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Parkinson management

Manal Zafar, Ariyana Bozzorg, Madeleine E Hackney
PURPOSE: Our aims were to determine (1) the impact of aging versus combined aging and disease on participation and (2) participation before and after a 12-week, Adapted Tango dance intervention (AT) in older adults with and without Parkinson's disease (PD). METHODS: Participant responses to open and closed-ended questions on the Impact on Participation and Autonomy questionnaire (IPA) were recorded before, one-week-after, and three-months after 20 lessons of AT...
October 21, 2016: Disability and Rehabilitation
Laura M Struble, Mary C Blazek, Helen C Kales
A 92-year-old patient with Parkinson disease and dementia provides an opportunity for the advanced practice registered nurse to shift thinking about behavioral disturbances in dementia, away from controlling behavior with pharmacologic approaches, such as antipsychotics, toward understanding behavior by applying the nonpharmacologic Describe, Investigate, Create, and Evaluate method.
November 19, 2016: Nurse Practitioner
Orjan Skogar, Johan Lokk
This review focuses on the diagnosis and management of Parkinson-related pain which is one of the more frequently reported nonmotor symptoms in Parkinson's disease (PD), which is the second most common neurodegenerative disease after Alzheimer's disease. Pain is ranked high by patients as a troublesome symptom in all stages of the disease. In early-stage PD, pain is rated as the most bothersome symptom. Knowledge of the correct diagnosis of pain origin and possible methods of treatments for pain relief in PD is of great importance...
2016: Journal of Multidisciplinary Healthcare
Rachel Newby, Jane Alty, Peter Kempster
Mind-brain dualism has dominated historical commentary on dystonia, a dichotomous approach that has left our conceptual grasp of it stubbornly incomplete. This is particularly true of functional dystonia, most diagnostically challenging of all functional movement disorders, in which the question of inherent psychogenicity remains a focus of debate. Phenomenological signs considered in isolation lack the specificity to distinguish organic and nonorganic forms, and dystonia's variability has frustrated attempts to develop objective laboratory-supported standards...
October 18, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Youngsin Jung, Erik K St Louis
REM sleep behavior disorder (RBD) is a common parasomnia disorder affecting between 1 and 7 % of community-dwelling adults, most frequently older adults. RBD is characterized by nocturnal complex motor behavior and polysomnographic REM sleep without atonia. RBD is strongly associated with synucleinopathy neurodegeneration. The approach to RBD management is currently twofold: symptomatic treatment to prevent injury and prognostic counseling and longitudinal follow-up surveillance for phenoconversion toward overt neurodegenerative disorders...
November 2016: Current Treatment Options in Neurology
Lei-Fang Cao, Xiao-Yan Peng, Ya Huang, Bing Wang, Feng-Ming Zhou, Ruo-Xiao Cheng, Li-Hua Chen, Wei-Feng Luo, Tong Liu
In the present study, we investigated whether restoring descending noradrenergic inhibitory tone can attenuate pain in a PD rat model, which was established by stereotaxic infusion of 6-hydroxydopamine (6-OHDA) into the bilateral striatum (CPu). PD rats developed thermal and mechanical hypersensitivity at the 4th week after surgery. HPLC analysis showed that NE content, but not dopamine or 5-HT, significantly decreased in lumbar spinal cord in PD rats. Additional noradrenergic depletion by injection of N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) aggravated pain hypersensitivity in PD rats...
2016: Neural Plasticity
Emily Hopkins, David Moffat, Ian Parkinson, Peter Robinson, Hubertus Jersmann, Brendan Dougherty, Mohammed I Birader, Kate Francis, Phan Nguyen
BACKGROUND: Rapid on site examination (ROSE) is encouraged at endobronchial ultrasound transbronchial needles aspiration (EBUS-TBNA) to improve diagnostic yield. Due to new therapeutic options in lung cancer, it is not sufficient to merely distinguish between non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC). Immunohistochemistry (IHC) distinction is now standard practice, as well as additional molecular testing where clinically indicated. We investigated the diagnostic yield of on-site smears vs...
