Movement Disorders Centre, First Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Brno, Czech Republic; Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic.
Parkinsonism Relat Disord. 2019 Feb;59:65-73. doi: 10.1016/j.parkreldis.2019.02.042. Epub 2019 Feb 28.
Cognitive and behavioral symptoms are common in Parkinson's disease, may occur even in the prodromal stages of the disease, worsen with disease progression, and surpass motor symptoms as the major factors affecting patient quality of life and caregiver burden. The symptoms may be caused by the disease pathology or they may represent adverse effects of treatment, or both etiological factors may contribute. Although many of these symptoms are related to dopaminergic dysfunction or dopaminergic medication, other neurotransmitters are involved as well. Behavioral symptoms including impulse control disorders, apathy, psychosis, as well as mild cognitive impairment and dementia are reviewed with a special focus on current treatment approaches.
认知和行为症状在帕金森病中很常见,甚至可能在疾病的前驱期就出现,随着疾病的进展而恶化,并超过运动症状成为影响患者生活质量和照护者负担的主要因素。这些症状可能是由疾病的病理引起的,也可能是治疗的不良反应,或者两者都是病因。尽管这些症状中的许多与多巴胺能功能障碍或多巴胺能药物有关,但其他神经递质也参与其中。本文重点介绍了目前的治疗方法,对包括冲动控制障碍、淡漠、精神病在内的行为症状以及轻度认知障碍和痴呆进行了综述。