Neurodegenerative

神经退行性
  • 文章类型: Journal Article
    证据表明,神经退行性疾病和神经精神疾病受肠道微生物组改变的影响。各种疾病都与微生物群失调有关,然而,关于哪些微生物与每种疾病相关,尚无定论。我们研究的目的是系统地回顾过去十年的最新文献,以阐明肠道微生物组是否有助于理解神经退行性疾病的发病机制和进展。大多数纳入的研究表明,某些微生物的相对丰度之间存在很强的相关性,主要是厚壁门和拟杆菌,以及帕金森病(PD)和阿尔茨海默病(AD)等疾病。据推测,微生物及其副产物在脑蛋白积累中具有显著作用,神经炎症,和肠道通透性。微生物种群的估计可能会改善临床结果并阻碍疾病的进展。然而,需要进一步的研究包括更多的疾病和更大的患者样本,并确定与这些疾病相关的特定物种和亚种.
    Evidence shows that neurodegenerative and neuropsychiatric disorders are influenced by alterations in the gut microbiome. Various diseases have been linked to microbiome dysbiosis, yet there are inconclusive data regarding which microorganisms are associated with each disorder. The aim of our study is to systematically review the recent literature of the past decade to clarify whether the gut microbiome contributes to the understanding of pathogenesis and progression of neurodegenerative disorders. Most included studies showed a strong correlation between the relative abundance of certain microorganisms, mainly species of the phyla Firmicutes and Bacteroidetes, and disorders such as Parkinson\'s disease (PD) and Alzheimer\'s disease (AD). It is speculated that the microorganisms and their byproducts have a significant role in brain protein accumulation, neuro-inflammation, and gut permeability. The estimation of microbial populations could potentially improve clinical outcomes and hinder the progression of the disease. However, further research is needed to include more diseases and larger patient samples and identify specific species and subspecies associated with these disorders.
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  • 文章类型: Systematic Review
    背景:无标记运动捕捉(MMC)使用摄像机或深度传感器进行全身跟踪,并提出了一种有希望的方法,可以客观地监控社区环境中的功能表现,帮助临床决策神经退行性疾病,如痴呆。
    目的:本系统综述的主要目的是通过全身追踪研究MMC的应用,量化痴呆症患者的功能表现,轻度认知障碍,帕金森病。
    方法:对Embase的系统搜索,MEDLINE,CINAHL,和Scopus数据库在2022年11月至2023年2月之间进行,共产生1595个结果。纳入标准为MMC和全身追踪。共纳入157项研究进行全文筛选,其中符合筛选标准的26项符合条件的研究纳入审查..
    结果:主要是,选定的研究集中在步态分析(n=24),而其他功能任务,例如坐下来站立(n=5)和踩踏(n=1),也被探索过。然而,纳入的任何研究均未评估日常生活活动.MMC模型在研究中各不相同,包括深度相机(n=18)与标准摄像机(n=5)或移动电话相机(n=2),并使用深度学习模型进行后处理。然而,只有6项研究与已建立的黄金标准动作捕捉模型进行了严格的比较.
    结论:尽管它有潜力成为分析痴呆症患者运动和姿势的有效工具,轻度认知障碍,和帕金森病,需要进一步的研究来确定MMC在量化真实世界中的移动性和功能表现方面的临床应用价值.
    BACKGROUND: Markerless motion capture (MMC) uses video cameras or depth sensors for full body tracking and presents a promising approach for objectively and unobtrusively monitoring functional performance within community settings, to aid clinical decision-making in neurodegenerative diseases such as dementia.
    OBJECTIVE: The primary objective of this systematic review was to investigate the application of MMC using full-body tracking, to quantify functional performance in people with dementia, mild cognitive impairment, and Parkinson disease.
