Faculty of Medicine, University of Algiers, Algiers, Algeria.
Faculty of Medicine, Saad Dahlab University, Blida, Algeria.
Curr Alzheimer Res. 2022;19(4):285-301. doi: 10.2174/1567205019666220418151914.
Behavioral and psychotic manifestations, including aggression, delusions, and hallucinations, are frequent comorbidities in patients with debilitating nervous illnesses such as Alzheimer's disease (AD), Amyotrophic Lateral Sclerosis, Multiple Sclerosis, and Parkinson's disease. ADrelated psychosis may be linked to a poor disease prognosis, highlighting that early detection and management are mandatory. The manifestations are variable and may be very heterogeneous, imposing a real diagnostic issue. Some assessment tools such as BEHAVE-AD, CERAD-BRSD, and the Psycho-Sensory Hallucinations Scale have been designed to facilitate the diagnosis. The mechanisms behind neurodegeneration-related psychosis are complex and are not fully understood, imposing a burden on researchers to find appropriate management modalities. Familial history and some genetic disturbances may have a determinant role in these delusions and hallucinations in cases with AD. The loss of neuronal cells, atrophy in some regions of the central nervous, and synaptic dysfunction may also contribute to these comorbidities. Furthermore, inflammatory disturbances triggered by pro-inflammatory agents such as interleukins and tumor necrosis factors are stratified among the potential risk factors for the onset of numerous psychotic symptoms in Alzheimer's patients. Little is known about the possible management tools; therefore, it is urgent to conduct well-designed trials to investigate pharmacological and non-pharmacological interventions that can improve the care process of these patients. This review summarizes the current findings regarding the AD-related psychosis symptoms, pathological features, assessment, and management.
行为和精神病症状，包括攻击、妄想和幻觉，是衰弱性神经疾病（如阿尔茨海默病、肌萎缩性侧索硬化症、多发性硬化症和帕金森病）患者常见的合并症。AD 相关的精神病可能与疾病预后不良有关，这强调了早期发现和管理是强制性的。其表现多种多样，可能非常异质，这给诊断带来了真正的问题。一些评估工具，如 BEHAVE-AD、CERAD-BRSD 和 Psycho-Sensory Hallucinations Scale，旨在促进诊断。神经退行性相关精神病背后的机制很复杂，尚未完全理解，这给研究人员寻找适当的管理方式带来了负担。家族史和一些遗传紊乱可能在 AD 患者的这些妄想和幻觉中起决定性作用。神经元细胞的丧失、中枢某些区域的萎缩和突触功能障碍也可能导致这些合并症。此外，由白细胞介素和肿瘤坏死因子等促炎剂引发的炎症紊乱被列为阿尔茨海默病患者发生多种精神病症状的潜在危险因素之一。对于可能的管理工具知之甚少；因此，迫切需要进行精心设计的试验，以研究能够改善这些患者护理过程的药物和非药物干预措施。本综述总结了目前关于 AD 相关精神病症状、病理特征、评估和管理的研究结果。
