特集 神経疾患治療の進歩2016
自律神経疾患の治療の進歩
キーワード:
orthostatic hypotension,
Parkinson disease,
postural tachycardia syndrome,
vasovagal syncope,
overactive bladder
2018 年 34 巻 5 号 p. 535-537
詳細
2018 年 34 巻 5 号 p. 535-537
Article on novel development of neurological treatment published in 2016 were reviewed.
1. Orthostatic hypotension (OH) : Droxidopa had the long–term safety and durability of efficacy in patients with symptomatic neurogenic OH. It reduced fall rates in Parkinson's disease (PD) patients with symptomatic neurogenic OH.
2. Postural tachycardia syndrome (POTS) : Adolescents with POTS demonstrated a significant increase in overall functional ability and significant reductions in depression and catastrophizing by an interdisciplinary rehabilitation program.
3. Vasovagal syncope : Non–pharmacological treatments such as increasing fluid and salt intake and physical counter maneuvers were first–line treatments. Pharmacological treatments including β–blockers, α–agonists and anti–cholinergic medications, etc. and pacemaker therapy were required when syncope was severe and refractory to conservative treatment.
4. Constipation : Abdominal massage was beneficial in relieving symptoms of constipation in patients with PD. STN–DBS improved gastric motility as well as gastrointestinal symptoms in PD. Fingolimod reduced synucleinopathy and improved gut motility in A53T mice.
5. Urinary disturbance : Mirabegron demonstrated low adherence and persistence similar to anticholinergic therapies. Electrical stimulation on overactive bladder was safe, efficacious, and worthy of clinical use.
