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Impact of multiple sclerosis on employment and income: Insights from a random sample representative of private sector employees in France using longitudinal administrative data 多发性硬化症对就业和收入的影响:利用纵向行政数据从法国私营部门雇员随机抽样中获得的启示。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.02.389
In France, few data sources are available to estimate the impact of multiple sclerosis (MS) on job retention and its consequences on the level of resources, especially in large representative samples. The aim of the present study was to measure impact of MS on employment rates, wages and income (including unemployment benefit, sickness benefit and disability pension) by comparing work trajectories of people living with MS with those of a matched control group. We used the HYGIE database, which is the result of the linkage of two administrative databases in the private sector for a random sample of over 900,000 people. In order to identify the causal effect of MS on employment after 1 to 20 years, the difference-in-differences method with matching (age, sex, career and health history) was used, overall and in subgroups. The year of entry in long-term disease status for MS was used to approximate the onset of MS. Overall, 946 people with MS were included. Their situation was fairly favorable before MS (88.1% in employment, resources higher than the median for the general population), but MS had strong and continuous negative effects. Indeed, at 10 years, the employment rate fell by 28.6 percentage points (pp) and the disability pension allowance increased by 50.5 pp; the wage percentile fell by 19.2 pp and the replacement income accounted for a growing share of total income (+ 39.7 pp). Although administrative data had several strengths, clinical information on the severity of the disease or on its therapeutic management was not available. In conclusion, this study shows that the effects of MS on the employed population in the private sector occur early in the disease course and are cumulative, and that replacement income helps to reduce the loss of resources thanks to the French health and social system.
在法国,很少有数据来源可用于估算多发性硬化症(MS)对保留工作的影响及其对资源水平的影响,尤其是在大型代表性样本中。本研究旨在通过比较多发性硬化症患者与匹配对照组的工作轨迹,衡量多发性硬化症对就业率、工资和收入(包括失业救济金、疾病救济金和残疾抚恤金)的影响。我们使用了 HYGIE 数据库,该数据库是将私营部门的两个行政数据库连接起来的结果,随机抽取了 90 多万人。为了确定多发性硬化症对 1 至 20 年后就业的因果影响,我们采用了差异匹配法(年龄、性别、职业和健康史),包括总体和分组。多发性硬化症患者进入长期疾病状态的年份被用来近似多发性硬化症的发病年份。总共纳入了 946 名多发性硬化症患者。他们在患多发性硬化症之前的情况相当良好(88.1%的人就业,资源高于普通人群的中位数),但多发性硬化症对他们产生了强烈且持续的负面影响。事实上,在 10 年的时间里,就业率下降了 28.6 个百分点(pp),残疾抚恤金津贴增加了 50.5 个百分点;工资百分位数下降了 19.2 个百分点,替代收入在总收入中所占的比例越来越大(+ 39.7 个百分点)。虽然行政数据有一些优势,但没有关于疾病严重程度或治疗管理的临床信息。总之,这项研究表明,多发性硬化症对私营部门就业人口的影响发生在病程早期,并且是累积性的,而替代收入有助于减少资源损失,这要归功于法国的医疗和社会体系。
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引用次数: 0
Dropped head syndrome in severe hypotension 严重低血压时的低头综合征。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.03.012

Introduction

Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, correctable by passive neck extension.

Methods

Case report.

Results

A patient with a heavy nephrological history (dialyzed since 5 years) complained for twenty months about a falling head. The symptomatology was punctuated by dialysis sessions, with aggravation secondary to dialysis. Clinical and paraclinical exploration for neurological, neuromuscular or orthopedic disease was negative. Analysis of the post-dialysis blood pressure showed a slow and gradual decline. From the date the patient became symptomatic, blood pressure was below 80/40 mmHg. The correction of blood pressure by increasing midodrine posology resulted in a cure of DHS.

