Bladder, Bowel, and Sexual Dysfunction in Parkinsons Disease英文文献资料.docVIP

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Bladder, Bowel, and Sexual Dysfunction in Parkinsons Disease英文文献资料.doc

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Bladder, Bowel, and Sexual Dysfunction in Parkinsons Disease英文文献资料

SAGE-HindawiAccesstoResearch Parkinson’sDisease Volume2011,ArticleID924605,21pages doi:10.4061/2011/924605 ReviewArticle Bladder,Bowel,andSexualDysfunctioninParkinson’sDisease RyujiSakakibara, 1 MasahikoKishi, EminaOgawa, FuyukiTateno, TomoyukiUchiyama, 1 1 1 2 andTomonoriYamanishi 3 TatsuyaYamamoto, 2 1 NeurologyDivision,DepartmentofInternalMedicine,SakuraMedicalCenter,TohoUniversity,564-1Shimoshizu, Sakura285-8741,Japan 2 3 DepartmentofNeurology,ChibaUniversity,Chiba263-8522,Japan DepartmentofUrology,DokkyoMedicalUniversity,Tochigi321-0293,Japan CorrespondenceshouldbeaddressedtoRyujiSakakibara,sakakibara@sakura.med.toho-u.ac.jp Received17October2010;Revised6May2011;Accepted30May2011 AcademicEditor:IrenaRektorova Copyright?2011RyujiSakakibaraetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Bladderdysfunction(urinaryurgency/frequency),boweldysfunction(constipation),andsexualdysfunction(erectiledysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson’s disease (PD). In contrast to motor disorders,pelvicorganautonomicdysfunctionsareoftennonresponsivetolevodopatreatment.Thebrainpathologycausingthe bladderdysfunction(appearanceofoveractivity)involvesanaltereddopamine-basalgangliacircuit,whichnormallysuppresses themicturitionre?ex.Bycontrast,peripheralmyentericpathologycausingslowedcolonictransit(lossofrectalcontractions)and centralpathologycausingweakstrainandparadoxicalanalsphinctercontractionondefecation(PSD,alsocalledasanismus)are responsiblefortheboweldysfunction.Inaddition,hypothalamicdysfunctionismostlyresponsibleforthesexualdysfunction (decreaseinlibidoanderection)inPD,viaaltereddopamine-oxytocinpathways,whichnormallypromotelibidoanderection. ThepathophysiologyofthepelvicorgandysfunctioninPDdi?ersfromthatinmultipl