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Sample records for parkinson disease dementia

  1. Parkinson's Disease Dementia

    Science.gov (United States)

    ... Find your local chapter Join our online community Parkinson's Disease Dementia Parkinson's disease dementia is an impairment ... disease. About Symptoms Diagnosis Causes & risks Treatments About Parkinson's disease dementia The brain changes caused by Parkinson's ...

  2. Parkinson Disease and Dementia.

    Science.gov (United States)

    Garcia-Ptacek, Sara; Kramberger, Milica G

    2016-09-01

    Dementia is a frequent complication of Parkinson disease (PD) with a yearly incidence of around 10% of patients with PD. Lewy body pathology is the most important factor in the development of Parkinson disease dementia (PDD) and there is evidence for a synergistic effect with β-amyloid. The clinical phenotype in PDD extends beyond the dysexecutive syndrome that is often present in early PD and encompasses deficits in recognition memory, attention, and visual perception. Sleep disturbances, hallucinations, neuroleptic sensitivity, and fluctuations are often present. This review provides an update on current knowledge of PDD including aspects of epidemiology, pathology, clinical presentation, management, and prognosis. © The Author(s) 2016.

  3. Prevalence and characteristics of dementia in Parkinson disease

    DEFF Research Database (Denmark)

    Aarsland, Dag; Andersen, Kjeld; Larsen, Jan P

    2003-01-01

    Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown.......Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown....

  4. Screening and Treatment for Depression, Dementia, and Psychosis with Parkinson Disease

    Science.gov (United States)

    ... AND TREATMENT FOR DEPRESSION, DEMENTIA, AND PSYCHOSIS WITH PARKINSON DISEASE Depression, dementia, and psychosis are common in people with Parkinson disease. These conditions can affect how people with ...

  5. Depression and dementia in Parkinson's disease.

    Science.gov (United States)

    Sinanović, Osman; Hudić, Josip; Zukić, Sanela; Kapidžić, Almasa; Zonić, Lejla; Vidović, Mirjana

    2015-03-01

    Parkinson's disease (PD) is a neurodegenerative disorder causing not only motor dysfunction but also cognitive, psychiatric, autonomic and sensory disturbances. Depression is the most common psychiatric disturbance identified in patients with PD and has been shown to be more common in PD than in other chronic and disabling disorders, occurring in approximately 40% of PD patients. However, the prevalence and clinical features associated with depression in PD remain controversial. Dementia is increasingly recognized as a symptom associated with idiopathic PD, and is found in up to 40% of all patients suffering from that condition. The aim of this study was to estimate the prevalence of depressive and dementia symptoms in PD patients. The study included 35 consecutive patients with PD, 13 (37.4%) male and 22 (62.6%) female (mean age 62.9 ± 11.0, range 36-85 years), mean duration of disease 4.7 ± 2.9 (range 1-10) years, hospitalized during one year at Clinical Department of Neurology, Tuzla University Clinical Center, Tuzla, Bosnia and Herzegovina. The Mini Mental State Examination (MMSE) was used for assessment of cognitive deterioration and Beck Depression Inventory (BDI) for depression. Computerized tomography was performed in all patients. According to BDI scale, depressive symptoms were present in all 35 PD patients: minimal in 4 (11.4%), low in 7 (20%), moderate in 8 (22.8%), severe in 9 (25.4%) and extreme in 7 (20%) patients. On MMSE scale, 9 (25.4%) patients were free from cognitive deterioration and 26 (74.6%) patients had moderate to severe deterioration, but 21 (60%) patients (7 (33.33%) male and 14 (66.66%) female) had symptoms of dementia (MMSE score ≤ 23). Using MMSE scale, 8 (22.8%) patients were free from dementia and 27 (77.2%) patients had some cognitive deterioration. Very mild symptoms of dementia were found in 6 (25.9%) and overt features of dementia in 21 (74.1%) PD patients. So, out of 35 PD study patients, 21 (60%) (7 (33.3%) male and 14

  6. Dementia in Parkinson's disease: a Brazilian sample

    Directory of Open Access Journals (Sweden)

    Beatriz Baldivia

    2011-10-01

    Full Text Available To determine the prevalence of dementia associated with Parkinson's disease (PD-D in a Brazilian sample adopting clinical and diagnostic procedures recommended by the Movement Disorders Society (MDS. Sixty-seven patients were consecutively submitted to neurological, neuropsychological and functional examinations. PD-D was established according to MDS clinical criteria (Level II and clinical procedures for PD-D (Level I and prevalence rate was compared between the levels adopted. Ten patients (14.9% were diagnosed as demented by Level I criteria whereas sixteen (23.8% were diagnosed based on Level II criteria. Level I criteria had low sensitivity in detecting PD-D (31.25%, but greater specificity (90.19. The PD-D group had significantly worse performance on all neuropsychological tests, were older (p<0.001, had an older age of onset ofdisease (p<0.01, had lower educational level (p<0.02 and had higher scores on functional scales. Current age (p=0.046 and Hoehn & Yahr score (p=0.048 were predictors for developing PD-D.

  7. Cerebral blood flow changes in Parkinson's disease associated with dementia

    International Nuclear Information System (INIS)

    Derejko, M.; Lass, P.; Slawek, J.; Nyka, W.M.

    2001-01-01

    Dementia is one of the main non-motor symptoms of Parkinson's disease (PD) and it is diagnosed in about 30% of cases. Its aetiology remains unclear and contributing factors are controversial. Dementia may be more common in old patients with severe motor symptoms and mild cognitive impairment. Clinico-pathological studies show the association between dementia in PD and the age-related group of dementias, such as AD and VaD. A valuable aid in the assessment of dementia in PD is cerebral blood flow (CBF) brain SPECT scanning. It shows three different patterns of rCBF reduction, including frontal lobe hypoperfusion, iu Alzheimer-likel type of hypoperfusion and multiple, vascular defects. The heterogeneity of rCBF reduction may reflect the multifactorial pathophysiology of dementia in PD. It may result from concomitant AD pathology, cerebrovascular disease, destruction of nigro-striato-frontal projection or may be a distinct disease of different aetiology. (author)

  8. Office-Based Screening for Dementia in Parkinson Disease: The Montreal Parkinson Risk of Dementia Scale in 4 Longitudinal Cohorts.

    Science.gov (United States)

    Dawson, Benjamin K; Fereshtehnejad, Seyed-Mohammad; Anang, Julius B M; Nomura, Takashi; Rios-Romenets, Silvia; Nakashima, Kenji; Gagnon, Jean-François; Postuma, Ronald B

    2018-06-01

    Parkinson disease dementia dramatically increases mortality rates, patient expenditures, hospitalization risk, and caregiver burden. Currently, predicting Parkinson disease dementia risk is difficult, particularly in an office-based setting, without extensive biomarker testing. To appraise the predictive validity of the Montreal Parkinson Risk of Dementia Scale, an office-based screening tool consisting of 8 items that are simply assessed. This multicenter study (Montreal, Canada; Tottori, Japan; and Parkinson Progression Markers Initiative sites) used 4 diverse Parkinson disease cohorts with a prospective 4.4-year follow-up. A total of 717 patients with Parkinson disease were recruited between May 2005 and June 2016. Of these, 607 were dementia-free at baseline and followed-up for 1 year or more and so were included. The association of individual baseline scale variables with eventual dementia risk was calculated. Participants were then randomly split into cohorts to investigate weighting and determine the scale's optimal cutoff point. Receiver operating characteristic curves were calculated and correlations with selected biomarkers were investigated. Dementia, as defined by Movement Disorder Society level I criteria. Of the 607 patients (mean [SD] age, 63.4 [10.1]; 376 men [62%]), 70 (11.5%) converted to dementia. All 8 items of the Montreal Parkinson Risk of Dementia Scale independently predicted dementia development at the 5% significance level. The annual conversion rate to dementia in the high-risk group (score, >5) was 14.9% compared with 5.8% in the intermediate group (score, 4-5) and 0.6% in the low-risk group (score, 0-3). The weighting procedure conferred no significant advantage. Overall predictive validity by the area under the receiver operating characteristic curve was 0.877 (95% CI, 0.829-0.924) across all cohorts. A cutoff of 4 or greater yielded a sensitivity of 77.1% (95% CI, 65.6-86.3) and a specificity of 87.2% (95% CI, 84.1-89.9), with a

  9. N-isopropyl-p-123I iodoamphetamine single photon emission computed tomography study of Parkinson's disease with dementia

    International Nuclear Information System (INIS)

    Matsui, Hideaki; Udaka, Fukashi; Miyoshi, Takafumi; Hara, Narihiro; Tamura, Akiko; Oda, Masaya; Kubori, Tamotsu; Nishinaka, Kazuto; Kameyama, Masakuni

    2005-01-01

    Intellectual deterioration occurs in 10-40% of patients with Parkinson's disease. However, there are many conflicting studies on its relation with brain perfusion and the nature of this dementing process remains controversial. The objective of this study was to compare cortical perfusion by SPECT using 123 I-IMP between Parkinson's disease patients with dementia and those without dementia and to investigate the correlation between dementia in Parkinson's disease and brain perfusion in various areas. Fifty-two cases of Parkinson's disease and 10 control cases were studied. The Parkinson's disease with dementia group included 30 cases and the Parkinson's disease without dementia group included 22 cases. By multiple logistic regression method, we demonstrated significant hypoperfusion in the occipital cortex in Parkinson's disease with dementia. The cause of dementia in Parkinson's disease may vary. We demonstrated that occipital hypoperfusion was closely correlated to dementia in Parkinson's disease compared to frontal, parietal and temporal perfusion. (author)

  10. Comparing Clinical Profiles in Alzheimer's Disease and Parkinson's Disease Dementia

    Directory of Open Access Journals (Sweden)

    Martin R. Farlow

    2013-09-01

    Full Text Available Background: Greater understanding of differences in baseline impairment and disease progression in patients with Alzheimer's disease (AD and Parkinson's disease dementia (PDD may improve the interpretation of drug effects and the design of future studies. Methods: This was a retrospective analysis of three randomized, double-blind rivastigmine databases (one in PDD, two in AD. Impairment on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog, Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL scale, 10-item Neuropsychiatric Inventory (NPI-10 and the ADCS-Clinical Global Impression of Change (CGIC was compared [standardized difference (Cohen's d, similar if Results: Patients with AD or PDD had similar levels of impairment on the ADAS-cog and NPI-10. Scores on the ADCS-ADL scale (standardized difference = 0.47 and the ADAS-cog memory domain (total, 0.33; items, 0.10-0.58 were higher in AD; PDD patients were more impaired in the language (0.23 and praxis (0.34 domains. AD patients receiving placebo showed greater deterioration on the ADAS-cog (0.14 and improvement on the NPI-10 (0.11 compared with patients with PDD. Conclusion: Differing patterns of impairment occur in AD and PDD.

  11. Comparing clinical profiles in Alzheimer's disease and Parkinson's disease dementia.

    Science.gov (United States)

    Farlow, Martin R; Schmitt, Frederick; Aarsland, Dag; Grossberg, George T; Somogyi, Monique; Meng, Xiangyi

    2013-01-01

    Greater understanding of differences in baseline impairment and disease progression in patients with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) may improve the interpretation of drug effects and the design of future studies. This was a retrospective analysis of three randomized, double-blind rivastigmine databases (one in PDD, two in AD). Impairment on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale, 10-item Neuropsychiatric Inventory (NPI-10) and the ADCS-Clinical Global Impression of Change (CGIC) was compared [standardized difference (Cohen's d), similar if <0.1]. Patients with AD or PDD had similar levels of impairment on the ADAS-cog and NPI-10. Scores on the ADCS-ADL scale (standardized difference = 0.47) and the ADAS-cog memory domain (total, 0.33; items, 0.10-0.58) were higher in AD; PDD patients were more impaired in the language (0.23) and praxis (0.34) domains. AD patients receiving placebo showed greater deterioration on the ADAS-cog (0.14) and improvement on the NPI-10 (0.11) compared with patients with PDD. Differing patterns of impairment occur in AD and PDD.

  12. Effects of Cholinesterase Inhibitors in Parkinson's Disease Dementia : A Review of Clinical Data

    NARCIS (Netherlands)

    van Laar, Teus; De Deyn, Peter Paul; Aarsland, Dag; Barone, Paolo; Galvin, James E.

    2011-01-01

    Aims: Cognitive impairment and dementia are common features of Parkinson's disease (PD). Patients with Parkinson's disease dementia (PDD) often have significant cholinergic defects, which may be treated with cholinesterase inhibitors (ChEIs). The objective of this review was to consider available

  13. Pleiotropic Effects of Variants in Dementia Genes in Parkinson Disease

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    Laura Ibanez

    2018-04-01

    Full Text Available Background: The prevalence of dementia in Parkinson disease (PD increases dramatically with advancing age, approaching 80% in patients who survive 20 years with the disease. Increasing evidence suggests clinical, pathological and genetic overlap between Alzheimer disease, dementia with Lewy bodies and frontotemporal dementia with PD. However, the contribution of the dementia-causing genes to PD risk, cognitive impairment and dementia in PD is not fully established.Objective: To assess the contribution of coding variants in Mendelian dementia-causing genes on the risk of developing PD and the effect on cognitive performance of PD patients.Methods: We analyzed the coding regions of the amyloid-beta precursor protein (APP, Presenilin 1 and 2 (PSEN1, PSEN2, and Granulin (GRN genes from 1,374 PD cases and 973 controls using pooled-DNA targeted sequence, human exome-chip and whole-exome sequencing (WES data by single variant and gene base (SKAT-O and burden tests analyses. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE or the Montreal Cognitive Assessment (MoCA. The effect of coding variants in dementia-causing genes on cognitive performance was tested by multiple regression analysis adjusting for gender, disease duration, age at dementia assessment, study site and APOE carrier status.Results: Known AD pathogenic mutations in the PSEN1 (p.A79V and PSEN2 (p.V148I genes were found in 0.3% of all PD patients. There was a significant burden of rare, likely damaging variants in the GRN and PSEN1 genes in PD patients when compared with frequencies in the European population from the ExAC database. Multiple regression analysis revealed that PD patients carrying rare variants in the APP, PSEN1, PSEN2, and GRN genes exhibit lower cognitive tests scores than non-carrier PD patients (p = 2.0 × 10−4, independent of age at PD diagnosis, age at evaluation, APOE status or recruitment site.Conclusions: Pathogenic mutations in

  14. Genetic architecture of sporadic frontotemporal dementia and overlap with Alzheimer's and Parkinson's diseases

    DEFF Research Database (Denmark)

    Ferrari, Raffaele; Wang, Yunpeng; Vandrovcova, Jana

    2017-01-01

    BACKGROUND: Clinical, pathological and genetic overlap between sporadic frontotemporal dementia (FTD), Alzheimer's disease (AD) and Parkinson's disease (PD) has been suggested; however, the relationship between these disorders is still not well understood. Here we evaluated genetic overlap between...

  15. Phenomenology and management of cognitive and behavioral disorders in Parkinson's disease. Rise and logic of dementia in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Papageorgiou Sokratis

    2006-08-01

    Full Text Available Abstract An overview of studies on the issue of dementia in Parkinson's disease shows that, over time, there has been an evolution in the perception of the magnitude of the problem and of its nature. Dementia seems today to be part of the disease. This change in the understanding of the disease can be accounted for by various methodological problems and by difficulties, on one hand, in the definition of dementia and its differentiation from other conditions, and, on the other hand, in the diagnosis of the disease itself in individual cases. Optimal therapeutic strategies are also examined, either based on cholinesterase inhibitors or antiparkinsonian drugs and symptomatic measures.

  16. I-123 IMP SPECT in Parkinson's disease; In relation to the presence or absence of dementia

    Energy Technology Data Exchange (ETDEWEB)

    Kawabata, Keita; Tachibana, Kyudai; Sugita, Minoru [Hyogo Medical Coll., Nishinomiya (Japan)

    1990-12-01

    To examine semiquantitatively regional cerebral blood flow, SPECT with N-isopropyl-p-(I-123)iodoamphetamine (I-123 IMP) was undertaken in 17 patients with Parkinson's disease. Seven patients with Alzheimer's disease and 9 senile control subjects were also imaged for comparison. Both the Parkinson's disease group and the Alzheimer's disease group had a decreased uptake of I-123 IMP in the frontal lobe, in comparison with the control group. A remarkably decreased uptake was seen in the lateral and parietal lobes in the group of Parkinson's disease associated with dementia, as well as in the Alzheimer's disease group. A significantly decreased uptake was observed in the frontal lobe, lateral lobe, thalamus, and basal ganglia in the Parkinson's disease group, irrespective of the presence or absence of dementia. For Parkinson's disease associated with dementia, there was much more significant decrease in I-123 IMP uptake. The pattern of regional cerebral blood flow in the Alzheimer's disease group was analogous to that in the Parkinson's disease group associated with dementia. This supports the hypothesis that Alzheimer's disease may be somewhat involved in the occurrence of dementia for Parkinson's disease. (N.K.).

  17. Comparison with Parkinson's disease and Parkinsonism in dementia with lewy bodies

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2002-01-01

    Dementia with lewy bodies (DLB) is recognized as a common cause of dementia in elderly people. It is characterized by Parkinsonism as well as fluctuation cognition and visual hallucination. It is not easy to differentiated DLB with Parkinsonism from Parkinson's disease (PD). We compared clinical features and I-123 IPT SPECT findings between two groups. Ten probable DLB patients and 15 PD patients were included. They were all matched for age (66.9±8.5) vs 65.8±8.5), education period (9.8±4.9 vs 9.1±4.5) and H and Y stage (2.9±0.8). Clinical features were scored. I-123 IPT SPECT were performed. The mean age of disease onset was seen more common in PD, but the severity of rigidity and bradykinesia was not significantly different. We found no significant difference of responsiveness to levodopa measured with decrement of UPDRS scores before and after treatment of levodopa. The mean disease duration reaching same H and Y stage was longer in PD than in DLB. The average K-MMSE score was significantly lower in DLB than in PD. The uptake ratio in the striatum in DLB was comparable to that in PD. In differentiating the two conditions the speed of disease progression and cognitive state were considered to be important. The level of dopamine transporter was not different between two diseases with same H and Y stage

  18. Depression and synaptic zinc regulation in Alzheimer disease, dementia with lewy bodies, and Parkinson disease dementia.

    Science.gov (United States)

    Whitfield, David R; Vallortigara, Julie; Alghamdi, Amani; Hortobágyi, Tibor; Ballard, Clive; Thomas, Alan J; O'Brien, John T; Aarsland, Dag; Francis, Paul T

    2015-02-01

    Depression is a common symptom in dementia with Lewy bodies (DLB), Parkinson disease dementia (PDD), and Alzheimer disease (AD), yet its molecular basis remains unclear and current antidepressants do not appear to be effective. Cerebral zinc has been implicated in depression and synaptic dysfunction. We investigated the relationship between synaptic zinc regulation (for which zinc transporter 3 [ZnT3] is responsible) and depression in a large clinicopathologic study. We examined brains from people with PDD (N = 29), DLB (N = 27), and AD (N = 15) and comparison subjects without depression or dementia (N = 24). Individuals were categorized according to the presence and severity of depression (on a scale of 0-3) based on standardized assessments during life (principally Neuropsychiatric Inventory). Western blotting was used to determine ZnT3 levels in Brodmann area 9 (BA9), and regression analysis was used to determine the relationship between ZnT3 and depression. Reductions in ZnT3 in BA9 were significantly associated with elevated depression scores in the study cohort (β = -0.351, df = 93, t = -3.318 p = 0.0004). This association remained when only individuals with DLB, PDD, and no dementia or depression were examined (β = -0.347, df = 78, t = -3.271, p = 0.002) or only individuals with AD and no dementia or depression were examined (β = -0.433, df = 37, t = -2.924, p = 0.006). Although decreased zinc levels have been implicated in the genesis of depression in animal models and in major depressive disorder in humans, this study provides the first evidence of a role for zinc in depression in people with dementia and highlights zinc metabolism as a therapeutic target. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. SCOPA-Cognition Cutoff Value for Detection of Parkinson's Disease Dementia

    NARCIS (Netherlands)

    Verbaan, Dagmar; Jeukens-Visser, Martine; Van Laar, Teus; van Rooden, Stephanie M.; Van Zwet, Erik W.; Marinus, Johan; van Hilten, Jacobus J.

    2011-01-01

    The SCOPA-Cognition is a reliable and valid test to evaluate cognitive functioning in Parkinson's disease and is widely used in clinical and research settings. Recently, the Movement Disorder Society introduced criteria for Parkinson's disease dementia. The objective of the present study was to use

  20. Episodic Memory in Alzheimer Disease, Frontotemporal Dementia, and Dementia With Lewy Bodies/Parkinson Disease Dementia: Disentangling Retrieval From Consolidation.

    Science.gov (United States)

    Economou, Alexandra; Routsis, Christopher; Papageorgiou, Sokratis G

    2016-01-01

    Differences in episodic memory performance in patients with Alzheimer disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB)/Parkinson disease with dementia (PDD) are inconsistent and task dependent. The inconsistencies may be attributed to the different tasks drawing on different memory processes. Few studies have examined episodic memory impairment in the above groups using memory tests that facilitate encoding, to distinguish memory deficits due to impairment of specific processes. We examined the memory performance of 106 AD patients, 51 FTD patients, 26 DLB/PDD patients, and 37 controls using the Five-Words Test, a 5-item memory test that facilitates encoding. The patient groups did not differ in modified Mini Mental State Examination scores. AD patients scored lowest on the Five-Words Test overall, and showed the greatest reduction from immediate total recall to delayed free recall relative to the other 2 groups, consistent with a predominantly consolidation deficit. DLB/PDD patients showed the largest improvement from delayed free to delayed total recall relative to the other 2 groups, consistent with a predominantly retrieval deficit. Deficits in both consolidation and retrieval underlie the memory impairment of the patients, to different extents, and contribute to the theoretical understanding of the nature of the memory impairment of the patient groups.

  1. Demência na doença de Parkinson Dementia in Parkinsn's disease

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    Leonardo Caixeta

    2008-12-01

    Full Text Available OBJETIVO: A presença de síndromes psiquiátricas, incluindo demência, associada a distúrbios motores tem sido cada vez mais reconhecida durante a última década, com destaque para o prejuízo cognitivo na doença de Parkinson idiopática. Esta revisão enfocará a epidemiologia, os aspectos clínicos, diagnósticos diferenciais, mecanismos subjacentes e o tratamento da demência na doença de Parkinson idiopática. MÉTODO: Uma revisão da literatura dos estudos que investigaram a demência da doença de Parkinson idiopática foi realizada. RESULTADOS: A demência é altamente prevalente na doença de Parkinson idiopática. O protótipo da demência na doença de Parkinson idiopática consiste numa síndrome disexecutiva com comprometimento da atenção, funções executivas e, secundariamente, a memória. Neuroquimicamente, o déficit mais significativo parece ser colinérgico; a demência se correlaciona com a presença de corpos de Lewy corticais e límbicos. Evidências preliminares sugerem que os anticolinesterásicos podem ser efetivos na demência da doença de Parkinson idiopática. CONCLUSÕES: O prejuízo cognitivo na doença de Parkinson idiopática é associado a características próprias e é responsável por importante incapacidade nestes pacientes.OBJECTIVE: The concomitant presence of psychiatric syndromes, including dementia, with motor disturbance has been increasingly recognized during the last decade, with emphasis on cognitive impairment in idiopatic Parkinson's disease. This review will focus on the epidemiology, clinical aspects, differential diagnosis, underlying mechanisms and treatment of dementia in Parkinson's disease. METHOD: A literature review of the studies that investigated the dementia in Parkinson's disease was performed. RESULTS: Dementia is highly prevalent in Parkinson's disease. The prototype of dementia in Parkinson's disease is a dysexecutive syndrome with impaired attention, executive functions and

  2. Parkinson's Disease Videos

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    Full Text Available ... Briefings: Dealing with Dementia in PD Expert Briefings: Anxiety in Parkinson's Disease Expert Briefings: Nutrition and Parkinson's ... and Tomorrow Expert Briefings: A Closer Look at Anxiety and Depression in Parkinson's Disease Expert Briefings: Driving ...

  3. Parkinson's Disease Videos

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    Full Text Available ... Gene and Cell Therapies Expert Briefings: Dealing with Dementia in PD Expert Briefings: Anxiety in Parkinson's Disease ... Lobo: Música en vivo con Lobo! Dealing with Dementia Hallucinations and Parkinson's with Dr. Friedman CareMAP: Putting ...

  4. Regional cerebral glucose metabolism in patients with Parkinson's disease with or without dementia

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, Masayuki; Ichiya, Yuichi; Hosokawa, Shinichi; Otsuka, Makoto; Kuwabara, Yasuo; Fukumura, Toshimitsu; Kato, Motohiro; Goto, Ikuo; Masuda, Kouji [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1992-11-01

    By means of positron emission tomography, the cerebral glucose metabolism in 5 patients with Parkinson's disease with dementia was compared with that in 9 patients without dementia, and that in 5 normal volunteers. The metabolic rates for glucose were measured by placing one hundred regions of interest. In the demented patients, cerebral glucose metabolism was diffusely decreased compared with that of the non-demented patients and the normal controls. The most significant decrease in glucose metabolism was observed in the angular gyrus (49.7% of the normal controls). The glucose metabolism in the cingulate, pre- and postcentral, occipital and subcortical regions was relatively spared (62.1 to 85.5% of the normal controls). In the patients without dementia, the glucose metabolism in each region was not significantly different from that in the normal controls. These results suggest that diffuse glucose hypometabolism in the cerebral cortex may correlate with that of patients with Parkinson's disease with dementia. (author).

  5. Cognitive screening in Parkinson's disease: Comparison of the Parkinson Neuropsychometric Dementia Assessment (PANDA) with 3 other short scales.

    Science.gov (United States)

    Gasser, A-I; Calabrese, P; Kalbe, E; Kessler, J; Rossier, P

    2016-02-01

    Cognitive screening is crucial in Parkinson's disease (PD). However, there is still a lack of short tools in French. In this study, we aimed to compare the Parkinson Neuropsychometric Dementia Assessment (PANDA) with the Mini Mental Parkinson (MMP), the Mini Mental State Examination (MMSE) and the Clock Test in French-speaking patients. We also aimed to propose cut-off scores for cognitive impairment and dementia for the French language version of the PANDA. Fifty-one patients with PD took the PANDA, the MMSE, the MMP, and the Clock Test. They also underwent extensive neuropsychological testing by a neuropsychologist who was blinded to the above-mentioned screening test results. Patients were classified as either having normal cognition (n=15), mild cognitive impairment (n=20) or dementia (n=16). When compared with the three other screening tools, the PANDA exhibited the highest area under the curve (AUC) for both cognitive disorders and dementia. Using the cut-off scores proposed for the German version, the PANDA had 94% specificity and 100% sensitivity for dementia and 100% and 72%, respectively for cognitive disorders. In our study, the PANDA exhibited a higher discriminative power than the three other tests in detecting cognitive disorders and dementia. In PD patients, the PANDA should thus be considered for the detection of cognitive impairment in routine clinical practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Memantine improves attention and episodic memory in Parkinson's disease dementia and dementia with Lewy bodies.

    Science.gov (United States)

    Wesnes, Keith A; Aarsland, Dag; Ballard, Clive; Londos, Elisabet

    2015-01-01

    In both dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), attentional dysfunction is a core clinical feature together with disrupted episodic memory. This study evaluated the cognitive effects of memantine in DLB and PDD using automated tests of attention and episodic memory. A randomised double-blind, placebo-controlled, 24-week three centre trial of memantine (20 mg/day) was conducted in which tests of attention (simple and choice reaction time) and word recognition (immediate and delayed) from the CDR System were administered prior to dosing and again at 12 and 24 weeks. Although other results from this study have been published, the data from the CDR System tests were not included and are presented here for the first time. Data were available for 51 patients (21 DLB and 30 PDD). In both populations, memantine produced statistically significant medium to large effect sized improvements to choice reaction time, immediate and delayed word recognition. These are the first substantial improvements on cognitive tests of attention and episodic recognition memory identified with memantine in either DLB or PDD. Copyright © 2014 John Wiley & Sons, Ltd.

  7. The Brainstem Pathologies of Parkinson's Disease and Dementia with Lewy Bodies

    NARCIS (Netherlands)

    Seidel, Kay; Mahlke, Josefine; Siswanto, Sonny; Krueger, Reijko; Heinsen, Helmut; Auburger, Georg; Bouzrou, Mohamed; Grinberg, Lea T.; Wicht, Helmut; Korf, Horst-Werner; den Dunnen, Wilfred; Rueb, Udo

    Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are among the human synucleinopathies, which show alpha-synuclein immunoreactive neuronal and/or glial aggregations and progressive neuronal loss in selected brain regions (eg, substantia nigra, ventral tegmental area, pedunculopontine

  8. Metabolic syndrome and dementia associated with Parkinson's disease: impact of age and hypertension

    Directory of Open Access Journals (Sweden)

    Arthur Oscar Schelp

    2012-02-01

    Full Text Available OBJECTIVE: To determine correlations between age and metabolic disorders in Parkinson's disease (PD patients. METHODS: This observational cross-sectional study included brief tests for dementia and the Mattis test. Signals of metabolic syndrome were evaluated. RESULTS: There was no significant effect from the presence of hypertension (OR=2.36 for patients under 65 years old and OR=0.64 for patients over 65, diabetes or hypercholesterolemia regarding occurrences of dementia associated with PD (24% of the patients. The study demonstrated that each year of age increased the estimated risk of dementia in PD patients by 9% (OR=1.09; 95%CI: 1.01-1.17. CONCLUSION: There was no evidence to correlate the presence of metabolic syndrome with the risk of dementia that was associated with PD. The study confirmed that dementia in PD is age dependent and not related to disease duration.

  9. Rivastigmine in Alzheimer's disease and Parkinson's disease dementia: an ADAS-cog factor analysis.

    Science.gov (United States)

    Weintraub, Daniel; Somogyi, Monique; Meng, Xiangyi

    2011-09-01

    Rivastigmine treatment is associated with significant improvements on the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) in patients with mild-to-moderate Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Both AD and PDD are purported to have different profiles of cognitive impairment, which may respond differentially to rivastigmine treatment. This was a retrospective analysis of 3 randomized, double-blind, rivastigmine trial databases (Investigation of transDermal Exelon in ALzheimer's disease [IDEAL; AD], EXelon in PaRkinson's disEaSe dementia Study [EXPRESS; PDD], and Alzheimer's Disease with ENA 713 [ADENA; AD]). Factor analyses of the 11 baseline ADAS-cog items derived the same factors in the 2 diseases, that is, "memory" and "language". Rivastigmine-treated AD and PDD patients showed significant improvements (P < .0001 versus placebo) on both factors. For both AD and PDD, rivastigmine had a numerically greater effect on memory than language. Treatment effect sizes were numerically greater in PDD compared with AD. Rivastigmine treatment is associated with improvement in memory and language in AD and PDD. The numerically greater response in PDD is consistent with greater cholinergic deficits in this disease state.

