Kim Ryul, Jeon Beomseok
Seoul National University, College of Medicine, Seoul, South Korea.
Seoul National University, College of Medicine, Seoul, South Korea.
Int Rev Neurobiol. 2017;134:989-1018. doi: 10.1016/bs.irn.2017.05.008. Epub 2017 Jun 12.
Nonmotor symptoms (NMS) are an integral component of Parkinson's disease (PD). Because the burden and range of NMS are key determinants of quality of life for patients and caregivers, their management is a crucial issue in clinical practice. Although a range of NMS have a dopaminergic pathophysiological basis, this fact is underrecognized, and thus, they are often regarded as dopamine unresponsive symptoms. However, substantial evidence indicates that many NMS respond to oral and transdermal dopaminergic therapies. In contrast, certain NMS are exacerbated or even precipitated by dopaminergic drugs and these unwanted effects may be seriously dangerous. Therefore, a dopaminergic strategy for NMS should be based on a consideration of the benefits vs the risks in individual patients with PD.
非运动症状（NMS）是帕金森病（PD）的一个重要组成部分。由于NMS的负担和范围是患者及其照护者生活质量的关键决定因素，因此对其进行管理是临床实践中的一个关键问题。尽管一系列NMS具有多巴胺能病理生理基础，但这一事实未得到充分认识，因此，它们通常被视为对多巴胺无反应的症状。然而，大量证据表明，许多NMS对口服和透皮多巴胺能疗法有反应。相比之下，某些NMS会因多巴胺能药物而加重甚至诱发，这些不良影响可能非常危险。因此，针对NMS的多巴胺能策略应基于对个体PD患者的获益与风险的考量。
