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[帕金森病中的自主神经特征]

[Autonomic features in Parkinson disease].

作者信息

Yamamoto Toshimasa, Tamura Naotoshi

机构信息

Department of Neurology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan.

出版信息

Brain Nerve. 2012 Apr;64(4):394-402.

Abstract

Nonmotor symptoms such as autonomic and neuropsychiatric dysfunctions, are commonly seen in Parkinson disease (PD). Recent studies have shown that PD is accompanied by cardiac sympathetic denervation and constipation even in the early stage. Neuropathological studies confirmed changes in the cardiac sympathetic nerves and the gastrointestinal tract. These findings suggest that PD neuropathology may occur first in the peripheral autonomic pathways and extend to the central autonomic pathways, in agreement with the "Braak theory". This article will reviews the symptoms and pathophysiology of gastrointestinal dysfunction, urinary disturbance, sexual dysfunction, sweating dysfunction, pupillary autonomic dysfunction, and orthostatic and postprandial hypotension in PD patients, and discuss to organ selectiveness in autonomic dysfunction in PD.

摘要

非运动症状,如自主神经和神经精神功能障碍,在帕金森病(PD)中很常见。最近的研究表明,即使在早期阶段,PD也伴有心脏交感神经去神经支配和便秘。神经病理学研究证实了心脏交感神经和胃肠道的变化。这些发现表明,PD神经病理学可能首先发生在外周自主神经通路,并延伸至中枢自主神经通路,这与“Braak理论”一致。本文将综述PD患者胃肠道功能障碍、泌尿障碍、性功能障碍、出汗功能障碍、瞳孔自主神经功能障碍以及直立性和餐后低血压的症状和病理生理学,并讨论PD自主神经功能障碍中的器官选择性。

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