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识别和治疗非典型帕金森病。

Recognizing and treating atypical Parkinson disorders.

作者信息

Armstrong Melissa J, McFarland Nikolaus

机构信息

Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States.

Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States.

出版信息

Handb Clin Neurol. 2019;167:301-320. doi: 10.1016/B978-0-12-804766-8.00016-9.

Abstract

Though less common than Parkinson's disease (PD), the atypical Parkinson disorders such as such as dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration are increasingly recognized and important to distinguish from PD. Atypical or "Parkinson-plus" disorders are multisystem disorders and generally progress more rapidly and respond poorly to current therapies compared to PD. Recent advances in our understanding of the pathophysiology of these disorders, however, have generated new interest in the development of novel diagnostics and disease-modifying therapeutics aimed at identifying and treating these disorders. In this review we discuss the clinical approach to the atypical Parkinson disorders and the recent developments in diagnostic and research criteria that take into account the phenotypic heterogeneity and advances in our understanding of the pathophysiology of these disorders.

摘要

虽然非典型帕金森病不如帕金森病(PD)常见,但诸如路易体痴呆、多系统萎缩、进行性核上性麻痹和皮质基底节变性等非典型帕金森病越来越受到认可,且对于与PD进行区分很重要。非典型或“帕金森叠加”疾病是多系统疾病,与PD相比,通常进展更快,对当前治疗反应不佳。然而,我们对这些疾病病理生理学认识的最新进展,引发了对开发新型诊断方法和疾病修饰疗法的新兴趣,这些疗法旨在识别和治疗这些疾病。在本综述中,我们讨论了非典型帕金森病的临床处理方法,以及诊断和研究标准的最新进展,这些进展考虑了表型异质性以及我们对这些疾病病理生理学认识的进步。

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