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Balance and parkinson's disease

Raquel Marin, Mario Diaz
Estrogens (E2) exert a plethora of neuroprotective actions against aged-associated brain diseases, including Alzheimer's disease (AD). Part of these actions takes place through binding to estrogen receptors (ER) embedded in signalosomes, where numerous signaling proteins are clustered. Signalosomes are preferentially located in lipid rafts which are dynamic membrane microstructures characterized by a peculiar lipid composition enriched in gangliosides, saturated fatty acids, cholesterol, and sphingolipids. Rapid E2 interactions with ER-related signalosomes appear to trigger intracellular signaling ultimately leading to the activation of molecular mechanisms against AD...
2018: Frontiers in Neuroscience
Esther M J Bekkers, Kim Dockx, Surendar Devan, Sam Van Rossom, Sabine M P Verschueren, Bastiaan R Bloem, Alice Nieuwboer
BACKGROUND: Postural instability and freezing of gait (FOG) are major problems in patients with Parkinson's disease (PD), and both contribute to falls. However, the interrelationship between these 2 deficits is still unclear. OBJECTIVE: This study investigated whether dual-tasking influenced postural control differently in freezers (FOG+) and nonfreezers (FOG-). METHODS: Thirty-three patients with PD (19 FOG+, 14 FOG-, well-matched) and 28 healthy controls underwent 4 postural control tasks, consisting of standing on either stable or unstable surfaces with eyes open or closed...
February 2018: Neurorehabilitation and Neural Repair
Michael Baer, Bradley Klemetson, Diana Scott, Andrew S Murtishaw, James W Navalta, Jefferson W Kinney, Merrill R Landers
BACKGROUND AND PURPOSE: Because falls can have deleterious consequences, it is important to understand the influence of fatigue and medications on balance in persons with Parkinson disease (PD). Thus, the purpose of this study was to investigate the effects of fatigue on balance in individuals with PD. Because brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we also explored its role. METHODS: A total of 27 individuals (age = 65...
April 2018: Journal of Neurologic Physical Therapy: JNPT
Elisa Pelosin, Ambra Bisio, Thierry Pozzo, Giovanna Lagravinese, Oscar Crisafulli, Roberta Marchese, Giovanni Abbruzzese, Laura Avanzino
Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects' body sway. Parkinson's disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation...
2018: Frontiers in Neurology
Jiayue Cai, Soojin Lee, Fang Ba, Saurabh Garg, Laura J Kim, Aiping Liu, Diana Kim, Z Jane Wang, Martin J McKeown
Falls and balance difficulties remain a major source of morbidity in Parkinson's Disease (PD) and are stubbornly resistant to therapeutic interventions. The mechanisms of gait impairment in PD are incompletely understood but may involve changes in the Pedunculopontine Nucleus (PPN) and its associated connections. We utilized fMRI to explore the modulation of PPN connectivity by Galvanic Vestibular Stimulation (GVS) in healthy controls ( n = 12) and PD subjects even without overt evidence of Freezing of Gait (FOG) while on medication ( n = 23)...
2018: Frontiers in Neuroscience
J S Barajas, D S Peterson
BACKGROUND: Protective steps are critical for fall prevention and are altered in people with Parkinson's disease (PD). Previous work suggests that perturbation training, in which patients are exposed to repeated slips, may improve protective postural responses. However, these studies typically take the average performance of several postural responses before and after training. To reduce falls in the community, training must improve protective stepping after the first perturbation exposure...
March 8, 2018: Journal of Neurology
Hana You, Louise-Laure Mariani, Graziella Mangone, Delphine Le Febvre de Nailly, Fanny Charbonnier-Beaupel, Jean-Christophe Corvol
There is currently no cure for Parkinson's disease. The symptomatic therapeutic strategy essentially relies on dopamine replacement whose efficacy was demonstrated more than 50 years ago following the introduction of the dopamine precursor, levodopa. The spectacular antiparkinsonian effect of levodopa is, however, balanced by major limitations including the occurrence of motor complications related to its particular pharmacokinetic and pharmacodynamic properties. Other therapeutic strategies have thus been developed to overcome these problems such as the use of dopamine receptor agonists, dopamine metabolism inhibitors and non-dopaminergic drugs...
