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Gait instability

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https://www.readbyqxmd.com/read/29779681/serum-uric-acid-level-and-its-association-with-motor-subtypes-and-non-motor-symptoms-in-early-parkinson-s-disease-pals-study
#1
Xinxin Huang, Samuel Yong-Ern Ng, Nicole Shuang-Yu Chia, Sanchalika Acharyya, Fiona Setiawan, Z-H Lu, Ebonne Ng, Kay-Yaw Tay, Wing-Lok Au, Eng-King Tan, Louis Chew-Seng Tan
OBJECTIVE: Uric acid has been found to be potentially neuroprotective in Parkinson's disease (PD). We investigated the relationship between serum uric acid levels and both motor and non-motor features in a prospective early PD cohort study. METHODS: Fasting serum uric acid levels were measured from 125 early PD patients. Demographic, clinical characteristics, motor and non-motor assessments were performed. Patients were categorized into three motor subtypes: tremor-dominant (TD), postural instability/gait difficulty (PIGD), and mixed...
May 17, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29776864/putaminal-dopamine-depletion-in-de-novo-parkinson-s-disease-predicts-future-development-of-wearing-off
#2
Su Jin Chung, Yoonju Lee, Jungsu S Oh, Jae Seung Kim, Phil Hyu Lee, Young H Sohn
INTRODUCTION: The present study aimed to investigate whether the level of presynaptic dopamine neuronal loss predicts future development of wearing-off in de novo Parkinson's disease. METHODS: This retrospective cohort study included a total of 342 non-demented patients with de novo Parkinson's disease who underwent dopamine transporter positron emission tomography scans at their initial evaluation and received dopaminergic medications for 24 months or longer. Onset of wearing-off was determined based on patients' medical records at their outpatient clinic visits every 3-6 months...
May 10, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29774765/-staying-safe-a-narrative-review-of-falls-prevention-in-people-with-parkinson-s-pdsafe
#3
Sophia Hulbert, Lynn Rochester, Alice Nieuwboer, Vicki Goodwin, Carolyn Fitton, Kim Chivers-Seymour, Ann Ashburn
BACKGROUND: Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms. Falling is common and disabling. Current medical management shows minimal impact to reduce falls or fall-related risk factors, such as deficits in gait, strength, and postural instability. Despite evidence supporting rehabilitation in reducing fall risk factors, the most appropriate intervention to reduce overall fall rate remains inconclusive. This article aims to 1) synthesise current evidence and conceptual models of falls rehabilitation in Parkinson's in a narrative review; and based on this evidence, 2) introduce the treatment protocol used in the falls prevention and multi-centre clinical trial "PDSAFE"...
May 18, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29753902/bilateral-upper-cerebellar-hemorrhage-due-to-pial-arteriovenous-fistula-and-its-pathophysiological-insight
#4
Yosuke Akamatsu, Toshiaki Hayashi, Kenichi Sato, Hiroshi Karibe, Motonobu Kameyama, Teiji Tominaga
OBJECTIVES: Bilateral upper cerebellar hemorrhage is extremely rare clinical entity, but relatively known as postoperative neurosurgical complication with as yet unknown etiology. Here, we report a case of bilateral upper cerebellar hemorrhage due to pial arteriovenous fistula and discussed possible pathophysiology of this bleeding pattern. CASE DESCRIPTION: A 4-year-old boy, who was previously healthy, presented with a sudden onset of headache, vomiting, and gait instability...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29751090/sex-dependent-and-sex-independent-muscle-activation-patterns-in-adult-gait-as-a-function-of-age
#5
Christopher A Bailey, Federica Corona, Giuseppina Pilloni, Micaela Porta, Maria Chiara Fastame, Paul Kenneth Hitchcott, Maria Pietronilla Penna, Massimiliano Pau, Julie N Côté
INTRODUCTION: Aging leads to poorer neuromuscular control that may impact mobility. However, the specific decades when these changes occur, and whether these time-based changes are sex-specific, are unclear. METHODS: Adults aged 20-82 years (N = 93, 51 females) walked six gait trials at their preferred speed over a 10-m platform. Electromyography (EMG) of the rectus femoris (RF), tibialis anterior (TA), and gastrocnemius lateralis (GL) were measured using wireless surface sensors...
