University of California, San Diego, United States; California Department of State Hospitals (DSH), Psychopharmacology Resource Network, United States.
J Neurol Sci. 2018 Jun 15;389:76-80. doi: 10.1016/j.jns.2018.02.004. Epub 2018 Feb 5.
Tardive dyskinesia (TD) research is at a crossroads because of renewed interest in this syndrome following the successful development and regulatory approval of two novel vesicular monoamine transport 2 (VMAT2) inhibitors. Despite these clinical advances, significant lacunae exist in the knowledge base of TD pathophysiology, prognosis, and epidemiology. Moreover, conflicting definitions of TD as either a syndrome that encompasses a broad array of related phenomena or as a specific subset of tardive syndromes are an impediment to both clinical and basic science research, and to educational efforts targeting nonspecialist clinicians. A unique opportunity is thus presented by the enhanced focus on TD to resolve fundamental issues with regards to nomenclature and clinical criteria, thereby facilitating more sophisticated surveillance and genetic and epidemiological research into tardive movement disorders related to dopamine receptor blocking agents. The widespread use of newer antipsychotics portends that TD will remain a persistent public health issue. This article will present one view of research avenues to be explored for this neuropsychiatric condition, including those that may yield immediate therapeutic benefits by extending expert knowledge into routine clinical care situations.
迟发性运动障碍（TD）的研究正处于十字路口，因为两种新型囊泡单胺转运体 2（VMAT2）抑制剂的成功开发和监管批准，重新引起了人们对这种综合征的兴趣。尽管有这些临床进展，但在 TD 的病理生理学、预后和流行病学的知识基础方面仍存在显著的空白。此外，TD 被定义为一种涵盖广泛相关现象的综合征，或作为迟发性综合征的一个特定亚组，这一概念上的冲突既妨碍了临床和基础科学研究，也妨碍了针对非专科临床医生的教育工作。因此，通过加强对 TD 的关注，为解决命名和临床标准方面的基本问题提供了一个独特的机会，从而有助于对与多巴胺受体阻滞剂相关的迟发性运动障碍进行更复杂的监测以及遗传和流行病学研究。新型抗精神病药物的广泛使用预示着 TD 将仍然是一个持续存在的公共卫生问题。本文将介绍一种探索这种神经精神疾病的研究途径的观点，包括那些通过将专家知识扩展到常规临床护理环境中，可能会立即带来治疗益处的途径。
