Machine learning models for the differential diagnosis of vascular parkinsonism and Parkinson's disease using [{sup 123}I]FP-CIT SPECT

Energy Technology Data Exchange (ETDEWEB)

Huertas-Fernandez, I.; Benitez-Rivero, S.; Jesus, S.; Caceres-Redondo, M.T.; Martin-Rodriguez, J.F.; Carrillo, F. [Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurologia y Neurofisiologia Clinica, Seville (Spain); Garcia-Gomez, F.J.; Marin-Oyaga, V.A.; Lojo, J.A. [Hospital Universitario Virgen del Rocio, Servicio de Medicina Nuclear, UDIM, Seville (Spain); Garcia-Solis, D. [Hospital Universitario Virgen del Rocio, Servicio de Medicina Nuclear, UDIM, Seville (Spain); Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Seville (Spain); Mir, P. [Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Unidad de Trastornos del Movimiento, Servicio de Neurologia y Neurofisiologia Clinica, Seville (Spain); Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Seville (Spain)

2015-01-15

The study's objective was to develop diagnostic predictive models using data from two commonly used [{sup 123}I]FP-CIT SPECT assessment methods: region-of-interest (ROI) analysis and whole-brain voxel-based analysis. We included retrospectively 80 patients with vascular parkinsonism (VP) and 164 patients with Parkinson's disease (PD) who underwent [{sup 123}I]FP-CIT SPECT. Nuclear-medicine specialists evaluated the scans and calculated bilateral caudate and putamen [{sup 123}I]FP-CIT uptake and asymmetry indices using BRASS software. Statistical parametric mapping (SPM) was used to compare the radioligand uptake between the two diseases at the voxel level. Quantitative data from these two methods, together with potential confounding factors for dopamine transporter availability (sex, age, disease duration and severity), were used to build predictive models following a tenfold cross-validation scheme. The performance of logistic regression (LR), linear discriminant analysis and support vector machine (SVM) algorithms for ROI data, and their penalized versions for SPM data (penalized LR, penalized discriminant analysis and SVM), were assessed. Significant differences were found in the ROI analysis after covariate correction between VP and PD patients in [{sup 123}I]FP-CIT uptake in the more affected side of the putamen and the ipsilateral caudate. Age, disease duration and severity were also found to be informative in feeding the statistical model. SPM localized significant reductions in [{sup 123}I]FP-CIT uptake in PD with respect to VP in two specular clusters comprising areas corresponding to the left and right striatum. The diagnostic predictive accuracy of the LR model using ROI data was 90.3 % and of the SVM model using SPM data was 90.4 %. The predictive models built with ROI data and SPM data from [{sup 123}I]FP-CIT SPECT provide great discrimination accuracy between VP and PD. External validation of these methods is necessary to confirm their

A mixed-methods study into ballet for people living with Parkinson's1

Science.gov (United States)

Houston, Sara; McGill, Ashley

2012-01-01

Background: Parkinson's is a neurological disease that is physically debilitating and can be socially isolating. Dance is growing in popularity for people with Parkinson's and claims have been made for its benefits. The paper details a mixed-methods study that examined a 12-week dance project for people with Parkinson's, led by English National Ballet. Methods: The effects on balance, stability and posture were measured through the Fullerton Advanced Balance Scale and a plumb-line analysis. The value of participation and movement quality were interpreted through ethnographic methods, grounded theory and Effort analysis. Results: Triangulation of results indicates that people were highly motivated, with 100% adherence, and valued the classes as an important part of their lives. Additionally, results indicated an improvement in balance and stability, although not in posture. Conclusions: Dancing may offer benefit to people with Parkinson's through its intellectual, artistic, social and physical aspects. The paper suggests that a range of research methods is fundamental to capture the importance of multifaceted activity, such as dance, to those with Parkinson's. PMID:23805165

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...

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...

PET-Studies in parkinson's disease

International Nuclear Information System (INIS)

Schwarz, J.

2002-01-01

Positron-emission-tomography (PET) has enabled to study the metabolism and blood flow in specific brain areas. Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease. (orig.) [de

Predictive Big Data Analytics: A Study of Parkinson?s Disease Using Large, Complex, Heterogeneous, Incongruent, Multi-Source and Incomplete Observations

OpenAIRE

Dinov, Ivo D.; Heavner, Ben; Tang, Ming; Glusman, Gustavo; Chard, Kyle; Darcy, Mike; Madduri, Ravi; Pa, Judy; Spino, Cathie; Kesselman, Carl; Foster, Ian; Deutsch, Eric W.; Price, Nathan D.; Van Horn, John D.; Ames, Joseph

2016-01-01

Background A unique archive of Big Data on Parkinson?s Disease is collected, managed and disseminated by the Parkinson?s Progression Markers Initiative (PPMI). The integration of such complex and heterogeneous Big Data from multiple sources offers unparalleled opportunities to study the early stages of prevalent neurodegenerative processes, track their progression and quickly identify the efficacies of alternative treatments. Many previous human and animal studies have examined the relationsh...

Thiazolidinediones and Parkinson Disease: A Cohort Study.

Science.gov (United States)

Connolly, John G; Bykov, Katsiaryna; Gagne, Joshua J

2015-12-01

Thiazolidinediones, a class of medications indicated for the treatment of type 2 diabetes mellitus, reduce inflammation and have been shown to provide a therapeutic benefit in animal models of Parkinson disease. We examined the association between treatment with thiazolidinediones and the onset of Parkinson disease in older individuals. We performed a cohort study of 29,397 Medicare patients enrolled in state pharmaceutical benefits programs who initiated treatment with thiazolidinediones or sulfonylureas during the years 1997 through 2005 and had no prior diagnosis of Parkinson disease. New users of thiazolidinediones were propensity score matched to new users of sulfonylureas and followed to determine whether they were diagnosed with Parkinson disease. We used Cox proportional hazards models to compare time to diagnosis of Parkinson disease in the propensity score-matched populations. To assess the association with duration of use, we performed several analyses that required longer continuous use of medications. In the primary analysis, thiazolidinedione users had a hazard ratio for a diagnosis of Parkinson disease of 1.09 (95% confidence interval: 0.71, 1.66) when compared with sulfonylurea users. Increasing the duration-of-use requirements to 10 months did not substantially change the association; the hazard ratios ranged from 1.00 (95% confidence interval: 0.49, 2.05) to 1.17 (95% confidence interval: 0.60, 2.25). Thiazolidinedione use was not associated with a longer time to diagnosis of Parkinson disease than was sulfonylurea use, regardless of duration of exposure. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Risk and protective factors for Parkinson's disease: a study in Swedish twins.

Science.gov (United States)

Wirdefeldt, Karin; Gatz, Margaret; Pawitan, Yudi; Pedersen, Nancy L

2005-01-01

Many studies have shown a protective effect of cigarette smoking on Parkinson's disease. However, criticism has been raised concerning confounding by genetic factors. We investigated the associations between Parkinson's disease and smoking, alcohol, coffee, area of living, and education in a co-twin control study. Because twins are matched for genetic and familial environmental factors, this design controls for confounding by these factors. We also examined control subjects unrelated to cases. Exposure information was taken from questionnaires answered in the 1960s and 1970s. Parkinson's disease cases were identified through the Swedish Inpatient Discharge Register (IDR) and the Cause of Death Register. In the unrelated control subject comparison, 476 Parkinson's disease cases and 2,380 control subjects were included. In the co-twin control comparison, 415 same-sex twin pairs were included. There was an inverse association between smoking and Parkinson's disease using unrelated control subjects and co-twin control cases. There was no association between Parkinson's disease and alcohol, coffee, or area of living. High educational level was associated with Parkinson's disease in the unrelated control subject comparison but not in the co-twin control comparison. We confirm the protective effect of smoking on Parkinson's disease and establish that the association is only partially explained by genetic and familial environmental factors.

Efficacy of rasagiline and selegiline in Parkinson?s disease: a head-to-head 3-year retrospective case?control study

OpenAIRE

Cereda, Emanuele; Cilia, Roberto; Canesi, Margherita; Tesei, Silvana; Mariani, Claudio Bruno; Zecchinelli, Anna Lena; Pezzoli, Gianni

2017-01-01

Monoamine oxidase type B (MAO-B) inhibitors, such as selegiline and rasagiline, can be used as monotherapy or adjuvant therapy to levodopa in Parkinson?s disease (PD). Data on long-term efficacy of MAO-B inhibitors are limited with no head-to-head comparison available to date. The aim of this case?control retrospective study was to analyze data from patients with PD attending the Parkinson Institute (Milan, Italy) over a 6-year period (2009?2015) and compare the effects of selegiline and rasa...

Longitudinal Study of Gray Matter Changes in Parkinson Disease.

Science.gov (United States)

Jia, X; Liang, P; Li, Y; Shi, L; Wang, D; Li, K

2015-12-01

The pathology of Parkinson disease leads to morphological brain volume changes. So far, the progressive gray matter volume change across time specific to patients with Parkinson disease compared controls remains unclear. Our aim was to investigate the pattern of gray matter changes in patients with Parkinson disease and to explore the progressive gray matter volume change specific to patients with Parkinson disease with disease progression by using voxel-based morphometry analysis. Longitudinal cognitive assessment and structural MR imaging of 89 patients with Parkinson disease (62 men) and 55 healthy controls (33 men) were from the Parkinson's Progression Markers Initiative data base, including the initial baseline and 12-month follow-up data. Two-way analysis of covariance was performed with covariates of age, sex, years of education, imaging data from multiple centers, and total intracranial volume by using Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra tool from SPM8 software. Gray matter volume changes for patients with Parkinson disease were detected with decreased gray matter volume in the frontotemporoparietal areas and the bilateral caudate, with increased gray matter volume in the bilateral limbic/paralimbic areas, medial globus pallidus/putamen, and the right occipital cortex compared with healthy controls. Progressive gray matter volume decrease in the bilateral caudate was found for both patients with Parkinson disease and healthy controls, and this caudate volume was positively associated with cognitive ability for both groups. The progressive gray matter volume increase specific to the patients with Parkinson disease was identified close to the left ventral lateral nucleus of thalamus, and a positive relationship was found between the thalamic volume and the tremor scores in a subgroup with tremor-dominant patients with Parkinson disease. The observed progressive changes in gray matter volume in Parkinson disease may provide

PET activation in basal ganglia disorders: Parkinson`s disease and dystonia; PET-Aktivierungsstudien bei Basalganglienerkrankungen: Morbus Parkinson und Dystonien

Energy Technology Data Exchange (ETDEWEB)

Ceballos-Baumann, A.O. [Neurologische Klinik, Technische Univ. Muenchen (Germany); Boecker, H. [Neurologische Klinik, Technische Univ. Muenchen (Germany); Conrad, B. [Neurologische Klinik, Technische Univ. Muenchen (Germany)

1997-03-01

This article reviews PET activation studies with performance of different motor paradigms (joy-stick movements, imagination of movement, writing) in patients with movement disorders. The focus will be on Parkinson`s disease (PD) and dystonia. PET findings will be related to clinical and electrophysiological observations. PET activation studies before and after therapeutic interventions such as pallidotomy in Parkinson`s disease and botulinum toxin in writer`s cramp are described. The contribution of PET activation studies to the understanding of the pathophysiology of dystonia and PD is discussed. (orig.) [Deutsch] Der Beitrag beschreibt verschiedene PET-Aktivierungsstudien mit motorischen Paradigmen (`joystick`-Bewegungen, Vorstellung von Bewegung, Schreiben) bei Bewegungsstoerungen, im wesentlichen bei Patienten mit Dystonie, einer Hyperkinese, und Morbus Parkinson als Hypokinese. Die experimentellen Befunde werden mit der Klinik in Bezug gebracht. Neue Untersuchungen vor und nach therapeutischen Interventionen, wie die stereotaktische Pallidotomie bei Parkinson und die Botulinum-Toxin-Therapie bei Schreibkrampf, werden beschrieben. Der Beitrag von PET-Aktivierungsstudien zum Verstaendnis der Pathophysiologie von Bewegungsstoerungen wird diskutiert. (orig.)

Parkinson's: another look.

Science.gov (United States)

Broxmeyer, L

2002-10-01

Recent studies in the Parkinson's literature have cited a tuberculosis-like germ called Nocardia as being responsible for Parkinson's disease. Kohbata seemingly cemented a relationship between Nocardia and Parkinson's by finding serologic evidence in 20 of 20 Parkinson's patients, acknowledging that blood tests for Nocardia and the mycobacteria such as tuberculosis often cross-react, as they belong to the same order of bacteria, the Actinomycetales. Besides this difficulty in differentiation, a well-used medical school textbook of microbiology, Atlas, points out that even among experts, different observers may classify the same strain of bacteria as Nocardia or Mycobacterium tuberculosis. Parkinson's: another look is a theoretical article which presents compelling, well-documented evidence for an infectious cause for Parkinson's disease on historical, epidemiological, pharmacologic, microbiological, and biochemical levels.

Metabolic topography of Parkinsonism

Energy Technology Data Exchange (ETDEWEB)

Kim, Jae Seung [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2007-04-15

Parkinson's disease is one of the most frequent neurodegenerative diseases, which mainly affects the elderly. Parkinson's disease is often difficult to differentiate from atypical parkinson disorder such as progressive supranuclear palsy, multiple system atrophy, dementia with Lewy body, and corticobasal ganglionic degeneration, based on the clinical findings because of the similarity of phenotypes and lack of diagnostic markers. The accurate diagnosis of Parkinson's disease and atypical Parkinson disorders is not only important for deciding on treatment regimens and providing prognosis, but also it is critical for studies designed to investigate etiology and pathogenesis of parkinsonism and to develop new therapeutic strategies. Although degeneration of the nigrostriatal dopamine system results in marked loss of striatal dopamine content in most of the diseases causing parkinsonism, pathologic studies revealed different topographies of the neuronal cell loss in Parkinsonism. Since the regional cerebral glucose metabolism is a marker of integrated local synaptic activity and as such is sensitive to both direct neuronal/synaptic damage and secondary functional disruption at synapses distant from the primary site of pathology, and assessment of the regional cerebral glucose metabolism with F-18 FDG PET is useful in the differential diagnosis of parkinsonism and evaluating the pathophysiology of Parkinsonism.

Metabolic topography of Parkinsonism

International Nuclear Information System (INIS)

Kim, Jae Seung

2007-01-01

Parkinson's disease is one of the most frequent neurodegenerative diseases, which mainly affects the elderly. Parkinson's disease is often difficult to differentiate from atypical parkinson disorder such as progressive supranuclear palsy, multiple system atrophy, dementia with Lewy body, and corticobasal ganglionic degeneration, based on the clinical findings because of the similarity of phenotypes and lack of diagnostic markers. The accurate diagnosis of Parkinson's disease and atypical Parkinson disorders is not only important for deciding on treatment regimens and providing prognosis, but also it is critical for studies designed to investigate etiology and pathogenesis of parkinsonism and to develop new therapeutic strategies. Although degeneration of the nigrostriatal dopamine system results in marked loss of striatal dopamine content in most of the diseases causing parkinsonism, pathologic studies revealed different topographies of the neuronal cell loss in Parkinsonism. Since the regional cerebral glucose metabolism is a marker of integrated local synaptic activity and as such is sensitive to both direct neuronal/synaptic damage and secondary functional disruption at synapses distant from the primary site of pathology, and assessment of the regional cerebral glucose metabolism with F-18 FDG PET is useful in the differential diagnosis of parkinsonism and evaluating the pathophysiology of Parkinsonism

Prevalence and risk factors of Parkinson's disease in retired Thai traditional boxers.

Science.gov (United States)

Lolekha, Praween; Phanthumchinda, Kammant; Bhidayasiri, Roongroj

2010-09-15

Boxing is often believed to be a frequent cause for parkinsonism caused by chronic repetitive head injury, with Muhammad Ali frequently cited as an example. The purpose of this study is to determine the prevalence of Parkinson's disease (PD) in retired Thai traditional boxers. Two standardized screening questionnaires were sent to all registered Thai traditional boxers. Subjects who screened positive for parkinsonism were invited for clinical examinations by two independent neurologists. Among 704 boxers (70%) who completed the questionnaires, 8 boxers (1.14%) had parkinsonism: 5 with PD, 1 with progressive supranuclear palsy and 2 with vascular parkinsonism. Boxers with PD were found to have an older mean age than those without PD (P = 0.003). The analysis of probable risk factors disclosed an association between the number of professional bouts (>100 times) and PD (P = 0.01). The crude prevalence of PD in Thai boxers was 0.71% (95% CI: 0.09-1.33), with a significant increase with age. The prevalence rate of PD in those aged 50 and above was 0.17% (95% CI: 0.15-0.20), age-adjusted to the USA 1970 census, which is comparable to that of the general populations. The analysis determined that the number of professional bouts is a risk factor among these boxers, supporting the notion that repetitive head trauma may pose an additional risk to certain individuals who are already susceptible to PD. © 2010 Movement Disorder Society.

[Rasagiline is not for all Parkinson disease patients: the ADAGIO study].

NARCIS (Netherlands)

Laar, T. van; Boon, A.J.; Bloem, B.R.

2010-01-01

Rasagiline is a MAO-B inhibitor that is currently registered for the symptomatic treatment of Parkinson disease. The ADAGIO trial studied the potential disease-modifying properties of rasagiline in 1100 patients with Parkinson disease, using an innovative 'delayed start' design. Patients were

Prospective study of coffee consumption and risk of Parkinson's disease.

Science.gov (United States)

Sääksjärvi, K; Knekt, P; Rissanen, H; Laaksonen, M A; Reunanen, A; Männistö, S

2008-07-01

To examine the prediction of coffee consumption on the incidence of Parkinson's disease. The study population comprised 6710 men and women, aged 50-79 years and free from Parkinson's disease at the baseline. At baseline, enquiries were made about coffee consumption in a self-administered questionnaire as the average number of cups per day. During a 22-year follow-up, 101 incident cases of Parkinson's disease occurred. Parkinson's disease cases were identified through a nationwide registry of patients receiving medication reimbursement, which is based on certificates from neurologist. After adjustments for age, sex, marital status, education, community density, alcohol consumption, leisure-time physical activity, smoking, body mass index, hypertension and serum cholesterol, the relative risk for subjects drinking 10 or more cups of coffee per day compared with non-drinkers was 0.26 (95% confidence interval 0.07-0.99, P-value for trend=0.18). The association was stronger among overweight persons and among persons with lower serum cholesterol level (P-value for interaction=0.04 and 0.03, respectively). The results support the hypothesis that coffee consumption reduces the risk of Parkinson's disease, but protective effect of coffee may vary by exposure to other factors.

Transplantation of ES cells to Parkinson model rat irradiated with carbon ion beam

International Nuclear Information System (INIS)

Inaji, Motoki; Okauchi, Takashi; Nagai, Yuji; Nojima, Kumie

2003-01-01

The present study was designed to make better Parkinson model animal and evaluate the transplantation treatment with ES cell. In the first year, we irradiated left striatum of adult rats with charged carbon particles (290 MeV/nucleon, 5 mm spread-out Bragg peak, 100 Gy) for purpose of making Parkinson model rats. At 4, 8, 12 weeks after the irradiation, we performed the rotation test to methamphetamine and the autoradiography on dopamine D2 receptor and transporter using 11 C-raclopride and 11 C-PE2I to measure the effects of the irradiation. As a result, the number of rotation increased and the distributions of dopamine D2 receptor and transporter in the striatum decreased during the time after the irradiation. These results suggested that the secondary neural damage due to the vascular degeneration caused the progressive destruction of dopamine system. To make more stable Parkinson model rats, we need to use smaller collimator and develop the accurate stereotactic irradiation system in the further research. (author)

Impulse control disorders in advanced Parkinson's disease with dyskinesia: The ALTHEA study.

Science.gov (United States)

Biundo, Roberta; Weis, Luca; Abbruzzese, Giovanni; Calandra-Buonaura, Giovanna; Cortelli, Pietro; Jori, Maria Cristina; Lopiano, Leonardo; Marconi, Roberto; Matinella, Angela; Morgante, Francesca; Nicoletti, Alessandra; Tamburini, Tiziano; Tinazzi, Michele; Zappia, Mario; Vorovenci, Ruxandra Julia; Antonini, Angelo

2017-11-01

Impulse control disorders and dyskinesia are common and disabling complications of dopaminergic treatment in Parkinson's disease. They may coexist and are possibly related. The objectives of this study were to assess the frequency and severity of impulse control disorders in Parkinson's disease patients with dyskinesia. The ALTHEA study enrolled 251 Parkinson's disease patients with various degrees of dyskinesia severity from 11 movement disorders centers in Italy. Each patient underwent a comprehensive assessment including Unified Dyskinesia Rating Scale and the Questionnaire for Impulsive Compulsive Disorders in Parkinson Disease-Rating Scale. There was an overall 55% frequency of impulse control disorder and related behaviors (36% were clinically significant). The positive patients were younger at disease diagnosis and onset and had higher Unified Dyskinesia Rating Scale historical and total score (P = 0.001 and P = 0.02, respectively, vs negative). There was an increased frequency of clinically significant impulse control disorders in patients with severe dyskinesia (P = 0.013), a positive correlation between the questionnaire total score and dopamine agonist dose (P = 0.018), and a trend with levodopa dose. More than half of Parkinson's disease patients with dyskinesia have impulse control disorders and related behaviors, which are frequently clinically significant. Dopaminergic therapy total dose is associated with their severity. Clinicians should carefully assess patients with maladaptive behaviors and dyskinesia because they do not properly evaluate their motor and nonmotor status. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

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.

Toxoplasma gondii exposure and Parkinson's disease: a case–control study

Science.gov (United States)

Alvarado-Esquivel, Cosme; Méndez-Hernández, Edna Madai; Salas-Pacheco, José Manuel; Ruano-Calderón, Luis Ángel; Hernández-Tinoco, Jesús; Arias-Carrión, Oscar; Sánchez-Anguiano, Luis Francisco; Castellanos-Juárez, Francisco Xavier; Sandoval-Carrillo, Ada Agustina; Liesenfeld, Oliver; Ramos-Nevárez, Agar

2017-01-01

Objectives To determine the association between Toxoplasma gondii infection and Parkinson's disease and to investigate whether T. gondii seropositivity is associated with the general characteristics of patients with Parkinson's disease. Design Case–control study. Setting Cases and controls were enrolled in Durango City, Mexico. Participants 65 patients with Parkinson's disease and 195 age- and gender-matched control subjects without Parkinson's disease. Primary and secondary outcome measures Serum samples of participants were analysed for anti-T. gondii IgG and IgM antibodies by commercially available enzyme-linked immunoassays. Prevalence of T. gondii DNA was determined in seropositive subjects using PCR. The association between clinical data and infection was examined by bivariate analysis. Results Anti-T. gondii IgG antibodies were found in 6/65 cases (9.2%) and in 21/195 controls (10.8%) (OR 0.84; 95% CI 0.32 to 2.18; p=0.81). The frequency of high (>150 IU/mL) antibody levels was similar among cases and controls (p=0.34). None of the anti-T. gondii IgG positive cases and four of the anti-T. gondii IgG positive controls had anti-T. gondii IgM antibodies (p=0.54). The prevalence of T. gondii DNA was comparable in seropositive cases and controls (16.7% and 25%, respectively; p=1.0). Seroprevalence of T. gondii infection was associated with a young age onset of disease (p=0.03), high Unified Parkinson Disease Rating Scale scores (p=0.04) and depression (p=0.02). Seropositivity to T. gondii infection was lower in patients treated with pramipexole than in patients without this treatment (p=0.01). However, none of the associations remained significant after Bonferroni correction. Conclusions The results do not support an association between T. gondii infection and Parkinson's disease. However, T. gondii infection might have an influence on certain symptoms of Parkinson's disease. Further research to elucidate the role of T. gondii exposure on Parkinson's disease

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)

A mixed-methods study into ballet for people living with Parkinson's.

Science.gov (United States)

Houston, Sara; McGill, Ashley

2013-06-01

Background : Parkinson's is a neurological disease that is physically debilitating and can be socially isolating. Dance is growing in popularity for people with Parkinson's and claims have been made for its benefits. The paper details a mixed-methods study that examined a 12-week dance project for people with Parkinson's, led by English National Ballet. Methods : The effects on balance, stability and posture were measured through the Fullerton Advanced Balance Scale and a plumb-line analysis. The value of participation and movement quality were interpreted through ethnographic methods, grounded theory and Effort analysis. Results : Triangulation of results indicates that people were highly motivated, with 100% adherence, and valued the classes as an important part of their lives. Additionally, results indicated an improvement in balance and stability, although not in posture. Conclusions : Dancing may offer benefit to people with Parkinson's through its intellectual, artistic, social and physical aspects. The paper suggests that a range of research methods is fundamental to capture the importance of multifaceted activity, such as dance, to those with Parkinson's.

Seasonal temperature is associated with Parkinson's disease prescriptions: an ecological study

Science.gov (United States)

Rowell, David; Nghiem, Son; Ramagopalan, Sreeram; Meier, Ute-Christiane

2017-12-01

The aim of this study is to test what effect the weather may have on medications prescribed to treat Parkinson's disease. Twenty-three years of monthly time, series data was sourced from the Pharmaceutical Benefits Scheme (PBS) and the Bureau of Meteorology (BOM). Data were available for eight states and territories and their corresponding capital cities. The dependent variable was the aggregate levodopa equivalent dose (LED) for 51 Parkinson's medications identified on the PBS. Two explanatory variables of interest, temperature and solar exposure, were identified in the BOM data set. Linear and cosinor models were estimated with fixed and random effects, respectively. The prescribed LED was 4.2% greater in January and 4.5% lower in July. Statistical analysis showed that temperature was associated with the prescription of Parkinson medications. Our results suggest seasonality exists in Parkinson's disease symptoms and this may be related to temperature. Further work is needed to confirm these findings and understand the underlying mechanisms as a better understanding of the causes of any seasonal variation in Parkinson's disease may help clinicians and patients manage the disease more effectively.

Significance of frontal cortical atrophy in Parkinson's disease: computed tomographic study

Energy Technology Data Exchange (ETDEWEB)

Lee, Kyung Sang; Suh, Jung Ho; Chung, Tae Sub; Kim, Dong Ik [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-10-15

Fifty-five patients with Parkinson's disease were evaluated clinically and with brain computed tomography (CT) in order to determine the incidence of frontal cortical and subcortical atrophy. Twenty cases of age-related healthy control group were also scanned. The CT criteria of frontal cortical atrophy that was used in this study were the maximum width of frontal hemispheric cortical sulci and width of anterior interhemispheric fissure between frontal lobes comparing with maximum width of hemispheric cortical sulci except frontal lobes. And the criteria of frontal subcortical atrophy were bifrontal index bicaudate index, and Evans index. The results are as follows: 1. Cortical atrophic changes in Parkinson's disease were more prominent in frontal lobe rather than other causes of cortical atrophy. 2. Frontal cortical and subcortical atrophic changes were also more prominent in Parkinson's disease rather than age-related control group. 3. Subcortical atrophic changes in frontal lobe were always associated with cortical atrophic changes. 4. Changes of basal ganglia were hardly seen in Parkinson's disease. 5. Cortical atrophic changes in frontal lobe must be the one of significant findings in Parkinson's disease.

Significance of frontal cortical atrophy in Parkinson's disease: computed tomographic study

International Nuclear Information System (INIS)

Lee, Kyung Sang; Suh, Jung Ho; Chung, Tae Sub; Kim, Dong Ik

1987-01-01

Fifty-five patients with Parkinson's disease were evaluated clinically and with brain computed tomography (CT) in order to determine the incidence of frontal cortical and subcortical atrophy. Twenty cases of age-related healthy control group were also scanned. The CT criteria of frontal cortical atrophy that was used in this study were the maximum width of frontal hemispheric cortical sulci and width of anterior interhemispheric fissure between frontal lobes comparing with maximum width of hemispheric cortical sulci except frontal lobes. And the criteria of frontal subcortical atrophy were bifrontal index bicaudate index, and Evans index. The results are as follows: 1. Cortical atrophic changes in Parkinson's disease were more prominent in frontal lobe rather than other causes of cortical atrophy. 2. Frontal cortical and subcortical atrophic changes were also more prominent in Parkinson's disease rather than age-related control group. 3. Subcortical atrophic changes in frontal lobe were always associated with cortical atrophic changes. 4. Changes of basal ganglia were hardly seen in Parkinson's disease. 5. Cortical atrophic changes in frontal lobe must be the one of significant findings in Parkinson's disease

Mutation analysis for DJ-1 in sporadic and familial parkinsonism: screening strategy in parkinsonism.

Science.gov (United States)

Tomiyama, Hiroyuki; Li, Yuanzhe; Yoshino, Hiroyo; Mizuno, Yoshikuni; Kubo, Shin-Ichiro; Toda, Tatsushi; Hattori, Nobutaka

2009-05-22

DJ-1 mutations cause autosomal recessive parkinsonism (ARP). Although some reports of DJ-1 mutations have been published, there is lack of information on the prevalence of these mutations in large-scale studies of both familial and sporadic parkinsonism. In this genetic screening study, we analyzed the distribution and frequency of DJ-1 mutations by direct nucleotide sequencing of coding exons and exon-intron boundaries of DJ-1, in 386 parkin-negative parkinsonism patients (371 index cases: 67 probands of autosomal recessive parkinsonism families, 90 probands of autosomal dominant parkinsonism families, 201 patients with sporadic parkinsonism, and 13 with unknown family histories) from 12 countries (Japan 283, China 27, Taiwan 22, Korea 22, Israel 16, Turkey 5, Philippines 2, Bulgaria 2, Greece 2, Tunisia 1, USA 2, Ukraine 1, unknown 1). None had causative mutation in DJ-1, suggesting DJ-1 mutation is very rare among patients with familial and sporadic parkinsonism from Asian countries and those with other ethnic background. This is in contrast to the higher frequencies and worldwide distribution of parkin- and PINK1-related parkinsonism in ARP and sporadic parkinsonism. Thus, after obtaining clinical information, screening for mutations in (1) parkin, (2) PINK1, (3) DJ-1, (4) ATP13A2 should be conducted in that order, in ARP and sporadic parkinsonism, based on their reported frequencies. In addition, haplotype analysis should be employed to check for homozygosity of 1p36, which harbors a cluster of causative genes for ARP such as DJ-1, PINK1 and ATP13A2 in ARP and sporadic parkinsonism, especially in parkinsonism with consanguinity.

Inverse Association of Parkinson Disease With Systemic Lupus Erythematosus: A Nationwide Population-based Study.

Science.gov (United States)

Liu, Feng-Cheng; Huang, Wen-Yen; Lin, Te-Yu; Shen, Chih-Hao; Chou, Yu-Ching; Lin, Cheng-Li; Lin, Kuen-Tze; Kao, Chia-Hung

2015-11-01

The effects of the inflammatory mediators involved in systemic lupus erythematous (SLE) on subsequent Parkinson disease have been reported, but no relevant studies have focused on the association between the 2 diseases. This nationwide population-based study evaluated the risk of Parkinson disease in patients with SLE.We identified 12,817 patients in the Taiwan National Health Insurance database diagnosed with SLE between 2000 and 2010 and compared the incidence rate of Parkinson disease among these patients with that among 51,268 randomly selected age and sex-matched non-SLE patients. A Cox multivariable proportional-hazards model was used to evaluate the risk factors of Parkinson disease in the SLE cohort.We observed an inverse association between a diagnosis of SLE and the risk of subsequent Parkinson disease, with the crude hazard ratio (HR) being 0.60 (95% confidence interval 0.45-0.79) and adjusted HR being 0.68 (95% confidence interval 0.51-0.90). The cumulative incidence of Parkinson disease was 0.83% lower in the SLE cohort than in the non-SLE cohort. The adjusted HR of Parkinson disease decreased as the follow-up duration increased and was decreased among older lupus patients with comorbidity.We determined that patients with SLE had a decreased risk of subsequent Parkinson disease. Further research is required to elucidate the underlying mechanism.

Prospective study of caffeine consumption and risk of Parkinson's disease in men and women.

Science.gov (United States)

Ascherio, A; Zhang, S M; Hernán, M A; Kawachi, I; Colditz, G A; Speizer, F E; Willett, W C

2001-07-01

Results of case-control studies and of a prospective investigation in men suggest that consumption of coffee could protect against the risk of Parkinson's disease, but the active constituent is not clear. To address the hypothesis that caffeine is protective against Parkinson's disease, we examined the relationship of coffee and caffeine consumption to the risk of this disease among participants in two ongoing cohorts, the Health Professionals' Follow-Up Study (HPFS) and the Nurses' Health Study (NHS). The study population comprised 47,351 men and 88,565 women who were free of Parkinson's disease, stroke, or cancer at baseline. A comprehensive life style and dietary questionnaire was completed by the participants at baseline and updated every two to four years. During the follow-up (10 years in men, 16 years in women), we documented a total of 288 incident cases of Parkinson's disease. Among men, after adjustment for age and smoking, the relative risk of Parkinson's disease was 0.42 (95% CI: 0.23-0.78; p for trend coffee (p for trend = 0.004), caffeine from noncoffee sources (p for trend coffee. Among women, the relationship between caffeine or coffee intake and risk of Parkinson's disease was U-shaped, with the lowest risk observed at moderate intakes (1-3 cups of coffee/day, or the third quintile of caffeine consumption). These results support a possible protective effect of moderate doses of caffeine on risk of Parkinson's disease.

Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

International Nuclear Information System (INIS)

Kitamura, Shin

1983-01-01

Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways. (J.P.N.)

Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

Energy Technology Data Exchange (ETDEWEB)

Kitamura, Shin [Nippon Medical School, Tokyo

1983-04-01

Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways.

Dopamine transporter imaging study in parkinsonism occurring in fragile X premutation carriers.

Science.gov (United States)

Ceravolo, R; Antonini, A; Volterrani, D; Rossi, C; Goldwurm, S; Di Maria, E; Kiferle, L; Bonuccelli, U; Murri, L

2005-12-27

The authors studied four patients with parkinsonism carrying the fragile X premutation using SPECT with ([23)I]FP-CIT. They found evidence of preserved presynaptic nigrostriatal function, suggesting that parkinsonism in the X fragile premutation might be related to postsynaptic dopaminergic changes or different neurotransmitter alterations.

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parkin mutation dosage and the phenomenon of anticipation: a molecular genetic study of familial parkinsonism

Directory of Open Access Journals (Sweden)

Schellenberg Gerard D

2005-02-01

Full Text Available Abstract Background parkin mutations are a common cause of parkinsonism. Possessing two parkin mutations leads to early-onset parkinsonism, while having one mutation may predispose to late-onset disease. This dosage pattern suggests that some parkin families should exhibit intergenerational variation in age at onset resembling anticipation. A subset of familial PD exhibits anticipation, the cause of which is unknown. The aim of this study was to determine if anticipation was due to parkin mutation dosage. Methods We studied 19 kindreds that had early-onset parkinsonism in the offspring generation, late-onset parkinsonism in the parent generation, and ≥ 20 years of anticipation. We also studied 28 early-onset parkinsonism cases without anticipation. Patients were diagnosed by neurologists at a movement disorder clinic. parkin analysis included sequencing and dosage analysis of all 12 exons. Results Only one of 19 cases had compound parkin mutations, but contrary to our postulate, the affected relative with late-onset parkinsonism did not have a parkin mutation. In effect, none of the anticipation cases could be attributed to parkin. In contrast, 21% of early-onset parkinsonism patients without anticipation had parkin mutations. Conclusion Anticipation is not linked to parkin, and may signify a distinct disease entity.

A 5-Year Follow-up Study on the Relationship between Obstructive Sleep Apnea and Parkinson Disease.

Science.gov (United States)

Sheu, Jau-Jiuan; Lee, Hsin-Chien; Lin, Herng-Ching; Kao, Li-Ting; Chung, Shiu-Dong

2015-12-15

Sleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset. The data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort. Of the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA. Female patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period. © 2015 American Academy of Sleep Medicine.

Parkinson's Disease Dementia

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... 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 ...

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Central Pain Processing in Early-Stage Parkinson's Disease: A Laser Pain fMRI Study.

Directory of Open Access Journals (Sweden)

Christine Petschow

Full Text Available Pain is a common non-motor symptom in Parkinson's disease. As dopaminergic dysfunction is suggested to affect intrinsic nociceptive processing, this study was designed to characterize laser-induced pain processing in early-stage Parkinson's disease patients in the dopaminergic OFF state, using a multimodal experimental approach at behavioral, autonomic, imaging levels.13 right-handed early-stage Parkinson's disease patients without cognitive or sensory impairment were investigated OFF medication, along with 13 age-matched healthy control subjects. Measurements included warmth perception thresholds, heat pain thresholds, and central pain processing with event-related functional magnetic resonance imaging (erfMRI during laser-induced pain stimulation at lower (E = 440 mJ and higher (E = 640 mJ target energies. Additionally, electrodermal activity was characterized during delivery of 60 randomized pain stimuli ranging from 440 mJ to 640 mJ, along with evaluation of subjective pain ratings on a visual analogue scale.No significant differences in warmth perception thresholds, heat pain thresholds, electrodermal activity and subjective pain ratings were found between Parkinson's disease patients and controls, and erfMRI revealed a generally comparable activation pattern induced by laser-pain stimuli in brain areas belonging to the central pain matrix. However, relatively reduced deactivation was found in Parkinson's disease patients in posterior regions of the default mode network, notably the precuneus and the posterior cingulate cortex.Our data during pain processing extend previous findings suggesting default mode network dysfunction in Parkinson's disease. On the other hand, they argue against a genuine pain-specific processing abnormality in early-stage Parkinson's disease. Future studies are now required using similar multimodal experimental designs to examine pain processing in more advanced stages of Parkinson's disease.

A study of the cerebral blood flow pattern and cognitive deficit in Parkinson's disease

International Nuclear Information System (INIS)

Tamaru, Fuyuhiko

1997-01-01

Cerebral blood flow pattern in Parkinson's disease was examined by 123 I-IMP SPECT to determine whether the deficit in cognitive function is reflected in it. The patient group with Parkinson's disease showed deterioration in intelligence (Minimental state examination, Raven's Colored Progressive Matrices) and frontal lobe test (the Wisconsin Card Sorting Test). Though the uptake ratio of prefrontal area/occipital area in 123 I-IMP SPECT study varied widely in the Parkinson's disease group compared to the normal control group, there was no significant difference in the mean. Selective depletion of frontal lobe blood flow was not confirmed in this study. There was no correlation between cerebral blood flow pattern and cognitive functions including frontal lobe function and intelligence. We concluded that the deficit in cognitive function was not reflected in the cerebral blood flow pattern in Parkinson's disease. (author)

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

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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...

Clear Speech Variants: An Acoustic Study in Parkinson's Disease

Science.gov (United States)

Lam, Jennifer; Tjaden, Kris

2016-01-01

Purpose: The authors investigated how different variants of clear speech affect segmental and suprasegmental acoustic measures of speech in speakers with Parkinson's disease and a healthy control group. Method: A total of 14 participants with Parkinson's disease and 14 control participants served as speakers. Each speaker produced 18 different…

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

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.

Dysphagia and sialorrhea: the relationship to Parkinson's disease.

Science.gov (United States)

Nicaretta, Denise Hack; Rosso, Ana Lucia; Mattos, James Pitágoras de; Maliska, Carmelindo; Costa, Milton M B

2013-01-01

Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients. Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia.

PET-Studies in parkinson's disease; Untersuchungen mit der Positronen-Emissions-Tomographie (PET) bei Patienten mit Morbus Parkinson

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Schwarz, J. [Klinik fuer Neurologie, Univ. Leipzig (Germany)

2002-09-01

Positron-emission-tomography (PET) has enabled to study the metabolism and blood flow in specific brain areas. Besides, there is a variety of radiotracers that allow quantification of the function of distinct molecules. In respect to Parkinson's disease, PET allowed for the first time to assess the number of dopaminergic neurons in vivo. Thus, helping confirming a dopaminergic deficit, measuring disease progression and also help to determine the function of dopaminergic grafts. Current research has shifted to determine the role of related neurotransmitter systems in the pathophysiology of Parkinson's disease. (orig.) [German] Die positronen-emissions-tomographie (PET) bietet neben der Messung von Metabolismus und Blutfluss die Moeglichkeit der Darstellung von einzelnen Molekuelen. Bei Patienten mit Morbus Parkinson hat es diese Technik erstmals erlaubt, die Anzahl der dopaminergen Neurone zu quantifizieren, wodurch die Diagnose gesichert, die Progression der Erkrankung beurteilt und auch das Anwachsen von Implantaten beurteilt werden kann. Die PET hat einen wesentlichen Beitrag zu unserem heutigen Wissen ueber die Pathophysiologie dieser Erkrankung beigetragen. (orig.)

Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly.

OpenAIRE

Larsen, J P

1991-01-01

OBJECTIVE--To examine the extent of under-diagnosis and overdiagnosis of Parkinson's disease and to determine quality of treatment in a defined population. DESIGN--Clinical evaluation of an elderly population. SETTING--40 Norwegian nursing homes. SUBJECTS--3322 residents of nursing homes, of whom 500 were selected by nursing staff for evaluation on the basis of a structured information programme on Parkinson's disease and 269 were examined in detail by neurologists. MAIN OUTCOME MEASURES--Pat...

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Parkinsonism and AIDS: a clinical comparative study before and after HAART

Directory of Open Access Journals (Sweden)

Ana Lucia Zuma de Rosso

2009-09-01

Full Text Available In 2002, after analyzing 28 HIV-positive patients with movement disorders we emphasized the decreasing not only of Parkinsonism but also of other involuntary movements in HIV patients in the last few years. The objective of this study is to compare the clinical results between HIV-positive patients with Parkinsonism before and after HAART. In 14 years (1986-1999 2,460 HIV-positive patients were seen in our Hospital 14 (0.6% of which presented with Parkinsonism. Eight years after (2000-2007 970 HIV positive patients were seen and only two (0.2% had Parkinsonism. We conclude that after the introduction of HAART there was an evident decrease in AIDS-related Parkinsonism.No ano de 2002, após analisarmos 28 pacientes HIV-positivos que apresentavam distúrbios do movimento, enfatizamos o declínio, não só do parkinsonismo, como também de outros movimentos involuntários em pacientes infectados pelo HIV nos últimos anos. O objetivo deste estudo é comparar os resultados clínicos entre pacientes HIV-positivos com parkinsonismo antes e depois da introdução do esquema HAART. Em 14 anos (1986-1999, 2.460 pacientes HIV-positivos foram avaliados em nosso Hospital dos quais 14 (0,6% apresentaram parkinsonismo. Nos oito anos seguintes (2000-2007, 970 pacientes HIV-positivos foram avaliados e somente dois (0,2% tinham parkinsonismo. Concluímos que após a introdução do esquema HAART houve evidente declínio do parkinsonismo secundário à AIDS.

Imaging biomarkers in Parkinson?s disease and Parkinsonian syndromes: current and emerging concepts

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Saeed, Usman; Compagnone, Jordana; Aviv, Richard I.; Strafella, Antonio P.; Black, Sandra E.; Lang, Anthony E.; Masellis, Mario

2017-01-01

Two centuries ago in 1817, James Parkinson provided the first medical description of Parkinson?s disease, later refined by Jean-Martin Charcot in the mid-to-late 19th century to include the atypical parkinsonian variants (also termed, Parkinson-plus syndromes). Today, Parkinson?s disease represents the second most common neurodegenerative disorder with an estimated global prevalence of over 10 million. Conversely, atypical parkinsonian syndromes encompass a group of relatively heterogeneous d...

VEGFR tyrosine kinase inhibitor II (VRI) induced vascular insufficiency in zebrafish as a model for studying vascular toxicity and vascular preservation

International Nuclear Information System (INIS)

Li, Shang; Dang, Yuan Ye; Oi Lam Che, Ginny; Kwan, Yiu Wa; Chan, Shun Wan; Leung, George Pak Heng; Lee, Simon Ming Yuen; Hoi, Maggie Pui Man

2014-01-01

In ischemic disorders such as chronic wounds and myocardial ischemia, there is inadequate tissue perfusion due to vascular insufficiency. Besides, it has been observed that prolonged use of anti-angiogenic agents in cancer therapy produces cardiovascular toxicity caused by impaired vessel integrity and regeneration. In the present study, we used VEGFR tyrosine kinase inhibitor II (VRI) to chemically induce vascular insufficiency in zebrafish in vivo and human umbilical vein endothelial cells (HUVEC) in vitro to further study the mechanisms of vascular morphogenesis in these pathological conditions. We also explored the possibility of treating vascular insufficiency by enhancing vascular regeneration and repair with pharmacological intervention. We observed that pretreatment of VRI induced blood vessel loss in developing zebrafish by inhibiting angiogenesis and increasing endothelial cell apoptosis, accompanied by down-regulation of kdr, kdrl and flt-1 genes expression. The VRI-induced blood vessel loss in zebrafish could be restored by post-treatment of calycosin, a cardiovascular protective isoflavone. Similarly, VRI induced cytotoxicity and apoptosis in HUVEC which could be rescued by calycosin post-treatment. Further investigation of the underlying mechanisms showed that the PI3K/AKT/Bad cell survival pathway was a main contributor of the vascular regenerative effect of calycosin. These findings indicated that the cardiovascular toxicity in anti-angiogenic therapy was mainly caused by insufficient endothelial cell survival, suggesting its essential role in vascular integrity, repair and regeneration. In addition, we showed that VRI-induced blood vessel loss in zebrafish represented a simple and effective in vivo model for studying vascular insufficiency and evaluating cancer drug vascular toxicities. - Highlights: • In vivo VRI model • Rescue effects of calycosin • Calycosin EC survival pathways

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.

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Enfermedad de Parkinson

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Orozco V., Jorge Luis; Fundación Valle de Lili

2002-01-01

¿Qué tan frecuente es la enfermedad de Parkinson?/ ¿Qué ocasiona la enfermedad?/ ¿Existen otras formas de Parkinsonismo?/ ¿Quién desarrolla la enfermedad de Parkinson?/ ¿Cuales son los síntomas principales?/ ¿Cómo se diagnostica la enfermedad de Parkinson?/ ¿Cómo se trata la enfermedad?/Tratamiento quirúrgico/Aspectos prácticos del tratamiento/Verdades sobre la enfermedad de Parkinson.

PDON: Parkinson's disease ontology for representation and modeling of the Parkinson's disease knowledge domain.

Science.gov (United States)

Younesi, Erfan; Malhotra, Ashutosh; Gündel, Michaela; Scordis, Phil; Kodamullil, Alpha Tom; Page, Matt; Müller, Bernd; Springstubbe, Stephan; Wüllner, Ullrich; Scheller, Dieter; Hofmann-Apitius, Martin

2015-09-22

Despite the unprecedented and increasing amount of data, relatively little progress has been made in molecular characterization of mechanisms underlying Parkinson's disease. In the area of Parkinson's research, there is a pressing need to integrate various pieces of information into a meaningful context of presumed disease mechanism(s). Disease ontologies provide a novel means for organizing, integrating, and standardizing the knowledge domains specific to disease in a compact, formalized and computer-readable form and serve as a reference for knowledge exchange or systems modeling of disease mechanism. The Parkinson's disease ontology was built according to the life cycle of ontology building. Structural, functional, and expert evaluation of the ontology was performed to ensure the quality and usability of the ontology. A novelty metric has been introduced to measure the gain of new knowledge using the ontology. Finally, a cause-and-effect model was built around PINK1 and two gene expression studies from the Gene Expression Omnibus database were re-annotated to demonstrate the usability of the ontology. The Parkinson's disease ontology with a subclass-based taxonomic hierarchy covers the broad spectrum of major biomedical concepts from molecular to clinical features of the disease, and also reflects different views on disease features held by molecular biologists, clinicians and drug developers. The current version of the ontology contains 632 concepts, which are organized under nine views. The structural evaluation showed the balanced dispersion of concept classes throughout the ontology. The functional evaluation demonstrated that the ontology-driven literature search could gain novel knowledge not present in the reference Parkinson's knowledge map. The ontology was able to answer specific questions related to Parkinson's when evaluated by experts. Finally, the added value of the Parkinson's disease ontology is demonstrated by ontology-driven modeling of PINK1

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Pragmatic communication is impaired in Parkinson disease.

Science.gov (United States)

Hall, Deborah; Ouyang, Bichun; Lonnquist, Eryn; Newcombe, Jill

2011-05-01

The purpose of this study was to determine whether severity of disease, cognitive function, age, gender, or amount of social interaction were associated with pragmatic dysfunction in Parkinson disease. No studies have previously been done to investigate variables that may be associated with pragmatic dysfunction in Parkinson disease. A case-control study was conducted with 17 Parkinson disease patients and 17 convenience controls. Each Parkinson disease patient and a control were interviewed, and their pragmatic skills were evaluated using a scale of pragmatic communication skills. Correlation analysis was used to determine what factors were associated with pragmatic dysfunction in the Parkinson disease patients. Cases scored lower on the pragmatic scale with a mean of 29.7 compared with 38.9 in the controls (p communication skills had moderate to strong correlations with the MMSE (r = .81, p = .002), Unified Parkinson's Disease Rating Scale score (r = -.71, p = .002), and duration of disease (r = -.53, p = .03). These results show that Parkinson disease patients have impaired pragmatic function compared with controls on both verbal and nonverbal sections, and this impairment correlates with mental state, duration, and severity of disease.

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Imputation of sequence variants for identification of genetic risks for Parkinson's disease: a meta-analysis of genome-wide association studies

NARCIS (Netherlands)

Nalls, M.A.; Plagnol, V.; Hernandez, D.G.; Sharma, M.; Sheerin, U.M.; Saad, M.; Simon-Sanchez, J.; Schulte, C.; Lesage, S.; Sveinbjornsdottir, S.; Stefansson, K.; Martinez, M.; Hardy, J.; Heutink, P.; Brice, A.; Gasser, T.; Singleton, A.B.; Wood, N.W.; Bloem, B.R.; Post, B.; Scheffer, H.; Warrenburg, B.P.C. van de; et al.,

2011-01-01

BACKGROUND: Genome-wide association studies (GWAS) for Parkinson's disease have linked two loci (MAPT and SNCA) to risk of Parkinson's disease. We aimed to identify novel risk loci for Parkinson's disease. METHODS: We did a meta-analysis of datasets from five Parkinson's disease GWAS from the USA

Progress of PET imaging in the study of neural stem cell transplantation treating Parkinson's disease

International Nuclear Information System (INIS)

Tan Haibo; Liu Xingdang

2004-01-01

PET imaging has important value in the study of neural stem cell transplantation treating Parkinson's disease, especial in the evaluation of the effect, the study of treating mechanisms and the comparation of effect in different transplantation places. PET imaging as a non-invasive method plays a more and more important role in the study of neural stem cell transplantation treating Parkinson's disease. (authors)

Combined Diffusion Tensor Imaging and Apparent Transverse Relaxation Rate Differentiate Parkinson Disease and Atypical Parkinsonism.

Science.gov (United States)

Du, G; Lewis, M M; Kanekar, S; Sterling, N W; He, L; Kong, L; Li, R; Huang, X

2017-05-01

Both diffusion tensor imaging and the apparent transverse relaxation rate have shown promise in differentiating Parkinson disease from atypical parkinsonism (particularly multiple system atrophy and progressive supranuclear palsy). The objective of the study was to assess the ability of DTI, the apparent transverse relaxation rate, and their combination for differentiating Parkinson disease, multiple system atrophy, progressive supranuclear palsy, and controls. A total of 106 subjects (36 controls, 35 patients with Parkinson disease, 16 with multiple system atrophy, and 19 with progressive supranuclear palsy) were included. DTI and the apparent transverse relaxation rate measures from the striatal, midbrain, limbic, and cerebellar regions were obtained and compared among groups. The discrimination performance of DTI and the apparent transverse relaxation rate among groups was assessed by using Elastic-Net machine learning and receiver operating characteristic curve analysis. Compared with controls, patients with Parkinson disease showed significant apparent transverse relaxation rate differences in the red nucleus. Compared to those with Parkinson disease, patients with both multiple system atrophy and progressive supranuclear palsy showed more widespread changes, extending from the midbrain to striatal and cerebellar structures. The pattern of changes, however, was different between the 2 groups. For instance, patients with multiple system atrophy showed decreased fractional anisotropy and an increased apparent transverse relaxation rate in the subthalamic nucleus, whereas patients with progressive supranuclear palsy showed an increased mean diffusivity in the hippocampus. Combined, DTI and the apparent transverse relaxation rate were significantly better than DTI or the apparent transverse relaxation rate alone in separating controls from those with Parkinson disease/multiple system atrophy/progressive supranuclear palsy; controls from those with Parkinson

A Multicenter Comparative Study of Impulse Control Disorder in Latin American Patients With Parkinson Disease.

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Ramírez Gómez, Carolina Candelaria; Serrano Dueñas, Marcos; Bernal, Oscar; Araoz, Natalia; Sáenz Farret, Michel; Aldinio, Victoria; Montilla, Verónica; Micheli, Federico

Impulse control disorder (ICD) is a common adverse effect in patients with Parkinson disease who receive dopamine agonists; however, other factors are involved in its manifestations. To study the frequency and factors involved in the development of this adverse effect in a Latin American population, we conducted a cross-sectional multicenter study. Two hundred fifty-five patients in 3 Latin American centers were evaluated by examination and application of scales (Unified Parkinson's Disease Rating Scale, Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale, Hoehn and Yahr, Clinical Impression of Severity Index for Parkinson's Disease). Of the patients, 27.4% had ICD, most of whom were on dopamine agonists. Other associated risk factors included a younger age at onset of Parkinson disease, moderate symptoms, a shorter evolution of the clinical manifestations, rapid eye movement (REM) sleep disorder behavior, and the consumption of tea, mate, and alcohol. The frequency of ICD is higher in Latin America than in Anglo-Saxon populations. Consuming tea and mate, in addition to the use of dopamine agonists, is a factor that may demonstrate a genetic link that predisposes patients to the establishment of an ICD.

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Living with Parkinson's

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Diagnosis (Parkinson's Disease)

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Stages of Parkinson's

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Imputation of sequence variants for identification of genetic risks for Parkinson's disease: a meta-analysis of genome-wide association studies

NARCIS (Netherlands)

Nalls, Michael A.; Plagnol, Vincent; Hernandez, Dena G.; Sharma, Manu; Sheerin, Una-Marie; Saad, Mohamad; Simon-Sanchez, Javier; Schulte, Claudia; Lesage, Suzanne; Sveinbjornsdottir, Sigurlaug; Arepalli, Sampath; Barker, Roger; Ben-Shlomo, Yoav; Berendse, Henk W.; Berg, Daniela; Bhatia, Kailash; de Bie, Rob M. A.; Biffi, Alessandro; Bloem, Bas; Bochdanovits, Zoltan; Bonin, Michael; Bras, Jose M.; Brockmann, Kathrin; Brooks, Janet; Burn, David J.; Charlesworth, Gavin; Chen, Honglei; Chinnery, Patrick F.; Chong, Sean; Clarke, Carl E.; Cookson, Mark R.; Cooper, J. Mark; Corvol, Jean Christophe; Counsell, Carl; Damier, Philippe; Dartigues, Jean-Francois; Deloukas, Panos; Deuschl, Guenther; Dexter, David T.; van Dijk, Karin D.; Dillman, Allissa; Durif, Frank; Duerr, Alexandra; Edkins, Sarah; Evans, Jonathan R.; Foltynie, Thomas; Gao, Jianjun; Gardner, Michelle; Gibbs, J. Raphael; Goate, Alison; Gray, Emma; Guerreiro, Rita; Gustafsson, Omar; Harris, Clare; van Hilten, Jacobus J.; Hofman, Albert; Hollenbeck, Albert; Holton, Janice; Hu, Michele; Huang, Xuemei; Huber, Heiko; Hudson, Gavin; Hunt, Sarah E.; Huttenlocher, Johanna; Illig, Thomas; Jonsson, Palmi V.; Lambert, Jean-Charles; Langford, Cordelia; Lees, Andrew; Lichtner, Peter; Limousin, Patricia; Lopez, Grisel; Lorenz, Delia; McNeill, Alisdair; Moorby, Catriona; Moore, Matthew; Morris, Huw R.; Morrison, Karen E.; Mudanohwo, Ese; O'Sullivan, Sean S.; Pearson, Justin; Perlmutter, Joel S.; Petursson, Hjoervar; Pollak, Pierre; Post, Bart; Potter, Simon; Ravina, Bernard; Revesz, Tamas; Riess, Olaf; Rivadeneira, Fernando; Rizzu, Patrizia; Ryten, Mina; Sawcer, Stephen; Schapira, Anthony; Scheffer, Hans; Shaw, Karen; Shoulson, Ira; Sidransky, Ellen; Smith, Colin; Spencer, Chris C. A.; Stefansson, Hreinn; Stockton, Joanna D.; Strange, Amy; Talbot, Kevin; Tanner, Carlie M.; Tashakkori-Ghanbaria, Avazeh; Tison, Francois; Trabzuni, Daniah; Traynor, Bryan J.; Uitterlinden, Andre G.; Velseboer, Daan; Vidailhet, Marie; Walker, Robert; van de Warrenburg, Bart; Wickremaratchi, Mirdhu; Williams, Nigel; Williams-Gray, Caroline H.; Winder-Rhodes, Sophie; Stefansson, Kari; Martinez, Maria; Hardy, John; Heutink, Peter; Brice, Alexis; Gasser, Thomas; Singleton, Andrew B.; Wood, Nicholas W.

2011-01-01

Background Genome-wide association studies (GWAS) for Parkinson's disease have linked two loci (MAPT and SNCA) to risk of Parkinson's disease. We aimed to identify novel risk loci for Parkinson's disease. Methods We did a meta-analysis of datasets from five Parkinson's disease GWAS from the USA and

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Full Text Available ... Parkinson's Pipeline 2011: Treating Your Parkinson's Expert Briefings: Cognition and PD: What You've Always Wanted to ... Care Between Appointments? How Does Parkinson's Disease Affect Memory? CareMAP: La Alimentación y la Deglución, Parte 2 ...

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Gum chewing improves swallow frequency and latency in Parkinson patients: a preliminary study.

Science.gov (United States)

South, Angela R; Somers, Stephanie M; Jog, Mandar S

2010-04-13

Reduced swallowing frequency affects secretion management in Parkinson disease (PD). Gum chewing increases saliva flow and swallow frequency. This study uses chewing gum to modify swallow frequency and latency between swallows in patients with PD. 1) Assess the frequency and latency of swallow at baseline (BL), during gum chewing (GC), and post gum chewing (PGC) for participants with PD (stage 2-4) nonsymptomatic for prandial dysphagia; and 2) assess carryover after gum is expectorated. Twenty participants were studied across 3 tasks, each of 5 minutes in duration: BL, GC, and PGC. Respiratory and laryngeal signals were continuously recorded using PowerLab (version 5.5.5; ADI Instruments, Castle Hill, Australia). Frequency and latency of swallow events were calculated. Differences (analysis of variance) are reported for frequency (p Parkinson disease. This study provides Class III evidence that chewing gum increases swallow frequency and decreases latency of swallowing in an experiment in patients with stage 2 to 4 Parkinson disease who are nonsymptomatic for significant prandial dysphagia.

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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.

Magnetic resonance spectroscopic study of parkinsonism related to boxing.

OpenAIRE

Davie, C A; Pirtosek, Z; Barker, G J; Kingsley, D P; Miller, P H; Lees, A J

1995-01-01

Proton magnetic resonance spectroscopy, localised to the lentiform nucleus, was carried out in three ex-professional boxers who developed a parkinsonian syndrome, six patients with idiopathic Parkinson's disease, and six age matched controls. The three ex-boxers all showed a pronounced reduction in the absolute concentration of N-acetylaspartate compared with the patients with idiopathic Parkinson's disease and the control group. This reduction is likely to reflect neuronal loss occurring in ...

Study of an integrated non-motor symptoms questionnaire for Parkinson's disease

Institute of Scientific and Technical Information of China (English)

YU Bo; XIAO Zhi-ying; LI Jia-zhen; YUAN Jing; LIU Yi-ming

2010-01-01

Background Although the validity of non-motor symptoms screening questionnaire (NMSQuest) for Parkinson's disease has been verified in several recent researches, the specificity of the questionnaire is still in doubt. This study aimed to compare the non-motor symptoms (NMS) in Parkinson's disease (PD) with a medically ill control group.Methods In this study, the first comprehensive clinic-based NMS screening questionnaire for PD developed by the Parkinson's Disease Non-Motor Group (PDNMG) was used. Data from 90 PD patients and 270 sex-and age-matched control subjects, including stroke (n=90), heart disease (n=90) and diabetes (n=90) were analyzed.Results Compared with control group, NMS was more common in PD; on an average, most PD patients reported more than 12 non-motor items. There was a correlation of total NMS score in PD patients with Hoehn & Yahr Staging, but not with age, sex distribution, disease duration, or age at disease onset. Additionally, depression, constipation and impaired olfaction which occurred prior to the motor symptoms of PD were reported in this study.Conclusions NMS are more common in PD patients. There are some NMS that occurred at the preclinical stage of PD and might predict the onset of motor symptoms of PD patients.

Large-Scale Wearable Sensor Deployment in Parkinson's Patients: The Parkinson@Home Study Protocol

NARCIS (Netherlands)

Silva de Lima, A.L.; Hahn, T.; Vries, N.M. de; Cohen, E.; Bataille, L.; Little, M.A.; Baldus, H.; Bloem, B.R.; Faber, M.J.

2016-01-01

BACKGROUND: Long-term management of Parkinson's disease does not reach its full potential because we lack knowledge about individual variations in clinical presentation and disease progression. Continuous and longitudinal assessments in real-life (ie, within the patients' own home environment) might

Recent advances in imaging in Parkinson disease

International Nuclear Information System (INIS)

Baba, Toru; Takeda, Atsushi

2012-01-01

Despite recent knowledge on the pathophysiology of Parkinson disease, the precise and early diagnosis of this condition remains difficult. Advances in imaging techniques have enabled the assessment of in vivo structural, neurometabolic, and neurochemical changes in Parkinson disease, and their role as biomarkers have assumed greater importance in recent years. We presently review the various approaches with these imaging techniques for the study of Parkinson disease. Voxel-based morphometry studies with structural MRI showed a characteristic pattern of gray matter loss, and fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) studies have indicated latent network abnormalities in Parkinson disease. Moreover, radiotracer imaging with dopaminergic markers facilitates the assessment of pre- and postsynaptic nigro-striatal integrity, and other radiotracers have been used in the studies of nondopaminergic neurotransmitter systems, such as the cholinergic, noradrenergic, and serotonergic systems. These imaging techniques can be used to detect presymptomatic disease and to monitor disease progression. Thus, imaging data provide meaningful insights into the pathological process in Parkinson disease. (author)

Safety and Efficacy Study of VY-AADC01 for Advanced Parkinson's Disease

Science.gov (United States)

2018-02-27

Idiopathic Parkinson's Disease; Parkinson's Disease; Basal Ganglia Disease; Brain Diseases; Central Nervous System Diseases; Movement Disorders; Nervous System Diseases; Neurodegenerative Diseases; Parkinsonian Disorders

Comparative studies of D2 receptors and brain perfusion in hemi-parkinsonism rats

International Nuclear Information System (INIS)

Lin Yansong; Lin Xiangtong

2000-01-01

The relationship between dopamine D 2 receptors and brain perfusion in hemi-parkinsonism rats was studied. Hemi-parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra (SN) and ventral tegmental area (VTA), apomorphine (Apo) which could induced the successful model rat rotates toward the intact side was used to select the rats, 125 I-IBZM ex-vivo autoradiography analysis and 99m Tc-HM-PAO regional cerebral biodistribution were used to evaluate D 2 receptors and cerebral blood flow. The HPLC-ECD were used to measure striatum DA and its metabolites content. The lesioned side striatum DA and its metabolites HVA DOPAC reduced significantly than that of the intact side and pseudo-operated group, striatum/cerebellum 125 I-IBZM uptake ratio was 8.04 +- 0.71 in lesioned side of hemi-parkinsonism rats, significantly increased compared with the intact side and the pseudo-operated group (p 0.05). These results indicated that in the 6-OH-DA lesioned side DA content decreased significantly and an up-regulation of striatum D 2 receptor binding sites was induced in hemi-parkinsonism rats, which showed good correlation with rotation behavior induced by Apo. Comparing with cerebral blood flow, D 2 receptor reflected by IBZM seems to be more specific and earlier to detect the cerebral functional impairment in experimental hemi-parkinsonism

Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study.

Science.gov (United States)

Martínez-Fernández, Raul; Rodríguez-Rojas, Rafael; Del Álamo, Marta; Hernández-Fernández, Frida; Pineda-Pardo, Jose A; Dileone, Michele; Alonso-Frech, Fernando; Foffani, Guglielmo; Obeso, Ignacio; Gasca-Salas, Carmen; de Luis-Pastor, Esther; Vela, Lydia; Obeso, José A

2018-01-01

Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain. Eligible participants had Parkinson's disease with markedly asymmetric parkinsonism. Patients with severe dyskinesia, history of stereotactic surgery or brain haemorrhage, a diagnosis of an unstable cardiac or psychiatric disease, or a skull density ratio of 0·3 or less were excluded. Enrolled patients underwent focused ultrasound unilateral subthalamotomy. The subthalamic nucleus was targeted by means of brain images acquired with a 3-Tesla MRI apparatus. Several sonications above the definitive ablation temperature of 55°C were delivered and adjusted according to clinical response. The primary outcomes were safety and a change in the motor status of the treated hemibody as assessed with part III of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) in both off-medication and on-medication states at 6 months. Adverse events were monitored up to 48 h after treatment and at scheduled clinic visits at 1, 3, and 6 months after treatment. The study is registered with ClinicalTrials.gov, number NCT02912871. Between April 26 and June 14, 2016, ten patients with markedly asymmetric parkinsonism that was poorly controlled pharmacologically were enrolled for focused ultrasound unilateral subthalamotomy. By 6 months follow-up, 38 incidents of adverse events had been recorded, none of which were serious or severe. Seven adverse events were present at 6 months. Three of these adverse events were directly related to subthalamotomy: off-medication dyskinesia in the treated arm

Sleep disorders and Parkinson disease; lessons from genetics.