    METHODS: A systematic search of the Embase, MEDLINE, CINAHL, and Scopus databases was conducted between November 2022 and February 2023, which yielded a total of 1595 results. The inclusion criteria were MMC and full-body tracking. A total of 157 studies were included for full-text screening, out of which 26 eligible studies that met the selection criteria were included in the review. .
    RESULTS: Primarily, the selected studies focused on gait analysis (n=24), while other functional tasks, such as sit to stand (n=5) and stepping in place (n=1), were also explored. However, activities of daily living were not evaluated in any of the included studies. MMC models varied across the studies, encompassing depth cameras (n=18) versus standard video cameras (n=5) or mobile phone cameras (n=2) with postprocessing using deep learning models. However, only 6 studies conducted rigorous comparisons with established gold-standard motion capture models.
    CONCLUSIONS: Despite its potential as an effective tool for analyzing movement and posture in individuals with dementia, mild cognitive impairment, and Parkinson disease, further research is required to establish the clinical usefulness of MMC in quantifying mobility and functional performance in the real world.
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  • 文章类型: Journal Article
    神经发生是一个对能量要求很高的过程,这就是为什么血管是神经源性生态位的活跃部分,因为它们允许祖细胞急需的氧合。在这方面,虽然被忽视了很长时间,“氧位”应被认为是成人神经发生的重要干预因素。许多神经保护试验失败的一个可能假设是它们依赖于靶向高度特异性神经保护途径的化合物。这种方法可能太有限,考虑到导致细胞死亡的过程的复杂性。因此,研究应该采用更多的多因素方法。在有限范围的具有多模式神经调节能力的药物中,在各种脑损伤模型中,高压氧疗法已证明可有效减少继发性脑损伤。这种疗法不仅作为神经保护机制,而且作为强大的神经再生机制。
    Neurogenesis is a high energy-demanding process, which is why blood vessels are an active part of the neurogenic niche since they allow the much-needed oxygenation of progenitor cells. In this regard, although neglected for a long time, the \"oxygen niche\" should be considered an important intervenient in adult neurogenesis. One possible hypothesis for the failure of numerous neuroprotective trials is that they relied on compounds that target a highly specific neuroprotective pathway. This approach may be too limited, given the complexity of the processes that lead to cell death. Therefore, research should adopt a more multifactorial approach. Among the limited range of agents with multimodal neuromodulatory capabilities, hyperbaric oxygen therapy has demonstrated effectiveness in reducing secondary brain damage in various brain injury models. This therapy functions not only as a neuroprotective mechanism but also as a powerful neuroregenerative mechanism.
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  • 文章类型: Journal Article
    背景:基于视觉的系统和人体姿态估计算法的发展具有检测,通过步态分析对神经退行性疾病进行早期监测和干预。然而,现有技术与实际临床实践之间的差距是显而易见的,因为大多数临床医生仍然依赖于耗时的主观观察步态分析或客观的基于标记物的分析.
    目的:本文旨在研究基于视觉的运动捕捉的主要发展以及如何将这些进展整合到临床实践中。
    方法:在六个在线数据库中使用布尔搜索词进行文献综述。还包括商业系统搜索。然后使用预定的方法学标准来评估所选物品的质量。
    结果:共评估了17项研究,有13项研究专注于步态分类系统,四项研究专注于步态测量系统。在步态分类系统中,九项研究利用人工智能辅助技术,而四项研究采用了统计技术。结果表明,分类器模型识别的步态特征与现有的临床评定量表高度相关。这些系统通常表现出很高的分类准确性,并且在诊断疾病严重程度方面是有效的。从视频数据中提取时空和运动学关节信息的步态测量系统通常发现步态参数的精确测量具有较低的平均绝对误差,较高的评估员内和评估员间可靠性。
    结论:低成本,基于视觉的便携式系统可以为步态的量化提供概念证明,步态评估工具的扩展,神经退行性疾病的远程步态分析和矫形评估的护理点系统。然而,某些挑战,包括小样本量,闭塞风险,以及训练模型中的选择偏差,需要解决。然而,这些系统可以作为补充工具,为临床医生提供必要的步态信息,以客观地评估疾病的严重程度,并为增强患者护理定制个性化治疗。
    BACKGROUND: Developments in vision-based systems and human pose estimation algorithms have the potential to detect, monitor and intervene early on neurodegenerative diseases through gait analysis. However, the gap between the technology available and actual clinical practice is evident as most clinicians still rely on subjective observational gait analysis or objective marker-based analysis that is time-consuming.