  10. Clinical utility of FDG PET in Parkinson's disease and atypical parkinsonism associated with dementia.

    Science.gov (United States)

    Walker, Zuzana; Gandolfo, Federica; Orini, Stefania; Garibotto, Valentina; Agosta, Federica; Arbizu, Javier; Bouwman, Femke; Drzezga, Alexander; Nestor, Peter; Boccardi, Marina; Altomare, Daniele; Festari, Cristina; Nobili, Flavio

    2018-05-19

    There are no comprehensive guidelines for the use of FDG PET in the following three clinical scenarios: (1) diagnostic work-up of patients with idiopathic Parkinson's disease (PD) at risk of future cognitive decline, (2) discriminating idiopathic PD from progressive supranuclear palsy, and (3) identifying the underlying neuropathology in corticobasal syndrome. We therefore performed three literature searches and evaluated the selected studies for quality of design, risk of bias, inconsistency, imprecision, indirectness and effect size. Critical outcomes were the sensitivity, specificity, accuracy, positive/negative predictive value, area under the receiving operating characteristic curve, and positive/negative likelihood ratio of FDG PET in detecting the target condition. Using the Delphi method, a panel of seven experts voted for or against the use of FDG PET based on published evidence and expert opinion. Of 91 studies selected from the three literature searches, only four included an adequate quantitative assessment of the performance of FDG PET. The majority of studies lacked robust methodology due to lack of critical outcomes, inadequate gold standard and no head-to-head comparison with an appropriate reference standard. The panel recommended the use of FDG PET for all three clinical scenarios based on nonquantitative evidence of clinical utility. Despite widespread use of FDG PET in clinical practice and extensive research, there is still very limited good quality evidence for the use of FDG PET. However, in the opinion of the majority of the panellists, FDG PET is a clinically useful imaging biomarker for idiopathic PD and atypical parkinsonism associated with dementia.

  11. Parkinson's Disease Videos

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    Full Text Available ... CareMAP: Dealing with Dementia OHSU - Parkinson's Disease: Pharmacological Management of Depression, ... Care or Team Approach Important? What Is the Relationship Between Depression and ...

  12. Brain Connectivity Alterations Are Associated with the Development of Dementia in Parkinson's Disease.

    Science.gov (United States)

    Bertrand, Josie-Anne; McIntosh, Anthony R; Postuma, Ronald B; Kovacevic, Natasha; Latreille, Véronique; Panisset, Michel; Chouinard, Sylvain; Gagnon, Jean-François

    2016-04-01

    Dementia affects a high proportion of Parkinson's disease (PD) patients and poses a burden on caregivers and healthcare services. Electroencephalography (EEG) is a common nonevasive and nonexpensive technique that can easily be used in clinical settings to identify brain functional abnormalities. Only few studies had identified EEG abnormalities that can predict PD patients at higher risk for dementia. Brain connectivity EEG measures, such as multiscale entropy (MSE) and phase-locking value (PLV) analyses, may be more informative and sensitive to brain alterations leading to dementia than previously used methods. This study followed 62 dementia-free PD patients for a mean of 3.4 years to identify cerebral alterations that are associated with dementia. Baseline resting state EEG of patients who developed dementia (N = 18) was compared to those of patients who remained dementia-free (N = 44) and of 37 healthy subjects. MSE and PLV analyses were performed. Partial least squares statistical analysis revealed group differences associated with the development of dementia. Patients who developed dementia showed higher signal complexity and lower PLVs in low frequencies (mainly in delta frequency) than patients who remained dementia-free and controls. Conversely, both patient groups showed lower signal variability and higher PLVs in high frequencies (mainly in gamma frequency) compared to controls, with the strongest effect in patients who developed dementia. These findings suggest that specific disruptions of brain communication can be measured before PD patients develop dementia, providing a new potential marker to identify patients at highest risk of developing dementia and who are the best candidates for neuroprotective trials.

  13. Parkinson's Disease Videos

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    Full Text Available ... Gene and Cell Therapies Expert Briefings: Dealing with Dementia in PD Expert Briefings: Anxiety in Parkinson's Disease ... 1 What Is Patient-Centered Care? Dealing with Dementia CareMAP: Life Beyond This Life What Are Some ...

  14. Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson's Disease Dementia and Dementia with Lewy Bodies.

    Science.gov (United States)

    Watermeyer, Tamlyn J; Hindle, John V; Roberts, Julie; Lawrence, Catherine L; Martyr, Anthony; Lloyd-Williams, Huw; Brand, Andrew; Gutting, Petra; Hoare, Zoe; Edwards, Rhiannon Tudor; Clare, Linda

    2016-01-01

    Alongside the physical symptoms associated with Parkinson's disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual's needs and abilities. Fundamental to this therapy is a person's capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson's disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants' goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered with ISRCTN16584442 (DOI 10.1186/ISRCTN16584442 13/04/2015).

  15. Astrocyte dysfunction following molybdenum-associated purine loading could initiate Parkinson's disease with dementia.

    Science.gov (United States)

    Bourke, Christopher A

    2018-01-01

    Sporadic or idiopathic Parkinson's disease is a movement disorder with a worldwide distribution, a long pre-clinical latent period and a frequent association with dementia. The combination of molybdenum deficiency and purine ingestion could explain the movement disorder, the distribution, the latent period and the dementia association. Recent studies in sheep have shown that molybdenum deficiency enables some dietary purines to accumulate in the central nervous system. This causes astrocyte dysfunction, altered neuromodulation and eventually irreversible central nervous system disease. Humans and sheep share the ability to salvage purines and this ability places humans at risk when they ingest xanthosine, inosine, adenosine and guanosine. Adenosine ingestion in molybdenum-deficient humans will lead to adenosine loading and potentially a disturbance to the A2a adenosine receptors in the nigro-striatum. This could result in Parkinson's disease. Guanosine ingestion in molybdenum-deficient humans will lead to guanosine loading and potentially a disturbance to the guanosine receptors in the hippocampus, amygdala and ventral striatum. This could result in dementia. The molybdenum content of the average daily diet in the United States is 0.07 ppm and in the United Kingdom 0.04 ppm. Central nervous system disease occurs in sheep at <0.04 ppm. Consistent with the role proposed for molybdenum deficiency in Parkinson's disease is the observation that affected individuals have elevated sulfur amino acid levels, depressed sulfate levels, and depressed uric acid levels. Likewise the geographical distribution of Parkinson's dementia complex on Guam corresponds with the distribution of molybdenum-deficient soils hence molybdenum-deficient food gardens on that island.

  16. Sexuality in patients with Parkinson's disease, Alzheimer's disease, and other dementias.

    Science.gov (United States)

    Bronner, Gila; Aharon-Peretz, Judith; Hassin-Baer, Sharon

    2015-01-01

    Sexual dysfunction (SD) is common among patients with Parkinson's disease (PD), Alzheimer's disease (AD), and other dementias. Sexual functioning and well-being of patients with PD and their partners are affected by many factors, including motor disabilities, non-motor symptoms (e.g., autonomic dysfunction, sleep disturbances, mood disorders, cognitive abnormalities, pain, and sensory disorders), medication effects, and relationship issues. The common sexual problems are decreased desire, erectile dysfunction, difficulties in reaching orgasm, and sexual dissatisfaction. Hypersexuality is one of a broad range of impulse control disorders reported in PD, attributed to antiparkinsonian therapy, mainly dopamine agonists. Involvement of a multidisciplinary team may enable a significant management of hypersexuality. Data on SD in demented patients are scarce, mainly reporting reduced frequency of sex and erectile dysfunction. Treatment of SD is advised at an early stage. Behavioral problems, including inappropriate sexual behavior (ISB), are distressing for patients and their caregivers and may reflect the prevailing behavior accompanying dementia (disinhibition or apathy associated with hyposexuality). The neurobiologic basis of ISB is still only vaguely understood but assessment and intervention are recommended as soon as ISB is suspected. Management of ISB in dementia demands a thorough evaluation and understanding of the behavior, and can be treated by non-pharmacologic and pharmacologic interventions. © 2015 Elsevier B.V. All rights reserved.

  17. [The prevalence of Parkinson's disease, associated dementia, and depression in Dresden].

    Science.gov (United States)

    Riedel, O; Schneider, C; Klotsche, J; Reichmann, H; Storch, A; Wittchen, H-U

    2013-02-01

    Parkinson's disease (PD) is frequently compounded by dementia and depression. Yet local total estimates on the prevalence of PD with dementia/depression are still lacking. These are socioeconomically important, especially for the eastern federal states in Germany due to the demographic structures. We conducted a two-staged total estimation in the area of Dresden. First, all local office-based neurologists, hospitals and retirement homes were asked to list their patients/residents with PD on a single study day. Then a random sample of patients/home residents was neuropsycholoigcally examined, including the Mini-mental-state exam and the Montgomery-Asberg Depression rating scale. Dementia was diagnosed according to DSM-IV criteria. Overall, 886 PD cases (95 % CI: 809 - 926) were estimated, of which 252 (95 % CI: 226 - 279) suffered from dementia and 216 (95 % CI: 191 - 242) from depression. Dementia rates increased by age with 13.8 % (≤ 65 years) to 40.2 % (≥ 76 years). Depression rates ranged from 23.3 % to 28.0 %. Overall, 20.6 % of all ambulatory treated PD patients and 85.7 % of all home residents with PD had dementia. The prevalence of PD in Dresden dovetails with previous reported estimates. Dementia and depression are frequent complications in outpatients as well as home residents with PD. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Cortical serotonin-S2 receptor binding in Lewy body dementia, Alzheimer's and Parkinson's diseases.

    Science.gov (United States)

    Cheng, A V; Ferrier, I N; Morris, C M; Jabeen, S; Sahgal, A; McKeith, I G; Edwardson, J A; Perry, R H; Perry, E K

    1991-11-01

    The binding of the selective 5-HT2 antagonist [3H]ketanserin has been investigated in the temporal cortex of patients with Alzheimer's disease (SDAT), Parkinson's disease (PD), senile dementia of Lewy body type (SDLT) and neuropathologically normal subjects (control). 5-HT2 binding was reduced in SDAT, PD with dementia and SDLT. SDAT showed a 5-HT2 receptor deficit across most of the cortical layers. A significant decrease in 5-HT2 binding in the deep cortical layers was found in those SDLT cases without hallucinations. SDLT cases with hallucinations only showed a deficit in one upper layer. There was a significant difference in cortical layers III and V between SDLT without hallucinations and SDLT with hallucinations. The results confirm an abnormality of serotonin binding in various forms of dementia and suggest that preservation of 5-HT2 receptor in the temporal cortex may differentiate hallucinating from non-hallucinating cases of SDLT.

  19. A rivastigmine patch for the treatment of Alzheimer's disease and Parkinson's disease dementia.

    Science.gov (United States)

    Cummings, Jeffrey; Winblad, Bengt

    2007-11-01

    Rivastigmine patch is the first transdermal treatment to be approved for Alzheimer's disease (AD) and Parkinson's disease dementia in the USA and for AD in Europe. It provides smooth, continuous drug delivery, and has the potential to maintain rivastigmine concentrations within an optimal therapeutic window while avoiding the peaks and troughs associated with oral drug delivery. The target dose, rivastigmine 9.5 mg/24 h patch (a 10 cm(2) patch), is given once daily and requires a simple one-step dose titration to the therapeutic dose. In a 24-week study in 1195 AD patients, the rivastigmine 9.5 mg/24 h patch provided similar efficacy to the highest dose range of capsules, with approximately three-times fewer reports of nausea and vomiting. Patients in the 9.5 mg/24 h patch and 12 mg/day capsule groups evidenced significant improvements versus placebo on both primary outcome measures: the Alzheimer's Disease Assessment Scale-Cognitive subscale; and Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change; in addition to the following secondary outcome measures: Alzheimer's Disease Cooperative Study-Activities of Daily Living scale; Mini-Mental State Examination; and Trail Making Test Part A for assessment of attention, visual tracking and motor processing speed. Treatment differences on the Neuropsychiatric Inventory and Ten Point Clock-drawing Test did not reach statistical significance in this study. The patch may be the optimal way to treat dementia patients with rivastigmine.

  20. The impact of autonomic dysfunction on survival in patients with dementia with Lewy bodies and Parkinson's disease with dementia.

    Directory of Open Access Journals (Sweden)

    Kajsa Stubendorff

    Full Text Available INTRODUCTION: Autonomic dysfunction is a well-known feature in neurodegenerative dementias, especially common in α-synucleinopathies like dementia with Lewy bodies and Parkinson's disease with dementia. The most common symptoms are orthostatic hypotension, incontinence and constipation, but its relevance in clinical practice is poorly understood. There are no earlier studies addressing the influence of autonomic dysfunction on clinical course and survival. The aim of this study was to investigate the frequency of the three most common features of autonomic dysfunction and analyze how it affects survival. METHODS: Thirty patients with dementia with Lewy bodies and Parkinson's disease with dementia were included in this prospective, longitudinal follow-up study. Presence of incontinence and constipation was recorded at baseline. Blood pressure was measured at baseline, after 3 months and after 6 months according to standardized procedures, with 5 measurements during 10 minutes after rising. Orthostatic hypotension was defined using consensus definitions and persistent orthostatic hypotension was defined as 5 or more measurements with orthostatic hypotension. Difference in survival was analyzed 36 months after baseline. RESULTS: There was a high frequency of persistent orthostatic blood pressure (50%, constipation (30% and incontinence (30%. Patients with persistent orthostatic hypotension had a significantly shorter survival compared to those with no or non-persistent orthostatic hypotension (Log rank x(2 = 4.47, p = 0.034. Patients with constipation and/or urinary incontinence, in addition to persistent orthostatic hypotension, had a poorer prognosis compared to those with isolated persistent orthostatic hypotension or no orthostatic hypotension (Log rank x(2 = 6.370, p = 0.041. DISCUSSION: According to our findings, the identification of autonomic dysfunction seems to be of great importance in clinical practice, not only to

  1. Apathy in patients with Parkinson disease without dementia or depression: a PET study.

    Science.gov (United States)

    Robert, Gabriel; Le Jeune, Florence; Lozachmeur, Clément; Drapier, Sophie; Dondaine, Thibault; Péron, Julie; Travers, David; Sauleau, Paul; Millet, Bruno; Vérin, Marc; Drapier, Dominique

    2012-09-11

    We sought to identify apathy metabolic bases in Parkinson disease (PD). A total of 45 patients with PD who were not clinically depressed (Montgomery-Åsberg Depression Rating Scale [MADRS] dementia (Mattis Dementia Rating Scale [MDRS] >130) were assessed with the Apathy Evaluation Scale (AES) and underwent a resting-state F-18 fluorodeoxyglucose PET (FDG-PET) scan. A motor assessment comprising the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) was conducted and total levodopa equivalent daily dose (LEDD) was calculated. Imaging data were analyzed with statistical parametric mapping. Age, LEDD, and MDRS scores were introduced as covariates. Positive correlations were observed between the AES score and cerebral metabolism in the right inferior frontal gyrus (Brodmann area [BA] 47), right middle frontal gyrus (BA 10), right cuneus (BA 18), and right anterior insula (BA 13). Negative correlations were observed between the AES score and cerebellar metabolism in the semilunar lobules bilaterally, within the posterior lobe. Using an AES score equal to or above 42 to define clinical apathy, prevalence in our patient group was 17.8%. The AES score was negatively correlated with the MDRS score and positively correlated with the "retardation" subscore of the MADRS. It was not correlated with either UPDRS III or LEDD. Results indicate that the frontal, temporal, and cerebellar areas known to be involved in reward, emotion, and cognition are also implicated in apathy in patients with PD without dementia or depression. Their roles in the etiopathology of apathy are discussed.

  2. Italian version of the Parkinson Neuropsychometric Dementia Assessment (PANDA): a useful instrument to detect cognitive impairments in Parkinson's Disease.

    Science.gov (United States)

    Pignatti, Riccardo; Bertella, Laura; Scarpina, Federica; Mauro, Alessandro; Portolani, Elisa; Calabrese, Pasquale

    2014-01-01

    Parkinson's disease (PD) is frequently characterized by cognitive and affective dysfunctions. The "Parkinson Neuropsychometric Dementia Assessment" (PANDA) is a screening tool designed for the early detection of mild cognitive impairment as well as dementia in PD. The PANDA is already validated in German and in French. The aim of the present work was to provide normative data for the Italian-speaking population, Swiss regions included; moreover, the effectiveness of the PANDA compared to the Mini Mental State Examination (MMSE) was tested. One-hundred and eleven PD patients with and without cognitive impairment and one-hundred and three matched healthy subjects participated at this study; all patients underwent an extensive neuropsychological evaluation. A PANDA total score of 13 appeared to be the most fitting cut-off with a sensitivity of 96.6% and a specificity of 82.2%; with the MMSE, the same value of sensitivity but with a specificity of 72,4% was reached only by adopting a cut-off of 28. Moreover, a PANDA range of 13-17 appeared to be suggestive for possible cognitive disturbance. The present work provides evidence for the effectiveness of the PANDA in evaluating cognitive deficits also in PD Italian-speaking patients, even when their pathological degree is still initial or very mild.

  3. Pareidolia in Parkinson's disease without dementia: A positron emission tomography study.

    Science.gov (United States)

    Uchiyama, Makoto; Nishio, Yoshiyuki; Yokoi, Kayoko; Hosokai, Yoshiyuki; Takeda, Atsushi; Mori, Etsuro

    2015-06-01

    Pareidolia, which is a particular type of complex visual illusion, has been reported to be a phenomenon analogous to visual hallucinations in patients with dementia with Lewy bodies. However, whether pareidolia is observed in Parkinson's disease (PD) or whether there are common underlying mechanisms of these two types of visual misperceptions remains to be elucidated. A test to evoke pareidolia, the Pareidolia test, was administered to 53 patients with PD without dementia and 24 healthy controls. The regional cerebral metabolic rate of glucose was measured using 18F-fluorodeoxyglucose positron emission tomography in the PD patients. PD patients without dementia produced a greater number of pareidolic illusions compared with the controls. Pareidolia was observed in all of the patients having visual hallucinations as well as a subset of those without visual hallucinations. The number of pareidolic illusions was correlated with hypometabolism in the bilateral temporal, parietal and occipital cortices. The index of visual hallucinations was correlated with hypometabolism in the left parietal cortex. A region associated with both pareidolia and visual hallucinations was found in the left parietal lobe. Our study suggests that PD patients without dementia experience pareidolia more frequently than healthy controls and that posterior cortical dysfunction could be a common neural mechanism of pareidolia and visual hallucinations. Pareidolia could represent subclinical hallucinations or a predisposition to visual hallucinations in Lewy body disease. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Subcortical grey matter changes in untreated, early stage Parkinson's disease without dementia.

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    Lee, Hye Mi; Kwon, Kyum-Yil; Kim, Min-Jik; Jang, Ji-Wan; Suh, Sang-Il; Koh, Seong-Beom; Kim, Ji Hyun

    2014-06-01

    Previous MRI studies have investigated cortical or subcortical grey matter changes in patients with Parkinson's disease (PD), yielding inconsistent findings between the studies. We therefore sought to determine whether focal cortical or subcortical grey matter changes may be present from the early disease stage. We recruited 49 untreated, early stage PD patients without dementia and 53 control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetry and shape analysis were used to assess volume changes and shape deformation of the subcortical grey matter structures, respectively. Voxel-based morphometry showed neither reductions nor increases in grey matter volume in patients compared to controls. Compared to controls, PD patients had significant reductions in adjusted volumes of putamen, nucleus accumbens, and hippocampus (corrected p grey matter and clinical variables representing disease duration and severity. Our results suggest that untreated, early stage PD without dementia is associated with volume reduction and shape deformation of subcortical grey matter, but not with cortical grey matter reduction. Our findings of structural changes in the posterolateral putamen and ventromedial putamen/nucleus accumbens could provide neuroanatomical basis for the involvement of motor and limbic striatum, further implicating motor and non-motor symptoms in PD, respectively. Early hippocampal involvement might be related to the risk for developing dementia in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Parkinson's Disease Videos

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    Full Text Available ... Swallowing: Part 2 What Is the Relationship Between Depression and Parkinson's Disease? What Is Patient-Centered Care? Hallucinations and Delusions Dealing with Dementia CareMAP: Medicamentos ...

  6. Genetic factors influencing frontostriatal dysfunction and the development of dementia in Parkinson's disease

    Science.gov (United States)

    Huertas, Ismael; Jesús, Silvia; García-Gómez, Francisco Javier; Lojo, José Antonio; Bernal-Bernal, Inmaculada; Bonilla-Toribio, Marta; Martín-Rodriguez, Juan Francisco; García-Solís, David; Gómez-Garre, Pilar; Mir, Pablo

    2017-01-01

    The dual syndrome hypothesis for cognitive impairment in Parkinson's disease (PD) establishes a dichotomy between a frontrostriatal dopamine-mediated syndrome, which leads to executive deficits, and a posterior cortical syndrome, which leads to dementia. Certain genes have been linked to these syndromes although the exact contribution is still controversial. The study’s objective was to investigate the role of APOE, MAPT, COMT, SNCA and GBA genes in the dual syndromes. We genotyped APOE (rs429358 and rs7412), MAPT (rs9468), COMT (rs4680) and SNCA (rs356219) risk polymorphisms and sequenced GBA in a cohort of 298 PD patients. The degree of dopaminergic depletion was investigated with [123I]FP-CIT SPECTs and the presence of dementia was ascertained with a long-term review based on established criteria. The association between genetic and imaging parameters was studied with linear regression, and the relationship with dementia onset with Cox regression. We found that APOE2 allele (Pput = 0.002; Pcau = 0.01), the minor allele 'G' in SNCA polymorphism (Pput = 0.02; Pcau = 0.006) and GBA deleterious variants in (Pput = 0.01; Pcau = 0.001) had a detrimental effect on striatal [123I]FP-CIT uptake in PD. Conversely, Met/Met carriers in COMT polymorphism had increased caudate uptake (Pcau = 0.03). The development of dementia was influenced by APOE4 allele (HR = 1.90; P = 0.03) and GBA deleterious variants (HR = 2.44; P = 0.01). Finally, we observed no role of MAPT locus in any of the syndromes. As a conclusion, APOE2, SNCA, COMT and GBA influence frontostriatal dysfunction whereas APOE4 and GBA influence the development of dementia, suggesting a double-edged role of GBA. The dichotomy of the dual syndromes may be driven by a broad dichotomy in these genetic factors. PMID:28399184

  7. Genetic factors influencing frontostriatal dysfunction and the development of dementia in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Ismael Huertas

    Full Text Available The dual syndrome hypothesis for cognitive impairment in Parkinson's disease (PD establishes a dichotomy between a frontrostriatal dopamine-mediated syndrome, which leads to executive deficits, and a posterior cortical syndrome, which leads to dementia. Certain genes have been linked to these syndromes although the exact contribution is still controversial. The study's objective was to investigate the role of APOE, MAPT, COMT, SNCA and GBA genes in the dual syndromes. We genotyped APOE (rs429358 and rs7412, MAPT (rs9468, COMT (rs4680 and SNCA (rs356219 risk polymorphisms and sequenced GBA in a cohort of 298 PD patients. The degree of dopaminergic depletion was investigated with [123I]FP-CIT SPECTs and the presence of dementia was ascertained with a long-term review based on established criteria. The association between genetic and imaging parameters was studied with linear regression, and the relationship with dementia onset with Cox regression. We found that APOE2 allele (Pput = 0.002; Pcau = 0.01, the minor allele 'G' in SNCA polymorphism (Pput = 0.02; Pcau = 0.006 and GBA deleterious variants in (Pput = 0.01; Pcau = 0.001 had a detrimental effect on striatal [123I]FP-CIT uptake in PD. Conversely, Met/Met carriers in COMT polymorphism had increased caudate uptake (Pcau = 0.03. The development of dementia was influenced by APOE4 allele (HR = 1.90; P = 0.03 and GBA deleterious variants (HR = 2.44; P = 0.01. Finally, we observed no role of MAPT locus in any of the syndromes. As a conclusion, APOE2, SNCA, COMT and GBA influence frontostriatal dysfunction whereas APOE4 and GBA influence the development of dementia, suggesting a double-edged role of GBA. The dichotomy of the dual syndromes may be driven by a broad dichotomy in these genetic factors.

  8. Mild cognitive impairment as a risk factor for Parkinson's disease dementia.

    Science.gov (United States)

    Hoogland, Jeroen; Boel, Judith A; de Bie, Rob M A; Geskus, Ronald B; Schmand, Ben A; Dalrymple-Alford, John C; Marras, Connie; Adler, Charles H; Goldman, Jennifer G; Tröster, Alexander I; Burn, David J; Litvan, Irene; Geurtsen, Gert J

    2017-07-01

    The International Parkinson and Movement Disorder Society criteria for mild cognitive impairment in PD were recently formulated. The aim of this international study was to evaluate the predictive validity of the comprehensive (level II) version of these criteria by assessment of their contribution to the hazard of PD dementia. Individual patient data were selected from four separate studies on cognition in PD that provided information on demographics, motor examination, depression, neuropsychological examination suitable for application of level II criteria, and longitudinal follow-up for conversion to dementia. Survival analysis evaluated the predictive value of level II criteria for cognitive decline toward dementia as expressed by the relative hazard of dementia. A total of 467 patients were included. The analyses showed a clear contribution of impairment according to level II mild cognitive impairment criteria, age, and severity of PD motor symptoms to the hazard of dementia. There was a trend of increasing hazard of dementia with declining neuropsychological performance. This is the first large international study evaluating the predictive validity of level II mild cognitive impairment criteria for PD. The results showed a clear and unique contribution of classification according to level II criteria to the hazard of PD dementia. This finding supports their predictive validity and shows that they contribute important new information on the hazard of dementia, beyond known demographic and PD-specific factors of influence. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  9. Evaluating rivastigmine in mild-to-moderate Parkinson's disease dementia using ADAS-cog items.

    Science.gov (United States)

    Schmitt, Frederick A; Aarsland, Dag; Brønnick, Kolbjørn S; Meng, Xiangyi; Tekin, Sibel; Olin, Jason T

    2010-08-01

    Rivastigmine has been shown to improve cognition in patients with Parkinson's disease dementia (PDD). To further explore the impact of anticholinesterase therapy on PDD, Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) items were assessed in a retrospective analysis of a 24-week, double-blind, placebo-controlled trial of rivastigmine. Mean changes from baseline at week 24 were calculated for ADAS-cog item scores and for 3 cognitive domain scores. A total of 362 patients were randomized to 3 to 12 mg/d rivastigmine capsules and 179 to placebo. Patients with PDD receiving rivastigmine improved versus placebo on items: word recall, following commands, ideational praxis, remembering test instructions, and comprehension of spoken language (P ADAS-cog is sensitive to broad cognitive changes in PDD. Overall, rivastigmine was associated with improvements on individual cognitive items and general cognitive domains.

  10. Prion disease resembling frontotemporal dementia and parkinsonism linked to chromosome 17

    Directory of Open Access Journals (Sweden)

    Nitrini Ricardo

    2001-01-01

    Full Text Available OBJECTIVE: To compare the clinical features of a familial prion disease with those of frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17. BACKGROUND: Prion diseases are not usually considered in the differential diagnosis of FTDP-17, since familial Creutzfeldt-Jakob disease (CJD, the most common inherited prion disease, often manifests as a rapidly progressive dementia. Conversely, FTDP-17 usually has an insidious onset in the fifth decade, with abnormal behavior and parkinsonian features. METHOD: We present the clinical features of 12 patients from a family with CJD associated with a point mutation at codon 183 of the prion protein gene. RESULTS: The mean age at onset was 44.0 ± 3.7; the duration of the symptoms until death ranged from two to nine years. Behavioral disturbances were the predominant presenting symptoms. Nine patients were first seen by psychiatrists. Eight patients manifested parkinsonian signs. CONCLUSION: These clinical features bear a considerable resemblance to those described in FTDP-17.

  11. Distinct brain metabolic patterns separately associated with cognition, motor function, and aging in Parkinson's disease dementia.

    Science.gov (United States)

    Ko, Ji Hyun; Katako, Audrey; Aljuaid, Maram; Goertzen, Andrew L; Borys, Andrew; Hobson, Douglas E; Kim, Seok Min; Lee, Chong Sik

    2017-12-01

    We explored whether patients with Parkinson's disease dementia (PDD) show a distinct spatial metabolic pattern that characterizes cognitive deficits in addition to motor dysfunction. Eighteen patients with PDD underwent 3 separate positron emission tomography sessions with [ 18 F]fluorodeoxyglucose (for glucose metabolism), fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane (for dopamine transporter density) and Pittsburgh compound-B (for beta-amyloid load). We confirmed in PDD versus normal controls, overall hypometabolism in the posterior and prefrontal brain regions accompanied with hypermetabolism in subcortical structures and the cerebellar vermis. A multivariate network analysis then revealed 3 metabolic patterns that are separately associated with cognitive performance (p = 0.042), age (p = 0.042), and motor symptom severity (p = 0.039). The age-related pattern's association with aging was replicated in healthy controls (p = 0.047) and patients with Alzheimer's disease (p = 0.002). The cognition-related pattern's association with cognitive performance was observed, with a trend-level of correlation, in patients with dementia with Lewy bodies (p = 0.084) but not in patients with Alzheimer's disease (p = 0.974). We found no association with fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane and Pittsburgh compound-B positron emission tomography with patients' cognitive performance. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Demography, diagnostics, and medication in dementia with Lewy bodies and Parkinson's disease with dementia: data from the Swedish Dementia Quality Registry (SveDem

    Directory of Open Access Journals (Sweden)

    Fereshtehnejad SM

    2013-06-01

    Full Text Available Seyed-Mohammad Fereshtehnejad,1 Dorota Religa,2,3 Eric Westman,1 Dag Aarsland,2,4 Johan Lökk,1,3 Maria Eriksdotter1,3 1Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS, Karolinska Institutet, Stockholm, Sweden; 2Alzheimer's Disease Research Center, Department of Neurobiology, Care Sciences and Society (NVS, Karolinska Institutet, Stockholm, Sweden; 3Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden; 4Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway Introduction: Whether dementia with Lewy bodies (DLB and Parkinson's disease with dementia (PDD should be considered as one entity or two distinct conditions is a matter of controversy. The aim of this study was to compare the characteristics of DLB and PDD patients using data from the Swedish Dementia Quality Registry (SveDem. Methods: SveDem is a national Web-based quality registry initiated to improve the quality of diagnostic workup, treatment, and care of patients with dementia across Sweden. Patients with newly diagnosed dementia of various types were registered in SveDem during the years 2007–2011. The current cross-sectional report is based on DLB (n = 487 and PDD (n = 297 patients. Demographic characteristics, diagnostic workup, Mini-Mental State Examination (MMSE score, and medications were compared between DLB and PDD groups. Results: No gender differences were observed between the two study groups (P = 0.706. PDD patients were significantly younger than DLB patients at the time of diagnosis (74.8 versus 76.8 years, respectively; P < 0.001. A significantly higher prevalence of patients with MMSE score #24 were found in the PDD group (75.2% versus 67.6%; P = 0.030. The mean number of performed diagnostic modalities was significantly higher in the DLB group (4.9 ± 1.7 than in the PDD group (4.1 ± 1.6; P< 0.001. DLB patients were more likely than PDD patients to be treated with

  13. Cognitive profiling of Parkinson disease patients with mild cognitive impairment and dementia.

    Science.gov (United States)

    Biundo, Roberta; Weis, Luca; Facchini, Silvia; Formento-Dojot, Patrizia; Vallelunga, Annamaria; Pilleri, Manuela; Antonini, Angelo

    2014-04-01

    Prevalence of mild cognitive impairment (MCI) and dementia in Parkinson disease (PD) is variable because different classification criteria are applied and there is lack of consensus about neuropsychological tests and cut-off used for cognitive profiling. Given the important therapeutic consequences for patient management, we aimed at identifying suitable diagnostic cognitive tests and respective screening cut-off values for MCI and dementia in PD (PDD). We evaluated 105 PD patients using an extensive neuropsychological battery categorized as PD without cognitive impairment (PD-CNT) (35%), PD-MCI (47%) and PDD (18%) based on established criteria and calculated Receiver Operating Characteristic (ROC) curves. We found different sensitivity and specificity among neuropsychological tests in detecting PD-MCI and PDD. In particular performance in attention/set shifting, verbal memory and language abilities, discriminated both PD-MCI and PDD from PD-CNT. Abilities involved mainly in semantic retrieval mechanisms discriminated PD-CNT from PD-MCI but also PD-MCI from PDD. Finally deficits in executive and visual-spatial abilities were only affected in PDD. Our data point to an independent and different load of each test in defining different PD cognitive statuses. These findings can help selection of appropriate cognitive batteries in longitudinal studies and definition of stage-specific therapeutic targets. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Pilot study of a three-step diagnostic pathway for young and old patients with Parkinson's disease dementia: screen, test and then diagnose.

