Influence of continuous subcutaneous apomorphine infusion on cognition and behavior in Parkinson's disease: A systematic review.

IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Revue neurologique Pub Date : 2024-08-06 DOI:10.1016/j.neurol.2024.06.008
J-F Houvenaghel, M Meyer, E Schmitt, A Arifi, E Benchetrit, A Bichon, C Cau, L Lavigne, E Le Mercier, V Czernecki, K Dujardin
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Abstract

Introduction: The efficacy of continuous subcutaneous apomorphine infusion (CSAI) for motor complications of Parkinson's disease (PD) is established. However, its effect on cognition and behavior remains controversial. The main objective of this systematic review was to describe the existing literature on the effects of CSAI on cognition and behavior and to determine the quality for each study.

Methods: PubMed/Medline, Embase, APA PsycInfo®, and Cochrane Library databases were searched, following PRISMA recommendations. Only longitudinal studies evaluating the effect of CSAI on cognition (global cognition, executive functions, visuospatial abilities, language, memory, attention, social cognition) and/or behavior (depression, anxiety, apathy, psychotic symptoms, impulse control disorders, neuropsychiatric fluctuations) in PD were included. The quality of the included studies was also assessed with a questionnaire.

Results: Twenty-three longitudinal studies evaluated the effect of CSAI on cognition and/or behavior. Overall, results were suggestive of positive effects, notably on executive functions and emotion recognition. However, there were some reports of cognitive slowing and long-term global cognitive deterioration. At the behavioral level, no study showed significant adverse effect of CSAI. Occasionally, a slight improvement of depression, anxiety, apathy, and neuropsychiatric fluctuations was reported. Nevertheless, only four studies met good quality criteria and controlled study regarding cognition were lacking.

Conclusion: The results suggest that CSAI has no obvious negative effects on cognition and behavior in PD. This treatment even shows promise in reducing certain symptoms such as neuropsychiatric fluctuations. However, due to methodological limitations in many studies, no robust conclusions can be drawn. Further multicenter controlled trials are needed to confirm these results.

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持续皮下注射阿朴吗啡对帕金森病患者认知和行为的影响:系统综述。
简介:持续皮下注射阿朴吗啡(CSAI)对帕金森病(PD)运动并发症的疗效已得到证实。然而,其对认知和行为的影响仍存在争议。本系统性综述的主要目的是描述CSAI对认知和行为影响的现有文献,并确定每项研究的质量:方法:按照 PRISMA 建议检索了 PubMedline/Medline、Embase、APA PsycInfo® 和 Cochrane 图书馆数据库。只纳入了评估 CSAI 对认知(整体认知、执行功能、视觉空间能力、语言、记忆、注意力、社会认知)和/或行为(抑郁、焦虑、冷漠、精神病性症状、冲动控制障碍、神经精神波动)的影响的纵向研究。此外,还通过问卷对纳入研究的质量进行了评估:23项纵向研究评估了CSAI对认知和/或行为的影响。总体而言,研究结果表明CSAI对认知和/或行为有积极影响,尤其是在执行功能和情绪识别方面。不过,也有一些关于认知能力减退和长期整体认知能力退化的报告。在行为方面,没有研究显示 CSAI 有明显的不良影响。偶尔有报告称,抑郁、焦虑、冷漠和神经精神波动略有改善。然而,只有四项研究达到了良好质量标准,并且缺乏有关认知能力的对照研究:结果表明,CSAI 对帕金森病患者的认知和行为没有明显的负面影响。结论:研究结果表明,CSAI 对帕金森病患者的认知和行为没有明显的负面影响,甚至有望减轻某些症状,如神经精神波动。然而,由于许多研究在方法上存在局限性,因此无法得出可靠的结论。还需要进一步的多中心对照试验来证实这些结果。
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来源期刊
Revue neurologique
Revue neurologique 医学-临床神经学
CiteScore
4.80
自引率
0.00%
发文量
598
审稿时长
55 days
期刊介绍: The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.
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