    OBJECTIVE: This paper aims to examine the main developments of vision-based motion capture and how such advances may be integrated into clinical practice.
    METHODS: The literature review was conducted in six online databases using Boolean search terms. A commercial system search was also included. A predetermined methodological criterion was then used to assess the quality of the selected articles.
    RESULTS: A total of seventeen studies were evaluated, with thirteen studies focusing on gait classification systems and four studies on gait measurement systems. Of the gait classification systems, nine studies utilized artificial intelligence-assisted techniques, while four studies employed statistical techniques. The results revealed high correlations of gait features identified by classifier models with existing clinical rating scales. These systems demonstrated generally high classification accuracies and were effective in diagnosing disease severity levels. Gait measurement systems that extract spatiotemporal and kinematic joint information from video data generally found accurate measurements of gait parameters with low mean absolute errors, high intra- and inter-rater reliability.
    CONCLUSIONS: Low cost, portable vision-based systems can provide proof of concept for the quantification of gait, expansion of gait assessment tools, remote gait analysis of neurodegenerative diseases and a point of care system for orthotic evaluation. However, certain challenges, including small sample sizes, occlusion risks, and selection bias in training models, need to be addressed. Nevertheless, these systems can serve as complementary tools, equipping clinicians with essential gait information to objectively assess disease severity and tailor personalized treatment for enhanced patient care.
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  • 文章类型: Journal Article
    磁共振波谱(MRS)是一种成像技术,用于测量组织中的代谢变化。由于缺乏证据,MRS不是诊断神经退行性疾病的优先事项,因为它是一种相对专业的技术,需要专门的设备和专业知识来执行和解释。本系统综述旨在全面收集最常见的神经退行性疾病的MRS结果。
    对四个电子数据库的系统搜索(PubMed,Scopus,WebofScience,和ScienceDirect)是针对2017年至2022年发表的研究进行的。选择了提供特定生物标志物水平的文章,以及通过治疗评估疾病的研究,应用除1H以外的原子核的特色MRS,或比较不同的动物模型均被排除。
    共25篇,在引言中加上3篇文章以获取额外信息,包括在这次审查中。六种最常见的神经退行性疾病,即,老年痴呆症和帕金森氏症,亨廷顿舞蹈病,共济失调,多发性硬化症(MS),多系统萎缩(MSA),通过MRS检查进行性核上性麻痹(PSP)。在所有这些疾病中都可以看到N-乙酰天冬氨酸(NAA)的变化和比例,这可能导致早期诊断。然而,还有其他生物标志物,如Cr和Chon,这可以给出令人信服的结果。
    这项观察性研究是使用MRS作为诊断方法证明神经退行性疾病期间代谢变化的最新证据的首次综合。研究结果表明,阿尔茨海默病(AD)中的N-乙酰天冬氨酸(NAA)和NAA/Cr比率降低,帕金森病(PD),共济失调,MS,反映神经元丢失或功能障碍。在一些研究中发现胆碱和肌醇增加,提示细胞膜更新和神经炎症。其他代谢物如谷氨酸和γ-氨基丁酸的研究结果不太一致。然而,由于缺乏对相同兴趣量(VOI)的研究以及参与者数量少,因此存在局限性.
