帕金森病中侧躯干屈曲的最新进展。
Recent advancements in lateral trunk flexion in Parkinson disease.
作者信息
Kataoka Hiroshi, Sugie Kazuma
机构信息
Department of Neurology, Nara Medical University, Nara Medical University, Kashihara, Nara, Japan.
出版信息
Neurol Clin Pract. 2019 Feb;9(1):74-82. doi: 10.1212/CPJ.0000000000000574.
PURPOSE OF REVIEW
Understanding the pathophysiologic underpinnings of lateral trunk flexion (LTF) in Parkinson disease (PD) has been growing. Adjusting antiparkinsonian medications, botulinum toxin, or surgical intervention has been found efficacious in some patients. Nevertheless, these treatments remain limited, often resulting in inadequate outcomes. We review patients with LTF with PD, including recent advancements in treatment and neuroimaging examination.
RECENT FINDINGS
The basal ganglia system is a major contributing factor to LTF, and the therapeutic intervention also targets the basal ganglia system, including dystonic contraction. The perceptions of the postural verticality or spatial cognition of the correct body orientation promote the severity of LTF or result in a chronic condition with irreversible structural deformities.
CONCLUSION
The combination of pharmacologic interventions with nonpharmacologic interventions, such as rehabilitation, might be needed to manage LTF, and the initiation of these treatments should be started as early as possible.
综述目的
对帕金森病（PD）中侧躯干屈曲（LTF）病理生理学基础的认识不断深入。已发现调整抗帕金森药物、肉毒杆菌毒素或手术干预对部分患者有效。然而，这些治疗仍有局限性，常常导致疗效不佳。我们对PD合并LTF的患者进行综述，包括近期治疗进展和神经影像学检查。
最新发现
基底神经节系统是LTF的主要促成因素，治疗干预也以基底神经节系统为靶点，包括肌张力障碍性收缩。对姿势垂直度或正确身体方位的空间认知的感知会加重LTF的严重程度或导致出现伴有不可逆结构畸形的慢性病。
结论
可能需要将药物干预与非药物干预（如康复治疗）相结合来管理LTF，且这些治疗应尽早开始。
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