Dyspnea is an under‐recognized and debilitating symptom that is reported in up to 40% of patients with Parkinson's disease and may have multiple origins. Despite its frequency, it is poorly researched, and there is a general lack of understanding of the pathophysiology of dyspnea and respiratory dysfunction in PD. Consequently, a number of PD patients are labelled as having “unexplained dyspnea.” Studies to date have focused mainly on evaluating ventilatory capacity and lung volumes, and little is known about the effects of the disease on the medullary and pontine ventilatory control centers within the brainstem. This is of particular relevance in view of neuropathological studies demonstrating early involvement of the dorsal medulla and other brainstem structures by the disease process. The possibility that impaired brainstem ventilatory control is a contributory mechanism for dyspnea and could be a premotor manifestation in some PD patients therefore warrants further attention. This review focuses on clinical, pathological, and experimental evidence for the involvement of brainstem respiratory centers in PD. We highlight the need for further research, particularly in PD patients with unexplained dyspnea. © 2020 International Parkinson and Movement Disorder Society

中文翻译：

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脑干通气功能障碍：帕金森病呼吸困难的一种可能机制？

呼吸困难是一种未被充分认识且使人衰弱的症状，多达 40% 的帕金森病患者报告了呼吸困难，并且可能有多种原因。尽管其频率很高，但研究很少，并且对 PD 呼吸困难和呼吸功能障碍的病理生理学普遍缺乏了解。因此，许多 PD 患者被标记为“无法解释的呼吸困难”。迄今为止的研究主要集中在评估通气能力和肺容量，而对疾病对脑干内的髓质和脑桥通气控制中心的影响知之甚少。鉴于神经病理学研究表明疾病过程早期涉及背髓质和其他脑干结构，这尤其重要。脑干通气控制受损可能是呼吸困难的一个促成机制，并且可能是一些 PD 患者的运动前表现，因此值得进一步关注。本综述侧重于脑干呼吸中枢参与 PD 的临床、病理和实验证据。我们强调需要进一步研究，特别是在患有不明原因呼吸困难的 PD 患者中。© 2020 国际帕金森和运动障碍协会