    UNASSIGNED: Magnetic resonance spectroscopy (MRS) is an imaging technique used to measure metabolic changes in the tissue. Due to the lack of evidence, MRS is not a priority in diagnosing neurodegenerative diseases because it is a relatively specialized technique that requires specialized equipment and expertise to perform and interpret. This systematic review aimed to present a comprehensive collection of MRS results in the most common neurodegenerative diseases.
    UNASSIGNED: A systematic search of four electronic databases (PubMed, Scopus, Web of Science, and ScienceDirect) was conducted for studies published from 2017 to 2022. Articles that provided specific biomarker levels were selected, and studies that assessed the diseases via treatment, featured MRS applying nuclei other than 1H, or compared different animal models were excluded.
    UNASSIGNED: A total of 25 articles, plus 3 articles for extra information in the introduction, were included in this review. Six of the most common neurodegenerative diseases, i.e., Alzheimer\'s and Parkinson\'s disease, Huntington chorea, ataxia, multiple sclerosis (MS), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) were examined via MRS. The changes and ratios of N-acetylaspartate (NAA) could be seen in all of these disorders, which could lead to early diagnosis. However, there are other biomarkers, such as Cr and Chon, which can give convincing results.
    UNASSIGNED: This observational study is the first synthesis of the latest evidence proving metabolic changes during neurodegenerative diseases using MRS as a diagnosis method. The findings indicate decreased N-acetylaspartate (NAA) and NAA/Cr ratios in Alzheimer\'s disease (AD), Parkinson\'s disease (PD), ataxias, and MS, reflecting neuronal loss or dysfunction. Increased choline and myo-inositol were noted in some studies, suggesting cell membrane turnover and neuroinflammation. Findings were less consistent for other metabolites like glutamate and gamma-aminobutyric acid. However, there were limitations due to the lack of studies on the same volumes of interest (VOIs) and the small number of participants.
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  • 文章类型: Journal Article
    帕金森病(PD)是慢性和进行性的大脑神经退行性疾病,其特征是运动症状包括震颤,刚性,姿势不稳定,和运动迟缓.PD神经病理学是由于黑质中多巴胺能神经元的进行性变性和存活神经元中路易体的积累。大脑含有最大量的胆固醇,主要由星形胶质细胞和神经胶质细胞合成。胆固醇在PD的发病机理中错综复杂,可能有益或有害。因此,关于胆固醇在PD神经病理学中的作用存在争议。此外,降胆固醇药物他汀类药物可影响脑胆固醇。不同的研究强调了他汀类药物,通过抑制脑HMG-CoA,可以通过抑制神经元胆固醇来影响神经元的完整性,调节突触可塑性和神经递质释放。此外,他汀类药物以可能有益或有害的双向方式影响不同神经退行性疾病的发展和进展。因此,本综述的目的是阐明胆固醇和他汀类药物对PD神经病理学的双重作用.
    Parkinson disease (PD) is chronic and progressive neurodegenerative disease of the brain characterized by motor symptoms including tremors, rigidity, postural instability, and bradykinesia. PD neuropathology is due to the progressive degeneration of dopaminergic neurons in the substantia nigra and accumulation of Lewy bodies in the survival neurons. The brain contains a largest amount of cholesterol which is mainly synthesized from astrocytes and glial cells. Cholesterol is intricate in the pathogenesis of PD and may be beneficial or deleterious. Therefore, there are controversial points concerning the role of cholesterol in PD neuropathology. In addition, cholesterol-lowering agents\' statins can affect brain cholesterol. Different studies highlighted that statins, via inhibition of brain HMG-CoA, can affect neuronal integrity through suppression of neuronal cholesterol, which regulates synaptic plasticity and neurotransmitter release. Furthermore, statins affect the development and progression of different neurodegenerative diseases in bidirectional ways that could be beneficial or detrimental. Therefore, the objective of the present review was to clarify the double-sward effects of cholesterol and statins on PD neuropathology.