May 8, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29748110/interoceptive-processing-deficit-a-behavioral-marker-for-subtyping-parkinson-s-disease
#6
Gabriella Santangelo, Carmine Vitale, Chiara Baiano, Alfonsina D'Iorio, Katia Longo, Paolo Barone, Marianna Amboni, Massimiliano Conson
BACKGROUND: Non-motor symptoms in Parkinson's disease (PD), such as cognitive, emotional, autonomic and somatosensory alterations, are not ubiquitous but vary between the tremor dominant (TD) and postural instability/gait difficulty (PIGD) subtypes of the syndrome. Non-motor phenomena (e.g., anxiety, depression and apathy) have been related to representation of autonomic and somatosensory sensations (interoception), and recent findings suggest interoceptive deficits in PD. OBJECTIVES: To test whether interoceptive processing is differently affected in TD and PIGD phenotypes, by assessing both interoceptive accuracy and sensibility in PD patients with TD and PIGD subtypes, and in healthy controls...
May 5, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29744050/iatrogenic-nerve-lesion-following-laparoscopic-surgery-a-case-report
#7
Michele Vecchio, Andrea Santamato, Fortunato Geneovese, Giulia Malaguarnera, Vito Emanuele Catania, Saverio Latteri
Background: Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table. Presentation of the case: A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29740058/model-based-and-model-free-machine-learning-techniques-for-diagnostic-prediction-and-classification-of-clinical-outcomes-in-parkinson-s-disease
#8
Chao Gao, Hanbo Sun, Tuo Wang, Ming Tang, Nicolaas I Bohnen, Martijn L T M Müller, Talia Herman, Nir Giladi, Alexandr Kalinin, Cathie Spino, William Dauer, Jeffrey M Hausdorff, Ivo D Dinov
In this study, we apply a multidisciplinary approach to investigate falls in PD patients using clinical, demographic and neuroimaging data from two independent initiatives (University of Michigan and Tel Aviv Sourasky Medical Center). Using machine learning techniques, we construct predictive models to discriminate fallers and non-fallers. Through controlled feature selection, we identified the most salient predictors of patient falls including gait speed, Hoehn and Yahr stage, postural instability and gait difficulty-related measurements...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29713303/association-between-peripheral-inflammation-and-datscan-data-of-the-striatal-nuclei-in-different-motor-subtypes-of-parkinson-disease
#9
Hossein Sanjari Moghaddam, Farzaneh Ghazi Sherbaf, Mahtab Mojtahed Zadeh, Amir Ashraf-Ganjouei, Mohammad Hadi Aarabi
The interplay between peripheral and central inflammation has a significant role in dopaminergic neural death in nigrostriatal pathway, although no direct assessment of inflammation has been performed in relation to dopaminergic neuronal loss in striatal nuclei. In this study, the correlation of neutrophil to lymphocyte ratio (NLR) as a marker of peripheral inflammation to striatal binding ratios (SBRs) of DAT SPECT images in bilateral caudate and putamen nuclei was calculated in 388 drug-naïve early PD patients [288 tremor dominant (TD), 73 postural instability and gait difficulty (PIGD), and 27 indeterminate] and 148 controls...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29706993/instrumental-or-physical-exercise-rehabilitation-of-balance-improves-both-balance-and-gait-in-parkinson-s-disease
#10
Marica Giardini, Antonio Nardone, Marco Godi, Simone Guglielmetti, Ilaria Arcolin, Fabrizio Pisano, Marco Schieppati
We hypothesised that rehabilitation specifically addressing balance in Parkinson's disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n = 15, and Exercises, n = 17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program...
2018: Neural Plasticity
https://www.readbyqxmd.com/read/29703644/comparison-of-two-motor-subtype-classifications-in-de-novo-parkinson-s-disease
#11
Seong-Min Choi, Byeong C Kim, Bang-Hoon Cho, Kyung Wook Kang, Kang-Ho Choi, Joon-Tae Kim, Seung-Han Lee, Man-Seok Park, Myeong-Kyu Kim, Ki-Hyun Cho
BACKGROUND: Clinical subtypes of Parkinson's disease (PD) have been empirically defined based on the prominent motor symptoms. The aim of this study was to compare the prevalence of non-motor symptoms across PD motor subtypes in patients with PD. METHODS: A total of 192 patients with de novo PD were included. The patients were classified into the tremor-dominant/mixed/akinetic-rigid (TD/mixed/AR) and tremor-dominant/mixed/postural instability and gait disturbance (TD/mixed/PIGD) subtypes, according to previous reports...