March 7, 2018: Cell and Tissue Research
Ulfuara Shefa, Min-Sik Kim, Na Young Jeong, Junyang Jung
Hydrogen sulfide (H2 S), a toxic gaseous molecule, plays a physiological role in regulating homeostasis and cell signaling. H2 S is produced from cysteine by enzymes, such as cystathionine β -synthase (CBS), cystathionine γ -lyase (CSE), cysteine aminotransferase (CAT), and 3-mercaptopyruvate sulfurtransferase (3MST). These enzymes regulate the overall production of H2 S in the body. H2 S has a cell-signaling function in the CNS and plays important roles in combating oxidative species such as reactive oxygen species (ROS) and reactive nitrogen species (RNS) in the body...
2018: Oxidative Medicine and Cellular Longevity
Imke Galazky, Jörn Kaufmann, Stefan Lorenzl, Georg Ebersbach, Florin Gandor, Tino Zaehle, Sylke Specht, Sabine Stallforth, Uwe Sobieray, Edyta Wirkus, Franziska Casjens, Hans-Jochen Heinze, Andreas Kupsch, Jürgen Voges
BACKGROUND: The pedunculopontine nucleus has been suggested as a potential deep brain stimulation target for axial symptoms such as gait and balance impairment in idiopathic Parkinson's disease as well as atypical Parkinsonian disorders. METHODS: Seven consecutive patients with progressive supranuclear palsy received bilateral pedunculopontine nucleus deep brain stimulation. Inclusion criteria comprised of the clinical diagnosis of progressive supranuclear palsy, a levodopa-resistant gait and balance disorder, age <75 years, and absence of dementia or major psychiatric co-morbidities...
February 19, 2018: Parkinsonism & related Disorders
Cynthia A Kelm-Nelson, Michael A Trevino, Michelle R Ciucci
Parkinson disease (PD) related to homozygous mutations in the Pink1 gene is associated with nigrostriatal dopamine depletion and a wide range of sensorimotor deficits. In humans and animal models of PD, not all sensorimotor deficits are levodopa-responsive. We hypothesized that the underlying mechanisms of locomotion, limb control, and vocal communication behavior include other pathologies. Here, Pink1 -/- rats were treated with an oral dose of levodopa and limb motor and vocal communication behaviors were measured...
February 26, 2018: Neuroscience
Maria Izabel Rodrigues Severiano, Bianca Simone Zeigelboim, Hélio Afonso Ghizoni Teive, Geslaine Janaína Barbosa Santos, Vinícius Ribas Fonseca
OBJECTIVE: To assess the effectiveness of balance exercises by means of virtual reality games in Parkinson's disease. METHODS: Sixteen patients were submitted to anamnesis, otorhinolaryngological and vestibular examinations, as well as the Dizziness Handicap Inventory, Berg Balance Scale, SF-36 questionnaire, and the SRT, applied before and after rehabilitation with virtual reality games. RESULTS: Final scoring for the Dizziness Handicap Inventory and Berg Balance Scale was better after rehabilitation...
February 2018: Arquivos de Neuro-psiquiatria
Ryan P Duncan, Linda R Van Dillen, Jane M Garbutt, Gammon M Earhart, Joel S Perlmutter
Background: Subthalamic nucleus deep brain stimulation (STN-DBS) reduces tremor, muscle stiffness, and bradykinesia in people with Parkinson's Disease (PD). Walking speed, known to be reduced in PD, typically improves after surgery; however, other important aspects of gait may not improve. Furthermore, balance may worsen and falls may increase after STN-DBS. Thus, interventions to improve balance and gait could reduce morbidity and improve quality of life following STN-DBS. Physical therapy (PT) effectively improves balance and gait in people with PD, but studies on the effects of PT have not been extended to those treated with STN-DBS...
2018: Pilot and Feasibility Studies
Paola Ortelli, Davide Ferrazzoli, Rossana Bera, Luca Caremani, Nir Giladi, Roberto Maestri, Giuseppe Frazzitta
BACKGROUND: Parkinsonian patients in advanced stages of disease suffer from many motor and non-motor symptoms, whose responsiveness to dopamine replacement therapy and deep brain stimulation is poor. It is necessary to find complementary strategies in order to improve the clinical conditions of patients in advanced Parkinson's disease (PD) stages. OBJECTIVE: We aimed to understand whether an inpatient, motor-cognitive, multidisciplinary, aerobic, intensive and goal-based rehabilitation treatment (MIRT), specifically designed for PD, is effective for patients in advanced stages of disease...
