Association between neurotransmitters and dyskinesia in patients with vascular Parkinson syndrome and the predictive value of neurotransmitters / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the association between neurotransmitters and dyskinesia in patients with vascular Parkinson syndrome(VPS) and the predictive value of neurotransmitters. Methods A retrospective analysis was performed for 60 patients with VPS who were hospitalized in Department of Neurology in our hospital from December 2020 to December 2022,and they were enrolled as observation group;60 patients with Parkinson disease who were hospitalized in our hospital during the same period of time were enrolled as control group;60 patients who underwent physical examination in the Physical Examination Center of our hospital during the same period of time were enrolled as healthy group. The simplified Fugl-Meyer Assessment(FMA) score was used to evaluate the motor function of patients. The above three groups were compared in terms of serum neurotransmitters[5-hydroxytryptamine(5-HT),dopamine(DA)] and FMA score;the VPS patients with different Hoehn-Yahr stages were compared in terms of serum neurotransmitters and FMA score;the VPS patients with different severities of dyskinesia were compared in terms of serum neurotransmitters. A Pearson correlation analysis was used to investigate the correlation of serum 5-HT and DA with FMA score;the receiver operating characteristic(ROC) curve was plotted and the area under the ROC curve(AUC) was calculated to analyze the efficacy of 5-HT and DA in predicting dyskinesia. Results The observation group had significantly lower serum 5-HT and DA and FMA score than the control group and the healthy group(P<0.05),and the control group had significantly lower serum 5-HT and DA and FMA score than the healthy group(P<0.05). The stage Ⅳ group had significantly lower serum 5-HT and DA and FMA score than the stage Ⅲ group,and the stage Ⅲ group had significantly lower serum 5-HT and DA and FMA score than the stage Ⅱ group(P<0.05). The severe dyskinesia group had significantly lower serum 5-HT and DA than the obvious dyskinesia group(P<0.05),the obvious dyskinesia group had significantly lower serum 5-HT and DA than the moderate dyskinesia group(P<0.05),and the moderate dyskinesia group had significantly lower serum 5-HT and DA than the mild dyskinesia group(P<0.05). Serum 5-HT and DA were positively correlated with FMA score(r=0.411 and 0.403,P<0.05). The combined measurement of 5-HT and DA had an AUC of 0.803(95% CI 0.713-0.938) in predicting dyskinesia,with higher sensitivity and specificity than the measurement of each index alone(sensitivity:92.72% vs 75.27%/72.87%,P<0.05;specificity:90.83% vs. 72.64%/70.09%,P<0.05). Conclusion Dyskinesia in VPS patients is closely associated with the abnormally low expression of serum 5-HT and DA,both of which are involved in dyskinesia. The combined measurement of serum 5-HT and DA can improve the predictive efficacy of dyskinesia and thus has a certain reference value.