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  • 文章类型: Journal Article
    目的:本系统评价旨在评估太极拳对神经退行性疾病患者健康相关生活质量(HRQoL)的影响。
    方法:本综述遵循了2020年更新的PRISMA(系统评价和荟萃分析的首选报告项目)的指南。在五个电子数据库中进行系统搜索(Medline通过PubMed,WebofScience,Scopus,PEDro,和OTseeker)进行。
    方法:纳入了截至2023年3月发表的研究太极拳干预改善神经退行性疾病患者HRQoL的随机对照试验(RCT)。
    方法:由两名独立研究人员从每项研究中提取数据,并根据Cochrane建议将其提取为数据提取表。评估方法学质量和偏倚风险。
    结果:使用ReviewManager5.3软件进行荟萃分析。
    结果:在筛选的439条记录中,8个RCT符合资格标准.他们评估了认知能力下降(n=2)或帕金森病(n=6)。RCT比较组包括积极干预或常规护理。太极拳治疗的持续时间为8至24周。使用固定效应模型的敏感性分析表明,太极拳治疗显着增加HRQoL[P<001,SMD(95%CI)=.41[.21,.60],I2=4%]。
    结论:太极拳能有效改善神经退行性疾病患者的HRQoL,但干预间的异质性相对较高.由于太极拳在神经退行性疾病康复中的益处的研究仍然有限,因此需要进一步的研究。
    OBJECTIVE: This systematic review aimed to evaluate the effects of Tai Chi on the health-related quality of life (HRQoL) of people with neurodegenerative diseases.
    METHODS: This review followed the guidelines of the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. A systematic search in five electronic databases (Medline via PubMed, Web of Science, Scopus, PEDro, and OTseeker) was performed.
    METHODS: Randomized control trials (RCTs) examining Tai Chi interventions to improve HRQoL in patients with neurodegenerative diseases published through March 2023 were included.
    METHODS: Data were extracted from each study by two independent researchers into a data extraction form based on the Cochrane recommendations. Methodological quality and risk of bias were assessed.
    RESULTS: A meta-analysis was performed using Review Manager 5.3 software.
    RESULTS: Of the 439 records that were screened, eight RCTs met the eligibility criteria. They assessed cognitive decline (n = 2) or Parkinson\'s disease (n = 6). RCT comparison groups included active interventions or usual care. The duration of Tai Chi therapy ranged from 8 to 24 weeks. A sensitivity analysis using a fixed effect model indicated that Tai Chi therapy significantly increased HRQoL [P < 001, SMD (95% CI) = .41 [.21, .60], I2 = 4%].
    CONCLUSIONS: Tai Chi can effectively improve the HRQoL of people with neurodegenerative diseases, but the heterogeneity across intervention was relatively high. Further studies are needed as research into the benefits of Tai Chi in neurodegenerative disease rehabilitation is still limited.
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  • 文章类型: Journal Article
    背景:痴呆症非常普遍,是世界范围内导致死亡的主要原因之一。根据之前的研究,糖尿病可能会增加患痴呆症的可能性。然而,抗糖尿病药物与痴呆之间的关联尚不清楚.这项调查研究了使用钠-葡萄糖转运蛋白2抑制剂(SGLT2i)与糖尿病患者痴呆风险之间的关系。
    方法:截至2023年4月18日,四个数据库-欧洲PMC,Medline,Scopus,和Cochrane图书馆进行了相关文献搜索。我们纳入了所有检查使用SGLT2i的成人糖尿病患者痴呆风险的研究。随机效应模型用于计算本次调查的结果,产生具有95%置信区间(CI)的合并比值比(OR)。
    结果:来自7项观察性研究的汇总数据显示,使用SGLT2i与糖尿病患者患痴呆的风险较低有关(OR0.45,95%CI0.34-0.61;p<0.00001,I2=97%)。由于SGLT2i的神经保护作用而导致的痴呆风险的降低仅受到血脂异常的显著影响(p=0.0004),但不是按样本量(p=0.2954),研究持续时间(p=0.0908),年龄(p=0.0805),性别(p=0.5058),高血压(p=0.0609),心血管疾病(p=0.1619),或中风(p=0.2734)。
    结论:根据这项研究,服用SGLT2i可通过有益的神经保护作用降低糖尿病患者痴呆的发病率.为了验证我们的研究结果,仍然需要随机对照试验(RCT)。
    BACKGROUND: Dementia is quite prevalent and among the leading causes of death worldwide. According to earlier research, diabetes may increase the possibility of developing dementia. However, the association between antidiabetic agents and dementia is not yet clear. This investigation examines the association between the use of sodium-glucose transporter 2 inhibitors (SGLT2i) and the risk of dementia in patients with diabetes.
