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视觉空间忽视的药物治疗:一项系统综述。

Pharmacological Treatment of Visuospatial Neglect: A Systematic Review.

作者信息

van der Kemp Jet, Dorresteijn Marit, Ten Brink Antonia F, Nijboer Tanja C W, Visser-Meily Johanna M A

机构信息

Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.

出版信息

J Stroke Cerebrovasc Dis. 2017 Apr;26(4):686-700. doi: 10.1016/j.jstrokecerebrovasdis.2017.02.012. Epub 2017 Feb 23.

Abstract

OBJECTIVES

The aims of the current review were (1) to give an overview of human studies investigating pharmacotherapy to ameliorate visuospatial neglect and (2) to evaluate the quality of those studies.

METHODS

A systematic literature search using PubMed, Scopus, and ResearchGate was conducted in regard to studies that evaluated pharmacological interventions aiming to ameliorate poststroke visuospatial neglect. The search was limited in the following features: species (human), adults (≥18 years of age), language (English), and type of neglect (visuospatial). Two independent authors extracted data on study content and effectiveness and evaluated the quality of studies and methods.

RESULTS

A total of 11 studies were identified. Three studies were considered to be of moderate quality, the others of low quality. Seven studies represented dopaminergic treatment; 3 studies represented cholinergic treatment; and 1 study represented noradrenergic treatment. Three dopaminergic studies showed primarily positive effects of dopaminergic stimulation on visuospatial neglect, whereas three others showed adverse effects. All 3 cholinergic studies found positive effects in some outcome measures concerning visuospatial neglect. Noradrenergic stimulation improved maintenance of attention when exploring space.

CONCLUSIONS

Currently, cholinergic therapy might be the best option for future research. However, we must emphasize the explorative nature and the limited quality of the reviewed studies.

摘要

目的

本综述的目的是:(1)概述研究药物治疗以改善视觉空间忽视的人体研究;(2)评估这些研究的质量。

方法

使用PubMed、Scopus和ResearchGate进行系统的文献检索,检索对象为评估旨在改善中风后视觉空间忽视的药物干预措施的研究。检索在以下方面受限:物种(人类)、成年人(≥18岁)、语言(英语)和忽视类型(视觉空间)。两名独立作者提取了关于研究内容和有效性的数据,并评估了研究及方法的质量。

结果

共识别出11项研究。3项研究质量中等,其他研究质量较低。7项研究涉及多巴胺能治疗;3项研究涉及胆碱能治疗;1项研究涉及去甲肾上腺素能治疗。3项多巴胺能研究主要显示多巴胺能刺激对视觉空间忽视有积极作用,而其他3项研究显示有不良作用。所有3项胆碱能研究在一些关于视觉空间忽视的结局指标中均发现有积极作用。去甲肾上腺素能刺激在探索空间时改善了注意力维持。

结论

目前,胆碱能治疗可能是未来研究的最佳选择。然而,我们必须强调所综述研究的探索性质和有限的质量。

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