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甲基苯丙胺使用与帕金森病未来发病风险:证据与临床意义。

Methamphetamine use and future risk for Parkinson's disease: Evidence and clinical implications.

机构信息

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; School of Psychiatry, University of New South Wales, Sydney, Australia.

National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.

出版信息

Drug Alcohol Depend. 2018 Jun 1;187:134-140. doi: 10.1016/j.drugalcdep.2018.02.032. Epub 2018 Apr 10.

Abstract

BACKGROUND

Methamphetamine use has been posited to be a risk factor for the development of Parkinson's disease (PD) and parkinsonism. The clinical implications of a potential association between methamphetamine use and PD are considered.

METHODS

A review of methamphetamine and PD and parkinsonism was conducted, including evidence from animal models, clinical and population studies.

RESULTS

There is biological plausibility to a link between methamphetamine use and PD. Though clinical and epidemiological evidence in this area is scant, a number of studies suggest that methamphetamine is associated with a moderately increased risk of PD and parkinsonism, and may also lead to premature onset of PD. The long lag time between exposure to methamphetamine and onset of PD, the potential for recovery from neurotoxic effects, and tobacco smoking each may attenuate the association. Individual and drug use characteristics that may modulate a user's risk remain poorly understood.

CONCLUSIONS

The use of methamphetamine may be an initiating event in the development of PD and parkinsonism, in addition to other risk factors that a given individual may hold. Clinicians should be vigilant to signs of prodromal and emerging PD among methamphetamine users. In individuals with premature onset illness, information on current or prior exposure to methamphetamine should be sought.

摘要

背景

甲基苯丙胺的使用被认为是帕金森病(PD)和帕金森综合征发展的一个风险因素。本文考虑了潜在的甲基苯丙胺使用与 PD 之间的关联的临床意义。

方法

对甲基苯丙胺与 PD 和帕金森综合征进行了综述,包括来自动物模型、临床和人群研究的证据。

结果

甲基苯丙胺使用与 PD 之间存在生物学上的联系。尽管在这一领域的临床和流行病学证据很少,但许多研究表明,甲基苯丙胺与 PD 和帕金森综合征的中度风险增加有关,并且可能导致 PD 的发病提前。暴露于甲基苯丙胺和 PD 发病之间的长潜伏期、神经毒性效应的潜在恢复能力以及吸烟都可能减弱这种关联。个体和药物使用特征可能会调节使用者的风险,但这些特征仍知之甚少。

结论

除了特定个体可能持有的其他风险因素外,使用甲基苯丙胺可能是 PD 和帕金森综合征发展的一个起始事件。临床医生应该对甲基苯丙胺使用者出现前驱期和新发 PD 的迹象保持警惕。对于发病较早的患者,应询问当前或既往接触甲基苯丙胺的情况。

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