Pharmacologic Treatment of Motor Symptoms Associated with Parkinson Disease
Pharmacologic Treatment of Motor Symptoms Associated with Parkinson Disease
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DOI：
10.1016/j.ncl.2019.12.002
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发表时间：
2020-05-01
影响因子：
2.4
通讯作者：
Mahlknecht, Philipp
中科院分区：
文献类型：
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作者：
Poewe, Werner;Mahlknecht, Philipp
帕金森病（PD）的主要运动特征是由纹状体多巴胺缺乏引起的。药物多巴胺替代治疗是PD药物治疗的主要手段。左旋多巴仍然是治疗PD运动症状最有效的药物。MAO-B抑制剂和多巴胺激动剂是有用的选择。左旋多巴的主要限制是运动反应波动和药物诱导的运动障碍的发展。辅助MAO-B和COMT抑制剂以及多巴胺激动剂和持续输注左旋多巴肠凝胶或皮下阿朴吗啡可有效减少运动波动，金刚烷胺是唯一具有减少运动障碍疗效的药物。
The cardinal motor features of Parkinson disease (PD) are driven by striatal dopamine deficiency. Pharmacologic dopamine substitution is the main-stay of drug treatment of PD. Levodopa is still the most efficacious drug to treat PD motor symptoms. MAO-B inhibitors and dopamine agonists are useful options. The main limitation of levodopa is the development of motor response fluctuations and drug-induced dyskinesias. Adjunct MAO-B and COMT inhibitors as well as dopamine agonists and continuous infusions of levodopa intestinal gel or subcutaneous apomorphine are efficacious in reducing motor fluctuations and amantadine is the only drug with established efficacy in reducing dyskinesias.