National Institutes of Health, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, USA.
J Neurol Sci. 2011 Nov 15;310(1-2):82-5. doi: 10.1016/j.jns.2011.07.056. Epub 2011 Aug 27.
Many nonmotor fluctuations (NMFs) may occur in addition to the classic motor fluctuations (MFs) in patients with Parkinson's disease (PD) within several years of initiation of dopaminergic treatment. Patients can experience these NMFs in the "on" and/or "off" periods. NMFs can be divided into three groups: Autonomic, cognitive/psychiatric, and sensory. Nonmotor sensory fluctuations (NMSFs) occurring in association with "on" period are more frequently recognized than those in the "off" state. NMSFs commonly reported include pain, numbness, paresthesia/dysesthesia, akathisia, rest-legs syndrome (RLS), dyspnea, and internal tremor (IT). Proposed treatments of NMSFs are based on whether they occur during "off" or "on" state. These include reduction of dopaminergic medication, use of long-acting dopamine agonists or controlled released levodopa (LD), surgical intervention, and/or targeted pharmacological intervention to minimize dopaminergic side effects. NMSFs might be related to dopaminergic mechanisms although difficulty in managing these symptoms with dopaminergic therapy suggests a different pathway.
Recognition of NMSFs is important in the care of patients with Parkinson disease to prevent unnecessary interventions and for appropriate medication regimen adjustments.
除了帕金森病（PD）患者在开始多巴胺治疗后数年内出现的经典运动波动（MF）外，可能还会出现许多非运动波动（NMF）。患者在“开”期和/或“关”期可能会出现这些 NMF。NMF 可分为三组：自主神经、认知/精神和感觉。与“开”期相关的非运动感觉波动（NMSF）比“关”期更易被识别。常见的 NMSF 包括疼痛、麻木、感觉异常/感觉障碍、静坐不能、不宁腿综合征（RLS）、呼吸困难和内脏震颤（IT）。NMSF 的治疗方法基于其发生在“关”期还是“开”期。这些包括减少多巴胺能药物、使用长效多巴胺激动剂或控释左旋多巴（LD）、手术干预和/或靶向药物干预以最小化多巴胺能副作用。尽管用多巴胺能疗法治疗这些症状存在困难，但 NMSF 可能与多巴胺能机制有关。
识别 NMSF 对于帕金森病患者的护理很重要，可防止不必要的干预和适当的药物治疗调整。
