The neuropsychiatry of Parkinson's disease: advances and challenges.
The neuropsychiatry of Parkinson's disease: advances and challenges.
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帕金森氏病的神经精神病学：进步和挑战。
DOI：
10.1016/s1474-4422(21)00330-6
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Schrag A
中科院分区：
文献类型：
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作者：
Weintraub D;Aarsland D;Chaudhuri KR;Dobkin RD;Leentjens AF;Rodriguez-Violante M;Schrag A
在帕金森病患者中，神经精神体征和症状在整个病程中很常见。这些症状可能会导致失能，并且与运动症状一样具有临床相关性，并且它们的表现可能与普通人群中的对应症状相似或不同。发生神经精神体征和症状的相关因素和危险因素包括人口统计学、临床和心理社会特征。这些介绍的潜在神经生物学很复杂，而且还没有被很好地理解，最有力的证据表明与帕金森病相关的神经病理变化、与多巴胺能治疗相关的机制以及非帕金森病特有的影响。存在评估工具和正式的诊断标准，但在临床实践中很少对这些体征和症状进行常规筛查。越来越多的证据支持一系列药物和非药物干预措施，但有效的治疗选择相对较少。优化帕金森病患者神经精神症状的管理需要更多的研究、提高认识、专门培训和开发创新的护理模式。
In people with Parkinson’s disease, neuropsychiatric signs and symptoms are common throughout the disease course. These symptoms can be disabling and as clinically relevant as motor symptoms, and their presentation can be similar to, or distinct from, their counterparts in the general population. Correlates and risk factors for developing neuropsychiatric signs and symptoms include demographic, clinical, and psychosocial characteristics. The underlying neurobiology of these presentations is complex and not well understood, with the strongest evidence for neuropathological changes associated with Parkinson’s disease, mechanisms linked to dopaminergic therapy, and effects not specific to Parkinson’s disease. Assessment instruments and formal diagnostic criteria exist, but there is little routine screening of these signs and symptoms in clinical practice. Mounting evidence supports a range of pharmacological and non-pharmacological interventions, but relatively few efficacious treatment options exist. Optimising the management of neuropsychiatric presentations in people with Parkinson’s disease will require additional research, raised awareness, specialised training, and development of innovative models of care.