Therapeutic Perspective on Tardive Syndrome with Special Reference to Deep Brain Stimulation.

Therapeutic Perspective on Tardive Syndrome with Special Reference to Deep Brain Stimulation.
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DOI:
10.3389/fpsyt.2016.00207
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发表时间:
2016
影响因子:
4.7
通讯作者:
Goto S
Goto S
中科院分区:
医学3区
文献类型:
--
作者:
Morigaki R;Mure H;Kaji R;Nagahiro S;Goto S

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迟发综合征 (TDS) 是一种潜在的永久性且不可逆的多动性运动障碍,由接触多巴胺受体阻断剂引起。美国神经病学学会发布的指南推荐 TDS 的一线药物治疗为氯硝西泮(B 级)、银杏叶(B 级)、金刚烷胺(C 级)和丁苯那嗪(C 级)。最近,一项 II 类研究为 TDS 患者使用苍白球内部 (GPi) 深部脑刺激 (DBS) 提供了 C 级证据。尽管 TDS 的确切发病机制仍有待阐明,但 GPi-DBS 对 TDS 患者的有益作用表明该疾病可能是一种基底神经节疾病。除了了解 TDS 病理生理学方面的最新进展外,本文还介绍了目前 DBS 在治疗难治性 TDS 中的应用。
Tardive syndrome (TDS) is a potentially permanent and irreversible hyperkinetic movement disorder caused by exposure to dopamine receptor blocking agents. Guidelines published by the American Academy of Neurology recommend pharmacological first-line treatment for TDS with clonazepam (level B), ginkgo biloba (level B), amantadine (level C), and tetrabenazine (level C). Recently, a class II study provided level C evidence for use of deep brain stimulation (DBS) of the globus pallidus internus (GPi) in patients with TDS. Although the precise pathogenesis of TDS remains to be elucidated, the beneficial effects of GPi-DBS in patients with TDS suggest that the disease may be a basal ganglia disorder. In addition to recent advances in understanding the pathophysiology of TDS, this article introduces the current use of DBS in the treatment of medically intractable TDS.
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