帕金森病(Parkinson disease,PD)是以一组以典型运动症状为主要临床特征的神经退行性疾病。典型临床运动症状除了四主征:震颤、强直、少动(akinesia)和运动迟缓(bradykinesia)、姿势步态不稳之外,还有相对次要的运动症状,如精确抓握障碍、手写障碍、语言功能受损及构音障碍。临床对四主征较为熟悉,但是对次要运动症状认识不足,本文通过阐述不同运动症状的临床特征、神经机制及不同症状的相互关系,进一步归纳不同症状对药物及手术治疗反应不同的原因,为不同临床表现亚型PD的深部脑刺激术靶点选择以及PD的脑网络研究提供参考。
Parkinson's disease(PD) is a progressive neurodegenerative disease characterized by a range of motor symptoms. Besides the cardinal symptoms such as akinesia,bradykinesia,tremor,rigidity,postural and gait disturbance,it also has secondary symptoms,including:micrographia,hypophonia,dysarthria and decline in fine motor skills such as precison grip. Clinicians usually are familiar with cardinal motor symptoms rather than those seemingly secondary ones. We provide an extensive review of the clinical features,underlining neuromechanism and their relationship,paving the way for further insight into how medical or surgical treatment improve motor symptoms,eventually facilitating overall management of unified motor systems,and providing evidence for appropriate DBS target choice and brain network study in different PD subtypes.