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Gan-Or, Ziv; Alcalay, Roy N; Rouleau, Guy A; Postuma, Ronald B

2018-01-31

Parkinson disease is a common, age-related neurodegenerative disorder, projected to afflict millions of individuals in the near future. Understanding its etiology and identifying clinical, genetic or biological markers for Parkinson disease onset and progression is therefore of major importance. Various sleep-related disorders are the most common group of non-motor symptoms in advanced Parkinson disease, but they can also occur during its prodromal phase. However, with the exception of REM sleep behavior disorder, it is unclear whether they are part of the early pathological process of Parkinson disease, or if they develop as Parkinson disease advances because of treatments and neurodegeneration progression. The advancements in genetic studies in the past two decades have generated a wealth of information, and recent genetic studies offer new insight on the association of sleep-related disorders with Parkinson disease. More specifically, comparing genetic data between Parkinson disease and sleep-related disorders can clarify their association, which may assist in determining whether they can serve as clinical markers for Parkinson disease risk or progression. In this review, we discuss the current knowledge on the genetics of sleep-related disorders in Parkinson disease context, and the potential implications on research, diagnosis, counseling and treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Radiological study of cerebro-vascular accidents

International Nuclear Information System (INIS)

Misri, H.T.; Kabawe, Bassam

1991-01-01

The role of computerized tomography scanner in studying the cerebro-vascular accidents has been discussed. One hundred fifty patients with cerebro-vascular accidents were studied at Aleppo University Hospital between 1989-1990. Clinical history and physical examination were recorded, as well as, computerized tomography scanning in all cases without using the contrast media mostly. Relationship between the density of the lesion (inforctionor hemorrhage) and the time has been found. This relationship can help in forensic medicine. (author). 29 refs., 5 tabs., 2 figs

Clinical profile of parkinsonism and Parkinson's disease in Lagos, Southwestern Nigeria

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Ojo Oluwadamilola O

2010-01-01

Full Text Available Abstract Background Current data on the pattern of parkinsonism and Parkinson's disease in Nigerians are sparse. This database was designed to document the clinical profile of PD in Nigerians, and compare this to prior observations. Methods A database of patients presenting to the Neurology out-patients clinic of the Lagos University Teaching Hospital was established in October 1996. Demographic and clinical data at presentation (disease stage using Hoehn and Yahr scale; 'off' state severity on the Unified Parkinson's disease Rating Scale were documented for patients diagnosed with parkinsonism between October 1996 and December 2006. Cases were classified as Parkinson's disease or secondary parkinsonism (in the presence of criteria suggestive of a secondary aetiology. Results The hospital frequency of parkinsonism (over a 2-year period, and relative to other neurologic disorders was 1.47% (i.e. 20/1360. Of the 124 patients with parkinsonism, 98 (79.0% had PD, while 26 (21.0% had secondary parkinsonism. Mean age (SD at onset of PD (61.5 (10.0 years was slightly higher than for secondary parkinsonism (57.5 (14.0 years (P = 0.10. There was a male preponderance in PD (3.3 to 1 and secondary parkinsonism (2.7 to 1, while a positive family history of parkinsonism was present in only 1.02% (1/98 of PD. There was a modestly significant difference in age at onset (SD of PD in men (60.3 (10.4 compared to women (65.2 (7.9 (T = 2.08; P = 0.04. The frequency of young onset PD (≤ 50 years was 16.3% (16/98. The mean time interval from onset of motor symptoms to diagnosis of PD was 24.6 ± 26.1 months with majority presenting at a median 12 months from onset. On the H&Y scale, severity of PD at presentation was a median 2.0 (range 1 to 4. PD disease subtype was tremor-dominant in 31 (31.6%, mixed 54 (55.1% and akinetic-rigid 14 (14.3%. Hypertension was present as a co-morbidity in 20 (20.4%, and diabetes in 6 (6.12%. Conclusions The clinical profile of PD in

Increased risk of parkinsonism associated with welding exposure.

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Racette, Brad A; Criswell, Susan R; Lundin, Jessica I; Hobson, Angela; Seixas, Noah; Kotzbauer, Paul T; Evanoff, Bradley A; Perlmutter, Joel S; Zhang, Jing; Sheppard, Lianne; Checkoway, Harvey

2012-10-01

Manganese (Mn), an established neurotoxicant, is a common component of welding fume. The neurological phenotype associated with welding exposures has not been well described. Prior epidemiologic evidence linking occupational welding to parkinsonism is mixed, and remains controversial. This was a cross-sectional and nested case-control study to investigate the prevalence and phenotype of parkinsonism among 811 shipyard and fabrication welders recruited from trade unions. Two reference groups included 59 non-welder trade workers and 118 newly diagnosed, untreated idiopathic PD patients. Study subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism cases were defined as welders with UPDRS3 score ≥15. Normal was defined as UPDRS3welding. Adjusted prevalence ratios for parkinsonism were calculated in relation to quartiles of welding years. The overall prevalence estimate of parkinsonism was 15.6% in welding exposed workers compared to 0% in the reference group. Among welders, we observed a U-shaped dose-response relation between weighted welding exposure-years and parkinsonism. UPDRS3 scores for most domains were similar between welders and newly diagnosed idiopathic Parkinson disease (PD) patients, except for greater frequency of rest tremor and asymmetry in PD patients. This work-site based study among welders demonstrates a high prevalence of parkinsonism compared to nonwelding-exposed workers and a clinical phenotype that overlaps substantially with PD. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparative studies of D2 receptors and cerebral blood flow in hemi-Parkinsonism rats

International Nuclear Information System (INIS)

Lin Yansong; Lin Xiangtong

2000-01-01

Objective: To study the relationship between dopamine D 2 receptors and cerebral blood flow in hemi-Parkinsonism rats. Methods: Hemi-Parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra and ventral tegmental area, apomorphine (Apo) which could induce the successful model rat to rotate toward the intact side was used to select the rat models, 125 I-IBZM in vivo autoradiography and 99 Tc m -HMPAO regional cerebral biodistribution analysis were used to study D 2 receptors and cerebral blood flow. The HPLC-ECD was used to measure striatum DA and its metabolite content . Results: the lesioned side striatum DA and its metabolites homovanillic acid (HVA) 3,4-dihyroxy-phenylacetic acid (DOPAC) reduced significantly than that of the intact side and pseudo-operated group, striatum/cerebellum 125 I-IBZM uptake ratio was 8.04 +- 0.71 in lesioned side of hemi-Parkinsonism rats, significantly increased compared with the intact side and the pseudo-operated group (P 0.05). Conclusions: the 6-OH-DA lesioned side DA content decreased significantly and thus induced a compensative up-regulation of striatum D 2 receptor binding sites in hemi-Parkinsonism rats, which show good correlation with rotation behavior induced by Apo. Comparing with cerebral blood flow, D 2 receptor reflected by IBZM seems to be more specific and earlier to detect the cerebral functional impairment in experimental hemi-Parkinsonism

Glaucoma correlates with increased risk of Parkinson's disease in the elderly: a national-based cohort study in Taiwan.

Science.gov (United States)

Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

2017-08-01

Very little is known about the association between glaucoma and Parkinson's disease in the elderly. The objective of this study was to determine whether glaucoma is associated with Parkinson's disease in older people in Taiwan. A retrospective cohort study was conducted to analyze the Taiwan National Health Insurance Program database from 2000 to 2010. We included 4330 subjects aged 65 years or older with newly diagnosed glaucoma as the glaucoma group, and 17,000 randomly selected subjects without a glaucoma diagnosis as the non-glaucoma group. Both groups were matched for sex, age, other comorbidities, and index year of glaucoma diagnosis. The incidence of Parkinson's disease at the end of 2011 was measured. A multivariable Cox proportional hazard regression model was used to measure the hazard ratio and 95% confidence intervals for Parkinson's disease associated with glaucoma. The overall incidence of Parkinson's disease was 1.28-fold higher in the glaucoma group than that in the non-glaucoma group (7.73 vs. 6.02 per 1000 person-years; 95% confidence interval 1.18, 1.40). After controlling for potential confounding factors, the adjusted hazard ratio of Parkinson's disease was 1.23 for the glaucoma group (95% confidence interval 1.05, 1.46), compared with the non-glaucoma group. Older people with glaucoma correlate with a small but statistically significant increase in the risk for Parkinson's disease. Whether glaucoma may be a non-motor feature of Parkinson's disease in older people requires further research to confirm.

There is no Parkinson disease.

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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.

Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

Directory of Open Access Journals (Sweden)

Yvette M. Bordelon

2011-01-01

Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

Therapeutic Dancing for Parkinson's Disease

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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.

Asymmetric Drug-Induced Parkinsonism and Psychopathology: A Prospective Naturalistic Study in Long-Stay Psychiatric Patients

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Lydia E. Pieters

2018-02-01

Full Text Available BackgroundDrug-induced parkinsonism (DIP is the most common movement disorder induced by antipsychotics. Although DIP is mostly symmetric, asymmetric DIP is reported in a substantial part of the patients. We investigated the frequency of motor asymmetry in DIP and its relationship to the severity of psychopathology in long-stay psychiatric patients.MethodsWe obtained data from a cohort study of 207 long-stay psychiatric patients on the frequency and risk factors of tardive dyskinesia, akathisia, tardive dystonia, and DIP. From July 2003 to May 2007 (mean follow-up, 1.1 year drug-induced movement disorders were assessed at least two times in each patient, with a frequency of persistent DIP of 56.2%. All patients who had at least one time parkinsonism in the upper/lower limb(s were included for analyses (190 patients, 79 women; mean age, 48.0 ± 12.9 years. The Unified Parkinson Disease Rating Scale motor scale was used to calculate the frequency of asymmetric parkinsonism. Multilevel mixed models were built to explore the relationship between asymmetry in parkinsonism and the severity of psychopathology, measured on the Clinical Global Impression-Schizophrenia scale severity index (CGI-SCH SI.ResultsThe frequency of asymmetric parkinsonism was 20.8%. Asymmetry in parkinsonism was associated with symptom severity on all CGI-SCH SI scales (β range, 0.37–3.74 and significantly associated with the positive symptom scale (β, 3.74; 95% CI, 0.35–7.31.ConclusionDIP is asymmetric in a substantial part of patients. Asymmetric presentation of DIP is of clinical relevance as it is related to the severity of psychopathology and may alert the clinician of more severe psychopathology. Future research is recommended to provide insight into the neuropsychopathology and clinical value of asymmetric parkinsonism for psychiatric patients.

DYSPHAGIA AND SIALORRHEA: the relationship to Parkinson's disease

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Denise Hack NICARETTA

2013-03-01

Full Text Available Context Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. Objective The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Method Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Results Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients. Conclusions Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia. Contexto Disfagia e sialorreia em pacientes com doença de Parkinson são automaticamente entendidos como decorrentes do comprometimento neurológico produzido pela doença de Parkinson. Objetivo Estabelecer se estas duas queixas s

Asymmetrical Pedaling Patterns in Parkinson's Disease Patients

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Penko, Amanda L.; Hirsch, Joshua R.; Voelcker-Rehage, Claudia; Martin, Philip E.; Blackburn, Gordon; Alberts, Jay L.

2015-01-01

Background Approximately 1.5 million Americans are affected by Parkinson's disease [1] which includes the symptoms of postural instability and gait dysfunction. Currently, clinical evaluations of postural instability and gait dysfunction consist of a subjective rater assessment of gait patterns using items from the Unified Parkinson's Disease Rating Scale, and assessments can be insensitive to the effectiveness of medical interventions. Current research suggests the importance of cycling for Parkinson's disease patients, and while Parkinson's gait has been evaluated in previous studies, little is known about lower extremity control during cycling. The purpose of this study is to examine the lower extremity coordination patterns of Parkinson's patients during cycling. Methods Twenty five participants, ages 44-72, with a clinical diagnosis of idiopathic Parkinson's disease participated in an exercise test on a cycle ergometer that was equipped with pedal force measurements. Crank torque, crank angle and power produced by right and left leg were measured throughout the test to calculate Symmetry Index at three stages of exercise (20 Watt, 60 Watt, maximum performance). Findings Decreases in Symmetry Index were observed for average power output in Parkinson's patients as workload increased. Maximum power Symmetry Index showed a significant difference in symmetry between performance at both the 20 Watt and 60 Watt stage and the maximal resistance stage. Minimum power Symmetry Index did not show significant differences across the stages of the test. While lower extremity asymmetries were present in Parkinson's patients during pedaling, these asymmetries did not correlate to postural instability and gait dysfunction Unified Parkinson's Disease Rating Scale scores. Interpretation This pedaling analysis allows for a more sensitive measure of lower extremity function than the Unified Parkinson's Disease Rating Scale and may help to provide unique insight into current and

Parkinson's Foundation

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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 ... one of our signature fundraising programs. Whether you walk with us at Moving Day®, run in a marathon or fundraise your ...

Dopaminreceptorscintigraphy in Parkinson's disease - Clinical correlation

International Nuclear Information System (INIS)

Riklund Aahlstroem, K.E.; Hietala, S.-O.; Johansson, F.

2002-01-01

Parkinson's disease is a severe, progressive neuro degenerative disorder which is characterised by a degeneration of the dopamine containing cells and loss of dopamine transporters (DA) in substantia nigra. Earlier 123 I-β-CIT SPECT studies have demonstrated this loss of DA content in Parkinson's disease. Recently a new radioligand 123 I-FP-CIT, with faster kinetics than b-CIT became available for imaging of the DA transporter. The applicability of this radioligand was tested in a large clinical material with early and advanced Parkinson's disease using a one day protocol. 123 I-FP-CIT uptake was decreased in patients with Parkinson's disease and this was seen three hours after injection of the radioligand. In the Parkinson's disease group the uptake in the putamen was reduced more than in the caudate nucleus. Specific to non-specific striatal uptake ratios correlated with the Hoehn and Yahr stage. It appeared that 123 I-FP-CIT SPECT allows a significant discrimination between patients with Parkinson's disease and other movement disorders. The scintigraphic observations were correlated to clinical findings. The results will be presented and discussed

ASPEK PSIKIATRI PADA PENYAKIT PARKINSON

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Putu Agus Grantika

2015-10-01

Full Text Available Penyakit Parkinson merupakan suatu kelainan degeneratif sistem saraf pusat yang disebabkan olehaktivitas neuron dopaminergik yang sangat berkurang, terutama di daerah pars kompakta dari nigrasubstantia. Penyakit Parkinson menampilkan gejala motor dan gejala nonmotor yang meliputi berbagaidomain termasuk gejala-gejala di bidang psikiatri.Gejala psikiatri pada penyakit Parkinson seringterjadi bahkan pada tahap awal penyakit, dan memiliki konsekuensi penting terhadap kualitas hidupdan fungsi sehari-hari. Gejala psikiatri yang paling sering muncul pada penyakit Parkinson adalahpsikosis,  depresi,  dan  kecemasan. Patofisiologi  gangguan neuropsikiatri  ini  sangat  kompleks  danmultifaktorial, melibatkan proses neurodegeneratif, mekanisme psikologis dan efek yang berkaitandengan pengobatan farmakologis. [MEDICINA 2015;46:28-32].Parkinson?s disease is a degenerative disorder of the central nervous systemdue togreatly reduced ofthe activity of dopaminergic neurons, especially pars compacta area in the substantia nigra. Parkinson?sdisease show motor and non-motor symptoms that include a variety of domains, including psychiatricsymptoms. Psychiatric symptoms in Parkinson?s disease often occur in the early stages of disease, andhas important consequences for the quality of life and daily functioning. The most frequent psychiatricsymptoms appear in Parkinson?s disease are psychosis, depression, and anxiety. Pathophysiology ofneuropsychiatric disorders are complex and multifactorial,  involving neuro degenerative processes,psychological mechanisms and associated with the effects of pharmacological treatment. [MEDICINA2015;46:28-32].

Lumbar Spine Surgery in Patients with Parkinson Disease.

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Schroeder, Joshua E; Hughes, Alexander; Sama, Andrew; Weinstein, Joseph; Kaplan, Leon; Cammisa, Frank P; Girardi, Federico P

2015-10-21

Parkinson disease is the second most common neurodegenerative condition. The literature on patients with Parkinson disease and spine surgery is limited, but increased complications have been reported. All patients with Parkinson disease undergoing lumbar spine surgery between 2002 and 2012 were identified. Patients' charts, radiographs, and outcome questionnaires were reviewed. Parkinson disease severity was assessed with use of the modified Hoehn and Yahr staging scale. Complications and subsequent surgeries were analyzed. Risk for reoperation was assessed. Ninety-six patients underwent lumbar spine surgery. The mean patient age was 63.0 years. The mean follow-up duration was 30.1 months. The Parkinson disease severity stage was Parkinson disease severity stage of ≥3 (p Parkinson disease is good, with improvement of spine-related pain. A larger prospective study is warranted. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson?s Patients: A Report of Four Cases

OpenAIRE

BALCI, Nilay ??m?k; TONGA, Eda; G?L?EN, Mustafa

2013-01-01

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson?s disease. Four patients with Parkinson?s disease between the ages of 56 and 70 years (61.25?6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson?s Disease Rating Sca...

DYSPHAGIA AND SIALORRHEA: the relationship to Parkinson's disease

OpenAIRE

Denise Hack NICARETTA; Ana Lucia ROSSO; James Pitagoras de MATTOS; Carmelindo MALISKA; Milton M. B. COSTA

2013-01-01

Context Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. Objective The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Method Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by th...

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.

A comparison of Irish set dancing and exercises for people with Parkinson?s disease: A phase II feasibility study

OpenAIRE

Volpe, Daniele; Signorini, Matteo; Marchetto, Anna; Lynch, Timothy; Morris, Meg E

2013-01-01

Background People with idiopathic Parkinson?s disease (PD) frequently have low activity levels, poor mobility and reduced quality of life. Although increased physical activity may improve mobility, balance and wellbeing, adherence to exercises and activity programs over the longer term can be challenging, particularly for older people with progressive neurological conditions such as PD. Physical activities that are engaging and enjoyable, such as dancing, might enhance adherence over the long...

Is the Parkinson Anxiety Scale comparable across raters?

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Forjaz, Maria João; Ayala, Alba; Martinez-Martin, Pablo; Dujardin, Kathy; Pontone, Gregory M; Starkstein, Sergio E; Weintraub, Daniel; Leentjens, Albert F G

2015-04-01

The Parkinson Anxiety Scale is a new scale developed to measure anxiety severity in Parkinson's disease specifically. It consists of three dimensions: persistent anxiety, episodic anxiety, and avoidance behavior. This study aimed to assess the measurement properties of the scale while controlling for the rater (self- vs. clinician-rated) effect. The Parkinson Anxiety Scale was administered to a cross-sectional multicenter international sample of 362 Parkinson's disease patients. Both patients and clinicians rated the patient's anxiety independently. A many-facet Rasch model design was applied to estimate and remove the rater effect. The following measurement properties were assessed: fit to the Rasch model, unidimensionality, reliability, differential item functioning, item local independency, interrater reliability (self or clinician), and scale targeting. In addition, test-retest stability, construct validity, precision, and diagnostic properties of the Parkinson Anxiety Scale were also analyzed. A good fit to the Rasch model was obtained for Parkinson Anxiety Scale dimensions A and B, after the removal of one item and rescoring of the response scale for certain items, whereas dimension C showed marginal fit. Self versus clinician rating differences were of small magnitude, with patients reporting higher anxiety levels than clinicians. The linear measure for Parkinson Anxiety Scale dimensions A and B showed good convergent construct with other anxiety measures and good diagnostic properties. Parkinson Anxiety Scale modified dimensions A and B provide valid and reliable measures of anxiety in Parkinson's disease that are comparable across raters. Further studies are needed with dimension C. © 2014 International Parkinson and Movement Disorder Society.

A controlled trial of rasagiline in early Parkinson disease: the TEMPO Study.

Science.gov (United States)

2002-12-01

Monotherapy with rasagiline mesylate may be useful in early Parkinson disease (PD). To evaluate the safety and efficacy of the selective monoamine oxidase type B inhibitor rasagiline. Multicenter, 26-week, parallel-group, randomized, double-blind, placebo-controlled clinical trial. Academically based movement disorders clinics. Patients with early PD not requiring dopaminergic therapy (n = 404). Research participants were randomized to rasagiline mesylate at dosages of 1 mg or 2 mg per day or matching placebo. A 1-week escalation period was followed by a 25-week maintenance period. The primary prespecified measure of efficacy was the change in the total Unified Parkinson's Disease Rating Scal score between baseline and 26 weeks of treatment, comparing each active treatment group with the placebo group. Monotherapy with rasagiline was effective in this 26-week study. The adjusted effect size for the total Unified Parkinson's Disease Rating Scale was -4.20 units comparing 1 mg of rasagiline and placebo (95% confidence interval, -5.66 to -2.73 units; PRasagiline is effective as monotherapy for patients with early PD. The 2 dosages in this trial were both effective relative to placebo. Further study is warranted to evaluate the longer-term effects of rasagiline in PD.

Conditions Related to Parkinson's

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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 Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

What Is 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 Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

Parkinson's Disease Foundation News

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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 Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

Parkinson's Foundation: For Caregivers

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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 Us Local Resources Find an Event My PD Story Volunteer ... Support a Moving Day Walker Support a Parkinson's Champion Bequests & Planned ...

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...

Prevalence and incidence of Parkinson's disease in The Faroe Islands

DEFF Research Database (Denmark)

Wermuth, Lene; Bech, Sara Brynhild Winther; Petersen, Maria Skaalum

2008-01-01

A study in The Faroe Islands in 1995 suggested a high prevalence of idiopathic Parkinson's disease (IPD) and total parkinsonism of 187.6 and 233.4 per 100,000 inhabitants respectively.......A study in The Faroe Islands in 1995 suggested a high prevalence of idiopathic Parkinson's disease (IPD) and total parkinsonism of 187.6 and 233.4 per 100,000 inhabitants respectively....

Motor matters: tackling heterogeneity of Parkinson's disease in functional MRI studies.

Directory of Open Access Journals (Sweden)

Štefan Holiga

Full Text Available To tackle the heterogeneity of Parkinson's disease symptoms, most functional imaging studies tend to select a uniform group of subjects. We hypothesize that more profound considerations are needed to account for intra/inter-subject clinical variability and possibly for differing pathophysiological processes. Twelve patients were investigated using functional magnetic resonance imaging during visually-guided finger tapping. To account for disease heterogeneity, the motor score and individual symptom scores from the Unified Parkinson's Disease Rating Scale (UPDRS-III were utilized in the group-level model using two approaches either as the explanatory variable or as the effect of interest. Employment of the UPDRS-III score and symptom scores was systematically tested on the resulting group response to the levodopa challenge, which further accentuated the diversity of the diseased state of participants. Statistics revealed a bilateral group response to levodopa in the basal ganglia. Interestingly, systematic incorporation of individual motor aspects of the disease in the modelling amended the resulting activity patterns conspicuously, evidencing a manifold amount of explained variability by the particular score. In conclusion, the severity of clinical symptoms expressed in the UPDRS-III scores should be considered in the analysis to attain unbiased statistics, draw reliable conclusions and allow for comparisons between research groups studying Parkinson's disease using functional magnetic resonance imaging.

The effects of transdermal rotigotine on non-motor symptoms of Parkinson's disease: a multicentre, observational, retrospective, post-marketing study.

Science.gov (United States)

Valldeoriola, Francesc; Salvador, Antonio; Gómez-Arguelles, José Maria; Marey, José; Moya, Miguel; Ayuga, Ángel; Ramírez, Francisco

2018-04-01

This study evaluated the effect of ≥6 months of transdermal rotigotine on non-motor and motor symptoms of patients with advanced Parkinson's disease. The study was conducted in Spain between September 2011 and December 2012 (ClinicalTrials.gov: NCT01504529). The primary efficacy variable was the change from baseline in non-motor symptoms, as assessed by changes in Parkinson's Disease Non-Motor Symptoms Questionnaire total scores at 6 months. Secondary endpoints included the assessment of motor symptoms by Unified Parkinson's Disease Rating Scale III scores. Data from 378 patients (mean age: 70.2 years; 56.9% male) with Parkinson's disease receiving rotigotine from were collected. Mean disease duration was 6.1 years, and mean rotigotine treatment duration was 45.6 months. Rotigotine reduced non-motor symptoms by 14.6% (mean change from baseline in Parkinson's Disease Non-Motor Symptoms Questionnaire: -1.5 ± 3.4; p < 0.0001). The majority of patients (58.2%) had improved non-motor symptoms at 6 months. Comparing the baseline versus study end, fewer patients experienced events in the urinary (78.6% vs. 73.3%; p = 0.0066), sleep (82.8% vs. 72.8%; p < 0.0001) and mood/cognition (77.3% vs. 66.4%; p < 0.0001) domains of the Parkinson's Disease Non-Motor Symptoms Questionnaire. Mean motor symptoms were reduced from baseline by 8.0% (mean change from baseline in Unified Parkinson's Disease Rating Scale III: -2.6 ± 8.0; p < 0.0001). In clinical practice in Spain, rotigotine may be an effective treatment to reduce the non-motor and motor symptoms in patients with advanced Parkinson's disease.

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Comparative imaging study on monkeys with hemi-parkinsonism

International Nuclear Information System (INIS)

Wang Wei; Yu Xiaoping; Mao Jun; Liu Sheng; Wang Xiaoyi; Peng Guangchun; Wang Ruiwen

2003-01-01

Objective: To study the imaging appearance of experimental Parkinson's disease (PD) and to evaluate the different medical imaging exams on PD. Methods: CT, MRI, SPECT (dopamine transporter imaging and regional cerebral blood flow imaging, DAT imaging and rCBF imaging), and PET (glucose metabolism imaging) were performed on 8 monkeys before and after the infusion of MPTP into unilateral internal carotid artery to develop hemi-Parkinsonism models. Results: Hemi-Parkinsonism models were successfully induced on all 8 monkeys. On DAT imaging, the uptake values of the lesioned striatums decreased obviously after the MPTP treatment and were lower than that of the contralateral ones. The glucose metabolic rates of the lesioned striatums and thalamus in PD models were lower, compared to that of the healthy monkeys and that of the contralateral sides of themselves. Neither DAT nor glucose metabolism abnormalities was found on both the contralateral sides of the healthy and PD monkeys. On MRI images before MPTP treatment, only 4 of 8 PD models showed hypointense in bilateral globus pallidus. No abnormal MRI findings occurred in the first 2 months after injection of MPTP. At tile third month, hypointense appeared in globus pallidus of three monkeys. Enlarged hyposignal region in globus pallidus were found in three models. Of the above 6 monkeys, two appeared hypointense in putamina. Substantia nigra demonstrated no abnormalities before and after MPTP treatment. All rCBF and CT images were normal. Conclusion: The decreased density of DAT and decreased glucose metabolism on experimental PD can be showed early by DAT imaging and glucose metabolism imaging, MRI can show abnormal signal in the basal ganglia of PD but it is later than DAT and glucose metabolism imaging. CT and rCBF find no abnormality on PD

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Metaiodobenzylguanidine (MIBG) uptake in Parkinson's disease also decreases at thyroid

International Nuclear Information System (INIS)

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

2005-01-01

Decreased cardiac metaiodobenzylguanidine (MIBG) uptake was reported in Parkinson's disease and this contributes to the differential diagnosis between Parkinson's disease and other forms of parkinsonism such as multiple system atrophy. However, decreased MIBG uptake of the thyroid has not been demonstrated. The objective of this study was to compare MIBG uptake of the thyroid among Parkinson's disease, multiple system atrophy and controls. Twenty-six patients with Parkinson's disease, 11 patients with multiple system atrophy and 14 controls were examined in this study. Planar images were taken 15 minutes (early images) and 3 hours (late images) after intravenous injection of 111 MBq 123 I-MIBG. MIBG uptake of the thyroid on early images decreased significantly in Parkinson's disease compared to controls (p<0.0001) and multiple system atrophy (p=0.018). MIBG uptake of the thyroid on early images decreased significantly also in multiple system atrophy compared to controls (p=0.027). On late images, thyroid uptake differed significantly only between Parkinson's disease and controls (p=0.010). Our study is the first to demonstrate decreased MIBG uptake of the thyroid in Parkinson's disease. Sympathetic nervous denervation of Parkinson's disease occurred not only in the heart but also in the thyroid. (author)

Advanced Parkinson's or "complex phase" Parkinson's disease? Re-evaluation is needed.

Science.gov (United States)

Titova, Nataliya; Martinez-Martin, Pablo; Katunina, Elena; Chaudhuri, K Ray

2017-12-01

Holistic management of Parkinson's disease, now recognised as a combined motor and nonmotor disorder, remains a key unmet need. Such management needs relatively accurate definition of the various stages of Parkinson's from early untreated to late palliative as each stage calls for personalised therapies. Management also needs to have a robust knowledge of the progression pattern and clinical heterogeneity of the presentation of Parkinson's which may manifest in a motor dominant or nonmotor dominant manner. The "advanced" stages of Parkinson's disease qualify for advanced treatments such as with continuous infusion or stereotactic surgery yet the concept of "advanced Parkinson's disease" (APD) remains controversial in spite of growing knowledge of the natural history of the motor syndrome of PD. Advanced PD is currently largely defined on the basis of consensus opinion and thus with several caveats. Nonmotor aspects of PD may also reflect advancing course of the disorder, so far not reflected in usual scale based assessments which are largely focussed on motor symptoms. In this paper, we discuss the problems with current definitions of "advanced" PD and also propose the term "complex phase" Parkinson's disease as an alternative which takes into account a multimodal symptoms and biomarker based approach in addition to patient preference.

Quantitative motor performance and sleep benefit in Parkinson disease

NARCIS (Netherlands)

van Gilst, Merel; van Mierlo, P.; Bloem, B.R.; Overeem, S.

2015-01-01

STUDY OBJECTIVES: Many people with Parkinson disease experience "sleep benefit": temporarily improved mobility upon awakening. Here we used quantitative motor tasks to assess the influence of sleep on motor functioning in Parkinson disease. DESIGN: Eighteen Parkinson patients with and 20 without

Epidemiology of Parkinson's Disease: The Rotterdam Study

NARCIS (Netherlands)

M.C. de Rijk (Maarten)

1997-01-01

textabstractAt present, Parkinson's disease (PO), after Alzheimer's disease, is generally considered to be the most frequent progressive neurodegenerative disease in the elderly. Due to the growing proportion of elderly in many populations, more and more persons will be affected by this disabling

A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease.

Science.gov (United States)

2004-04-01

Treatment with rasagiline mesylate, an irreversible monoamine oxidase type B inhibitor, improves symptoms of early Parkinson disease (PD). Preclinical studies suggest that this compound may also modify the progression of PD. To compare the effects of early and later initiation of rasagiline on progression of disability in patients with PD. Double-blind, parallel-group, randomized, delayed-start clinical trial. Four hundred four subjects with early PD, not requiring dopaminergic therapy, enrolled at 32 sites in the United States and Canada. Subjects were randomized to receive rasagiline, 1 or 2 mg/d, for 1 year or placebo for 6 months followed by rasagiline, 2 mg/d, for 6 months. Change in total Unified Parkinson's Disease Rating Scale score from baseline to 12 months. Three hundred seventy-one subjects were included in the 1-year efficacy analysis. Subjects treated with rasagiline, 2 mg/d, for 1 year had a 2.29-unit smaller increase in mean adjusted total Unified Parkinson's Disease Rating Scale score compared with subjects treated with placebo for 6 months followed by rasagiline, 2 mg/d, for 6 months (P =.01). The mean adjusted difference between the placebo/rasagiline, 2 mg/d, group and those receiving rasagiline, 1 mg/d, for 1 year was -1.82 unit on the Unified Parkinson's Disease Rating Scale score (P =.05). Subjects treated with rasagiline, 2 and 1 mg/d, for 12 months showed less functional decline than subjects whose treatment was delayed for 6 months.

Ongoing challenges to finding people with Parkinson's disease for epidemiological studies: a comparison of population-level case ascertainment methods.

