chronic subjective dizziness not only improve vertigo symptomsbut also mood symptoms. |
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