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特发性和DYT1肌张力障碍的神经心理学和神经精神特征以及药物和手术治疗的影响

Neuropsychological and Neuropsychiatric Features of Idiopathic and DYT1 Dystonia and the Impact of Medical and Surgical treatment.

作者信息

Jahanshahi Marjan

机构信息

Cognitive Motor Neuroscience Group, Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, London WC1N 3BG, UK.

出版信息

Arch Clin Neuropsychol. 2017 Nov 1;32(7):888-905. doi: 10.1093/arclin/acx095.

Abstract

Dystonia is a hyperkinetic movement disorder, characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Executive dysfunction is a feature of cognitive function in idiopathic and DYT1 dystonia. Psychiatric morbidity is increased in dystonia, and depression, anxiety, obsessive compulsive disorders are the most common disorders. Sleep problems and pain are also frequently experienced. Evidence suggest that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, but also that psychiatric co-morbidity can be secondary to pain experience and the psychosocial functioning and quality of life of the patients. Medical treatment of dystonia with botulinum toxin injections into affected muscles or with deep brain stimulation surgery improves the symptoms as well as mood and the quality of the patients and does not produce any adverse effects on cognitive function.

摘要

肌张力障碍是一种运动亢进性运动障碍,其特征是持续性或间歇性肌肉收缩,导致异常的、通常是重复性的运动、姿势或两者皆有。执行功能障碍是特发性和DYT1肌张力障碍认知功能的一个特征。肌张力障碍患者的精神疾病发病率增加,其中抑郁症、焦虑症、强迫症是最常见的疾病。睡眠问题和疼痛也很常见。有证据表明,情绪和焦虑障碍是肌张力障碍神经生物学的内在特征,但精神疾病共病也可能继发于疼痛体验以及患者的心理社会功能和生活质量。向受影响的肌肉注射肉毒杆菌毒素或进行脑深部刺激手术对肌张力障碍进行医学治疗,可改善症状以及情绪和患者的生活质量,并且不会对认知功能产生任何不良影响。

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