Evans Andrew H, Katzenschlager Regina, Paviour Dominic, O'Sullivan John D, Appel Silke, Lawrence Andrew D, Lees Andrew J
Reta Lila Weston Institute of Neurological Studies, London, United Kingdom.
Mov Disord. 2004 Apr;19(4):397-405. doi: 10.1002/mds.20045.
Punding is a term that was coined originally to describe complex prolonged, purposeless, and stereotyped behaviour in chronic amphetamine users. A structured interview of 50 patients with higher dopamine replacement therapy requirements (>800 levodopa equivalent units/day) from 123 unselected patients with Parkinson's disease (PD) from a PD clinic identified 17 (14%) patients with punding. Punding was acknowledged as disruptive and unproductive by the patients themselves, but forcible attempts by family to interrupt the behaviour led to irritability and dysphoria. Punding was associated with very high doses of dopamine replacement therapy often related to a pattern of chronic inappropriate overuse of dopaminergic medication. We believe that this is an underreported, socially disabling phenomenon that is commonly associated with the syndrome of dopamine dysregulation and is phenomenologically distinct from both obsessive-compulsive disorder and mania.
刻板重复行为最初是一个用来描述慢性苯丙胺使用者中复杂、持续、无目的且刻板行为的术语。对一家帕金森病（PD）诊所123例未经挑选的帕金森病患者进行结构化访谈，其中50例多巴胺替代治疗需求较高（>800左旋多巴等效单位/天）的患者中，有17例（14%）存在刻板重复行为。患者自身承认刻板重复行为具有干扰性且无成效，但家人强行试图打断该行为会导致患者易怒和烦躁不安。刻板重复行为与非常高剂量的多巴胺替代治疗相关，这通常与慢性不适当过度使用多巴胺能药物的模式有关。我们认为这是一种未得到充分报道、导致社交功能障碍的现象，通常与多巴胺调节异常综合征相关，在现象学上与强迫症和躁狂症均不同。