Discussion

Considering the negativity of explorations, the cure of symptoms following the correction of arterial hypotension, the rhythmic nature of symptomatology by dialysis, and the recurrence of symptoms concomitantly with drops in blood pressure, we suggested that hypotension was the only etiology explaining this DHS.
简介低头综合征(DHS)的特征是下巴对着胸部的畸形,可通过颈部被动伸展进行矫正:方法:病例报告:一名有严重肾病史的患者(透析 5 年)20 个月来一直抱怨头部下垂。症状在透析过程中时有发生,透析后症状加重。临床和辅助检查均未发现神经、神经肌肉或骨科疾病。对透析后血压的分析表明,血压在缓慢逐渐下降。自患者出现症状之日起,血压一直低于 80/40mmHg。通过增加米多君的剂量来纠正血压,最终治愈了 DHS:考虑到探查的阴性、动脉低血压纠正后症状的治愈、透析后症状的节律性以及血压下降时症状的复发,我们认为低血压是解释该 DHS 的唯一病因。
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引用次数: 0
French guidelines for the diagnosis and management of Tourette syndrome. 法国图雷特综合征诊断和管理指南。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2024-05-17 DOI: 10.1016/j.neurol.2024.04.005
A Hartmann, S Ansquer, C Brefel-Courbon, P Burbaud, A Castrioto, V Czernecki, P Damier, E Deniau, S Drapier, I Jalenques, O Marechal, T Priou, M Spodenkiewicz, S Thobois, A Roubertie, T Witjas, M Anheim
<p><p>The term "Gilles de la Tourette syndrome", or the more commonly used term "Tourette syndrome" (TS) refers to the association of motor and phonic tics which evolve in a context of variable but frequent psychiatric comorbidity. The syndrome is characterized by the association of several motor tics and at least one phonic tic that have no identifiable cause, are present for at least one year and appear before the age of 18. The presence of coprolalia is not necessary to establish or rule out the diagnosis, as it is present in only 10% of cases. The diagnosis of TS is purely clinical and is based on the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). No additional tests are required to confirm the diagnosis of TS. However, to exclude certain differential diagnoses, further tests may be necessary. Very frequently, one or more psychiatric comorbidities are also present, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety, explosive outbursts, self-injurious behaviors, learning disorders or autism spectrum disorder. The condition begins in childhood around 6 or 7 years of age and progresses gradually, with periods of relative waxing and waning of tics. The majority of patients experience improvement by the end of the second decade of life, but symptoms may persist into adulthood in around one-third of patients. The cause of TS is unknown, but genetic susceptibility and certain environmental factors appear to play a role. The treatment of TS and severe forms of tics is often challenging and requires a multidisciplinary approach (involving the general practitioner (GP), pediatrician, psychiatrist, neurologist, school or occupational physicians, psychologist and social workers). In mild forms, education (of young patients, parents and siblings) and psychological management are usually recommended. Medical treatments, including antipsychotics, are essential in the moderate to severe forms of the disease (i.e. when there is a functional and/or psychosocial discomfort linked to tics). Over the past decade, cognitive-behavioral therapies have been validated for the treatment of tics. For certain isolated tics, botulinum toxin injections may also be useful. Psychiatric comorbidities, when present, often require a specific treatment. For very severe forms of TS, treatment by deep brain stimulation offers real therapeutic hope. If tics are suspected and social or functional impairment is significant, specialist advice should be sought, in accordance with the patient's age (psychiatrist/child psychiatrist; neurologist/pediatric neurologist). They will determine tic severity and the presence or absence of comorbidities. The GP will take over the management and prescription of treatment: encouraging treatment compliance, assessing side effects, and combating stigmatization among family and friends. They will also play an important role in rehabilitation therapies, as well as in ensur
