Non-motor symptoms in Parkinson's disease: cognition and behavior
Non-motor symptoms in Parkinson's disease: cognition and behavior
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DOI：
10.1684/pnv.2013.0423
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发表时间：
2013-09-01
影响因子：
0.6
通讯作者：
Czernecki, Virginie
中科院分区：
文献类型：
--
作者：
Bonnet, Anne Marie;Czernecki, Virginie
虽然帕金森病的诊断是基于运动症状，但现在众所周知，非运动症状是这种病理的组成部分，实际上涉及多个系统。这些非运动症状影响大量患者，有时可能出现在运动障碍之前。非运动症状主要包括神经心理学困难、神经精神症状和自主神经障碍，但也涉及例如疼痛和睡眠障碍。抑郁症可能发生在疾病的任何阶段，包括重度抑郁症、轻度抑郁症和心境恶劣。在疾病过程中，50%的患者会感到焦虑。冷漠存在于高达30-40%的患者中，由于失去动力，出现在情感，智力和行为领域。多巴胺失调综合征和冲动控制障碍并不罕见，并且与多巴胺能治疗有关。冲动控制障碍包括病态赌博、性欲亢进、强迫性购物和饮食失调。30%的患者可能会出现幻视，主要是由多巴胺能治疗引起的。通常，它们对生活质量的影响比运动症状本身更深，这是咨询期间关注的焦点。识别这些可以帮助提供更好的护理，对患者的生活质量产生积极影响。
Although the diagnosis of Parkinson disease is based on motor symptoms, it is now well known that non-motor symptoms are an integral part of this pathology, involving in fact multiple systems. These non-motor symptoms affect large population of patients and can appear sometimes before the motor disorders. The non-motor symptoms include mainly neuropsychological difficulties, neuropsychiatric symptoms, and autonomic disorders, but involve also pain and sleep disturbances for example. Depression may occur at any stage of the disease, and consists in major depressive disorder, minor depressive disorder, and dysthymia. During the course of the disease, 50% of patients experience anxiety. Apathy is present in up to 30-40% of patients, due to loss of motivation, appearing in emotional, intellectual and behavioral domains. Dopamine dysregulation syndrome and impulse control disorders are not rare, and in relation with dopaminergic therapies. Impulse control disorders include pathological gambling, hyper sexuality, compulsive shopping, and eating disorder. Visual hallucinations can occur in 30% of patients, mostly induced by dopaminergic therapies. Often, they have deeper impact on the quality of life than the motor symptoms themselves, which stay the focus of attention during consulting. Identifying those can help in providing better care with a positive impact on the quality of life of the patients.