    METHODS: Up to April 18, 2023, four databases-Europe PMC, Medline, Scopus, and Cochrane Library-were searched for relevant literature. We included all studies that examine dementia risk in adults with diabetes who use SGLT2i. Random-effect models were used to compute the outcomes in this investigation, producing pooled odds ratios (OR) with 95% confidence intervals (CI).
    RESULTS: Pooled data from seven observational studies revealed that SGLT2i use was linked to a lower risk of dementia in people with diabetes (OR 0.45, 95% CI 0.34-0.61; p < 0.00001, I2 = 97%). The reduction in the risk of dementia due to SGLT2i\'s neuroprotective effect was only significantly affected by dyslipidemia (p = 0.0004), but not by sample size (p = 0.2954), study duration (p = 0.0908), age (p = 0.0805), sex (p = 0.5058), hypertension (p = 0.0609), cardiovascular disease (p = 0.1619), or stroke (p = 0.2734).
    CONCLUSIONS: According to this research, taking SGLT2i reduces the incidence of dementia in people with diabetes by having a beneficial neuroprotective impact. Randomized controlled trials (RCTs) are still required in order to verify the findings of our research.
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  • 文章类型: Systematic Review
    目的:KCTD7相关的进行性肌阵挛性癫痫(PME)是一种罕见的常染色体隐性遗传疾病。这项研究旨在描述一个大型国际队列中的临床细节和遗传变异。
    方法:通过国际合作确定了与KCTD7相关的PME分子确诊的家族。此外,我们进行了系统审查,以确定以前报告的病例.显著的人口统计,癫痫,治疗,基因检测,脑电图(EEG),收集和总结影像相关变量.
    结果:纳入42例患者(36个家庭)。首次发作的中位年龄为14个月(四分位距=11.75-22.5)。肌阵挛性癫痫发作通常是注意到的第一癫痫发作类型(n=18,43.9%)。脑电图和脑磁共振成像的发现是可变的。许多患者表现出发育延迟,随后逐渐消退(n=16,38.1%)。21例(55%)的基因检测以前报道过KCTD7变异,17例(45%)的KCTD7基因有新的变异。该队列中有6名患者死亡(年龄范围=1.5-21岁)。系统评价确定了23项符合条件的研究,并从文献中进一步确定了59例以前报道的KCTD7相关疾病。大多数报告病例的表型与PME一致(n=52,88%)。文献中报道的其他表型包括视阵肌阵挛性共济失调综合征(n=2),肌张力障碍(n=2),和神经元类脂褐素病(n=3)。八例已发表的病例随着时间的推移而死亡(14%,年龄范围=3-18岁)。
    结论:本研究队列和系统评价合并了KCTD7相关疾病的表型谱和自然史。早发性耐药癫痫,无情的神经回归,严重的神经系统后遗症很常见。更好地了解自然史可能有助于未来的临床试验。
    OBJECTIVE: KCTD7-related progressive myoclonic epilepsy (PME) is a rare autosomal-recessive disorder. This study aimed to describe the clinical details and genetic variants in a large international cohort.
