帕金森病研究进展

 帕金森病（PD）是常见的神经系统变性疾病,典型的PD病理表现为脑中黑质多巴胺神经元退行性变和路易小体沉积,但这些改变不能完全解释PD产生的临床症状,目前PD的发病原因及机制尚不明确,尚未建立系统的早期诊断及保护治疗方式。随着诊断及治疗技术的提高,生物学标记物、脑网络及神经调控等有望为PD早期诊断、机制探索及个体化治疗提供基础。本文综述了PD在生物学标记物、脑网络研究及神经调控治疗领域的研究进展。     

帕金森病的认知障碍

 帕金森病是仅次于老年痴呆的第二大神经退行性疾病。随着社会老龄化的加剧,帕金森病的患病率大幅提高。认知障碍等非运动症状是目前影响帕金森病患者生活质量的主要因素。帕金森病认知障碍的生物学机制目前尚不明确,临床上患病率高、识别率低,缺乏有效的治疗手段。本文将围绕帕金森病认知障碍的前沿热点问题,介绍相关神经科学和医学研究的最新进展,涵盖认知障碍的神经化学基础、风险基因、其他非运动症状的影响和生物标记物等。     

Dopamine neurons derived from embryonic stem cells function in an animal model of Parkinson's disease

Parkinson's disease is a widespread condition caused by the loss of midbrain neurons that synthesize the neurotransmitter dopamine. Cells derived from the fetal midbrain can modify the course of the disease, but they are an inadequate source of dopamine-synthesizing neurons because their ability to generate these neurons is unstable. In contrast, embryonic stem (ES) cells proliferate extensively and can generate dopamine neurons. If ES cells are to become the basis for cell therapies, we must develop methods of enriching for the cell of interest and demonstrate that these cells show functions that will assist in treating the disease. Here we show that a highly enriched population of midbrain neural stem cells can be derived from mouse ES cells. The dopamine neurons generated by these stem cells show electrophysiological and behavioural properties expected of neurons from the midbrain. Our results encourage the use of ES cells in cell-replacement therapy for Parkinson's disease.     

Research advances in gene therapy for Parkinson's disease

During the long period of time when people have been seeking for an effective therapeutic method for PD, the gene therapy has shown greater and greater advantages over other methods. It can be performed mainly in two ways: ex vivo and in vivo. With the former, TH gene as well as some neurotrophic factor genes (such as GDNF, BNDF genes) can be invited to some cell lines or primary cells thus forming engineered cells and then implanting them into brain. While with the latter, viral vectors including HSV-1, Ad, AAV that can be utilized to construct recombinant viruses, or non-virus vectors can be used to delived DNA into brain directly. The present review summarizes the recent research advances in the gene therapy for PD, and it is reasonable for us to predict a notable progress in prevention and treatment for PD in the next decade.     

The corticomotoneurone connection is normal in Parkinson's disease

Voluntary movements in Parkinson's disease are initiated and executed slowly. It is assumed that the motor cortex and its output pathway are intact and that bradykinesia is due to abnormal motor commands delivered to a normal corticospinal system. We have tested this assumption using electrical stimulation of the motor cortex through the scalp in three patients with severe Parkinson's disease, studied during fluctuations from relatively normal mobility when receiving drugs (ON) to severe bradykinesia when not receiving drugs (OFF). Thresholds and latencies for motor cortex stimulation to excite thumb flexor muscles and the resulting fast mechanical responses were the same in both ON and OFF conditions, even though the patients were unable to execute fast thumb flexion movements voluntarily when OFF. We conclude that the excitability and conduction velocity of the corticospinal motor pathways are normal in Parkinson's disease.     

'Rejuvenation' protects neurons in mouse models of Parkinson's disease

Why dopamine-containing neurons of the brain's substantia nigra pars compacta die in Parkinson's disease has been an enduring mystery. Our studies suggest that the unusual reliance of these neurons on L-type Ca(v)1.3 Ca2+ channels to drive their maintained, rhythmic pacemaking renders them vulnerable to stressors thought to contribute to disease progression. The reliance on these channels increases with age, as juvenile dopamine-containing neurons in the substantia nigra pars compacta use pacemaking mechanisms common to neurons not affected in Parkinson's disease. These mechanisms remain latent in adulthood, and blocking Ca(v)1.3 Ca2+ channels in adult neurons induces a reversion to the juvenile form of pacemaking. Such blocking ('rejuvenation') protects these neurons in both in vitro and in vivo models of Parkinson's disease, pointing to a new strategy that could slow or stop the progression of the disease.     

