震颤治疗的技巧和窍门

IF 3.2 4区 医学 Q2 CLINICAL NEUROLOGY Journal of Neural Transmission Pub Date : 2024-10-01 Epub Date: 2024-07-24 DOI:10.1007/s00702-024-02806-x
Franziska Hopfner, Carsten Buhmann, Joseph Classen, Florian Holtbernd, Stephan Klebe, Jiri Koschel, Zacharias Kohl, Sebastian Paus, David J Pedrosa
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引用次数: 0

摘要

无论是由神经系统疾病、其他疾病还是药物副作用引起的震颤,都会对患者的生活造成严重影响。治疗的复杂性要求有明确的算法和策略。左旋多巴仍然是治疗帕金森震颤的关键药物,但存在反应差异。一些多巴胺激动剂以 D2 受体为靶点,可显著减轻震颤。普萘洛尔可有效治疗本质性震颤和本质性震颤加(ET/ET +),有时与骁悉一起使用可增加疗效,但副作用与剂量有关。作为备用药物,抗胆碱能药物和氯氮平可用于治疗帕金森震颤,1-辛醇和某些抗惊厥药物可用于治疗其他类型的震颤,尤其是 ET。侵入性脑深部刺激和病灶聚焦超声等疗法可用于治疗耐药病例。药物复查对所有形式的震颤都至关重要,但如果药物可能引发震颤,则尤为重要。基于传感器的检测和非药物干预(如腕带和物理疗法)拓宽了诊断和治疗的视野,有望改善未来的震颤治疗。了解治疗的细微差别是尊重患者需求和耐受性的震颤定制管理的关键。成功的策略可将药物、非侵入性和技术模式结合起来,以达到最佳症状控制和改善生活质量的目的。
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Tips and tricks in tremor treatment.

Tremor, whether arising from neurological diseases, other conditions, or medication side effects, significantly impacts patients' lives. Treatment complexities necessitate clear algorithms and strategies. Levodopa remains pivotal for Parkinson's tremor, though response variability exists. Some dopamine agonists offer notable tremor reduction targeting D2 receptors. Propranolol effectively manages essential tremor and essential tremor plus (ET/ET +), sometimes with primidone for added benefits, albeit dose-dependent side effects. As reserve medications anticholinergics and clozapine are used for treatment of parkinsonian tremor, 1-Octanol and certain anticonvulsant drugs for tremor of other orign, especially ET. Therapies such as invasive deep brain stimulation and lesional focused ultrasound serve for resistant cases. A medication review is crucial for all forms of tremor, but it is particularly important if medication may have triggered the tremor. Sensor-based detection and non-drug interventions like wristbands and physical therapy broaden diagnostic and therapeutic horizons, promising future tremor care enhancements. Understanding treatment nuances is a key for tailored tremor management respecting patient needs and tolerability. Successful strategies integrate pharmacological, non-invasive, and technological modalities, aiming for optimal symptom control and improved quality of life.

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来源期刊
Journal of Neural Transmission
Journal of Neural Transmission 医学-临床神经学
CiteScore
7.20
自引率
3.00%
发文量
112
审稿时长
2 months
期刊介绍: The investigation of basic mechanisms involved in the pathogenesis of neurological and psychiatric disorders has undoubtedly deepened our knowledge of these types of disorders. The impact of basic neurosciences on the understanding of the pathophysiology of the brain will further increase due to important developments such as the emergence of more specific psychoactive compounds and new technologies. The Journal of Neural Transmission aims to establish an interface between basic sciences and clinical neurology and psychiatry. It intends to put a special emphasis on translational publications of the newest developments in the field from all disciplines of the neural sciences that relate to a better understanding and treatment of neurological and psychiatric disorders.
期刊最新文献
Effect of subthalamic and nigral deep brain stimulation on speech and voice in Parkinson's patients. Mitochondrial dysfunction in Parkinson's disease. The effectiveness of non-invasive brain stimulation in treatment of major depressive disorder (MDD): a systematic review and transfer analysis. Subtle bradykinesia features are easier to identify and more prevalent than questionable dystonia in essential tremor. An orthogonal approach for analysis of underivatized steroid hormones using ultrahigh performance supercritical fluid chromatography-mass spectrometry (UHPSFC-MS).
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