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논문KCI 등재

알츠하이머병의 최신지견

Recent Advances in Diagnosis and Treatment of Alzheimer’s Disease

이석범|이정재
대한생물정신의학회 (The Korean Society Of Biological Psychiatry)|2016.05|생물정신의학 (Journal of Korean Society of Biological Psychiatry)|제23권 제2호|pp. 48-56

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참고문헌

키워드

DSM-5Cholinesterase inhibitor비약물적 중재Non-pharmacological interventionNINCDS-ADRDA콜린에스테라제억제제질병변경치료Disease modifying therapy
주제분류정신과학

초록

알츠하이머병은 콜린성 신경세포수가 줄어들며 인지기능저하를 보이는 만성 퇴행성 뇌 질환이다. 알츠하이머병은 전체 치매의 원인질환 중 가장 많은 비중을 차지하고 있어 치료 약물 임상시험 및 임상연구가 많이 이루어져 왔으며, 임상현장에서 가장 많이 접하게 되는 질환이다. 그럼에도 불구하고 발병원인에 대해 아직 밝혀지지 않은 면이 많으며 진단기준에 대해서도 논의할 부분이 많은 것이 사실이다. 최근 알츠하이머병 치료제로 사용 중인 약물도 고용량 제제로 사용이 가능하게 되었으며, 몇몇 약물들은 중증의 알츠하이머병까지 적응증을 넓히거나 두 가지 약물의 복합제제가 시판되고 있다. 또한 알츠하이머병의 발병기전에 기반한 새로운 약물들도 활발히 임상시험을 하고 있는 중이다. 본 논문은 알츠하이머병의 최근 진단적 변화와 그 의미에대해 검토해보고 약물적, 비약물적 치료의 최신 동향에 대해살펴 봄으로써, 진료현장에 도움이 되고 향후 연구 디자인을위한 방향을 제시하고자 한다.

Abstract

Alzheimer’s disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

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관련 논문AI추천

알츠하이머병에서 임상약물시험의 최신 동향강희영, 박경원대한신경과학회 · 대한신경과학회지2015 · 제33권 제4호알츠하이머 치매 약물치료의 현황과 미래김성윤대한신경정신의학회 · 신경정신의학2018 · 제57권 제1호알츠하이머병의 진단 기준연병길, 홍나래대한노인정신의학회 · 노인정신의학2012 · 제16권 제1호새로운 알츠하이머병 임상진단기준 : NIA-AA 진단가이드라인을 중심으로손보경, 이동영대한노인정신의학회 · 노인정신의학2012 · 제16권 제1호다시 보는 알츠하이머병의 아밀로이드 가설김병수대한생물치료정신의학회 · 생물치료정신의학2014 · 제20권 제3호알츠하이머병 치료의 생물학적 예측인자이창욱, 임제진, 주수현대한생물정신의학회 · 생물정신의학2014 · 제21권 제4호

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