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medical management of Parkinson

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https://www.readbyqxmd.com/read/28631520/striatal-changes-underlie-mpep-mediated-suppression-of-the-acquisition-and-expression-of-pramipexole-induced-place-preference-in-an-alpha-synuclein-rat-model-of-parkinson-s-disease
#1
Simon Loiodice, Portia McGhan, Vitalina Gryshkova, Renaud Fleurance, David Dardou, Aziz Hafidi, Andre Nogueira da Costa, Franck Durif
Impulsive-compulsive disorders in Parkinson's disease patients have been described as behavioural or substance addictions including pathological gambling or compulsive medication use of dopamine replacement therapy. A substantial gap remains in the understanding of these disorders. We previously demonstrated that the rewarding effect of the D2/D3 agonist pramipexole was enhanced after repeated exposure to L-dopa and alpha-synuclein mediated dopaminergic nigral loss with specific transcriptional signatures suggesting a key involvement of the glutamatergic pathway...
June 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#2
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28571034/remotely-programmed-deep-brain-stimulation-of-the-bilateral-subthalamic-nucleus-for-the-treatment-of-primary-parkinson-disease-a-randomized-controlled-trial-investigating-the-safety-and-efficacy-of-a-novel-deep-brain-stimulation-system
#3
Dianyou Li, Chencheng Zhang, Judith Gault, Wei Wang, Jianmin Liu, Ming Shao, Yanyan Zhao, Kristina Zeljic, Guodong Gao, Bomin Sun
BACKGROUND: Deep brain stimulation (DBS) is the most commonly performed surgery for the debilitating symptoms of Parkinson disease (PD). However, DBS systems remain largely unaffordable to patients in developing countries, warranting the development of a safe, economically viable, and functionally comparable alternative. OBJECTIVE: To investigate the efficacy and safety of wirelessly programmed DBS of bilateral subthalamic nucleus (STN) in patients with primary PD...
June 2, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28567500/treatment-of-sleep-dysfunction-in-parkinson-s-disease
#4
REVIEW
Amy W Amara, Lana M Chahine, Aleksandar Videnovic
Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sleep and neuropsychiatric disorders. The primary neurodegenerative process of PD involves brain regions that regulate the sleep-wake cycle, such as brainstem and hypothalamic nuclei. Sleep disorders in PD include insomnia, REM sleep behavior disorder (RBD), sleep disordered breathing (SDB), restless legs syndrome (RLS), and circadian disruption...
July 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28554416/treatment-of-older-parkinson-s-disease
#5
Abhishek Lenka, Chandrasekharapillai Padmakumar, Pramod K Pal
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease. The prevalence of PD increases with age. The spectrum of clinical features, the rate of progression of the disease, the burden of nonmotor symptoms, and the response to medications are different in older patients with PD from the relatively younger patients. Management of symptoms of PD in older patients is challenging because of possible existence of several age-related systemic illness. While dealing with older patients, it is crucial not to attribute all the physical symptoms to PD...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28548894/switching-from-an-oral-dopamine-receptor-agonist-to-rotigotine-transdermal-patch-a-review-of-clinical-data-with-a-focus-on-patient-perspective
#6
Sun Ju Chung, Mahnaz Asgharnejad, Lars Bauer, Arturo Benitez, Babak Boroojerdi, Tanja Heidbrede, Allison Little, Han Joon Kim
Dopamine receptor agonists (DAs) are commonly used to treat Parkinson's disease (PD) and restless legs syndrome (RLS). In certain situations, switching from oral DAs to rotigotine transdermal patch may be beneficial for the patient (e.g., optimal symptom control/side effects/perioperative management, preference for once-daily/non-oral administration, RLS augmentation treatment). Areas covered: This narrative review summarizes available data on DA dose equivalency, dose conversions, switching schedules, safety, tolerability, efficacy and patient treatment preferences of switching from oral DAs to rotigotine (and vice versa) in patients with PD/RLS...
May 26, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28529730/effect-of-low-versus-high-frequency-stimulation-on-freezing-of-gait-and-other-axial-symptoms-in-parkinson-patients-with-bilateral-stn-dbs-a-mini-review
#7
REVIEW
Tao Xie, Mahesh Padmanaban, Lisa Bloom, Ellen MacCracken, Breanna Bertacchi, Abraham Dachman, Peter Warnke
Some studies have shown that low frequency stimulation (LFS, most commonly 60 Hz), compared to high frequency stimulation (HFS, most commonly 130 Hz), has beneficial effects, short-term or even long-term, on improving freezing of gait (FOG) and other axial symptoms, including speech and swallowing function, in Parkinson disease (PD) patients with bilateral subthalamic nucleus deep brain stimulation (STN DBS). However, other studies failed to confirm this. It seems not clear what determines the difference in response to LFS...
