Zgaljardic D J, Foldi N S, Borod J C
Center for Neurosciences, North Shore University Hospital, Manhasset, NY, USA.
J Neural Transm (Vienna). 2004 Oct;111(10-11):1287-301. doi: 10.1007/s00702-004-0178-z. Epub 2004 Jul 7.
The cognitive and behavioral sequelae (i.e., nonmotor profile) of Parkinson's disease (PD), with executive dysfunction and depression being most prominent, have typically been overshadowed due to an emphasis on motor symptomatology. The apparent categorization of PD as a disorder isolated to the dopaminergic system may be a generalization of the disease pathology. Dopamine therapy, used for the treatment of motor symptoms, has not consistently been shown to resolve nonmotor impairments. Research evidence indicates that nondopaminergic neurotransmitter systems (i.e., serotonergic, noradrenergic, & cholinergic) are disrupted in PD and may contribute to cognitive and behavioral dysfunction. Furthermore, Lewy bodies within cortical and subcortical structures can add to the nonmotor profile in PD. Pharmacological interventions for the treatment of cognitive and behavioral impairments associated with PD are few, especially for nondemented patients. The current review of the literature highlights evidence that associates nonmotor dysfunctions with neurochemical and clinicopathological correlates of PD.
帕金森病（PD）的认知和行为后遗症（即非运动特征），其中执行功能障碍和抑郁最为突出，由于对运动症状的强调，这些后遗症通常被掩盖。将PD明显归类为仅累及多巴胺能系统的疾病，可能是对该疾病病理的一种概括。用于治疗运动症状的多巴胺疗法，并未始终如一地显示能解决非运动障碍。研究证据表明，非多巴胺能神经递质系统（即5-羟色胺能、去甲肾上腺素能和胆碱能系统）在PD中受到破坏，可能导致认知和行为功能障碍。此外，皮质和皮质下结构中的路易小体可加重PD的非运动特征。治疗与PD相关的认知和行为障碍的药物干预措施很少，尤其是对于未患痴呆症的患者。当前对文献的综述强调了将非运动功能障碍与PD的神经化学和临床病理相关性联系起来的证据。
