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帕金森病的精神和认知症状:一个人生故事

Psychiatric and cognitive symptoms of Parkinson's disease: A life's tale.

作者信息

Amstutz D, Sousa M, Maradan-Gachet M E, Debove I, Lhommée E, Krack P

机构信息

Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.

Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.

出版信息

Rev Neurol (Paris). 2025 Apr;181(4):265-283. doi: 10.1016/j.neurol.2024.11.004. Epub 2024 Dec 22.

Abstract

INTRODUCTION

Neuropsychiatric symptoms are highly prevalent in Parkinson's disease (PD) and significantly affect the quality of life of patients and their significant others. The aim of this work is to describe typical neuropsychiatric symptoms and their treatment.

METHODS

This is a narrative opinion paper, illustrated by a fictional case report. The most common neuropsychiatric symptoms such as depressive symptoms, anxiety, apathy, psychotic symptoms, impulse control disorders, as well as cognitive impairment are discussed in the context of prodromal stage, early stage, fluctuations stage, post-surgical intervention, and late stage of PD.

RESULTS

Multiple factors such as pathophysiology, dopaminergic medication, deep brain stimulation, personality traits and individual life circumstances influence neuropsychiatric symptoms. Since the complexity and causes of neuropsychiatric symptoms can change, management strategies have to be adapted and individualised throughout the disease trajectory.

DISCUSSION

Recognising neuropsychiatric symptoms within the framework of the disease stage and identifying their potential causes is pivotal to provide adequate interventions.

摘要

引言

神经精神症状在帕金森病(PD)中极为常见,严重影响患者及其重要他人的生活质量。本研究旨在描述典型的神经精神症状及其治疗方法。

方法

这是一篇叙述性观点论文,并配有一个虚构的病例报告。在PD的前驱期、早期、波动期、手术干预后及晚期等背景下,讨论了最常见的神经精神症状,如抑郁症状、焦虑、淡漠、精神病性症状、冲动控制障碍以及认知障碍。

结果

病理生理学、多巴胺能药物、脑深部电刺激、人格特质及个人生活环境等多种因素会影响神经精神症状。由于神经精神症状的复杂性和病因可能会发生变化,因此在整个疾病进程中,管理策略必须进行调整并个体化。

讨论

在疾病阶段的框架内识别神经精神症状并确定其潜在病因,对于提供充分的干预措施至关重要。

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