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选择性 5-羟色胺再摄取抑制剂的给药可能增强脑瘫的功能恢复。

Functional recovery in cerebral palsy may be potentiated by administration of selective serotonin reuptake inhibitors.

机构信息

New College, University of Oxford, Holywell Street, Oxford OX1 3BN, United Kingdom.

出版信息

Med Hypotheses. 2011 Sep;77(3):386-8. doi: 10.1016/j.mehy.2011.05.026. Epub 2011 Jun 16.

Abstract

Cerebral palsy is a disorder of movement and posture caused by a non-progressive lesion to the brain. The incidence of cerebral palsy is over 2 per 1000 live births in Europe. Management of cerebral palsy is primarily supportive--none of the current treatments offered attempt to correct the primary problem of a brain lesion. Neurological problems may be treated by upregulating cerebral plasticity. Evidence suggests that this is the mechanism of action of selective serotonin reuptake inhibitors (SSRIs) in the treatment of depression. Encouraging evidence of motor improvements in stroke patients treated with SSRIs suggest the possibility of similar improvements in cerebral palsy. Patients with less severe cerebral palsy show more evidence of plasticity than patients with more severe forms. Evidence should initially come from animal models, and thereafter case reports and case series in selected cases, before progression to large scale trials. SSRIs would have to be used in conjunction with cooling, which prevents secondary damage. Due consideration is needed to prevent harmful side-effects.

摘要

脑性瘫痪是一种由大脑非进行性损伤引起的运动和姿势障碍。在欧洲,脑性瘫痪的发病率超过每 1000 例活产儿 2 例。脑性瘫痪的治疗主要是支持性的——目前提供的治疗方法都不能纠正大脑损伤的主要问题。神经问题可以通过上调大脑可塑性来治疗。有证据表明,这是选择性 5-羟色胺再摄取抑制剂(SSRIs)治疗抑郁症的作用机制。用 SSRIs 治疗中风患者运动功能改善的令人鼓舞的证据表明,这种方法在脑性瘫痪中也可能有类似的改善。脑瘫程度较轻的患者比脑瘫程度较重的患者表现出更多的可塑性证据。证据最初应来自动物模型,然后是特定病例的病例报告和病例系列,之后再进行大规模试验。SSRIs 必须与冷却相结合使用,以防止继发损伤。需要充分考虑以防止有害的副作用。

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