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.
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.
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。
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