帕金森患者步行运动的定量分析

为了分析PD患者步行运动的变化特征,评价其运动功能,设计了一套基于穿戴式无线传感器网络的运动功能评价系统.该系统采集步行过程中的加速度和角速度数据,计算人体上下肢和躯干的时空参数,包括摆臂幅度、频率等5个上肢运动学参数,步长、步速等7个下肢运动学参数以及转弯时间、角度等3个躯干运动学参数,以评价运动的协调性和对称性.针对13例PD患者和15例相同年龄段健康老人的实验结果表明,在行走过程中,PD患者的步长与手臂摆动幅度均小于健康老人,但波动性较大,上肢和下肢的对称性和协调性均较差.据此可知,该方法能反映PD患者步行运动的变化特征,有效评价其运动功能.     

一类具扩散的染病捕食者与被捕食模型

对一类具扩散的染病捕食者与被捕食模型进行分析.通过线性化和特征值的方法讨论系统平衡点的局部稳定性,用Lyapunov函数方法结合局部稳定性的结论给出了系统平衡点的全局稳定性.     

Endocannabinoid-mediated rescue of striatal LTD and motor deficits in Parkinson's disease models

The striatum is a major forebrain nucleus that integrates cortical and thalamic afferents and forms the input nucleus of the basal ganglia. Striatal projection neurons target the substantia nigra pars reticulata (direct pathway) or the lateral globus pallidus (indirect pathway). Imbalances between neural activity in these two pathways have been proposed to underlie the profound motor deficits observed in Parkinson's disease and Huntington's disease. However, little is known about differences in cellular and synaptic properties in these circuits. Indeed, current hypotheses suggest that these cells express similar forms of synaptic plasticity. Here we show that excitatory synapses onto indirect-pathway medium spiny neurons (MSNs) exhibit higher release probability and larger N-methyl-d-aspartate receptor currents than direct-pathway synapses. Moreover, indirect-pathway MSNs selectively express endocannabinoid-mediated long-term depression (eCB-LTD), which requires dopamine D2 receptor activation. In models of Parkinson's disease, indirect-pathway eCB-LTD is absent but is rescued by a D2 receptor agonist or inhibitors of endocannabinoid degradation. Administration of these drugs together in vivo reduces parkinsonian motor deficits, suggesting that endocannabinoid-mediated depression of indirect-pathway synapses has a critical role in the control of movement. These findings have implications for understanding the normal functions of the basal ganglia, and also suggest approaches for the development of therapeutic drugs for the treatment of striatal-based brain disorders.     

Melanized dopaminergic neurons are differentially susceptible to degeneration in Parkinson's disease

In idiopathic Parkinson's disease massive cell death occurs in the dopamine-containing substantia nigra. A link between the vulnerability of nigral neurons and the prominent pigmentation of the substantia nigra, though long suspected, has not been proved. This possibility is supported by evidence that N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and its metabolite MPP+, the latter of which causes destruction of nigral neurons, bind to neuromelanin. We have directly tested this hypothesis by a quantitative analysis of neuromelanin-pigmented neurons in control and parkinsonian midbrains. The findings demonstrate first that the dopamine-containing cell groups of the normal human midbrain differ markedly from each other in the percentage of neuromelanin-pigmented neurons they contain. Second, the estimated cell loss in these cell groups in Parkinson's disease is directly correlated (r = 0.97, P = 0.0057) with the percentage of neuromelanin-pigmented neurons normally present in them. Third, within each cell group in the Parkinson's brains, there is greater relative sparing of non-pigmented than of neuromelanin-pigmented neurons. This evidence suggests a selective vulnerability of the neuromelanin-pigmented subpopulation of dopamine-containing mesencephalic neurons in Parkinson's disease.