    NARCIS (Netherlands)

    Robben, S.H.M.; Sleegers, M.J.; Dautzenberg, P.LJ.; Bergen, F.S. van; Bruggen, J.P.; Olde Rikkert, M.G.M.

    2010-01-01

    OBJECTIVE: To pilot a three-step diagnostic model for young and old patients with Parkinson's disease dementia (PDD). METHODS: Prospective investigator-blinded study. We developed a screening questionnaire for patients with Parkinson's disease (PD) and their caregivers. Further, patients were

  15. What can the treatment of Parkinson's disease learn from dementia care; applying a bio-psycho-social approach to Parkinson's disease.

    Science.gov (United States)

    Gibson, Grant

    2017-12-01

    Within contemporary medical practice, Parkinson's disease (PD) is treated using a biomedical, neurological approach, which although bringing numerous benefits can struggle to engage with how people with PD experience the disease. A bio-psycho-social approach has not yet been established in PD; however, bio-psycho-social approaches adopted within dementia care practice could bring significant benefit to PD care. This paper summarises existing bio-psycho-social models of dementia care and explores how these models could also usefully be applied to care for PD. Specifically, this paper adapts the bio-psycho-social model for dementia developed by Spector and Orrell (), to suggest a bio-psycho-social model, which could be used to inform routine care in PD. Drawing on the biopsychosocial model of Dementia put forward by Spector and Orrell (), this paper explores the application of a bio-psycho-social model of PD. This model conceptualises PD as a trajectory, in which several interrelated fixed and tractable factors influence both PD's symptomology and the various biological and psychosocial challenges individuals will face as their disease progresses. Using an individual case study, this paper then illustrates how such a model can assist clinicians in identifying suitable interventions for people living with PD. This model concludes by discussing how a bio-psycho-social model could be used as a tool in PD's routine care. The model also encourages the development of a theoretical and practical framework for the future development of the role of the PD specialist nurse within routine practice. A biopsychosocial approach to Parkinson's Disease provides an opportunity to move towards a holistic model of care practice which addresses a wider range of factors affecting people living with PD. The paper puts forward a framework through which PD care practice can move towards a biopsychosocial perspective. PD specialist nurses are particularly well placed to adopt such a model

  16. A QUANTITATIVE STUDY OF α-SYNUCLEIN PATHOLOGY IN FIFTEEN CASES OF DEMENTIA ASSOCIATED WITH PARKINSON DISEASE

    OpenAIRE

    Armstrong, Richard A.; Kotzbauer, Paul T.; Perlmutter, Joel S.; Campbell, Meghan C.; Hurth, Kyle M.; Schmidt, Robert E.; Cairns, Nigel J.

    2013-01-01

    The α-synuclein-immunoreactive pathology of dementia associated with Parkinson disease (DPD) comprises Lewy bodies (LB), Lewy neurites (LN), and Lewy grains (LG). The densities of LB, LN, LG together with vacuoles, neurons, abnormally enlarged neurons (EN), and glial cell nuclei were measured in fifteen cases of DPD. Densities of LN and LG were up to 19 and 70 times those of LB respectively, depending on region. Densities were significantly greater in amygdala, entorhinal cortex (EC), and sec...

  17. Cognitive Profiles of Patients with Mild Cognitive Impairment or Dementia in Alzheimer's or Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Helmut Hildebrandt

    2013-04-01

    Full Text Available Background: Alzheimer's disease (AD and Parkinson's disease (PD are associated with severe cognitive decline, but it is still unclear to what extent they become functionally more similar over time. Methods: We compared amnestic mild cognitively impaired (aMCI; n = 29 patients to mild cognitively impaired (MCI PD patients (n = 25, and patients with AD (n = 34 to patients with PD dementia (PDD; n = 15 with respect to cognitive functioning and mood. Results: aMCI patients were impaired in episodic memory, while MCI PD patients showed deficits in visuoconstruction and attention. AD and PDD patients showed comparable deficits on tests for language, attention and visuoconstruction. However, unlike PDD patients but similar to aMCI patients, AD patients showed a characteristic memory impairment, especially commission errors on recognition tasks, whereas PDD patients scored higher on the depressive mood questionnaire. Conclusions: In advanced stages of both diseases, the pattern of functional deficits associated with parietal and temporal lobe functions (attention, visuoconstruction and language is similar. However, specific differences, already present in the early stage (recognition errors in AD, associated with mediobasal temporal lobe functioning, and depressed mood in PDD, associated with non-motor basal ganglia loops, are also observed in the late stage.

  18. Efficacy of rivastigmine for cognitive symptoms in Parkinson disease with dementia.

    Science.gov (United States)

    Almaraz, Amy C; Driver-Dunckley, Erika D; Woodruff, Bryan K; Wellik, Kay E; Caselli, Richard J; Demaerschalk, Bart M; Adler, Charles H; Caviness, John N; Wingerchuk, Dean M

    2009-07-01

    Impairment of multiple neurotransmitter networks, including acetylcholine, may contribute to the cognitive impairment in patients with Parkinson disease with dementia (PDD). Therefore, cholinesterase inhibitors might improve cognitive function in PDD. On the other hand, enhancing cholinergic function could plausibly worsen features of parkinsonism. To determine if oral cholinesterase inhibitors improve measures of cognitive outcome and are tolerated by people with PDD. We addressed the question through the development of a critically appraised topic. Participants included consultant and resident neurologists, clinical epidemiologists, a medical librarian, and behavioral neurology and movement disorder specialists. Participants began with a structured clinical question, devised search strategies, compiled the best evidence, performed a critical appraisal, summarized the evidence, provided commentary, and declared bottom-line conclusions. A randomized controlled trial (n = 541) showed that, compared with placebo, rivastigmine (mean, 8.6 mg/d) significantly improved scores on 2 coprimary cognitive outcome scales in PDD, including the Alzheimer disease Cooperative Study-Clinician's Global Impression of Change. When dichotomized to evaluate clinically significant benefit (moderate or marked improvement), this outcome was not significant (risk difference = 5.3%; 95% confidence interval (CI) = -1.6 to 12.1). The number needed to treat (NNT) to avoid clinically significant worsening of cognition was 10 (95% CI = 6-28). The NNT for the combined outcome of either achieving clinically significant benefit or avoiding significant worsening was 7. The numbers needed to harm for cholinergic side effects were 9 (95% CI = 5-24) for parkinsonian symptoms and 11 (95% CI = 6-32) for rivastigmine discontinuation due to any side effect. Rivastigmine therapy for PDD is associated with significant tradeoffs in efficacy and adverse effects. Carefully monitored trials of rivastigmine may

  19. Addenbrooke's Cognitive Examination-Revised is accurate for detecting dementia in Parkinson's disease patients with low educational level.

    Science.gov (United States)

    Rocha, Maria Sheila Guimarães; Bassetti, Elida Maria; Oliveira, Maira Okada; Kuark, Roberta Gomes Borges; Estevam, Nathercia Marinho; Brucki, Sonia Maria Dozzi

    2014-01-01

    Diagnosis of Parkinson's disease dementia is a challenge in clinical settings. A comprehensive neuropsychological evaluation is time-consuming and expensive; brief instruments for cognitive evaluation must be easier to administer and provide a reliable classification. To study the validity of the Brazilian version of Addenbrooke's Cognitive Examination-Revised (ACE-R) for the cognitive assessment of Parkinson's disease (PD) patients with heterogeneous educational level. Patients were evaluated according to the diagnostic procedures recommended by the Movement Disorder Society (MDS) as the gold standard for the diagnosis of dementia in PD. We studied 70 idiopathic PD patients, with a mean (SD) age of 64.1 (9.3) years and mean disease duration of 7.7 (5.3) years and educational level of 5.9 years, matched for education and age to controls. Twenty-seven patients fulfilled MDS clinical criteria for PD dementia. Mean scores on the ACE-R were 54.7 (12.8) points for patients with PD dementia, 76 (9.9) for PD patients without dementia and 79.7 (1.8) points for healthy controls. The area under the receiver operating curve, taking the MDS diagnostic procedures as a reference, was 0.93 [95% CI, 0.87-0.98; p<0.001] for ACE-R. The optimal cut-off value for ACE-R was ≤72 points [sensitivity 90%; specificity 85%; Kappa concordance (K) 0.79]. ACE-R appears to be a valid tool for dementia evaluation in PD patients with heterogeneous educational level, displaying good correlation with clinical criteria and diagnostic procedures of the MDS.

  20. Addenbrooke's Cognitive Examination-Revised is accurate for detecting dementia in Parkinson's disease patients with low educational level

    Directory of Open Access Journals (Sweden)

    Maria Sheila Guimarães Rocha

    Full Text Available ABSTRACT Diagnosis of Parkinson's disease dementia is a challenge in clinical settings. A comprehensive neuropsychological evaluation is time-consuming and expensive; brief instruments for cognitive evaluation must be easier to administer and provide a reliable classification. Objective: To study the validity of the Brazilian version of Addenbrooke's Cognitive Examination-Revised (ACE-R for the cognitive assessment of Parkinson's disease (PD patients with heterogeneous educational level. Methods: Patients were evaluated according to the diagnostic procedures recommended by the Movement Disorder Society (MDS as the gold standard for the diagnosis of dementia in PD. Results: We studied 70 idiopathic PD patients, with a mean (SD age of 64.1 (9.3 years and mean disease duration of 7.7 (5.3 years and educational level of 5.9 years, matched for education and age to controls. Twenty-seven patients fulfilled MDS clinical criteria for PD dementia. Mean scores on the ACE-R were 54.7 (12.8 points for patients with PD dementia, 76 (9.9 for PD patients without dementia and 79.7 (1.8 points for healthy controls. The area under the receiver operating curve, taking the MDS diagnostic procedures as a reference, was 0.93 [95% CI, 0.87-0.98; p<0.001] for ACE-R. The optimal cut-off value for ACE-R was ≤72 points [sensitivity 90%; specificity 85%; Kappa concordance (K 0.79]. Conclusion: ACE-R appears to be a valid tool for dementia evaluation in PD patients with heterogeneous educational level, displaying good correlation with clinical criteria and diagnostic procedures of the MDS.

  1. Correlation between pathology and neuromelanin MR imaging in Parkinson's disease and dementia with Lewy bodies

    International Nuclear Information System (INIS)

    Kitao, Shinichiro; Fujii, Shinya; Miyoshi, Fuminori; Kaminou, Toshio; Ogawa, Toshihide; Matsusue, Eiji; Kato, Shinsuke; Ito, Hisao

    2013-01-01

    Direct correlation between neuropathological findings and postmortem neuromelanin MR imaging (NmMRI) was performed in the substantia nigra pars compacta (SNc) to clarify the pathological background of the signal changes in normal, Parkinson's disease (PD), and dementia with Lewy bodies (DLB) cases. NmMRI of 10 % formalin-fixed autopsied midbrains was performed in three cases (normal control, DLB, and PD) with a 3T imaging system, using a 3D gradient echo T1-weighted sequence with a magnetization transfer contrast pulse. Neuropathological examinations of the midbrains were performed, and the density of neuromelanin-positive neurons (number per square millimeter) was determined. The extent of iron deposition in the midbrain was also evaluated using ferritin immunohistochemistry. Furthermore, we directly correlated the contrast signal ratio in the SNc and the density of neuromelanin-containing neurons. Diffuse hyperintense areas in the SNc reflected well-preserved neuromelanin-containing neurons in the normal control case, whereas an iso-intense area in the SNc showed severe loss of neuromelanin-containing neurons in the DLB and PD cases. Increased signal intensity in the SNc was apparently not influenced by iron deposition. Furthermore, a significant positive correlation between signal intensity and the density of neuromelanin-containing neurons was seen in the SNc. Based on the direct correlation between postportem NmMRI and neuropathological findings, signal intensity in the SNc is closely related to the quantity of neuromelanin-containing neurons but is not influenced by iron deposition. (orig.)

  2. Non-motor symptoms of Parkinson's disease

    National Research Council Canada - National Science Library

    Chaudhuri, K. Ray

    2009-01-01

    ... dysfunction of Parkinson's disease 95 Daisy L. Whitehead and Richard. G. Brown 9 Depression, anxiety and apathy in Parkinson's disease 107 David A. Gallagher and Anette Schrag 10 Dementia in Pa...

  3. Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease.

    Science.gov (United States)

    Cholerton, Brenna; Johnson, Catherine O; Fish, Brian; Quinn, Joseph F; Chung, Kathryn A; Peterson-Hiller, Amie L; Rosenthal, Liana S; Dawson, Ted M; Albert, Marilyn S; Hu, Shu-Ching; Mata, Ignacio F; Leverenz, James B; Poston, Kathleen L; Montine, Thomas J; Zabetian, Cyrus P; Edwards, Karen L

    2018-05-01

    Identification of factors associated with progression of cognitive symptoms in Parkinson's disease (PD) is important for treatment planning, clinical care, and design of future clinical trials. The current study sought to identify whether prediction of cognitive progression is aided by examining baseline cognitive features, and whether this differs according to stage of cognitive disease. Participants with PD in the Pacific Udall Center Clinical Consortium who had longitudinal data available and were nondemented at baseline were included in the study (n = 418). Logistic and Cox regression models were utilized to examine the relationship between cognitive, demographic, and clinical variables with risk and time to progression from no cognitive impairment to mild cognitive impairment (PD-MCI) or dementia (PDD), and from PD-MCI to PDD. Processing speed (OR = 1.05, p = 0.009) and working memory (OR = 1.01, p = 0.03) were associated with conversion to PDD among those with PD-MCI at baseline, over and above demographic variables. Conversely, the primary predictive factor in the transition from no cognitive impairment to PD-MCI or PDD was male sex (OR = 4.47, p = 0.004), and males progressed more rapidly than females (p = 0.01). Further, among females with shorter disease duration, progression was slower than for their male counterparts, and poor baseline performance on semantic verbal fluency was associated with shorter time to cognitive impairment in females but not in males. This study provides evidence for sex differences in the progression to cognitive impairment in PD, while specific cognitive features become more important indicators of progression with impending conversion to PDD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. [Dementia and depression determine care dependency in Parkinson's disease: analysis of 1,449 outpatients receiving nursing care in Germany].

    Science.gov (United States)

    Riedel, O; Dodel, R; Deuschl, G; Förstl, H; Henn, F; Heuser, I; Oertel, W; Reichmann, H; Riederer, P; Trenkwalder, C; Wittchen, H U

    2011-08-01

    Parkinson's disease (PD) is frequently accompanied by dementia or depression which can aggravate the clinical picture of the disease and increase the risk of care dependency (CD). Little is known about the associations between PD, these neuropsychiatric comorbidities and CD in outpatients. A nationwide sample of outpatients (n=1,449) was examined by office-based neurologists (n=315) comprising the documentation of the general, neurological status and the degree of CD. The dementia status was clinically rated according to the established DSM-IV criteria. Depression was screened with the Montgomery-Asberg Depression Rating Scale (MADRS). Overall, 18.3% of all patients were care dependent. Even after adjustment for PD severity, patients with depression (OR=2.8; 95% CI 1.8-4.3), dementia (OR=2.7; 95% CI 1.8-4.1) or both (OR=3.9; 95% CI 2.5-60,0) were at higher risk for CD than patients without dementia or depression. Patients aged ≥76 years were fourfold more likely to be care dependent than patients aged ≤65 years (OR=3.5; 95% CI 2.3-5.5). Across all age groups, patients with depression featured the highest increments (from 11.9 to 42.0%). The risk for CD is substantially elevated in outpatients with PD when further neuropsychiatric symptoms are present. The data suggest that depression contributes equally to disability as does dementia.

  5. Combined Analysis of CSF Tau, Aβ42, Aβ1–42% and Aβ1–40ox% in Alzheimer's Disease, Dementia with Lewy Bodies and Parkinson's Disease Dementia

    Directory of Open Access Journals (Sweden)

    Mirko Bibl

    2010-01-01

    Full Text Available We studied the diagnostic value of CSF Aβ42/tau versus low Aβ1–42% and high Aβ1–40ox% levels for differential diagnosis of Alzheimer's disease (AD and dementia with Lewy bodies (DLB, respectively. CSF of 45 patients with AD, 15 with DLB, 21 with Parkinson's disease dementia (PDD, and 40 nondemented disease controls (NDC was analyzed by Aβ-SDS-PAGE/immunoblot and ELISAs (Aβ42 and tau. Aβ42/tau lacked specificity in discriminating AD from DLB and PDD. Best discriminating biomarkers were Aβ1–42% and Aβ1–40ox% for AD and DLB, respectively. AD and DLB could be differentiated by both Aβ1–42% and Aβ1–40ox% with an accuracy of 80% at minimum. Thus, we consider Aβ1–42% and Aβ1–40ox% to be useful biomarkers for AD and DLB, respectively. We propose further studies on the integration of Aβ1–42% and Aβ1–40ox% into conventional assay formats. Moreover, future studies should investigate the combination of Aβ1–40ox% and CSF alpha-synuclein for the diagnosis of DLB.

  6. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Disease? How Is It Treated? CareMAP: Rest and Sleep: Part 2 What Are the Causes of Parkinson's ... Dealing with Dementia Unconditional Love CareMAP: Rest and Sleep: Part 1 CareMAP: The Caregiving Journey When and ...

  7. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... CareMAP: Dealing with Dementia OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis CareMAP: Cambios en el ... to Know? Why Is Comprehensive Care or Team Approach Important? What Is the Relationship Between Depression and ...

  8. The effects of cognitive reserve and lifestyle on cognition and dementia in Parkinson's disease--a longitudinal cohort study.

    Science.gov (United States)

    Hindle, John V; Hurt, Catherine S; Burn, David J; Brown, Richard G; Samuel, Mike; Wilson, Kenneth C; Clare, Linda

    2016-01-01

    Cognitive reserve theory seeks to explain the observed mismatch between the degree of brain pathology and clinical manifestations. Early-life education, midlife social and occupational activities and later-life cognitive and social interactions are associated with a more favourable cognitive trajectory in older people. Previous studies of Parkinson's disease (PD) have suggested a possible role for the effects of cognitive reserve, but further research into different proxies for cognitive reserve and longitudinal studies is required. This study examined the effects of cognitive lifestyle on cross-sectional and longitudinal measures of cognition and dementia severity in people with PD. Baseline assessments of cognition, and of clinical, social and demographic information, were completed by 525 participants with PD. Cognitive assessments were completed by 323 participants at 4-year follow-up. Cognition was assessed using the measures of global cognition dementia severity. Cross-sectional and longitudinal serial analyses of covariance for cognition and binomial regression for dementia were performed. Higher educational level, socio-economic status and recent social engagement were associated with better cross-sectional global cognition. In those with normal cognition at baseline, higher educational level was associated with better global cognition after 4 years. Increasing age and low levels of a measure of recent social engagement were associated with an increased risk of dementia. Higher cognitive reserve has a beneficial effect on performance on cognitive tests and a limited effect on cognitive decline and dementia risk in PD. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Antihypertensive agents and risk of Parkinson's disease, essential tremor and dementia: a population-based prospective study (NEDICES).

    Science.gov (United States)

    Louis, Elan D; Benito-León, Julián; Bermejo-Pareja, Félix

    2009-01-01

    Recent interest in antihypertensive agents, especially calcium channel blockers, has been sparked by the notion that these medications may be neuroprotective. A modest literature, with mixed results, has examined whether these medications might lower the odds or risk of Parkinson's disease (PD) or dementia. There are no data for essential tremor (ET). To examine the association between antihypertensive use (defined broadly and by individual subclasses) and ET, PD and dementia. For each disorder, we used cross-sectional data (association with prevalent disease) and prospective data (association with incident disease). Prospective population-based study in Spain enrolling 5,278 participants at baseline. Use of antihypertensive medications (aside from beta-blockers) was similar in prevalent ET cases and controls. Baseline use of antihypertensive agents was not associated with reduced risk of incident ET. Antihypertensive medication use was not associated with prevalent or incident PD. Calcium channel blocker use was marginally reduced in prevalent dementia cases (OR(adjusted) = 0.63, p = 0.06) but was not associated with reduced risk of incident dementia (RR(adjusted) = 1.02, p = 0.95). We did not find evidence of a protective effect of antihypertensive medications in these three neurodegenerative disorders. Copyright 2009 S. Karger AG, Basel.

  10. Goal-orientated cognitive rehabilitation for dementias associated with Parkinson's disease-A pilot randomised controlled trial.

    Science.gov (United States)

    Hindle, John V; Watermeyer, Tamlyn J; Roberts, Julie; Brand, Andrew; Hoare, Zoe; Martyr, Anthony; Clare, Linda

    2018-05-01

    To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study. This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9). Primary outcomes were ratings of goal attainment and satisfaction with goal attainment. Secondary outcomes included quality of life, mood, cognition, health status, everyday functioning, and carers' ratings of goal attainment and their own quality of life and stress levels. Assessments were at 2 and 6 months following randomisation. At 2 months, cognitive rehabilitation was superior to treatment-as-usual and relaxation therapy for the primary outcomes of self-rated goal attainment (d = 1.63 and d = 1.82, respectively) and self-rated satisfaction with goal attainment (d = 2.04 and d = 1.84). At 6 months, cognitive rehabilitation remained superior to treatment-as-usual (d = 1.36) and relaxation therapy (d = 1.77) for self-rated goal attainment. Cognitive rehabilitation was superior to treatment as usual and/or relaxation therapy in a number of secondary outcomes at 2 months (mood, self-efficacy, social domain of quality of life, carers' ratings of participants' goal attainment) and at 6 months (delayed recall, health status, quality of life, carer ratings of participants' goal attainment). Carers receiving cognitive rehabilitation reported better quality of life, health status, and lower stress than those allocated to treatment-as-usual. Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson's disease. Copyright © 2018 John Wiley & Sons, Ltd.

  11. Sensitivity and specificity of Addenbrooke's Cognitive Examination, Mattis Dementia Rating Scale, Frontal Assessment Battery and Mini Mental State Examination for diagnosing dementia in Parkinson's disease.

    Science.gov (United States)

    Kaszás, B; Kovács, N; Balás, I; Kállai, J; Aschermann, Z; Kerekes, Z; Komoly, S; Nagy, F; Janszky, J; Lucza, T; Karádi, K

    2012-06-01

    Among the non-motor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. Highly sensitive and specific screening instruments for detecting dementia in PD (PDD) are required in the clinical practice. In our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination, ACE; Frontal Assessment Battery, FAB and Mattis Dementia Rating Scale, MDRS) in 73 Parkinson's disease patients without depression. By receiver operating characteristic curve analysis, these screening instruments were tested against the recently established clinical diagnostic criteria of PDD. Best cut-off score for ACE to identify PDD was 80 points (sensitivity = 74.0%, specificity = 78.1%). For FAB the most optimal cut-off value was 12 points (sensitivity = 66.3%, specificity = 72.2%); whereas for MDRS it was 125 points (sensitivity = 89.8%, specificity = 98.3%). Among the examined test batteries, MDRS had the best clinicometric profile for detecting PDD. Although the types of applied screening instruments might differ from movement disorder clinic to clinic within a country, determination of the most specific and sensitive test for the given population remains to be an important task. Our results demonstrated that the specificity and sensitivity of MDRS was better than those of ACE, FAB and MMSE in Hungary. However, further studies with larger sample size and more uniform criteria for participation are required to determine the most suitable screening instrument for cognitive impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Parkinson's Disease Videos

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    Full Text Available ... the First Few Years with Parkinson's Expert Briefings: Pain in PD Expert Briefings: Parkinson's Disease: Financial, Legal ... Briefings: Complementary Approaches to Parkinson's Expert Briefings: Understanding Pain in Parkinson's Expert Briefings: The Parkinson's Pipeline 2011: ...

  13. Slowing of oscillatory brain activity is a stable characteristic of Parkinson's disease without dementia

    NARCIS (Netherlands)

    Stoffers, D.; Bosboom, JL; Deijen, J.B.; Wolters, E.C.M.J.; Berendse, H.W.; Stam, L.

    2007-01-01

    Extensive changes in resting-state oscillatory brain activity have recently been demonstrated using magnetoencephalography (MEG) in moderately advanced, non-demented Parkinson's disease patients relative to age-matched controls. The aim of the present study was to determine the onset and evolution

  14. Post-cueing deficits with maintained cueing benefits in patients with Parkinson's disease dementia

    Directory of Open Access Journals (Sweden)

    Susanne eGräber

    2014-11-01

    Full Text Available In Parkinson’s disease (PD internal cueing mechanisms are impaired leading to symptoms such as like hypokinesia. However external cues can improve movement execution by using cortical resources. These cortical processes can be affected by cognitive decline in dementia.It is still unclear how dementia in PD influences external cueing. We investigated a group of 25 PD patients with dementia (PDD and 25 non-demented PD patients (PDnD matched by age, sex and disease duration in a simple reaction time (SRT task using an additional acoustic cue. PDD patients benefited from the additional cue in similar magnitude as did PDnD patients. However, withdrawal of the cue led to a significantly increased reaction time in the PDD group compared to the PDnD patients. Our results indicate that even PDD patients can benefit from strategies using external cue presentation but the process of cognitive worsening can reduce the effect when cues are withdrawn.

  15. Clinical and pathological study on early diagnosis of Parkinson's disease and dementia with Lewy bodies

    International Nuclear Information System (INIS)

    Orimo, Satoshi

    2008-01-01

    [ 123 I] Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy has been used to evaluate postganglionic cardiac sympathetic innervation in heart diseases and some neurological disorders. To see clinical usefulness of MIBG myocardial scintigraphy to differentiate Parkinson's disease (PD) and dementia with Lewy bodies (DLB) from related movement disorders and Alzheimer disease (AD), we performed MIBG myocardial scintigraphy in patients with these disorders. Cardiac uptake of MIBG is specifically reduced in PD and DLB, and this imaging approach is a sensitive diagnostic tool that possibly differentiates PD and DLB from related movement disorders and AD. To see pathological basis of the reduced cardiac uptake of MIBG in Lewy body disease, we immunohistichemically examined cardiac tissues from patients with PD, DLB, related movement disorders and AD using antibodies against tyrosine hydroxylase (TH) and phosphorylated neurofilament (NF). Not only TH- but also NF-immunoreactive (ir) axons in the epicardial nerve fascicles were markedly decreased in Lewy body disease, namely cardiac sympathetic denervation, which accounts for the reduced cardiac uptake of MIBG in Lewy body disease. Patients with PD and DLB have Lewy bodies (LBs) in the nervous system, whereas patients with multiple system atrophy (MSA), progressive supranuclear palsy, corticobasal degeneration, parkin-associated PD and AD have no LBs in the nervous system. Even in patients with MSA, cardiac sympathetic denervation was associated with the presence of LBs. Therefore, cardiac sympathetic denervation is closely related to the presence of LBs in a wide range of neurodegenerative processes. Taken together, we conclude that the reduced cardiac uptake of MIBG is a potential biomarker for the presence of LBs. Because α-synuclein is one of the key molecules in the pathogenesis of PD, we further investigate how α-synuclein aggregates are involved in degeneration of the cardiac sympathetic nerve in PD. We

  16. Parkinson's Disease Videos

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  17. Parkinson's Disease Videos

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  18. Dementia and mild cognitive impairment in patients with Parkinson's disease Demência e transtorno cognitivo leve em pacientes com doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Gloria Maria Almeida Souza Tedrus

    2009-06-01

    Full Text Available The objective of this research was to assess the occurrence of cognitive impairment in 32 individuals (average age: 67.2 years old with Parkinson' disease (PD. Procedures: clinical-neurological assessment; modified Hoehn and Yahr staging scale (HYS; standard neuropsychological battery of CERAD (Consortium to Establish a Registry for Alzheimer' Disease; Pfeffer questionnaire; and Clinical Dementia Rating. A comparison was made with a control group (CG, consisting of 26 individuals with similar age and educational level but without cognitive impairment. The PD patients showed an inferior performance in the CERAD battery when compared to the CG. Three PD sub-groups were characterised according to cognition: no cognitive impairment - 15 cases; mild cognitive impairment - 10; dementia - 7 cases. There was a significant association between motor disability (HYS and the occurrence of dementia. Dementia and mild cognitive impairment frequently occur in PD patients and should be investigated in a routine way.O objetivo desta pesquisa foi avaliar a ocorrência de déficits cognitivos em 32 indivíduos (idade média: 67,2 anos com doença de Parkinson (DP. Procedimentos: avaliação clínico-neurológica, escala de Hoehn and Yahr modificada (EHY, bateria neurospicológica do CERAD (Consortium to Establish a Registry for Alzheimer' Disease, questionário de Pfeffer e escore clínico da demência (Clinical Dementia Rating. Foi feita comparação com grupo controle (GC de 26 indivíduos sem declínio cognitivo, com idade e nível educacional similares. Os pacientes com DP tiveram desempenho inferior na bateria CERAD, quando comparados ao do GC. Foram caracterizados 3 subgrupos com PD segundo a cognição: sem déficits cognitivos - 15 casos; transtorno cognitivo leve - 10; demência - 7 casos. Houve associação entre comprometimento motor e ocorrência de demência. Demência e transtorno cognitivo leve são freqüentes em pacientes com DP e devem ser

  19. Parkinson's disease

    DEFF Research Database (Denmark)

    Astradsson, Arnar; Aziz, Tipu Z

    2015-01-01

    INTRODUCTION: The mean age of onset of Parkinson's disease is about 65 years, with a median time of 9 years between diagnosis and death. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of fetal cell or stem cell......-derived therapy in people with Parkinson's disease? We searched: Medline, Embase, The Cochrane Library and other important databases up to September 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from...

  20. A three dimensional anatomical view of oscillatory resting-state activity and functional connectivity in Parkinson's disease related dementia: An MEG study using atlas-based beamforming

    NARCIS (Netherlands)

    Ponsen, M.M.; Stam, C.J.; Bosboom, J.L.W.; Berendse, H.W.; Hillebrand, A.

    2013-01-01

    Parkinson's disease (PD) related dementia (PDD) develops in up to 80% of PD patients. The present study was performed to further unravel the underlying pathophysiological mechanisms by applying a new analysis approach that uses an atlas-based MEG beamformer to provide a detailed anatomical mapping

  1. Parkinson's Disease Videos

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  2. Parkinson's Disease

    Science.gov (United States)

    ... a long and relatively healthy life. What Causes Parkinson's Disease? In the very deep parts of the brain, there is a collection of nerve cells that help control movement, known as the basal ganglia (say: BAY-sul GAN-glee-ah). In a ...