April 18, 2018: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29701258/evaluation-of-smartphone-based-testing-to-generate-exploratory-outcome-measures-in-a-phase-1-parkinson-s-disease-clinical-trial
#12
Florian Lipsmeier, Kirsten I Taylor, Timothy Kilchenmann, Detlef Wolf, Alf Scotland, Jens Schjodt-Eriksen, Wei-Yi Cheng, Ignacio Fernandez-Garcia, Juliane Siebourg-Polster, Liping Jin, Jay Soto, Lynne Verselis, Frank Boess, Martin Koller, Michael Grundman, Andreas U Monsch, Ronald B Postuma, Anirvan Ghosh, Thomas Kremer, Christian Czech, Christian Gossens, Michael Lindemann
BACKGROUND: Ubiquitous digital technologies such as smartphone sensors promise to fundamentally change biomedical research and treatment monitoring in neurological diseases such as PD, creating a new domain of digital biomarkers. OBJECTIVES: The present study assessed the feasibility, reliability, and validity of smartphone-based digital biomarkers of PD in a clinical trial setting. METHODS: During a 6-month, phase 1b clinical trial with 44 Parkinson participants, and an independent, 45-day study in 35 age-matched healthy controls, participants completed six daily motor active tests (sustained phonation, rest tremor, postural tremor, finger-tapping, balance, and gait), then carried the smartphone during the day (passive monitoring), enabling assessment of, for example, time spent walking and sit-to-stand transitions by gyroscopic and accelerometer data...
April 27, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29698346/a-mixed-presentation-of-serotonin-syndrome-vs-neuroleptic-malignant-syndrome-in-a-12-year-old-boy
#13
Christie Sun, Hannah Sweet, Alicia B Minns, Desiree Shapiro, Willough Jenkins
BACKGROUND: Neuroleptic malignant syndrome (NMS) and serotonin syndrome (SS) are serious medical conditions associated with commonly prescribed psychiatric medications. Although the mechanisms differ, they can be clinically difficult to distinguish. We report a case of a pediatric patient with complicated psychiatric history that developed features of both syndromes in the setting of polypharmacy. CASE: A 12-year-old boy with a history of developmental delay, attention-deficit hyperactivity disorder, and posttraumatic stress disorder presented to the emergency department with behavior changes consisting of delayed reactions, gait instability, drooling, and slowed movements...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29689731/magnetoencephalography-and-normal-pressure-hydrocephalus-a-case-report
#14
A Kotini, T Birbilis, P Anninos, I Seimenis
A 82-year-old male experiencing headaches, dementia, urinary incontinence and gait instability was diagnosed with normal pressure hydrocephalus (NPH) and underwent a resting state magnetoencephalography (MEG) examination. MEG data were recorded in a magnetically shielded room with a whole-head 122 channel biomagnetometer. Following MEG, a ventriculoperitoneal (VP) shunt was placed in his head and greatly improved his symptomatology. Spontaneous MEG recordings revealed lower magnetic fields at frontal and frontotemporal regions compared to central and posterior regions...
April 18, 2018: Journal of Integrative Neuroscience
https://www.readbyqxmd.com/read/29674286/longitudinal-changes-over-thirty-six-months-in-postural-control-dynamics-and-cognitive-function-in-people-with-parkinson-s-disease
#15
Annette Pantall, Silvia Del Din, Lynn Rochester
BACKGROUND: Postural instability is a common motor feature in people with Parkinson's disease (PD) together with non-motor features such as cognitive dysfunction. Management of postural instability is challenging as it is often resistant to dopaminergic therapy. Greater knowledge of postural control is essential to understand postural instability in PD. RESEARCH QUESTION: This study aimed to answer how postural control differs in people with PD compared to healthy older adults (HOA)...