吉勒-德拉-图雷特综合征 "或更常用的术语 "图雷特综合征"(TS)是指运动性抽动和发音性抽动的综合征,这些抽动是在精神疾病并发症多变但频繁的情况下发生的。该综合征的特征是,患者伴有几种运动性抽动和至少一种发音性抽动,这些抽动无法确定原因,至少持续一年,并且在 18 岁之前出现。秽语抽动并不是确诊或排除诊断的必要条件,因为只有 10% 的病例会出现秽语抽动。TS 的诊断纯属临床诊断,以《精神疾病诊断与统计手册》(DSM-5)中定义的症状为依据。确诊 TS 无需进行其他检查。不过,为了排除某些鉴别诊断,可能需要进行进一步检查。很多情况下,TS 还伴有一种或多种精神并发症,包括注意力缺陷多动障碍、强迫症、焦虑症、爆发力、自伤行为、学习障碍或自闭症谱系障碍。这种病在儿童期约 6 或 7 岁时开始出现,病情逐渐发展,抽搐症状会有相对的消长期。大多数患者在第二个十年结束时症状会有所改善,但约有三分之一的患者症状会持续到成年。TS 的病因尚不清楚,但遗传易感性和某些环境因素似乎在其中发挥了作用。TS 和严重抽搐症的治疗通常具有挑战性,需要采用多学科方法(包括全科医生、儿科医生、精神科医生、神经科医生、学校或职业医生、心理学家和社会工作者)。对于轻度抽搐,通常建议对年轻患者、父母和兄弟姐妹进行教育和心理治疗。对于中度至重度患者(即因抽搐导致功能和/或心理不适),包括抗精神病药物在内的药物治疗是必不可少的。在过去十年中,认知行为疗法已被证实可用于治疗抽搐。对于某些孤立的抽搐,注射肉毒杆菌毒素也可能有用。如果存在精神并发症,通常需要进行特殊治疗。对于非常严重的 TS,脑深部刺激疗法带来了真正的治疗希望。如果怀疑患有抽搐症,且社交或功能障碍严重,则应根据患者的年龄寻求专科医生的建议(精神科医生/儿童精神科医生;神经科医生/儿童神经科医生)。他们将确定抽搐的严重程度以及是否存在合并症。全科医生将负责管理和开具治疗处方:鼓励患者遵从治疗、评估副作用、消除家人和朋友对患者的鄙视。他们还将在康复治疗中发挥重要作用,并确保在患者的学校或职业环境中为其提供便利。
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引用次数: 0
French guidelines for the diagnosis and management of Tourette syndrome 法国图雷特综合征诊断和管理指南。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.04.005
<div><div>The term “Gilles de la Tourette syndrome”, or the more commonly used term “Tourette syndrome” (TS) refers to the association of motor and phonic tics which evolve in a context of variable but frequent psychiatric comorbidity. The syndrome is characterized by the association of several motor tics and at least one phonic tic that have no identifiable cause, are present for at least one year and appear before the age of 18. The presence of coprolalia is not necessary to establish or rule out the diagnosis, as it is present in only 10% of cases. The diagnosis of TS is purely clinical and is based on the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). No additional tests are required to confirm the diagnosis of TS. However, to exclude certain differential diagnoses, further tests may be necessary. Very frequently, one or more psychiatric comorbidities are also present, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety, explosive outbursts, self-injurious behaviors, learning disorders or autism spectrum disorder. The condition begins in childhood around 6 or 7 years of age and progresses gradually, with periods of relative waxing and waning of tics. The majority of patients experience improvement by the end of the second decade of life, but symptoms may persist into adulthood in around one-third of patients. The cause of TS is unknown, but genetic susceptibility and certain environmental factors appear to play a role. The treatment of TS and severe forms of tics is often challenging and requires a multidisciplinary approach (involving the general practitioner (GP), pediatrician, psychiatrist, neurologist, school or occupational physicians, psychologist and social workers). In mild forms, education (of young patients, parents and siblings) and psychological management are usually recommended. Medical treatments, including antipsychotics, are essential in the moderate to severe forms of the disease (i.e. when there is a functional and/or psychosocial discomfort linked to tics). Over the past decade, cognitive-behavioral therapies have been validated for the treatment of tics. For certain isolated tics, botulinum toxin injections may also be useful. Psychiatric comorbidities, when present, often require a specific treatment. For very severe forms of TS, treatment by deep brain stimulation offers real therapeutic hope. If tics are suspected and social or functional impairment is significant, specialist advice should be sought, in accordance with the patient's age (psychiatrist/child psychiatrist; neurologist/pediatric neurologist). They will determine tic severity and the presence or absence of comorbidities. The GP will take over the management and prescription of treatment: encouraging treatment compliance, assessing side effects, and combating stigmatization among family and friends. They will also play an important role in rehabilitation therapies, as well as in e
