患有严重精神疾病的患者的锥体外系症状的患病率：以帕金森病为重点。,Frontiers in Neurology

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患有严重精神疾病的患者的锥体外系症状的患病率：以帕金森病为重点。
Frontiers in Neurology ( IF 2.7 ) Pub Date : 2020-11-10 , DOI: 10.3389/fneur.2020.593143
Beatrice Roiter ₁ , Giorgio Pigato ₁ , Angelo Antonini ₁

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患有严重精神疾病的患者可能会出现锥体束外症状，作为伴随的神经系统疾病的一部分或继发于药物治疗。锥体外系症状常常无法识别，对坚持治疗产生负面影响，对生活质量产生负面影响，并可能导致耻辱感。我们估计了重度精神疾病住院患者锥体外系症状的患病率，并将其与人口统计学和临床变量相关联。另外，我们在具有帕金森氏病提示的临床表现的受试者中评估了123I-FP-CIT SPECT与纹状体多巴胺转运蛋白的结合，并记录了6个月的治疗管理和临床进展。在285例患者中有144例出现锥体束外症状（占50.5％），主要是震颤（94例患者，占33％）。有38例患者（13。3％的人患有帕金森病，而且年龄较大，合并症和药物治疗较多。在15/38例患者中，纹状体多巴胺转运蛋白结合异常，导致剂量减少或改变精神药物以及联合抗帕金森疗法。我们的研究证实了重度精神疾病住院患者锥体外系症状的临床和流行病学相关性。一小部分具有锥体外系症状的患者具有与帕金森氏病可能的诊断兼容的特征。123I-FP-CIT SPECT可用于识别多巴胺能功能障碍并启动多巴胺替代疗法。在15/38例患者中，纹状体多巴胺转运蛋白结合异常，导致剂量减少或改变精神药物以及联合抗帕金森疗法。我们的研究证实了重度精神疾病住院患者锥体外系症状的临床和流行病学相关性。一小部分具有锥体外系症状的患者具有与帕金森氏病可能的诊断兼容的特征。123I-FP-CIT SPECT可用于识别多巴胺能功能障碍并启动多巴胺替代疗法。在15/38例患者中，纹状体多巴胺转运蛋白结合异常，导致剂量减少或改变精神药物以及联合抗帕金森疗法。我们的研究证实了重度精神疾病住院患者锥体外系症状的临床和流行病学相关性。一小部分具有锥体外系症状的患者具有与帕金森氏病可能的诊断兼容的特征。123I-FP-CIT SPECT可用于识别多巴胺能功能障碍并启动多巴胺替代疗法。一小部分具有锥体外系症状的患者具有与帕金森氏病可能的诊断兼容的特征。123I-FP-CIT SPECT可用于识别多巴胺能功能障碍并启动多巴胺替代疗法。一小部分具有锥体外系症状的患者具有与帕金森氏病可能的诊断兼容的特征。123I-FP-CIT SPECT可用于识别多巴胺能功能障碍并启动多巴胺替代疗法。

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Prevalence of Extrapyramidal Symptoms in In-Patients With Severe Mental Illnesses: Focus on Parkinsonism.

Patients with severe mental illnesses may present extrapyramidal symptoms as part of a concomitant neurological disorder or secondary to medications. Extrapyramidal symptoms are frequently unrecognized, have negative consequences for adherence to treatment, negatively affect quality of life and can induce stigma. We estimated and correlated with demographic and clinical variables prevalence of extrapyramidal symptoms in in-patients with severe mental illnesses. Additionally we evaluated 123I-FP-CIT SPECT binding to striatal dopamine transporter in subjects with clinical manifestations suggestive of Parkinson's Disease and recorded therapeutic management and clinical evolution for 6-months. Extrapyramidal symptoms were present in 144 out of 285 patients (50.5%), mainly tremor (94 patients, 33%). There were 38 patients (13.3%) with parkinsonism and they had older age, more medical comorbidities and medical treatments. In 15/38 patients striatal dopamine transporter binding was abnormal resulting in dose reduction or change of psychotropic drugs as well as combination with antiparkinson therapy. Our study confirmed the clinical and epidemiological relevance of extrapyramidal symptoms among inpatients with severe mental illnesses. A small percentage of patients with extrapyramidal symptoms had features compatible with possible diagnosis of Parkinson's Disease. 123I-FP-CIT SPECT was useful to identify dopaminergic dysfunction and initiate dopamine replacement therapy.

更新日期：2020-11-10

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