Science.gov (United States)

Harris, M Anne; Koehoorn, Mieke; Teschke, Kay

2011-07-01

Locating Parkinson's disease cases for epidemiological studies has long been challenging. Self reports, secondary records of physician diagnosis and drug tracer methods each exhibit known disadvantages but have rarely been compared directly. Prescriptions of levodopa have in some studies been considered to comprise a reasonable proxy for Parkinson's disease diagnosis. We tested this assumption by comparing three methods of population-level case ascertainment. We compared the number of Parkinson's disease cases in British Columbia derived from self-reports in the 2001 Canadian Community Health Survey to those obtained from administrative records of filled levodopa prescriptions and to Parkinson's disease diagnoses from physician visit billing and hospital discharge records in 1996 and 2005. We directly compared a case definition based on levodopa prescriptions with a definition based on records of physician diagnosis by calculating positive predictive value and sensitivity. Crude prevalence estimates ranged from approximately 100 to 200 per 100,000. Levodopa-based case definitions overestimated prevalence, while physician- and hospital-record-based case definitions provided lower prevalence estimates compared to survey derived estimates. The proportion of levodopa users with a diagnosis of Parkinson's disease declined from 62% to 52% between 1996 and 2005. This decrease was most dramatic among women (64%-44%) and those under age 65 (54%-39%). Sex and age trends suggest increasing use of levodopa among patients with conditions other than Parkinson's disease, such as restless legs syndrome. Increased non-Parkinson's levodopa use decreases the efficiency of levodopa as a Parkinson's disease case tracer. Copyright © 2011 Elsevier Ltd. All rights reserved.

Nonmotor symptoms in a malaysian Parkinson's disease population.

Science.gov (United States)

Azmin, Shahrul; Khairul Anuar, Abdul Manaf; Tan, Hui Jan; Nafisah, Wan Yahya; Raymond, Azman Ali; Hanita, Othman; Shah, Shamsul Azhar; Norlinah, Mohamed Ibrahim

2014-01-01

Background. The nonmotor symptoms are important determinants of health and quality of life in Parkinson's disease but are not well recognized and addressed in clinical practice. This study was conducted to determine the prevalence of nonmotor symptoms and their impact on quality of life in patients with Parkinson's disease. Methods. This was a cross-sectional study among patients with idiopathic Parkinson's disease. Exclusion criteria were a Mini Mental State Examination score of diet playing a role in this observation requires further study.

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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)....

[The Competence Network Parkinson (CNP)].

Science.gov (United States)

Oertel, Wolfgang H; Deuschl, Guenther; Eggert, Karla

2016-04-01

The Competence Network Parkinson (CNP) is a research infrastructure for disease-oriented translational and clinical research in the field of Parkinson syndromes (PS). It was initiated in 1999 and funded until 2008 by the German Ministry for Education and Research (BMBF). The CNP created a highly frequented website with information on PS for the general public and for experts. The CNP designed and established one of the first electronic internet-based data entry systems (secuTrial®) - fulfilling the legal standards of data safety and security - a material bank for genetic research on Parkinson's disease (PD), implemented and investigated new methods for early diagnosis of PD and related atypical PS including in vivo dopamine transporter imaging (DAT SPECT), established the German Parkinson Study Group (GPS-Pharma) with 40 certified trial centres for pharmacotherapeutical trials and the German interdisciplinary Parkinson Study Group (neurology and neurosurgery) for deep brain stimulation (GPS-DBS), and carried out several pharmacoeconomic and health care studies on PD in Germany. Sustainability of the infrastructure CNP has in part been achieved in form of the GPS-Pharma and the GPS-DBS, as well as in the German Study Group on REM Sleep Behaviour Disorder (RBD), a prodromal phase of PD. Part of the CNP activities, such as genetic research and research on cohorts of PD patients, have been incorporated into the German Center for Neurodegenerative Disorders (DZNE). Furthermore, topics such as health care research are funded within projects of the EU research program. The article describes problems in setting up a competence network from scratch and contains recommendations how to avoid them in the future.

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Parkinson disease - discharge

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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 ...

A prospective study of 137 patients with Parkinson's disease and anosmia

Directory of Open Access Journals (Sweden)

Soltanzadeh A

1997-08-01

Full Text Available In this research we tried to study frequency of clinical manifestations in Parkinson's disease. Hence, a prospective study was conducted in 317 patients who were affected by Parkinson's disease. In a questionnaire we collected data of patient's age, gender and signs and symptoms and then analyzed them. The most common features in our patients were tremor and muscular rigidity. Olfactory dysfunction was observed in 61% of our patients. Dysarthria, stooped posture, fixed facial expression, intellectual deterioration and the on-off response had various frequency among the patients. A new and important point in our research was considerable frequency of Anosmia or Hyposmia in spite of it's low prevalence among the patients of previous studies.

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Cognitive rehabiliation for Parkinson's disease demantia: a study protocol for a pilot randomised controlled trial.

Science.gov (United States)

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

2016-03-22

There is growing interest in developing non-pharmacological treatments to address the cognitive deficits apparent in Parkinson's disease dementia and dementia with Lewy bodies. Cognitive rehabilitation is a goal-oriented behavioural intervention which focuses on improving everyday functioning through management of cognitive difficulties; it has been shown to be effective in Alzheimer's disease. To date, no studies have assessed its potential efficacy for addressing the impact of cognitive impairment in people with Parkinson's disease or dementia with Lewy bodies. Participants (n = 45) will be recruited from movement disorders, care for the elderly and memory clinics. Inclusion criteria include: a diagnosis of Parkinson's disease, Parkinson's disease dementia or dementia with Lewy bodies according to consensus criteria and an Addenbrooke's Cognitive Examination - III score of ≤ 82. Exclusion criteria include: a diagnosis of any other significant neurological condition; major psychiatric disorder, including depression, which is not related to the patient's Parkinson's disease and unstable medication use for their physical or cognitive symptoms. A single-blind pilot randomised controlled trial, with concurrent economic evaluation, will compare the relative efficacy of cognitive rehabilitation with that of two control conditions. Following a goal-setting interview, the participants will be randomised to one of the three study arms: cognitive rehabilitation (eight weekly sessions), relaxation therapy (eight weekly sessions) or treatment as usual. Randomisation and treatment group allocation will be carried out by a clinical trials unit using a dynamic adaptive sequential randomisation algorithm. The primary outcomes are patients' perceived goal attainment at a 2-months post-intervention assessment and a 6-months follow-up. Secondary outcomes include patients' objective cognitive performance (on tests of memory and executive function) and satisfaction with goal

Cerebral blood flow studied by 133Xe inhalation technique in parkinsonism: loss of hyperfrontal pattern

International Nuclear Information System (INIS)

Bes, A.; Gueell, A.; Fabre, N.; Dupui, P.; Victor, G.; Geraud, G.

1983-01-01

Cerebral blood flow (grey matter flow) in parkinsonism requires further investigation. The noninvasive method of 133 Xe inhalation permits study of larger numbers of subjects than previously used invasive techniques such as the intracarotid 133 Xe injection method. Measurements were made in this laboratory in 30 subjects having Parkinson's disease. Mean hemispheric blood flow (F1) values were 70.4 +/- 9.3 ml/100 g/min, compared to 76.3 for a group of age-matched normal subjects, which is a decrease of -7.8%. The most striking difference was the loss of the hyperfrontal distribution in parkinsonism. The prefrontal F1 values were only 1.8% greater than the hemisphere grey matter flow, compared with 8.5% in controls of a similar age group

Genetics Home Reference: Parkinson disease

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... 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 ...

A case with Parkinsonism secondary to bilateral subdural hematoma

Directory of Open Access Journals (Sweden)

Adalet Arıkanoğlu

2011-03-01

Full Text Available Subdural hematoma is a rare cause of secondary Parkinsonism. In this study, we presented a case of Parkinsonian syndrome caused by a bilateral subdural hematoma. The patient’s Parkinsonism completely healed following successful surgical removal of the hematomas without any anti-parkinson drug.

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Risk of Parkinson's disease following zolpidem use: a retrospective, population-based cohort study.

Science.gov (United States)

Huang, Hui-Chun; Tsai, Chon-Haw; Muo, Chih-Hsin; Lin, Kang-Hsu; Lu, Ming-Kuei; Sung, Fung-Chang; Kao, Chia-Hung

2015-01-01

To evaluate the influence of long-term zolpidem use on the incidence of developing Parkinson's disease. 2,961 subjects who used zolpidem for the first time longer than 3 months between 1998 and 2000 were identified in the National Health Insurance system of Taiwan. Subjects without a history of zolpidem use were randomly selected as a comparison cohort and frequency matched to zolpidem users based on age, sex, and index date. The diagnosis of Parkinson's disease was based on the criteria of the International Classification of Diseases, Ninth Revision, Clinical Modification. Its incidence until the end of 2009 was calculated and its hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression models and Kaplan-Meier analysis. The overall incidence of Parkinson's disease was greater among zolpidem users than in the comparison cohort (HR = 1.88; 95% CI, 1.45-2.45). However, there was no difference in Parkinson's disease incidence between these 2 cohorts after 5 years of observation. The risk of Parkinson's disease increased with increasing zolpidem dose, with an HR of 0.70 for low-dose users (zolpidem only (HR = 2.35; 95% CI, 1.66-3.33) compared to those using benzodiazepines only (HR = 1.31; 95% CI, 0.91-1.90). By stratified analysis, zolpidem use with concurrent depression (HR = 4.79) increased the risk of Parkinson's disease compared to that of zolpidem users without concurrent depression. Zolpidem use might unmask preclinical Parkinson's disease, especially in patients with depression. However, large population-based, unbiased, randomized trials are warranted to confirm this finding. © Copyright 2015 Physicians Postgraduate Press, Inc.

Sleep disorders and an increased risk of Parkinson's disease in individuals with non-apnea sleep disorders: a population-based cohort study.

Science.gov (United States)

Hsiao, Yi-Han; Chen, Yung-Tai; Tseng, Ching-Ming; Wu, Li-An; Perng, Diahn-Warng; Chen, Yuh-Min; Chen, Tzeng-Ji; Chang, Shi-Chuan; Chou, Kun-Ta

2017-10-01

Sleep disorders are common non-motor symptoms in patients with Parkinson's disease. Our study aims to explore the relationship between non-apnea sleep disorders and future Parkinson's disease. This is a cohort study using a nationwide database. The participants were recruited from the Taiwan National Health Insurance Research Database between 2000 and 2003. A total of 91 273 adult patients who had non-apnea sleep disorders without pre-existing Parkinson's disease were enrolled. An age-, gender-, income-, urbanization- and Charlson comorbidity index score-matched control cohort consisting of 91 273 participants was selected for comparison. The two cohorts were followed for the occurrence of Parkinson's disease, death or until the end of 2010, whichever came first. The Kaplan-Meier analyses revealed patients with non-apnea sleep disorders tended to develop Parkinson's disease (log-rank test, P sleep disorders was an independent risk factor for the development of Parkinson's disease [crude hazard ratio: 1.63, 95% confidence interval (CI): 1.54-1.73, P sleep disorders, especially chronic insomnia, are associated with a higher risk for future Parkinson's disease. © 2017 European Sleep Research Society.

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The health-related, social, and economic consequences of parkinsonism: a controlled national study

DEFF Research Database (Denmark)

Jennum, Poul Jørgen; Assenholt, Maria Elizabeth Anna; Korbo, Lise

2011-01-01

Parkinson's disease (PD) and atypical parkinsonism (AP) cause a significant socioeconomic burden, but there is insufficient information about the total disease burden at a national level. Thus, the goal of this study was to estimate the excess direct and indirect costs of PD and AP in a national...... on income data derived from the Coherent Social Statistics. Patients with PD and AP had significantly higher rates of health-related contact and medication use and a higher socioeconomic cost. Furthermore, they had very low employment rates, and those in employment had a lower income level than employed...

Comparison of Olfactory Identification Patterns among Parkinson's Disease Patients from Different Countries.

Science.gov (United States)

Millar Vernetti, Patricio; Rossi, Malco; Cerquetti, Daniel; Perez Lloret, Santiago; Merello, Marcelo

2016-01-01

Olfactory function assessment is an important screening tool and also may differentiate Parkinson's disease (PD) patients from other parkinsonisms, including nondegenerative ones, such as, normal pressure hydrocephalus, vascular, drug induced, or infectious parkinsonism. Several authors in different countries have reported various sets of odors that best differentiate between these conditions. It is debated if distinctive patterns of "restrictive" or "selective" hyposmia in PD may be affected by cultural aspects. To compare the olfactory identification function in PD across different countries, we analyzed Sniffin' Sticks identification task results between 112 PD patients from Argentina and previously reported data of PD patients from Brazil (106 patients), the Netherlands (400 patients), Germany (40 patients), China (110 patients), and Sri Lanka (89 patients). Categorical principal component analysis (CATPCA) was performed to find components reflecting groups of odors similarly perceived across subjects. CATPCA analysis found 2 components for each group which shared 10 out of 16 odors amongst each other. We found that only the shared items of component 2 (orange, mint, banana, garlic, coffee, cloves, and fish) showed uniform results across all of the included countries, whereas variations in component 1 (licorice, turpentine, and apple) were attributed mostly to differences across control groups. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Parkinson's Disease: Diagnosis and Treatment

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... 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 ...

Current Experimental Studies of Gene Therapy in Parkinson's Disease

Directory of Open Access Journals (Sweden)

Jing-ya Lin

2017-05-01

Full Text Available Parkinson's disease (PD was characterized by late-onset, progressive dopamine neuron loss and movement disorders. The progresses of PD affected the neural function and integrity. To date, most researches had largely addressed the dopamine replacement therapies, but the appearance of L-dopa-induced dyskinesia hampered the use of the drug. And the mechanism of PD is so complicated that it's hard to solve the problem by just add drugs. Researchers began to focus on the genetic underpinnings of Parkinson's disease, searching for new method that may affect the neurodegeneration processes in it. In this paper, we reviewed current delivery methods used in gene therapies for PD, we also summarized the primary target of the gene therapy in the treatment of PD, such like neurotrophic factor (for regeneration, the synthesis of neurotransmitter (for prolong the duration of L-dopa, and the potential proteins that might be a target to modulate via gene therapy. Finally, we discussed RNA interference therapies used in Parkinson's disease, it might act as a new class of drug. We mainly focus on the efficiency and tooling features of different gene therapies in the treatment of PD.

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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)

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).

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Full Text Available ... Shop A A You are here Home PD Library Search library Topic Type Living Alone: Home Safety and Management ... Sexuality and Intimacy in Parkinson's Expert Briefings: Improving Communication in Parkinson's Disease: One Voice, Many Listeners Expert ...

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Orofaryngeale slikstoornissen bij de ziekte van Parkinson

NARCIS (Netherlands)

Kalf, J.G.

2014-01-01

OROPHARYNGEAL SWALLOWING DISORDERS IN PARKINSON'S DISEASE: Parkinson's disease is one of the most common and best studied neurodegenerative diseases. The typical motor features, like hypokinesia and rigidity are also seen in chewing and swallowing, but this 'hypokinetic dysphagia' is a complaint

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)

Autoimmune disease and risk for Parkinson disease A population-based case-control study

DEFF Research Database (Denmark)

Rugbjerg, K.; Friis, S.; Ritz, B.

2009-01-01

Objective: Inflammatory mediators are increased in autoimmune diseases and may activate microglia and might cause an inflammatory state and degeneration of dopaminergic neurons in the brain. Thus, we evaluated whether having an autoimmune disease increases the risk for developing Parkinson disease...... do not support the hypothesis that autoimmune diseases increase the risk for Parkinson disease. The decreased risk observed among patients with rheumatoid arthritis might be explained by underdiagnosis of movement disorders such as Parkinson disease in this patient group or by a protective effect...

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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 ... a lower risk of complications and have better quality of life. Learn More Research Research We Fund Parkinson's Outcomes ...

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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 ...

Arterial vascularization patterns of the splenium: An anatomical study.

Science.gov (United States)

Kahilogullari, G; Comert, A; Ozdemir, M; Brohi, R A; Ozgural, O; Esmer, A F; Egemen, N; Karahan, S T

2013-09-01

The aim of this study was to provide detailed information about the arterial vascularization of the splenium of the corpus callosum (CC). The splenium is unique in that it is part of the largest commissural tract in the brain and a region in which pathologies are seen frequently. An exact description of the arterial vascularization of this part of the CC remains under debate. Thirty adult human brains (60 hemispheres) were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. Then, the brains were fixed in formaldehyde, and dissections were performed using a surgical microscope. The diameter of the arterial branches supplying the splenium of the CC at their origin was investigated, and the vascularization patterns of these branches were observed. Vascular supply to the splenium was provided by the anterior pericallosal artery (40%) from the anterior circulation and by the posterior pericallosal artery (88%) and posterior accessory pericallosal artery (50%) from the posterior circulation. The vascularization pattern of the splenium differs in each hemisphere and is usually supplied by multiple branches. The arterial vascularization of the splenium of the CC was studied comprehensively considering the ongoing debate and the inadequacy of the studies on this issue currently available in the literature. This anatomical knowledge is essential during the treatment of pathologies in this region and especially for splenial arteriovenous malformations.

Pathophysiology of diurnal drooling in Parkinson's disease

NARCIS (Netherlands)

Kalf, J.G.; Munneke, M.; Engel-Hoek, L. van den; Swart, B.J.M. de; Borm, G.F.; Bloem, B.R.; Zwarts, M.J.

2011-01-01

Drooling is an incapacitating feature of Parkinson's disease. Better pathophysiological insights are needed to improve treatment. In this study, we tested the hypothesis that the cause of drooling is multifactorial. We examined 15 patients with Parkinson's disease with distinct diurnal saliva loss

[Metronome therapy in patients with Parkinson disease].

Science.gov (United States)

Enzensberger, W; Oberländer, U; Stecker, K

1997-12-01

We studied 10 patients with Parkinson's disease and 12 patients with Parkinson-plus-syndrome, trying to improve patients' gait by application of various external rhythmic stimuli, including metronome stimulation (96 beats per minute = middle andante). The test course of the patients was 4 x 10 meters and 3 U-turns. The patients' gait quality under stimulation was compared with their free walk (velocity, number of steps, number of freezing episodes). Metronome stimulation significantly reduced the time and number of steps needed for the test course and also diminished the number of freezing episodes. March music stimulation was less effective and tactile stimulation (rhythmically tapping on the patient's shoulder) even produced negative results. The positive effect of metronome stimulation was also found, when the tests were not performed inside the hospital building, but outside in the hospital parc. Metronome stimulation was comparably effective in both patient sub-groups examined in this study (M. Parkinson, Parkinson-plus-syndrome) and seems to be an important additional help in the treatment of these patients. Electronical metronomes are not expensive, easy in handling, and portable. A theoretical explanation of metronome stimulation effectivity in patients with Parkinson's disease still needs to be elucidated.

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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 Briefings: ... Is Comprehensive Care or Team Approach Important? OHSU - Therapeutic Approaches for PD: Depression, Anxiety & ... Bathroom: Part 1 CareMAP: Cambios en el ...

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Full Text Available ... Part 2 Young Onset Parkinson Conference: Lessons Learned What Are the Causes of Parkinson's Disease? Are There Disorders That Have Similar Symptoms? How Does the DBS Device Work? How Does Depression Affect the Patient's Family and Social Network? CareMAP: ...

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Full Text Available ... Education CareMAP: Managing Advanced Parkinson's Website Nurse Webinars: Nursing Solutions: Improving Parkinson's Care Everywhere CareMAP: Medicamentos y la Salud en General, Parte 1 Expert Briefings: Apathy or Depression: Which One Is It? CareMAP: El Descanso y ...

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Full Text Available ... in Care: Real Stories CareMAP: Medications and General Health Part 1 What Is Patient-Centered Care? Dealing ... Parkinson Conference: Lessons Learned CareMAP: Medications and General Health Part 2 ¿Cómo Se Diagnostica el Parkinson? CareMAP: ...

Hospitalization in Parkinson disease: a survey of National Parkinson Foundation Centers

NARCIS (Netherlands)

Chou, K.L.; Zamudio, J.; Schmidt, P.; Price, C.C.; Parashos, S.A.; Bloem, B.R.; Lyons, K.E.; Christine, C.W.; Pahwa, R.; Bodis-Wollner, I.; Oertel, W.H.; Suchowersky, O.; Aminoff, M.J.; Malaty, I.A.; Friedman, J.H.; Okun, M.S.

2011-01-01

OBJECTIVES: To explore current practices and opinions regarding hospital management of Parkinson disease (PD) patients in specialized PD Centers. METHODS: Fifty-one out of 54 National Parkinson Foundation (NPF) Centers worldwide completed an online survey regarding hospitalization of PD patients.

Effects of interactive metronome training on postural stability and upper extremity function in Parkinson's disease: a case study.

Science.gov (United States)

Kim, Arim; Lee, Hye-Sun; Song, Chiang-Soon

2017-01-01

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson's disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson's disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient's static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson's disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson's disease.

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.

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Full Text Available ... CareMAP: Thinking Changes: Part 1 CareMAP: Challenges and Rewards of Caregiving What Are the Risks and Benefits ... People with Parkinson's? How Does Parkinson's Disease Affect Memory? CareMAP: La Alimentación y la Deglución, Parte 2 ...

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... 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: ...

Mobility (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 ... 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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Full Text Available ... People with Parkinson's? How Does Parkinson's Disease Affect Memory? CareMAP: La Alimentación y la Deglución, Parte 2 ... and Benefits of DBS Surgery? CareMAP: Managing Caregiver Stress CareMAP: End-of-Life Care Natalie Diaz, MD, ...

Dopamine transporter SPECT in patients with Parkinson's disease

International Nuclear Information System (INIS)

Hamano, Tadanori; Tsuchida, Tatsuro; Hirayama, Mikio; Fujiyama, Jiro; Mutoh, Tatsuro; Yonekura, Yoshiharu; Kuriyama, Masaru

2000-01-01

The major neuropathological feature in Parkinson's disease (PD) is severe degeneration of the dopamine (DA) neurons in the substantia nigra. Dopamine transporter (DAT) is an important protein in the regulation of DA neurotransmission. It has been reported that PD patients show a loss of DAT in striatum. We report here the findings of single photon emission computed tomography (SPECT) of the DAT with 2β-carboxymethoxy-3β-(4[ 123 I]iodophenyl)tropane ([ 123 I]β-CIT) to investigate striatal DAT in 10 patients with PD, one patient with vascular parkinsonism (VP), and one patient with dystonia syndrome. Patients were evaluated using the Webster rating scale. Specific/nondisplaceable striatal binding ratio (V3'') was obtained in each case. In PD patients, the uptake of [ 123 I]β-CIT was reduced, especially in the tail of putamen compared with caudate nucleus. Even in the early stage of PD, the uptake of β-CIT was reduced not only in the severely affected side, but also in the mildly disturbed side of the brain. Putamen caudate ratio was generally low in PD patients. In VP patient, the uptake was reduced, but putamen caudate ratio was not decreased. V3'' values showed significant correlation with the severity of clinical symptoms such as self-care, facies, posture, gait, speech, and Hoehn-Yahr's stage. On the other hand, V3'' values were not significantly correlated with the degree of tremor, seborrhea, and duration of the illness. In conclusion, we found that SPECT of the [ 123 I]β-CIT is a useful method for the diagnosis in the patients presenting parkinsonism, and for the clinico-physiological estimation of parkinsonian symptoms such as self-care, facies, posture, gait, and speech. (author)

Hitler's parkinsonism.

Science.gov (United States)

Boettcher, Lillian B; Bonney, Phillip A; Smitherman, Adam D; Sughrue, Michael E

2015-07-01

Of the multitude of medical and psychiatric conditions ascribed to Hitler both in his lifetime and since his suicide in April 1945, few are more substantiated than parkinsonism. While the timeline of the development of this condition, as well as its etiology, are debated, there is clear evidence for classic manifestations of the disease, most prominently a resting tremor but also stooped posture, bradykinesia, micrographia, and masked facial expressions, with progression steadily seen over his final years. Though ultimately speculation, some have suggested that Hitler suffered from progressive cognitive and mood disturbances, possibly due to parkinsonism, that affected the course of events in the war. Here, the authors discuss Hitler's parkinsonism in the context of the Third Reich and its eventual destruction, maintaining that ultimately his disease had little effect on the end result.

Association between polychlorinated biphenyls and Parkinson's disease neuropathology.

Science.gov (United States)

Hatcher-Martin, Jaime M; Gearing, Marla; Steenland, Kyle; Levey, Allan I; Miller, Gary W; Pennell, Kurt D

2012-10-01

Polychlorinated biphenyls (PCBs) are synthetic chemicals primarily used as coolants and insulators in electrical equipment. Although banned for several decades, PCBs continue to exist in the environment because of their long half-life, continued presence in items produced before the ban, and poor disposal practices. Epidemiological and experimental studies have identified exposure to PCBs as a potential risk factor for Parkinson's disease, perhaps more so in females. The objective of this work was to examine the association between PCB levels in post-mortem human brain tissue and the diagnosis of Parkinson's disease, as well as the degree of nigral depigmentation. We also sought to determine if this association was more significant when patients were stratified by sex. Post-mortem brain samples from control patients and those diagnosed with Parkinson's disease were obtained from the Emory University Brain Bank and from the Nun Study. Concentrations of eight prevalent PCB congeners were extracted from post-mortem brain tissue and analyzed using gas chromatography-mass spectrometry. PCB congeners 153 and 180 were significantly elevated in the brains of Parkinson's disease patients. When stratified by sex, the female Parkinson's disease group demonstrated significantly elevated concentrations of total PCBs and specifically congeners 138, 153, and 180 compared to controls, whereas PCB concentrations in males were not significantly different between control and Parkinson's disease groups. In a separate population of women (Nun Study) who had no clinical signs or symptoms of PD, elevated concentrations total PCB and congeners 138, 153 and 180 were also observed in post-mortem brain tissue exhibiting moderate nigral depigmentation compared to subjects with mild or no depigmentation. These quantitative data demonstrate an association between brain PCB levels and Parkinson's disease-related pathology. Furthermore, these data support epidemiological and laboratory studies

Substantia Nigra Free Water Increases Longitudinally in Parkinson Disease.

Science.gov (United States)

Guttuso, T; Bergsland, N; Hagemeier, J; Lichter, D G; Pasternak, O; Zivadinov, R

2018-02-01

Free water in the posterior substantia nigra obtained from a bi-tensor diffusion MR imaging model has been shown to significantly increase over 1- and 4-year periods in patients with early-stage idiopathic Parkinson disease compared with healthy controls, which suggests that posterior substantia nigra free water may be an idiopathic Parkinson disease progression biomarker. Due to the known temporal posterior-to-anterior substantia nigra degeneration in idiopathic Parkinson disease, we assessed longitudinal changes in free water in both the posterior and anterior substantia nigra in patients with later-stage idiopathic Parkinson disease and age-matched healthy controls for comparison. Nineteen subjects with idiopathic Parkinson disease and 19 age-matched healthy control subjects were assessed on the same 3T MR imaging scanner at baseline and after approximately 3 years. Baseline mean idiopathic Parkinson disease duration was 7.1 years. Both anterior and posterior substantia nigra free water showed significant intergroup differences at baseline ( P Parkinson disease versus healthy controls); however, only anterior substantia nigra free water showed significant longitudinal group × time interaction increases ( P = .021, idiopathic Parkinson disease versus healthy controls). There were no significant longitudinal group × time interaction differences found for conventional diffusion tensor imaging or free water-corrected DTI assessments in either the anterior or posterior substantia nigra. Results from this study provide further evidence supporting substantia nigra free water as a promising disease-progression biomarker in idiopathic Parkinson disease that may help to identify disease-modifying therapies if used in future clinical trials. Our novel finding of longitudinal increases in anterior but not posterior substantia nigra free water is potentially a result of the much longer disease duration of our cohort compared with previously studied cohorts and the known

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).

A biodegradable vascularizing membrane: a feasibility study.

Science.gov (United States)

Kaushiva, Anchal; Turzhitsky, Vladimir M; Darmoc, Marissa; Backman, Vadim; Ameer, Guillermo A

2007-09-01

Regenerative medicine and in vivo biosensor applications require the formation of mature vascular networks for long-term success. This study investigated whether biodegradable porous membranes could induce the formation of a vascularized fibrous capsule and, if so, the effect of degradation kinetics on neovascularization. Poly(l-lactic acid) (PLLA) and poly(dl-lactic-co-glycolic) acid (PLGA) membranes were created by a solvent casting/salt leaching method. Specifically, PLLA, PLGA 75:25 and PLGA 50:50 polymers were used to vary degradation kinetics. The membranes were designed to have an average 60mum pore diameter, as this pore size has been shown to be optimal for inducing blood vessel formation around nondegradable polymer materials. Membrane samples were imaged by scanning electron microscopy at several time points during in vitro degradation to assess any changes in pore structure. The in vivo performance of the membranes was assessed in Sprague-Dawley rats by measuring vascularization within the fibrous capsule that forms adjacent to implants. The vascular density within 100microm of the membranes was compared with that seen in normal tissue, and to that surrounding the commercially available vascularizing membrane TheraCyte. The hemoglobin content of tissue containing the membranes was measured by four-dimensional elastic light scattering as a novel method to assess tissue perfusion. Results from this study show that slow-degrading membranes induce greater amounts of neovascularization and a thinner fibrous capsule relative to fast degrading membranes. These results may be due both to an initially increased number of macrophages surrounding the slower degrading membranes and to the maintenance of their initial pore structure.

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 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: ...

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.

Moderate-intensity interval training increases serum brain-derived neurotrophic factor level and decreases inflammation in Parkinson's disease patients.

Science.gov (United States)

Zoladz, J A; Majerczak, J; Zeligowska, E; Mencel, J; Jaskolski, A; Jaskolska, A; Marusiak, J

2014-06-01

It has been demonstrated that physical training increases serum brain-derived neurotrophic factor (BDNF) in healthy people. The aim of this study was to establish the effect of physical training on the basal serum level of the BDNF in the Parkinson's disease patients (PD patients) in relation to their health status. Twelve PD patients (mean ± S.E.M: age 70 ± 3 years; body mass 70 ± 2 kg; height 163 ± 3 cm) performed a moderate-intensity interval training (three 1-hour training sessions weekly), lasting 8 weeks. Basal serum BDNF in the PD patients before training amounted to 10,977 ± 756 pg x mL(-1) and after 8 weeks of training it has increased to 14,206 ± 1256 pg x mL(-1) (i.e. by 34%, P=0.03). This was accompanied by an attenuation of total Unified Parkinson's Disease Rating Scale (UPDRS) (P=0.01). The training resulted also in a decrease of basal serum soluble vascular cell adhesion molecule 1 (sVCAM-1) (P=0.001) and serum tumor necrosis factor-α (TNF-α) (P=0.03) levels. We have concluded that the improvement of health status of the Parkinson's disease patients after training could be related to the increase of serum BDNF level caused by the attenuated inflammation in those patients.

Altered Kinematics of Facial Emotion Expression and Emotion Recognition Deficits Are Unrelated in Parkinson?s Disease

OpenAIRE

Bologna, Matteo; Berardelli, Isabella; Paparella, Giulia; Marsili, Luca; Ricciardi, Lucia; Fabbrini, Giovanni; Berardelli, Alfredo

2016-01-01

Background Altered emotional processing, including reduced emotion facial expression and defective emotion recognition, has been reported in patients with Parkinson?s disease (PD). However, few studies have objectively investigated facial expression abnormalities in PD using neurophysiological techniques. It is not known whether altered facial expression and recognition in PD are related. Objective To investigate possible deficits in facial emotion expression and emotion recognition and their...

The relationship between dysphagia and clinical types in Parkinson?s disease

OpenAIRE

Monteiro, Douglas; Coriolano, Maria das Graças Wanderley de Sales; Belo, Luciana Rodrigues; Lins, Otávio Gomes

2014-01-01

A disfagia é um sintoma comum na doença de Parkinson, porém a causa e o mecanismo permanecem obscuros. Sabe-se que manifestações disfágicas podem provir de sintomas motores característicos da doença de Parkinson. Sendo assim, o estudo tem como objetivo investigar se a literatura indica a relação entre disfagia e os tipos clínicos (sintomas predominantes) na doença de Parkinson, e se a Levodopa influencia na deglutição desses pacientes. A busca foi realizada utilizando as bases de dados: porta...

Depressive disorders and anti-parkinson drug treatment

DEFF Research Database (Denmark)

Brandt-Christensen, M; Lopez, A G; Nilsson, F M

2007-01-01

OBJECTIVE: To estimate the rate of treatment with anti-parkinson drugs (APD) among patients with depression. METHOD: In a nationwide case register linkage study, all persons with a main diagnosis of depression during 5 years were identified. A control group of persons with diagnoses of osteoarthr...... that prescription of APD reflects the presence of Parkinson's disease, results support a positive statistical association between depressive disorders and Parkinson's disease.......OBJECTIVE: To estimate the rate of treatment with anti-parkinson drugs (APD) among patients with depression. METHOD: In a nationwide case register linkage study, all persons with a main diagnosis of depression during 5 years were identified. A control group of persons with diagnoses...... of osteoarthritis was included. The subsequent risk of getting treatment with APD was estimated for the two groups. Statistical analyses involved Poisson's regression and competing risk models. RESULTS: A total of 14 991 persons were included. The rate of getting APD was 2.57 (95% CI: 1.46-4.52) times higher...

