Neuropsychiatric symptoms in the dementias
Neuropsychiatric symptoms in the dementias
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DOI：
10.1097/00019052-200208000-00007
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发表时间：
2002-08-01
影响因子：
4.8
通讯作者：
Cummings, JL
中科院分区：
文献类型：
--
作者：
Assal, F;Cummings, JL
综述的目的神经精神或非认知症状越来越多地被认为是dementias.Recent findingsIn阿尔茨海默病的表现，最近的进展包括行为特征的识别，冷漠和抑郁的区分，精神病的危险因素的特征及其与激动和侵略的联系，以及在没有严重抑郁症的情况下抑郁症状的分析。功能性神经影像学数据主要支持前扣带回在冷漠中的作用。眶额和前扣带回缠结负荷与躁动有关，眶额和颞中毒蕈碱M2受体增加与精神病和幻觉有关。多巴胺和5-羟色胺受体或转运蛋白的遗传多态性与攻击性、幻觉或精神病有关。与其他痴呆症相比，额颞叶痴呆症患者表现出不同的行为，特别是异常的社会行为。妄想和幻视的频率在帕金森病、帕金森病伴痴呆和路易体痴呆中增加，表明路易体病理学和胆碱能缺乏等共同机制。后者支持这些症状的改善胆碱酯酶抑制剂。SummaryFuture研究方向包括临床和基础神经科学调查。早期神经精神症状的检测可能是痴呆的一个标志，并应探讨是否存在轻度神经精神损害综合征。更多的纵向研究与病理证实将促进与神经精神症状的相关性。功能性神经影像学和行为神经遗传学将允许在体内的相关性，从而帮助病人的管理和护理。
Purpose of reviewNeuropsychiatric, or non-cognitive symptoms are increasingly recognized as manifestations of dementias.Recent findingsIn Alzheimer's disease, recent advances have included the identification of behavioral profiles, differentiation of apathy and depression, characterization of risk factors for psychosis and its links to agitation and aggression, and an analysis of depressive symptoms in the absence of major depression. Functional neuroimaging data mainly supported the role of the anterior cingulate in apathy. The orbitofrontal and anterior cingulate tangle burden were associated with agitation, and increased orbitofrontal and mid-temporal muscarinic M2 receptors with psychosis and hallucinations. Selected genetic polymorphisms of dopamine and serotonin receptors or transporters were linked with aggression, hallucinations or psychosis. When compared with other dementias, individuals with frontotemporal dementia disclosed, as expected, different behaviors and particularly aberrant social behavior. The frequency of delusions and visual hallucinations was increased in Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies, suggesting common mechanisms such as Lewy body pathology and cholinergic deficiency. The latter was supported by an improvement of these symptoms by cholinesterase inhibitors.SummaryFuture research directions include both clinical and basic neuroscience investigations. The detection of early neuropsychiatric symptoms might be a marker for dementia, and the possible existence of a mild neuropsychiatric impairment syndrome should be explored. More longitudinal studies with pathological confirmation will facilitate correlations with neuropsychiatric symptoms. Functional neuroimaging and behavioral neurogenetics will permit in-vivo correlations and consequently help patient management and care.