2018: Journal of Parkinson's Disease
Ioannis Bargiotas, Julien Audiffren, Nicolas Vayatis, Pierre-Paul Vidal, Stephane Buffat, Alain P Yelnik, Damien Ricard
The fact that almost one third of population >65 years-old has at least one fall per year, makes the risk-of-fall assessment through easy-to-use measurements an important issue in current clinical practice. A common way to evaluate posture is through the recording of the center-of-pressure (CoP) displacement (statokinesigram) with force platforms. Most of the previous studies, assuming homogeneous statokinesigrams in quiet standing, used global parameters in order to characterize the statokinesigrams. However the latter analysis provides little information about local characteristics of statokinesigrams...
2018: PloS One
Hiroshi Kataoka, Noriyuki Tanaka, Takao Kiriyama, Nobuyuki Eura, Masanori Ikeda, Tesseki Izumi, Yoshiko Furiya, Kazuma Sugie, Satoshi Ueno
BACKGROUND: Freezing of gait (FOG) has been linked to increased numbers of steps taken while walking. We tested the hypothesis that an increased number of steps associated with FOG might predict the exacerbation of the severity of Parkinson's disease (PD). METHODS: We prospectively studied 26 patients. Clinical assessments were performed and balance was evaluated in 30 patients with Hoehn-Yahr stage III PD 6 years previously. Gait parameters were analyzed with the use of an originally designed, suddenly narrowed path...
February 22, 2018: European Neurology
Sagrario Pérez-de la Cruz
OBJECTIVES: Various exercise strategies have been suggested to address movement deficits in order to improve motor function and quality of life for individuals in the early or moderate stages of Parkinson disease. The purpose is to evaluate the effects of an aquatic Ai Chi intervention on balance, gait speed and quality of life of patients. DESIGN AND INTERVENTION: Twenty-nine people with Parkinson disease participated in this pilot study. People were randomized into (1) aquatic Ai Chi program (experimental group) and (2) a dry land conventional Western physical therapy intervention (control group)...
February 2018: Complementary Therapies in Medicine
Talia Herman, S Shema-Shiratzky, L Arie, N Giladi, J M Hausdorff
In a prospective 5-year study among Parkinson's disease (PD) tremor-dominant (TD) patients, we investigated who will remain TD and who will later convert into the postural instability gait difficulty (PIGD) phenotype. At follow-up, 38% were still considered TD. At baseline the TD non-convertors had more years of education and better cognitive function than the convertors and significantly smaller deterioration in gait, balance, cognitive function and other non-motor symptoms. These results highlight the potential role of cognition in protecting against the development of PIGD symptoms...
February 15, 2018: Journal of Neural Transmission
Oleksandr V Popovych, Peter A Tass
Demand-controlled deep brain stimulation (DBS) appears to be a promising approach for the treatment of Parkinson's disease (PD) as revealed by computational, pre-clinical and clinical studies. Stimulation delivery is adapted to brain activity, for example, to the amount of neuronal activity considered to be abnormal. Such a closed-loop stimulation setup might help to reduce the amount of stimulation current, thereby maintaining therapeutic efficacy. In the context of the development of stimulation techniques that aim to restore desynchronized neuronal activity on a long-term basis, specific closed-loop stimulation protocols were designed computationally...
2018: Frontiers in Physiology
Lisa Alcock, Brook Galna, Jeffrey M Hausdorff, Sue Lord, Lynn Rochester
BACKGROUND: Gait impairment places older adults and people with Parkinson's disease (PD) at an increased risk of falls when walking over obstacles. Increasing the height of obstacles results in greater challenge to balance however little is known about the demands encountered when negotiating obstacles of greater depth which may be greater for PD who often walk with a short, shuffling gait. RESEARCH QUESTION: To describe gait adaptation in older adults and people with PD when walking over long and tall obstacles...
January 31, 2018: Gait & Posture
Neha Singh, Sheekha Vijayanti, Lekha Saha
Epilepsy is a complex, chronic neurological disorder characterized by increased and abnormal synchronization of neuronal electrical activity, which is manifested as seizures. It is associated with many comorbid conditions such as depression, anxiety, sleep disorder, psychiatric disorder etc. which consequently causes higher mortality rate. The understanding of its cellular and molecular mechanism is partial, because of which it remains an ongoing health problem, despite the increasing availability of newer antiepileptic drugs...
February 15, 2018: International Journal of Neuroscience
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