吉勒-德拉-图雷特综合征 "或更常用的术语 "图雷特综合征"(TS)是指运动性抽动和发音性抽动的综合征,这些抽动是在精神疾病并发症多变但频繁的情况下发生的。该综合征的特征是,患者伴有几种运动性抽动和至少一种发音性抽动,这些抽动无法确定原因,至少持续一年,并且在 18 岁之前出现。秽语抽动并不是确诊或排除诊断的必要条件,因为只有 10% 的病例会出现秽语抽动。TS 的诊断纯属临床诊断,以《精神疾病诊断与统计手册》(DSM-5)中定义的症状为依据。确诊 TS 无需进行其他检查。不过,为了排除某些鉴别诊断,可能需要进行进一步检查。很多情况下,TS 还伴有一种或多种精神并发症,包括注意力缺陷多动障碍、强迫症、焦虑症、爆发力、自伤行为、学习障碍或自闭症谱系障碍。这种病在儿童期约 6 或 7 岁时开始出现,病情逐渐发展,抽搐症状会有相对的消长期。大多数患者在第二个十年结束时症状会有所改善,但约有三分之一的患者症状会持续到成年。TS 的病因尚不清楚,但遗传易感性和某些环境因素似乎在其中发挥了作用。TS 和严重抽搐症的治疗通常具有挑战性,需要采用多学科方法(包括全科医生、儿科医生、精神科医生、神经科医生、学校或职业医生、心理学家和社会工作者)。对于轻度抽搐,通常建议对年轻患者、父母和兄弟姐妹进行教育和心理治疗。对于中度至重度患者(即因抽搐导致功能和/或心理不适),包括抗精神病药物在内的药物治疗是必不可少的。在过去十年中,认知行为疗法已被证实可用于治疗抽搐。对于某些孤立的抽搐,注射肉毒杆菌毒素也可能有用。如果存在精神并发症,通常需要进行特殊治疗。对于非常严重的 TS,脑深部刺激疗法带来了真正的治疗希望。如果怀疑患有抽搐症,且社交或功能障碍严重,则应根据患者的年龄寻求专科医生的建议(精神科医生/儿童精神科医生;神经科医生/儿童神经科医生)。他们将确定抽搐的严重程度以及是否存在合并症。全科医生将负责管理和开具治疗处方:鼓励患者遵从治疗、评估副作用、消除家人和朋友对患者的鄙视。他们还将在康复治疗中发挥重要作用,并确保在患者的学校或职业环境中为其提供便利。
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引用次数: 0
Professor Alan B. Scott (1932–2021): “The inventor of Botox” 艾伦·b·斯科特教授(1932-2021):“肉毒杆菌的发明者”。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2023.10.012
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引用次数: 0
Importance of glucose and its metabolism in neurodegenerative disorder, as well as the combination of multiple therapeutic strategies targeting α-synuclein and neuroprotection in the treatment of Parkinson's disease 葡萄糖及其代谢在神经退行性疾病中的重要性,以及针对α-突触核蛋白和神经保护的多种治疗策略在帕金森病治疗中的联合应用。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2023.08.011
According to recent findings, Phosphoglycerate Kinase 1 (pgk-1) enzyme is linked to Parkinson's disease (PD). Mutations in the PGK-1 gene lead to decreases in the pgk-1 enzyme which causes an imbalance in the levels of energy demand and supply. An increase in glycolytic adenosine triphosphate (ATP) production would help alleviate energy deficiency and sustain the acute energetic need of neurons. Neurodegeneration is caused by an imbalance or reduction in ATP levels. Recent data suggest that medications that increase glycolysis and neuroprotection can be used to treat PD. The current study focuses on treatment options for disorders associated with the pgk-1 enzyme, GLP-1, and A2A receptor which can be utilized to treat PD. A combination of metformin and terazosin, exenatide and meclizine, istradefylline and salbutamol treatments may benefit parkinsonism. The review also looked at potential target-specific new techniques that might assist in satisfying unfulfilled requirements in the treatment of PD.
根据最近的研究发现,磷酸甘油酸激酶1 (pgk-1)酶与帕金森病(PD)有关。PGK-1基因的突变导致PGK-1酶的减少,从而导致能量需求和供应水平的不平衡。糖酵解三磷酸腺苷(ATP)产生的增加有助于缓解能量缺乏和维持神经元的急性能量需求。神经退行性变是由ATP水平失衡或减少引起的。最近的数据表明,增加糖酵解和神经保护的药物可用于治疗帕金森病。目前的研究重点是与pgk-1酶、GLP-1和A2A受体相关的疾病的治疗选择,这些疾病可用于治疗PD。二甲双胍和特拉唑嗪、艾塞那肽和美甲嗪、依曲替林和沙丁胺醇联合治疗可能对帕金森病有益。该综述还着眼于潜在的靶向性新技术,这些新技术可能有助于满足PD治疗中未实现的要求。
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引用次数: 0
Advocating for rituximab as first-line treatment for NMOSD-AQP4 patients in France: Cost and efficacy considerations 在法国倡导将利妥昔单抗作为 NMOSD-AQP4 患者的一线治疗:成本和疗效考虑因素。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.06.003
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引用次数: 0
Pathways to epilepsy surgery in children with tuberous sclerosis complex-associated epilepsy 结节性硬化症复合体相关癫痫患儿接受癫痫手术的途径。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.04.009

