帕金森病冲动控制障碍的Scoping综述

Impulse Control Disorder in Parkinson’s Disease:A Scoping Review

目的探讨帕金森病冲动控制障碍的流行病学、发病机制、危险因素、筛查和评估方法、诊断策略和治疗方法。方法采用主题检索方式,检索PubMed、Medline、Embase、Cochrane Library、CNKI、维普数据库和万方数据帕金森病并发冲动控制障碍的中英文相关文献,截至2020年12月,并辅以参考文献回溯和手工检索。提取相关数据进行Scoping综述。结果共返回文献2355篇,最终纳入30篇,来自10个国家,主要来源于医学、神经病学、精神病学、睡眠医学运动障碍等相关的期刊,发表时间集中在2010年至2020年。研究主要涉及帕金森病并发冲动控制障碍的发病机制、危险因素、筛查和评估方法、诊断策略和治疗方法等。结论帕金森病患者并发冲动控制障碍的危险因素众多,多巴胺能药物是其主要危险因素,特别是多巴胺受体激动剂。对冲动控制障碍的干预强调预防和早期识别。应在调整多巴胺受体激动剂的基础上,根据患者症状类型,制定个体化治疗方案。

Objective To explore the epidemiology,pathogenesis,risk factors,screening and evaluation,diagnostic strategies and treatment of impulse control disorder after Parkinson’s disease(PD).Methods Studies related to Parkinson’s disease complicated with impulse control disorder were retrieved using subject search from PubMed,Medline,Embase,Cochrane Library,CNKI,VIP and Wanfang Data,until December,2020,and supplemented by reference backtracking and manual retrieval.Results A total of 2355 studies were returned first,and 30 were included,from ten countries,mainly published in journals about medicine,neurology,psychiatry,sleep medicine and movement disorders,etc.,between 2010 and2020.The researches mainly involved the pathogenesis,risk factors,screening and evaluation,diagnostic strategies and treatment.Conclusion There are many risk factors for impulse control disorder in PD patients,mostly the dopaminergic drugs,especially dopamine receptor agonists.Interventions for impulse control disorders emphasize prevention and early identification.Individualized and symptomatic treatments based on adjustment of dopamine receptor agonists are needed.