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与运动障碍相关的认知综合征。

Cognitive Syndromes Associated With Movement Disorders.

出版信息

Continuum (Minneap Minn). 2022 Jun 1;28(3):726-749. doi: 10.1212/CON.0000000000001134.

Abstract

PURPOSE OF REVIEW

This article reviews the recognition and management of cognitive syndromes in movement disorders, including those with parkinsonism, chorea, ataxia, dystonia, and tremor.

RECENT FINDINGS

Cognitive and motor syndromes are often intertwined in neurologic disorders, including neurodegenerative diseases such as Parkinson disease, atypical parkinsonian syndromes, Huntington disease, and other movement disorders. Cognitive symptoms often affect attention, working memory, and executive and visuospatial functions preferentially, rather than language and memory, but heterogeneity can be seen in the various movement disorders. A distinct cognitive syndrome has been recognized in patients with cerebellar syndromes. Appropriate recognition and screening for cognitive changes in movement disorders may play a role in achieving accurate diagnoses and guiding patients and their families regarding progression and management decisions.

SUMMARY

In the comprehensive care of patients with movement disorders, recognition of cognitive syndromes is important. Pharmacologic treatments for the cognitive syndromes, including mild cognitive impairment and dementia, in these movement disorders lag behind the therapeutics available for motor symptoms, and more research is needed. Patient evaluation and management require a comprehensive team approach, often linking neurologists as well as neuropsychologists, psychologists, psychiatrists, social workers, and other professionals.

摘要

目的综述

本文综述了运动障碍中认知综合征的识别和管理,包括帕金森病、舞蹈病、共济失调、肌张力障碍和震颤等具有帕金森特征的疾病。

最新发现

认知和运动综合征常相互交织在神经退行性疾病中,包括帕金森病、非典型帕金森综合征、亨廷顿病和其他运动障碍等神经变性疾病。认知症状常优先影响注意力、工作记忆、执行和视空间功能,而不是语言和记忆,但在各种运动障碍中也存在异质性。在小脑疾病患者中已经识别出一种独特的认知综合征。在运动障碍中对认知变化的适当识别和筛查可能有助于做出准确诊断,并指导患者及其家属了解疾病进展和管理决策。

总结

在运动障碍患者的综合治疗中,识别认知综合征非常重要。这些运动障碍的认知综合征(包括轻度认知障碍和痴呆)的药物治疗落后于运动症状的治疗方法,需要更多的研究。患者评估和管理需要采用综合团队方法,通常需要神经科医生以及神经心理学家、心理学家、精神科医生、社会工作者和其他专业人员的共同参与。

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