September 2016: Journal of Thoracic Disease
Jacob Taylor, William S Anderson, Jason Brandt, Zoltan Mari, Gregory M Pontone
Although Parkinson disease (PD) is defined clinically by its motor symptoms, it is increasingly recognized that much of the disability and worsened quality of life experienced by patients with PD is attributable to psychiatric symptoms. The authors describe a model of multidisciplinary care that enables these symptoms to be effectively managed. They describe neuropsychiatric complications of PD itself and pharmacologic and neurostimulation treatments for parkinsonian motor symptoms and discuss the management of these complications...
September 3, 2016: American Journal of Geriatric Psychiatry
Michael M Lipp, Richard Batycky, Jerome Moore, Mika Leinonen, Martin I Freed
Inhaled drugs offer advantages, such as rapid onset of action, but require formulations and delivery systems that reproducibly and conveniently administer the drug. CVT-301 is a powder formulation of levodopa delivered by a breath-actuated inhaler that has been developed for treating OFF episodes (motor fluctuations between doses of standard oral levodopa) in patients with Parkinson's disease (PD). We present preclinical, phase 1, and phase 2 results for CVT-301. In dogs insufflated with a levodopa powder, plasma levodopa peaked in all animals 2...
October 12, 2016: Science Translational Medicine
Rijan Bajracharya, J William O Ballard
Dietary management plays a key role in the treatment of many diseases. However, no prospective studies have critically investigated the potential for dietary modification to delay the onset, or slow the progression, of Parkinson's Disease (PD). To study whether manipulating the Protein to Carbohydrate (P:C) ratio in the diet could affect the progression of PD, we compared Drosophila melanogaster parkin null mutants and their experimental controls fed with diets differing in their P:C ratio. We considered lifespan and feeding behaviors as well as motor and cellular functions on the 1:2 and 1:16 P:C diets...
October 6, 2016: Mechanisms of Ageing and Development
Cafer Saka
Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant developed. MAOIs elevate the levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine oxidase. They are also used in the treatment of Parkinson's disease, tuberculosis, and several other disorders. Therefore, it is very important to develop efficient analytical methods for monitoring and management. There are two isoforms of monoamine oxidase, MAO-A and MAO-B. In this article, analyses of MAOIs in pharmaceutical formulations and biological fluids were reviewed from 2000 to the present, including all types of chromatographic, spectrophotometric, electrophoretic, and voltammetric techniques, focusing on isoniazid, tranylcypromine, moclobemide, rasagiline, and selegiline...
October 7, 2016: Critical Reviews in Analytical Chemistry
Paul J Cocker, M Tremblay, S Kaur, Catharine A Winstanley
RATIONALE: Whilst dopamine agonist therapies can successfully manage the symptoms of diseases such as Parkinson's disease (PD), fibromyalgia and restless leg syndrome, they can also cause impulse control and addiction disorders such as gambling disorder (GD). These compulsive behaviours seriously undermine the utility of such treatments. OBJECTIVES: The objective of the study was to model this phenomenon using a rodent slot machine task (rSMT) in order to investigate the neurobiological basis underlying such behavioural changes...
October 6, 2016: Psychopharmacology
Shashank Agarwal, Jori E Fleisher
Much of the clinical and research attention for Parkinson's Disease (PD) has focused on mild to moderate stages. As the disease advances, it can become difficult for patients to attend clinical visits. These patients are often lost to follow-up, and consequently, vanish from the pool of potential research subjects who could inform our management of this understudied population. We aim to increase awareness about this population and potential interventions to improve continuity of care and foster research in advanced PD...
2016: European Neurological Review
Kevin Ita
With the increasing proportion of the global geriatric population, it becomes obvious that neurodegenerative diseases will become more widespread. From an epidemiological standpoint, it is necessary to develop new therapeutic agents for the management of Alzheimer's disease, Parkinson's disease, multiple sclerosis and other neurodegenerative disorders. An important approach in this regard involves the use of the transdermal route. With transdermal drug delivery systems, it is possible to modulate the pharmacokinetic profiles of these medications and improve patient compliance...
