Mele Bria, Van Shinia, Holroyd-Leduc Jayna, Ismail Zahinoor, Pringsheim Tamara, Goodarzi Zahra
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
BMJ Open. 2020 Sep 9;10(9):e037632. doi: 10.1136/bmjopen-2020-037632.
To conduct a scoping review of the literature on apathy in Parkinson's disease (PD), to better understand how apathy in Parkinson's disease is diagnosed, treated and managed.
MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Central Register of Control Trials and Cochrane Database of Systematic Reviews were searched to 17 May 2017. An updated review was run from 17 May 2017 to 28 January 2019. The grey literature was searched using the CADTH Grey Matters tool. Original peer-reviewed research was included if it included individuals with PD and apathy. Non-original data was only included if it was in the form of meta-analysis. All information regarding diagnosis, treatment and management of PD was extracted. Citation screening and extraction were performed in duplicate.
From 11 375 citations, 362 articles were included in the final review. The majority of included studies focussed on prevalence, with few studies examining treatment. Twenty screening tools for apathy were identified. Fifty per cent of treatment studies were randomised control trials (RCTs). RCTs applied treatment methods including: exercise, mindfulness, rotigotine (Neupro) transdermal patch and rivastigmine (Exelon).
This review identified a large body of literature describing current knowledge on diagnosing, treating and managing apathy in PD. Future research should aim to detect an ideal screening tool for apathy in PD, to identify the best treatment options for apathy and the variety of comorbidities it may present with and finally aim to better understand postoperative apathy in those with deep brain stimulation.
对帕金森病（PD）淡漠相关文献进行范围综述，以更好地了解帕金森病淡漠的诊断、治疗和管理方式。
检索截至2017年5月17日的MEDLINE、Embase、PsycINFO、CINAHL、Cochrane对照试验中央注册库和Cochrane系统评价数据库。2017年5月17日至2019年1月28日进行了更新综述。使用CADTH灰色文献工具检索灰色文献。如果原始同行评审研究纳入了患有PD和淡漠的个体，则予以纳入。仅当非原始数据为荟萃分析形式时才纳入。提取所有关于PD诊断、治疗和管理的信息。文献筛选和提取由两人独立进行。
从11375条文献中，最终综述纳入了362篇文章。大多数纳入研究聚焦于患病率，很少有研究考察治疗。确定了20种淡漠筛查工具。50%的治疗研究为随机对照试验（RCT）。RCT应用的治疗方法包括：运动、正念、罗替戈汀（Neupro）透皮贴剂和卡巴拉汀（Exelon）。
本综述确定了大量描述帕金森病淡漠诊断、治疗和管理现有知识的文献。未来研究应致力于找到一种理想的帕金森病淡漠筛查工具，确定淡漠的最佳治疗方案以及其可能伴发的各种合并症，最终更好地了解接受深部脑刺激患者的术后淡漠情况。
