中华脑科疾病与康复杂志(电子版) 2016年6月,6卷3期

综述

神经内分泌变化与帕金森病的相关性

吕燕 田玉玲

030001 太原,山西医科大学第一医院神经内科
田玉玲,Email:374655151@qq.com

摘要:帕金森病多见于中老年人,是一种常见的神经系统变性疾病。帕金森病痴呆指帕金森病患者认知功能损害达到痴呆的程度,研究帕金森病痴呆发生的危险因素对帕金森病痴呆的治疗及改善预后具有重要意义。目前有研究表明,亚临床甲状腺功能减退对帕金森病痴呆有一定影响,胰岛素抵抗与帕金森病痴呆有密切的关系,血皮质醇水平同年龄相关的认知功能下降密切相关,雌激素对帕金森病有保护作用。不同研究对神经内分泌与帕金森病的相关性存在争议,本文对帕金森病与甲状腺功能、胰岛素抵抗、血皮质醇水平及雌激素水平的相关性进行探讨。

关键词: 帕金森病; 痴呆; 甲状腺功能减退症; 雌激素类; 胰岛素抵抗; 皮质醇

参考文献

1 中华医学会神经病学分会帕金森病及运动障碍学组.帕金森病痴呆的诊断与治疗指南[J].中华神经科杂志,2011,44(9):635-637.
2 Metzler-Baddeley C.A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer′s disease and Parkinson′s disease with dementia[J].Cortex,2007,43(5):583-600.
3 Bronnick K,Emre M,Lane R,et al.Profile of cognitive impairment in dementia associated with Parkinson′s disease compared with Alzheimer,s disease[J].Neurol Neurosurg Psychiatry,2007,78(10):1064-1068.
4 Stolakis V,Kalafatakis K,Botis J,et al.The regulatory role of neurotensim on hypothalamic-anterior pituitary axons:emphasis orl the control of thyroid-related functions[J].Neuropeptides,2010,44(1):1-7.
5 Fawaz CS,Maael P,Leo D,et al.Presynaptic action of neurotensin on dopamine release through inhibition of D2 receptor function[J].BMC Neurosci,2009,10:96.
6 Charlett A,Dobbs RJ,Purkiss AG,et al.Cortisolis higher in parkinsonism and associated with gait deficit[J].Acta Neurol Scand,1998,97(2):77-85.
7 Morris JK,Bomhoff GL,Gorres BK,et al.Insulin resistance impairs nigrostriatal dopamine function[J].Exp Neurol,2011,231(1):171-180.
8 Umehara T,Matsuno H,Toyoda C,et al.Thyroid hormone level is associated with motor symoptoms in de novo Parkinson′s disease[J].J Neurol,2015,262(7):1762-1768.
9 Aziz NA,Piji H,Frolich M,et al.Diural secretion profiles of hormoen,thyrotrophin and prolactin in Parkinson′s disease[J].J Neuroendocrinol,2011,23(6):519-524.
10 Munhoz RP,Teive HA,Troiano AR,et al.Parkinson′s disease and thyroid dysfunction[J].Parkinsonism Relat Disord,2004,10(6):381-383.
11 Tandeter H,Levy A,Gutman G,et al.Subclinical thyroid disease in patients with Parkinson′s disease[J].Arch Gerontol Geriatr,2001,33(3):295-300.
12 Choi SM,Kim BC,Choi KM,et al.Thyroid status and cognitive function in euthyroid patients with early Parkinson′s disease[J].Dement Geriatr Cogn Disord,2014,38(3/4):178-185.
13 徐燕平,陈应柱,李晓波,等.亚临床甲减对帕金森病患者认知功能的影响[J].中国实用神经疾病杂志,2015,18(9):56-57.
14 Parsaik AK,Singh B,Roberts RO,et al.Hypothyroidism and risk of mild cognitive impairment in elderly persons--a population based study[J].JAMA Neurol,2014,71(2):201-207.
15 Skogar O,Fall PA,Hallgren G,et al.Diurnal salivary cortisol concentration in Parkinson′s disease:increased total secretion and morning cortisol concentrations[J].Int J Gen Med,2011,4:561-569.
16 Hartmann A,Veldhuis JD,Deuschle M,et al.Twenty-four hour cortisol release profiles in patients with Alzheimer′s and Parkinson′s disease compared to normal controls:ultradian secretory pulsatility and diurnal variation[J].Neurobiol Aging,1997,18(3):285-289.
17 Tornhage CJ,Skogar O,Borg A,et al.short-and long-term effects of tactile massage on salivary cortisol concentrations in Parkinson′s disease:a randomised controlled pilot study[J].BMC Complement Altern Med,2013,13:357-366.
18 Brown ES,Jeon-Slaughter H,Lu H,et al.Hippocampal volume in healthy controls given 3-day stress doses of hydrocortisone[J].Neuropsychopharmacology,2015,40(5):1216-1221.
19 Lund PK,Hoyt EC,Bizon J.Transcriptional mechanisms of hippocampal aging[J].Exp Gerontol,2004,39(11/12):1613-1622.
20 Hu G,Jousilahti P,Bidel S,et al.Type 2 diabetes and the risk of Parkinson′s disease[J].Diabetes Care,2007,30(4):842-847.
21 Driver JA,Smith A,Buring JE,et al.Prospective cohort study of type 2 diabetes and the risk of Parkinson′s disease[J].Diabetes Care,2008,31(10):2003-2005.
22 胡重灵,杨新玲.帕金森病患者血糖水平分析[J].中华实用诊断与治疗杂志,2010,24(12):1184-1186.
23 Cereda E,Barichella M,Cassani E,et,al.Clinical features of Parinson disease when onset of diabetes came first:a case-control study[J].Neurology,2012,78(19):1507-1511.
24 Bosco D,Plastino M,Cristiano D,et al.Dementia is associated with insulin resistance in patients with Parkinson′s disease[J].J Neurol Sci,2012,315(1/2):39-43.
25 黄静,张玉虎,聂坤,等.帕金森病认知功能障碍及病情程度与血糖水平的关系[J].临床神经病学杂志,2014,27(2):81-83.
26 黄婷婷.胰岛素抵抗对帕金森患者认知功能障碍的影响[J].白求恩医学杂志,2015,13(2):129-130.
27 伍俊伊,王岚,刘正芳.胰岛素抵抗与帕金森病痴呆的相关性研究[J].武汉大学学报:医学版,2013,34(3):426-428.

(编辑:沈承亮 收稿日期:2016-04-22)