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帕金森病的诊断和治疗:一篇综述
Melissa J Armstrong1,2, Michael S Okun1,2
1Department of Neurology, University of Florida College of Medicine, Gainesville.
JAMA
|February 12, 2020
概括
帕金森病是一种常见的神经疾病, 目前的治疗方法可以控制症状,但不能阻止疾病的进展,这凸显了需要先进的治疗方法.
科学领域:
- 神经学
- 运动障碍
- 神经退行性疾病
背景情况:
- 帕金森病是最常见的帕金森症,
- 影响全球600多万人, 带来重大健康挑战.
研究的目的:
- 总结诊断标准,疾病异质性和目前帕金森病的治疗策略.
- 强调现有治疗方法的症状性质和缺乏疾病修饰的选择.
主要方法:
- 诊断依赖于患者病史,包括前兆特征和运动/认知症状,以及体检.
- 在不确定的情况下,多巴胺转运器单光子发射计算机断层扫描有助于诊断.
- 根据症状表现,进展和药物反应来确定疾病变异.
主要成果:
- 帕金森病呈现异质性,其亚型从轻微的运动主导到扩散的恶性形式.
- 症状治疗侧重于运动和非运动症状,使用多巴胺和非多巴胺剂.
- 像深度大脑刺激和勒沃多巴-卡比多巴肠道悬浮等先进的治疗方法可以解决并发症.
结论:
- 帕金森病是一种异质的疾病,其进展率可变.
- 目前的治疗主要是症状性,使用药物和非药物方法.
- 目前尚无疾病修饰治疗方法,强调综合性症状管理和并发症的先进治疗的重要性.
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