Can loss of the swallow tail sign help distinguish between Parkinson Disease and the Parkinson-Plus syndromes?

Science.gov (United States)

Oustwani, Christopher Sami; Korutz, Alexander William; Lester, Malisa Siri; Kianirad, Yasaman; Simuni, Tanya; Hijaz, Tarek Aref

To determine if loss of the swallow tail sign (STS) can distinguish Parkinson Disease (PD) from the Parkinson-Plus syndromes. Twenty-five patients with PD, 21 with Parkinson-Plus syndromes, and 14 control patients were included. Presence of the STS was assessed. The STS was present in 79% of controls, statistically greater than the PD/Parkinson-Plus patients. There was no difference in the presence of the STS between the PD/Parkinson-Plus subgroups or when scanning at 1.5 T or 3 T. Loss of the STS could not distinguish between PD and Parkinson-Plus patients. The STS can be identified at both 1.5 T and 3 T. Copyright © 2017 Elsevier Inc. All rights reserved.

Contribution of inter-muscular synchronization in the modulation of tremor intensity in Parkinson?s disease

OpenAIRE

He, Xin; Hao, Man-Zhao; Wei, Ming; Xiao, Qin; Lan, Ning

2015-01-01

Background Involuntary central oscillations at single and double tremor frequencies drive the peripheral neuromechanical system of muscles and joints to cause tremor in Parkinson?s disease (PD). The central signal of double tremor frequency was found to correlate more directly to individual muscle EMGs (Timmermann et al. 2003). This study is aimed at investigating what central components of oscillation contribute to inter-muscular synchronization in a group of upper extremity muscles during t...

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)

Parkinson's disease in Russia: prevalence and incidence

Directory of Open Access Journals (Sweden)

Razdorskaya V.V.

2016-09-01

Full Text Available The results of the regional studies on the frequency of Parkinson's disease (PD and the incidence of it in Russia have been generalized, the main factors that determine the quality of the estimates of this disease epidemiological indicators have been identifyd. The article summarizes data from 19 original studies on the epidemiology of parkinsonism and Parkinson's disease in Russia published between 2005-2015. Due to the statistical heterogeneity of the primary results computational analytics was not applied to the data; however, data consolidation allowed to perform a trend analysis of epidemiological indicators. The methodological basis of the majority of studies was medical aid appealabil-ity; two of the studies used door-to-door surveys. One of the studies returned questionably low epidemiological indicators obtained from the medical records, and the rest showed the standardized prevalence of 30.0-139.9/100,000 and incidence of 7.63-21.8/100,000 per year. Contribution of Parkinson's disease to the nosological structure of parkinsonism was >61.3%. Estimate of the number of patients with PD in Russia is approximately 210,000 people. Conclusions are made regarding the prevalence of PD in Russia according to the cross-cutting research on the level of indicators in the Western countries. The prevalence of PD by appealability is 2-3 times less than the prevalence in continuous research, both national and foreign. The incidence of PD, demonstrated in half of the studies, is stable from region to region and is comparable with the universally recognized values.

Woman with x-linked recessive dystonia-parkinsonism: clue to the epidemiology of parkinsonism in Filipino women?

Science.gov (United States)

Domingo, Aloysius; Lee, Lillian V; Brüggemann, Norbert; Freimann, Karen; Kaiser, Frank J; Jamora, Roland D G; Rosales, Raymond L; Klein, Christine; Westenberger, Ana

2014-09-01

Despite recessive inheritance, X-linked dystonia-parkinsonism (Lubag disease) has also been described in women presenting with a late-onset isolated parkinsonian syndrome. Interestingly, unlike in other populations, there is a slight female predominance in the prevalence of parkinsonism in the Philippines. In a Filipino woman with suspected Parkinson disease, we confirmed the presence of all changes specific for X-linked dystonia-parkinsonism in genomic DNA. Subsequently, we analyzed complementary DNA and evaluated the methylation status of the androgen receptor gene. Owing to extremely skewed (98%:2%) X-chromosome inactivation, the patient expressed almost solely the mutated allele in a disease-specific change, rendering her molecularly comparable with a hemizygously affected man. Skewed X-chromosome inactivation is the likely cause of parkinsonism in this heterozygous mutation carrier. Because women carriers of the genetic changes specific for X-linked dystonia-parkinsonism are common in the Philippines, the epigenetic factor of nonrandom X-chromosome inactivation may contribute to the skewing of the sex prevalence of parkinsonism toward women in this country, warranting further investigation.

Magnetic resonance imaging of Parkinsonism

International Nuclear Information System (INIS)

Mukai, Eiichiro; Makino, Naoki; Fujishiro, Kenichiro.

1989-01-01

We have analyzed magnetic resonance images in 33 patients; 18 patients with Parkinson's disease, 1 patient with diurnally fluctuating progressive dystonia, 1 patient with pure akinesia, 6 patients with multiple system atrophy, 1 patient with flunarizine induced parkinsonism, and 4 patients with unclassified parkinsonism. The MR images were obtained using a 1.5-T GE MR System. A spin-echo pulse sequence was used with a TE of 30 msec and 80 msec and a TR of 2000 msec. No signal abnormalities were seen in any patient with Parkinson's disease but 3 showed slightly decreased signal intensity of the putamen on T2-weighted sequences. Patients with diurnally fluctuating progressive dystonia and pure akinesia evidensed no abnormal findings. All six patients with multiple system atrophy demonstrated decreased signal intensity of the putamen, particularly along their lateral and posterior portions, and an enlarged substantia nigra. Atrophy of the pons and cerebellum was detected in all cases with multiple system atrophy. One case of flunarizine induced parkinsonism showed slightly decreased signal intensity of the putamen. Four cases of unclassified parkinsonism showed decreased signal in the putamen on T2-weighted sequences. Magnetic resonance imaging has the potential to become a useful diagnostic tool in the management of parkinsonism. (author)

Magnetic resonance imaging of Parkinsonism

Energy Technology Data Exchange (ETDEWEB)

Mukai, Eiichiro [National Hospital of Nagoya (Japan); Makino, Naoki; Fujishiro, Kenichiro

1989-06-01

We have analyzed magnetic resonance images in 33 patients; 18 patients with Parkinson's disease, 1 patient with diurnally fluctuating progressive dystonia, 1 patient with pure akinesia, 6 patients with multiple system atrophy, 1 patient with flunarizine induced parkinsonism, and 4 patients with unclassified parkinsonism. The MR images were obtained using a 1.5-T GE MR System. A spin-echo pulse sequence was used with a TE of 30 msec and 80 msec and a TR of 2000 msec. No signal abnormalities were seen in any patient with Parkinson's disease but 3 showed slightly decreased signal intensity of the putamen on T2-weighted sequences. Patients with diurnally fluctuating progressive dystonia and pure akinesia evidensed no abnormal findings. All six patients with multiple system atrophy demonstrated decreased signal intensity of the putamen, particularly along their lateral and posterior portions, and an enlarged substantia nigra. Atrophy of the pons and cerebellum was detected in all cases with multiple system atrophy. One case of flunarizine induced parkinsonism showed slightly decreased signal intensity of the putamen. Four cases of unclassified parkinsonism showed decreased signal in the putamen on T2-weighted sequences. Magnetic resonance imaging has the potential to become a useful diagnostic tool in the management of parkinsonism. (author).

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.

Effectiveness of occupational therapy in Parkinson's disease: study protocol for a randomized controlled trial.

Science.gov (United States)

Sturkenboom, Ingrid H W M; Graff, Maud J; Borm, George F; Adang, Eddy M M; Nijhuis-van der Sanden, Maria W G; Bloem, Bastiaan R; Munneke, Marten

2013-02-02

Occupational therapists may have an added value in the care of patients with Parkinson's disease whose daily functioning is compromised, as well as for their immediate caregivers. Evidence for this added value is inconclusive due to a lack of rigorous studies. The aim of this trial is to evaluate the (cost) effectiveness of occupational therapy in improving daily functioning of patients with Parkinson's disease. A multicenter, assessor-blinded, two-armed randomized controlled clinical trial will be conducted, with evaluations at three and six months. One hundred ninety-two home-dwelling patients with Parkinson's disease and with an occupational therapy indication will be assigned to the experimental group or to the control group (2:1). Patients and their caregivers in the experimental group will receive ten weeks of home-based occupational therapy according to recent Dutch guidelines. The intervention will be delivered by occupational therapists who have been specifically trained to treat patients according to these guidelines. Participants in the control group will not receive occupational therapy during the study period. The primary outcome for the patient is self-perceived daily functioning at three months, assessed with the Canadian Occupational Performance Measure. Secondary patient-related outcomes include: objective performance of daily activities, self-perceived satisfaction with performance in daily activities, participation, impact of fatigue, proactive coping skills, health-related quality of life, overall quality of life, health-related costs, and effectiveness at six months. All outcomes at the caregiver level will be secondary and will include self-perceived burden of care, objective burden of care, proactive coping skills, overall quality of life, and care-related costs. Effectiveness will be evaluated using a covariance analysis of the difference in outcome at three months. An economic evaluation from a societal perspective will be conducted, as

Perfusion and metabolism imaging studies in Parkinson's disease

DEFF Research Database (Denmark)

Borghammer, Per

2012-01-01

Positron emission tomography (PET) and single photon emission computed tomography (SPECT) are important tools in the evaluation of brain blood flow and glucose metabolism in Parkinson's disease (PD). However, conflicting results are reported in the literature depending on the type of imaging data...

Parkinson's Disease Videos

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Full Text Available ... Rest and Sleep: Part 2 What Are the Causes of Parkinson's Disease? Are There Disorders That Have Similar Symptoms? How ... What Do I Do if I Suspect Compulsive Behavior in a Loved One with PD? How Is Parkinson's Disease Diagnosed? CareMAP: Getting Dressed Adolfo Diaz, PTA, NPF - ...

Parkinson's Disease Videos

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Full Text Available ... Nursing Solutions: Improving Parkinson's Care Everywhere CareMAP: La Alimentación y la Deglución, Parte 1 CareMAP: El Baño, ... How Does Parkinson's Disease Affect Memory? CareMAP: La Alimentación y la Deglución, Parte 2 Caregiver Summit 2016: ...

A study investigating the experience of working for people with Parkinson's and the factors that influence workplace success.

Science.gov (United States)

Mullin, Rebecca L; Chaudhuri, K Ray; Andrews, Thomasin C; Martin, Anne; Gay, Stella; White, Claire M

2017-05-10

The experience of working for people with Parkinson's disease (PD) is known to vary substantially and affects the length of time in employment after diagnosis. This study aims at exploring the experience of working for people with PD and to create a model detailing the factors that influence their workplace success. A qualitative grounded theoretical approach was used. Seventeen working people with PD were selected for individual interviews which were conducted sequentially. Data were analyzed in an iterative, inductive process of coding to identify common themes and to generate a model that explains the data. Two core themes that influence workplace success for people with PD were identified. 'Feeling in control of Parkinson's' describes the actions that they make to remain in control. 'Being able to control Parkinson's in the workplace' describes external factors that they believe influence their ability to work successfully. The theoretical model demonstrates how a variety of factors interplay to influence workplace success for people with PD. PD is often poorly understood but the ability to explore and devise strategies for oneself and the flexibility to work around a fluctuating daily pattern were regularly identified as strategies that facilitated success. Implications for Rehabilitation The experience of working for people with Parkinson's is variable and is influenced by how in control the person with Parkinson's feels and the strategies they use to manage challenges. There is a need for greater workplace education to enhance employers' understanding of Parkinson's to ensure better support for strategies or reasonable adjustments by employers. People with Parkinson's are able to devise strategies to overcome some of their own specific workplace challenges including through technology but often, they prefer not to use disability aids. Daily fluctuations in Parkinson's symptoms are an important factor influencing workplace success.

Natural History of Parkinson's Disease in the Province of Segovia: Disability in a 20 Years Longitudinal Study.

Science.gov (United States)

Duarte, Jacinto; García Olmos, Luis Miguel; Mendoza, Amelia; Martínez Pueyo, Ángel; Clavería, Luis Erik

2015-01-01

Parkinson's disease mainly affects the elderly population causing a progressive functional disability with motor, psychic, and cognitive deterioration. This study was carried out to evaluate disability caused by Parkinson's disease by analyzing the median time to reach Hoehn and Yahr stage III and to investigate predictor variables based on a 20-year longitudinal follow-up study. We examined 273 patients with Parkinson's disease recruited between 1978 and 1998. We performed a survival analysis using the Kaplan-Meier method to determine the time to disability and we used a Cox regression model to adjust prognosis factors. The median time to reach Hoehn and Yahr stage III was 7.73 years (95% CI: 5.95-8.05). Independent predictors of disability were: age at onset, the hazard ratio (HR) = 1.10, 95% CI: 1.08-1.12; UPDRS II (activities of daily living) HR = 1.08, 95% CI: 1.03-1.14; and akinesia and rigidity at onset HR = 1.55, 95% CI: 1.07-2.24. Patients with Parkinson's disease evolve gradually toward disability, and prognostic factors of this evolution were identified. © 2015 S. Karger AG, Basel.

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....

Factors contributing to malnutrition in patients with Parkinson's disease.

Science.gov (United States)

Kim, Sung R; Chung, Sun J; Yoo, Sung-Hee

2016-04-01

Our objective in this study was to evaluate the nutritional status and to identify clinical, psychosocial, and nutritional factors contributing to malnutrition in Korean patients with Parkinson's disease. We used a descriptive, cross-sectional study design. Of 102 enrolled patients, 26 (25.5%) were malnourished and 27 (26.5%) were at risk of malnutrition based on Mini-Nutritional Assessment scores. Malnutrition was related to activity of daily living score, Hoehn and Yahr stage, duration of levodopa therapy, Beck Depression Inventory and Spielberger's Anxiety Inventory scores, body weight, body weight at onset of Parkinson's disease, and body mass index. On multiple logistic regression analysis, anxiety score, duration of levodopa therapy, body weight at onset of Parkinson's disease, and loss of body weight were significant factors predicting malnutrition in Parkinson's disease patients. Therefore, nutritional assessment, including psychological evaluation, is required for Parkinson's disease patients to facilitate interdisciplinary nutritional intervention for malnourished patients. © 2014 John Wiley & Sons Australia, Ltd.

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...

Association of restless legs syndrome, pain, and mood disorders in Parkinson's disease.

Science.gov (United States)

Rana, Abdul Qayyum; Qureshi, Abdul Rehman M; Rahman, Labiba; Jesudasan, Ajantha; Hafez, Kevin K; Rana, Mohammad A

2016-01-01

The objectives of the study were to analyze the association between Parkinson's disease and restless legs syndrome, and to explore the relationship between mood disorder comorbidity (anxiety and depression), pain, and restless legs syndrome. This study included 123 Parkinson's disease patients and 123 non-Parkinson's disease patients matched for age and gender, and evaluated for anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence. This was performed using semi-structured interviews and a neurological examination through the restless legs syndrome diagnostic criteria and the following inventories; Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pain Disability Index. Parkinson's disease patients had significantly greater anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence in comparison to controls. In addition, Parkinson's disease patients' comorbid for anxiety and depression had significantly greater pain severity, pain interference, and pain disability, but not RLS prevalence, in comparison to Parkinson's disease only, Parkinson's disease anxiety, and Parkinson's disease depression patients. Pain interference, pain severity, and pain disability is greater among Parkinson's disease patients with anxiety and depression, in comparison to Parkinson's disease patients without anxiety and depression. On the contrary, the prevalence of restless legs syndrome was not found to be relevant.

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.

Clinical course and prognosis in patients with Gaucher disease and parkinsonism

Science.gov (United States)

Lopez, Grisel; Kim, Jenny; Wiggs, Edythe; Cintron, Dahima; Groden, Catherine; Tayebi, Nahid; Mistry, Pramod K.; Pastores, Gregory M.; Zimran, Ari; Goker-Alpan, Ozlem

2016-01-01

Objective: The goal of this study was to characterize the parkinsonian phenotype in patients with Gaucher disease (GD) who developed parkinsonism in order to evaluate clinical course and prognosis. Methods: This is a retrospective observational study conducted at the Clinical Center of the NIH, Bethesda, MD, over a period of 10 years. The study included 19 patients with GD and parkinsonism. The severity of Gaucher and parkinsonian symptoms was determined from clinical data including physical, neurologic, pathologic, and neurocognitive evaluations, family histories, imaging studies, olfactory testing, and validated questionnaires. Results: We found an earlier age at onset of parkinsonism and evidence of mild cognitive dysfunction in our cohort. Although the clinical course in some patients was similar to that of idiopathic Parkinson disease with a favorable levodopa response, others exhibited features characteristic of dementia with Lewy bodies. When we examined the patients as a group, we did not observe a uniformly aggressive form of parkinsonism after the initial onset of symptoms, contrary to other published reports. Conclusions: Appreciable clinical variation was seen in this cohort with GD and parkinsonism. Although some patients had early onset and prominent cognitive changes, others had a later, slower course, indicating that GBA1 mutations may not be a reliable prognostic indicator in Parkinson disease in clinical settings. PMID:27123476

Parkinson's Disease Videos

Medline Plus

Full Text Available ... 2 ¿Cómo Se Diagnostica el Parkinson? CareMAP: Prioritizing Health Needs of the Caregiver Is Compulsive Behavior a Side Effect ... Are Some Practical Strategies for Improving the Quality of Sleep? How Does Parkinson's Disease Affect the Urinary System? CareMAP: Plans and Scheduling: Part 1 ¿Cuáles son ...

Parkinson's Disease Videos

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Full Text Available ... About Depression? CareMAP: Movimientos y Caídas, Parte 1 ¿Cuáles Son las Causas del Parkinson? ¿Existen Otros Trastornos que Tienen ... or Delusions? CareMAP: Plans and Scheduling: Part 1 ¿Cuáles son las diferentes formas y etapas del Parkinson? ¿Cómo es ...

Parkinson's Disease Videos

Medline Plus

Full Text Available ... Caregivers Need to Know? CareMAP: Ayudando a una Persona con la Enfermedad de Parkinson Why Is Comprehensive Care or Team Approach ... el Sueño, Parte 2 Panel de Expertos: Sesión de Preguntas y Respuestas con todos los ... Se Trata el Parkinson? CareMAP: Cambios para Realizar en Casa, ...

Comparative studies of D2 receptors and cerebral blood flow in hemi-parkinsonism rats

International Nuclear Information System (INIS)

Lin, Y.; Lin, X.

2000-01-01

To study the relationship between dopamine (DA) D 2 receptors and cerebral blood flow in hemiparkinsonism rats. Hemi-parkinsonism rats were made by stereotaxic 6-hydroxy dopamine (6-OH-DA) lesions in substantia nigra and ventral tegmental area, apomorphine (Apo) which could induce the successful model rat rotates toward the intact side was used to screen that rats, 125 I-IBZM in vivo autoradiography and 99m Tc-HM-PAO regional brain biodistribution were used to study D 2 receptors and cerebral blood flow. The HPLC-ECD were used to measure the concentration of DA and it metabolites homovanillic acid (HVA), 3,4-dehydroxyphenyl acetic acid (DOPAC) in bilateral striatum (ST). The lesioned side ST DA and its metabolites HVA DOPAC reduced significantly than that of the intact side and pseudo-operated control group, ST/cerebellum (CB) 125 I-IBZM uptake ratio was 8.04 ±0.71 in lesioned side of hemi-parkinsonism rats, significantly increased compared with the intact side and the pseudo-operated group (p 99m Tc 30.1±4.53% enhancement as compared to the intact side, and also show good correlation with 30 min Apo induced rotation numbers (r=0.98), the regional cerebral blood flow study didn't show significant difference between bilateral brain cortex area (p>0.05). The DA content decreased significantly and induced an up-regulation of ST D 2 receptor binding sites in 6-OH-DA lesioned side in hemi-parkinsonism rats, the increased percentage of lesioned-intact side ST/CB 125 I-IBZM uptake ratio showed good correlation with rotation behavior induced by Apo. Compare with cerebral blood flow, D 2 receptor reflected by IBZM seems to be more specific and earlier to detect the cerebral functional impairment in experimental hemi-parkinsonism

Neuromuscular rate of force development deficit in Parkinson disease.

Science.gov (United States)

Hammond, Kelley G; Pfeiffer, Ronald F; LeDoux, Mark S; Schilling, Brian K

2017-06-01

Bradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease. Nine persons with mild Parkinson Disease (Hoehn & Yahr≤2, Unified Parkinson Disease Rating Scale total score=mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique. Thirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n=7) had significantly slower voluntary rate of force development (p=0.008; d=1.97) and rate of force development ratio (p=0.004; d=2.18) than controls (n=6). No significant differences were found between groups for all other variables. Persons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease. Copyright © 2017. Published by Elsevier Ltd.

Adolf Hitler had post-encephalitic Parkinsonism.

Science.gov (United States)

Lieberman, A

1996-04-01

Adolf Hitler had Parkinson symptoms in 1934, at age 45 years. He may have had transient symptoms in 1923, at age 34 years. Young-onset parkinsonism, during the 1920s, favored a diagnosis of post-encephalitic rather than idiopathic parkinsonism. Hitler had oculogyric crises, phenomena only associated with post-encephalitic parkinsonism. In addition, he had dystonic facial spasms, palilalia and a sleep disorder, phenomena more likely to be associated with post-encephalitic than idiopathic parkinsonism. In November 1918, at age 29 years, Hitler may have had von Economo's encephalitis, while he was a patient in a hospital, recovering from poison gas. This paper looks at the possible relationship of von Economo's encephalitis to Hitler's asocial behavior; his obsessions and compulsions, his cruelty and rages. The influence of Hitler's parkinsonism on his conduct during World War II is discussed.

The emerging science of precision medicine and pharmacogenomics for Parkinson's disease.

Science.gov (United States)

Payami, Haydeh

2017-08-01

Current therapies for Parkinson's disease are problematic because they are symptomatic and have adverse effects. New drugs have failed in clinical trials because of inadequate efficacy. At the core of the problem is trying to make one drug work for all Parkinson's disease patients, when we know this premise is wrong because (1) Parkinson's disease is not a single disease, and (2) no two individuals have the same biological makeup. Precision medicine is the goal to strive for, but we are only at the beginning stages of building the infrastructure for one of the most complex projects in the history of science, and it will be a long time before Parkinson's disease reaps the benefits. Pharmacogenomics, a cornerstone of precision medicine, has already proven successful for many conditions and could also propel drug discovery and improve treatment for Parkinson's disease. To make progress in the pharmacogenomics of Parkinson's disease, we need to change course from small inconclusive candidate gene studies to large-scale rigorously planned genome-wide studies that capture the nuclear genome and the microbiome. Pharmacogenomic studies must use homogenous subtypes of Parkinson's disease or apply the brute force of statistical power to overcome heterogeneity, which will require large sample sizes achievable only via internet-based methods and electronic databases. Large-scale pharmacogenomic studies, together with biomarker discovery efforts, will yield the knowledge necessary to design clinical trials with precision to alleviate confounding by disease heterogeneity and interindividual variability in drug response, two of the major impediments to successful drug discovery and effective treatment. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

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

Vascularized nerve grafts: an experimental study.

Science.gov (United States)

Donzelli, Renato; Capone, Crescenzo; Sgulò, Francesco Giovanni; Mariniello, Giuseppe; Maiuri, Francesco

2016-08-01

The aim of this study is to define an experimental model in order to promote the functional recovery of the nerves using grafts with vascular support (Vascular Nerve Grafts - VNG). The aim of this study is to define, on an experimental model in normal recipient bed, whether the functional recovery with VNG is superior to that obtained non-vascularized graft (NNG). Twenty male rabbits, which underwent dissection of sciatic nerve, were later treated by reinnervation through an autograft. In 10 animals the reconstruction of sciatic nerve was realized with VNG; in 10 control animals the reconstruction of sciatic nerve was realized with NNG. The VNG group showed a better axonal organization and a significantly higher number of regenerated axons in the early phases (after 30 days) than the NNG group, whereas the difference in the axonal number at day 90 was less significant; besides, the axon diameter and the myelin thickness were not significantly improved by VNG group. Our data suggests that the use of VNG leads to a faster regeneration process and a better functional recovery, although the final results are comparable to those of the NNG. VNG improve the quality of the axonal regeneration (axonal diameter and Schwann cells), although the increase in the axonal number is not significant and does not improve the long-term functional outcome.

Relational databases for rare disease study: application to vascular anomalies.

Science.gov (United States)

Perkins, Jonathan A; Coltrera, Marc D

2008-01-01

To design a relational database integrating clinical and basic science data needed for multidisciplinary treatment and research in the field of vascular anomalies. Based on data points agreed on by the American Society of Pediatric Otolaryngology (ASPO) Vascular Anomalies Task Force. The database design enables sharing of data subsets in a Health Insurance Portability and Accountability Act (HIPAA)-compliant manner for multisite collaborative trials. Vascular anomalies pose diagnostic and therapeutic challenges. Our understanding of these lesions and treatment improvement is limited by nonstandard terminology, severity assessment, and measures of treatment efficacy. The rarity of these lesions places a premium on coordinated studies among multiple participant sites. The relational database design is conceptually centered on subjects having 1 or more lesions. Each anomaly can be tracked individually along with their treatment outcomes. This design allows for differentiation between treatment responses and untreated lesions' natural course. The relational database design eliminates data entry redundancy and results in extremely flexible search and data export functionality. Vascular anomaly programs in the United States. A relational database correlating clinical findings and photographic, radiologic, histologic, and treatment data for vascular anomalies was created for stand-alone and multiuser networked systems. Proof of concept for independent site data gathering and HIPAA-compliant sharing of data subsets was demonstrated. The collaborative effort by the ASPO Vascular Anomalies Task Force to create the database helped define a common vascular anomaly data set. The resulting relational database software is a powerful tool to further the study of vascular anomalies and the development of evidence-based treatment innovation.

A Clinical and Molecular Genetic Study of 50 Families with Autosomal Recessive Parkinsonism Revealed Known and Novel Gene Mutations.

Science.gov (United States)

Taghavi, Shaghayegh; Chaouni, Rita; Tafakhori, Abbas; Azcona, Luis J; Firouzabadi, Saghar Ghasemi; Omrani, Mir Davood; Jamshidi, Javad; Emamalizadeh, Babak; Shahidi, Gholam Ali; Ahmadi, Mona; Habibi, Seyed Amir Hassan; Ahmadifard, Azadeh; Fazeli, Atena; Motallebi, Marzieh; Petramfar, Peyman; Askarpour, Saeed; Askarpour, Shiva; Shahmohammadibeni, Hossein Ali; Shahmohammadibeni, Neda; Eftekhari, Hajar; Shafiei Zarneh, Amir Ehtesham; Mohammadihosseinabad, Saeed; Khorrami, Mehdi; Najmi, Safa; Chitsaz, Ahmad; Shokraeian, Parasto; Ehsanbakhsh, Hossein; Rezaeidian, Jalal; Ebrahimi Rad, Reza; Madadi, Faranak; Andarva, Monavvar; Alehabib, Elham; Atakhorrami, Minoo; Mortazavi, Seyed Erfan; Azimzadeh, Zahra; Bayat, Mahdis; Besharati, Amir Mohammad; Harati-Ghavi, Mohammad Ali; Omidvari, Samareh; Dehghani-Tafti, Zahra; Mohammadi, Faraz; Mohammad Hossein Pour, Banafsheh; Noorollahi Moghaddam, Hamid; Esmaili Shandiz, Ehsan; Habibi, Arman; Taherian-Esfahani, Zahra; Darvish, Hossein; Paisán-Ruiz, Coro

2018-04-01

In this study, the role of known Parkinson's disease (PD) genes was examined in families with autosomal recessive (AR) parkinsonism to assist with the differential diagnosis of PD. Some families without mutations in known genes were also subject to whole genome sequencing with the objective to identify novel parkinsonism-related genes. Families were selected from 4000 clinical files of patients with PD or parkinsonism. AR inheritance pattern, consanguinity, and a minimum of two affected individuals per family were used as inclusion criteria. For disease gene/mutation identification, multiplex ligation-dependent probe amplification, quantitative PCR, linkage, and Sanger and whole genome sequencing assays were carried out. A total of 116 patients (50 families) were examined. Fifty-four patients (46.55%; 22 families) were found to carry pathogenic mutations in known genes while a novel gene, not previously associated with parkinsonism, was found mutated in a single family (2 patients). Pathogenic mutations, including missense, nonsense, frameshift, and exon rearrangements, were found in Parkin, PINK1, DJ-1, SYNJ1, and VAC14 genes. In conclusion, variable phenotypic expressivity was seen across all families.

Relationship between manual dexterity and the unified parkinson's disease rating scale-motor exam.

Science.gov (United States)

Hwang, Sujin; Song, Chiang-Soon

2016-12-01

[Purpose] The purpose of this study was to examine the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam as a clinical tool for quantifying upper extremity function in persons with Parkinson's disease. [Subjects and Methods] Thirty-two persons with idiopathic Parkinson's disease participated in this study. This study measured two clinical outcomes, the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam, to investigate the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam. [Results] The box-and-block test on the more affected side was positive relationship with the box-and-block test on the less affected side. The Unified Parkinson's Disease Rating Scale-motor exam score had a negative correlation with the box-and-block test results for both sides. [Conclusion] A positive association was noted between manual dexterity and motor function in patients with idiopathic Parkinson disease. The results of this study suggest that the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam are good clinical measures that quantify upper extremity function and are necessary for the accurate evaluation of patients and to plan intervention strategies.

Daytime Napping, Nighttime Sleeping, and Parkinson Disease

Science.gov (United States)

Gao, Jianjun; Huang, Xuemei; Park, Yikyung; Hollenbeck, Albert; Blair, Aaron; Schatzkin, Arthur; Chen, Honglei

2011-01-01

Preliminary evidence suggests that daytime sleepiness may predate clinical diagnosis of Parkinson disease. The authors examined daytime napping and nighttime sleeping durations, reported in 1996–1997 by 220,934 US NIH-AARP Diet and Health Study participants, in relation to Parkinson disease diagnoses at 3 clinical stages: established (cases diagnosed before 1995, n = 267), recent (1995–1999, n = 396), and prediagnostic (2000 and after, n = 770). Odds ratios and 95% confidence intervals were derived from multivariate logistic regression models. Longer daytime napping was associated with higher odds of Parkinson disease at all 3 clinical stages: the odds ratios comparing long nappers (>1 hour/day) with nonnappers were 3.9 (95% confidence interval: 2.8, 5.6) for established cases, 2.2 (95% confidence interval: 1.7, 3.0) for recent cases, and 1.5 (95% confidence interval: 1.2, 1.9) for prediagnostic cases. Further control for health status or nighttime sleeping duration attenuated the association for established cases but made little difference for recent or prediagnostic cases. In the nighttime sleeping analysis, a clear U-shaped association with Parkinson disease was observed for established cases; however, this association was attenuated markedly for recent cases and disappeared for prediagnostic cases. This study supports the notion that daytime sleepiness, but not nighttime sleeping duration, is one of the early nonmotor symptoms of Parkinson disease. PMID:21402730

Electroconvulsive Therapy Intervention for Parkinson's Disease.

Science.gov (United States)

Narang, Puneet; Glowacki, Anna; Lippmann, Steven

2015-01-01

Electroconvulsive therapy is an established means to improve function in a variety of psychiatric and neurologic conditions, particularly for patients who remain treatment-refractory. Parkinson's disease is a neurodegenerative disorder that sometimes does not respond well to conventional pharmacotherapies. Reports have indicated that electroconvulsive therapy may be an effective and safe treatment for those patients with Parkinson's disease who are not optimally responding to first-line treatments. Despite these reports, however, electroconvulsive therapy is not often used by clinicians in patients with treatment-resistant Parkinson's disease, perhaps due to stigma, lack of knowledge regarding its safety and efficacy, and/or inability to predict the duration of therapeutic benefit. Our objective was to determine if the available literature on ECT supports it as a safe and effective treatment option in patients with treatment-refractory Parkinson's disease. Motoric improvement induced by electroconvulsive therapy has been documented for decades in persons with Parkinson's disease. Efficacy and safety are reported following electroconvulsive therapy in people with Parkinson's disease who have sub-optimal response to medicines or experience the "on/off" phenomenon to L-dopa. Electroconvulsive therapy is an effective option for acute and maintenance treatment of Parkinson's disease in select patients. Inability to predict how long the beneficial effects of ECT therapy will last in patients with Parkinson's disease may be a reason why this treatment is underutilized by clinicians. More research is warranted to clarify parameters for application and duration of therapeutic benefit in individuals with difficult-to-treat Parkinson's disease.

