认知和行为障碍可能会影响共享护理计划和治疗决策在肌缩性侧面硬化症
Veria Vacchiano1,2, Arianna Cherici2, Maria Sasca Criante3
1UOC Clinica Neurologica, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Amyotrophic lateral sclerosis & frontotemporal degeneration
|December 16, 2025
概括
肌缩侧面硬化症 (ALS) 患者的认知和行为障碍与侵入性治疗的接受度增加有关. 共享护理计划 (SCP) 讨论揭示了这些关联,突出了神经心理状态对医疗决策的影响.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 医学伦理 医学伦理
背景情况:
- 肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病,影响运动神经元,经常与认知和行为缺陷同时发生.
- 共享护理计划 (SCP) 促进了协作决策,这对于将医疗干预与个体患者的价值观和偏好保持一致至关重要.
研究的目的:
- 探索诊断为ALS的患者的神经心理障碍和治疗决策之间的关系.
- 了解认知和行为状态如何影响SCP框架内接受关键医疗干预.
主要方法:
- 一组118名ALS患者使用爱丁堡认知和行为ALS屏幕 (ECAS) 进行评估,参与了共享护理计划 (SCP) 讨论.
- 关于非侵入性通风 (NIV),人工营养 (PEG/RIG) 和气管切除的治疗决定在常规的临床SCP咨询中被记录下来.
主要成果:
- 与78%的患者开始SCP讨论;NIV (96%),PEG/RIG (63.9%) 和气管切除术 (17.8%) 的接受率各不相同.
- 接受PEG/RIG与女性性别和较低的ECAS分数相关 (总体而言,ALS特定领域,口头流利,语义流利).
- 气管切除术的接受与年轻的年龄以及认知或行为障碍的存在相关,特别是结合认知和行为障碍 (ALS-CBI) 的ALS.
结论:
- 在ALS患者中神经心理障碍似乎与同意侵入性医疗治疗的可能性更高相关.
- 这些发现强调了评估ALS管理和共享决策过程中的认知和行为状态的重要性.
相关概念视频
Alzheimer's Disease: Treatment
752
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
752
Alzheimer's Disease: Overview
1.6K
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
1.6K
Autism Spectrum Disorder
897
Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
897
Modeling in Therapy
364
Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in...
364
Negative and Cognitive Symptoms of Schizophrenia
399
Negative symptoms of schizophrenia indicate a reduction or absence of typical behaviors and emotional responses found in healthy individuals, while positive symptoms reflect an excess or distortion of normal functioning.
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...
399
Parkinson's Disease: Overview
1.7K
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
1.7K


