Szatmari Szabolcs, Illigens Ben Min-Woo, Siepmann Timo, Pinter Alexandra, Takats Annamaria, Bereczki Daniel
Department of Neurology, Sibiu County Emergency Hospital, Sibiu; 2nd Department of Neurology, Targu Mures Emergency Clinical County Hospital, Targu Mures, Romania; János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary.
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Neuropsychiatr Dis Treat. 2017 Mar 16;13:815-826. doi: 10.2147/NDT.S130997. eCollection 2017.
Neuropsychiatric and cognitive symptoms are common in Parkinson's disease (PD) and may precede and exceed motor symptoms as major factors impacting disease course and quality of life. Neuropsychiatric symptoms (NPS) in PD are various and are attributed to pathologic changes within multiple brain regions, to psychological stress, and to adverse effects of dopamine replacement therapy. Sleep disorders and mood symptoms such as apathy, depression, and anxiety may antedate the development of motor symptoms by years, while other NPS such as impulse control disorders, psychosis, and cognitive impairment are more common in later stages of the disease. Few studies report on NPS in the early, untreated phase of PD. We reviewed the current literature on NPS in PD with a focus on the early, drug-naive stages of PD. Among these early disease stages, premotor and early motor phases were separately addressed in our review, highlighting the underlying pathophysiological mechanisms as well as epidemiological characteristics, clinical features, risk factors, and available techniques of clinical assessment.
神经精神和认知症状在帕金森病（PD）中很常见，可能先于运动症状出现且程度超过运动症状，成为影响疾病进程和生活质量的主要因素。PD中的神经精神症状（NPS）多种多样，归因于多个脑区的病理变化、心理压力以及多巴胺替代疗法的不良反应。睡眠障碍和情绪症状，如淡漠、抑郁和焦虑，可能在运动症状出现前数年就已出现，而其他NPS，如冲动控制障碍、精神病和认知障碍，在疾病后期更为常见。很少有研究报道PD未经治疗的早期阶段的NPS。我们回顾了关于PD中NPS的当前文献，重点关注PD未经药物治疗的早期阶段。在这些疾病早期阶段中，我们的综述分别探讨了运动前期和早期运动期，强调了潜在的病理生理机制以及流行病学特征、临床特征、危险因素和可用的临床评估技术。
