Butala Ankur, Shepard Melissa, Pontone Greg
Departments of Neurology and Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Handb Clin Neurol. 2019;165:83-121. doi: 10.1016/B978-0-444-64012-3.00007-1.
Parkinson disease (PD) is a neurodegenerative disorder with a complex pathophysiology characterized by the progressive loss of dopaminergic neurons within the substantia nigra. Persons with PD experience several motoric and neuropsychiatric symptoms. Neuropsychiatric features of PD include depression, anxiety, psychosis, impulse control disorders, and apathy. In this chapter, we will utilize the National Institutes of Mental Health Research Domain Criteria (RDoC) to frame and integrate observations from two prevailing disease constructions: neurotransmitter anomalies and circuit physiology. When there is available evidence, we posit how unified translational observations may have clinical relevance and postulate importance outside of PD. Finally, we review the limited evidence available for pharmacologic management of these symptoms.
帕金森病（PD）是一种神经退行性疾病，其病理生理学复杂，特征是黑质内多巴胺能神经元逐渐丧失。帕金森病患者会出现多种运动和神经精神症状。帕金森病的神经精神特征包括抑郁、焦虑、精神病、冲动控制障碍和冷漠。在本章中，我们将利用美国国立精神卫生研究所的研究领域标准（RDoC）来构建和整合来自两种流行疾病结构的观察结果：神经递质异常和神经回路生理学。如有可用证据，我们将提出统一的转化观察结果如何可能具有临床相关性，并假定其在帕金森病之外的重要性。最后，我们回顾了针对这些症状的药物治疗的有限证据。
