Austin Kim Wieczorek, Ameringer Suzanne Weil, Cloud Leslie Jameleh
Virginia Commonwealth University School of Nursing, 1100 East Leigh Street, Richmond, VA 23219, USA.
Virginia Commonwealth University Parkinson's and Movement Disorders Center and VCU Health Neuroscience, Orthopaedic, and Wellness Center, 11958 West Broad Street, Richmond, VA 23233, USA.
Parkinsons Dis. 2016;2016:9869712. doi: 10.1155/2016/9869712. Epub 2016 Dec 12.
Parkinson's disease (PD) is characterized by complex symptoms and medication-induced motor complications that fluctuate in onset, severity, responsiveness to treatment, and disability. The unpredictable and debilitating nature of PD and the inability to halt or slow disease progression may result in psychological stress. Psychological stress may exacerbate biological mechanisms believed to contribute to neuronal loss in PD and lead to poorer symptom and health outcomes. The purpose of this integrated review is to summarize and appraise animal and human research studies focused on biological mechanisms, symptom, and health outcomes of psychological stress in PD. A search of the electronic databases PubMed/Medline and CINAHL from 1980 to the present using the key words resulted in 11 articles that met inclusion criteria. The results revealed significant associations between psychological stress and increased motor symptom severity and loss of dopamine-producing neurons in animal models of PD and between psychological stress and increased symptom severity and poorer health outcomes in human subjects with PD. Further research is needed to fully elucidate the underlying biological mechanisms responsible for these relationships, for the ultimate purpose of designing targeted interventions that may modify the disease trajectory.
帕金森病（PD）的特征是症状复杂以及药物引起的运动并发症，这些并发症在发作、严重程度、对治疗的反应和残疾程度方面存在波动。帕金森病不可预测且使人衰弱的特性，以及无法阻止或减缓疾病进展，可能会导致心理压力。心理压力可能会加剧被认为导致帕金森病神经元损失的生物学机制，并导致更差的症状和健康结果。这篇综合综述的目的是总结和评估专注于帕金森病心理压力的生物学机制、症状和健康结果的动物和人体研究。使用关键词在1980年至今的电子数据库PubMed/Medline和CINAHL中进行检索，得到了11篇符合纳入标准的文章。结果显示，在帕金森病动物模型中，心理压力与运动症状严重程度增加和产生多巴胺的神经元损失之间存在显著关联，在帕金森病人类受试者中，心理压力与症状严重程度增加和健康结果较差之间也存在显著关联。需要进一步研究以充分阐明导致这些关系的潜在生物学机制，最终目的是设计出可能改变疾病轨迹的针对性干预措施。
