アブストラクト
Japanese
| Title | Lewy小体型認知症の治療 |
|---|---|
| Subtitle | 特集 Lewy小体病の診断と治療の新たな展開 |
| Authors | 森悦朗**,*** |
| Authors (kana) | |
| Organization | **大阪大学大学院連合小児発達学研究科 行動神経学・神経精神医学寄附講座, ***東北大学名誉教授 |
| Journal | 神経治療学 |
| Volume | 37 |
| Number | 1 |
| Page | 32-38 |
| Year/Month | 2020 / |
| Article | 報告 |
| Publisher | 日本神経治療学会 |
| Abstract | 「はじめに」Lewy小体型認知症 (dementia with Lewy bodies ; DLB) は, 病理学的には大脳皮質にLewy小体の出現を特徴とする, Alzheimer病 (Alzheimer disease ; AD) に次いで多い変性性認知症で, 臨床的には, 早期には重篤な記憶障害を欠く進行性認知症があり, 具体的な反復する幻視, 認知障害の大きな変動, パーキンソニズムを伴うことを特徴とする. DLBでは, ADに比べ記憶障害が比較的軽く, 注意障害, 遂行機能障害, 視空間・視知覚障害が際だつ. また幻視を中心とした幻覚, 錯視, 誤認妄想, REM睡眠行動障害 (REM sleep behavior disorder : RBD) などの特徴的な行動異常は, パーキンソニズムや自律神経障害と伴に, DLB特有の臨床的および介護上の問題となる. ADに比較すると生命予後は悪く, 認知症の進行速度も早いことが知られている. |
| Practice | 臨床医学：内科系 |
| Keywords | dementia with Lewy bodies, pharmacotherapy, donepezil, cognitive impairment, parkinsonism |
English
| Title | Treatment of dementia with Lewy bodies |
|---|---|
| Subtitle | |
| Authors | Etsuro MORI*,** |
| Authors (kana) | |
| Organization | *Department of Behavioral Neurology and Neuropsychiatry, Osaka University, **Professor Emeritus, Tohoku University |
| Journal | Neurological Therapeutics |
| Volume | 37 |
| Number | 1 |
| Page | 32-38 |
| Year/Month | 2020 / |
| Article | Report |
| Publisher | Japanese Society of Neurological Therapeutics |
| Abstract | Dementia with Lewy bodies (DLB) causes various symptoms such as psychiatric symptoms, parkinsonism, and failures of autonomic nervous system in addition to cognitive impairment, all of which are clinical and care problems. This review provides evidence-based commentary on treatment of DLB. Donepezil has been the central means since its approval in 2014 for the treatment of cognitive impairment of DLB, and evidence of it is accumulating and gives clues of the usage of it. Although there is insufficient evidence on the efficacy of donepezil for BPSD, it is still the first choice before antipsychotics. On the other hand, motor disorders due to parkinsonism are also important therapeutic targets. Levodopa is the mainstay of treatment. Recently, multicenter, placebo-controlled, randomizeouble-blind, controlled trials have shown the efficacy of adding zonisamide over levodopa treatment for parkinsonism in DLB. Unfortunately, there is no high level of evidence of treatment for a variety of other conditions, and individual patients will be treated with knowledge of other diseases. |
| Practice | Clinical internal medicine |
| Keywords | dementia with Lewy bodies, pharmacotherapy, donepezil, cognitive impairment, parkinsonism |
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残りの31件を表示する
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