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[亨廷顿舞蹈症中的运动障碍]

[Locomotion disturbances in Huntington's disease].

作者信息

Delval A, Krystkowiak P

机构信息

EA2683, IFR 114, service de neurologie et de neurophysiologie clinique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France.

出版信息

Rev Neurol (Paris). 2010 Feb;166(2):213-20. doi: 10.1016/j.neurol.2009.05.013. Epub 2009 Jul 14.

Abstract

In Huntington's disease (HD), perturbed locomotion occurs early in the course of the disease and presents numerous clinical features. The gait disorders in HD might best be defined as a timing disorder; however, hypokinesia (i.e. a decrease in stride length) also plays an important role in disturbed locomotion as HD progresses. Gait impairments are particularly important because they lead to an increased risk of falls. Falls risk factors and consequences depend on the stage of the disease. A satisfactory therapeutic strategy for gait impairments is a serious challenge: the use of a metronome during gait in HD patients does not effectively improve their gait. Attention deficits in HD may be a major determinant of this failure. The effect of antichoreic medications on gait is still controversial because of the absence of specific evaluation of these medications on gait disturbances.

摘要

在亨廷顿舞蹈症(HD)中,运动障碍在疾病进程早期就会出现,并呈现出众多临床特征。HD中的步态障碍或许最好被定义为一种时间节律障碍;然而,运动徐缓(即步幅减小)在HD进展过程中导致的运动紊乱中也起着重要作用。步态损伤尤为重要,因为它们会增加跌倒风险。跌倒的风险因素和后果取决于疾病阶段。针对步态损伤制定令人满意的治疗策略是一项严峻挑战:在HD患者步态过程中使用节拍器并不能有效改善其步态。HD中的注意力缺陷可能是导致这种治疗失败的主要决定因素。由于缺乏针对这些药物对步态障碍的具体评估,抗舞蹈症药物对步态的影响仍存在争议。

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