Joza Stephen, Camicioli Richard, Ba Fang
Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Can J Neurol Sci. 2020 Jan;47(1):30-43. doi: 10.1017/cjn.2019.287. Epub 2019 Oct 25.
Parkinson's disease (PD) and other synucleinopathies, namely dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), are common degenerative neurological disorders that share synuclein pathology. Although certain cardinal features of parkinsonism, including bradykinesia and rigidity, respond well to levodopa, axial features, such as gait and balance impairment, are less reliably responsive to dopaminergic therapy and surgical interventions. Consequently, falls are common in PD and other synucleinopathies and are a major contributor toward injury and loss of independence. This underscores the need for appropriate fall risk assessment and implementation of preventative measures in all patients with parkinsonism. The aim of this review is therefore to explore modifiable and non-modifiable risk factors for falls in synucleinopathies. We next review and evaluate the evidence for pharmacological, nonpharmacological, and surgical approaches for fall prevention, and emphasize individualized and multifaceted approaches.
帕金森病（PD）以及其他突触核蛋白病，即路易体痴呆（DLB）和多系统萎缩（MSA），是常见的退行性神经疾病，它们都存在突触核蛋白病变。尽管帕金森综合征的某些主要特征，包括运动迟缓及僵硬，对左旋多巴反应良好，但诸如步态和平衡障碍等轴性症状对多巴胺能治疗和手术干预的反应则不太可靠。因此，跌倒在帕金森病及其他突触核蛋白病中很常见，并且是导致受伤和丧失独立生活能力的主要因素。这凸显了对所有帕金森综合征患者进行适当的跌倒风险评估和实施预防措施的必要性。因此，本综述的目的是探讨突触核蛋白病中跌倒的可改变和不可改变的风险因素。接下来，我们将回顾和评估预防跌倒的药物、非药物和手术方法的证据，并强调个体化和多方面的方法。
