帕金森病中运动症状不对称对非运动结局的影响:一项系统综述

Impact of motor symptom asymmetry on non-motor outcomes in Parkinson's disease: a systematic review.

作者信息

Voruz P, Guérin D, Péron J A

机构信息

Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, Geneva, Switzerland.

Neurosurgery Department, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.

出版信息

NPJ Parkinsons Dis. 2025 Jul 1;11(1):188. doi: 10.1038/s41531-025-01046-4.

Abstract

Parkinson's disease (PD) presents with diverse symptoms, partly influenced by motor symptom asymmetry, which reflects hemispheric brain specialization. This systematic review of 80 studies explored how lateralized motor symptoms affect non-motor outcomes in PD, including cognition, emotion, and psychiatric health. Patients with right-sided motor symptoms (left-hemisphere pathology) show more global cognitive decline and higher dementia risk, while those with left-sided symptoms (right-hemisphere pathology) more often experience psychiatric issues like depression, anxiety, and impaired emotional recognition. Visuospatial deficits were consistently linked to left-sided symptoms, aligning with right-hemisphere dysfunction. Although findings vary across studies, this pattern suggests the relevance of brain lateralization in non-motor symptom assessment. Motor asymmetry may also affect treatment responses, such as deep brain stimulation outcomes. However, inconsistencies in study methods-definitions of asymmetry, motor subtypes, and comorbidities-limit meta-analytic conclusions. Overall, incorporating motor symptom asymmetry into PD diagnosis and treatment could enhance personalized care, warranting more standardized future research.

摘要

帕金森病(PD)表现出多种症状,部分受运动症状不对称性的影响,这种不对称性反映了大脑半球的特化。这项对80项研究的系统综述探讨了偏侧性运动症状如何影响PD患者的非运动结局,包括认知、情绪和精神健康。有右侧运动症状(左侧半球病变)的患者表现出更广泛的认知衰退和更高的痴呆风险,而有左侧症状(右侧半球病变)的患者更常出现抑郁、焦虑和情绪识别受损等精神问题。视觉空间缺陷一直与左侧症状相关,这与右侧半球功能障碍一致。尽管各研究结果存在差异,但这种模式表明大脑偏侧化在非运动症状评估中的相关性。运动不对称性也可能影响治疗反应,如深部脑刺激的效果。然而,研究方法的不一致性——不对称性的定义、运动亚型和合并症——限制了荟萃分析的结论。总体而言,将运动症状不对称性纳入PD的诊断和治疗中可以加强个性化护理,这使得未来需要更标准化的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83df/12215339/6926dda1f80e/41531_2025_1046_Fig1_HTML.jpg

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