Autonomni poremećaji u Parkinsonovoj bolesti

master's thesis

• Title (english): Autonomic dysfunction in Parkinson's disease
• Author: Katharina Jažić
• Mentor: Srđana Telarović (mentor)
• Committee member: Zdravka Poljaković (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Srđana Telarović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Parkinsonova bolest (PB) druga je najčešća neurodegenerativna bolest koja je obilježena rigorom, akinetičkim tremorom, bradikinezijom te posturalnom nestabilnošću. Bolesnici s ovom bolešću mogu imati i brojne nemotoričke simptome poput poremećaja kognicije, depresije, hiposmije, poremećaja spavanja i autonomnih poremećaja. Dijagnoza PB se temelji na kliničkim kriterijima, dok su slikovne pretrage samo pomoć u razlikovanju PB od bolesti sa sličnom kliničkom slikom. Liječenje PB je simptomatsko. Motorički simptomi zadovoljavajuće odgovaraju na liječenje levodopom i ostalim antiparkinsonicima u početnim stadijima bolesti, nakon čega učinak levodope popušta, uz razvoj neželjenih nuspojava i komplikacija terapije. Nemotorički simptomi PB nažalost su često neprepoznati, a samim time i neliječeni. Autonomni poremećaji također su prisutni u gotovo svih bolesnika, posebice s napredovanjem bolesti, a mogu se očitovati spektrom simptoma, uz urinarnu inkontinenciju i ortostatsku hipotenziju kao najčešće. Konstipacija je često prisutna u bolesnika puno prije nastupa motoričkih simptoma i mogla bi biti korisni biomarker za postavljanje dijagnoze PB u prodromalnom stadiju. Disfagija, učestala u kasnijim stadijima bolesti, vezana je uz povišeni rizik od aspiracijske pneumonije koja je jedan od glavnih uzroka smrti u PB. Simptomi autonomnih poremećaja negativno utječu na kvalitetu života te uzrokuju povlačenje pacijenata od svoje okoline.

Abstract (english)

Parkinson's disease (PD) is the second most common neurodegenerative disease characterised by rigor, akinetic tremor, bradikinesia and postural instability. Various non – motor symptoms are experienced by patients as well, such as cognitive
impairment, depression, hyposmia, sleep disturbances and autonomic dysfunction. PD is diagnosed based on clinical criteria, while imaging techniques are only a tool for differentiating between PD and other diseases with similar clinical presentation. Treatment for PD is symptomatic. Motor symptoms respond well to levodopa treatment in the initial stages of the disease, after which the effects of levodopa subside and side effects and complications arise. Non – motor symptoms are highly present in patients, although often overlooked and therefore, not treated. Autonomic dysfunction affects all patients in some capacity, especially those in advanced stages of the disease, and it can manifest itself with an array of symptoms, urinary incontinence and orthostatic hypotension being the most common. Constipation is often noted in patients well before the onset of motor symptoms and could be a useful diagnostic biomarker in the prodromal stage of PD. Dysphagia, often present in later stages of PD, is associated with a higher risk of causing aspiration pneumonia, one of the main causes of death in patients with PD.
Symptoms of autonomic dysfunction negatively affect quality of life and cause patients to socially withdraw.

• Keywords: autonomni poremećaji; Parkinsonova bolest; kvaliteta života
• Keywords (english): autonomic dysfunction; Parkinson's disease; quality of life
• Language: croatian
• URN:NBN: urn:nbn:hr:105:975743
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-04-14 07:22:45