  3. Glucocerebrosidase mutations and neuropsychiatric phenotypes in Parkinson's disease and Lewy body dementias: Review and meta-analyses.

    Science.gov (United States)

    Creese, Byron; Bell, Emily; Johar, Iskandar; Francis, Paul; Ballard, Clive; Aarsland, Dag

    2018-03-01

    Heterozygous mutations in glucocerebrosidase gene (GBA) are a major genetic risk factor for Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Recently, there has been a considerable focus on the relationship between GBA mutations and emergence of cognitive impairment and neuropsychiatric symptoms in these diseases. Here, we review the literature in this area, with a particular focus, including meta-analysis, on the key neuropsychiatric symptoms of cognitive impairment, psychosis, and depression in Parkinson's disease. Our meta-analysis demonstrated that GBA mutations are associated with a 2.4-fold increased risk of cognitive impairment. In addition, our novel meta-analyses of psychosis and depression showed a 1.8- and 2.2-fold increased risk respectively associated with GBA mutations, although due to possible bias and heterogeneity the depression findings should be interpreted with caution. While the precise mechanisms which increase susceptibility to neurodegeneration in GBA carriers are not known, evidence of greater cortical Lewy body pathology, reduced patterns of cortical activation, and hippocampal pathology in animal models are all consistent with a direct effect of GBA mutations on these symptoms. Extension of this work in DLB and individuals without neurodegeneration will be important in further characterizing how GBA mutations increase risk for PD and DLB and influence disease course. © 2017 Wiley Periodicals, Inc.

  4. The Role of Insulin/IGF-1/PI3K/Akt/GSK3β Signaling in Parkinson's Disease Dementia

    Directory of Open Access Journals (Sweden)

    Liying Yang

    2018-02-01

    Full Text Available Dementia, a condition that frequently afflicts patients in advanced stages of Parkinson's disease (PD, results in decreased quality of life and survival time. Nevertheless, the pathological mechanisms underlying Parkinson's disease dementia (PDD are not completely understood. The symptoms characteristic of PDD may be the result of functional and structural deficiencies. The present study implicates the accumulation of Lewy bodies in the cortex and limbic system as a potent trigger in the development of PDD. In addition, significant Alzheimer-type pathologies, including amyloid-β (Aβ plaques and NFTs, are observed in almost half of PDD patients. Interestingly, links between PDD pathogenesis and the mechanisms underlying the development of insulin resistance have begun to emerge. Furthermore, previous studies have demonstrated that insulin treatment reduces amyloid plaques in Alzheimer's disease (AD, and normalizes the production and functionality of dopamine and ameliorates motor impairments in 6-OHDA-induced rat PD models. GSK3β, a downstream substrate of PI3K/Akt signaling following induction by insulin and IGF-1, exerts an influence on AD and PD physiopathology. The genetic overexpression of GSK3β in cortex and hippocampus results in signs of neurodegeneration and spatial learning deficits in in vivo models (Lucas et al., 2001, whereas its inhibition results in improvements in cognitive impairment in these rodents, including AD and PD. Accordingly, insulin- or IGF-1-activated PI3K/Akt/GSK3β signaling may be involved in PDD pathogenesis, at least in the pathology of PD-type + AD-type.

  5. Dementia and severity of parkinsonism determines the handicap of patients in late-stage Parkinson's disease: the Barcelona-Lisbon cohort.

    Science.gov (United States)

    Coelho, M; Marti, M J; Sampaio, C; Ferreira, J J; Valldeoriola, F; Rosa, M M; Tolosa, E

    2015-02-01

    Handicap has not been explored as a patient-centred outcome measure in Parkinson's disease (PD). The clinical features and medication use in late stages of PD (LS-PD) were reported previously. Handicap, medical conditions, use of healthcare resources and the impact of LS-PD upon caregivers were characterized in a cross-sectional study of LS-PD stages 4 or 5 of Hoehn and Yahr (H&Y). Handicap was measured using the London Handicap Scale (LHS: 0, maximal handicap; 1, no handicap). The mean LHS score in 50 patients was 0.33 (SD ±0.15). The presence of dementia, the Unified Parkinson's Disease Rating Scale part I score and the H&Y stage in 'off' independently predicted the LHS score (adjusted R(2) = 0.62; P = 0.000). Comorbidities and past medical conditions were frequent. Thirty-five patients lived at their house. Forty-five received unpaid care. Mean visits to the family doctor in the preceding 6 months were 2.2 (SD ±3.0) and to a neurologist 1.7 (SD ±1.0). Use of other health resources was low. Unpaid caregivers spent much time with patients and reported a high burden. Handicap could be measured in LS-PD and the LHS was easily completed by patients and caregivers. The high handicap in our cohort was mostly driven by the presence of dementia, behavioural complaints and the severity of non-dopaminergic motor features. Patients visited doctors infrequently and made low use of health resources, whilst unpaid caregivers reported a high burden. © 2014 EAN.

  6. Progression of dopaminergic degeneration in dementia with Lewy bodies and Parkinson's disease with and without dementia assessed using 123I-FP-CIT SPECT

    International Nuclear Information System (INIS)

    Colloby, Sean J.; McKeith, Ian G.; O'Brien, John T.; Williams, E. David; Burn, David J.; Lloyd, Jim J.

    2005-01-01

    The objective of this study was to investigate the rate of progression of nigrostriatal dopaminergic loss in subjects with dementia with Lewy bodies (DLB), Parkinson's disease (PD) and PD with dementia (PDD) using serial 123 I-FP-CIT SPECT imaging. We hypothesised that striatal rates of decline in patients would be greater than in controls, and that DLB and PDD would show similar rates, reflecting the similarity in neurobiological mechanisms of dopaminergic loss between the two disorders. We studied 20 patients with DLB, 20 with PD, 15 with PDD and 22 healthy age-matched controls. Semi-automated region of interest (ROI) analysis was performed on both baseline and repeat scans for each subject and mean striatal uptake ratios (caudate, anterior and posterior putamen) were calculated. Rates of decline in striatal binding between groups were assessed using ANCOVA. Significant differences between patients and controls were observed in caudate (DLB, PD, PDD, p≤0.01), anterior putamen (DLB, PDD, p≤0.05; PD, p=0.07) and posterior putamen (DLB, PD, PDD, p<0.006). Rates of decline were similar between DLB, PD and PDD. (orig.)

  7. Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease.

    Science.gov (United States)

    van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E; Rick, Jacqueline; Chahine, Lama M; Dahodwala, Nabila; Trojanowski, John Q; Roalf, David R; Moberg, Paul J; Weintraub, Daniel

    2014-12-01

    Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. © 2014 International Parkinson and Movement Disorder Society.

  8. Diagnosis, assessment and management of delusional jealousy in Parkinson's disease with and without dementia.

    Science.gov (United States)

    Perugi, Giulio; Poletti, Michele; Logi, Chiara; Berti, Caterina; Romano, Anna; Del Dotto, Paolo; Lucetti, Claudio; Ceravolo, Roberto; Dell'Osso, Liliana; Bonuccelli, Ubaldo

    2013-09-01

    Patients with Parkinson's disease (PD) may present delusional jealousy (DJ). In a previous cross-sectional prevalence study we identified 15 cognitively preserved and five demented PD patients with DJ. The current study aimed at evaluating their clinical (motor and non-motor) characteristics and the pharmacological treatments associated with DJ, and its subsequent pharmacological management. Patients were assessed by neurologists and psychiatrists using the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale, the Brief Psychiatric Rating Scale, the Beck Depression Inventory, the Hamilton Anxiety Scale and the Neuropsychiatric Inventory. Efficacy of DJ management was evaluated in follow-up visits. All patients were in therapy with dopamine agonists. A subgroup of five cognitively preserved patients developed DJ after a short period of treatment of therapy with dopamine agonists, while other patients developed DJ after a longer period of dopaminergic treatment. Psychiatric comorbidities were common in cognitively preserved and in demented patients. The pharmacological management included the interruption of dopamine agonists in two patients and the reduction of dopamine agonist dose plus the use of antipsychotics in other patients. These clinical data suggest that the management of medicated PD patients should include investigation for the presence of DJ and the evaluation of clinical characteristics potentially relevant to the prevention or the early recognition of delusions.

  9. Parkinson's Disease Videos

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  10. Parkinson's Disease Videos

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  11. Neuropsychiatric Symptoms in Parkinson's Disease with Mild Cognitive Impairment and Dementia

    Directory of Open Access Journals (Sweden)

    Iracema Leroi

    2012-01-01

    Full Text Available Neuropsychiatric symptoms commonly complicate Parkinson’s disease (PD, however the presence of such symptoms in mild cognitive impairment (PD-MCI specifically has not yet been well described. The objective of this study was to examine and compare the prevalence and profile of neuropsychiatric symptoms in patients with PD-MCI (n = 48 to those with PD and no cognitive impairment (PD-NC, n = 54 and to those with dementia in PD (PDD, n = 25. PD-MCI and PDD were defined using specific consensus criteria, and neuropsychiatric symptoms were assessed with the 12-item Neuropsychiatric Inventory (NPI. Self-rated apathy, depression, and anxiety rating scales were also administered. Over 79% of all participants reported at least one neuropsychiatric symptom in the past month. The proportion in each group who had total NPI scores of ≥4 (“clinically significant” was as follows: PD-NC, 64.8%; PD-MCI, 62%; PDD 76%. Apathy was reported in almost 50% of those with PD-MCI and PDD, and it was an important neuropsychiatric symptom differentiating PD-MCI from PD-NC. Psychosis (hallucinations and delusions increased from 12.9% in PD-NC group; 16.7% in PD-MCI group; and 48% in PDD group. Identifying neuropsychiatric symptoms in PD-MCI may have implications for ascertaining conversion to dementia in PD.

  12. Parkinson's Disease Videos

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  13. Parkinson's Disease Videos

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  14. Parkinson's Disease Videos

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  15. Parkinson's Disease Videos

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    Full Text Available ... and Apathy in Parkinson's Disease Nurse Webinars: Interdisciplinary Education on Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and Parkinson's Nurse: ...

  16. Parkinson's Disease Videos

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  17. Parkinson's Disease Videos

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    Full Text Available ... Parkinson's There is a lot to know about Parkinson's disease. Learn about symptoms, how it is diagnosed and ... your quality of life and live well with Parkinson's disease. Learn More Expert Care Patient Centered Care Centers ...

  18. Parkinson's Disease Videos

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  19. I-123 IMP SPECT in Parkinson's disease

    International Nuclear Information System (INIS)

    Kawabata, Keita; Tachibana, Kyudai; Sugita, Minoru

    1990-01-01

    To examine semiquantitatively regional cerebral blood flow, SPECT with N-isopropyl-p-[I-123]iodoamphetamine (I-123 IMP) was undertaken in 17 patients with Parkinson's disease. Seven patients with Alzheimer's disease and 9 senile control subjects were also imaged for comparison. Both the Parkinson's disease group and the Alzheimer's disease group had a decreased uptake of I-123 IMP in the frontal lobe, in comparison with the control group. A remarkably decreased uptake was seen in the lateral and parietal lobes in the group of Parkinson's disease associated with dementia, as well as in the Alzheimer's disease group. A significantly decreased uptake was observed in the frontal lobe, lateral lobe, thalamus, and basal ganglia in the Parkinson's disease group, irrespective of the presence or absence of dementia. For Parkinson's disease associated with dementia, there was much more significant decrease in I-123 IMP uptake. The pattern of regional cerebral blood flow in the Alzheimer's disease group was analogous to that in the Parkinson's disease group associated with dementia. This supports the hypothesis that Alzheimer's disease may be somewhat involved in the occurrence of dementia for Parkinson's disease. (N.K.)

  20. Parkinson's Disease Videos

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  1. Parkinson's Disease Videos

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  2. Parkinson's Disease Videos

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  3. Parkinson's Disease Videos

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  4. Parkinson's Disease Videos

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  5. Parkinson's Disease Videos

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  6. Parkinson's Disease Videos

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  7. Parkinson's Disease Videos

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    Full Text Available ... Improving Parkinson's Care Everywhere Expert Briefings: Apathy or Depression: Which One Is It? CareMAP: El Descanso y ... Expert Briefings: A Closer Look at Anxiety and Depression in Parkinson's Disease Expert Briefings: Driving and Parkinson's: ...

  8. Parkinson's Disease Videos

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  9. Cross-sectional and longitudinal associations of motor fluctuations and non-motor predominance with cerebrospinal τ and Aβ as well as dementia-risk in Parkinson's disease.

    Science.gov (United States)

    Modreanu, Raluca; Cerquera, Sonia Catalina; Martí, María José; Ríos, José; Sánchez-Gómez, Almudena; Cámara, Ana; Fernández, Manel; Compta, Yaroslau

    2017-02-15

    Experimental, neuropathological and cerebrospinal fluid (CSF) studies support τ and amyloid-β (Aβ) relevance in Parkinson's disease (PD) related dementia. Lesser motor fluctuations (MFs) and non-motor features have also been related to PD-dementia. Yet, little is known about the association of MFs and non-motor symptoms with CSF τ and Aβ in PD. We hypothesized that lesser MFs and non-motor predominance are related to these CSF markers and dementia-risk in PD. We studied 58 PD patients (dementia at baseline, n=21; dementia at 18-months, n=35) in whom CSF Aβ and τ had been determined with ELISA techniques. MFs and a number of non-motor symptoms (apathy, anxiety, irritability, depression, visual hallucinations, spatial disorientation, memory complaints) over disease course were dichotomized as absent-mild vs. moderate-severe by retrospective clinical chart review blind to CSF findings. Non-motor predominance was defined as ≥3 non-motor symptoms (after the cohort-median of non-motor symptoms per patient) with ≥2 being moderate-severe and ≥1 having been present from onset, with all these being more disabling overall than motor features. Cross-sectionally, CSF biomarkers were non-parametrically compared according to dichotomized MFs and non-motor predominance. Longitudinally, dementia was the outcome (dependent variable), CSF markers, MFs and non-motor predominance were the predictors (independent variables), and potential modifiers as age, sex, and memory complaints were the covariates in binary regression models. Absent-mild MFs were associated with higher CSF τ markers and shorter time-to-dementia, while non-motor predominance and decreasing CSF Aβ independently increased longitudinal dementia-risk. In summary, absent-mild MFs, non-motor predominance and CSF τ and Aβ might define endophenotypes related to the timing or risk of dementia in PD. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Parkinson's Disease Videos

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  11. Correlation between pathology and neuromelanin MR imaging in Parkinson's disease and dementia with Lewy bodies

    Energy Technology Data Exchange (ETDEWEB)

    Kitao, Shinichiro; Fujii, Shinya; Miyoshi, Fuminori; Kaminou, Toshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori (Japan); Matsusue, Eiji [Tottori Prefectural Central Hospital, Department of Radiology, Tottori, Tottori (Japan); Kato, Shinsuke [Tottori University, Division of Neuropathology, Department of Brain and Neurosciences, Faculty of Medicine, Yonago, Tottori (Japan); Ito, Hisao [Tottori University, Division of Organ Pathology, Department of Microbiology and Pathology, Faculty of Medicine, Yonago, Tottori (Japan)

    2013-08-15

    Direct correlation between neuropathological findings and postmortem neuromelanin MR imaging (NmMRI) was performed in the substantia nigra pars compacta (SNc) to clarify the pathological background of the signal changes in normal, Parkinson's disease (PD), and dementia with Lewy bodies (DLB) cases. NmMRI of 10 % formalin-fixed autopsied midbrains was performed in three cases (normal control, DLB, and PD) with a 3T imaging system, using a 3D gradient echo T1-weighted sequence with a magnetization transfer contrast pulse. Neuropathological examinations of the midbrains were performed, and the density of neuromelanin-positive neurons (number per square millimeter) was determined. The extent of iron deposition in the midbrain was also evaluated using ferritin immunohistochemistry. Furthermore, we directly correlated the contrast signal ratio in the SNc and the density of neuromelanin-containing neurons. Diffuse hyperintense areas in the SNc reflected well-preserved neuromelanin-containing neurons in the normal control case, whereas an iso-intense area in the SNc showed severe loss of neuromelanin-containing neurons in the DLB and PD cases. Increased signal intensity in the SNc was apparently not influenced by iron deposition. Furthermore, a significant positive correlation between signal intensity and the density of neuromelanin-containing neurons was seen in the SNc. Based on the direct correlation between postportem NmMRI and neuropathological findings, signal intensity in the SNc is closely related to the quantity of neuromelanin-containing neurons but is not influenced by iron deposition. (orig.)

  12. Mild Cognitive Impairment as a Risk Factor for Parkinson's Disease Dementia

    NARCIS (Netherlands)

    Hoogland, Jeroen; Boel, Judith A.; de Bie, Rob M. A.; Geskus, Ronald B.; Schmand, Ben A.; Dalrymple-Alford, John C.; Marras, Connie; Adler, Charles H.; Goldman, Jennifer G.; Tröster, Alexander I.; Burn, David J.; Litvan, Irene; Geurtsen, Gert J.

    2017-01-01

    Background: The International Parkinson and Movement Disorder Society criteria for mild cognitive impairment in PD were recently formulated. Objectives: The aim of this international study was to evaluate the predictive validity of the comprehensive (level II) version of these criteria by assessment

  13. Parkinson disease - discharge

    Science.gov (United States)

    Your doctor has told you that you have Parkinson disease . This disease affects the brain and leads ... have you take different medicines to treat your Parkinson disease and many of the problems that may ...

  14. Parkinson's Disease Videos

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  15. Parkinson's Disease Videos

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  16. A quantitative study of α-synuclein pathology in fifteen cases of dementia associated with Parkinson disease.

    Science.gov (United States)

    Armstrong, Richard A; Kotzbauer, Paul T; Perlmutter, Joel S; Campbell, Meghan C; Hurth, Kyle M; Schmidt, Robert E; Cairns, Nigel J

    2014-02-01

    The α-synuclein-immunoreactive pathology of dementia associated with Parkinson disease (DPD) comprises Lewy bodies (LB), Lewy neurites (LN), and Lewy grains (LG). The densities of LB, LN, LG together with vacuoles, neurons, abnormally enlarged neurons (EN), and glial cell nuclei were measured in fifteen cases of DPD. Densities of LN and LG were up to 19 and 70 times those of LB, respectively, depending on region. Densities were significantly greater in amygdala, entorhinal cortex (EC), and sectors CA2/CA3 of the hippocampus, whereas middle frontal gyrus, sector CA1, and dentate gyrus were least affected. Low densities of vacuoles and EN were recorded in most regions. There were differences in the numerical density of neurons between regions, but no statistical difference between patients and controls. In the cortex, the density of LB and vacuoles was similar in upper and lower laminae, while the densities of LN and LG were greater in upper cortex. The densities of LB, LN, and LG were positively correlated. Principal components analysis suggested that DPD cases were heterogeneous with pathology primarily affecting either hippocampus or cortex. The data suggest in DPD: (1) ratio of LN and LG to LB varies between regions, (2) low densities of vacuoles and EN are present in most brain regions, (3) degeneration occurs across cortical laminae, upper laminae being particularly affected, (4) LB, LN and LG may represent degeneration of the same neurons, and (5) disease heterogeneity may result from variation in anatomical pathway affected by cell-to-cell transfer of α-synuclein.

  17. Parkinson's Disease Videos

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  18. Parkinson's Disease Videos

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  5. Neocortical concentrations of neuropeptides in senile dementia of the Alzheimer and Lewy body type: comparison with Parkinson's disease and severity correlations.

    Science.gov (United States)

    Leake, A; Perry, E K; Perry, R H; Jabeen, S; Fairbairn, A F; McKeith, I G; Ferrier, I N

    1991-02-15

    Corticotropin releasing hormone (CRH), somatostatin (SRIF), and arginine vasopressin (AVP) concentrations were estimated using radioimmunoassay in the temporal and occipital cortices in postmortem brain from patients clinically and neuropathologically diagnosed as senile dementia of the Lewy body type (SDLT), senile dementia of the Alzheimer type (SDAT), and Parkinson's disease (PD) and from neurologically normal controls. The concentration of temporal and occipital neocortical CRH was diminished in both SDAT and SDLT compared to control values, whereas SRIF was reduced only in temporal cortex in both these conditions. In contrast, the concentrations of both CRH and SRIF were unaltered in PD. The concentrations of AVP in SDLT, SDAT, and PD were similar to those found in the control groups. The decrement in SRIF, but not CRH, was found to be correlated with some indices of severity of illness in SDAT; a similar but nonsignificant trend for SRIF was observed in SDLT.

  6. Magnetisation transfer measurements of the subcortical grey and white matter in Parkinson's disease with and without dementia and in progressive supranuclear palsy

    International Nuclear Information System (INIS)

    Hanyu, H.; Asano, T.; Sakurai, H.; Takasaki, M.; Shindo, H.; Abe, K.

    2001-01-01

    We measured the magnetisation transfer ratio (MTR) in the subcortical grey and white matter of 11 patients with idiopathic Parkinson's disease (PD) without dementia, six with PD with dementia (PDD), six with progressive supranuclear palsy (PSP), and 12 elderly control subjects to assess regional differences in structural brain damage. There were no significant differences in MTR in any region between PD and controls. However, patients with PDD had significantly lower MTR in the subcortical white matter, including the frontal white matter and the genu of the corpus callosum than the controls, whereas PSP had significantly lower MTR in the subcortical grey matter, including the putamen, globus pallidus and thalamus, in addition to the subcortical white matter. This suggests that regional patterns of structural brain damage can be detected using the magnetisation transfer technique. Measurement of MTR in the subcortical grey and white matter may be useful in differential diagnosis. (orig.)

  7. Psychosis in Parkinson's Disease.

    Science.gov (United States)

    Ffytche, Dominic H; Aarsland, Dag

    2017-01-01

    Although illusions, hallucinations and delusions did not play a prominent role in James Parkinson's original clinical descriptions, the longitudinal view of disease progression he advocated has important lessons for the study of such symptoms today. A focus on longitudinal progression rather than individual symptoms led to the concept of PD psychosis-a spectrum of positive symptoms in Parkinson's disease. The publication of criteria for PD psychosis in 2007 helped unify the disparate set of symptoms, raising their profile and resulting in a rapid expansion of literature focussing on clinical aspects, mechanisms, and treatment. Here we review this literature and the evolving view of PD psychosis. Adding to previous evidence of a prospective risk for dementia and the move to supervised care, key recent developments include: recognition of prevalence increase with disease duration; a broadening of symptoms included in PD psychosis; better characterization of higher visual and cognitive dysfunction risk factors; structural, functional, and neurotransmitter imaging biomarker evidence; and approval of pimavanserin in the United States for the treatment of PD psychosis. The accumulating evidence raises novel questions and directions for future research that promise a better understanding of the clinical management of PD psychosis and its role as a biomarker for PD stage and progression. © 2017 Elsevier Inc. All rights reserved.

  8. A core avenue for transcultural research on dementia: on the cross-linguistic generalization of language-related effects in Alzheimer's disease and Parkinson's disease.

    Science.gov (United States)

    Calvo, Noelia; Ibáñez, Agustín; Muñoz, Edinson; García, Adolfo M

    2018-06-01

    Language is a key source of cross-cultural variability, which may have both subtle and major effects on neurocognition. However, this issue has been largely overlooked in two flourishing lines of research assessing the relationship between language-related neural systems and dementia. This paper assesses the limitations of the evidence on (i) the neuroprotective effects of bilingualism in Alzheimer's disease and (ii) specific language deficits as markers of Parkinson's disease. First, we outline the rationale behind each line of research. Second, we review available evidence and discuss the potential impact of cross-linguistic factors. Third, we outline ideas to foster progress in both fields and, with it, in cross-cultural neuroscience at large. On the one hand, studies on bilingualism suggest that sustained use of more than one language may protect against Alzheimer's disease symptoms. On the other hand, insights from the embodied cognition framework point to syntactic and action-verb deficits as early (and even preclinical) markers of Parkinson's disease. However, both fields share a key limitation that lies at the heart of cultural neuroscience: the issue of cross-linguistic generalizability. Relevant evidence for both research trends comes from only a handful of (mostly Indo-European) languages, which are far from capturing the full scope of structural and typological diversity of the linguistic landscape worldwide. This raises questions on the external validity of reported findings. Greater collaboration between linguistic typology and cognitive neuroscience seems crucial as a first step to assess the impact of transcultural differences on language-related effects across neurodegenerative diseases. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Parkinson's Disease Videos

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  4. ɑ-Synuclein strains and seeding in Parkinson's disease, incidental Lewy body disease, dementia with Lewy bodies and multiple system atrophy: similarities and differences.

    Science.gov (United States)

    Peelaerts, W; Bousset, L; Baekelandt, V; Melki, R

    2018-04-27

    Several age-related neurodegenerative disorders are characterized by the deposition of aberrantly folded endogenous proteins. These proteins have prion-like propagation and amplification properties but so far appear nontransmissible between individuals. Because of the features they share with the prion protein, PrP, the characteristics of pathogenic protein aggregates in several progressive brain disorders, including different types of Lewy body diseases (LBDs), such as Parkinson's disease (PD), multiple system atrophy (MSA) and dementia with Lewy bodies (DLB), have been actively investigated. Even though the pleomorphic nature of these syndromes might suggest different underlying causes, ɑ-synuclein (ɑSyn) appears to play an important role in this heterogeneous group of diseases (the synucleinopathies). An attractive hypothesis is that different types of ɑSyn protein assemblies have a unique and causative role in distinct synucleinopathies. We will discuss the recent research progress on ɑSyn assemblies involved in PD, MSA and DLB; their behavior as strains; current spreading hypotheses; their ability to seed centrally and peripherally; and their implication for disease pathogenesis.

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  9. Parkinson's disease and anxiety

    OpenAIRE

    Walsh, K; Bennett, G

    2001-01-01

    There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience clinically significant anxiety. This anxiety may be a psychological reaction to the stress of the illness or may be related to the neurochemical changes of the disease itself. Antiparkinsonian drugs may have a role in the pathogenesis of the anxiety. The anxiety disorders in Parkinson's disease patients appear to be clustered in th...

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  12. CBF tomograms with [/sup 99m/Tc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results

    International Nuclear Information System (INIS)

    Costa, D.C.; Ell, P.J.; Burns, A.; Philpot, M.; Levy, R.

    1988-01-01

    We present preliminary data on the utility of functional brain imaging with [99mTc]-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the on-off syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the on-off syndrome studied during an on phase (under levodopa therapy) and on another occasion after withdrawal of levodopa (off) demonstrated a significant change in the uptake of [99mTc]-d,l-HM-PAO in the caudate nucleus (lower on off) and thalamus (higher on off). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. [99mTc]-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions

  13. CBF tomograms with (/sup 99m/Tc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results

    Energy Technology Data Exchange (ETDEWEB)

    Costa, D.C.; Ell, P.J.; Burns, A.; Philpot, M.; Levy, R.

    1988-12-01

    We present preliminary data on the utility of functional brain imaging with (99mTc)-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the on-off syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the on-off syndrome studied during an on phase (under levodopa therapy) and on another occasion after withdrawal of levodopa (off) demonstrated a significant change in the uptake of (99mTc)-d,l-HM-PAO in the caudate nucleus (lower on off) and thalamus (higher on off). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. (99mTc)-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions.

  14. Cognitive decline in Parkinson disease

    Science.gov (United States)

    Aarsland, Dag; Creese, Byron; Politis, Marios; Chaudhuri, K. Ray; ffytche, Dominic H.; Weintraub, Daniel; Ballard, Clive

    2017-01-01

    Dementia is a frequent problem encountered in advanced stages of Parkinson disease (PD). In recent years, research has focused on the pre-dementia stages of cognitive impairment in PD, including mild cognitive impairment (MCI). Several longitudinal studies have shown that MCI is a harbinger of dementia in PD, although the course is variable, and stabilization of cognition — or even reversal to normal cognition — is not uncommon. In addition to limbic and cortical spread of Lewy pathology, several other mechanisms are likely to contribute to cognitive decline in PD, and a variety of biomarker studies, some using novel structural and functional imaging techniques, have documented in vivo brain changes associated with cognitive impairment. The evidence consistently suggests that low cerebrospinal fluid levels of amyloid-β42, a marker of comorbid Alzheimer disease (AD), predict future cognitive decline and dementia in PD. Emerging genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms. Cognitive enhancing medications have some effect in PD dementia, but no convincing evidence that progression from MCI to dementia can be delayed or prevented is available, although cognitive training has shown promising results. PMID:28257128

  15. There is no Parkinson disease.

    Science.gov (United States)

    Weiner, William J

    2008-06-01

    The term Parkinson disease defines a specific clinical condition characterized by a typical history and characteristic signs. This review examines the historical evolution of the concept of Parkinson disease and how the misunderstanding of Parkinson disease may be hindering clinical research trials. It is proposed that this syndrome be called Parkinson diseases or parkinsonism type 1 through infinity.

  16. Cognitive impairment in early-stage non-demented Parkinson's disease patients

    DEFF Research Database (Denmark)

    Pfeiffer, Helle Cecilie Viekilde; Løkkegaard, A; Zoetmulder, Marielle

    2013-01-01

    In Parkinson's disease (PD), Parkinson's disease dementia (PDD) and Parkinson's disease-mild cognitive impairment (PD-MCI) are common. PD-MCI is a risk factor for developing PDD. Knowledge of cognition in early-stages PD is essential in understanding and predicting the dementia process....

  17. Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia.

    Science.gov (United States)

    Akhtar, Rizwan S; Xie, Sharon X; Chen, Yin J; Rick, Jacqueline; Gross, Rachel G; Nasrallah, Ilya M; Van Deerlin, Vivianna M; Trojanowski, John Q; Chen-Plotkin, Alice S; Hurtig, Howard I; Siderowf, Andrew D; Dubroff, Jacob G; Weintraub, Daniel

    2017-01-01

    Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative) by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2%) were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%). Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients.

  18. Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia.

    Directory of Open Access Journals (Sweden)

    Rizwan S Akhtar

    Full Text Available Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2% were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%. Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients.

  19. Parkinson's Disease Videos

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    Full Text Available ... Help with Freezing Episodes? OHSU - Parkinson's Disease: Pharmacological Management of ... or Team Approach Important? OHSU - Therapeutic Approaches for PD: Depression, Anxiety & ...

  20. Parkinson's Disease Videos

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    Full Text Available ... live well with Parkinson's disease. Learn More Expert Care Patient Centered Care Centers of Excellence Bringing Care to You Expert Care Programs Professional Education Expert ...

  1. Genetics Home Reference: Parkinson disease

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Parkinson disease Parkinson disease Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Parkinson disease is a progressive disorder of the nervous ...

  2. Local cerebral metabolic rate of /sup 11/C-L-Methionine in early stages of dementia, schizophrenia, Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Bustany, P; Henry, J F; de Rotrou, J; Signoret, J L; Ziegler, M; Zarifian, E; Soussaline, F; Comar, D

    1983-06-01

    A dynamic three-compartment model of methionine metabolism in brain was applied in human patients using /sup 11/C-L-methionine and positron emission tomography (P.E.T). Psychometric evaluations of demented patients were correlated with a significant diminution of protein synthesis in the frontal area. This diminution was lower in ebephrenic patients (-17%) but was consistent with the results obtained with /sup 18/F glucose. No significant abnormality was detected in patients with Parkinson disease.

