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parkinsonism falls

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
Inbal Maidan, Freek Nieuwhof, Hagar Bernad-Elazari, Bastiaan R Bloem, Nir Giladi, Jeffrey M Hausdorff, Jurgen A H R Claassen, Anat Mirelman
BACKGROUND: In a randomized control trial conducted in patients with Parkinson's disease, a treadmill training program combined with virtual reality that targeted motor and cognitive aspects of safe ambulation led to fewer falls, compared with treadmill training alone. OBJECTIVE: To investigate if the 2 types of training differentially affected prefrontal activation and if this might explain differences in fall rates after the intervention. METHODS: Sixty-four patients with Parkinson's disease were randomized into the treadmill training arm (n = 34, mean age 73...
March 1, 2018: Neurorehabilitation and Neural Repair
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
Ruwei Ou, Qianqian Wei, Bei Cao, Wei Song, Yanbing Hou, Hui Liu, Xiaoqin Yuan, Bi Zhao, Ying Wu, Huifang Shang
Objective: To explore the clinical predictors of freezing of gait (FOG) in Chinese patients with Parkinson's disease (PD). Methods: This study included 225 patients with PD who completed a three-year follow-up visit. The end-point was the presence of FOG (freezers), which was assessed during the follow-up visit. Group comparisons were conducted, followed by a further forward binary logistic regression analysis. Results: Eighty-five patients with PD (38%) had developed FOG at the end of study...
March 2018: Brain and Behavior
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
Lawrence W Elmer, Jorge L Juncos, Carlos Singer, Daniel D Truong, Susan R Criswell, Sotirios Parashos, Larissa Felt, Reed Johnson, Rajiv Patni
BACKGROUND: Although levodopa is considered the most effective pharmacotherapy for motor symptoms of Parkinson's disease (PD), chronic use is associated with motor complications, including fluctuating response and unpredictable, involuntary movements called dyskinesia. ADS-5102 (amantadine) extended-release (ER) capsules (GOCOVRITM ) is a recent US FDA-approved treatment for dyskinesia in PD patients. ADS-5102 is a high-dose, ER formulation of amantadine, administered orally once daily at bedtime, that achieves high plasma drug concentrations throughout the day...
March 12, 2018: CNS Drugs
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
Jose-Alberto Palma, Horacio Kaufmann
Dysfunction of the autonomic nervous system afflicts most patients with Parkinson disease and other synucleinopathies such as dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure, reducing quality of life and increasing mortality. For example, gastrointestinal dysfunction can lead to impaired drug pharmacodynamics causing a worsening in motor symptoms, and neurogenic orthostatic hypotension can cause syncope, falls, and fractures. When recognized, autonomic problems can be treated, sometimes successfully...
March 2018: Movement Disorders: Official Journal of the Movement Disorder Society
A M Ardi Handojoseno, Ganesh R Naik, Moran Gilat, James M Shine, Tuan N Nguyen, Quynh T Ly, Simon J G Lewis, Hung T Nguyen
Freezing of gait (FOG) is an episodic gait disturbance affecting initiation and continuation of locomotion in many Parkinson's disease (PD) patients, causing falls and a poor quality of life. FOG can be experienced on turning and start hesitation, passing through doorways or crowded areas dual tasking, and in stressful situations. Electroencephalography (EEG) offers an innovative technique that may be able to effectively foresee an impending FOG. From data of 16 PD patients, using directed transfer function (DTF) and independent component analysis (ICA) as data pre-processing, and an optimal Bayesian neural network as a predictor of a transition of 5 seconds before the impending FOG occurs in 11 in-group PD patients, we achieved sensitivity and specificity of 85...
2018: Studies in Health Technology and Informatics
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
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
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
Ben Parkinson, Drew Armit, Peter McEwen, Michelle Lorimer, Ian A Harris
BACKGROUND: Climate factors have been shown to be associated with spontaneous musculoskeletal and some surgical site infections with increased rates of infection during warmer periods. To date, little research has been performed to determine if this phenomenon is associated with differences in the risk of revision for prosthetic joint infection (PJI) in primary TKA. QUESTIONS/PURPOSES: (1) Does the rate of revision for early PJI within the first year after primary TKA differ between tropical and nontropical regions? (2) Is there a seasonal variation in the rate of revision for PJI? (3) Is the geographic and seasonal variation (if present) associated with the sex, age, and/or American Society of Anesthesiologists (ASA) grade of the patient? METHODS: All 219,983 primary TKAs performed for osteoarthritis over a 5-year period (2011-2015) in the Australian Orthopaedic Association National Joint Replacement Registry were examined based on the month of the primary procedure to determine the rate of revision for PJI within 12 months...