Background

Previous studies showed the efficacy of epilepsy surgery in carefully selected children with epilepsy associated with tuberous sclerosis complex. However, how this selection is conducted, and the characteristics of the patients brought to surgery are still poorly described. By conducting a multicentric retrospective cohort study covering the practice of the last twenty years, we describe the paths leading to epilepsy surgery in children with epilepsy associated with tuberous sclerosis complex.

Methods

We identified 84 children diagnosed with tuberous sclerosis complex and epilepsy by matching two exhaustive registries of genetic diseases and subsequent medical records reviews within two French neuropediatric and epilepsy centers. Demographic, clinical, longitudinal, and diagnostic and surgical procedures data were collected.

Results

Forty-six percent of the children were initially drug-resistant and 19% underwent resective surgery, most often before the age of four. Stereotactic electroencephalography was performed prior to surgery in 44% of cases. Fifty-seven and 43% of patients remained seizure-free one and ten years after surgery, respectively. In addition, 52% of initially drug-resistant patients who did not undergo surgery were seizure-free at the last follow-up. The number of anti-seizure medications required decreased in 50% of cases after surgery. Infantile spasms, intellectual disability, autism spectrum disorder or severe behavioral disorders were not contraindications to surgery but were associated with a higher rate of complications and a lower rate of seizure freedom after surgery.

