调查痴呆症中过度活跃和精神病症状的神经病理相关性:系统性审查
Giulia Negro1,2, Michele Rossi3, Camillo Imbimbo4
1Neurology Department, Fondazione IRCCS San Gerardo dei Tintori, San Gerardo Hospital, Monza, Italy.
Frontiers in dementia
|February 14, 2025
概括
痴呆症 (BPSD) 的行为和心理症状,特别是过度活动-冲动性-易怒性-失禁性-侵略性-激发性 (HIDA) 和精神病 (P) 领域,与杏仁体和边缘系统中的TAU病变和多种蛋白病变有关. 这些症状并不特定于一种蛋白质病变,而是取决于病变的位置和严重程度.
科学领域:
- 神经科学是一个神经科学.
- 神经病理学神经病理学
- 老年精神病学是一门精神病学专业.
背景情况:
- 痴呆症的行为和心理症状 (BPSD) 是常见的,在痴呆症护理中具有挑战性.
- 在BPSD的过度活跃-冲动性-易怒性-失禁-侵略性-激发性 (HIDA) 和精神病 (P) 领域,人们对其机制的理解不佳.
- 了解HIDA-P症状的神经病理基础对于改善痴呆症管理至关重要.
研究的目的:
- 系统地审查痴呆症中HIDA-P症状的神经病理相关物.
- 研究特定蛋白质病变和神经回路功能障碍与HIDA-P症状之间的关联.
- 确定HIDA和精神病领域是否存在不同的神经病理基础.
主要方法:
- 按照PRISMA指南进行系统审查.
- 在 MEDLINE,CENTRAL 和 EMBASE 数据库中进行了搜索.
- 包括关于HIDA和痴呆症中精神病神经病理学的研究;使用NOS和CARE指南评估的数据;由于异质性的叙事综合.
主要成果:
- 37项研究分析了18823例痴呆病例 (83.44%是阿尔茨海默氏症).
- 包括激动和妄想在内的HIDA-P症状在所有痴呆类型中都很常见.
- 在杏仁体和边缘系统中,TAU病变和同时发生的蛋白病变 (TDP-43,Lewy相关的病变) 与HIDA-P症状有关.
结论:
- HIDA-P症状与重叠的神经回路的参与有关,特别是杏仁体和边缘系统.
- 这些地区的TAU病变和多重蛋白病变是HIDA-P症状发展的核心.
- 损伤的地形和严重程度比HIDA-P症状的特定蛋白质组成更为关键;β-粉样蛋白和血管损伤似乎不那么重要.
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