  3. Local cerebral metabolic rate of 11C-L-Methionine in early stages of dementia, schizophrenia, Parkinson's disease

    International Nuclear Information System (INIS)

    Bustany, P.; Henry, J.F.; de Rotrou, J.; Signoret, J.L.; Ziegler, M.; Zarifian, E.; Soussaline, F.; Comar, D.

    1983-06-01

    A dynamic three-compartment model of methionine metabolism in brain was applied in human patients using 11 C-L-Methionine and positron emission tomography (P.E.T). Psychometric evaluations of demented patients were correlated with a significant diminution of protein synthesis in the frontal area. This diminution was lower in ebephrenic patients (-17%) but was consistent with the results obtained with 18 F glucose. No significant abnormality was detected in patients with Parkinson disease

  4. Adult-onset phenylketonuria with rapidly progressive dementia and parkinsonism.

    Science.gov (United States)

    Tufekcioglu, Zeynep; Cakar, Arman; Bilgic, Basar; Hanagasi, Hasmet; Gurvit, Hakan; Emre, Murat

    2016-06-01

    Phenylketonuria (PKU) is an autosomal recessive metabolic disorder due to mutations in the phenylalanine hydroxylase (PAH) gene, which converts phenylalanine (PHE) to tyrosine. Although it is principally a childhood disorder, in rare cases, the first signs of PKU may develop in late adulthood resembling common neurological diseases. Here we report a 59-year-old, previously normal functioning man who was admitted with blurred vision, cognitive problems, and gait difficulty that began 8 months before. He had brisk reflexes and left side dominant parkinsonism. His Mini-Mental State Examination (MMSE) score was 25/30, and neuropsychological evaluation revealed a dysexecutive syndrome with simultanagnosia and constructional apraxia. His Clinical Dementia Rating score (CDR) was 1. Cranial MRI revealed bilateral diffuse hyperintense lesions in parietal and occipital white matter in T2, fluid-attenuated inversion recovery, and diffusion weighted images. Diagnostic workup for rapidly progressive dementias was all normal except PHE level which was found to be highly elevated (1075 μmol/L, normal 39-240 μmol/L) with normal tyrosine level (61.20 μmol/L, normal 35-100 μmol/L). Three months after PHE-restricted diet, his cognitive impairment and signs of parkinsonism significantly improved, with MRI scan unchanged. This case demonstrates that late-onset PKU is a rare, treatable cause of rapidly progressive dementia and parkinsonism with certain constellations such as consanguinity and white matter abnormalities (WMAs) in imaging.

  5. Parkinson's Disease Videos

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  6. Parkinson's Disease Videos

    Science.gov (United States)

    ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping Skills for ... Caregivers: Caremap and Caring & Coping CareMAP: Movement and Falls: Part ... There Any Ways to Control the Rate of Progression of the Disease? CareMAP: ...

  7. Parkinson's Disease Videos

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  8. Cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Jing YUAN

    2017-07-01

    Full Text Available Parkinson's disease cognitive impairment (PD-CI is one of the major non-motor symtoms (NMS of PD, including Parkinson's disease with mild cognitive impairment (PD - MCI and Parkinson's disease dementia (PDD. Executive dysfunction is relatively prominent, but other cognitive domains as visuospatial ability, memory and language can also be affected. Main risk factors for PD-CI include male gender, advanced age, low education, severe motor symptoms, low baseline cognitive function and excessive daytime sleepiness (EDS. Lewy bodies are main pathological changes, and Alzheimer's disease (AD related pathological changes can also be seen. The application value of decreased α?synuclein (α-Syn and β-amyloid 1-42 (Aβ1-42 levels in cerebrospinal fluid (CSF as biomarkers remains controversial. There are few related research and no defined pathogenic genes currently. Both dopaminergic pathway and acetylcholinergic pathway are involved in the occurrence of PD - CI as demonstrated in PET studies. Cortical and subcortical atrophy are associated with PD - CI as observed in MRI studies. Olfactory dysfunction may be one of the predictors of cognitive impairment. PDD and dementia with Lewy bodies (DLB share common biological characteristics, therefore the differential diagnosis sometimes is difficult. Cholinesterase inhibitors (ChEIs and memantine help to improve clinical symptoms, but treatment decision should be made with individualization. Cognitive behavioral treatment (CBT has potential clinical value and should be investigated by more studies. DOI: 10.3969/j.issn.1672-6731.2017.06.004

  9. Parkinson disease

    Science.gov (United States)

    ... The disease leads to shaking ( tremors ) and trouble walking and moving . ... include: Difficulty starting movement, such as starting to walk or ... are not moving. This is called resting tremor. Occur when your ...

  10. Parkinson's Disease: Diagnosis and Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Parkinson's Disease Parkinson's Disease: Diagnosis and Treatment Past Issues / Winter 2014 ... live productive lives and maintain mobility. How is Parkinson's Diagnosed? There are no blood or laboratory tests ...

  11. Parkinson's Disease Videos

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  12. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... and Its Treatment Affect Sexual Functioning? CareMAP: Balancing Life and Caregiving CareMAP: Travel and Transportation: Part 1 ...

  13. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... for PD Patients? How Does the DBS Device Work? CareMAP: Bathroom: Part 2 CareMAP: El Vestirse ¿Cómo ...

  14. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... Functioning? CareMAP: Las Actividades en Casa CareMAP: Balancing Life and Caregiving Jose Maria Lobo: Música en vivo ...

  15. Parkinson's Disease Videos

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  16. Parkinson's Disease Videos

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  17. Parkinson's Disease Videos

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  18. Parkinson's Disease Videos

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  19. Parkinson's Disease Videos

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    Full Text Available ... Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and Parkinson's Nurse: ... Psychosis What Medications Help with Cognitive Impairment? CareMAP: Travel and Transportation: Part 2 Parkinson’s Disease Psychosis: A ...

  20. Parkinson's Disease Videos

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    Full Text Available ... Non-Parkinson's Disease Medications? CareMAP: Life Beyond This Life What Treatments Exist for Parkinson's Disease Patients with a ... Learned Unconditional Love How Does the DBS Device ... When and What Type of Treatment Is Initiated After Diagnosis? Building ...

  1. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... Learned Unconditional Love How Does the DBS Device Work? CareMAP: Rest and Sleep: Part 1 CareMAP: Cambios ...

  2. Parkinson's Disease Videos

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  3. Parkinson's Disease Videos

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  4. Falls in Parkinson's disease.

    NARCIS (Netherlands)

    Grimbergen, Y.A.M.; Munneke, M.; Bloem, B.R.

    2004-01-01

    PURPOSE OF REVIEW: To summarize the latest insights into the clinical significance, assessment, pathophysiology and treatment of falls in Parkinson's disease. RECENT FINDINGS: Recent studies have shown that falls are common in Parkinson's disease, even when compared with other fall-prone

  5. Parkinson's Disease Videos

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    Full Text Available ... Day? How Does Parkinson's Disease Affect the Urinary System? NPF Caregiver Summit 2016: Tools For Family Caregivers: Caremap and Caring & Coping OHSU - Parkinson's Disease: Managing Depression, Anxiety & Psychosis CareMAP: Movement and Falls: Part 2 CareMAP: ...

  6. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... Care: Real Stories How Does the DBS Device Work? CareMAP: Movement and Falls: Part 1 CareMAP: Cambios ...

  7. Parkinson's Disease Videos

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    Full Text Available ... library Topic Type Living Alone: Home Safety and Management in PD Expert Briefings: Marijuana and PD: What ... Patients with Parkinson's Disease? OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis CareMAP: Movimientos y Caídas, ...

  8. Parkinson's Disease Videos

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    Full Text Available ... Nonmotor Symptoms of Parkinson's Disease Expert Briefings: Gait, Balance and Falls in Parkinson's Disease Expert Briefings: Coping ... Transportation: Part 1 How Does the DBS Device Work? CareMAP: Mealtime and Swallowing: Part 1 CareMAP: Cambios ...

  9. Automatic extraction of the cingulum bundle in diffusion tensor tract-specific analysis. Feasibility study in Parkinson's disease with and without dementia

    International Nuclear Information System (INIS)

    Ito, Kenji; Masutani, Yoshitaka; Suzuki, Yuichi; Ino, Kenji; Kunimatsu, Akira; Ohtomo, Kuni; Kamagata, Koji; Yasmin, Hasina; Aoki, Shigeki

    2013-01-01

    Tract-specific analysis (TSA) measures diffusion parameters along a specific fiber that has been extracted by fiber tracking using manual regions of interest (ROIs), but TSA is limited by its requirement for manual operation, poor reproducibility, and high time consumption. We aimed to develop a fully automated extraction method for the cingulum bundle (CB) and to apply the method to TSA in neurobehavioral disorders such as Parkinson's disease (PD). We introduce the voxel classification (VC) and auto diffusion tensor fiber-tracking (AFT) methods of extraction. The VC method directly extracts the CB, skipping the fiber-tracking step, whereas the AFT method uses fiber tracking from automatically selected ROIs. We compared the results of VC and AFT to those obtained by manual diffusion tensor fiber tracking (MFT) performed by 3 operators. We quantified the Jaccard similarity index among the 3 methods in data from 20 subjects (10 normal controls [NC] and 10 patients with Parkinson's disease dementia [PDD]). We used all 3 extraction methods (VC, AFT, and MFT) to calculate the fractional anisotropy (FA) values of the anterior and posterior CB for 15 NC subjects, 15 with PD, and 15 with PDD. The Jaccard index between results of AFT and MFT, 0.72, was similar to the inter-operator Jaccard index of MFT. However, the Jaccard indices between VC and MFT and between VC and AFT were lower. Consequently, the VC method classified among 3 different groups (NC, PD, and PDD), whereas the others classified only 2 different groups (NC, PD or PDD). For TSA in Parkinson's disease, the VC method can be more useful than the AFT and MFT methods for extracting the CB. In addition, the results of patient data analysis suggest that a reduction of FA in the posterior CB may represent a useful biological index for monitoring PD and PDD. (author)

  10. Comparative study of CT scan findings and intellectual function between Parkinson's disease and vascular Parkinsonism

    International Nuclear Information System (INIS)

    Indo, Toshikatsu

    1986-01-01

    Comparative study of CT scan findings and intellectual function between 64 cases with Parkinson's disease and 25 cases with vascular Parkinsonism was carried out. The rate of abnormality of CT scan findings, either ventricular dilatation or widening of sulci, in vascular Parkinsonism was strikingly high compared with Parkinson's disease. Patients could be divided into three groups according to the degree of overall abnormalities of CT scan findings (group A: markedly abnormal, group B: mildly abnormal, group C: normal). Incidences of group A were 9.4 % in Parkinson's disease and 52 % in vascular Parkinsonism, whereas those of group C were 56 % in the former and 28 % in the latter. All patients of group A were over 65 years of age in Parkinson's disease, but one-third of patients in group A were under 59 years of age in vascular Parkinsonism. Moreover, in vascular Parkinsonism, the level of disability was directly proportional to the abnormality of CT scan findings. The rate of predementia and dementia classified by Hasegawa's intelligence scale was 12.5 % in Parkinson's disease and 48 % in vascular Parkinsonism. No difference was found between the mean values of intelligence scale and background factors in Parkinson's disease. On the other hand, the mean value was significantly low in proportion to the poverty of L-dopa effect in vascular Parkinsonism. From these results, the abnormality of CT scan findings and intellectual impairment were probably related to the cerebral pathological process in vascular Parkinsonism, but these relationship was absent in Parkinson's disease. (author)

  11. Comparative study of CT scan findings and intellectual function between Parkinson's disease and vascular Parkinsonism

    Energy Technology Data Exchange (ETDEWEB)

    Indo, Toshikatsu

    1986-01-01

    Comparative study of CT scan findings and intellectual function between 64 cases with Parkinson's disease and 25 cases with vascular Parkinsonism was carried out. The rate of abnormality of CT scan findings, either ventricular dilatation or widening of sulci, in vascular Parkinsonism was strikingly high compared with Parkinson's disease. Patients could be divided into three groups according to the degree of overall abnormalities of CT scan findings (group A: markedly abnormal, group B: mildly abnormal, group C: normal). Incidences of group A were 9.4 % in Parkinson's disease and 52 % in vascular Parkinsonism, whereas those of group C were 56 % in the former and 28 % in the latter. All patients of group A were over 65 years of age in Parkinson's disease, but one-third of patients in group A were under 59 years of age in vascular Parkinsonism. Moreover, in vascular Parkinsonism, the level of disability was directly proportional to the abnormality of CT scan findings. The rate of predementia and dementia classified by Hasegawa's intelligence scale was 12.5 % in Parkinson's disease and 48 % in vascular Parkinsonism. No difference was found between the mean values of intelligence scale and background factors in Parkinson's disease. On the other hand, the mean value was significantly low in proportion to the poverty of L-dopa effect in vascular Parkinsonism. From these results, the abnormality of CT scan findings and intellectual impairment were probably related to the cerebral pathological process in vascular Parkinsonism, but these relationship was absent in Parkinson's disease.

  12. [Behavioral impairments in Parkinson's disease].

    Science.gov (United States)

    Kashihara, Kenichi

    2004-09-01

    Behavioral impairments in parkinsonian patients include agitation, hypersexuality, stereotypic movement, pathological gambling, abuse of antiparkinsonian drugs, REM sleep behavioral disorder, and restless legs syndrome. Dementia, psychoses, and emotional disorders, such as depression and anxiety/panic disorder, also impair behavior. Symptoms may be produced by dysfunction of the central nervous system, medication, and/or the psychosocial problems associated with Parkinson's disease. Treatment therefore should be based on the cause of the symptoms seen. In some cases, the reduction or change of antiparkinsonian drugs, or both, may be effective. Treatment of the motor symptoms of Parkinson's disease, including motor fluctuations, may reduce the risk of panic attacks being evoked in the 'off' period. Use of antidepressants, sedatives, and neuroleptics may often be effective. Physicians should identify the causes of the symptoms of behavioral impairment and select appropriate treatments.

  13. Parkinson's Disease Videos

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  18. Parkinson's Disease Videos

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    Full Text Available ... How Is Parkinson's Disease Diagnosed? CareMAP: Managing Caregiver Stress CareMAP: Getting Dressed CareMAP: End-of-Life Care ... Salud en General, Parte 2 CareMAP: Rest and Sleep: Part 2 Dra. Claudia Martinez, MAPC - Parkinson- Pasion, ...

  19. Parkinson's Disease Videos

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  20. Xenotransplantation in Parkinson's disease

    NARCIS (Netherlands)

    Koopmans, Jan

    2006-01-01

    Parkinson's disease is a neurodegenerative disorder characterised by loss of dopaminergic neurones in the substantia nigra pars compacta and subsequent shortage of dopamine in the striatum of the these patients causing the well known symptoms first described by James Parkinson in 1817. In this

  1. Demência na doença de Parkinson: avaliação crítica da literatura Dementia in Parkinson's disease: a critical review of literature

    Directory of Open Access Journals (Sweden)

    Luciana de Abreu e Lima Pamplona

    1996-12-01

    momento, não reconhece agentes eficazes.In the last 30 years, Parkinson's disease has been object of great progress. The majority of patients reaches a longer life with quality because of the modern therapeutic approach. However, dementia that can occur in the evolutive process, has its neuropathology not completelly defined until now. There are lesions in the basal ganglia, in the ventral area of the mesencephalic tegmentum, in the thalamus, in the substantia nigra and in the frontal cortex. The presence of Lewy bodies in the cortex is associated with dementia, in the same way that the anatomopathological features of Alzheimer's disease, in many cases. Dementia should have a multifactorial basis. Different types of neurotransmitters, like serotonin, acetylcholine and dopamine, or even hormones, like Cortisol, may be altered in a great number of demented parkinsonians. Depression, found in up to 40% of patients, have been related as a risk factor for dementia, present approximatelly in 25% of cases. Studies in this area are still conflicting, with some confirming the relation among depression, cortical atrophy, hypercortisolemia and Parkinson's disease. Neuropsychologic studies show that the dementia in Parkinson's disease is of subcortical type. It is also known that parkinsonians, even those without cognitive deficiencies clinically significant, present deficits if submitted to more detailed neuropsychological tests. It is assumed, so, that cognitive impairments are intrinsic to the disease, varying its expression among patients. Dementia shall be diagnosed based on the criteria established in the diagnostic and statistical manual of mental disorders of the American Psychiatry Association, as well as computed tomography and magnetic resonance. For treatment, parkinsonian dementia does not recognize efficacious agents until now.

  2. Anosognosia for cognitive and behavioral symptoms in Parkinson's disease with mild dementia and mild cognitive impairment: Frequency and neuropsychological/neuropsychiatric correlates.

    Science.gov (United States)

    Orfei, Maria Donata; Assogna, Francesca; Pellicano, Clelia; Pontieri, Francesco Ernesto; Caltagirone, Carlo; Pierantozzi, Mariangela; Stefani, Alessandro; Spalletta, Gianfranco

    2018-04-17

    Anosognosia is a multidimensional phenomenon with detrimental effects on patients' illness course, therapy compliance and quality of life. We aimed at investigating anosognosia for cognitive and behavioral symptoms in Parkinson's Disease (PD) with dementia (PDD) and, for the first time, in PD with Mild Cognitive Impairment (MCI-PD). Community dwelling subjects (47 mild PDD, 136 multidomain MCI-PD (mdMCI-PD), 5 single domain MCI-PD (sdMCI-PD), and 197 PD without cognitive impairment (noCI-PD) were enrolled in a cross-sectional design study. All the subjects were administered the Anosognosia Questionnaire for Dementia, the Mental Deterioration Battery and a number of neuropsychiatric inventories. A diagnosis of anosognosia was made in 36% of patients with mild PDD and 16% with mdMCI-PD, whether it was negligible in sdMCI-PD and noCI-PD. Higher severity of anosognosia for cognitive impairment was also found in PDD and in mdMCI-PD. SdMCI-PD had the lower severity of anosognosia for cognitive impairment. Higher anosognosia for cognitive impairment was associated to lower depression in noCI-PD (r = -0.227, p = 0.0013) and mdMCI-PD (r = -0.266, p = 0.0016), and to reduced hedonic tone in noCI-PD (r = -0.191, p = 0.0071). Greater anosognosia was associated to lower executive performances in PDD (r = 0.424, p = 0.0074). Anosognosia for non-motor symptoms is frequent in PD patients with mild dementia or mdMCI. Results confirm the role of neuropsychiatric characteristics in anosognosia also in PD, the high prevalence of anosognosia in neurodegenerative illnesses and suggest a common pathogenic path for anosognosia in different neurodegenerative and psychiatric disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Parkinson's Disease Videos

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  4. Parkinson's Disease Videos

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  5. Parkinson's Disease Videos

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  6. Parkinson's Disease Videos

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  7. Pathogenesis of Parkinson's disease

    OpenAIRE

    Riederer, Peter; Lange, Klaus W.

    1992-01-01

    The importance of genetic aspects, ageing, environmental factors, head trauma, defective mitochondrial respiration, altered iron metabolism, oxidative stress and glutamatergic overactivity of the basal ganglia in the pathogenesis of Parkinson's disease (PD) are considered in this review.

  8. Parkinson's Disease Videos

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  10. Parkinson's Disease Videos

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  11. Parkinson's Disease Videos

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  13. Parkinson's Disease Videos

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  14. Learning about Parkinson's Disease

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    Skip to main content Learning About Parkinson's Disease Enter Search Term(s): Español Research Funding An Overview Bioinformatics Current Grants Education and Training Funding Extramural Research ...

  15. Parkinson's Disease Videos

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  16. Parkinson's Disease Videos

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  17. Parkinson's Disease Videos

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  18. Parkinson's Disease Videos

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  19. Parkinson's Disease Videos

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  20. Parkinson's Disease Videos

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  1. Parkinson's Disease Videos

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  2. Parkinson's Disease Videos

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  3. Parkinson's Disease Videos

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  4. Parkinson's Disease Videos

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  5. Parkinson's Disease Videos

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  6. Parkinson's Disease Videos

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  9. Parkinson's Disease Videos

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  10. Nondipping in Parkinson's Disease

    OpenAIRE

    Sita Sommer; Billur Aral-Becher; Wolfgang Jost

    2011-01-01

    Objective. The aim of this study was to identify patients with Parkinson's disease who showed loss or decrease of nocturnal blood pressure fall (nondipper patients) as a marker of autonomic dysfunction. Presence or absence of orthostatic hypotension was considered to investigate whether alterations in circadian blood pressure pattern are associated with posture-related dysregulation of blood pressure. Methods. 40 patients with Parkinson's disease underwent 24-hour blood pressure monitoring. 2...

  11. CT scan of Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, T; Noguchi, S; Nishitani, H [National Sanatorium of Utano, Kyoto (Japan); Kitano, H; Ikegami, Y

    1981-04-01

    In forty-eight patients with Parkinson's disease, we examined the ventricular size and the degree of cortical atrophy which were measured by the photos of CT scan and compared them with their clinical symptoms and side effects of anti-parkinsonian drugs. The ventricular size was expressed as the ventricular ratio which is the percentage of superimposed lateral ventricular area to the white and gray matter area at the slice number 2B of CT scan photos. The degree of the cortical atrophy was expressed as the sulcal numbers which were clearly visualized at the slice number 3B or 4A of CT scan photos. We used the CT scan photos of age-matched other patients which did not show definit central nervous system abnormalities. Our findings were as follows: (1) The ventricular enlargement was observed in the parkinsonian patients who showed dementia and/or Yahr's classification grades IV or V. (2) There was no correlation between the duration of this disease and the L--dopa treatments with the ventricular size and sulcal numbers. (3) The side effects of drugs such as visual hallucination were tended to be observed in the patients who showed the ventricular enlargement. (4) There was no definite correlation between the degree of cortical atrophy with clinical symptoms and side effects of various drugs. These findings suggested that the ventricular enlargement in Parkinson's disease was an important sign of dementia and the tendency of appearance of side effects of various drugs.

  12. CT scan of Parkinson's disease

    International Nuclear Information System (INIS)

    Konishi, Tetsuro; Noguchi, Sadako; Nishitani, Hiroshi; Kitano, Haruo; Ikegami, Yoshinori.

    1981-01-01

    In forty-eight patients with Parkinson's disease, we examined the ventricular size and the degree of cortical atrophy which were measured by the photos of CT scan and compared them with their clinical symptoms and side effects of anti-parkinsonian drugs. The ventricular size was expressed as the ventricular ratio which is the percentage of superimposed lateral ventricular area to the white and gray matter area at the slice number 2B of CT scan photos. The degree of the cortical atrophy was expressed as the sulcal numbers which were clearly visualized at the slice number 3B or 4A of CT scan photos. We used the CT scan photos of age-matched other patients which did not show definit central nervous system abnormalities. Our findings were as follows: (1) The ventricular enlargement was observed in the parkinsonian patients who showed dementia and/or Yahr's classification grades IV or V. (2) There was no correlation between the duration of this disease and the L--dopa treatments with the ventricular size and sulcal numbers. (3) The side effects of drugs such as visual hallucination were tended to be observed in the patients who showed the ventricular enlargement. (4) There was no definite correlation between the degree of cortical atrophy with clinical symptoms and side effects of various drugs. These findings suggested that the ventricular enlargement in Parkinson's disease was an important sign of dementia and the tendency of appearance of side effects of various drugs. (author)

  13. Somatization in Parkinson's Disease

    DEFF Research Database (Denmark)

    Carrozzino, Danilo; Bech, Per; Patierno, Chiara

    2017-01-01

    The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we...... consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR)....

  14. Therapies in Parkinson's disease.

    Science.gov (United States)

    Jankovic, Joseph; Poewe, Werner

    2012-08-01

    This review examines currently available therapeutic strategies for Parkinson's disease, emphasizing evidence-based data as well as a patient-centered approach to the treatment of motor and nonmotor symptoms. Although clinical trials of disease-modifying approaches have been thus far disappointing, steady advances are being made in the symptomatic treatment of Parkinson's disease. In this review, we focus on recent studies with monoamine oxidase type B inhibitors (selegiline and rasagiline), coenzyme Q10, creatine, and exercise in early Parkinson's disease. We also discuss the relative merits and disadvantages of delaying the initiation of levodopa therapy, the role of dopamine agonists, particularly ropinirole and pramipexole, and management of motor and behavioral complications, such as fluctuations, dyskinesias and impulse-control disorders. Novel formulations and delivery approaches for conventional and new drugs are also discussed. Finally, we review recent studies of surgical treatments of Parkinson's disease, such as deep brain stimulation. Numerous clinical trials have provided evidence that health-related quality of life can be substantially improved with early diagnosis and institution of exercise and other physical measures, appropriate timing of dopaminergic therapy, and strategies to delay and treat levodopa-related motor complications and nonmotor Parkinson's disease-related symptoms.

  15. Comparison study of positron emission tomography, X-ray CT and MRI in Parkinsonism with dementia

    International Nuclear Information System (INIS)

    Okada, Junichi; Peppard, R.; Calne, D.B.

    1989-01-01

    Brain atrophy and local cerebral metabolic rate of glucose (LCMR-glc) in Parkinson's disease with dementia and Parkinsonism-dementia complex (PDC) were studied using positron emission tomography (PET) with F-18-2-deoxy-2-fluoro-D-glucose, X-ray CT and magnetic resonance imaging (MRI). The group of Parkinson's disease with dementia (n=7) had a significantly decreased LCMR-glc in all regions when compared with the age-matched normal group. In the group of Parkinson's disease without dementia (n=6), LCMR-glc was also significantly lower than the control group, although it was higher than the group with associated dementia. Some of the normal aged persons had cortical atrophy. There was no correlation between LCMR-glc and cortical atrophy. Six Guamnian patients had PDC associated with amyotrophic lateral sclerosis (ALS), and four patients had it without ALS. LCMR-glc did not differ in the two groups. It was, however, significantly lower than that in 5 Guamanian and 10 Caucasian normal persons. The group of PDC had a noticeable cortical atrophy and ventricular dilatation, regardless of the presence or absence of ALS. There was correlation between decrease of LCMR-glc and cortical atrophy of the frontal, parietal and temporal lobes. Parkinson's disease and PDC were different from Alzheimer's disease in which a decreased LCMR-glc has been reported to be usually confined to the cerebral cortex. Cortical atrophy and ventricular dilatation were depicted on MRI and CT in the PDC group, but did not in the group of Parkinson's disease. PET was useful in the functional examination and both MRI and CT were useful in the anatomical examination of these diseases. (Namekawa, K)

  16. Comparison study of positron emission tomography, X-ray CT and MRI in Parkinsonism with dementia

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Junichi; Peppard, R; Calne, D B

    1989-05-01

    Brain atrophy and local cerebral metabolic rate of glucose (LCMR-glc) in Parkinson's disease with dementia and Parkinsonism-dementia complex (PDC) were studied using positron emission tomography (PET) with F-18-2-deoxy-2-fluoro-D-glucose, X-ray CT and magnetic resonance imaging (MRI). The group of Parkinson's disease with dementia (n=7) had a significantly decreased LCMR-glc in all regions when compared with the age-matched normal group. In the group of Parkinson's disease without dementia (n=6), LCMR-glc was also significantly lower than the control group, although it was higher than the group with associated dementia. Some of the normal aged persons had cortical atrophy. There was no correlation between LCMR-glc and cortical atrophy. Six Guamnian patients had PDC associated with amyotrophic lateral sclerosis (ALS), and four patients had it without ALS. LCMR-glc did not differ in the two groups. It was, however, significantly lower than that in 5 Guamanian and 10 Caucasian normal persons. The group of PDC had a noticeable cortical atrophy and ventricular dilatation, regardless of the presence or absence of ALS. There was correlation between decrease of LCMR-glc and cortical atrophy of the frontal, parietal and temporal lobes. Parkinson's disease and PDC were different from Alzheimer's disease in which a decreased LCMR-glc has been reported to be usually confined to the cerebral cortex. Cortical atrophy and ventricular dilatation were depicted on MRI and CT in the PDC group, but did not in the group of Parkinson's disease. PET was useful in the functional examination and both MRI and CT were useful in the anatomical examination of these diseases. (Namekawa, K).

  17. Comparison study of positron emission tomography, X-ray CT and MRI in Parkinsonism with dementia

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Junichi; Peppard, R.; Calne, D.B.

    1989-05-01

    Brain atrophy and local cerebral metabolic rate of glucose (LCMR-glc) in Parkinson's disease with dementia and Parkinsonism-dementia complex (PDC) were studied using positron emission tomography (PET) with F-18-2-deoxy-2-fluoro-D-glucose, X-ray CT and magnetic resonance imaging (MRI). The group of Parkinson's disease with dementia (n=7) had a significantly decreased LCMR-glc in all regions when compared with the age-matched normal group. In the group of Parkinson's disease without dementia (n=6), LCMR-glc was also significantly lower than the control group, although it was higher than the group with associated dementia. Some of the normal aged persons had cortical atrophy. There was no correlation between LCMR-glc and cortical atrophy. Six Guamnian patients had PDC associated with amyotrophic lateral sclerosis (ALS), and four patients had it without ALS. LCMR-glc did not differ in the two groups. It was, however, significantly lower than that in 5 Guamanian and 10 Caucasian normal persons. The group of PDC had a noticeable cortical atrophy and ventricular dilatation, regardless of the presence or absence of ALS. There was correlation between decrease of LCMR-glc and cortical atrophy of the frontal, parietal and temporal lobes. Parkinson's disease and PDC were different from Alzheimer's disease in which a decreased LCMR-glc has been reported to be usually confined to the cerebral cortex. Cortical atrophy and ventricular dilatation were depicted on MRI and CT in the PDC group, but did not in the group of Parkinson's disease. PET was useful in the functional examination and both MRI and CT were useful in the anatomical examination of these diseases. (Namekawa, K).

  18. Motor assessment in Parkinson`s disease.

    Science.gov (United States)

    Opara, Józef; Małecki, Andrzej; Małecka, Elżbieta; Socha, Teresa

    2017-09-21

    Parkinson's disease (PD) is one of most disabling disorders of the central nervous system. The motor symptoms of Parkinson's disease: shaking, rigidity, slowness of movement, postural instability and difficulty with walking and gait, are difficult to measure. When disease symptoms become more pronounced, the patient experiences difficulties with hand function and walking, and is prone to falls. Baseline motor impairment and cognitive impairment are probable predictors of more rapid motor decline and disability. An additional difficulty is the variability of the symptoms caused by adverse effects of drugs, especially levodopa. Motor assessment of Parkinson`s Disease can be divided into clinimetrics, assessment of balance and posture, arm and hand function, and gait/walking. These are many clinimetric scales used in Parkinson`s Disease, the most popular being the Hoehn and Yahr stages of progression of the disease and Unified Parkinson's Disease Rating Scale. Balance and posture can be assessed by clinimetric scales like the Berg BS, Tinetti, Brunel BA, and Timed Up and Go Test, or measured by posturometric platforms. Among skill tests, the best known are: the Purdue Pegboard Test, Nine-Hole Peg Test, Jebsen and Taylor test, Pig- Tail Test, Frenchay Arm Test, Action Research Arm Test, Wolf FMT and Finger-Tapping Test. Among motricity scales, the most popular are: the Fugl-Meyer Motor Assessment Scale and Södring Motor Evaluation. Gait and walking can also be assessed quantitatively and qualitatively. Recently, the most popular is three-dimensional analysis of movement. This review article presents the current possibilities of motor assessment in Parkinson`s disease.

