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非典型帕金森病的现有和未来治疗方法。系统评价。

Available and future treatments for atypical parkinsonism. A systematic review.

机构信息

IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.

出版信息

CNS Neurosci Ther. 2019 Feb;25(2):159-174. doi: 10.1111/cns.13068. Epub 2018 Oct 7.

Abstract

AIMS

Success in treating patients with atypical parkinsonian syndromes, namely progressive supranuclear palsy (PSP), cortico-basal degeneration (CBD), multiple system atrophy (MSA), Parkinson's disease with dementia (PDD), and Lewy body dementia with (LBD), remains exceedingly low. The present work overviews the most influential research literature collected on MEDLINE, ISI Web of Science, Cochrane Library, and Scopus for available treatment in atypical parkinsonisms without time restriction.

DISCUSSION

Transdermal rotigotine, autologous mesenchymal stem cells, tideglusib, and coenzyme Q10 along with donepezil, rivastigmine, memantine, and the deep brain stimulation have shown some benefits in alleviating symptoms in APS. Moreover, many new clinical trials are ongoing testing microtubule stabilizer, antitau monoclonal antibody, tau acetylation inhibition, cell replacement, selective serotonin reuptake inhibitor, active immunization, inhibition of toxic α-synuclein oligomers formation, and inhibition of microglia.

CONCLUSION

A detailed knowledge of the pathological mechanism underlying the disorders is needed, and disease-modifying therapies are required to offer better therapeutic options to physician and caregivers of APS patients.

摘要

目的

治疗非典型帕金森综合征患者(即进行性核上性麻痹(PSP)、皮质基底节变性(CBD)、多系统萎缩(MSA)、帕金森病伴痴呆(PDD)和路易体痴呆(LBD))的成功率仍然极低。本研究综述了在无时间限制的情况下,针对非典型帕金森病的可用治疗方法,在 MEDLINE、ISI Web of Science、Cochrane 图书馆和 Scopus 上收集的最有影响力的研究文献。

讨论

透皮罗替高汀、自体间充质干细胞、替度鲁肽和辅酶 Q10 以及多奈哌齐、利斯的明、美金刚和深部脑刺激在缓解 APS 症状方面显示出一些益处。此外,许多新的临床试验正在进行中,测试微管稳定剂、抗 tau 单克隆抗体、tau 乙酰化抑制、细胞替代、选择性 5-羟色胺再摄取抑制剂、主动免疫、抑制有毒 α-突触核蛋白寡聚物的形成和抑制小胶质细胞。

结论

需要详细了解这些疾病的病理机制,并需要进行疾病修饰治疗,为 APS 患者的医生和护理人员提供更好的治疗选择。

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Parkinson Disease and Dementia.帕金森病与痴呆症。
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Atypical parkinsonism - new advances.非典型帕金森综合征——新进展
Curr Opin Neurol. 2016 Aug;29(4):480-5. doi: 10.1097/WCO.0000000000000355.
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Therapeutic interventions in parkinsonism: Corticobasal degeneration.帕金森综合征的治疗干预:皮质基底节变性
Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S96-100. doi: 10.1016/j.parkreldis.2015.09.023. Epub 2015 Sep 9.

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