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创伤性脑损伤的精神药理学

Psychopharmacology of traumatic brain injury.

作者信息

Polich Ginger, Iaccarino Mary Alexis, Zafonte Ross

机构信息

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States.

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States.

出版信息

Handb Clin Neurol. 2019;165:253-267. doi: 10.1016/B978-0-444-64012-3.00015-0.

Abstract

The pathophysiology of traumatic brain injury (TBI) can be highly variable, involving functional and/or structural damage to multiple neuroanatomical networks and neurotransmitter systems. This wide-ranging potential for physiologic injury is reflected in the diversity of neurobehavioral and neurocognitive symptoms following TBI. Here, we aim to provide a succinct, clinically relevant, up-to-date review on psychopharmacology for the most common sequelae of TBI in the postacute to chronic period. Specifically, treatment for neurobehavioral symptoms (depression, mania, anxiety, agitation/irritability, psychosis, pseudobulbar affect, and apathy) and neurocognitive symptoms (processing speed, attention, memory, executive dysfunction) will be discussed. Treatment recommendations will reflect general clinical practice patterns and the research literature.

摘要

创伤性脑损伤(TBI)的病理生理学变化很大,涉及多个神经解剖网络和神经递质系统的功能和/或结构损伤。这种广泛的生理损伤可能性反映在TBI后神经行为和神经认知症状的多样性上。在此,我们旨在对急性后期至慢性期TBI最常见后遗症的精神药理学进行简洁、临床相关且最新的综述。具体而言,将讨论针对神经行为症状(抑郁、躁狂、焦虑、激越/易怒、精神病性症状、假性球麻痹情感和淡漠)和神经认知症状(处理速度、注意力、记忆力、执行功能障碍)的治疗。治疗建议将反映一般临床实践模式和研究文献。

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