  19. Mild Cognitive Impairment in Parkinson's Disease-What Is It?

    Science.gov (United States)

    Weil, Rimona S; Costantini, Alyssa A; Schrag, Anette E

    2018-03-10

    Mild cognitive impairment is a common feature of Parkinson's disease, even at the earliest disease stages, but there is variation in the nature and severity of cognitive involvement and in the risk of conversion to Parkinson's disease dementia. This review aims to summarise current understanding of mild cognitive impairment in Parkinson's disease. We consider the presentation, rate of conversion to dementia, underlying pathophysiology and potential biomarkers of mild cognitive impairment in Parkinson's disease. Finally, we discuss challenges and controversies of mild cognitive impairment in Parkinson's disease. Large-scale longitudinal studies have shown that cognitive involvement is important and common in Parkinson's disease and can present early in the disease course. Recent criteria for mild cognitive impairment in Parkinson's provide the basis for further study of cognitive decline and for the progression of different cognitive phenotypes and risk of conversion to dementia. Improved understanding of the underlying pathology and progression of cognitive change are likely to lead to opportunities for early intervention for this important aspect of Parkinson's disease.

  20. Diabetes mellitus and Parkinson disease.

    Science.gov (United States)

    Pagano, Gennaro; Polychronis, Sotirios; Wilson, Heather; Giordano, Beniamino; Ferrara, Nicola; Niccolini, Flavia; Politis, Marios

    2018-05-08

    To investigate whether diabetes mellitus is associated with Parkinson-like pathology in people without Parkinson disease and to evaluate the effect of diabetes mellitus on markers of Parkinson pathology and clinical progression in drug-naive patients with early-stage Parkinson disease. We compared 25 patients with Parkinson disease and diabetes mellitus to 25 without diabetes mellitus, and 14 patients with diabetes mellitus and no Parkinson disease to 14 healthy controls (people with no diabetes mellitus or Parkinson disease). The clinical diagnosis of diabetes mellitus was confirmed by 2 consecutive fasting measurements of serum glucose levels >126 mL/dL. Over a 36-month follow-up period, we then investigated in the population with Parkinson disease whether the presence of diabetes mellitus was associated with faster motor progression or cognitive decline. The presence of diabetes mellitus was associated with higher motor scores ( p Parkinson disease. In patients with diabetes but without Parkinson disease, the presence of diabetes mellitus was associated with lower striatal dopamine transporter binding ( p Parkinson disease, the presence of diabetes mellitus was associated with faster motor progression (hazard ratio = 4.521, 95% confidence interval = 1.468-13.926; p Parkinson-like pathology, and when present in patients with Parkinson disease, can induce a more aggressive phenotype. © 2018 American Academy of Neurology.

  1. Quantitative neuropathological study of Alzheimer-type pathology in the hippocampus: comparison of senile dementia of Alzheimer type, senile dementia of Lewy body type, Parkinson's disease and non-demented elderly control patients.

    Science.gov (United States)

    Ince, P; Irving, D; MacArthur, F; Perry, R H

    1991-12-01

    A Lewy body dementing syndrome in the elderly has been recently described and designated senile dementia of Lewy body type (SDLT) on the basis of a distinct clinicopathological profile. The pathological changes seen in SDLT include the presence of cortical Lewy bodies (LB) frequently, but not invariably, associated with senile plaque (SP) formation. Whilst neocortical neurofibrillary tangles (NFT) are sparse or absent, a proportion of these cases show involvement of the temporal archicortex by lesions comprising Alzheimer-type pathology (ATP, i.e. NFT, SP and granulovacuolar degeneration [GVD]). Thus the relationship between SDLT and senile dementia of Alzheimer type (SDAT) is complex and controversial. In this study quantitative neuropathology was used to compare the intensity and distribution of ATP in the hippocampus and entorhinal cortex of 53 patients from 3 disease groups (SDLT, SDAT, Parkinson's disease (PD)) and a group of neurologically and mentally normal elderly control patients. For most brain areas examined the extent of ATP between the patient groups followed the trend SDAT greater than SDLT greater than PD greater than control. Statistical comparison of these groups revealed significant differences between the mean densities of NFT, SP and GVD although individual cases showed considerable variability. These results confirm additional pathological differences between SDAT and SDLT regarding the intensity of involvement of the temporal archicortex by ATP. Many patients with Lewy body disorders (LBdis) show a predisposition to develop ATP albeit in a more restricted distribution (e.g. low or absent neocortical NFT) and at lower densities than is found in SDAT. Some cases of SDLT show minimal SP and NFT formation in both neocortex and archicortex supporting previously published data distinguishing this group from Alzheimer's disease.

  2. Parkinson's Disease Videos

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  3. Parkinson's Disease Videos

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  4. Parkinson's Disease Videos

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  5. Parkinson's Disease Videos

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  6. Kinesiotherapy of Parkinson`s disease and Parkinson`s syndrom

    OpenAIRE

    Zechovská, Lenka

    2013-01-01

    Author: Lenka Zechovská Institution: Rehabilitation Clinic, Faculty of Medicine in Hradec Králové Title: Kinesiotherapy of Parkinson's disease and Parkinson's syndrome Supervisor: Mgr. Ivana Vondráková Number of pages: 115 Number of attachments: 8 Year of defence: 2013 Keywords: Parkinson's disease, basal ganglia, tremor, rigidity, hypokinesia Bachelor thesis deals with the problems of Parkinson's disease and Parkinson's syndrome. The theoretical part includes the basal ganglia pathophysiolog...

  7. Pharmacotherapy for Parkinson's disease.

    Science.gov (United States)

    Chen, Jack J; Swope, David M

    2007-12-01

    The available pharmacotherapies for Parkinson's disease address symptomatology because no agent has been demonstrated to provide definite neuroprotection against the disease. Choice of pharmacotherapy must include consideration of short-term benefits as well as long-term consequences. Patients with mild Parkinson's disease often function adequately without symptomatic treatment. However, recent data suggest that initiation of treatment with a well-tolerated agent (e.g., the monoamine oxidase [MAO]-B inhibitor rasagiline) in the absence of functional impairment is associated with improved long-term outcomes. Consideration should also be given to many patient-specific factors, including patient expectations, level of disability, employment status, functional as well as chronologic age, expected efficacy and tolerability of drugs, and response to previous Parkinson's disease therapies. Increasingly, initial monotherapy begins with a nondopaminergic agent or, if the patient is considered functionally young, a dopamine agonist. Since Parkinson's disease is a progressive disorder, adjustments to pharmacotherapy must be expected over time. When greater symptomatic relief is desired, or in the more frail elderly patient, levodopa therapy should be considered. If motor fluctuations develop, addition of a catechol-O-methyltransferase inhibitor or MAO-B inhibitor should be considered. For management of levodopa-induced dyskinesias, addition of amantadine is an option. Surgery may be considered when patients need additional symptomatic control or are experiencing severe motor complications despite pharmacologically optimized therapy.

  8. Parkinson's Disease Videos

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    Full Text Available ... Musica en vivo con Lobo! CareMAP: Managing Caregiver Stress CareMAP: End-of-Life Care What Is the ... Walk at Moving Day OHSU - Parkinson's Disease: Pharmacological Management of Depression, Anxiety & Psychosis Interview with Nathan Slewett ...

  9. Parkinson's Disease Videos

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    Full Text Available ... Education on Parkinson's Disease Expert Briefings: Getting Around: Transportation and Travel with PD Expert Briefings: Sleep and ... for PD: Depression, Anxiety & Psychosis CareMAP: Travel and Transportation: Part 2 CareMAP: Bathroom: Part 1 ¿Cómo Se ...

  10. Parkinson's Disease Videos

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    Full Text Available ... many things you can do to maintain and improve your quality of life and live well with Parkinson's disease. ... a Depression Diagnosis? What Are Some Strategies to Improve the Quality of Community Care for PD Patients? CareMAP: Ayudando ...

  11. Parkinson's Disease Videos

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    Full Text Available ... CareMAP: The Caregiving Journey What Medications Help with Cognitive Impairment? Parkinson’s Disease Psychosis: A Caregiver’s Story CareMAP: ... Lobo: Música en vivo con Lobo! Expert Briefings: Cognitive Issues: Advice for Parkinson's Care Partners Are There ...

  12. Parkinson's Disease Videos

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    Full Text Available ... Needs of the Caregiver How Does Parkinson's Disease Affect the Urinary System? CareMAP: Putting Things in Place CareMAP: Thinking Changes: Part 2 NPF Caregiver Summit 2016: Tools For Family Caregivers: Caremap and Caring & Coping CareMAP: ... Preparing Paid Caregivers CareMAP: La Alimentación ...

  13. Parkinson's Disease Videos

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    Full Text Available ... Care: Real Stories What Are the Risks and Benefits of DBS Surgery? Is Depression Under-Diagnosed in Patients with Parkinson's Disease? CareMAP: Managing Caregiver Stress CareMAP: Movimientos y Caídas, Parte 2 CareMAP: End-of-Life Care Caregiver Summit 2016: Maintaining Dignity & Identity CareMAP: ...

  14. Parkinson's Disease Videos

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    Full Text Available ... you can do to maintain and improve your quality of life and live well with Parkinson's disease. Learn More Expert Care Patient Centered Care Centers of Excellence Bringing Care to You Expert Care Programs Professional Education Expert Care Research shows people with Parkinson’s who ...

  15. Parkinson's Disease Videos

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    Full Text Available ... Spouse About Sexual Dysfunction? Attachment: consultation.jpg OHSU - Therapeutic Approaches for PD: Depression, Anxiety & Psychosis What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Travel and Transportation: Part 2 Hallucinations and Delusions CareMAP: ...

  16. Parkinson's Disease Videos

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    Full Text Available ... to Give There are many ways you can support the fight against Parkinson’s. Whatever form your gift takes, you can be confident that it goes toward ... Briefings: Nutrition and Parkinson's Disease NY Nightly News with Chuck ...

  17. Parkinson's Disease Videos

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    Full Text Available ... Communication and the PD Partnership Expert Briefings: Fatigue, Sleep Disorders and Parkinson's Disease Expert Briefings: What's in the ... and Scheduling: Part 2 What Are the Common Sleep Disorders Encountered in Patients with PD? CareMAP: Planear y ...

  18. Parkinson's Disease Videos

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    Full Text Available ... A A You are here Home PD Library Search library Topic Type Expert Briefings: Marijuana and PD: What Do We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model Interventions Expert Briefings: Parkinson's Disease Psychosis: ...

  19. Parkinson's Disease Videos

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    Full Text Available ... Americans living with Parkinson’s disease. Learn more Ways to Give Donate Make a Tribute Gift Support a Moving ... Parkinson's Champion Bequests & Planned Giving Shop More Ways to Give Ways to Give There are many ways you ...

  20. Nondipping in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Sita Sommer

    2011-01-01

    Full Text Available Objective. The aim of this study was to identify patients with Parkinson's disease who showed loss or decrease of nocturnal blood pressure fall (nondipper patients as a marker of autonomic dysfunction. Presence or absence of orthostatic hypotension was considered to investigate whether alterations in circadian blood pressure pattern are associated with posture-related dysregulation of blood pressure. Methods. 40 patients with Parkinson's disease underwent 24-hour blood pressure monitoring. 21 patients were diagnosed with arterial hypertension and received anti-hypertensive drugs. Nondipper patients were defined as having nocturnal decrease of mean systolic and diastolic blood pressure less than 10%. Presence or absence of orthostatic hypotension was determined by Schellong's test. Results. We identified 35 nondipper patients (88%. Nondipping was detected in 20 patients with orthostatic hypotension (95% and in 15 patients without orthostatic hypotension (79%. 18 patients with hypertensive and 22 patients with normal blood pressure values were detected. Conclusions. In conclusion 24-hour blood pressure monitoring showed a high prevalence of nondipping in 40 patients with Parkinson's disease with and without orthostatic hypotension independent of coexisting arterial hypertension and antihypertensive treatment. 24-hour blood pressure monitoring may be useful to identify non-dipping as a marker of autonomic dysfunction in patients with Parkinson's disease.

  1. Parkinson's Disease Videos

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    Full Text Available ... in Patients with Parkinson's Disease? CareMAP: Managing Caregiver Stress CareMAP: Movimientos y Caídas, Parte 2 CareMAP: End-of-Life Care Caregiver Summit 2016: Maintaining Dignity & Identity CareMAP: ...

  2. Parkinson's Disease Videos

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    Full Text Available ... With Non-Parkinson's Disease Medications? Walking for a Father and a Brother: Donna’s Story CareMAP: Life Beyond ... DBS Surgery? NPF Caregiver Summit 2016: Tools For Family Caregivers: Caremap and Caring & Coping CareMAP: Managing Caregiver ...

  3. Parkinson's Disease Videos

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    Full Text Available ... area About Shop A A You are here Home PD Library Search library Topic Type Expert Briefings: ... How Is Parkinson's Disease Diagnosed? CareMAP: Activities at Home CareMAP: Getting Dressed CareMAP: Caring for Someone with ...

  4. Parkinson's Disease Videos

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    Full Text Available ... Parkinson's Disease Patients with a Depression Diagnosis? CareMAP: Thinking Changes: Part 2 CareMAP: Ayudando a una Persona ... Life Care When Should Medications Be Adjusted? CareMAP: Thinking Changes: Part 1 CareMAP: Planear y Fijar Horarios, ...

  5. Parkinson's Disease Videos

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    Full Text Available ... Expert Briefings: What's Missing? Communication and the PD Partnership Expert Briefings: Fatigue, Sleep Disorders and Parkinson's Disease ... Rewards of Caregiving What Are the Risks and Benefits of DBS Surgery? CareMAP: Managing Caregiver Stress CareMAP: ...

  6. Parkinson's Disease Videos

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    Full Text Available ... How Does Depression Affect the Patient's Family and Social Network? CareMAP: Where to Find Help CareMAP: Peace ... Day? How Does Parkinson's Disease Affect the Urinary System? CareMAP: Medications and General Health Part 1 What ...

  7. Parkinson's Disease Videos

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    Full Text Available ... Movement and Falls: Part 1 What Is the Relationship Between Depression and Parkinson's Disease? CareMAP: Plans and Scheduling: Part 2 Hallucinations and Delusions What Are the Common Sleep Disorders Encountered in Patients with PD? CareMAP: Medicamentos y la Salud en ...

  8. Parkinson's Disease Videos

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    Full Text Available ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? Aware in Care: Real Stories How Do I Manage Non-Motor Problems Such as Hypersexuality? Are There Any Interactions With Non-Parkinson's Disease Medications? Is Depression Under-Diagnosed in Patients with ...

  9. Parkinson's Disease Videos

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    Full Text Available ... What Is the Helpline? Unconditional Love How Does Speech Therapy Help Parkinson's Patients? CareMAP: Rest and Sleep: ... Parkinson's Mid-Stride: A Treatment Guide to Parkinson's Speech and Swallowing Psychosis: A Mind Guide to Parkinson's ...

  10. Parkinson's Disease Videos

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    Full Text Available ... Care Partners CareMAP: Preparing Paid Caregivers How Does Speech Therapy Help Parkinson's Patients? What Are Some Tips ... Parkinson's Mid-Stride: A Treatment Guide to Parkinson's Speech and Swallowing Psychosis: A Mind Guide to Parkinson's ...

  11. Parkinson's Disease Videos

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    Full Text Available ... Moving Day Walker Support a Parkinson's Champion Bequests & Planned Giving Shop More Ways to Give Ways to ... Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in Parkinson's Expert Briefings: Complementary Approaches to Parkinson's ...

  12. Parkinson's Disease Videos

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    Full Text Available ... a Fundraiser Understanding Parkinson's What Is Parkinson's? Causes & Statistics Early Signs Movement Symptoms Non-Movement Symptoms Diagnosis ... Solutions: Innovations in PD Nurse Education CareMAP: Managing Advanced Parkinson's Website Nurse Webinars: Nursing Solutions: Improving Parkinson's ...

  13. Parkinson's Disease: The Newest Advances

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Parkinson's Disease: The Newest Advances Past Issues / Summer 2006 ... Landis What are the risk factors for developing Parkinson's? The clearest risk factor is age. In addition, ...

  14. The Everyday Cognition Scale in Parkinson's disease

    OpenAIRE

    Cooper, Rachel A.; Benge, Jared; Lantrip, Crystal; Soileau, Michael J.

    2017-01-01

    This brief report describes caregiver ratings on the Everyday Cognition (ECog) scale, a psychometrically robust measure of cognitively driven daily activities that was initially designed for other neurodegenerative conditions, in individuals with Parkinson's disease (PD). In 49 individuals with PD, those with suspected PD dementia had more difficulties across ECog domains than those with normal cognition or mild cognitive impairment. Results from multiple regression analyses revealed that act...

  15. The different faces of the p. A53T alpha-synuclein mutation: A screening of Greek patients with parkinsonism and/or dementia.

    Science.gov (United States)

    Breza, Marianthi; Koutsis, Georgios; Karadima, Georgia; Potagas, Constantin; Kartanou, Chrisoula; Papageorgiou, Sokratis G; Paraskevas, George P; Kapaki, Elisabeth; Stefanis, Leonidas; Panas, Marios

    2018-04-13

    The p. A53T mutation in the alpha-synuclein (SNCA) gene is a rare cause of autosomal dominant Parkinson's disease (PD). Although generally rare, it is particularly common in the Greek population due to a founder effect. A53T-positive PD patients often develop dementia during disease course and may very rarely present with dementia. We screened for the p. A53T SNCA mutation a total of 347 cases of Greek origin with parkinsonism and/or dementia, collected over 15 years at the Neurogenetics Unit, Eginition Hospital, University of Athens. Cases were classified into: "pure parkinsonism", "pure dementia" and "parkinsonism plus dementia". In total, 4 p. A53T SNCA mutation carriers were identified. All had autosomal dominant family history and early onset. Screening of the "pure parkinsonism" category revealed 2 cases with typical PD. The other two mutation carriers were identified in the "parkinsonism plus dementia" category. One had a diagnosis of PD dementia and the other of behavioral variant frontotemporal dementia. Screening of patients with "pure dementia" failed to identify any further A53T-positive cases. Our results confirm that the p. A53T SNCA mutation is relatively common in Greek patients with PD or PD plus dementia, particularly in cases with early onset and/or autosomal dominant family history. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. The skin in Parkinson's disease.

    Science.gov (United States)

    Flint, A

    1977-09-01

    The characteristic oily skin in individuals with parkinsonism has long been observed by clinicians. The oiliness seems to be associated with periods when the disease is most active. This seborrhea has been observed particularly in post-encephalitic parkinsonism, as well as in idiopathic paralysis agitans. It also occurs in phenothiazine-induced parkinsonism.

  17. Parkinson's Disease Videos

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    Full Text Available ... HELPLINE 1-800-4PD-INFO (473-4636) helpline@parkinson.org Search Our Site General Gift Tribute Gift Moving Day Support a Fundraiser Understanding Parkinson's What Is Parkinson's? Causes & Statistics Early Signs Movement ...

  18. Parkinson's Disease Videos

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    Full Text Available ... Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in Parkinson's Expert Briefings: Complementary Approaches to Parkinson's ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? CareMAP: Planear ...

  19. Parkinson's Disease Videos

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    Full Text Available ... of Exercise on PD Expert Briefings: Parkinson's and Parenting Expert Briefings: Occupational Therapy and Parkinson's: Tips for ... Briefings: Nutrition and Parkinson's CareMAP: When Is It Time to Get Help? Ask the Helpline: Why Does ...

  20. Parkinson's Disease Videos

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    Full Text Available ... Skills for Parkinson's Care Partners Expert Briefings: What's New in Genetics and Parkinson's? Expert Briefings: Understanding the ... Miami, FL 33131 NY: 1359 Broadway, Suite 1509, New York, NY 10018 contact@parkinson.org Press Room ...

  1. Parkinson's Disease Videos

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    Full Text Available ... options are available. Learn More Living with Parkinson's Managing Parkinson's In Your Area Resources & Support PD Library ... otra canción” Expert Briefings: Diagnosis PD, Now What? Managing the First Few Years with Parkinson's Expert Briefings: ...

  2. Parkinson's Disease Videos

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    Full Text Available ... Symptoms of PD Expert Briefings: The Effects of Exercise on PD Expert Briefings: Parkinson's and Parenting Expert ... Non-Motor Symptoms Ask the Helpline: Why Is Exercise Important for People with Parkinson's? How Does Parkinson's ...

  3. Parkinson's Disease Videos

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    Full Text Available ... Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in Parkinson's Expert Briefings: Complementary Approaches to Parkinson's ... Prioritizing Health Needs of the Caregiver Is Compulsive Behavior a Side Effect of PD Medications? CareMAP: Preparing ...

  4. Parkinson's Disease Videos

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    Full Text Available ... PD Expert Briefings: Parkinson's and Parenting Expert Briefings: Occupational Therapy and Parkinson's: Tips for Healthy Living Expert ... Expert Briefings: Driving and Parkinson's: Balancing Independence and Safety Expert Briefings: Caring for a Person with Late ...

  5. Diagnosis (Parkinson's Disease)

    Science.gov (United States)

    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

  6. What Is Parkinson's Disease?

    Science.gov (United States)

    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

  7. Parkinson's Disease Foundation News

    Science.gov (United States)

    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

  8. Parkinson's Disease Videos

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    Full Text Available ... Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in Parkinson's Expert Briefings: Complementary Approaches to Parkinson's ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? How Do ...

  9. Parkinson's Disease Videos

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    Full Text Available ... Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in Parkinson's Expert Briefings: Complementary Approaches to Parkinson's ... y Respuestas con todos los presentadores Is Compulsive Behavior a Side Effect of PD Medications? ¿Cómo Se ...

  10. Lateralisation in Parkinson disease

    DEFF Research Database (Denmark)

    Riederer, P.; Jellinger, K. A.; Kolber, P.

    2018-01-01

    Asymmetry of dopaminergic neurodegeneration and subsequent lateralisation of motor symptoms are distinctive features of Parkinson’s disease compared to other forms of neurodegenerative or symptomatic parkinsonism. Even 200 years after the first description of the disease, the underlying causes...... for this striking clinicopathological feature are not yet fully understood. There is increasing evidence that lateralisation of disease is due to a complex interplay of hereditary and environmental factors that are reflected not only in the concept of dominant hemispheres and handedness but also in specific...

  11. Sleepiness in Idiopathic REM Sleep Behavior Disorder and Parkinson Disease.

    Science.gov (United States)

    Arnulf, Isabelle; Neutel, Dulce; Herlin, Bastien; Golmard, Jean-Louis; Leu-Semenescu, Smaranda; Cochen de Cock, Valérie; Vidailhet, Marie

    2015-10-01

    To determine whether patients with idiopathic and symptomatic RBD were sleepier than controls, and if sleepiness in idiopathic RBD predicted earlier conversion to Parkinson disease. The Epworth Sleepiness Scale (ESS) and its determinants were compared at the time of a video-polysomnography for an RBD diagnosis in patients with idiopathic RBD, in patients with Parkinson disease, and in controls. Whether sleepiness at time of RBD diagnosis predicted an earlier conversion to neurodegenerative diseases was retrospectively analyzed in the followed-up patients. The 75 patients with idiopathic RBD were sleepier (ESS: 7.8 ± 4.6) at the time of RBD diagnosis than 74 age- and sex-matched controls (ESS: 5.0 ± 3.6, P sleep measures. Among the 69 patients with idiopathic RBD who were followed up for a median 3 years (1-15 years), 16 (23.2%) developed parkinsonism (n = 6), dementia (n = 6), dementia plus parkinsonism (n = 2), and multiple system atrophy (n = 2). An ESS greater than 8 at time of RBD diagnosis predicted a shorter time to phenoconversion to parkinsonism and dementia, from RBD onset, and from RBD diagnosis (when adjusted for age and time between RBD onset and diagnosis). Sleepiness is associated with idiopathic REM sleep behavior disorder and predicts more rapid conversion to parkinsonism and dementia, suggesting it is an early marker of neuronal loss in brainstem arousal systems. © 2015 Associated Professional Sleep Societies, LLC.

  12. Integrated molecular landscape of Parkinson's disease

    NARCIS (Netherlands)

    Klemann, C.J.H.M.; Martens, G.J.; Sharma, M.; Martens, M.B.; Isacson, O.; Gasser, T.; Visser, J.E.; Poelmans, G.J.V.

    2017-01-01

    Parkinson's disease is caused by a complex interplay of genetic and environmental factors. Although a number of independent molecular pathways and processes have been associated with familial Parkinson's disease, a common mechanism underlying especially sporadic Parkinson's disease is still largely

  13. Eletrencefalograma digital com mapeamento em demência de Alzheimer e doença de Parkinson: estudo prospectivo controlado Digital EEG with brain mapping in Alzheimer's dementia and Parkinson's disease: a prospective controlled study

    Directory of Open Access Journals (Sweden)

    Marcos C. Sandmann

    1996-03-01

    Full Text Available Com o intuito de estudar a atividade eletrencefalográfica em vigilia da demência senil de tipo Alzheimer (DA e da doença de Parkinson (DP foi iniciado estudo prospectivo e controlado. Foram comparados 6 pacientes com DA e 11 pacientes com DP, com um grupo controle composto por 12 pacientes com depressão maior crônica leve a moderada (DSM-III-R, 1987. Nos três grupos, através de análise espectral, foi obtida a mediana da frequência da energia da atividade dominante posterior. O grupo controle apresentou atividade posterior com frequência de 8,79 ± 0,52 (m±dp. No grupo com DA este valor foi 6,65 ± 0,80 (m±dp e no grupo com DP 7,69± 1,39 (m±dp. A hipótese experimental de que pacientes com DA e DP diferem dos controles em relação à atividade de fundo (definida como anormal sendo In order to evaluate the EEG activity during wakefulness in senile dementia of the Alzheimer type (AD and Parkinson's disease (PD, a prospective controlled study was performed. We compared 6 AD and 11 PD patients with a control group of 12 patients with mild to moderate major chronic depression (DSM-III-R 1987. The median of the frequencies and the power of the posterior dominant activity was obtained in the three groups using spectral analysis. The posterior activity had a frequency of 8.79±0.52 (mean±sd in the contrc group, 6.65+0.80 (mean+sd in the AD group and 7.69+1.39 (mean±sd in the PD group. The experimental hypothesis that patients with AD and PD differ from controls in relation to the background activity (defined a abnormal <8 was confirmed by the chi square test (p=0.0l and the t test showed that the mean of the frequency of the posterior power was significantly lower in AD (p=0.01 and PD (p=0.05 patients, compared with the controls. The results indicate that this abnormality could be correlated with the degree of cortical damage and natural history of these disorders.

  14. Addenbrooke's Cognitive Examination validation in Parkinson's disease.

    Science.gov (United States)

    Reyes, M A; Perez-Lloret, S; Lloret, S P; Roldan Gerschcovich, E; Gerscovich, E R; Martin, M E; Leiguarda, R; Merello, M

    2009-01-01

    There is a clear need for brief, sensitive and specific cognitive screening instruments in Parkinson's disease (PD). To study Addenbrooke's Cognitive Examination (ACE) validity for cognitive assessment of PD patient's using the Mattis Dementia Rating Scale (MDRS) as reference method. A specific scale for cognitive evaluation in PD, in this instance the Scales for Outcomes of Parkinson's disease-Cognition (SCOPA-COG), as well as a general use scale the Mini-mental state examination (MMSE) were also studied for further correlation. Forty-four PD patients were studied, of these 27 were males (61%), with a mean (SD) age of 69.5 (11.8) years, mean (SD) disease duration of 7.6 (6.4) years (range 1-25), mean (SD) total Unified Parkinson's Disease Rating Scale (UPDRS) score 37 (24) points, UPDRS III 16.5 (11.3) points. MDRS, ACE and SCOPA-COG scales were administered in random order. All patients remained in on-state during the study. Addenbrooke's Cognitive Examination correlated with SCOPA-COG (r = 0.93, P Addenbrooke's Cognitive Examination appears to be a valid tool for dementia evaluation in PD, with a cut-off point which should probably be set at 83 points, displaying good correlation with both the scale specifically designed for cognitive deficits in PD namely SCOPA-COG, as well as with less specific tests such as MMSE.

  15. Neuropsychiatric Manifestations of Parkinson`s Disease

    Directory of Open Access Journals (Sweden)

    Ana Peixinho

    2014-10-01

    Full Text Available Parkinson’s disease affects about 1% of the world population older than 65 years. It’s most frequently considered a movement disorder, but the neuropsychiatric manifestations associated with the disease and/or its treatment may be of equal or greater significance in some patients. We will discuss briefly the epidemiology, physiopathology and diagnosis of Parkinson’s disease, highlighting the neuropsychiatric manifestations: depression, anxiety, psychosis, dementia, sleep disorders, dopamine dysregulation syndrome.

  16. Gender differences in Parkinson's disease

    NARCIS (Netherlands)

    Haaxma, Charlotte A.; Bloem, Bastiaan R.; Borm, George F.; Oyen, Wim J. G.; Leenders, Klaus L.; Eshuis, Silvia; Booij, Jan; Dluzen, Dean E.; Horstink, Martin W. I. M.

    Objective: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson's disease (PD). Methods: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists ( disease duration Results: Age at onset

  17. Gender differences in Parkinson's disease.

    NARCIS (Netherlands)

    Haaxma, C.A.; Bloem, B.R.; Borm, G.F.; Oyen, W.J.G.; Leenders, K.L.; Eshuis, S.; Booij, J.; Dluzen, D.E.; Horstink, M.W.I.M.

    2007-01-01

    OBJECTIVE: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson's disease (PD). METHODS: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration < or = 10 years). We

  18. Gender differences in Parkinson's disease

    NARCIS (Netherlands)

    Haaxma, Charlotte A.; Bloem, Bastiaan R.; Borm, George F.; Oyen, Wim J. G.; Leenders, Klaus L.; Eshuis, Silvia; Booij, Jan; Dluzen, Dean E.; Horstink, Martin W. I. M.

    2007-01-01

    OBJECTIVE: To investigate gender differences in basic disease characteristics, motor deterioration and nigrostriatal degeneration in Parkinson's disease (PD). METHODS: We studied 253 consecutive PD patients who were not receiving levodopa or dopamine agonists (disease duration < or = 10 years). We

  19. Low LDL cholesterol, PCSK9 and HMGCR genetic variation, and risk of Alzheimer's disease and Parkinson's disease

    DEFF Research Database (Denmark)

    Benn, Marianne; Nordestgaard, Børge G.; Frikke-Schmidt, Ruth

    2017-01-01

     Risk of Alzheimer's disease, vascular dementia, all dementia, and Parkinson's disease.Results In observational analyses, the multifactorially adjusted hazard ratio for Parkinson's disease in participants with an LDL cholesterol level ....79), whereas the corresponding hazard ratios for Alzheimer's disease, vascular dementia, or any dementia did not differ from 1.0. PCSK9 and HMGCR variants combined were associated with a 9.3% lower LDL cholesterol level. In genetic, causal analyses adjusted for age, sex, and year of birth, the risk ratios...... for a lifelong 1 mmol/L lower LDL cholesterol level were 0.57 (0.27 to 1.17) for Alzheimer's disease, 0.81 (0.34 to 1.89) for vascular dementia, 0.66 (0.34 to 1.26) for any dementia, and 1.02 (0.26 to 4.00) for Parkinson's disease. Summary level data from the International Genomics of Alzheimer's Project using...

