Manckoundia Patrick, Soungui Eric Ntari, Tavernier-Vidal Béatrice, Mourey France
Service de médecine interne gériatrie, Hôpital de Champmaillot, CHU, Dijon, France, Inserm U1093, Motricité-plasticité : performance, dysfonctionnement, vieillissement et technologies d'optimisation, Université de Bourgogne, Dijon, France.
Ehpad, Hôpital de Champmaillot, CHU, Dijon, France.
Geriatr Psychol Neuropsychiatr Vieil. 2014 Mar;12(1):94-100. doi: 10.1684/pnv.2014.0450.
Psychomotor disadaptation syndrome (PDS) was first described in France by the Dijon geriatric school, 25 years ago, and named "psychomotor regression syndrome". The initial clinical description still remains without modifications. However, progress has been made both in understanding its physiopathology and management, and its name has been changed into PDS in the late 1990s. Since the early 2000s, it was also termed frontal-sub-cortical dysfunction syndrome. PDS results from decompensation of postural function, gait and psychomotor automatisms linked to posture and motor programming impairment related to fronto-sub-cortical lesions. PDS is characterized by retropulsion, non-specific gait disorders, neurological signs (including akinesia, reactional hypertonia, and impaired reactive postural responses and protective reactions) and psychological disorders (fear of standing and walking as an acute feature or cognitive processing retardation and anhedonia as a chronic feature). PDS occurrence is linked to three factors implicated in functional reserve impairment due to frontal-sub-cortical structures disturbances: aging, chronic affections (mainly of degenerative or vascular origin), and acute organic or functional factors which induce cerebral blood flow decrease. Multidisciplinary management, including medical motor physiotherapy and psychological approach, is required for patients with PDS care.
精神运动适应不良综合征（PDS）于25年前由法国第戎老年病学派首次描述，并命名为“精神运动衰退综合征”。最初的临床描述至今仍未改变。然而，在理解其生理病理学和治疗方面已经取得了进展，其名称在20世纪90年代后期改为PDS。自21世纪初以来，它也被称为额-皮质下功能障碍综合征。PDS是由于姿势功能、步态以及与姿势和运动编程受损相关的精神运动自动行为失代偿所致，而姿势和运动编程受损与额-皮质下病变有关。PDS的特征包括后冲、非特异性步态障碍、神经体征（包括运动不能、反应性张力亢进、反应性姿势反应和保护性反应受损）以及心理障碍（急性特征为害怕站立和行走，慢性特征为认知加工迟缓及快感缺失）。PDS的发生与因额-皮质下结构紊乱导致功能储备受损的三个因素有关：衰老、慢性疾病（主要是退行性或血管性起源）以及导致脑血流量减少的急性器质性或功能性因素。对PDS患者进行护理需要多学科管理，包括医学运动物理治疗和心理治疗方法。
