帕金森病合并抑郁、焦虑的诊治及发病机制研究进展

Recent advance in diagnosis,treatment and pathogenesis of Parkinson's disease comorbid depression and anxiety

帕金森病(PD)是一种基于纹状体黑质多巴胺能神经元损伤的神经退行性疾病,运动功能障碍是其典型的临床特征。但PD也常伴随一系列的以抑郁、焦虑等为代表的非运动症状(NMS),不仅干扰了PD患者的临床管理,还严重影响患者的生活质量。PD合并抑郁、焦虑的病理生理学机制目前尚不清楚,但与疾病进程、运动功能障碍的严重程度以及神经递质、细胞因子代谢紊乱等密切相关。本文围绕PD合并抑郁、焦虑的流行病学特征与诊断标准、病理生理学机制、治疗策略等方面的研究进展进行综述,以期提高PD患者NMS的临床管理与生活质量。

Parkinson's disease(PD)is a kind of neurodegenerative disease based on damage of striatal nigrostriatal dopaminergic neurons,with motor dysfunction as typical clinical feature.However,PD is often accompanied by a series of non-motor symptoms(NMS)represented by depression and anxiety,which not only interferes with clinical management of PD patients,but also seriously affects quality of life of patients.Pathophysiological mechanism of PD comorbid depression and anxiety is still unclear,but is closely related to the disease process,severity of motor dysfunction,and metabolic disorders of neurotransmitter cytokines.This article reviews the epidemiological characteristics,diagnostic criteria,pathophysiological mechanism and treatment strategies of PD comorbid depression and anxiety,in order to improve the NMS clinical management and quality of life of PD patients.