  20. Rasagiline in the pharmacotherapy of Parkinson's disease--a review.

    Science.gov (United States)

    Rascol, Olivier

    2005-10-01

    Despite the current efficacious symptomatic approaches, the search is on for new therapies for Parkinson's disease that can control the cardinal symptoms of the disease (tremor, rigidity and bradykinesia), control/prevent motor complications induced by long-term levodopa, act on non-motor disease symptoms (dementia, dysautonomia, pain, insomnia, falls) and halt disease progression. Rasagiline is a monoamine oxidase-B inhibitor that has demonstrated efficacy against the cardinal symptoms of Parkinson's disease when used as monotherapy in early Parkinson's disease, and as an adjunct to levodopa in advanced disease stages. It reduces the duration and severity of poor symptom response episodes in fluctuating patients. Preliminary results allow discussion of putative effects of rasagiline on some non-motor signs and disease progression. This article outlines the evidence surrounding the efficacy and safety of rasagiline, and discusses its potential to address some of the currently unmet needs of Parkinson's disease therapy.

  1. Parkinson's disease and driving ability

    Science.gov (United States)

    Singh, Rajiv; Pentland, Brian; Hunter, John; Provan, Frances

    2007-01-01

    Objectives To explore the driving problems associated with Parkinson's disease (PD) and to ascertain whether any clinical features or tests predict driver safety. Methods The driving ability of 154 individuals with PD referred to a driving assessment centre was determined by a combination of clinical tests, reaction times on a test rig and an in‐car driving test. Results The majority of cases (104, 66%) were able to continue driving although 46 individuals required an automatic transmission and 10 others needed car modifications. Ability to drive was predicted by the severity of physical disease, age, presence of other associated medical conditions, particularly dementia, duration of disease, brake reaction, time on a test rig and score on a driving test (all pautomatic transmission. A combination of clinical tests and in‐car driving assessment will establish safety to drive, and a number of clinical correlates can be shown to predict the likely outcome and may assist in the decision process. This is the largest series of consecutive patients seen at a driving assessment centre reported to date, and the first to devise a scoring system for on‐road driving assessment. PMID:17178820

  2. Oxysterols and Parkinson's disease

    DEFF Research Database (Denmark)

    Björkhem, Ingemar; Lövgren-Sandblom, Anita; Leoni, Valerio

    2013-01-01

    Oxysterols are important for cholesterol homeostasis in the brain and may be affected in neurodegenerative diseases. The levels of the brain-derived oxysterol 24S-hydroxycholesterol (24S-OH) have been reported to be markedly reduced in the circulation of patients with Parkinson's disease (PD) (Lee...... et al., Antioxid. Redox Signal. 11 (2009) 407-420). The finding is surprising in view of the fact that other neurodegenerative diseases are associated with relatively modest effects on the circulating levels of 24S-OH. We determined the plasma and cerebrospinal fluid (CSF) levels of 24S-OH and 27......-hydroxycholesterol (27-OH) in patients with PD with different disease duration using a highly accurate method based on isotope dilution-mass spectrometry. All the patients had plasma levels of the different oxysterols within the normal range. When analyzing CSF, 10% of the PD patients were found to have levels of 24...

  3. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  4. Presymptomatic detection of Parkinson's disease.

    Science.gov (United States)

    Jenner, P

    1993-01-01

    Presymptomatic detection of Parkinson's disease is necessary if neuroprotective therapies are to be utilized in its treatment. Various methods (PET, electrophysiology, enzyme assays, olfactory function) may be applicable but none has been rigorously evaluated. Other possible approaches are now considered. Plasma HVA levels (pHVA) in the presence of debrisoquine may reflect cerebral dopamine function. However, there are no detectable differences in pHVA between newly diagnosed and untreated parkinsonian patients and control subjects. Compensatory increases in dopamine turnover may mask a decrease in pHVA in the early stages of the disease. So, at present this technique could not be used as a diagnostic tool. Post-mortem studies of brain in Parkinson's disease may provide clues to biochemical markers indicative of nigral pathology. Mitochondrial complex I activity is reduced in substantia nigra in Parkinson's disease and it was reported also to be markedly reduced in blood platelets. However, subsequent studies suggest that the difference in platelet complex I activity is too small to be diagnostic of Parkinson's disease. There are also selective reductions in brain glutathione levels in Parkinson's disease restricted to substantia nigra, which do not occur in other neurodegenerative disorders and are not due to drug treatment. Importantly, in incidental Lewy body disease (preclinical Parkinson's disease) nigral glutathione levels are reduced to the same degree as in advanced Parkinson's disease. So, some peripheral index of altered glutathione function may be valuable in the early detection of the disease process.

  5. Reading comprehension in Parkinson's disease.

    Science.gov (United States)

    Murray, Laura L; Rutledge, Stefanie

    2014-05-01

    Although individuals with Parkinson's disease (PD) self-report reading problems and experience difficulties in cognitive-linguistic functions that support discourse-level reading, prior research has primarily focused on sentence-level processing and auditory comprehension. Accordingly, the authors investigated the presence and nature of reading comprehension in PD, hypothesizing that (a) individuals with PD would display impaired accuracy and/or speed on reading comprehension tests and (b) reading performances would be correlated with cognitive test results. Eleven adults with PD and 9 age- and education-matched control participants completed tests that evaluated reading comprehension; general language and cognitive abilities; and aspects of attention, memory, and executive functioning. The PD group obtained significantly lower scores on several, but not all, reading comprehension, language, and cognitive measures. Memory, language, and disease severity were significantly correlated with reading comprehension for the PD group. Individuals in the early stages of PD without dementia or broad cognitive deficits can display reading comprehension difficulties, particularly for high- versus basic-level reading tasks. These reading difficulties are most closely related to memory, high-level language, and PD symptom severity status. The findings warrant additional research to delineate further the types and nature of reading comprehension impairments experienced by individuals with PD.

  6. Parkinson's Disease Videos

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  7. Parkinson's Disease Videos

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    Full Text Available ... Miami, FL 33131 NY: 1359 Broadway, Suite 1509, New York, NY 10018 contact@parkinson.org Press Room Ask ... Miami, FL 33131 NY: 1359 Broadway, Suite 1509, New York, NY 10018 contact@parkinson.org

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    Full Text Available ... for Swallowing Problems? What Are the Risks and Benefits of DBS Surgery? CareMAP: Cambios para Realizar en ... for People with Parkinson's? What Are the Neuroprotective Benefits of Exercise for PD Patients? How Does Parkinson's ...

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  18. Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE

    Directory of Open Access Journals (Sweden)

    Anabel Chade

    Full Text Available Abstract Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. Objective: The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. Methods: 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia, 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Results: Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. Conclusions: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

  19. Detecting cognitive impairment in patients with Parkinson's disease with a brief cognitive screening tool: the Addenbrooke's Cognitive Examination (ACE).

    Science.gov (United States)

    Chade, Anabel; Roca, María; Torralva, Teresa; Gleichgerrcht, Ezequiel; Fabbro, Nicolás; Arévalo, Gonzalo Gómez; Gershanik, Oscar; Manes, Facundo

    2008-01-01

    Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE) is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia), 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

  20. [Dementia due to Endocrine Diseases].

    Science.gov (United States)

    Matsunaga, Akiko; Yoneda, Makoto

    2016-04-01

    Endocrine diseases affecting various organs, such as the pituitary gland, the thyroid, the parathyroid, the adrenal glands and the pancreas, occasionally cause dementia. While Alzheimer's disease (AD) is the main cause of dementia in the elderly and is untreatable, dementia caused by endocrine diseases is treatable in most cases. However, patients with dementia associated with endocrine diseases show memory impairments similar to those found in AD, often leading to misdiagnoses. Patients with endocrine diseases often present with other characteristic systemic and neuropsychiatric symptoms caused by altered hormone levels. Such neuropsychiatric symptoms include involuntary movements, depression, seizures, and muscle weakness. In these cases, abnormalities in imaging and blood or urine tests are helpful in making a differential diagnosis. As delays in the diagnosis and treatment of these patients may cause irreversible brain damage, it is imperative for clinicians to carefully exclude the possibility of latent endocrine diseases when treating patients with dementia.

  1. Parkinson's Disease Videos

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  2. Parkinson's Disease Videos

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  3. A comparison of substantia nigra T1 hyperintensity in Parkinson's disease dementia, Alzheimer's disease and age-matched controls: Volumetric analysis of neuromelanin imaging

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Won Jin; Park, Ju Yeon; Yun, Won Sung; Jeon, Ji Yeong; Moon, Yeon Sil; Kim, Hee Jin; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of); Kwak, Ki Chang; Lee, Jong Min [Dept. of Biomedical Engineering, Hanyang University, Seoul (Korea, Republic of)

    2016-09-15

    Neuromelanin loss of substantia nigra (SN) can be visualized as a T1 signal reduction on T1-weighted high-resolution imaging. We investigated whether volumetric analysis of T1 hyperintensity for SN could be used to differentiate between Parkinson's disease dementia (PDD), Alzheimer's disease (AD) and age-matched controls. This retrospective study enrolled 10 patients with PDD, 18 patients with AD, and 13 age-matched healthy elderly controls. MR imaging was performed at 3 tesla. To measure the T1 hyperintense area of SN, we obtained an axial thin section high-resolution T1-weighted fast spin echo sequence. The volumes of interest for the T1 hyperintense SN were drawn onto heavily T1-weighted FSE sequences through midbrain level, using the MIPAV software. The measurement differences were tested using the Kruskal-Wallis test followed by a post hoc comparison. A comparison of the three groups showed significant differences in terms of volume of T1 hyperintensity (p < 0.001, Bonferroni corrected). The volume of T1 hyperintensity was significantly lower in PDD than in AD and normal controls (p < 0.005, Bonferroni corrected). However, the volume of T1 hyperintensity was not different between AD and normal controls (p = 0.136, Bonferroni corrected). The volumetric measurement of the T1 hyperintensity of SN can be an imaging marker for evaluating neuromelanin loss in neurodegenerative diseases and a differential in PDD and AD cases.

  4. Risco de quedas em idosos com doença de Parkinson e demência de Alzheimer: um estudo transversal Risk of falls among elderly people with Parkinson's disease and Alzheimer's dementia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    G Christofoletti

    2006-12-01

    Full Text Available OBJETIVO: Comparar o risco de quedas entre idosos com doença de Parkinson (DP, demência de Alzheimer (DA e saudáveis (controle. Além disso, pretendeu-se analisar as relações do risco de quedas com declínio cognitivo e com nível de atividade física. MÉTODO: vinte idosos, sendo sete com DP (69,57 ± 2,40 anos, seis com DA (77,5 ± 2,32 anos e sete saudáveis (74,71 ± 2,58 anos, foram avaliados por meio dos seguintes instrumentos: Escala de Equilíbrio Funcional de Berg (EEFB, Timed Up and Go test (TUG, Mini-Exame do Estado Mental (MEEM e Questionário Baecke Modificado para Idosos (QBMI. RESULTADOS: O teste de Kruskal-Wallis apontou diferença significativa entre os grupos, tanto em relação à EEFB (KW=9,67, pOBJECTIVE: To compare the risk of falls among elderly people with Parkinson's disease (PD and Alzheimer's dementia (AD and among healthy peers (controls. In addition, the aim was to analyze relationships between risk of falls and cognitive decay and between risk of falls and physical activity. METHOD: Twenty subjects were assessed: seven with PD (69.57 ± 2.40 years, six with AD (77.5 ± 2.32 years and seven healthy peers (74.71 ± 2.58 years. The following instruments were used: Berg Balance Scale (BBS, Timed Up and Go test (TUG, Mini-Mental State Examination (MMSE and Modified Baecke Questionnaire for Older Adults (MBQOA. RESULTS: The Kruskal-Wallis (KW test indicated significant differences between the groups, relating to BBS (KW = 9.67, p<0.01 and TUG (KW = 9.14, p<0.01, for time expended, and KW = 10.04, p<0.01, for number of steps. Bonferroni post-hoc pairs analysis showed that balance was highly compromised in the AD group, such that lower MMSE values were observed. The PD group was characterized by presenting higher levels of physical activity. Spearman's test produced low correlations between MMSE and BBS (r s=0.59; MMSE and TUG (r s=-0.52 and r s=-0.62; MBQOA and BBS (r s=0.54; and MBQOA and TUG (r s=-0.39 and r s=-0

  5. Parkinson's Disease Videos

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  8. Reduced sympathetic activity in idiopathic rapid-eye-movement sleep behavior disorder and Parkinson's disease

    DEFF Research Database (Denmark)

    Sorensen, Gertrud Laura; Mehlsen, Jesper; Jennum, Poul

    2013-01-01

    More than 50% of patients with idiopathic REM sleep behavior disorder (iRBD) will develop Parkinson's disease or Lewy body dementia. In a previous study, we found attenuated heart rate responses in iRBD and Parkinson's disease patients during sleep. The current study aimed to evaluate heart rate...... variability further in order to identify possible changes in these components during wakefulness and sleep in patients with iRBD and Parkinson's disease....

  9. Parkinson disease and positron tomography

    International Nuclear Information System (INIS)

    Baron, J.C.

    1984-10-01

    Physiopathologic investigations of Parkinson disease and parkinsonian syndrome using positron tomography are briefly reviewed: study of cerebral blood flow and metabolism; effects of L-DOPA; study of dopaminergic receptors and of 18 F-Fluoro-L-DOPA incorporation [fr

  10. Deep brain stimulation for the treatment of Alzheimer disease and dementias.

    Science.gov (United States)

    Laxton, Adrian W; Lozano, Andres M

    2013-01-01

    To review the use of deep brain stimulation (DBS) for treatment of dementia. A PubMed literature search was conducted to identify all studies that have investigated the use of DBS for treatment of dementia. Three studies examined the use of DBS for dementia. One study involved fornix DBS for Alzheimer disease (AD), and two studies involved DBS of the nucleus basalis of Meynert, one to treat AD and one to treat Parkinson disease dementia. Evidence for the use of DBS to treat dementia is preliminary and limited. Fornix and nucleus basalis of Meynert DBS can influence activity in the pathologic neural circuits that underlie AD and Parkinson disease dementia. Further investigation into the potential clinical effects of DBS for dementia is warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

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  19. Pain in Parkinson's Disease

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    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With ... by a physical therapist Get active and keep moving. Exercise helps ... 30-45 minutes daily. Walking, swimming, yoga, tai chi, dancing, etc. are all ...

  20. Mobility (Parkinson's Disease)

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    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With ... might seem counterintuitive, but to increase your confidence moving, you have to ... as you are able. Walk with a friend or family member. Exercise does ...

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  2. Nutraceuticals in Parkinson's Disease.

    Science.gov (United States)

    Hang, Liting; Basil, Adeline Henry; Lim, Kah-Leong

    2016-09-01

    Current pharmacological strategies for Parkinson's disease (PD), the most common neurological movement disorder worldwide, are predominantly symptom relieving and are often plagued with undesirable side effects after prolonged treatment. Despite this, they remain as the mainstay treatment for PD due to the lack of better alternatives. Nutraceuticals are compounds derived from natural food sources that have certain therapeutic value and the advent of which has opened doors to the use of alternative strategies to tackle neurodegenerative diseases such as PD. Notably, nutraceuticals are able to position themselves as a "safer" strategy due to the fact that they are naturally derived compounds, therefore possibly having less side effects. Significant efforts have been put into better comprehending the role of nutraceuticals in PD, and we will look at some of them in this review. Broadly speaking, these compounds execute their positive effects via modulating signalling pathways, inhibiting oxidative stress, inflammation and apoptosis, as well as regulating mitochondrial homoeostasis. Importantly, we will highlight how a component of green tea, epigallocatechin-3-gallate (EGCG), confers neuroprotection in PD via its ability to activate AMP kinase and articulate how its beneficial effects in PD are possibly due to enhancing mitochondrial quality control.

  3. Lewy body dementias

    DEFF Research Database (Denmark)

    Løkkegaard, Annemette; Korbo, Lise

    2017-01-01

    Dementia with Lewy bodies and Parkinson disease dementia share the same pathophysiology. Together they are called Lewy body dementias and are the second most common type of dementia. Lewy body dementias receive little attention, and patients are often misdiagnosed, leading to less than ideal...

  4. Therapeutic Dancing for Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Lorenna Pryscia Carvalho Aguiar

    2016-06-01

    Full Text Available Therapeutic dancing has been advocated as an effective adjunct to conventional physical therapies for people living with Parkinson's disease (PD. This systematic review evaluates studies on the outcomes of different dance genres on mobility and quality of life in PD. We searched databases including CINHAL (1982–2015, Medline (1922–2015, Scopus (1996–2015, Web of Science (2002–2015, Embase (2007–2015, PEDro (1999–2015 and the Cochrane Library (1996–2015. The key words were: Parkinson's disease, Parkinson*, Parkinsonism, dance, dance therapy, dance genres, safety, feasibility, and quality of life. Two independent investigators reviewed the texts. Only randomized controlled trials, quasirandomized controlled trials, and case series studies were included. There was emerging evidence that therapeutic dance can be safe and feasible for people with mild to moderately severe PD, with beneficial effects on walking, freezing of gait, and health related quality of life.

  5. Gene Therapy for Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Rachel Denyer

    2012-01-01

    Full Text Available Current pharmacological and surgical treatments for Parkinson's disease offer symptomatic improvements to those suffering from this incurable degenerative neurological disorder, but none of these has convincingly shown effects on disease progression. Novel approaches based on gene therapy have several potential advantages over conventional treatment modalities. These could be used to provide more consistent dopamine supplementation, potentially providing superior symptomatic relief with fewer side effects. More radically, gene therapy could be used to correct the imbalances in basal ganglia circuitry associated with the symptoms of Parkinson's disease, or to preserve or restore dopaminergic neurons lost during the disease process itself. The latter neuroprotective approach is the most exciting, as it could theoretically be disease modifying rather than simply symptom alleviating. Gene therapy agents using these approaches are currently making the transition from the laboratory to the bedside. This paper summarises the theoretical approaches to gene therapy for Parkinson's disease and the findings of clinical trials in this rapidly changing field.

  6. Noradrenaline and Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Claire eDelaville

    2011-05-01

    Full Text Available Parkinson’s disease (PD is characterized by the degeneration of dopamine (DA neurons in the substantia nigra pars compacta, and motor symptoms including bradykinesia, rigidity and tremor at rest. These symptoms are manifest when around 70% of striatal DA is lost. In addition to motor deficits, PD is also characterized by the manifestation of non-motor symptoms. However, depletion of DA alone in animal models has failed to simultaneously elicit both the motor and non-motor deficits of PD because the disease is a multi-system disorder that features a profound loss of other neurotransmitter systems. There is growing evidence that additional loss of noradrenaline (NA neurons of the locus coeruleus, the principal source of NA in the brain, could be involved in the clinical expression of motor as well as in non-motor deficits. In the present review, we analyzed the latest data obtained from animal models of parkinsonism and from parkinsonian patients providing evidence for the implication of NA in the pathophysiology of PD. Recent studies have shown that NA depletion alone or combined with DA depletion resulted in motor as well as in non-motor dysfunctions. In addition, by using selective agonists and antagonists of alpha receptors we, and others, have shown that α2 receptors are implicated in the control of motor activity and that α2 receptor antagonists can improve PD motor symptoms as well as L-Dopa-induced dyskinesia. Here we provide arguments that the loss of NA neurons in PD has an impact on all PD symptoms and that the association of NAergic agents to dopaminergic medication can be beneficial in the treatment of the disease.

  7. Parkinson's Disease Videos

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  12. Parkinson's Disease Videos

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    Full Text Available ... Does a Caregiver Need to Know About Cognitive Impairment? Dra. Claudia Martinez, MAPC - Parkinson- Pasion, Positivismo y ... Beyond This Life What Medications Help with Cognitive Impairment? What Are Some Tips for Following a Medication ...

  13. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... PD Library Legal, Financial, & Insurance Matters Blog For Caregivers Living with Parkinson's While living with PD can ... We Really Know? Nurse Webinars: Nursing Solutions: Improving Caregiver Strain through Science and Model Interventions Expert Briefings: ...

  14. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Cómo Se Trata el Parkinson? Jose Maria Lobo: Música en vivo con Lobo! How Do PD and ... of Exercise for PD Patients? Jose Maria Lobo: Musica en vivo con Lobo! Are There Any Ways ...

  15. Dysphagia in Parkinson's Disease.

    Science.gov (United States)

    Suttrup, Inga; Warnecke, Tobias

    2016-02-01

    More than 80 % of patients with Parkinson's disease (PD) develop dysphagia during the course of their disease. Swallowing impairment reduces quality of life, complicates medication intake and leads to malnutrition and aspiration pneumonia, which is a major cause of death in PD. Although the underlying pathophysiology is poorly understood, it has been shown that dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia in PD. Clinical assessment of dysphagia in PD patients is challenging and often delivers unreliable results. A modified water test assessing maximum swallowing volume is recommended to uncover oropharyngeal dysphagia in PD. PD-specific questionnaires may also be useful to identify patients at risk for swallowing impairment. Fiberoptic endoscopic evaluation of swallowing and videofluoroscopic swallowing study are both considered to be the gold standard for evaluation of PD-related dysphagia. In addition, high-resolution manometry may be a helpful tool. These instrumental methods allow a reliable detection of aspiration events. Furthermore, typical patterns of impairment during the oral, pharyngeal and/or esophageal swallowing phase of PD patients can be identified. Therapy of dysphagia in PD consists of pharmacological interventions and swallowing treatment by speech and language therapists (SLTs). Fluctuating dysphagia with deterioration during the off-state should be treated by optimizing dopaminergic medication. The methods used during swallowing treatment by SLTs shall be selected according to the individual dysphagia pattern of each PD patient. A promising novel method is an intensive training of expiratory muscle strength. Deep brain stimulation does not seem to have a clinical relevant effect on swallowing function in PD. The goal of this review is giving an overview on current stages of epidemiology, pathophysiology, diagnosis, and treatment of PD-associated dysphagia, which might be helpful for neurologists

  16. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Care? Dealing with Dementia CareMAP: Life Beyond This Life What Are Some Tips for Following a Medication Schedule? How Does the DBS Device Work? CareMAP: Cambios para Realizar en Casa, Parte 1 ...

  17. Managing Parkinson's disease with continuous dopaminergic stimulation

    NARCIS (Netherlands)

    Wolters, Erik; Lees, Andrew J.; Volkmann, Jens; van Laar, Teus; Hovestadt, Ad

    The pathophysiology of Parkinson's disease is marked by the loss of dopaminergic neurons, which leads to striatal dopaminergic deficiency. This causes resting tremor, hypokinesia, rigidity, bradykinesia, and loss of postural reflexes. Most current treatments for Parkinson's disease aim to restore

  18. Parkinson's disease mild cognitive impairment: application and validation of the criteria

    NARCIS (Netherlands)

    Geurtsen, Gert J.; Hoogland, Jeroen; Goldman, Jennifer G.; Schmand, Ben A.; Tröster, Alexander I.; Burn, David J.; Litvan, Irene; Filoteo, J. Vincent; Hurtig, Howard; Chen-Plotkin, Alice; Adler, Charles H.; Jacobson, Sandra A.; Leverenz, Jim; Zabetian, Cyrus; Huang, Xuemei; Eslinger, Paul J.; Marras, Connie; Duff-Canning, Sarah; Dalrymple-Alford, John C.; Anderson, Tim J.; Naismith, Sharon L.; Lewis, Simon J. G.; Wu, Ruey-Meei; Yu, Rwei-Ling; Bhattacharyya, Kalyan B.; Williams-Gray, Caroline H.; Breen, David P.; Barker, Roger A.; Yarnall, Alison J.; de Bie, Rob M. A.; Koene, Ted; Klein, Martin; Trautmann, Ellen; Mollenhauer, Brit; Dodel, Richard; Kulisevsky, Jaime; Pagonabaragga, Javier; Rodriguez-Oroz, Maria C.; Gasca-Salas, Carmen; Junque, Carme; Segura, Barbara; Sportiello, Marco Timpano; Cammisuli, Davide M.; Barone, Paolo; Pedersen, Kenn Freddy; Alves, Guido

    2014-01-01

    Dementia in Parkinson's disease (PD) is a serious health issue and a major concern for many patients. In most cases mild cognitive impairment (MCI) is considered a transitional stage between normal cognitive functioning and dementia which is of potential importance in the early identification of

  19. Neuregulins, Neuroprotection and Parkinson's Disease

    National Research Council Canada - National Science Library

    Yurek, David M; Seroogy, Kim B

    2006-01-01

    ... s disease, in primary neuronal cultures of midbrain dopamine cells, and in a dopaminergic cell line. Overall, results from these studies may form the basis for the therapeutic application of neuregulins to the treatment of neurotoxin-induced neurodegenerative disorders such as Parkinson's disease.

  20. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... Young Onset Parkinson Conference: Lessons Learned How Does the DBS Device Work? CareMAP: Cambios para Realizar en Casa, Parte 1 CareMAP: Mealtime and Swallowing: Part 1 What Do I Do if I Suspect Compulsive Behavior ...

  1. Parkinson's Disease Videos

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    Full Text Available ... Expert Briefings: Caring for a Person with Late Stage Parkinson's Expert Briefings: Impulsive and Compulsive Behaviors in ... Surgery? CareMAP: Managing Caregiver Stress CareMAP: End-of-Life Care Natalie Diaz, MD, Harbor-UCLA Medical Center: “ ...

  2. Parkinson's Disease Videos

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    Full Text Available ... Tips for Care Partners Nurse Webinars: Nursing Solutions: Innovations in PD Nurse Education CareMAP: Managing Advanced Parkinson's ... Medications? What to Expect Emotionally What are some strategies to prevent falls in PD patients? CareMAP: Mealtime ...

  3. Parkinson's Disease Videos

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    Full Text Available ... Caregiver Stress CareMAP: Getting Dressed CareMAP: End-of-Life Care CareMAP: Thinking Changes: Part 1 Adolfo Diaz, PTA, NPF - National Parkinson Foundation CareMAP: Challenges and Rewards of Caregiving What Are the Risks ...

  4. Parkinson's Disease Videos

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    Full Text Available ... Sleep: Part 2 How Does the DBS Device Work? CareMAP: The Caregiving Journey CareMAP: Cambios para Realizar ... MAPC - Parkinson- Pasion, Positivismo y Participacion” CareMAP: Balancing Life and Caregiving CareMAP: Travel and Transportation: Part 1 ...

  5. Parkinson's Disease Videos

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    Full Text Available ... What Does a Caregiver Need to Know About Cognitive Impairment? CareMAP: Movimientos y Caídas, Parte 1 How ... CareMAP: Movimientos y Caídas, Parte 2 Expert Briefings: Cognitive Issues: Advice for Parkinson's Care Partners Caregiver Summit ...

  6. Parkinson's Disease Videos

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    Full Text Available ... Bringing Care to You Expert Care Programs Professional Education Expert Care Research shows people with Parkinson’s who seek skilled care are at a lower risk of complications and have better quality of life. Learn More Research Research We Fund Parkinson's Outcomes ...

  7. Parkinson's Disease Videos

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    Full Text Available ... PTA, NPF - National Parkinson Foundation CareMAP: Managing Caregiver Stress CareMAP: End-of-Life Care CareMAP: Thinking Changes: ... and Delusions How Does Depression Affect the Patient's Family and Social Network? CareMAP: Medicamentos y la Salud ...

  8. Parkinson's Disease Videos

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    Full Text Available ... Psychosis: A Caregiver’s Story CareMAP: Medications and General Health Part 1 CareMAP: Las Actividades en Casa What ... la Enfermedad de Parkinson CareMAP: Medications and General Health Part 2 CareMAP: El Descanso y el Sueño, ...

  9. Parkinson's Disease Videos

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    Full Text Available ... Parkinson’s Wellness Program: Step by Step CareMAP: Balancing Life and Caregiving Young Onset Parkinson Conference: Lessons Learned CareMAP: Travel and Transportation: Part 1 How Does the DBS Device Work? CareMAP: Mealtime and Swallowing: Part 1 CareMAP: Cambios ...

  10. Parkinson's Disease Videos

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    Full Text Available ... Improving Parkinson's Care Everywhere CareMAP: El Descanso y el Sueño, Parte 1 CareMAP: La Alimentación y la Deglución, ... and Swallowing: Part 2 CareMAP: El Descanso y el Sueño, Parte 2 What Does a Caregiver Need to ...

  11. Parkinson's Disease Videos

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    Full Text Available ... Following a Medication Schedule? CareMAP: Medications and General Health Part 1 Ask the Helpline: What Is a ... Discussion ¿Cómo Se Diagnostica el Parkinson? CareMAP: Prioritizing Health Needs of the Caregiver CareMAP: Putting Things in ...

  12. Parkinson's Disease Videos

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    Full Text Available ... Care for PD Patients? CareMAP: Bathroom: Part 2 What Do Caregivers Need to Know? Why Is Comprehensive Care or ... out some of our most read additions below: What You and Your Family Should Know Medications Fitness Counts Caring & Coping Caregiver's Guide Managing Parkinson's Mid-Stride: A Treatment Guide ...

  13. Parkinson's Disease Videos

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    Full Text Available ... Following a Medication Schedule? CareMAP: Medications and General Health Part 1 What Is Patient-Centered Care? Hallucinations ... Thinking Changes: Part 2 CareMAP: Medications and General Health Part 2 ¿Cómo Se Diagnostica el Parkinson? CareMAP: ...

  14. Parkinson's Disease Videos

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    Full Text Available ... Overlooked PD Symptoms Nursing Solutions: PD Medication Adherence Challenges Jose Maria Lobo y Voces Del Párkinson: “Soy ... NY Nightly News with Chuck Scarborough Expert Briefings: Challenges of Advanced Parkinson's and Tips for Better Living ...

  15. Parkinson's Disease Videos

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    Full Text Available ... Statistics Early Signs Movement Symptoms Non-Movement Symptoms Diagnosis Treatment Understanding Parkinson's There is a lot to ... Soy el compas de otra canción” Expert Briefings: Diagnosis PD, Now What? Managing the First Few Years ...

  16. Parkinson's Disease Videos

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    Full Text Available ... Solutions: PD Medication Adherence Challenges Jose Maria Lobo y Voces Del Párkinson: “Soy el compas de otra ... Solutions: Improving Parkinson's Care Everywhere CareMAP: La Alimentación y la Deglución, Parte 1 CareMAP: El Baño, Parte ...

  17. Parkinson's Disease Videos

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    Full Text Available ... Caregivers Living with Parkinson's While living with PD can be challenging, there are many things you can do to maintain and improve your quality of ... Ways to Give There are many ways you can support the fight against Parkinson’s. Whatever form your ...

  18. Parkinson's Disease Videos

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    Full Text Available ... Health Part 2 How Does the DBS Device Work? ¿Cómo Se Diagnostica el Parkinson? CareMAP: Cambios para ... Depression, Anxiety & Psychosis What Are Some Strategies for Problems with Urination? CareMAP: Changes Around the House: Part ...

  19. Parkinson's Disease Videos

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    Full Text Available ... What Does a Caregiver Need to Know About Cognitive Impairment? CareMAP: Getting Dressed How Do I Manage ... Tips for Following a Medication Schedule? Expert Briefings: Cognitive Issues: Advice for Parkinson's Care Partners CareMAP: Medications ...

  20. Parkinson's Disease Videos

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    Full Text Available ... Swallowing: Part 1 CareMAP: Cambios para Realizar en Casa, Parte 1 What Do I Do if I ... la progresión del Parkinson? CareMAP: Las Actividades en Casa How Can Falls Be Prevented? How Can Caregivers ...