Risk for Parkinson's disease among patients with osteoarthritis: a Danish cohort study

DEFF Research Database (Denmark)

Rugbjerg, Kathrine; Friis, Søren; Jørgensen, Thomas

2010-01-01

prevalence of NSAID use among cohort members, and lung cancer (0.77; 95% CI, 0.73-0.80), indicating a lower prevalence of smoking than usual. Our results do not support the hypothesis that patients with prolonged use of NSAID and other analgesics are at reduced risk for Parkinson's disease. A possible lower......It has been suggested that use of nonsteroidal anti-inflammatory drugs (NSAID) protects against Parkinson's disease, although the results are not consistent. We investigated the risk for Parkinson's disease in patients with osteoarthritis, who are typically intensive users of NSAID. By using......-2007 was compared with that expected from the age-, gender- and period-specific hospital contact rates of the general Danish population, and standardized incidence ratios (SIRs) and associated 95% confidence intervals (CIs) were derived. Cohort members were also linked to the Danish Cancer Register to estimate...

History of Bioelectrical Study and the Electrophysiology of the Primo Vascular System

Directory of Open Access Journals (Sweden)

Sang Hyun Park

2013-01-01

Full Text Available Background. Primo vascular system is a new anatomical structure whose research results have reported the possibility of a new circulatory system similar to the blood vascular system and cells. Electrophysiology, which measures and analyzes bioelectrical signals tissues and cells, is an important research area for investigating the function of tissues and cells. The bioelectrical study of the primo vascular system has been reported by using modern techniques since the early 1960s by Bonghan Kim. This paper reviews the research result of the electrophysiological study of the primo vascular system for the discussion of the circulatory function. We hope it would help to study the electrophysiology of the primo vascular system for researchers. This paper will use the following exchangeable expressions: Kyungrak system = Bonghan system = Bonghan circulatory system = primo vascular system = primo system; Bonghan corpuscle = primo node; Bonghan duct = primo vessel. We think that objective descriptions of reviewed papers are more important than unified expressions when citing the papers. That said, this paper will unify the expressions of the primo vascular system.

Medium-to-high prevalence of screening-detected parkinsonism in the urban area of Tehran, Iran: data from a community-based door-to-door study.

Science.gov (United States)

Fereshtehnejad, Seyed-Mohammad; Shafieesabet, Mahdiyeh; Rahmani, Arash; Delbari, Ahmad; Lökk, Johan

2015-01-01

Parkinsonism occurs in all ethnic groups worldwide; however, there are wide variations in the prevalence rates reported from different countries, even for neighboring regions. The huge socioeconomic burden of parkinsonism necessitates the need for prevalence studies in each country. So far, there is neither data registry nor prevalence information on parkinsonism in the Iranian population. The aim of our study was to estimate the prevalence rate of probable parkinsonism in a huge urban area in Iran, Tehran using a community-based door-to-door survey. We used a random multistage sampling of the households within the network of health centers consisting of 374 subunits in all 22 districts throughout the entire urban area of Tehran. Overall, 20,621 individuals answered the baseline checklist and screening questionnaire and data from 19,500 persons aged ≥30 years were entered in the final analysis. Health care professionals used a new six-item screening questionnaire for parkinsonism, which has been previously shown to have a high validity and diagnostic value in the same population. A total of 157 cases were screened for parkinsonism using the validated six-item questionnaire. After age and sex adjustment based on the Tehran population, the prevalence of parkinsonism was calculated as 222.9 per 100,000. Using the World Health Organization's World Standard Population, the standardized prevalence rate of parkinsonism was 285 per 100,000 (95% confidence interval 240-329). The male:female ratio of probable parkinsonism was calculated as 1.62, and there was a significant increase in the screening rate by advancing age. The calculated rates for the prevalence of parkinsonism in our study are closer to reports from some European and Middle Eastern countries, higher than reports from Eastern Asian and African populations, and lower than Australia. The prevalence rate of >200 in 100,000 for parkinsonism in Tehran, Iran could be considered a medium-to-high rate.

Insecticide Exposure in Parkinsonism

National Research Council Canada - National Science Library

Bloomquist, Jeffrey

2002-01-01

Behavioral, neurochemical, and immunocytochemical studies characterized the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and permethrin (PM...

Insecticide Exposure in Parkinsonism

National Research Council Canada - National Science Library

Bloomquist, Jeffrey

2001-01-01

Behavioral, neurochemical, and immunocytochemical studies characterized the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and permethrin (PM...

Diagnostic value of the impairment of olfaction in Parkinson's disease.

Science.gov (United States)

Casjens, Swaantje; Eckert, Angelika; Woitalla, Dirk; Ellrichmann, Gisa; Turewicz, Michael; Stephan, Christian; Eisenacher, Martin; May, Caroline; Meyer, Helmut E; Brüning, Thomas; Pesch, Beate

2013-01-01

Olfactory impairment is increasingly recognized as an early symptom in the development of Parkinson's disease. Testing olfactory function is a non-invasive method but can be time-consuming which restricts its application in clinical settings and epidemiological studies. Here, we investigate odor identification as a supportive diagnostic tool for Parkinson's disease and estimate the performance of odor subsets to allow a more rapid testing of olfactory impairment. Odor identification was assessed with 16 Sniffin' sticks in 148 Parkinson patients and 148 healthy controls. Risks of olfactory impairment were estimated with proportional odds models. Random forests were applied to classify Parkinson and non-Parkinson patients. Parkinson patients were rarely normosmic (identification of more than 12 odors; 16.8%) and identified on average seven odors whereas the reference group identified 12 odors and showed a higher prevalence of normosmy (31.1%). Parkinson patients with rigidity dominance had a twofold greater prevalence of olfactory impairment. Disease severity was associated with impairment of odor identification (per score point of the Hoehn and Yahr rating OR 1.87, 95% CI 1.26-2.77). Age-related impairment of olfaction showed a steeper gradient in Parkinson patients. Coffee, peppermint, and anise showed the largest difference in odor identification between Parkinson patients and controls. Random forests estimated a misclassification rate of 22.4% when comparing Parkinson patients with healthy controls using all 16 odors. A similar rate (23.8%) was observed when only the three aforementioned odors were applied. Our findings indicate that testing odor identification can be a supportive diagnostic tool for Parkinson's disease. The application of only three odors performed well in discriminating Parkinson patients from controls, which can facilitate a wider application of this method as a point-of-care test.

Pain in 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 ... by a physical therapist Get active and keep moving. Exercise helps ... 30-45 minutes daily. Walking, swimming, yoga, tai chi, dancing, etc. are all ...

Specialized mouse embryonic stem cells for studying vascular development.

Science.gov (United States)

Glaser, Drew E; Burns, Andrew B; Hatano, Rachel; Medrzycki, Magdalena; Fan, Yuhong; McCloskey, Kara E

2014-01-01

Vascular progenitor cells are desirable in a variety of therapeutic strategies; however, the lineage commitment of endothelial and smooth muscle cell from a common progenitor is not well-understood. Here, we report the generation of the first dual reporter mouse embryonic stem cell (mESC) lines designed to facilitate the study of vascular endothelial and smooth muscle development in vitro. These mESC lines express green fluorescent protein (GFP) under the endothelial promoter, Tie-2, and Discomsoma sp. red fluorescent protein (RFP) under the promoter for alpha-smooth muscle actin (α-SMA). The lines were then characterized for morphology, marker expression, and pluripotency. The mESC colonies were found to exhibit dome-shaped morphology, alkaline phosphotase activity, as well as expression of Oct 3/4 and stage-specific embryonic antigen-1. The mESC colonies were also found to display normal karyotypes and are able to generate cells from all three germ layers, verifying pluripotency. Tissue staining confirmed the coexpression of VE (vascular endothelial)-cadherin with the Tie-2 GFP+ expression on endothelial structures and smooth muscle myosin heavy chain with the α-SMA RFP+ smooth muscle cells. Lastly, it was verified that the developing mESC do express Tie-2 GFP+ and α-SMA RFP+ cells during differentiation and that the GFP+ cells colocalize with the vascular-like structures surrounded by α-SMA-RFP cells. These dual reporter vascular-specific mESC permit visualization and cell tracking of individual endothelial and smooth muscle cells over time and in multiple dimensions, a powerful new tool for studying vascular development in real time.

Parkinson's Disease Subtypes in the Oxford Parkinson Disease Centre (OPDC) Discovery Cohort.

Science.gov (United States)

Lawton, Michael; Baig, Fahd; Rolinski, Michal; Ruffman, Claudio; Nithi, Kannan; May, Margaret T; Ben-Shlomo, Yoav; Hu, Michele T M

2015-01-01

Within Parkinson's there is a spectrum of clinical features at presentation which may represent sub-types of the disease. However there is no widely accepted consensus of how best to group patients. Use a data-driven approach to unravel any heterogeneity in the Parkinson's phenotype in a well-characterised, population-based incidence cohort. 769 consecutive patients, with mean disease duration of 1.3 years, were assessed using a broad range of motor, cognitive and non-motor metrics. Multiple imputation was carried out using the chained equations approach to deal with missing data. We used an exploratory and then a confirmatory factor analysis to determine suitable domains to include within our cluster analysis. K-means cluster analysis of the factor scores and all the variables not loading into a factor was used to determine phenotypic subgroups. Our factor analysis found three important factors that were characterised by: psychological well-being features; non-tremor motor features, such as posture and rigidity; and cognitive features. Our subsequent five cluster model identified groups characterised by (1) mild motor and non-motor disease (25.4%), (2) poor posture and cognition (23.3%), (3) severe tremor (20.8%), (4) poor psychological well-being, RBD and sleep (18.9%), and (5) severe motor and non-motor disease with poor psychological well-being (11.7%). Our approach identified several Parkinson's phenotypic sub-groups driven by largely dopaminergic-resistant features (RBD, impaired cognition and posture, poor psychological well-being) that, in addition to dopaminergic-responsive motor features may be important for studying the aetiology, progression, and medication response of early Parkinson's.

Placental vascular complications in HIV-infected pregnant women: a case-control study

OpenAIRE

CANLORBE, Geoffroy

2012-01-01

Background: Data from international literature suggest a link between HIV infection and placental vascular complications during pregnancy. Current studies on the subject are conflicting.Objective: The aim of the study was to evaluate the incidence of placental vascular complications during pregnancy among HIV+ and HIV- patients.Study Design: It is a single-center case-control study comparing the rates of gestational hypertension, preeclampsia, eclampsia and vascular intrauterine growth retard...

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

Insecticide Exposure in Parkinsonism

National Research Council Canada - National Science Library

Bloomquist, Jeffrey

2003-01-01

Behavioral, neurochemical, and immunocytochemical studies are characterizing the possible role of insecticide exposure in the etiology of Parkinson's disease as it may relate to Gulf War Syndrome. Chlorpyrifos (CP) and/or permethrin (PM...

Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

International Nuclear Information System (INIS)

Vasconcellos, Luiz Felipe Rocha; Novis, Sergio A. Pereira; Rosso, Ana Lucia Z.; Moreira, Denise Madeira

2009-01-01

The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

Multiple modes of impulsivity in Parkinson's disease.

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Cristina Nombela

Full Text Available Cognitive problems are a major factor determining quality of life of patients with Parkinson's disease. These include deficits in inhibitory control, ranging from subclinical alterations in decision-making to severe impulse control disorders. Based on preclinical studies, we proposed that Parkinson's disease does not cause a unified disorder of inhibitory control, but rather a set of impulsivity factors with distinct psychological profiles, anatomy and pharmacology. We assessed a broad set of measures of the cognitive, behavioural and temperamental/trait aspects of impulsivity. Sixty adults, including 30 idiopathic Parkinson's disease patients (Hoehn and Yahr stage I-III and 30 healthy controls, completed a neuropsychological battery, objective behavioural measures and self-report questionnaires. Univariate analyses of variance confirmed group differences in nine out of eleven metrics. We then used factor analysis (principal components method to identify the structure of impulsivity in Parkinson's disease. Four principal factors were identified, consistent with four different mechanisms of impulsivity, explaining 60% of variance. The factors were related to (1 tests of response conflict, interference and self assessment of impulsive behaviours on the Barrett Impulsivity Scale, (2 tests of motor inhibitory control, and the self-report behavioural approach system, (3 time estimation and delay aversion, and (4 reflection in hypothetical scenarios including temporal discounting. The different test profiles of these four factors were consistent with human and comparative studies of the pharmacology and functional anatomy of impulsivity. Relationships between each factor and clinical and demographic features were examined by regression against factor loadings. Levodopa dose equivalent was associated only with factors (2 and (3. The results confirm that impulsivity is common in Parkinson's disease, even in the absence of impulse control disorders, and

Nilai Rerata Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio Vascular Pedicle-Thoracic Ratio Orang Dewasa Normal Indonesia Studi di RS dr. Cipto Mangunkusomo

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Rommy Zunera

2016-03-01

Full Text Available Vascular pedicle width (VPW adalah jarak tepi luar vena kava superior ke tepi luar arteri subklavia kiri. Pemeriksaan VPW di foto toraks bersifat non-invasif, cepat dan mudah untuk memprediksi hipervolemia.Penelitian ini bertujuan untuk mengetahui rerata nilai VPW orang dewasa normal Indonesia. VPW diukurdengan dua metode: pertama pengukuran VPW tunggal yang akurasinya terbatas di foto toraks digital karenarelatif tidak dipengaruhi faktor magnifikasi. Metode kedua untuk foto toraks nondigital yaitu pengukuranrasio:vascular pedicle-cardiac ratio (VPCR dan vascular pedicle-thoracic ratio (VPTR. Pengukuran serupadilakukan terhadap  topogram CT scan toraks AP terlentang dan CT scan toraks lalu dibandingkan akurasipengukuran di topogram dengan CT scan  toraks sebagai standar baku. Sampel terdiri atas 104 foto toraksPA subyek normal dan 103 CT scan  toraks subyek terpilih. Pada pemeriksaan toraks PA didapatkan rerata VPW 48,0±5,5mm, rerata VPCR 40,3±4,6%, dan rerata VPTR 17,2±1,7%. Pada pemeriksaan topogram CTscan didapatkan rerata VPW 50,3±6,2mm, rerata VPTR 45±5,1%, dan rerata VPTR 19,8±2,5%. Rerata VPWpada CT scan toraks 50,4±6,1mm. Pengukuran di foto toraks AP 10% lebih besar dibandingkan pada fototoraks PA dan pengukuranVPW di foto toraks terbukti memiliki akurasi  tinggi. Kata kunci: fototoraks, vascular pedicle width, vascular pedicle-cardiac ratio, vascular pedicle-thoracic ratio, hipervolemia.   The Mean Value of Vascular Pedicle Width, Vascular Pedicle-Cardiac Ratio,Vascular Pedicle-Thoracic Ratio of Normal Indonesian Adult Study In dr. Cipto Mangunkusomo Hospital Abstract Vascular pedicle width (VPW is the distance, from a perpendicular line at the takeoff point of the left subclavian artery off the aorta to the point at which the superior vena cava. Measurement of VPW on chestx-ray is relatively non-invasive, fast and easy technique as  hypervolemia predictor. The purpose of thisstudy is to know the mean VPW value of normal

The discriminating nature of dopamine transporter image in parkinsonism: the competency of dopaminergic transporter imaging in differential diagnosis of parkinsonism 123I-FP-CIT SPECT study

International Nuclear Information System (INIS)

Kim, Bom Sahn; Jang, Sung June; Eo, Jae Seon; Park, Eun Kyung; Kim, Yu Kyeong; Kim, Jong Min; Lee, Won Woo; Kim, Sang Eun

2007-01-01

The aim of this study was to evaluate the discriminating nature of 123 I-FP-CIT SPECT in patients with parkinsonism. 123 I-FP-CIT SPECT images acquired from the 18 normal controls; NC (60.4 ± 10.0 yr) and 237 patients with parkinsonism (65.9 ± 9.2 yr) were analyzed. From spatially normalized images, regional counts of the caudate, putamen, and occipital lobe were obtained using region of interest method. Binding potential (BP) was calculated with the ratio of specific to nonspecific binding activity at equilibrium. Additionally, the BP ratio of putamen to caudate (PCR) and asymmetric index (ASI) were measured. BPs of NC (3.37 ± 0.57, 3.10± 0.41, 3.23 ± 0.48 for caudate, putamen, whole striatum, respectively) had no significant difference with those of essential tremor; ET (3.31 ± 0.64, 3.06 ± 0.61, 3.14 ± 0.63) and Alzheimer's disease; AD (3.33 ± 0.60, 3.29 ± 0.79, 3.31 ± 0.70), but were higher than those of Parkinson's disease; PD (1.92 ± 0.74, 1.39 ±0.68, 1.64 ± 0.68), multiple system atrophy; MSA (2.36 ± 1.07, 2.16 ± 0.91, 2.26 ± 0.96), and dementia with Lewy body; DLB (1.95± 0.72, 1.64 ± 0.65, 1.79 ± 0.66)(ρ 123 I-FP-CIT SPECT was a good value in differential diagnosis of parkinsonism

Wolff-Parkinson-White Syndrome and Accessory Pathways

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... the American Heart Association Cardiology Patient Page Wolff-Parkinson-White Syndrome and Accessory Pathways James Kulig , Bruce ... rate, which can be dangerous. What is Wolff-Parkinson-White Syndrome? Wolff-Parkinson-White syndrome (WPW) is ...

Predictive risk factors for chronic low back pain in Parkinson's disease.

Science.gov (United States)

Ozturk, Erhan Arif; Kocer, Bilge Gonenli

2018-01-01

Although previous studies have reported that the prevalence of low back pain in Parkinson's disease was over 50% and low back pain was often classified as chronic, risk factors of chronic low back pain have not been previously investigated. The aim of this study was to determine the predictive risk factors of chronic low back pain in Parkinson's disease. One hundred and sixty-eight patients with Parkinson's disease and 179 controls were consecutively included in the study. Demographic data of the two groups and disease characteristics of Parkinson's disease patient group were recorded. Low back pain lasting for ≥3 months was evaluated as chronic. Firstly, the bivariate correlations were calculated between chronic low back pain and all possible risk factors. Then, a multivariate regression was used to evaluate the impact of the predictors of chronic low back pain. The frequency of chronic low back pain in Parkinson's disease patients and controls were 48.2% and 26.7%, respectively (p chronic low back pain in Parkinson's disease were general factors including age (odds ratio = 1.053, p = 0.032) and Hospital Anxiety and Depression Scale - Depression subscore (odds ratio = 1.218, p = 0.001), and Parkinson's disease-related factors including rigidity (odds ratio = 5.109, p = 0.002) and posture item scores (odds ratio = 5.019, p = 0.0001). The chronic low back pain affects approximately half of the patients with Parkinson's disease. Prevention of depression or treatment recommendations for managing depression, close monitoring of anti- parkinsonian medication to keep motor symptoms under control, and attempts to prevent, correct or reduce abnormal posture may help reduce the frequency of chronic low back pain in Parkinson's disease. Copyright © 2017 Elsevier B.V. All rights reserved.

Post-dengue parkinsonism

OpenAIRE

Azmin, Shahrul; Sahathevan, Ramesh; Suehazlyn, Zainudin; Law, Zhe Kang; Rabani, Remli; Nafisah, Wan Yahya; Tan, Hui Jan; Norlinah, Mohamed Ibrahim

2013-01-01

Background Dengue is a common illness in the tropics. Equally common are neurological complications that stem from dengue infection. However, to date, parkinsonism following dengue has not been reported in medical literature. Case presentation A previously well 18-year old man developed parkinsonism, in addition to other neurological symptoms following serologically confirmed dengue fever. Alternative etiologies were excluded by way of imaging and blood investigations. Conclusions The authors...

SPECT imaging of dopaminergic system: a preliminary study of nine patients with clinically uncertain Parkinsonism

International Nuclear Information System (INIS)

Dey, S. K.; Gopinath, G.; Buscombe, J. R.

2004-01-01

Parkinsonism is the result of various neuro degenerative disorders, the common and related causes are Parkinson's disease (PD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). In each of these three causes, there is degeneration of presynaptic neurons in corpus striatum. Nine patients having clinically uncertain parkinsonian symptoms undergone brain SPECT imaging using the tracer (I-123 Ioflupane) that binds to dopamine transporter (DaT) in the pre-synaptic nerve terminals in basal ganglia. There was significantly decreased tracer uptake in the tail (putamen) portion of basal ganglia in five patients confirming presence of presynaptic neuro degeneration and reported as parkinsonism. Three patients revealed normal tracer uptake with one equivocal result. DaT imaging can effectively confirm parkinsonism and discriminate from normal subjects as well as other clinical simulators like essential tremor and dopa-responsive dystonia where no neuro degeneration occur.(author)

Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson's disease.

Directory of Open Access Journals (Sweden)

Esther J Smits

Full Text Available OBJECTIVE: To assess whether standardized handwriting can provide quantitative measures to distinguish patients diagnosed with Parkinson's disease from age- and gender-matched healthy control participants. DESIGN: Exploratory study. Pen tip trajectories were recorded during circle, spiral and line drawing and repeated character 'elelelel' and sentence writing, performed by Parkinson patients and healthy control participants. Parkinson patients were tested after overnight withdrawal of anti-Parkinsonian medication. SETTING: University Medical Center Groningen, tertiary care, the Netherlands. PARTICIPANTS: Patients with Parkinson's disease (n = 10; mean age 69.0 years; 6 male and healthy controls (n = 10; mean age 68.1 years; 6 male. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Movement time and velocity to detect bradykinesia and the size of writing to detect micrographia. A rest recording to investigate the presence of a rest-tremor, by frequency analysis. RESULTS: Mean disease duration in the Parkinson group was 4.4 years and the patients were in modified Hoehn-Yahr stages 1-2.5. In general, Parkinson patients were slower than healthy control participants. Median time per repetition, median velocity and median acceleration of the sentence task and median velocity of the elel task differed significantly between Parkinson patients and healthy control participants (all p<0.0014. Parkinson patients also wrote smaller than healthy control participants and the width of the 'e' in the elel task was significantly smaller in Parkinson patients compared to healthy control participants (p<0.0014. A rest-tremor was detected in the three patients who were clinically assessed as having rest-tremor. CONCLUSIONS: This study shows that standardized handwriting can provide objective measures for bradykinesia, tremor and micrographia to distinguish Parkinson patients from healthy control participants.

Neuroimaging in pre-motor Parkinson's disease

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Thomas R. Barber

2017-01-01

Full Text Available The process of neurodegeneration in Parkinson's disease begins long before the onset of clinical motor symptoms, resulting in substantial cell loss by the time a diagnosis can be made. The period between the onset of neurodegeneration and the development of motoric disease would be the ideal time to intervene with disease modifying therapies. This pre-motor phase can last many years, but the lack of a specific clinical phenotype means that objective biomarkers are needed to reliably detect prodromal disease. In recent years, recognition that patients with REM sleep behaviour disorder (RBD are at particularly high risk of future parkinsonism has enabled the development of large prodromal cohorts in which to investigate novel biomarkers, and neuroimaging has generated some of the most promising results to date. Here we review investigations undertaken in RBD and other pre-clinical cohorts, including modalities that are well established in clinical Parkinson's as well as novel imaging methods. Techniques such as high resolution MRI of the substantia nigra and functional imaging of Parkinsonian brain networks have great potential to facilitate early diagnosis. Further longitudinal studies will establish their true value in quantifying prodromal neurodegeneration and predicting future Parkinson's.

Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

Directory of Open Access Journals (Sweden)

van der Vlugt Maureen J

2011-02-01

Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol.

Science.gov (United States)

van Norden, Anouk Gw; de Laat, Karlijn F; Gons, Rob Ar; van Uden, Inge Wm; van Dijk, Ewoud J; van Oudheusden, Lucas Jb; Esselink, Rianne Aj; Bloem, Bastiaan R; van Engelen, Baziel Gm; Zwarts, Machiel J; Tendolkar, Indira; Olde-Rikkert, Marcel G; van der Vlugt, Maureen J; Zwiers, Marcel P; Norris, David G; de Leeuw, Frank-Erik

2011-02-28

Cerebral small vessel disease (SVD) is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML) and the normal appearing white matter (NAWM). Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI) provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white matter in the transition from "normal" aging to cognitive and

Vitamin K status and vascular calcification: evidence from observational and clinical studies.

Science.gov (United States)

Shea, M Kyla; Holden, Rachel M

2012-03-01

Vascular calcification occurs when calcium accumulates in the intima (associated with atherosclerosis) and/or media layers of the vessel wall. Coronary artery calcification (CAC) reflects the calcium burden within the intima and media of the coronary arteries. In population-based studies, CAC independently predicts cardiovascular disease (CVD) and mortality. A preventive role for vitamin K in vascular calcification has been proposed based on its role in activating matrix Gla protein (MGP), a calcification inhibitor that is expressed in vascular tissue. Although animal and in vitro data support this role of vitamin K, overall data from human studies are inconsistent. The majority of population-based studies have relied on vitamin K intake to measure status. Phylloquinone is the primary dietary form of vitamin K and available supplementation trials, albeit limited, suggest phylloquinone supplementation is relevant to CAC. Yet observational studies have found higher dietary menaquinone, but not phylloquinone, to be associated with less calcification. Vascular calcification is highly prevalent in certain patient populations, especially in those with chronic kidney disease (CKD), and it is plausible vitamin K may contribute to reducing vascular calcification in patients at higher risk. Subclinical vitamin K deficiency has been reported in CKD patients, but studies linking vitamin K status to calcification outcomes in CKD are needed to clarify whether or not improving vitamin K status is associated with improved vascular health in CKD. This review summarizes the available evidence of vitamin K and vascular calcification in population-based studies and clinic-based studies, with a specific focus on CKD patients.

Dopamine transporter SPECT in patients with Parkinson's disease

Energy Technology Data Exchange (ETDEWEB)

Hamano, Tadanori; Tsuchida, Tatsuro; Hirayama, Mikio; Fujiyama, Jiro; Mutoh, Tatsuro; Yonekura, Yoshiharu; Kuriyama, Masaru [Fukui Medical Univ., Matsuoka (Japan)

2000-03-01

The major neuropathological feature in Parkinson's disease (PD) is severe degeneration of the dopamine (DA) neurons in the substantia nigra. Dopamine transporter (DAT) is an important protein in the regulation of DA neurotransmission. It has been reported that PD patients show a loss of DAT in striatum. We report here the findings of single photon emission computed tomography (SPECT) of the DAT with 2{beta}-carboxymethoxy-3{beta}-(4[{sup 123}I]iodophenyl)tropane ([{sup 123}I]{beta}-CIT) to investigate striatal DAT in 10 patients with PD, one patient with vascular parkinsonism (VP), and one patient with dystonia syndrome. Patients were evaluated using the Webster rating scale. Specific/nondisplaceable striatal binding ratio (V3'') was obtained in each case. In PD patients, the uptake of [{sup 123}I]{beta}-CIT was reduced, especially in the tail of putamen compared with caudate nucleus. Even in the early stage of PD, the uptake of {beta}-CIT was reduced not only in the severely affected side, but also in the mildly disturbed side of the brain. Putamen caudate ratio was generally low in PD patients. In VP patient, the uptake was reduced, but putamen caudate ratio was not decreased. V3'' values showed significant correlation with the severity of clinical symptoms such as self-care, facies, posture, gait, speech, and Hoehn-Yahr's stage. On the other hand, V3'' values were not significantly correlated with the degree of tremor, seborrhea, and duration of the illness. In conclusion, we found that SPECT of the [{sup 123}I]{beta}-CIT is a useful method for the diagnosis in the patients presenting parkinsonism, and for the clinico-physiological estimation of parkinsonian symptoms such as self-care, facies, posture, gait, and speech. (author)

Disordered axial movement in Parkinson's disease.

OpenAIRE

Steiger, M J; Thompson, P D; Marsden, C D

1996-01-01

Axial motor impairments are a common cause of disability in patients with Parkinson's disease, become more prominent with longer disease duration, and have been said to be less responsive to levodopa replacement therapy. The ability to turn in bed while lying supine before and after dopaminergic stimulation was studied in a group of 36 patients with Parkinson's disease; 23 were in Hoehn and Yahr stages 3-5 when "off", and 13 were in stages 1-2. Turning was also compared with postural stabilit...

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, ...

High prevalence of Helicobacter pylori infection in Malaysian Parkinson's disease patients

Directory of Open Access Journals (Sweden)

Nafisah WY

2013-11-01

Full Text Available WY Nafisah,1 A Hamdi Najman,1 R Hamizah,1 S Azmin,1 R Rabani,1 SA Shah,2 MI Norlinah11Department of Medicine, 2Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MalaysiaBackground: Studies have reported a higher prevalence of Helicobacter pylori (H. pylori infection in Parkinson's disease.Objectives: To determine the frequency of H. pylori in patients with Parkinson's disease compared to controls and its effect on symptom severity and quality of life.Methods: A cross-sectional comparative study involving 29 Parkinson's disease patients and 23 controls. The 13C-urea breath test was used to diagnose H. pylori. Symptom severity and quality of life were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS and 39-item Parkinson's Disease Questionnaire (PDQ-39, respectively.Results: The frequency of H. pylori infection was 48.3% in the Parkinson's disease group and 21.7% in controls (P=0.048. This became more significant (P=0.012 when we excluded relatives of H. pylori-positive patients from the control group. There was no association between Hoehn and Yahr stages, UPDRS and PDQ-39 scores, and H. pylori.Conclusion: H. pylori infection is more prevalent in the Malaysian Parkinson's disease population compared to controls (48.3% versus 21.7%. However, symptom severity and quality of life was not related to H. pylori infection.Keywords: Parkinson's disease, Helicobacter pylori, prevalence, 13C-urea breath test

Correlates of constipation in people with Parkinson's.

Science.gov (United States)

Gage, H; Kaye, J; Kimber, A; Storey, L; Egan, M; Qiao, Y; Trend, P

2011-02-01

To investigate clinical, demographic and dietary factors associated with constipation in a sample of community dwelling people with Parkinson's disease, recruited through a specialist outpatient clinic. Partners/carers provided a convenience control group. Participants completed a baseline questionnaire (background information, diet and exercise, activities of daily living: mobility and manual dexterity, health-related quality of life (SF-12), stool frequency and characteristics, extent of concern due to constipation, laxative taking), and a four-week stool diary. The Rome criterion was used to determine constipation status. Multiple regression methods were used to explore the correlates of constipation. Baseline data were provided by 121 people with Parkinson's, (54 controls), of whom 73% (25%) met the Rome criterion. Prospective diary data from 106 people with Parkinson's (43 controls) showed lower proportions: 35% (7%) meeting the Rome criterion. Among all study subjects, i.e. Parkinson's patients and controls taken together, the presence of constipation is predicted by having Parkinson's disease (p = .003; odds ratio 4.80, 95% CI 1.64-14.04) and mobility score (p = .04; odds ratio 1.15, 95% CI 1.01-1.31), but not by dietary factors. Amongst people with Parkinson's constipation is predicted by number of medications (p = .027). Laxative taking masks constipation, and is significantly associated with wearing protection against bowel incontinence (p = .009; odds ratio 4.80, 95% CI: 1.48-15.52). Constipation is disease-related, not a lifestyle factor. More research is needed on optimal management and laxative use. Copyright © 2010 Elsevier Ltd. All rights reserved.

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...

Neuroprotective properties of curcumin in toxin-base animal models of Parkinson?s disease: a systematic experiment literatures review

OpenAIRE

Wang, Xin-Shi; Zhang, Zeng-Rui; Zhang, Man-Man; Sun, Miao-Xuan; Wang, Wen-Wen; Xie, Cheng-Long

2017-01-01

Background Curcumin (diferuloylmethane), a polyphenol extracted from the plant Curcuma longa, is widely used in Southeast Asia, China and India in food preparation and for medicinal purposes. Meanwhile, the neuroprotective actions of curcumin have been documented for experimental therapy in Parkinson?s disease (PD). Methods In this study, we used a systematic review to comprehensively assess the efficacy of curcumin in experimental PD. Using electronic and manual search for the literatures, w...

Incidence and risk factors of Parkinson's disease in The Netherlands.

NARCIS (Netherlands)

Hofman, A.; Collette, H.J.A.; Bartelds, A.I.M.

1989-01-01

The incidence and some risk factors of Parkinson's disease were investigated in a study performed in The Netherlands. The study was based on a disease register of the Sentinel Stations, which provide a complete ascertainment of new patients with Parkinson's disease in 60 general practices in The

Excess amounts of 3-iodo-l-tyrosine induce Parkinson-like features in experimental approaches of Parkinsonism.