Conclusion

Despite the assumption of complex multifocal epilepsy and practical difficulties in young children with tuberous sclerosis complex, successful surgery results are comparable with other populations of patients with drug-resistant epilepsy, and a spontaneous evolution to drug-sensitive epilepsy may occur in non-operated patients.
背景:以往的研究表明,对经过严格挑选的结节性硬化综合征癫痫患儿进行癫痫手术治疗具有疗效。然而,对于如何进行选择以及接受手术治疗的患者的特征,目前仍缺乏充分的描述。通过对过去二十年的临床实践进行多中心回顾性队列研究,我们描述了结节性硬化综合症相关癫痫患儿接受癫痫手术的途径:我们通过比对两份详尽的遗传病登记表以及随后在两家法国神经儿科和癫痫中心进行的病历审查,确定了 84 名被诊断患有结节性硬化症综合征和癫痫的儿童。收集了人口统计学、临床、纵向、诊断和手术数据:结果:46%的患儿最初具有耐药性,19%的患儿接受了切除手术,其中大部分患儿在四岁之前就接受了手术。44%的病例在手术前进行了立体定向脑电图检查。分别有57%和43%的患者在术后一年和十年仍无癫痫发作。此外,在最初耐药但未接受手术的患者中,52%的患者在最后一次随访时没有癫痫发作。50%的患者在手术后所需的抗癫痫药物数量有所减少。婴儿痉挛症、智力障碍、自闭症谱系障碍或严重行为障碍并非手术禁忌症,但与较高的并发症发生率和较低的术后无癫痫发作率有关:结论:尽管假定结节性硬化综合征幼儿患有复杂的多灶性癫痫并存在实际困难,但手术的成功率与其他耐药性癫痫患者不相上下,而且未接受手术的患者可能会自发演变为对药物敏感的癫痫。
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引用次数: 0
Cortical type memory impairment in CADASIL: Watch out for the second train! CADASIL 的皮层型记忆障碍:小心第二列火车!
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.05.005
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引用次数: 0
The effectiveness and safety of non-pharmacological intervention for pain management in Parkinson's disease: A systematic review 帕金森病疼痛管理的非药物干预的有效性和安全性:一项系统综述。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2023.04.010
Chronic pain is a non-motor symptom affecting from 60 to 80% of patients with Parkinson's disease (PD). PD patients can suffer from different types of pain, either specific or not specific of the disease, and depending on various pathophysiological mechanisms (nociceptive, nociplastic or neuropathic), which can be present at any stage of the disease. Non-pharmacological interventions (NPIs) are essential to complement routine care interventions in PD pain management. Moreover, in the literature, it has been shown that 42% of PD patients are already using complementary therapies. Hence, our aim was to investigate the effectiveness and safety of NPIs for pain management in PD. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eighteen published randomized control trials (RCTs) were included between 2004 and 2021 leading to a total of 976 PD patients. From them, we reported fifteen different NPIs classified in seven categories: physical exercises, balneotherapy, manual therapy, acupuncture, botanical preparation, body-psychological practice and multiprotection care. Our results have shown that NPIs for PD pain management had a low-to-moderate level of evidence showing mainly favourable results, even if some NPIs presented inconclusive results. Moreover, our review highlighted the clinical relevance of some specific NPIs in PD pain management: NPIs consisting of active physical activities, opposed to passive activities. The safety of NPIs was also confirmed since only few minor transient adverse events were reported. Nevertheless, even if some interesting results were found, the methodology of future studies needs to be more robust and to include comprehensive descriptions in order to offer reliable and sound recommendations to clinicians.
慢性疼痛是一种非运动症状,影响60%至80%的帕金森病(PD)患者。PD患者可能会遭受不同类型的疼痛,无论是疾病的特异性还是非特异性,并取决于各种病理生理机制(伤害性、伤害性或神经性),这些机制可能存在于疾病的任何阶段。非药物干预(NPI)对于补充PD疼痛管理中的常规护理干预至关重要。此外,在文献中,已经表明42%的帕金森病患者已经在使用补充疗法。因此,我们的目的是研究NPI在帕金森病疼痛管理中的有效性和安全性。根据系统评价和荟萃分析的首选报告项目(PRISMA)声明进行了系统评价。2004年至2021年间,纳入了18项已发表的随机对照试验(RCT),共有976名帕金森病患者。从中,我们报告了15种不同的NPI,分为七类:体育锻炼、温和疗法、手法疗法、针灸、植物制剂、身体心理实践和多重保护护理。我们的研究结果表明,用于PD疼痛管理的NPI具有低到中等水平的证据,显示出主要有利的结果,即使一些NPI呈现出不确定的结果。此外,我们的综述强调了一些特定NPI在PD疼痛管理中的临床相关性:NPI由主动的身体活动组成,而不是被动的活动。NPI的安全性也得到了证实,因为只有少数轻微的短暂不良事件被报道。然而,即使发现了一些有趣的结果,未来研究的方法也需要更加稳健,并包括全面的描述,以便为临床医生提供可靠和合理的建议。
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Revue neurologique
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