Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
J Parkinsons Dis. 2024;14(s1):S135-S146. doi: 10.3233/JPD-230228.
Non-pharmacological interventions, including cognitive-behavioral therapy (CBT), non-invasive brain stimulation (NIBS), electroconvulsive therapy (ECT), light therapy (LT), and physical rehabilitation/exercise, have shown promise as effective approaches to treat symptoms of depression and anxiety in individuals with Parkinson's disease (PD). In this narrative literature overview, we discuss the state-of-the-art regarding these treatment options and address future perspectives for clinical practice and research. Non-pharmacological interventions hold promise to treat depression and anxiety in PD. There is meta-analytic evidence for the efficacy of CBT, NIBS, ECT, LT, and exercise on improving depressive symptoms. For the treatment of anxiety symptoms, CBT shows large effects but scientific evidence of other non-pharmacological interventions is limited. Importantly, these treatments are safe interventions with no or mild side-effects. More research is needed to tailor treatment to the individuals' needs and combined interventions may provide synergistic effects.We conclude that non-pharmacological interventions should be considered as alternative or augmentative treatments to pharmacological and neurosurgical approaches for the treatment of depression and anxiety in individuals with PD.
非药物干预措施,包括认知行为疗法(CBT)、非侵入性脑刺激(NIBS)、电惊厥疗法(ECT)、光照疗法(LT)和物理康复/运动,已被证明是治疗帕金森病(PD)患者抑郁和焦虑症状的有效方法。在本综述中,我们讨论了这些治疗选择的最新进展,并探讨了未来在临床实践和研究中的前景。非药物干预措施有望治疗 PD 患者的抑郁和焦虑症状。CBT、NIBS、ECT、LT 和运动对改善抑郁症状的疗效有荟萃分析证据。对于焦虑症状的治疗,CBT 显示出较大的效果,但其他非药物干预措施的科学证据有限。重要的是,这些治疗方法是安全的干预措施,几乎没有或仅有轻微的副作用。需要更多的研究来根据个体的需求调整治疗方法,联合干预可能会产生协同作用。我们的结论是,非药物干预措施应被视为 PD 患者抑郁和焦虑治疗的药物和神经外科方法的替代或补充治疗方法。
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