October 5, 2016: Journal of Drug Targeting
Cindy Canivet, Nadège Costa, Fabienne Ory-Magne, Céline Arcari, Christine Mohara, Laure Pourcel, Hélène Derumeaux, Emilie Bérard, Robert Bourrel, Laurent Molinier, Christine Brefel-Courbon
BACKGROUND: Parkinson's disease (PD) is characterized by its impact on quality of life, constituting a substantial economic burden on society. Education programs implicating patients more in the management of their illness and complementing medical treatment may be a beneficial adjunct in PD. This study assessed the impact of an education program on quality of life and its cost-effectiveness in PD patients. METHODS: This single-center, prospective, randomized study assessed an education program consisting of individual and group sessions over a 12-month period...
2016: PloS One
Amit Batla, Natalie Tayim, Mahreen Pakzad, Jalesh N Panicker
Urogenital dysfunction is commonly reported in Parkinson's disease (PD), and history taking and a bladder diary form the cornerstone of evaluation. The assessment of lower urinary tract (LUT) symptoms include urinalysis, ultrasonography, and urodynamic studies and help to evaluate concomitant urological pathologies such as benign prostate enlargement. Antimuscarinic medications are the first line treatment for overactive bladder (OAB) symptoms and solifenacin has been specifically studied in PD. Antimuscarininc drugs may exacerbate PD-related constipation and xerostomia, and caution is advised when using these medications in individuals where cognitive impairment is suspected...
October 2016: Current Treatment Options in Neurology
Nóra Török, Zsófia Majláth, Levente Szalárdy, László Vécsei
The therapeutic management of Parkinson's disease (PD) is challenging and has not been fully resolved. The main challenges include motor fluctuations and levodopa-induced dyskinesia. Moreover, no disease-modifying or neuroprotective therapy is currently available. Areas covered: This review focuses on α-synuclein aggregation inhibitors and their therapeutic role in PD, with special attention to heat shock proteins, immunotherapy (active and passive), the potential of targeting the Ser129 phosphorylation site, and the antibiotic possibilities...
October 8, 2016: Expert Opinion on Investigational Drugs
Umer Akbar, Arlet G Kurkchubasche, Joseph H Friedman
Guidelines for the management of Parkinson's disease (PD) patients in the perioperative setting are lacking. Areas covered: Here we review potential problems that may arise when PD patients are undergoing an operation. We also review the literature, where available, and provide our expert opinion and recommendations based on experience. Expert commentary: Elderly patients with PD are especially prone to complications in the perioperative setting. Extreme caution must be used to ensure appropriate medication administration, transition to non-oral agents, if indicated, and early mobilization to achieve rapid recovery after surgery...
October 3, 2016: Expert Review of Neurotherapeutics
Steve W Parry, Harry Hill, Joanna Lawson, Nick Lawson, David Green, Heidi Trundle, Judith McNaught, Victoria Strassheim, Alma Caldwell, Richard Mayland, Phillip Earley, Peter McMeekin
National and international evidence and guidelines on falls prevention and management in community-dwelling elderly adults recommend that falls services should be multifactorial and their interventions multicomponent. The way that individuals are identified as having had or being at risk of falls in order to take advantage of such services is far less clear. A novel multidisciplinary, multifactorial falls, syncope, and dizziness service model was designed with enhanced case ascertainment through proactive, primary care-based screening (of individual case notes of individuals aged ≥60) for individual fall risk factors...
September 27, 2016: Journal of the American Geriatrics Society
Alfonso Fasano, Silke Appel-Cresswell, Mandar Jog, Mateusz Zurowkski, Sarah Duff-Canning, Melanie Cohn, Marina Picillo, Christopher R Honey, Michel Panisset, Renato Puppi Munhoz
In this review, we have gathered all the available evidence to guide medication management after deep brain stimulation (DBS) in Parkinson's disease (PD). Surprisingly, we found that almost no study addressed drug-based management in the postoperative period. Dopaminergic medications are usually reduced, but whether the levodopa or dopamine agonist is to be reduced is left to the personal preference of the treating physician. We have summarized the pros and cons of both approaches. No study on the management of cognitive problems after DBS has been done, and only a few studies have explored the pharmacological management of such DBS-resistant symptoms as voice (amantadine), balance (donepezil) or gait disorders (amantadine, methylphenidate)...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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