帕金森病冲动控制障碍的临床诊疗研究进展

Advances in Clinical Diagnosis and Treatment of Impulse Control Disorders in Parkinson’s Disease

帕金森病(PD)冲动控制障碍是一类备受关注的PD非运动症状,主要包括病理性赌博、性欲亢进、强迫性进食和强迫性购物4类,分别具有不同的临床特征。PD冲动控制障碍的病因及发病机制尚不明确,其危险因素根据能否进行干预可分为可控因素和非可控因素,发病机制涉及遗传易感性、神经递质及神经环路改变等多种机制。PD冲动控制障碍的诊断及评估主要依赖临床症状及相关量表。目前治疗手段缺乏循证医学依据,临床管理应以预防为主。

Impulse control disorders in Parkinson’s disease are a group of non-motor symptoms of Parkinson’s disease that are of great concern,including pathological gambling,hypersexuality,binge eating and compulsive shopping,each with different clinical features.The etiology and pathogenesis of impulse control disorders in Parkinson’s disease are still unclear,and the risk factors can be divided into controllable and noncontrollable factors according to whether interventions can be performed,and the pathogenesis involves various mechanisms such as genetic susceptibility,neurotransmitter and neural circuit alterations.The diagnosis and assessment of impulse control disorders in Parkinson’s disease mainly rely on clinical symptoms and related scales,but its treatment currently lacks evidence-based basis,and clinical management should focus on prevention.