  1. Parkinson's Disease Videos

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    Full Text Available ... Help CareMAP: Peace in Caring CareMAP: Rest and Sleep: Part 2 What Are the Causes of Parkinson's ... to Get Help? Unconditional Love CareMAP: Rest and Sleep: Part 1 CareMAP: The Caregiving Journey Caregiver Summit ...

  2. Parkinson's Disease Videos

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    Full Text Available ... One Is It? CareMAP: El Descanso y el Sueño, Parte 1 Expert Briefings: What's in the PD ... Care Between Appointments? CareMAP: El Descanso y el Sueño, Parte 2 Hallucinations and Parkinson's with Dr. Friedman ...

  3. Parkinson's Disease Videos

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    Full Text Available ... Expert Briefings: Nutrition and Parkinson's CareMAP: End-of-Life Care CareMAP: Thinking Changes: Part 1 Ask the ... Medicinal: “Terapia fisica para el Parkinson” CareMAP: Balancing Life and Caregiving CareMAP: Travel and Transportation: Part 1 ...

  4. Parkinson's Disease Videos

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    Full Text Available ... Improving Parkinson's Care Everywhere CareMAP: El Descanso y el Sueño, Parte 1 CareMAP: La Alimentación y la Deglución, ... That Have Similar Symptoms? CareMAP: El Descanso y el Sueño, Parte 2 How Does Depression Affect the Patient's ...

  5. Parkinson's Disease Videos

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    Full Text Available ... Expert Briefings: Nutrition and Parkinson's CareMAP: End-of-Life Care CareMAP: Thinking Changes: Part 1 Ask the Helpline: Why Does Caregiving Change ... Medicinal: “Terapia fisica para el Parkinson” CareMAP: Balancing Life and Caregiving ... and Transportation: Part 1 Why Dance for PD? CareMAP: Mealtime and ...

  6. Parkinson's Disease Videos

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    Full Text Available ... What Does a Caregiver Need to Know About Cognitive Impairment? CareMAP: Movimientos y Caídas, Parte 2 How ... para Realizar en Casa, Parte 1 Expert Briefings: Cognitive Issues: Advice for Parkinson's Care Partners CareMAP: Prioritizing ...

  7. Parkinson's Disease Videos

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    Full Text Available ... Your Area Resources & Support PD Library Legal, Financial, & Insurance Matters Blog For Caregivers Living with Parkinson's While ... Following a Medication Schedule? CareMAP: Medications and General Health Part 1 Panel de Expertos: Sesión de Preguntas ...

  8. Parkinson's Disease Videos

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    Full Text Available ... Story CareMAP: Activities at Home Aware in Care: Real Stories CareMAP: Caring for Someone with Advanced Parkinson's ... Expert Briefings: Depression and PD: Treatment Options CareMAP: Travel and Transportation: Part 2 Ask the Helpline: What ...

  9. Parkinson's Disease Videos

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    Full Text Available ... 2 ¿Cómo Se Diagnostica el Parkinson? CareMAP: Prioritizing Health Needs of the Caregiver What Is the Impact of PD Medications on Excessive Daytime Sleepiness? Is Compulsive Behavior a Side Effect of PD Medications? CareMAP: Preparing Paid Caregivers What ...

  10. Autobiographical memory in Parkinson's disease: a retrieval deficit.

    Science.gov (United States)

    Souchay, Celine; Smith, Sarah Jane

    2013-09-01

    This study examined the effects of providing cues to facilitate autobiographical memory retrieval in Parkinson's disease. Previous findings have shown that individuals with Parkinson's disease retrieve fewer specific autobiographical memories than older adult controls. These findings are clinically significant since the quality of autobiographical memory is linked to identity and sense of self. In the current study, 16 older adults with Parkinson's disease without dementia and 16 matched older adult controls were given 3 min in which to recall autobiographical memories associated with five different time periods and to give each memory a short title. Participants were later asked to retrieve the memories in three phases: firstly in a free recall phase; secondly in response to general cues (time periods) and finally in response to specific cues (the short titles previously given). The number of memories and the quality of the memory (general or specific) was recorded in each condition. Compared with matched older adult controls, the Parkinson's disease group was impaired in retrieving the memories that they had previously given in the free recall phase and in response to general cues. The performance of the group with Parkinson's disease was only equivalent to the older adults when they retrieved memories in response to self-generated cues. The findings are discussed in relation to theories of autobiographical memory and the neuropsychology of Parkinson's disease. © 2013 The British Psychological Society.

  11. Role of rasagiline in treating Parkinson?s disease: Effect on disease progression

    OpenAIRE

    Malaty, Irene A; Fernandez, Hubert H

    2009-01-01

    Rasagiline is a second generation, selective, irreversible monoamine oxidase type B (MAO-B) inhibitor. It has demonstrated efficacy in monotherapy for early Parkinson?s disease (PD) patients in one large randomized, placebo-controlled trial (TVP-1012 in Early Monotherapy for Parkinson?s Disease Outpatients), and has shown ability to reduce off time in more advanced PD patients with motor fluctuations in two large placebo-controlled trials (Parkinson?s Rasagiline: Efficacy and Safety in the Tr...

  12. Metabolic Imaging in Parkinson Disease.

    Science.gov (United States)

    Meles, Sanne K; Teune, Laura K; de Jong, Bauke M; Dierckx, Rudi A; Leenders, Klaus L

    2017-01-01

    This review focuses on recent human 18 F-FDG PET studies in Parkinson disease. First, an overview is given of the current analytic approaches to metabolic brain imaging data. Next, we discuss how 18 F-FDG PET studies have advanced understanding of the relation between distinct brain regions and associated symptoms in Parkinson disease, including cognitive decline. In addition, the value of 18 F-FDG PET studies in differential diagnosis, identifying prodromal patients, and the evaluation of treatment effects are reviewed. Finally, anticipated developments in the field are addressed. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  13. Parkinson's Disease Videos

    Medline Plus

    Full Text Available ... What Does a Caregiver Need to Know About Cognitive Impairment? How Do I Manage Non-Motor Problems Such ... en vivo con Lobo! What Medications Help with Cognitive Impairment? Dealing with Dementia CareMAP: Life Beyond This Life ...

  14. rCBF SPECT in Parkinson's disease patients with mental dysfunction

    International Nuclear Information System (INIS)

    Bissessur, S.; Tissingh, G.; Wolters, E.C.; Scheltens, P.

    1997-01-01

    Functional imaging of the brain using SPECT provides information correlative to the alterations of regional blood flow. In this paper we review the literature pertaining to SPECT in Parkinson's disease with and without dementia and depression. Parkinson's disease itself is not associated with a consistent pattern of cerebral blood flow alterations in the basal ganglia, but reduced parietal blood flow is more often reported. The heterogeneity of blood flow changes possibly reflects the multifactorial pathophysiology of the disease. In demented Parkinson's disease patients frontal hypoperfusion is often found or bilateral temporoparietal deficits, probably indicative of concomitant Alzheimer's disease. The SPECT studies undertaken in depressed patients with and without Parkinson's disease show highly conflicting and inconsistent results, probably due to methodological and diagnostic flaws (especially the inclusion of demented Parkinson patients). Several lines of reasoning point to a prefrontal dysfunction and future SPECT studies are planned to study this region in non-demented Parkinson's disease patients with and without major depression. (author)

  15. MRI in Parkinson's disease and vascular Parkinsonism

    International Nuclear Information System (INIS)

    Aotsuka, Akiyo; Shinotoh, Hitoshi; Hirayama, Keizo; Ikehira, Hiroo; Fukuda, Hiroshi.

    1991-01-01

    We examined the magnetic resonance (MR) image of midbrain and striatum in 30 patients with Parkinson's disease (PD), 10 patients with vascular Parkinsonism (VP) and 10 age-matched control subjects. Studies were performed on a high field strength (1.5 tesla) MRI unit. T2-weighted spin echo pulse sequence (TR 2500 ms/TE 40 ms) was used. Intensity profiles of a straight line perpendicular to the pars compacta through the center of the red nucleus were made on an image of the midbrain. We measured the width of the valley at half-height between the peaks of intensity representing the red nucleus and the crus cerebri-pars reticulata complex and used this as an index of the width of the pars compacta signal. The mean width of the pars compacta signal was 2.7 mm in the PD group and 4.3 mm in controls. The difference between the means was highly significant (p<0.01). While not significant statistically, there was a trend toward narrowing of the width of pars compacta signal of substantia nigra in the PD group as the Yahr's grade or disease duration progressed. In hemiparkinsonism, MRI revealed significant narrowing of the pars compacta signal on the contra-lateral side to the clinical predominant side. The mean width of the pars compacta signal was 3.9 mm in the VP group, but the decrease was not significant. MRI in VP group showed multiple high intensity area in the basal ganglia and the white matter, and periventricular hyperintensity area (PVHIA). There was no statistically significant difference in the frequency of restoration of the signal intensity in the lateral portion of the substantia nigra among PD, VP and control groups. The low signal intensity in the posterolateral putamen was not found in the 3 groups. The narrowing of the pars compacta signal has been attributed either to atrophy of the pars compacta or to increased deposition of iron in this region. The narrowing of the pars compacta signal reflected pathophysiology of PD. (J.P.N.)

  16. Cholinergic nicotinic and muscarinic receptors in dementia of Alzheimer, Parkinson and Lewy body types.

    Science.gov (United States)

    Perry, E K; Smith, C J; Court, J A; Perry, R H

    1990-01-01

    Cholinergic nicotinic and muscarinic receptor binding were measured in post mortem human brain tissue, using low (nM) concentrations of (3H)-nicotine to detect predominately the high affinity nicotinic site and (3H)-N-methylscopolamine in the presence and absence of 3 x 10(-4) M carbachol to measure both the low and high affinity agonist subtypes of the muscarinic receptor group. Consistent with most previous reports, the nicotinic but not muscarinic binding was reduced in the different forms of dementia associated with cortical cholinergic deficits, including Alzheimer's and Parkinson's disease, senile dementia of Lewy body type (SDLT) and Down's syndrome (over 50 years). Analysis of (3H)-nicotine binding displaced by a range of carbachol concentrations (10(-9)-10(-3) M) indicated 2 binding sites for nicotine and that the high affinity rather than low affinity site was reduced in Alzheimer's disease. In all 3 cortical areas investigated (temporal, parietal and occipital) there were increases in the low affinity muscarinic site in Parkinson's disease and SDLT but not Alzheimer's disease or middle-aged Down's syndrome. This observation raised the question of whether the presence of neurofibrillary tangles (evident in the latter but not former 2 disorders) is incompatible with denervation-induced muscarinic supersensitivity in cholinoceptive neurons which include cortical pyramids generally affeted by tangle formation.

  17. Sweating dysfunction in Parkinson's disease

    NARCIS (Netherlands)

    Swinn, L; Schrag, A; Viswanathan, R; Lees, A; Quinn, N; Bloem, Bastiaan R.

    2003-01-01

    We sought to determine the prevalence and nature of sweating disturbances in patients with Parkinson's disease (PD), and investigated their correlation with other clinical features and with Quality of Life (QoL) measures. A questionnaire on symptoms and consequences of sweating dysfunction was

  18. Skin disorders in Parkinson's disease

    DEFF Research Database (Denmark)

    Ravn, Astrid-Helene; Thyssen, Jacob P; Egeberg, Alexander

    2017-01-01

    Parkinson's disease (PD) is one of the most common neurodegenerative disorders, characterized by a symptom triad comprising resting tremor, rigidity, and akinesia. In addition, non-motor symptoms of PD are well recognized and often precede the overt motor manifestations. Cutaneous manifestations...

  19. Genetic predisposition to Parkinson's disease

    DEFF Research Database (Denmark)

    Halling, Jónrit; Petersen, Maria Skaalum; Grandjean, Philippe

    2008-01-01

    OBJECTIVE: To investigate whether the genetic variants of CYP2D6 and HFE are more frequent in Parkinson's disease (PD) patients compared with controls in a population where the prevalence of these variants and PD are increased. METHODS: Blood samples were collected from 79 PD patients and 154...

  20. Pancreatic Polypeptide in Parkinson's Disease

    DEFF Research Database (Denmark)

    Knudsen, Karoline; Hartmann, Bolette; Fedorova, Tatyana D

    2017-01-01

    BACKGROUND AND OBJECTIVES: Parkinson's disease (PD) patients experience several non-motor symptoms from the gastrointestinal tract that may partly be caused by parasympathetic deficiency. The pancreas is densely innervated by the vagus nerve, which mediates early meal-induced secretion...

  1. Dream Robber: Living with Parkinson's disease

    Science.gov (United States)

    ... Current Issue Past Issues Dream Robber: Living with Parkinson's disease Past Issues / Summer 2006 Table of Contents ... effects of levodopa called dyskinesias. Additional Information on Parkinson's Web Links MedlinePlus: http://www.nlm.nih.gov/ ...

  2. Accelerated Age-Dependent Hippocampal Volume Loss in Parkinson Disease With Mild Cognitive Impairment.

    Science.gov (United States)

    Schneider, Christine B; Donix, Markus; Linse, Katharina; Werner, Annett; Fauser, Mareike; Klingelhoefer, Lisa; Löhle, Matthias; von Kummer, Rüdiger; Reichmann, Heinz; Storch, Alexander

    2017-09-01

    Patients with Parkinson disease are at high risk of developing dementia. During the course of the disease, a substantial number of patients will experience a cognitive decline, indicating the dynamics of the underlying neuropathology. Magnetic resonance imaging (MRI) has become increasingly useful for identifying structural characteristics in radiological brain anatomy existing prior to clinical symptoms. Whether these changes reflect pathology, whether they are aging related, or both often remains unclear. We hypothesized that aging-associated brain structural changes would be more pronounced in the hippocampal region among patients with Parkinson disease having mild cognitive deficits relative to cognitively unimpaired patients. Using MRI, we investigated 30 cognitively healthy patients with Parkinson disease and 33 patients with nondemented Parkinson disease having mild cognitive impairment. All participants underwent structural MRI scanning and extensive clinical and neuropsychological assessments. Irrespective of the study participants' cognitive status, older age was associated with reduced cortical thickness in various neocortical regions. Having mild cognitive impairment was not associated with an increased rate of cortical thinning or volume loss in these regions, except in the hippocampus bilaterally. Patients with Parkinson disease having mild cognitive impairment show an accelerated age-dependent hippocampal volume loss when compared with cognitively healthy patients with Parkinson disease. This may indicate pathological processes in a key region for memory functioning in patients with Parkinson disease at risk of developing dementia. Structural MRI of the hippocampal region could potentially contribute to identifying patients who should receive early treatment aimed at delaying the clinical onset of dementia.

  3. A clinical study in elderly patients with Parkinson's disease using MRI and SPECT; Parkinson's disease and the lacunar state

    Energy Technology Data Exchange (ETDEWEB)

    Umahara, Takahiko; Iwamoto, Toshihiko; Takasaki, Masaru; Katsunuma, Hideyo [Tokyo Medical Coll. (Japan)

    1991-11-01

    Parkinson's disease (PD) is often associated with dementia in elderly patients, and sometimes PD coexists with senile dementia of the Alzheimer type (SDAT) or cerebrovascular disease (CVD) in the elderly. However, since there are few previous clinical studies on the coincidence of, or relationship between PD and CVD, the authors evaluated these aspects in 34 elderly patients with PD using MRI and SPECT. All the patients were over 70 years old. The diagnosis of PD was based on the presence of three symptons (resting tremor, cogwheel rigidity and bradikinesia) which are characteristic of PD, and the effectiveness of L-DOPA therapy. We therefore believe that patients with vascular Parkinsonism were excluded from our study. In 34 cases, 24 (71%) had MRI evidence of CVD (mainly the lacunar state). In the 10 cases who had no CVD, 2 (20%) had severe dementia and the decrease of regional cerebral blood flow (rCBF) in the temporal and parietal lobes bilaterally correlated with the SPECT findings commonly found in SDAT. A comparison of the rCBF and the results of Hasegawa's dementia score (HDS) (verbal intelligence score) was made between the patients with PD associated with CVD and the patients with PD who had no CVD and no SPECT findings which correlated with SDAT. The rCBF in the frontal lobes and the results of the HDS of the former group were significantly lower than those of the latter. As mentioned above, elderly patients with PD often had CVD, leading to dementia. We also pointed out the difficulty in making a differential diagnosis between PD with CVD and vascular Parkinsonism, and the necessity of whether or not the concept of 'mixed type Parkinsonism' should be considered. (author).

  4. [Neuroepigenetics: Desoxyribonucleic acid methylation in Alzheimer's disease and other dementias].

    Science.gov (United States)

    Mendioroz Iriarte, Maite; Pulido Fontes, Laura; Méndez-López, Iván

    2015-05-21

    DNA methylation is an epigenetic mechanism that controls gene expression. In Alzheimer's disease (AD), global DNA hypomethylation of neurons has been described in the human cerebral cortex. Moreover, several variants in the methylation pattern of candidate genes have been identified in brain tissue when comparing AD patients and controls. Specifically, DNA methylation changes have been observed in PSEN1 and APOE, both genes previously being involved in the pathophysiology of AD. In other degenerative dementias, methylation variants have also been described in key genes, such as hypomethylation of the SNCA gene in Parkinson's disease and dementia with Lewy bodies or hypermethylation of the GRN gene promoter in frontotemporal dementia. The finding of aberrant DNA methylation patterns shared by brain tissue and peripheral blood opens the door to use those variants as epigenetic biomarkers in the diagnosis of neurodegenerative diseases. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. Fluctuating attention in Parkinson's disease

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Aarsland, Dag; Janvin, Carmen

    2001-01-01

    Lewy body dementia (DLB), which share many clinical and pathological features with Parkinson’s disease (PD), is charac- terised by marked fluctuations in cognition and consciousness. Fluctuating cognition has not been formally studied in PD, although some studies indicate that PD patients show...

  6. Driving safety in Parkinson's disease.

    Science.gov (United States)

    Zesiewicz, T A; Cimino, C R; Malek, A R; Gardner, N; Leaverton, P L; Dunne, P B; Hauser, R A

    2002-12-10

    In this study, 39 patients with PD and 25 control subjects without neurologic disease completed testing in a driving simulator. PD patients had more total collisions on the driving simulator than control subjects (t = -3.7, p < 0.01). In PD patients, collisions were associated with Hoehn and Yahr stage (chi(2) = 12.4, p = 0.006) and correlated with Unified Parkinson's Disease Rating Scale score (r = 0.5, p < 0.01).

  7. Technetium-99m hexamethylpropylene amine oxime single photon emission tomography of the brain in early Parkinson's disease: correlation with dementia and lateralization

    International Nuclear Information System (INIS)

    Wang Shuujiun; Lin Kerneng; Shan Dinge; Liao Kwankum; Fuh Jongling; Lee Liangshong; Liu Renshyan; Liu Hsiuchih

    1993-01-01

    Regional cerebral blood flow was assessed in 19 patients with early idiopathic Parkinson's disease (PD) and 12 control subjects of similar age by single-photon emission tomography using technetium-99m hexamethylpropylene amine oxime (HMPAO). Of the patients with PD, seven were mildly demented and 15 presented with hemiparkinsonism. Mean HMPAO cortical or basal ganglia/cerebellum activity ratios were calculated. Mean cortical and regional uptake ratios in non-demented PD patients were not significantly different from values in the controls. In contrast, besides generalized cortical hypoperfusion, demented PD patients had significantly lower HMPAO uptake in the frontal and basal ganglia regions than non-demented patients. These observations support the hypothesis of impaired neuronal activity in both cortical and subcortical regions of the brain in demented PD patients. In hemiparkinsonian patients, the only asymmetrical finding was a relative hypoperfusion in the contralateral parietal region. This may be due to deafferentation of the thalamoparietal pathways. The lack of asymmetrical uptake in basal ganglia in our PD patients may be explained by their staging at the time of the investigation (stage I and II, Hoehn and Yahr scale). (orig.)

  8. Technetium-99m hexamethylpropylene amine oxime single photon emission tomography of the brain in early Parkinson's disease: correlation with dementia and lateralization

    Energy Technology Data Exchange (ETDEWEB)

    Wang Shuujiun; Lin Kerneng; Shan Dinge; Liao Kwankum; Fuh Jongling; Lee Liangshong (National Yang-Ming Medical Coll., Taipei (Taiwan)); Liu Renshyan (Veterans General Hospital, Taipei (Taiwan). Dept. of Nuclear Medicine); Liu Hsiuchih (Veterans General Hospital, Taipei (Taiwan). Neurological Inst.)

    1993-04-01

    Regional cerebral blood flow was assessed in 19 patients with early idiopathic Parkinson's disease (PD) and 12 control subjects of similar age by single-photon emission tomography using technetium-99m hexamethylpropylene amine oxime (HMPAO). Of the patients with PD, seven were mildly demented and 15 presented with hemiparkinsonism. Mean HMPAO cortical or basal ganglia/cerebellum activity ratios were calculated. Mean cortical and regional uptake ratios in non-demented PD patients were not significantly different from values in the controls. In contrast, besides generalized cortical hypoperfusion, demented PD patients had significantly lower HMPAO uptake in the frontal and basal ganglia regions than non-demented patients. These observations support the hypothesis of impaired neuronal activity in both cortical and subcortical regions of the brain in demented PD patients. In hemiparkinsonian patients, the only asymmetrical finding was a relative hypoperfusion in the contralateral parietal region. This may be due to deafferentation of the thalamoparietal pathways. The lack of asymmetrical uptake in basal ganglia in our PD patients may be explained by their staging at the time of the investigation (stage I and II, Hoehn and Yahr scale). (orig.).

  9. Technetium-99m hexamethylpropylene amine oxime single photon emission tomography of the brain in early Parkinson's disease: correlation with dementia and lateralization

    Energy Technology Data Exchange (ETDEWEB)

    Shuujiun, Wang; Kerneng, Lin; Dinge, Shan; Kwankum, Liao; Jongling, Fuh; Liangshong, Lee [National Yang-Ming Medical Coll., Taipei (Taiwan); Renshyan, Liu [Veterans General Hospital, Taipei (Taiwan). Dept. of Nuclear Medicine; Hsiuchih, Liu [Veterans General Hospital, Taipei (Taiwan). Neurological Inst.

    1993-04-01

    Regional cerebral blood flow was assessed in 19 patients with early idiopathic Parkinson's disease (PD) and 12 control subjects of similar age by single-photon emission tomography using technetium-99m hexamethylpropylene amine oxime (HMPAO). Of the patients with PD, seven were mildly demented and 15 presented with hemiparkinsonism. Mean HMPAO cortical or basal ganglia/cerebellum activity ratios were calculated. Mean cortical and regional uptake ratios in non-demented PD patients were not significantly different from values in the controls. In contrast, besides generalized cortical hypoperfusion, demented PD patients had significantly lower HMPAO uptake in the frontal and basal ganglia regions than non-demented patients. These observations support the hypothesis of impaired neuronal activity in both cortical and subcortical regions of the brain in demented PD patients. In hemiparkinsonian patients, the only asymmetrical finding was a relative hypoperfusion in the contralateral parietal region. This may be due to deafferentation of the thalamoparietal pathways. The lack of asymmetrical uptake in basal ganglia in our PD patients may be explained by their staging at the time of the investigation (stage I and II, Hoehn and Yahr scale). (orig.).

  10. The genetics of dementias. Part 1: Molecular basis of frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17

    Directory of Open Access Journals (Sweden)

    Anna Kowalska

    2009-06-01

    Full Text Available Frontotemporal dementia (FTD, characterized by neurodegeneration mainly in the frontal and temporal lobes, accounts for ca. 10–15�0of all dementias. In 1892 the Czech-German neuropsychiatrist Arnold Pick reported the first case of FTD in a 71-year-old patient suffering from progressive dementia, memory disturbances, and aphasia associated with frontal and temporal lobe atrophy and the presence of neuronal inclusions. Later the inclusions were named Pick bodies. The neuropathological hallmark of FTD is very differentiated. In contrast to Alzheimer’s disease (AD, there are neither senile plaques nor neurofibrillary tangles in the brains of FTD patients. Frontotemporal dementias are tauopathies, a group of disorders caused by aberrant metabolism of tau protein, a family of proteins associated with microtubules (MAPT: macrotubule-associated tau protein. In the nervous system the protein stabilizes microtubules in neuronal axons and is thus responsible for crucial processes in neuron metabolism, such as signal transduction, plasticity, and intracellular transport. In the human brain, six isoforms are produced from the MAPT gene (chromosome 17 q21.2 by alternative mRNA splicing. The isoforms differ in the number of amino acids in the protein chain, the presence of three (3R tau type or four (4R tau type domains responsible for binding to microtubules, and one or two inserts containing from 29 to 58 amino acids. The isoforms are modified posttranslationally by hyperphosphorylation, glycation, or oxidation, which can change the protein’s properties and disturb its normal function. Altered metabolism of tau protein changes its interactions with tubulin, leading to destabilization of the microtubule structure and initiating the generation of toxic tau aggregates. The first mutations in the MAPT gene responsible for frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17 were found in 1998. So far over 40 mutations in the MAPT

  11. [Physical therapy for parkinson's disease].

    Science.gov (United States)

    Hubert, M

    2011-09-01

    Parkinson's disease is a complex neurologic and progressive incapacitating disease. Parkinson's disease severely threatens the quality of live and the number of patients worldwide is expected to rise considerably in the coming decade due to aging of the population. Even with optimal medical management using drugs or neurosurgery, patients are faced with progressively increasing impairments (e.g. in speech, mental and movement related functions), and restrictions in participation (e.g. domestic life and social activities). Physical therapy is often prescribed next to medical treatment but there is a lack of uniform treatment. A systematic literature search for guidelines, systematic reviews, trials, and expert opinions lead to a better understanding. The key question: Is physiotherapy able to optimally treat the Parkinson's disease symptoms? In which way, how and on which scientific bases can the physiotherapist participate to improve autonomy and to help them living independently and avoid, as long as possible, institutionalization? This article has integrated clinical research findings to provide clinicians with an overview to physical therapist management of disorders in people with Parkinson's disease. An Evidence-Based Physical Therapy Guideline providing practice recommendations was developed by the Royal Dutch Society for Physical Therapy (KNGF). Evidence from research was supplemented with clinical expertise and patients values. Randomized clinical trials reflect specific core areas of physical therapy, that is, transfer, posture, balance, reaching and grasping, gait and physical condition. Another aspect is that of educating patients (as well as their partners and family) about the disease process and the benefits of exercise therapy. Alternative therapies can be helpful like Tai Chi, virtual games, dancing, yoga, ball games for example.

  12. The Distinct Cognitive Syndromes of Parkinson's Disease: 5 Year Follow-Up of the CamPaIGN Cohort

    Science.gov (United States)

    Williams-Gray, Caroline H.; Evans, Jonathan R.; Goris, An; Foltynie, Thomas; Ban, Maria; Robbins, Trevor W.; Brayne, Carol; Kolachana, Bhaskar S.; Weinberger, Daniel R.; Sawcer, Stephen J.; Barker, Roger A.

    2009-01-01

    Cognitive abnormalities are common in Parkinson's disease, with important social and economic implications. Factors influencing their evolution remain unclear but are crucial to the development of targeted therapeutic strategies. We have investigated the development of cognitive impairment and dementia in Parkinson's disease using a longitudinal…

  13. Living Well with Parkinson's Disease Is an Art

    Science.gov (United States)

    ... Disease Living Well with Parkinson's Disease is an Art Past Issues / Winter 2014 Table of Contents What ... More "Living Well with Parkinson's Disease is an Art" Articles Living Well with Parkinson's Disease is an ...

  14. Swallowing disorders in Parkinson's disease.

    Science.gov (United States)

    Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

    Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO 2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  15. Addictive behaviors and Parkinson's disease.

    Science.gov (United States)

    Witjas, T; Eusebio, A; Fluchère, F; Azulay, J-P

    2012-01-01

    In Parkinson's disease, the degeneration of the dopaminergic system and the longstanding exposure to dopamine replacement therapy (DRT) may cause, in a group of vulnerable patients, dysregulation of the brain reward system. These patients develop DRT-related compulsions, which include addiction to levodopa or dopamine dysregulation syndrome (DDS), punding, and impulse control disorders (ICDs). ICDs or behavioral addiction reported in Parkinson's disease include pathological gambling, hypersexuality, compulsive buying and binge eating. Although the underlying pathophysiology is still poorly understood, these behaviors are linked by their reward-based and repetitive nature. Such behaviors may result in devastating psychosocial impairment for the patients and are often hidden. The recognition of these behaviors is important and allows a better clinical management. Although the limited data do not permit particular therapeutic strategies, some approaches are worth considering: DRT reduction, trials of non-dopaminergic medications and subthalamic chronic stimulation. Copyright © 2012. Published by Elsevier Masson SAS.

  16. Electroconvulsive therapy in Parkinson's disease.

    Science.gov (United States)

    Calderón-Fajardo, Humberto; Cervantes-Arriaga, Amin; Llorens-Arenas, Rodrigo; Ramírez-Bermudez, Jesús; Ruiz-Chow, Ángel; Rodríguez-Violante, Mayela

    2015-10-01

    Purpose To analyze the effectiveness of electroconvulsive therapy for the management of depression and/or psychosis refractory to drug therapy in patients with Parkinson disease.Methods A retrospective study was carried out including patients treated with electroconvulsive therapy during the period between 2002 and 2013. A review of the literature was performed.Results A total of 27 patients were included. In regards to the neuropsychiatric diagnosis, 14 patients had major depression, 12 patients had both psychosis and depression, and only one patient had isolated psychosis. The mean number of electroconvulsive therapy sessions was 12 ± 2.8. After electroconvulsive therapy, all patients showed a statistically significant improvement in the Brief Psychiatric Rating scale (reduction of 52% points) and Hamilton Depression Rating Scale (reduction of 50% points) independent of the presence of psychosis, depression or both.Conclusion Electroconvulsive therapy is effective for the treatment of refractory neuropsychiatric symptoms in Parkinson's disease.

  17. How Is Parkinson's Disease Treated?

    Science.gov (United States)

    ... the entire Parkinson's community. Learn more Get Involved Moving Day Walk Parkinson's Champions Create Your Own Fundraiser Advocate With Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

  18. Parkinson's disease as a result of aging

    OpenAIRE

    Rodriguez, Manuel; Rodriguez-Sabate, Clara; Morales, Ingrid; Sanchez, Alberto; Sabate, Magdalena

    2015-01-01

    It is generally considered that Parkinson's disease is induced by specific agents that degenerate a clearly defined population of dopaminergic neurons. Data commented in this review suggest that this assumption is not as clear as is often thought and that aging may be critical for Parkinson's disease. Neurons degenerating in Parkinson's disease also degenerate in normal aging, and the different agents involved in the etiology of this illness are also involved in aging. Senescence is a wider p...

  19. Dementia

    Science.gov (United States)

    ... aging. Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve ...

  20. [Music therapy on Parkinson disease].

    Science.gov (United States)

    Côrte, Beltrina; Lodovici Neto, Pedro

    2009-01-01

    This study is a result of a qualitative research, in the Gerontology and Music therapy scenario. It was analyzed the importance of alternative practices like playing an instrument (piano, violin, etc.), singing, or practicing a guided musical exercise as a therapy activity for elder people with Parkinson Disease. The analysis, systematization and interpretation of the data pointed: music therapy is an excellent way to improve the life of the patient that becomes more sociable, decreasing physical and psychological symptoms ('symptomatology') and the subject change for a singular and own position in the relation with your disease and the people around.