Science.gov (United States)

Fernández-Espejo, Emilio; Bis-Humbert, Cristian

2018-06-06

3-iodo-l-tyrosine might play a role in Parkinson's disease since this molecule is able, at high concentration, to inhibit tyrosine-hydroxylase activity, the rate-limiting enzyme in dopamine biosynthesis. The possible Parkinson-like effects of 3-iodo-l-tyrosine were tested on three experimental approaches in mice: cultured substantia nigra neurons, the enteric nervous system of the jejunum after intra-peritoneal infusions, and the nigrostriatal system following unilateral intrabrain injections. 3-iodo-l-tyrosine, a physiological molecule, was used at concentrations higher than its serum levels in humans. Parkinson-like signs were evaluated through abnormal aggregation of α-synuclein and tyrosine-hydroxylase, loss of tyrosine-hydroxylase-expressing and striatum-projecting neurons and fibers, reduced tyrosine-hydroxylase density, and Parkinson-like motor and non-motor deficits. The retrograde tracer FluoroGold was used in the brain model. The findings revealed that excess amounts of 3-iodo-l-tyrosine induce Parkinson-like effects in the three experimental approaches. Thus, culture neurons of substantia nigra show, after 3-iodo-l-tyrosine exposure, intracytoplasmic inclusions that express α-synuclein and tyrosine-hydroxylase. Intra-peritoneal infusions of 3-iodo-l-tyrosine cause, in the long-term, α-synuclein aggregation, thicker α-synuclein-positive fibers, and loss of tyrosine-hydroxylase-positive cells and fibers in intramural plexuses and ganglia of the jejunum. Infusion of 3-iodo-l-tyrosine into the left dorsal striata of mice damages the nigrostriatal system, as revealed through lower striatal tyrosine-hydroxylase density, reduced number of tyrosine-hydroxylase-expressing and striatum-projecting neurons in the left substantia nigra, as well as the emergence of Parkinson-like behavioral deficits such as akinesia, bradykinesia, motor disbalance, and locomotion directional bias. In conclusion, excess amounts of 3-iodo-l-tyrosine induce Parkinson-like features in

Bisphenol A glucuronidation in patients with Parkinson's disease.

Science.gov (United States)

Landolfi, Annamaria; Troisi, Jacopo; Savanelli, Maria Cristina; Vitale, Carmine; Barone, Paolo; Amboni, Marianna

2017-12-01

Bisphenol A (BPA) is a widely distributed estrogen-mimetic molecule, with well-established effects on the dopaminergic system. It can be found in canned food, dental sealants, thermal paper, etc. BPA undergoes liver conjugation with glucuronic acid and is subsequently excreted in the urine. In the present study we quantified the concentration of free and conjugated Bisphenol A in blood of patients affected by Parkinson Disease, using their spouses as controls. An interview was performed to determine possible confounders in BPA exposure. Free and conjugated BPA were quantified by gas chromatography coupled with mass spectrometry. Parkinson's Disease patients carried a statistically significant lower amount of conjugated Bisphenol A compared to controls. The two populations were mostly homogeneous in terms of exposure to possible Bisphenol A sources. The only exceptions were exposure to canned tuna and canned tomatoes PD patients consumed significantly more of both (pBisphenol A glucuronidation was found after stratification by typology of anti-Parkinson's drug taken and after conversion to the Levodopa Equivalent Daily Dose. BPA glucuronidation was decreased in patients with Parkinson disease. The possible unique mechanisms underlying Bisphenol A metabolism in PD patients deserve further elucidation. Moreover, further study is needed to assess a possible BPA role in Parkinson's Disease pathogenesis, due to its documented dopaminergic toxicity. Copyright © 2017 Elsevier B.V. All rights reserved.

Postural & striatal deformities in Parkinson`s disease: Are these rare?

Directory of Open Access Journals (Sweden)

Sanjay Pandey

2016-01-01

Full Text Available Parkinson`s disease (PD is the most common neurodegenerative disease and is characterized by tremor, rigidity and akinesia. Diagnosis is clinical in the majority of the patients. Patients with PD may have stooped posture but some of them develop different types of postural and striatal deformities. Usually these deformities are more common in atypical parkinsonian disorders such as progressive supranuclear palsy and multisystem atrophy. But in many studies it has been highlighted that these may also be present in approximately one third of PD patients leading to severe disability. These include antecollis or dropped head, camptocormia, p0 isa syndrome, scoliosis, striatal hands and striatal toes. The pathogenesis of these deformities is a complex combination of central and peripheral influences such as rigidity, dystonia and degenerative skeletal changes. Duration of parkinsonism symptoms is an important risk factor and in majority of the patients these deformities are seen in advanced statge of the disease. The patients with such symptoms may initially respond to dopaminergic medications but if not intervened they may become fixed and difficult to treat. Pain and restriction of movement are most common clinical manifestations and these may mimick symptoms of musculoskeletal disorders like rheumatoid arthritis. Early diagnosis is important as the patients may respond to adjustment in dopaminergic medications. Recent advances such as deep brain stimulation (DBS and ultrasound guided botulinum toxin injection are helpful in management of these deformities in patients with PD.

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

Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Vasconcellos, Luiz Felipe Rocha [1Hospital dos Servidores do Estado, Rio de Janeiro RJ (Brazil)], e-mail: luizneurol@terra.com.br; Novis, Sergio A. Pereira; Rosso, Ana Lucia Z. [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil); Moreira, Denise Madeira [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Neurologia Deolindo Couto; Leite, Ana Claudia C.B. [Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil)

2009-03-15

The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

Vascular Function at Baseline in the Hemodialysis Fistula Maturation Study

OpenAIRE

Dember, Laura M.; Imrey, Peter B.; Duess, Mai?Ann; Hamburg, Naomi M.; Larive, Brett; Radeva, Milena; Himmelfarb, Jonathan; Kraiss, Larry W.; Kusek, John W.; Roy?Chaudhury, Prabir; Terry, Christi M.; Vazquez, Miguel A.; Vongpatanasin, Wanpen; Beck, Gerald J.; Vita, Joseph A.

2016-01-01

Background End?stage renal disease is accompanied by functional and structural vascular abnormalities. The objective of this study was to characterize vascular function in a large cohort of patients with end?stage renal disease, using noninvasive physiological measurements, and to correlate function with demographic and clinical factors. Methods and Results We analyzed cross?sectional baseline data from the Hemodialysis Fistula Maturation Study, a multicenter prospective observational cohort ...

Effect and Mechanism of Chinese Herbal Medicine on Parkinson's Disease.

Science.gov (United States)

Zeng, Bai-Yun

2017-01-01

Parkinson's disease is a progressive neurodegenerative disorder. Although both genetic and environmental factors are implicated in the development of Parkinson's disease, the cause of the disease is still unclear. So far conventional treatments to Parkinson's are symptomatic relief and focused mainly on motor symptoms. Chinese herbal medicine has been used to treat many conditions in China, Korea, Japan, and many Southeast Asian countries for 1000 years. During past a few decades, Chinese herbal medicine has gained wider and increasing acceptance within both public and medical profession due to its effectiveness on many conditions in western countries. In this chapter, mechanisms of action of many Chinese herbal compounds/extracts and Chinese herb formulas on the models of Parkinson's were reviewed. Further, reports of effectiveness of Chinese herb formulas on patients with Parkinson's were summarized. It was shown that both Chinese herbal compounds/extracts and herb formulas have either specific target mechanisms of action or multitargets mechanisms of action, as antioxidant, antiinflammatory, and antiapoptosis agents. Clinical studies showed that Chinese herb formulas as an adjunct improved both motor and nonmotor symptoms, and reduced dose of dopaminergic drugs and occurrence of dyskinesia. The evidence from the studies suggests that Chinese herb medicine has potential, acting as neuroprotective to slow down the progression of Parkinson's, and it is able to simultaneously treat both motor and nonmotor symptoms of Parkinson's. More studies are needed to explore the new compounds/extracts derived from Chinese herbs, in particular, their mechanisms of action. It is hopeful that new drugs developed from Chinese herb compounds/extracts and Chinese herb formulas will lead to better and complimentary therapy to PD. © 2017 Elsevier Inc. All rights reserved.

Coffee consumption, gender, and Parkinson's disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen.

Science.gov (United States)

Ascherio, Alberto; Weisskopf, Marc G; O'Reilly, Eilis J; McCullough, Marjorie L; Calle, Eugenia E; Rodriguez, Carmen; Thun, Michael J

2004-11-15

Caffeine consumption is associated with a reduced risk of Parkinson's disease in men but not in women. This gender difference may be due to an interaction between caffeine and use of postmenopausal estrogens. The authors prospectively assessed the relation between coffee consumption and Parkinson's disease mortality among participants in the Cancer Prevention Study II, a cohort of over 1 million people enrolled in 1982. Causes of deaths were ascertained through death certificates from January 1, 1989, through 1998. Parkinson's disease was listed as a cause of death in 909 men and 340 women. After adjustment for age, smoking, and alcohol intake, coffee consumption was inversely associated with Parkinson's disease mortality in men (p(trend) = 0.01) but not in women (p = 0.6). In women, this association was dependent on postmenopausal estrogen use; the relative risk for women drinking 4 or more cups (600 ml) of coffee per day compared with nondrinkers was 0.47 (95% confidence interval: 0.27, 0.80; p = 0.006) among never users and 1.31 (95% confidence interval: 0.75, 2.30; p = 0.34) among users. These results suggest that caffeine reduces the risk of Parkinson's disease but that this hypothetical beneficial effect may be prevented by use of estrogen replacement therapy.

Diet and Nutrition (Parkinson's Disease)

Science.gov (United States)

... Living With Parkinson's › Managing Parkinson's › Diet & Nutrition Diet & Nutrition 1. Maintain Health 2. Ease PD Symptoms 3. ... your team Seek reliable information about diet and nutrition from your medical team and local resources. Please ...

Effects of movement imitation training in Parkinson's disease: A virtual reality pilot study.

Science.gov (United States)

Robles-García, Verónica; Corral-Bergantiños, Yoanna; Espinosa, Nelson; García-Sancho, Carlos; Sanmartín, Gabriel; Flores, Julián; Cudeiro, Javier; Arias, Pablo

2016-05-01

Hypometria is a clinical motor sign in Parkinson's disease. Its origin likely emerges from basal ganglia dysfunction, leading to an impaired control of inhibitory intracortical motor circuits. Some neurorehabilitation approaches include movement imitation training; besides the effects of motor practice, there might be a benefit due to observation and imitation of un-altered movement patterns. In this sense, virtual reality facilitates the process by customizing motor-patterns to be observed and imitated. To evaluate the effect of a motor-imitation therapy focused on hypometria in Parkinson's disease using virtual reality. We carried out a randomized controlled pilot-study. Sixteen patients were randomly assigned in experimental and control groups. Groups underwent 4-weeks of training based on finger-tapping with the dominant hand, in which imitation was the differential factor (only the experimental group imitated). We evaluated self-paced movement features and cortico-spinal excitability (recruitment curves and silent periods in both hemispheres) before, immediately after, and two weeks after the training period. Movement amplitude increased significantly after the therapy in the experimental group for the trained and un-trained hands. Motor thresholds and silent periods evaluated with transcranial magnetic stimulation were differently modified by training in the two groups; although the changes in the input-output recruitment were similar. This pilot study suggests that movement imitation therapy enhances the effect of motor practice in patients with Parkinson's disease; imitation-training might be helpful for reducing hypometria in these patients. These results must be clarified in future larger trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development of Parkinsonism following exposure to aripiprazole: two case reports

Directory of Open Access Journals (Sweden)

Lua Lannah L

2009-03-01

Full Text Available Abstract Introduction Aripiprazole is a novel atypical neuroleptic used in the treatment of psychosis. A few recent studies have demonstrated an association between the use of aripiprazole and an exacerbation of Parkinsonism, although this relationship is poorly defined. To our knowledge, this is the first case series describing an onset of Parkinsonism in patients without prior history of Parkinson's disease following aripiprazole treatment. Case presentation We describe two patients, ages 69 and 58, who developed cardinal features of Parkinson's disease shortly after receiving aripiprazole. Both patients were male veterans with a history of bipolar disorder treated with aripiprazole. They initially presented with asymmetric arm tremor, and subsequently developed rigidity, bradykinesia, and postural instability. On examination, they were found to be at a Hoehn and Yahr stage of 2.5 for their Parkinsonism. Conclusions While aripiprazole has been associated with infrequent extrapyramidal side effects, these cases raise concerns that its chronic exposure may lead to D2 receptor hypersensitivity and/or dysfunction and subsequent development of a syndrome mimicking idiopathic Parkinson's disease. With the available atypical neuroleptics becoming widely used in treating psychotic symptoms associated with a broad range of disorders, we advise closer monitoring due to their potential for inducing Parkinsonism.

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.)

The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson`s disease

Energy Technology Data Exchange (ETDEWEB)

Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo [Iwate Medical Univ., Morioka (Japan). School of Medicine

1998-12-01

Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO{sub 2}) were measured using the steady-state {sup 15}O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson`s disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean{+-}SD, 51.8{+-}3.7) and the duration of the illness ranged from 10 to 48 months (mean{+-}SD, 28.8{+-}15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson`s Disease Rating Scale decreased from 35.1 (SD{+-}11.3) to 25.7 (SD{+-}11.6). The cognitive function assessed by Hasegawa`s dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO{sub 2} decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO{sub 2} significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson`s disease. (author)

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

What James Parkinson Really Thought was Behind Parkinson's Disease

OpenAIRE

Dr. Lawrence Broxmeyer, MD

2017-01-01

In May, 2017, a Norwegian study done by Berstad and Berstad threw its support behind revitalizing of the hypothesis that with regard to Parkinson's disease (PD), the preponderance of convincing evidence points to a chronic infectious cause – not viral and most likely of the family Actinomycetales of which tuberculosis and the mycobacteria are premier members. The Berstads concluded that in accordance with such thoughts and despite the diagnostic challenges ahead, that further studies in human...

Effectiveness of acupuncture and bee venom acupuncture in idiopathic Parkinson's disease.

Science.gov (United States)

Cho, Seung-Yeon; Shim, So-Ra; Rhee, Hak Young; Park, Hi-Joon; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Cho, Ki-Ho; Park, Seong-Uk

2012-09-01

This study aimed to explore the effectiveness of both acupuncture and bee venom acupuncture as adjuvant therapies for idiopathic Parkinson's disease. We recruited 43 adults with idiopathic Parkinson's disease who had been on a stable dose of antiparkinsonian medication for at least 1 month. They were randomly assigned to 1 of 3 groups: acupuncture, bee venom acupuncture, or control. All participants were assessed using the Unified Parkinson's Disease Rating Scale, the Parkinson's Disease Quality of Life Questionnaire, the Beck Depression Inventory, the Berg Balance Scale, and the time and number of steps required to walk 30 m. Treatment groups underwent stimulation of 10 acupuncture points using acupuncture or bee venom acupuncture twice a week for 8 weeks. The initial assessment was repeated at the completion of treatment. The control group did not receive any treatment. Participants in the bee venom acupuncture group showed significant improvement on the Unified Parkinson's Disease Rating Scale (total score, as well as parts II and III individually), the Berg Balance Scale, and the 30 m walking time. When compared to the control group, the bee venom acupuncture group experienced significantly greater improvement on the Unified Parkinson's Disease Rating Scale. In the acupuncture group, the Unified Parkinson's Disease Rating Scale (part III and total scores) and the Beck Depression Inventory showed significant improvement. The control group showed no significant changes in any outcome after 8 weeks. In this pilot study, both acupuncture and bee venom acupuncture showed promising results as adjuvant therapies for Parkinson's disease. Copyright © 2012 Elsevier Ltd. All rights reserved.

Treatment of erectile dysfunction with sildenafil citrate (Viagra) in parkinsonism due to Parkinson's disease or multiple system atrophy with observations on orthostatic hypotension

Science.gov (United States)

Hussain, I; Brady, C; Swinn, M; Mathias, C; Fowler, C

2001-01-01

OBJECTIVES—To assess the efficacy and safety of sildenafil citrate (Viagra) in men with erectile dysfunction and parkinsonism due either to Parkinson's disease or multiple system atrophy.
METHODS—Twenty four patients with erectile disease were recruited, 12 with Parkinson's disease and 12 with multiple system atrophy, into a randomised, double blind, placebo controlled, crossover study of sildenafil citrate. The starting dose was 50 mg active or placebo medication with the opportunity for dose adjustment depending on efficacy and tolerability. The international index of erectile function questionnaire (IIEF) was used to assess treatment efficacy and a quality of life questionnaire to assess the effect of treatment on sex life and whole life. Criteria for entry included a definite neurological diagnosis and a standing systolic blood pressure of 90-180 mm Hg and diastolic blood pressure of 50-110 mm Hg, on treatment if necessary. Blood pressure was taken at randomisation (visit 2) and crossover (visit 5) lying, sitting, and standing, before and 1 hour after taking the study medication in hospital.
RESULTS—Sidenafil citrate was efficacious in men with parkinsonism with a significant improvement, as demonstrated in questionnaire responses, in ability to achieve and maintain an erection and improvement in quality of sex life. In Parkinson's disease there was minimal change in blood pressure between active and placebo medication. In multiple system atrophy, six patients were studied before recruitment was stopped because three men showed a severe drop in blood pressure 1 hour after taking the active medication. Two were already known to have orthostatic hypotension and were receiving treatment with ephedrine and midodrine but the third had asymptomatic hypotension. However, the blood pressures in all three had been within the inclusion criterion for the study protocol. Despite a significant postural fall in blood pressure after sildenafil, all patients with

Electrochemical studies of ropinirole, an anti-Parkinson's disease drug

Indian Academy of Sciences (India)

The oxidation behaviour of a potent anti-Parkinson's disease drug ropinirole hydrochloride was investigated over a wide pH range in aqueous solution at glassy carbon electrode using cyclic and square-wave voltammetry. The oxidation of drug is a pH dependent irreversible process and occurs in two steps.

New Perspective on Parkinsonism in Frontotemporal Lobar Degeneration

Directory of Open Access Journals (Sweden)

Hee Kyung Park

2013-04-01

Full Text Available Frontotemporal dementia (FTD is the second most common type of presenile dementia. Three clinical prototypes have been defined; behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Progressive supranuclear palsy, corticobasal degeneration, and motor neuron disease may possess clinical and pathological characteristics that overlap with FTD, and it is possible that they may all belong to the same clinicopathological spectrum. Frontotemporal lobar degeneration (FTLD is a clinicopathological syndrome that encompasses a heterogenous group of neurodegenerative disorders. Owing to the advancement in the field of molecular genetics, diagnostic imaging, and pathology, FTLD has been the focus of great interest. Nevertheless, parkinsonism in FTLD has received relatively less attention. Parkinsonism is found in approximately 20–30% of patients in FTLD. Furthermore, parkinsonism can be seen in all FTLD subtypes, and some patients with familial and sporadic FTLD can present with prominent parkinsonism. Therefore, there is a need to understand parkinsonism in FTLD in order to obtain a better understanding of the disease. With regard to the clinical characteristics, the akinetic rigid type of parkinsonism has predominantly been described. Parkinsonism is frequently observed in familial FTD, more specifically, in FTD with parkinsonism linked to chromosome 17q (FTDP-17. The genes associated with parkinsonism are microtubule associated protein tau (MAPT, progranulin (GRN or PGRN, and chromosome 9 open reading frame 72 (C9ORF72 repeat expansion. The neural substrate of parkinsonism remains to be unveiled. Dopamine transporter (DAT imaging revealed decreased uptake of DAT, and imaging findings indicated atrophic changes of the basal ganglia. Parkinsonism can be an important feature in FTLD and, therefore, increased attention is needed on the subject.

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.

The role of rasagiline in the treatment of Parkinson?s disease

OpenAIRE

Leegwater-Kim, Julie; Bortan, Elena

2010-01-01

Parkinson?s disease (PD) is the second most common neurodegenerative disorder, affecting 1% to 2% of people older than 60 years. Treatment of PD consists of symptomatic therapies while neuroprotective strategies have remained elusive. Rasagiline is a novel, potent, and irreversible monoamine oxidase type B (MAO-B) inhibitor which has been approved for treatment of PD. Rasagiline inhibits MAO-B more potently than selegiline and has the advantage of once-daily dosing. In several large, randomiz...

Medium-to-high prevalence of screening-detected parkinsonism in the urban area of Tehran, Iran: data from a community-based door-to-door study

Directory of Open Access Journals (Sweden)

Fereshtehnejad SM

2015-02-01

Full Text Available Seyed-Mohammad Fereshtehnejad,1,2 Mahdiyeh Shafieesabet,3 Arash Rahmani,4 Ahmad Delbari,1,5 Johan Lökk1,6 1Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS, Karolinska Institutet, Stockholm, Sweden; 2Firoozgar Clinical Research Development Center (FCRDC, Firoozgar Hospital, 3Medical Student Research Committee (MSRC, Faculty of Medicine, 4Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran; 5Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran; 6Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden Introduction: Parkinsonism occurs in all ethnic groups worldwide; however, there are wide variations in the prevalence rates reported from different countries, even for neighboring regions. The huge socioeconomic burden of parkinsonism necessitates the need for prevalence studies in each country. So far, there is neither data registry nor prevalence information on parkinsonism in the Iranian population. The aim of our study was to estimate the prevalence rate of probable parkinsonism in a huge urban area in Iran, Tehran using a community-based door-to-door survey.Materials and methods: We used a random multistage sampling of the households within the network of health centers consisting of 374 subunits in all 22 districts throughout the entire urban area of Tehran. Overall, 20,621 individuals answered the baseline checklist and screening questionnaire and data from 19,500 persons aged ≥30 years were entered in the final analysis. Health care professionals used a new six-item screening questionnaire for parkinsonism, which has been previously shown to have a high validity and diagnostic value in the same population.Results: A total of 157 cases were screened for parkinsonism using the validated six-item questionnaire. After

Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.

Science.gov (United States)

Lotan, Itay; Treves, Therese A; Roditi, Yaniv; Djaldetti, Ruth

2014-01-01

The use of cannabis as a therapeutic agent for various medical conditions has been well documented. However, clinical trials in patients with Parkinson disease (PD) have yielded conflicting results. The aim of the present open-label observational study was to assess the clinical effect of cannabis on motor and non-motor symptoms of PD. Twenty-two patients with PD attending the motor disorder clinic of a tertiary medical center in 2011 to 2012 were evaluated at baseline and 30 minutes after smoking cannabis using the following battery: Unified Parkinson Disease Rating Scale, visual analog scale, present pain intensity scale, Short-Form McGill Pain Questionnaire, as well as Medical Cannabis Survey National Drug and Alcohol Research Center Questionnaire. Mean (SD) total score on the motor Unified Parkinson Disease Rating Scale score improved significantly from 33.1 (13.8) at baseline to 23.2 (10.5) after cannabis consumption (t = 5.9; P effects of the drug were observed. The study suggests that cannabis might have a place in the therapeutic armamentarium of PD. Larger, controlled studies are needed to verify the results.

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

Science.gov (United States)

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

Everyday functioning of people with Parkinson's disease and impairments in executive function: a qualitative investigation.

Science.gov (United States)

Kudlicka, Aleksandra; Hindle, John V; Spencer, Laura E; Clare, Linda

2017-06-09

Executive function is the key area of cognitive impairment in Parkinson's disease. This study investigated how cognitive difficulties impact on everyday life of people with Parkinson's disease and their carers, and whether they explicitly mention executive-type difficulties. Semistructured interviews with 11 people with Parkinson's disease and six carers were analyzed thematically. People with Parkinson's disease performed within the normal range on cognitive screening tests, but all had abnormal scores on tests of executive function. Despite relatively mild executive deficits and no global cognitive impairment, participants described executive-type difficulties as well as a range of problems in other cognitive domains, such as memory, processing speed and apathy. Cognitive difficulties had a far-reaching impact on everyday life and their significance depended on personal circumstances, such as the level of responsibilities of the person with Parkinson's disease and the extent of available support. By presenting subjective accounts of living with Parkinson's disease and cognitive difficulties, this study improves our understanding of how the observed level of cognitive impairment translates into everyday functioning. The study results have implications for recognizing cognitive difficulties and for planning support for people with Parkinson's disease and their families, and can help identify ways of promoting effective self-management. Implications for rehabilitation Treatment of Parkinson's disease tends to focus on the movement disorder, meaning that cognitive difficulties and their impact can be overlooked. Participants in this study had only relatively mild executive deficits but described a range of cognitive problems, including executive-type difficulties. Cognitive difficulties have an emotional impact and can cause a range of challenges in everyday life, adding to the burden of physical symptoms of Parkinson's disease. Results of this study provide insights

Introducing a multifaceted exercise intervention particular to older adults diagnosed with Parkinson's disease: a preliminary study.

Science.gov (United States)

Peacock, Corey A; Sanders, Gabriel J; Wilson, Kayla A; Fickes-Ryan, Emily J; Corbett, Duane B; von Carlowitz, Kyle-Patrick A; Ridgel, Angela L

2014-08-01

With a substantial increase in diagnosed Parkinson's disease, it is of great importance to examine tolerance and physical measures of evolving exercise interventions. Of particular importance, a multifaceted exercise intervention combining active-assisted cycling and resistance training to older adults diagnosed with Parkinson's disease is being assessed. Fourteen older adults diagnosed with Parkinson's disease and ten healthy older adults (67.5 ± 7.9 years of age) engaged in an 8-week, 24-session, multifaceted exercise protocol. The protocol consisted of both active-assisted cycling and resistance training. Tolerance was measured, as well as multiple indicators of health-related physical fitness. These indicators examined improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility. Twenty-two older adults and older adults diagnosed with Parkinson's disease tolerated the intervention by completing all 24 sessions. Repeated-measures analysis of variance demonstrated significant (P ≤ 0.003) improvements in cardiovascular performance, muscular strength, muscular endurance, and flexibility for both groups of individuals. The multifaceted intervention is the first to combine both active-assisted cycling and resistance training. The older adult and the older adult diagnosed with Parkinson's disease exhibited both tolerance and health-related improvements in physical fitness following the intervention.

Evaluation of Parkinson's disease using magnetic resonance imaging

International Nuclear Information System (INIS)

Vedolin, Leonardo; Marchiori, Edson; Rieder, Carlos

2004-01-01

The objective of this study was to evaluate the magnetic resonance imaging findings in patients with Parkinson's disease. In the period from October 1999 to October 2002, 42 patients with parkinsonism were investigated using a 1.5 T MR equipment. Patients were divided into two groups: patients with Parkinson's disease (n = 26) and patients with atypical Parkinsonian syndrome (n = 16). The results were compared with a control group (n = 18). The following variables were evaluated: thickness of the mesencephalon compact pars, hypointense signal in the putamen, degree of brain atrophy, lesions in the mesencephalon, lesions in the white matter, and the presence of lesions in the posterior-lateral edge of the putamen. Statistical data analysis was carried out using the SPSS program. Results: The mean age was 58.2 years for the Parkinson's disease and control groups, and 60.5 years for the atypical Parkinsonian syndrome group. Patients with Parkinson's disease and atypical Parkinsonian syndromes presented decreased thickness of the compact pars and a higher degree of signal hypointensity in the putamen. Cerebral atrophy was more prominent in the patients with atypical Parkinsonian syndrome. Lesions in mesencephalon and white matter were similar in both groups. The frequency of hyperintense signal in the posterior-lateral edge of the putamen was low within the studied population, although that could suggest multiple-system atrophy. Magnetic resonance imaging allows the detection of brain morphological changes that may help in the diagnosis of Parkinsonian syndromes. (author)

Control effects of stimulus paradigms on characteristic firings of parkinsonism

Science.gov (United States)

Zhang, Honghui; Wang, Qingyun; Chen, Guanrong

2014-09-01

Experimental studies have shown that neuron population located in the basal ganglia of parkinsonian primates can exhibit characteristic firings with certain firing rates differing from normal brain activities. Motivated by recent experimental findings, we investigate the effects of various stimulation paradigms on the firing rates of parkinsonism based on the proposed dynamical models. Our results show that the closed-loop deep brain stimulation is superior in ameliorating the firing behaviors of the parkinsonism, and other control strategies have similar effects according to the observation of electrophysiological experiments. In addition, in conformity to physiological experiments, we found that there exists optimal delay of input in the closed-loop GPtrain|M1 paradigm, where more normal behaviors can be obtained. More interestingly, we observed that W-shaped curves of the firing rates always appear as stimulus delay varies. We furthermore verify the robustness of the obtained results by studying three pallidal discharge rates of the parkinsonism based on the conductance-based model, as well as the integrate-and-fire-or-burst model. Finally, we show that short-term plasticity can improve the firing rates and optimize the control effects on parkinsonism. Our conclusions may give more theoretical insight into Parkinson's disease studies.

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

Effect of Low Concentrations of Apomorphine on Parkinsonism in a Randomized, Placebo-Controlled, Crossover Study

Science.gov (United States)

Gunzler, Steven A.; Koudelka, Caroline; Carlson, Nichole E.; Pavel, Misha; Nutt, John G.

2011-01-01

Objective To determine whether low concentrations of a dopamine agonist worsen parkinsonism, which would suggest that activation of presynaptic dopamine autoreceptors causes a super-off state. Design Randomized, double-blind, placebo-controlled, crossover clinical trial. Setting Academic movement disorders center. Patients Patients with Parkinson disease and motor fluctuations. Intervention Fourteen patients with Parkinson disease and motor fluctuations were randomized to receive 1 of 6 possible sequences of placebo, low-dose (sub-threshold) apomorphine hydrochloride, and high-dose (threshold to suprathreshold) apomorphine hydrochloride infusions. Subthreshold doses of apomorphine hydrochloride (12.5 μg/kg/h every 2 hours and 25 μg/kg/h every 2 hours), threshold to suprathreshold doses of apomorphine hydrochloride (50 μg/kg/h every 2 hours and 100 μg/kg/h every 2 hours), and placebo were infused for 4 hours daily for 3 consecutive days. Main Outcome Measures Finger and foot tapping rates. Results There was no decline in finger or foot tapping rates during the low-dose apomorphine hydrochloride infusions relative to placebo. The high-dose infusions increased foot tapping (P<.001) and trended toward increasing finger tapping compared with placebo infusions. Conclusions Subthreshold concentrations of apomorphine did not worsen parkinsonism, suggesting that pre-synaptic dopamine autoreceptors are not important to the motor response in moderate to advanced Parkinson disease. PMID:18268187

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 ...

Diabetes and the risk of developing Parkinson's disease in Denmark

DEFF Research Database (Denmark)

Schernhammer, Eva; Hansen, Johnni; Rugbjerg, Kathrine

2011-01-01

Insulin contributes to normal brain function. Previous studies have suggested associations between midlife diabetes and neurodegenerative diseases, including Parkinson's disease. Using Danish population registers, we investigated whether a history of diabetes or the use of antidiabetes drugs...... was associated with Parkinson's disease....

Acupuncture as Adjuvant Therapy for Sleep Disorders in Parkinson's Disease.

Science.gov (United States)

Aroxa, Fábio Henrique de Amorim; Gondim, Ihana Thaís Guerra de Oliveira; Santos, Elba Lúcia Wanderley; Coriolano, Maria das Graças Wanderley de Sales; Asano, Amdore Guescel C; Asano, Nadja Maria Jorge

2017-01-01

There are few studies which attest the efficacy of acupuncture on treatment of sleep disturbs in Parkinson disease. The aimed of this randomized clinical trial was to evaluate the effects of acupuncture on sleep disturbs of 22 patients with diagnosis of idiopathic Parkinson disease (Hoehn-Yahr 1 to 3) who have assistance on the Pro-Parkinson Program of Clinical Hospital at Federal University of Pernambuco in Brazil. All participants were evaluated by Parkinson Disease Sleep Scale (PDSS) before and after 8 weeks. The experimental group was submitted to 8 sections (once a week) which had duration of 30 minutes. The control group had no intervention. The intervention was executed using the acupuncture points LR3 (Taichong), SP6 (Sanyinjiao), LI4 (Hegu), TE5 (Wai-Guan), HT7 (Shenmen), PC6 (Neiguan), LI11 (Quchi), GB20 (Fengchi). Paired analyses were obtained by Wilcoxon test and independent analyses were made according to Mann-Whitney test. This study presented a potential therapeutic benefit of acupuncture on sleep disturbs of Parkinson's disease patients. This study showed a possible therapeutic benefit through acupuncture in sleep disorders in patients with PD. However, we propose new studies related to the effects of acupuncture on the clinical symptoms and evolution of the disease. Copyright © 2017 Medical Association of Pharmacopuncture Institute. Published by Elsevier B.V. All rights reserved.

Nano- and microstructured materials for in vitro studies of the physiology of vascular cells

Directory of Open Access Journals (Sweden)

Alexandra M. Greiner

2016-11-01

Full Text Available The extracellular environment of vascular cells in vivo is complex in its chemical composition, physical properties, and architecture. Consequently, it has been a great challenge to study vascular cell responses in vitro, either to understand their interaction with their native environment or to investigate their interaction with artificial structures such as implant surfaces. New procedures and techniques from materials science to fabricate bio-scaffolds and surfaces have enabled novel studies of vascular cell responses under well-defined, controllable culture conditions. These advancements are paving the way for a deeper understanding of vascular cell biology and materials–cell interaction. Here, we review previous work focusing on the interaction of vascular smooth muscle cells (SMCs and endothelial cells (ECs with materials having micro- and nanostructured surfaces. We summarize fabrication techniques for surface topographies, materials, geometries, biochemical functionalization, and mechanical properties of such materials. Furthermore, various studies on vascular cell behavior and their biological responses to micro- and nanostructured surfaces are reviewed. Emphasis is given to studies of cell morphology and motility, cell proliferation, the cytoskeleton and cell-matrix adhesions, and signal transduction pathways of vascular cells. We finalize with a short outlook on potential interesting future studies.

VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration.

Science.gov (United States)

Shireman, Paula K; Rasmussen, Todd E; Jaramillo, Carlos A; Pugh, Mary Jo

2015-02-03

Limb injuries comprise 50-60% of U.S. Service member's casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and

Tai Chi Exercise to Improve Non-Motor Symptoms of Parkinson's Disease.

Science.gov (United States)

Nocera, Joe R; Amano, Shinichi; Vallabhajosula, Srikant; Hass, Chris J

2013-08-20

A substantial number of individuals with Parkinson's disease exhibit debilitating non-motor symptoms that decrease quality of life. To date, few treatment options exist for the non-motor symptomatology related to Parkinson's disease. The goal of this pilot investigation was to determine the effects of Tai Chi exercise on the non-motor symptomology in Parkinson's disease. Twenty-one individuals with Parkinson's disease were enrolled in a Tai Chi intervention (n=15) or a noncontact control group (n=6). Participants assigned to Tai Chi participated in 60-minute Tai Chi sessions three times per week, for 16 weeks. Pre and post measures included indices of cognitive-executive function including visuomotor tracking and attention, selective attention, working memory, inhibition, processing speed and task switching. Additionally, all participants were evaluated on the Parkinson's disease Questionnaire-39 and Tinetti's Falls Efficacy Scale. Results indicated that the Tai Chi training group had significantly better scores following the intervention than the control group on the Parkinson's disease Questionnaire-39 total score as well as the emotional well-being sub score. Trends for improvement were noted for the Tai Chi group on Digits Backwards, Tinetti's Falls Efficacy Scale, and the activities of daily living and communication sub scores of the Parkinson's disease Questionnaire-39. This research provides initial data that supports future studies to definitively establish efficacy of Tai Chi to improve non-motor features of Parkinson's disease.

123I-β-CIT SPECT imaging study in early Parkinson's disease

International Nuclear Information System (INIS)

Li Peiyong

1998-01-01

Purpose: To investigate the loss of dopamine transporters in hemi-Parkinson's disease (PD) using 123 I-β-CIT/SPECT. Methods: Seven patients with hemi-Parkinson's disease and 7 age- and sex- matched healthy subjects were studied by 123 I-β-CIT/SPECT. Striatal specific uptake of 123 I-β-CIT was calculated in the ratio of striatal uptake to cerebellar uptake. Results: Mean striatal specific uptake of 123 I-β-CIT in healthy subjects was 3.0 +- 0.5 and 5.5 +- 0.6 at 3h and 18h after injection. Striatal specific uptake in contralateral to the clinical symptom side was 2.0 +- 0.8 and 3.1 +- 0.4; in ipsilateral striatum was 2.3 +- 0.4 and 4.0 +- 0.5. There was a significant reduction of striatal tracer uptake in PD patients compared to the controls. Patient age correlated with the reduction in contralateral striatum but did not correlate with that in ipsilateral striatum. Conclusions: Striatal dopamine transporters bilaterally lost in early PD patients. 123 I-β-CIT uptake in contralateral striatum was reduced more severely than in ipsilateral striatum

Malnutrition in a sample of community-dwelling people with Parkinson's disease.

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Jamie M Sheard

Full Text Available OBJECTIVE: Malnutrition results in poor health outcomes, and people with Parkinson's disease may be more at risk of malnutrition. However, the prevalence of malnutrition in Parkinson's disease is not yet well defined. The aim of this study is to provide an estimate of the extent of malnutrition in community-dwelling people with Parkinson's disease. METHODS: This is a cross-sectional study of people with Parkinson's disease residing within a 2 hour driving radius of Brisbane, Australia. The Subjective Global Assessment (SGA and scored Patient Generated Subjective Global Assessment (PG-SGA were used to assess nutritional status. Body weight, standing or knee height, mid-arm circumference and waist circumference were measured. RESULTS: Nineteen (15% of the participants were moderately malnourished (SGA-B. The median PG-SGA score of the SGA-B group was 8 (4-15, significantly higher than the SGA-A group, U = 1860.5, p<.05. The symptoms most influencing intake were loss of appetite, constipation, early satiety and problems swallowing. CONCLUSIONS: As with other populations, malnutrition remains under-recognised and undiagnosed in people with Parkinson's disease. Regular screening of nutritional status in people with Parkinson's disease by health professionals with whom they have regular contact should occur to identify those who may benefit from further nutrition assessment and intervention.

The BioFIND study: Characteristics of a clinically typical Parkinson's disease biomarker cohort

Science.gov (United States)

Goldman, Jennifer G.; Alcalay, Roy N.; Xie, Tao; Tuite, Paul; Henchcliffe, Claire; Hogarth, Penelope; Amara, Amy W.; Frank, Samuel; Rudolph, Alice; Casaceli, Cynthia; Andrews, Howard; Gwinn, Katrina; Sutherland, Margaret; Kopil, Catherine; Vincent, Lona; Frasier, Mark

2016-01-01

ABSTRACT Background Identifying PD‐specific biomarkers in biofluids will greatly aid in diagnosis, monitoring progression, and therapeutic interventions. PD biomarkers have been limited by poor discriminatory power, partly driven by heterogeneity of the disease, variability of collection protocols, and focus on de novo, unmedicated patients. Thus, a platform for biomarker discovery and validation in well‐characterized, clinically typical, moderate to advanced PD cohorts is critically needed. Methods BioFIND (Fox Investigation for New Discovery of Biomarkers in Parkinson's Disease) is a cross‐sectional, multicenter biomarker study that established a repository of clinical data, blood, DNA, RNA, CSF, saliva, and urine samples from 118 moderate to advanced PD and 88 healthy control subjects. Inclusion criteria were designed to maximize diagnostic specificity by selecting participants with clinically typical PD symptoms, and clinical data and biospecimen collection utilized standardized procedures to minimize variability across sites. Results We present the study methodology and data on the cohort's clinical characteristics. Motor scores and biospecimen samples including plasma are available for practically defined off and on states and thus enable testing the effects of PD medications on biomarkers. Other biospecimens are available from off state PD assessments and from controls. Conclusion Our cohort provides a valuable resource for biomarker discovery and validation in PD. Clinical data and biospecimens, available through The Michael J. Fox Foundation for Parkinson's Research and the National Institute of Neurological Disorders and Stroke, can serve as a platform for discovering biomarkers in clinically typical PD and comparisons across PD's broad and heterogeneous spectrum. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society PMID:27113479

The clinical profile of idiopathic Parkinson's disease in a South ...

African Journals Online (AJOL)

The clinical profile of idiopathic Parkinson's disease in a South African hospital complex - the influence of ethnicity and gender. Marcelle Smith, Girish Modi. Abstract. Background Idiopathic Parkinson's Disease (IPD) has not been well studied in Black African populations. Data on the demographics, phenotype differences ...

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

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...

Suicide in patients with Parkinson's disease. An epidemiological study

DEFF Research Database (Denmark)

Stenager, E N; Wermuth, L; Stenager, Egon

1994-01-01

The purpose of this study was to estimate the risk of suicide for patients with Parkinson's disease (PD) in Denmark compared with that in the background population. The study involved 458 patients with a PD diagnosis, 226 men and 232 women. The follow-up period to either death or end of follow......-up on December 31, 1990 was 0 to 17 years, mean 5.7 years. Deaths in the follow-up period amounted to 254, 135 men and 119 women. Two women committed suicide. The number of expected suicides was 1.06 for men and 0.55 for women, a total of 1.62. Neither for men nor for women was the difference between expected...... and observed suicides statistically significant....

The Effect of Experimental Parkinson on Formalin-Induced Pain in Rat

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Mohammad Sofiabadi

2014-04-01

Full Text Available Background & Objectives : Pain is one of the preceding claims of Parkinson's disease (PD, that its mechanisms have not been fully identified. The purpose of this study was to investigate the chemical pain responses induced by subcutaneous injection of formalin in male parkinsonized rats.   Method : In this experimental study, 40 Wistar male rats were used and PD was established by stereotaxic injection of 6-OHDA toxin into the striatum. Parkinson's disease severity determined by apomorphine-induced rotation test and then the pain response of 4 groups, the control, sham and 2 weak or full Parkinson groups, were evaluated using formalin test. Data were analyzed using ANOVA and Tukey test.   Results : In both acute and chronic phases of the formalin test, the symptoms of pain in different groups were same, but at the interphase stage, pain intensity increased more in Parkinson 's rats, especially in full PD group compared to control (p<0.01.   Conclusion: These results suggest that the nigrostriatal dopaminergic pathway have important modulating role on chronic pain.

Large-scale identification of clinical and genetic predictors of motor progression in patients with newly diagnosed Parkinson's disease: a longitudinal cohort study and validation.

Science.gov (United States)

Latourelle, Jeanne C; Beste, Michael T; Hadzi, Tiffany C; Miller, Robert E; Oppenheim, Jacob N; Valko, Matthew P; Wuest, Diane M; Church, Bruce W; Khalil, Iya G; Hayete, Boris; Venuto, Charles S

2017-11-01

Better understanding and prediction of progression of Parkinson's disease could improve disease management and clinical trial design. We aimed to use longitudinal clinical, molecular, and genetic data to develop predictive models, compare potential biomarkers, and identify novel predictors for motor progression in Parkinson's disease. We also sought to assess the use of these models in the design of treatment trials in Parkinson's disease. A Bayesian multivariate predictive inference platform was applied to data from the Parkinson's Progression Markers Initiative (PPMI) study (NCT01141023). We used genetic data and baseline molecular and clinical variables from patients with Parkinson's disease and healthy controls to construct an ensemble of models to predict the annual rate of change in combined scores from the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts II and III. We tested our overall explanatory power, as assessed by the coefficient of determination (R 2 ), and replicated novel findings in an independent clinical cohort from the Longitudinal and Biomarker Study in Parkinson's disease (LABS-PD; NCT00605163). The potential utility of these models for clinical trial design was quantified by comparing simulated randomised placebo-controlled trials within the out-of-sample LABS-PD cohort. 117 healthy controls and 312 patients with Parkinson's disease from the PPMI study were available for analysis, and 317 patients with Parkinson's disease from LABS-PD were available for validation. Our model ensemble showed strong performance within the PPMI cohort (five-fold cross-validated R 2 41%, 95% CI 35-47) and significant-albeit reduced-performance in the LABS-PD cohort (R 2 9%, 95% CI 4-16). Individual predictive features identified from PPMI data were confirmed in the LABS-PD cohort. These included significant replication of higher baseline MDS-UPDRS motor score, male sex, and increased age, as well as a novel Parkinson's disease

Beskytter røyking mot Parkinsons sykdom

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Trond Peder Flaten

2009-10-01

Full Text Available  SAMMENDRAGDen negative sammenhengen mellom røyking og Parkinsons sykdom i epidemiologiske studier er robust.Det er prosentvis færre røykere og eks-røykere blant Parkinson-pasienter enn blant kontrollpersoner.Videre har røykere en lavere insidens og en lavere dødelighet enn andre av Parkinsons sykdom. Det er etåpent spørsmål om dette skyldes en beskyttende virkning av nikotin eller andre stoffer i tobakksrøyk somhydrazin eller karbonmonoksid, eller om det skyldes andre, underliggende faktorer. De mest aktuelle slikefaktorer er (1 selektiv dødelighet, altså at mange røykere ikke overlever lenge nok til å utvikleParkinsons sykdom, og (2 at personer som utvikler Parkinsons sykdom ofte har karaktertrekk som gjørdet mindre sannsynlig at de begynner å røyke. Det vitenskapelige grunnlaget er i alle fall for tynt for åanbefale røyking som et forebyggende virkemiddel mot Parkinsons sykdom. Og selv om det skulle viseseg at røyking virkelig beskytter mot sykdommen, veier de negative helsevirkningene av røyking myetyngre i folkehelsesammenheng. Allikevel bør denne assosiasjonen forfølges videre, ikke minst forpotensialet for en bedret forståelse av de underliggende patofysiologiske mekanismene bak sykdommen.Flaten TP. Does smoking protect against Parkinson’s disease? Nor J Epidemiol 1995; 5 (2: 145-150. ENGLISH SUMMARYIt is epidemiologically well established that Parkinson's disease is about twice as common among nonsmokers as among smokers. Whether this is due to a protective effect of nicotine or other compounds in cigarette smoke like hydrazine or carbon monoxide, or whether it is due to some other, confounding factor(s, remains to be established. The most relevant confounding factors are (1 selective mortality, that is, many smokers do not survive long enough to develop Parkinson's disease, and (2 that persons who eventually develop Parkinson's disease tend to have a preclinical personality type that makes them less likely

Experience of care home residents with Parkinson's disease: Reason for admission and service use.

Science.gov (United States)

Walker, Richard W; Palmer, Jessica; Stancliffe, Jonathan; Wood, Brian H; Hand, Annette; Gray, William K

2014-10-01

The care needs of people with Parkinson's disease (PD) are poorly understood. We aimed to investigate the factors that precipitate entry to institutional care, and on-going care needs once in care, within a representative cohort of community-dwelling people with PD. All people with idiopathic PD, Parkinson's plus syndromes and vascular parkinsonism under the care of the Northumbria Healthcare NHS Foundation Trust PD service who were living in care homes on 1 January 2013 were included. Disease severity (Hoehn and Yahr stage) and demographic data were collected. Admissions to hospital over the previous 2 years and in the year before institutional care admission were documented. A total of 90 patients (51 females) with a mean age of 81.3 years were included. During care home stay, the median number of emergency department attendances, the median number of hospital admissions and the median length of stay for those admitted per year were significantly lower than before care home admission. Both before care home admission and during care home stay, falls were the most common diagnoses in people attending emergency departments, with 32 of 65 (49.2%) admissions before and 34 of 59 (57.6%) admissions during care home stay having falls recorded as a cause of attendance. Hospital attendances and admissions were relatively common, even after institutional care home placement. Events precipitating admission, such as falls, might be preventable. PD nurse specialists could be an effective way to help train staff in homes where someone is known to have PD. © 2013 Japan Geriatrics Society.

Caracterização dos distúrbios cognitivos na Doença de Parkinson Characterizing cognitive disorders in Parkinson's disease

Directory of Open Access Journals (Sweden)

Mônica Maria de Azevedo Mello Carvalho Galhardo

2009-01-01

Full Text Available TEMA: comprometimentos cognitivos na doença de Parkinson. OBJETIVO: ressaltar a existência do déficit cognitivo na Doença de Parkinson, descrevendo as características dos comprometimentos cognitivos. CONCLUSÕES: as alterações cognitivas na Doença de Parkinson (referentes a memória, linguagem, capacidade visuo-espacial e funções executivas são constatadas na literatura, no entanto, há uma carência de informações quanto à reabilitação fonoaudiológica de pacientes nessa área específica da linguagem.BACKGROUND: cognitive commitments in Parkinson's disease. PURPOSE: to point out the existence of cognitive deficit in Parkinson's disease, describing its characteristics. CONCLUSIONS: cognitive alterations in Parkinson's disease (such as memory, language, visual-spatial capacity and execution functions are found in the literature, however, there is a lack of information such as the speech therapist rehabilitation of patients in such -specific language-related area.

Psychosis in parkinsonism: an unorthodox approach

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Onofrj M

2017-05-01

Full Text Available Marco Onofrj,1,2 Danilo Carrozzino,3,4 Aurelio D’Amico,1,2 Roberta Di Giacomo,1,2 Stefano Delli Pizzi,1 Astrid Thomas,1,2 Valeria Onofrj,5 John-Paul Taylor,6 Laura Bonanni1,2 1Department of Neuroscience Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, 2CE.S.I. University Foundation, 3Department of Psychological, Health, and Territorial Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy; 4Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark; 5Department of Bioimaging, University Cattolica del Sacro Cuore, Rome, Italy; 6Institute of Neuroscience, Campus for Ageing and Vitality Newcastle University Newcastle upon Tyne, Newcastle upon Tyne, UK Abstract: Psychosis in Parkinson’s disease (PD is currently considered as the occurrence of hallucinations and delusions. The historical meaning of the term psychosis was, however, broader, encompassing a disorganization of both consciousness and personality, including behavior abnormalities, such as impulsive overactivity and catatonia, in complete definitions by the International Classification of Diseases-10 (ICD-10 and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5. Our review is aimed at reminding that complex psychotic symptoms, including impulsive overactivity and somatoform disorders (the last being a recent controversial entity in PD, were carefully described in postencephalitic parkinsonism (PEP, many decades before dopaminergic treatment era, and are now described in other parkinsonisms than PD. Eminent neuropsychiatrists of the past century speculated that studying psychosis in PEP might highlight its mechanisms in other conditions. Yet, functional assessments were unavailable at the time. Therefore, the second part of our article reviews the studies of neural correlates of psychosis in parkinsonisms, by taking into account both theories on

Cause-Specific Mortality Among Spouses of Parkinson Disease Patients

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Nielsen, Malene; Hansen, Jonni; Ritz, Beate

2014-01-01

BACKGROUND: Caring for a chronically ill spouse is stressful, but the health effects of caregiving are not fully understood. We studied the effect on mortality of being married to a person with Parkinson disease. METHODS: All patients in Denmark with a first-time hospitalization for Parkinson...... disease between 1986 and 2009 were identified, and each case was matched to five population controls. We further identified all spouses of those with Parkinson disease (n = 8,515) and also the spouses of controls (n = 43,432). All spouses were followed in nationwide registries until 2011. RESULTS: Among...... men, being married to a Parkinson disease patient was associated with a slightly higher risk of all-cause mortality (hazard ratio = 1.06 [95% confidence interval = 1.00-1.11]). Mortality was particularly high for death due to external causes (1.42 [1.09-1.84]) including suicide (1.89 [1...

Gaucher disease and comorbidities: B-cell malignancy and parkinsonism.

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Cox, Timothy M; Rosenbloom, Barry E; Barker, Roger A

2015-07-01

Data emerging from the International Collaborative Gaucher Group (ICGG) Gaucher Registry together with other contemporary clinical surveys have revealed a close association between Gaucher disease and non-Hodgkin's B-cell lymphoma and myeloma and Gaucher disease and Parkinson's disease. Several possible explanations for increased B-cell proliferation and neoplasia in Gaucher disease have been proposed, including the possible influence of sphingosine (derived from the extra lysosomal metabolism of glucosylceramide), gene modifiers, splenectomy and immune system deregulation induced by cytokines, chemokines, and hydrolases released from Gaucher cells. Parkinson's disease is frequently seen in the otherwise-healthy relatives of Gaucher disease patients leading to the finding that GBA mutations represent a genetic risk factor for Parkinson's disease. The mechanism of the association between GBA mutations and Parkinson's disease has yet to be elucidated but the pathogenesis appears distinct from that of Gaucher disease. Several pathogenic pathways have been proposed including lysosomal and/or mitochondrial dysfunction. The effect of Gaucher disease specific therapies on the incidence of cancer or Parkinson's disease are not clear and will likely be evaluated in future ICGG Gaucher Registry studies. © 2015 Wiley Periodicals, Inc.

Changes in postural control in patients with Parkinson's disease: a posturographic study.

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Doná, F; Aquino, C C; Gazzola, J M; Borges, V; Silva, S M C A; Ganança, F F; Caovilla, H H; Ferraz, H B

2016-09-01

Postural instability is one of the most disabling features in Parkinson's disease (PD), and often leads to falls that reduce mobility and functional capacity. The objectives of this study were to analyse the limit of stability (LOS) and influence of the manipulation of visual, somatosensorial and visual-vestibular information on postural control in patients with PD and healthy subjects. Cross-sectional. Movement Disorders Unit, university setting. Eighty-two subjects aged between 37 and 83 years: 41 with Parkinson's disease in the 'on' state and 41 healthy subjects with no neurological disorders. Both groups were matched in terms of sex and age. Unified Parkinson's Disease Rating Scale (UPDRS)-motor score, modified Hoehn and Yahr staging, Dynamic Gait Index (DGI) and posturography with integrated virtual reality. The parameters analysed by posturography were LOS area, area of body centre of pressure excursion and balance functional reserve in the standing position in 10 conditions (open and closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction). The mean UPDRS motor score and DGI score were 27 [standard deviation (SD) 14] and 21 (SD 3), respectively. Thirteen participants scored between 0 and 19 points, indicating major risk of falls. Posturographic assessment showed that patients with PD had significantly lower LOS area and balance functional reserve values, and greater body sway area in all posturographic conditions compared with healthy subjects. Patients with PD have reduced LOS area and greater postural sway compared with healthy subjects. The deterioration in postural control was significantly associated with major risk of falls. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

[Parkinson's disease(s): recent insight into genetic factors

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Warrenburg, B.P.C. van de; Scheffer, H.; Heutink, P.; Bloem, B.R.

2007-01-01

In recent years, 5 genes have been identified that are unambiguously associated with genetic forms of Parkinson's disease. These genes probably explain less than 10% of all cases of Parkinson's disease. Clinically, these genetic forms can closely resemble idiopathic Parkinson's disease. Mutation

Dream Robber: Living with Parkinson's disease

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... 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/ ...

Magnetic resonance imaging of Parkinsonism

International Nuclear Information System (INIS)

Nakamura, Yusaku; Takahashi, Mitsuo; Kitaguchi, Masataka; Akaneya, Yukio; Mitui, Yoshiyuki; Tanaka, Hisashi

1991-01-01

We studied eighteen patients affected by Parkinsonism with symptoms of tremor, bradykinesia, or rigidity using magnetic resonance imaging (MRI). Patients ranged in age from 34 to 80 years (mean 62.8±11.6 years), and the duration of their disease had been 3.8±3.2 years. MRI examinations were performed with Shimazu and Siemens superconducting magnets, operating at 0.5 and 1.5 T magnetic fields, respectively. Both T 1 - and T 2 -weighted spin echo (SE) pulse sequences were used. In eight patients (44.4%), MRI demonstrated bilateral multiple lacunar infarction of the basal ganglia. The most common abnormality identified was multiple, bilateral lacunar infarcts in the lateral portion of the putamen. The average size of the lacunar infarction of the putamen was less than half that of the entire putamen. Patients with multiple lacunar infarction were significantly older than the other patients and had lower Yahr's scores. The clinical symptoms of patients with bilateral multiple lacunar infarction of the basal ganglia were compatible with the diagnosis of arteriosclerotic Parkinsonism of akinetic rigid type. It has been suggested that multiple lacunar infarction of the basal ganglia may have led to Parkinsonism in these patients. (author)

Parkinsong : a study of singing in patients with Parkinson's Disease

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Harris, Robert; de Jong, Bauke M.

2014-01-01

Dysarthritic Parkinson speech is characterised by impairment of expressive linguistic prosody, even making it difficult to understand. While rigidity and bradykinesia can be held responsible for a general decline in speaking ability, the origin of prosodic impairment must be seen in the light of the

Parkinsong: a study of singing in patients with Parkinson's Disease

NARCIS (Netherlands)

Robert Harris; Bauke M. de Jong

2014-01-01

Dysarthritic Parkinson speech is characterised by impairment of expressive linguistic prosody, even making it difficult to understand. While rigidity and bradykinesia can be held responsible for a general decline in speaking ability, the origin of prosodic impairment must be seen in the light of

Parkinson's disease associated with impaired oxidative phosphorylation

International Nuclear Information System (INIS)

Finsterer, J.; Jarius, C.; Baumgartner, M.

2001-01-01

Parkinson's disease may be due to primary or secondary oxidative phosphorylation (OXPHOS) defects. In a 76-year-old man with Parkinson's disease since 1992, slightly but recurrently elevated creatine phosphokinase, recurrently elevated blood glucose, thickening of the left ventricular myocardium, bifascicular block and hypacusis were found. Cerebral MRI showed atrophy, periventricular demyelination, multiple, disseminated, supra- and infratentorial lacunas, and haemosiderin deposits in both posterior horns. Muscle biopsy showed typical features of an OXPHOS defect. Whether the association of Parkinson's disease and impaired OXPHOS was causative or coincidental remains unknown. Possibly, the mitochondrial defect acted as an additional risk factor for Parkinson's disease or the OXPHOS defect worsened the preexisting neurological impairments by a cumulative or synergistic mechanism. In conclusion, this case shows that Parkinson's disease may be associated with a mitochondrially or nuclearly encoded OXPHOS defect, manifesting as hypacusis, myopathy, axonal polyneuropathy, cardiomyopathy and recurrent subclinical ischaemic strokes and haemorrhages. (orig.)

From miracle to reconciliation: a hermeneutic phenomenological study exploring the experience of living with Parkinson's disease following deep brain stimulation.

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Haahr, Anita; Kirkevold, Marit; Hall, Elisabeth O C; Ostergaard, Karen

2010-10-01

Deep Brain Stimulation for Parkinson's disease is a promising treatment for patients who can no longer be treated satisfactorily with L-dopa. Deep Brain Stimulation is known to relieve motor symptoms of Parkinson's disease and improve quality of life. Focusing on how patients experience life when treated with Deep Brain Stimulation can provide essential information on the process patients go through when receiving a treatment that alters the body and changes the illness trajectory. The aim of this study was to explore and describe the experience of living with Parkinson's disease when treated with Deep Brain Stimulation. The study was designed as a longitudinal study and data were gathered through qualitative in-depth interviews three times during the first year of treatment. Nine patients participated in the study. They were included when they had accepted treatment with Deep Brain Stimulation for Parkinson's disease. Data collection and data analysis were inspired by the hermeneutic phenomenological methodology of Van Manen. The treatment had a major impact on the body. Participants experienced great bodily changes and went through a process of adjustment in three phases during the first year of treatment with Deep Brain Stimulation. These stages were; being liberated: a kind of miracle, changes as a challenge: decline or opportunity and reconciliation: re-defining life with Parkinson's disease. The course of the process was unique for each participant, but dominant was that difficulties during the adjustment of stimulation and medication did affect the re-defining process. Patients go through a dramatic process of change following Deep Brain Stimulation. A changing body affects their entire lifeworld. Some adjust smoothly to changes while others are affected by loss of control, uncertainty and loss of everyday life as they knew it. These experiences affect the process of adjusting to life with Deep Brain Stimulation and re-define life with Parkinson's disease

Progression of MDS-UPDRS Scores Over Five Years in De Novo Parkinson Disease from the Parkinson's Progression Markers Initiative Cohort.

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Holden, Samantha K; Finseth, Taylor; Sillau, Stefan H; Berman, Brian D

2018-01-01

The Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UDPRS) is a commonly used tool to measure Parkinson disease (PD) progression. Longitudinal changes in MDS-UPDRS scores in de novo PD have not been established. Determine progression rates of MDS-UPDRS scores in de novo PD. 362 participants from the Parkinson's Progression Markers Initiative, a multicenter longitudinal cohort study of de novo PD, were included. Longitudinal progression of MDS-UPDRS total and subscale scores were modeled using mixed model regression. MDS-UPDRS scores increased in a linear fashion over five years in de novo PD. MDS-UPDRS total score increased an estimated 4.0 points/year, Part I 0.25 points/year, Part II 1.0 points/year, and Part III 2.4 points/year. The expected average progression of MDS-UPDRS scores in de novo PD from this study can assist in clinical monitoring and provide comparative data for detection of disease modification in treatment trials.

Cognitive impairment in Parkinson's disease

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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

Progressive dopamine and hypocretin deficiencies in Parkinson's disease: is there an impact on sleep and wakefulness?

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Wienecke, Miriam; Werth, Esther; Poryazova, Rositsa; Baumann-Vogel, Heide; Bassetti, Claudio L; Weller, Michael; Waldvogel, Daniel; Storch, Alexander; Baumann, Christian R

2012-12-01

Sleep-wake disturbances are frequent in patients with Parkinson's disease, but prospective controlled electrophysiological studies of sleep in those patients are surprisingly sparse, and the pathophysiology of sleep-wake disturbances in Parkinson's disease remains largely elusive. In particular, the impact of impaired dopaminergic and hypocretin (orexin) signalling on sleep and wakefulness in Parkinson's disease is still unknown. We performed a prospective, controlled electrophysiological study in patients with early and advanced Parkinson's disease, e.g. in subjects with presumably different levels of dopamine and hypocretin cell loss. We compared sleep laboratory tests and cerebrospinal fluid levels with hypocretin-deficient patients with narcolepsy with cataplexy, and with matched controls. Nocturnal sleep efficiency was most decreased in advanced Parkinson patients, and still lower in early Parkinson patients than in narcolepsy subjects. Excessive daytime sleepiness was most severe in narcolepsy patients. In Parkinson patients, objective sleepiness correlated with decrease of cerebrospinal fluid hypocretin levels, and repeated hypocretin measurements in two Parkinson patients revealed a decrease of levels over years. This suggests that dopamine and hypocretin deficiency differentially affect sleep and wakefulness in Parkinson's disease. Poorer sleep quality is linked to dopamine deficiency and other disease-related factors. Despite hypocretin cell loss in Parkinson's disease being only partial, disturbed hypocretin signalling is likely to contribute to excessive daytime sleepiness in Parkinson patients. © 2012 European Sleep Research Society.

The discriminating nature of dopamine transporter image in parkinsonism: the competency of dopaminergic transporter imaging in differential diagnosis of parkinsonism {sup 123}I-FP-CIT SPECT study

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Kim, Bom Sahn; Jang, Sung June; Eo, Jae Seon; Park, Eun Kyung; Kim, Yu Kyeong; Kim, Jong Min; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2007-08-15

The aim of this study was to evaluate the discriminating nature of {sup 123}I-FP-CIT SPECT in patients with parkinsonism. {sup 123}I-FP-CIT SPECT images acquired from the 18 normal controls; NC (60.4 {+-} 10.0 yr) and 237 patients with parkinsonism (65.9 {+-} 9.2 yr) were analyzed. From spatially normalized images, regional counts of the caudate, putamen, and occipital lobe were obtained using region of interest method. Binding potential (BP) was calculated with the ratio of specific to nonspecific binding activity at equilibrium. Additionally, the BP ratio of putamen to caudate (PCR) and asymmetric index (ASI) were measured. BPs of NC (3.37 {+-} 0.57, 3.10{+-} 0.41, 3.23 {+-} 0.48 for caudate, putamen, whole striatum, respectively) had no significant difference with those of essential tremor; ET (3.31 {+-} 0.64, 3.06 {+-} 0.61, 3.14 {+-} 0.63) and Alzheimer's disease; AD (3.33 {+-} 0.60, 3.29 {+-} 0.79, 3.31 {+-} 0.70), but were higher than those of Parkinson's disease; PD (1.92 {+-} 0.74, 1.39 {+-}0.68, 1.64 {+-} 0.68), multiple system atrophy; MSA (2.36 {+-} 1.07, 2.16 {+-} 0.91, 2.26 {+-} 0.96), and dementia with Lewy body; DLB (1.95{+-} 0.72, 1.64 {+-} 0.65, 1.79 {+-} 0.66)({rho} < 0.005). PD had statistically lower values of PCR and higher values of ASI than those of NC ({rho} < 0.005). And PD had significantly lower value of PCR, higher ASI and lower BP in the putamen and whole striatum than MSA ({rho} < 0.05). Dopamine transporter image of {sup 123}I-FP-CIT SPECT was a good value in differential diagnosis of parkinsonism.

Integrative network analysis unveils convergent molecular pathways in Parkinson's disease and diabetes.

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Jose A Santiago

Full Text Available Shared dysregulated pathways may contribute to Parkinson's disease and type 2 diabetes, chronic diseases that afflict millions of people worldwide. Despite the evidence provided by epidemiological and gene profiling studies, the molecular and functional networks implicated in both diseases, have not been fully explored. In this study, we used an integrated network approach to investigate the extent to which Parkinson's disease and type 2 diabetes are linked at the molecular level.Using a random walk algorithm within the human functional linkage network we identified a molecular cluster of 478 neighboring genes closely associated with confirmed Parkinson's disease and type 2 diabetes genes. Biological and functional analysis identified the protein serine-threonine kinase activity, MAPK cascade, activation of the immune response, and insulin receptor and lipid signaling as convergent pathways. Integration of results from microarrays studies identified a blood signature comprising seven genes whose expression is dysregulated in Parkinson's disease and type 2 diabetes. Among this group of genes, is the amyloid precursor protein (APP, previously associated with neurodegeneration and insulin regulation. Quantification of RNA from whole blood of 192 samples from two independent clinical trials, the Harvard Biomarker Study (HBS and the Prognostic Biomarker Study (PROBE, revealed that expression of APP is significantly upregulated in Parkinson's disease patients compared to healthy controls. Assessment of biomarker performance revealed that expression of APP could distinguish Parkinson's disease from healthy individuals with a diagnostic accuracy of 80% in both cohorts of patients.These results provide the first evidence that Parkinson's disease and diabetes are strongly linked at the molecular level and that shared molecular networks provide an additional source for identifying highly sensitive biomarkers. Further, these results suggest for the first

Integrative network analysis unveils convergent molecular pathways in Parkinson's disease and diabetes.

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Santiago, Jose A; Potashkin, Judith A

2013-01-01