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[抽动秽语综合征——综述]

[Tourette's syndrome - a review].

作者信息

Riederer F, Stamenkovic M, Schindler S D, Kasper S

机构信息

Klinik fur Neurologie, Medizinische Universitat zu Lubeck, Germany.

出版信息

Nervenarzt. 2002 Sep;73(9):805-19. doi: 10.1007/s00115-002-1270-y.

Abstract

Tourette's syndrome (TS) is a neuropsychiatric disorder characterised by the occurrence of chronic motor and vocal tics that usually begin in childhood. A prevalence of 4-5/10.000 individuals is estimated. Tourette's syndrome patients frequently show comorbidity with other psychiatric disorders such as obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), anxiety, and affective disorders. Some forms of OCD seem to share a common genetic etiology with TS and to be a facultative part of the TS phenotypic spectrum. Based on MRI, positron emission tomography (PET), and single photon emission computed tomography (SPECT), data alterations in the cortico-striato-pallido-thalamo-cortical functional systems have been discussed. Within these systems, dopaminergic neurotransmission is thought to play an important role in the pathophysiology of TS. Autoimmunological mechanisms seem to be important in some subtypes of TS and OCD that are triggered or exacerbated by infections with hemolytic streptococci. In these cases, immune modulatory therapy proved to be efficient. To date, there is no established treatment regimen for TS. The medications used most frequently are antipsychotics.

摘要

图雷特综合征(TS)是一种神经精神疾病,其特征是出现通常始于童年期的慢性运动性和发声性抽动。据估计,其患病率为4 - 5/10000人。图雷特综合征患者常与其他精神疾病共病,如强迫症(OCD)、注意力缺陷多动障碍(ADHD)、焦虑症和情感障碍。某些形式的强迫症似乎与图雷特综合征有共同的遗传病因,并且是图雷特综合征表型谱的一个兼性部分。基于磁共振成像(MRI)、正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT),已经讨论了皮质 - 纹状体 - 苍白球 - 丘脑 - 皮质功能系统的数据改变。在这些系统中,多巴胺能神经传递被认为在图雷特综合征的病理生理学中起重要作用。自身免疫机制在某些由溶血性链球菌感染引发或加重的图雷特综合征和强迫症亚型中似乎很重要。在这些情况下,免疫调节治疗被证明是有效的。迄今为止,尚无针对图雷特综合征的确立治疗方案。最常使用的药物是抗精神病药。

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