Auriel Eitan, Hausdorff Jeffrey M, Giladi Nir
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Clin Neuropharmacol. 2009 Mar-Apr;32(2):75-81. doi: 10.1097/WNF.0B013E318170576C.
Methylphenidate (MPH) is a central nervous system stimulant derived from an amphetamine and acts as a potent inhibitor of catecholamine reuptake and increases dopamine levels in the brain. Methylphenidate is widely used for the treatment of children and adults with attention deficit hyperactivity disorder. Because the dopaminergic system is critical to the pathological process in Parkinson disease (PD), it has been suggested that MPH, which increases dopaminergic stimulation at the postsynaptic receptor level, may provide symptomatic relief in PD patients. This article reviews those studies that have evaluated the potential of MPH to treat the motor and cognitive aspects of PD, summarizes the evidence for clinical use in other neurological diseases, and briefly reviews the physiological mechanisms whereby MPH may bring about its therapeutic effects. Methylphenidate does seem to be useful for ameliorating cognitive, affective, and motor deficits in PD and in other neurological patients; however, additional studies are needed before MPH can be routinely prescribed as an adjunct therapy in these populations.
哌甲酯（MPH）是一种源自苯丙胺的中枢神经系统兴奋剂，可作为强效儿茶酚胺再摄取抑制剂，并提高大脑中的多巴胺水平。哌甲酯被广泛用于治疗患有注意力缺陷多动障碍的儿童和成人。由于多巴胺能系统对帕金森病（PD）的病理过程至关重要，因此有人提出，在突触后受体水平增加多巴胺能刺激的哌甲酯可能会缓解PD患者的症状。本文回顾了那些评估哌甲酯治疗PD运动和认知方面潜力的研究，总结了其在其他神经系统疾病中临床应用的证据，并简要回顾了哌甲酯产生治疗作用的生理机制。哌甲酯似乎确实有助于改善PD患者以及其他神经系统疾病患者的认知、情感和运动缺陷；然而，在哌甲酯能够作为这些人群的辅助治疗常规开出处方之前，还需要进行更多的研究。
