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非典型帕金森病的非运动特征

Nonmotor Features in Atypical Parkinsonism.

作者信息

Bhatia Kailash P, Stamelou Maria

机构信息

Institute of Neurology, London, United Kingdom.

HYGEIA Hospital, Athens, Greece; Neurology Clinic, Philipps University Marburg, Marburg, Germany; University of Athens, Athens, Greece.

出版信息

Int Rev Neurobiol. 2017;134:1285-1301. doi: 10.1016/bs.irn.2017.06.001. Epub 2017 Jul 3.

Abstract

Atypical parkinsonism (AP) comprises mainly multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), which are distinct pathological entities, presenting with a wide phenotypic spectrum. The classic syndromes are now called MSA-parkinsonism (MSA-P), MSA-cerebellar type (MSA-C), Richardson's syndrome, and corticobasal syndrome. Nonmotor features in AP have been recognized almost since the initial description of these disorders; however, research has been limited. Autonomic dysfunction is the most prominent nonmotor feature of MSA, but also gastrointestinal symptoms, sleep dysfunction, and pain, can be a feature. In PSP and CBD, the most prominent nonmotor symptoms comprise those deriving from the cognitive/neuropsychiatric domain. Apart from assisting the clinician in the differential diagnosis with Parkinson's disease, nonmotor features in AP have a big impact on quality of life and prognosis of AP and their treatment poses a major challenge for clinicians.

摘要

非典型帕金森综合征(AP)主要包括多系统萎缩(MSA)、进行性核上性麻痹(PSP)和皮质基底节变性(CBD),它们是不同的病理实体,具有广泛的表型谱。经典综合征现在被称为MSA帕金森型(MSA-P)、MSA小脑型(MSA-C)、理查森综合征和皮质基底节综合征。几乎从这些疾病最初被描述起,AP中的非运动特征就已被认识到;然而,相关研究一直有限。自主神经功能障碍是MSA最突出的非运动特征,但胃肠道症状、睡眠功能障碍和疼痛也可能是其特征。在PSP和CBD中,最突出的非运动症状包括那些源自认知/神经精神领域的症状。除了协助临床医生对帕金森病进行鉴别诊断外,AP中的非运动特征对AP的生活质量和预后有很大影响,并且其治疗对临床医生构成了重大挑战。

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