April 13, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29672558/the-effects-of-unexpected-mechanical-perturbations-during-treadmill-walking-on-spatiotemporal-gait-parameters-and-the-dynamic-stability-measures-by-which-to-quantify-postural-response
#16
Forough Madehkhaksar, Jochen Klenk, Kim Sczuka, Katharina Gordt, Itshak Melzer, Michael Schwenk
Most falls occur after a loss of balance following an unexpected perturbation such as a slip or a trip. Greater understanding of how humans control and maintain stability during perturbed walking may help to develop appropriate fall prevention programs. The aim of this study was to examine changes in spatiotemporal gait and stability parameters in response to sudden mechanical perturbations in medio-lateral (ML) and anterior-posterior (AP) direction during treadmill walking. Moreover, we aimed to evaluate which parameters are most representative to quantify postural recovery responses...
2018: PloS One
https://www.readbyqxmd.com/read/29657237/management-of-sternal-dislocation-with-and-without-surgery-in-cats-owner-assessed-long-term-follow-up-of-two-clinical-cases
#17
Gab-Chol Choi, Md Mahbubur Rahman, Hwangmin Kim, Sehoon Kim, In-Seong Jeong
The aim of this paper is to report two cases of sternal dislocation (SD) in cats and the long-term outcomes with and without surgery. In a cat with poly-traumatized SD (Case 1), mandibular, radial, and ulnar fractures were corrected first, and the SD was allowed to heal without intervention for 14 months. However, normal healing did not occur and sternal instability remained. Therefore, the SD was corrected surgically, and the cat recovered fully within 4 weeks. In a cat with isolated SD (Case 2), surgery was performed, and normal posture and gait were regained after 5 weeks...
April 16, 2018: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29644085/protein-molecular-modeling-shows-residue-t599-is-critical-to-wild-type-function-of-polg-and-description-of-a-novel-variant-associated-with-the-sando-phenotype
#18
John E Richter, Hector G Robles, Elizabeth Mauricio, Ahmed Mohammad, Paldeep S Atwal, Thomas R Caulfield
Sensory ataxic neuropathy with dysarthria and ophthalmoparesis (SANDO) is a rare phenotype resulting from pathogenic variants of mitochondrial DNA polymerase gamma ( POLG ). We modeled a novel POLG variant, T599P, that causes the SANDO phenotype and another variant at the same residue, p.T599E, to observe their effect on protein function and confirm the pathogenicity of T599P. Through neoteric molecular modeling techniques, we show that changes at the T599 residue position introduce extra rigidity into the surrounding helix-loop-helix, which places steric pressure on nearby nucleotides...
2018: Human Genome Variation
https://www.readbyqxmd.com/read/29627500/objective-measures-of-unobstructed-walking-and-obstacle-avoidance-in-parkinson-s-disease-subtypes
#19
Diego Orcioli-Silva, Rodrigo Vitório, Ellen Lirani-Silva, Paulo Cezar Rocha Santos, Victor Spiandor Beretta, Lilian Teresa Bucken Gobbi
BACKGROUND: Objective measures of gait in Parkinson's disease (PD) patients according to motor subtypes are not yet fully understood. Although recent advances have been made for unobstructed walking, further work is required on locomotor tasks challenging postural stability, such as obstacle avoidance. RESEARCH QUESTION: This study aimed to investigate the influence of PD motor subtypes on objective measures of locomotion during unobstructed walking and obstacle avoidance...
March 30, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29623455/managing-gait-balance-and-posture-in-parkinson-s-disease
#20
REVIEW
Bettina Debû, Clecio De Oliveira Godeiro, Jarbas Correa Lino, Elena Moro
PURPOSE OF REVIEW: Postural instability and gait difficulties inexorably worsen with Parkinson's disease (PD) progression and become treatment resistant, with a severe impact on autonomy and quality of life. We review the main characteristics of balance instability, gait disabilities, and static postural alterations in advanced PD, and the available treatment strategies. RECENT FINDINGS: It remains very difficult to satisfactorily alleviate gait and postural disturbances in advanced PD...
April 6, 2018: Current Neurology and Neuroscience Reports
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