    METHODS: Families with molecularly confirmed diagnoses of KCTD7-related PME were identified through international collaboration. Furthermore, a systematic review was done to identify previously reported cases. Salient demographic, epilepsy, treatment, genetic testing, electroencephalographic (EEG), and imaging-related variables were collected and summarized.
    RESULTS: Forty-two patients (36 families) were included. The median age at first seizure was 14 months (interquartile range = 11.75-22.5). Myoclonic seizures were frequently the first seizure type noted (n = 18, 43.9%). EEG and brain magnetic resonance imaging findings were variable. Many patients exhibited delayed development with subsequent progressive regression (n = 16, 38.1%). Twenty-one cases with genetic testing available (55%) had previously reported variants in KCTD7, and 17 cases (45%) had novel variants in KCTD7 gene. Six patients died in the cohort (age range = 1.5-21 years). The systematic review identified 23 eligible studies and further identified 59 previously reported cases of KCTD7-related disorders from the literature. The phenotype for the majority of the reported cases was consistent with a PME (n = 52, 88%). Other reported phenotypes in the literature included opsoclonus myoclonus ataxia syndrome (n = 2), myoclonus dystonia (n = 2), and neuronal ceroid lipofuscinosis (n = 3). Eight published cases died over time (14%, age range = 3-18 years).
    CONCLUSIONS: This study cohort and systematic review consolidated the phenotypic spectrum and natural history of KCTD7-related disorders. Early onset drug-resistant epilepsy, relentless neuroregression, and severe neurological sequalae were common. Better understanding of the natural history may help future clinical trials.
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  • 文章类型: Journal Article
    肌萎缩侧索硬化症(ALS)是一种致命且无法治愈的疾病,需要多学科治疗方法和协作治疗努力。上部和下部运动神经元变性的组合最终导致呼吸衰竭,与其他痴呆型神经退行性疾病相似。本文的目的是通过对该疾病的当前治疗方式进行叙述性文献综述来开拓当前的ALS研究。通过这些努力,我们希望浓缩有关当前治疗的最相关信息,并加强对ALS患者的整体管理,随着寻求治疗的继续,这些患者的生活质量更高。我们使用Pubmed搜索策略和特定的MeSH术语来选择使用关键词“ALS”的文献文章,\"\"新的治疗方法,\"\"治疗,“和”对症治疗。“药物干预的组合,心理支持,和身体康复在提高ALS(PALS)患者的生活质量方面最有效。在潜在的药物疗法中,只有少数已被美国食品和药物管理局(FDA)批准用于治疗ALS及其症状。正在考虑的其他治疗方式包括基因治疗,细胞治疗,心理治疗,物理治疗,和言语治疗,除了机器人,替代喂养方法,和通信设备。
    Amyotrophic lateral sclerosis (ALS) is a fatal and incurable disease requiring a multidisciplinary treatment approach and a collaborative therapeutic effort. A combination of both upper and lower motor neuron degeneration ultimately leads to respiratory failure, similar to other dementia-type neurodegenerative diseases. The aim of this paper is to pioneer current ALS research by carrying out a narrative literature review of the current treatment modalities of the disease. Through these efforts, we hope to condense the most pertinent information regarding current treatments and enhance the management of ALS patients as a whole, giving these patients a better quality of life as the search for a cure continues. We used a Pubmed search strategy and specific MeSH terms for the selection of the literature articles using the keywords \"ALS,\" \"new treatment,\" \"treatment,\" and \"symptomatic treatment.\" A combination of pharmaceutical interventions, psychological support, and physical rehabilitation has been most effective in enhancing the quality of life of patients with ALS (PALS). Among potential pharmacological therapies, only a few have been approved by the US Food and Drug Administration(FDA) to be used to treat ALS and its symptoms. Other treatment modalities being considered include gene therapy, cellular therapy, psychological therapy, physical therapy, and speech therapy, alongside robotics, alternative feeding methods, and communication devices.
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