February 21, 2018: Clinical Orthopaedics and related Research
Avtar K Handa, Tahira Fatima, Autar K Mattoo
Biogenic amines-polyamines (PAs), particularly putrescine, spermidine and spermine are ubiquitous in all living cells. Their indispensable roles in many biochemical and physiological processes are becoming commonly known, including promoters of plant life and differential roles in human health and disease. PAs positively impact cellular functions in plants-exemplified by increasing longevity, reviving physiological memory, enhancing carbon and nitrogen resource allocation/signaling, as well as in plant development and responses to extreme environments...
2018: Frontiers in Chemistry
Manuela Galli, Caterina Vicidomini, Ana F Rozin Kleiner, Laura Vacca, Veronica Cimolin, Claudia Condoluci, Fabrizio Stocchi, Maria F DE Pandis
BACKGROUND: The shuffling steps pattern is a typical feature of gait in patients affected by Parkinson's Disease (PD), which progressively reduces their quality of life, being related to the risk of falls in this population. Recently, Automated Mechanical Peripheral Stimulation (AMPS) was presented as an integrative rehabilitative treatment based on peripheral stimulation able to improve the gait spatiotemporal parameters in PD patients. AIM: To evaluate the effects of AMPS on shuffling steps pattern by analyzing the kinematic and spatio-temporal gait parameters...
February 19, 2018: European Journal of Physical and Rehabilitation Medicine
Melissa J Armstrong
PURPOSE OF REVIEW: Progressive supranuclear palsy (PSP) is a 4R tau neuropathologic entity. While historically defined by the presence of a vertical supranuclear gaze palsy and falls in the first symptomatic year, clinicopathologic studies identify alternate presenting phenotypes. This article reviews the new PSP diagnostic criteria, diagnostic approaches, and treatment strategies. RECENT FINDINGS: The 2017 International Parkinson and Movement Disorder Society PSP criteria outline 14 core clinical features and 4 clinical clues that combine to diagnose one of eight PSP phenotypes with probable, possible, or suggestive certainty...
February 17, 2018: Current Neurology and Neuroscience Reports
Clive Ballard, Carol Banister, Zunera Khan, Jeffrey Cummings, George Demos, Bruce Coate, James M Youakim, Randall Owen, Srdjan Stankovic
BACKGROUND: Pimavanserin is a selective 5-HT2A receptor inverse agonist and antagonist approved in the USA for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. No safe or effective pharmacological treatment is approved for psychosis in patients with Alzheimer's disease. Therefore, we aimed to evaluate the safety, tolerability, and efficacy of pimavanserin versus placebo in patients with Alzheimer's disease psychosis. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, single-centre (with multiple affiliated nursing home sites across the UK) study...
March 2018: Lancet Neurology
Tee-Tau Eric Nyam, Chung-Han Ho, Yu-Lin Wang, Sher-Wei Lim, Jhi-Joung Wang, Chung-Ching Chio, Jinn-Rung Kuo, Che-Chuan Wang
BACKGROUND: Previous studies have implicated traumatic brain injury (TBI) as a risk factor for Parkinson's disease (PD). However, the incidence risk of new-onset TBI among patients with PD is not well established. This study investigated the contribution of PD to new-onset TBI associations. MATERIAL AND METHODS: The study selected 6,076 patients with PD and using 1:2 propensity score matching 12,152 general population cohorts in a longitudinal population database in Taiwan...
February 13, 2018: World Neurosurgery
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
Nicholas J Brandmeir, Cheryl L Brandmeir, David Carr, Kristine Kuzma, James McInerney
BACKGROUND: Falls and postural instability (PI) are major sources of morbidity in Parkinson disease (PD). Deep brain stimulation (DBS) is a major therapy for PD. The effects of DBS on PI and falls remain controversial. OBJECTIVE: To study if DBS worsens PI, validated measures of PI (Timed Up and Go, Berg Balance Scale, Unified Parkinson's Disease Rating Scale 3.12 [Pull Test], and the Biodex Sway Index with eyes closed on a firm and soft surface) and reported falls were used to prospectively evaluate the effect of DBS on PI at 3 and 12 mo postoperatively compared to baseline measurements...
February 10, 2018: Neurosurgery
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