帕金森病自主神经障碍的中枢机制与精准神经调控治疗研究进展OA

The pathological mechanism of neurogenic orthostatic hypotension(nOH)in Parkinson disease(PD)is shifting from peripheral sympathetic denervation to central network dysfunction.This article explores the core role of locus coeruleus(LC)degeneration and abnormalities in the central autonomic network(CAN)and the somato-cognitive action network(SCAN)in the pathogenesis of nOH.A current research challenge lies in determining whether network hypercon-nectivity is physiological compensation or a pathological marker,with a lack of longitudinal multimodal imaging data.Based on the novel understanding of CAN/SCAN impairment,the treatment of PD with nOH is transitioning towards pre-cise neuromodulation paradigms,including SCAN-targeted cortical stimulation,epidural spinal cord stimulation,and closed-loop neuromodulation,which provides new perspectives for individualized management in clinical practice.