2017: Translational Neurodegeneration
https://www.readbyqxmd.com/read/28509343/the-influence-of-vascular-risk-factors-on-cognitive-function-in-early-parkinson-s-disease
#8
Maxime Doiron, Mélanie Langlois, Nicolas Dupré, Martine Simard
OBJECTIVES: Hypertension, dyslipidemia, diabetes, and obesity are well-established risk factors for cognitive impairment and dementia in older adults. In contrast, previous studies that have assessed the impact of vascular risk factors (VRFs) on cognition in Parkinson's disease (PD) have had methodological limitations and reported conflicting findings. We address this question in a large well-characterized cohort of de novo PD patients. METHODS: A total of 367 untreated and non-demented patients aged 50 years and older with early PD (H&Y = 1...
May 16, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28506531/parkinson-s-disease-and-pregnancy-an-updated-review
#9
REVIEW
Mara Seier, Amie Hiller
Pregnancy does not often occur in the setting of Parkinson's disease (PD) as the most common age of onset is beyond the childbearing years, yet management of these two conditions is crucial for the health of both mother and child. Here we review treatment data of PD during pregnancy, primarily from case reports and drug registries, and focus on available evidence regarding the pregnancy risks for patient and fetus. Historically, it was reported that many women had worsening of symptoms during pregnancy but this may be because anti-parkinsonian medications were not recommended or were under dosed...
July 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28504022/safinamide-for-the-treatment-of-parkinson-s-disease
#10
Ruth Mary deSouza, Anthony Schapira
The major unmet needs in the medical treatment of Parkinson disease (PD) are reduction of motor side effects from dopaminergic drugs, management of non-motor symptoms and disease modification. Areas covered: Motor fluctuations and OFF periods are a significant determinant of quality of life in PD and reducing their duration and severity can significantly improve motor function. This aim may be partly facilitated by the development of effective adjunctive drugs for dopamine replacement. Safinamide (Xadago), which is a first generation anticonvulsant, has pharmacological properties which are of interest in the context of neurodegenerative diseases, leading to research into its potential as an adjunct to levodopa in PD...
June 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28497554/shaking-up-the-debate-ensuring-the-ethical-use-of-dbs-intervention-criteria-for-mid-stage-parkinson-s-patients
#11
REVIEW
Marleen Eijkholt, Laura Y Cabrera, Adolfo Ramirez-Zamora, Julie G Pilitsis
OBJECTIVES: Deep brain stimulation (DBS) is a well-established treatment for the management of severe motor fluctuations in advanced Parkinson's disease (PD). Until recently, device regulation, medical, and insurance practices limited DBS to patients with advanced stages of PD. In February 2016 this changed, however, when the US Food and Drug Administration (FDA) granted formal approval for the use of brain stimulator in mid-stage PD patients. In this article, we examine whether DBS in mid-stage PD can be ethically justified beyond the FDA approval...
May 11, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28490469/management-impact-of-imaging-brain-vesicular-monoamine-transporter-type-2-vmat2-in-clinically-uncertain-parkinsonian-syndrome-cups-with-18-f-av133-and-pet
#12
Paschal Kevin Alexander, Yennie Lie, Gareth Jones, Chomalaven Sivaratnam, Svetlana Bozinovski, Rachel S Mulligan, Kenneth Young, Victor Luis Villemagne, Christopher C Rowe
Objectives: Idiopathic Parkinson's disease (iPD) is a common neurodegenerative disorder where misdiagnosis occurs in up to 30% of patients after initial assessment and in 10-15% even after long-term follow-up. Vesicular monoamine transporter type II (VMAT2) imaging with Positron Emission Tomography (PET) allows assessment of the integrity of the presynaptic dopaminergic pathway. We investigated the management impact of VMAT2 imaging in patients with Clinically Uncertain Parkinsonian Syndromes (CUPS). Methods: Forty-seven patients with CUPS (56...
May 10, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28478793/antipsychotic-prescribing-practices-in-those-with-parkinsonism-adherence-to-guidelines
#13
Heather B Rigby, Sara Rehan, Barbara Hill-Taylor, Kara Matheson, Ingrid Sketris
Several evidence-informed treatment guidelines recommend against the use of typical antipsychotics in patients with Parkinson's disease; of the atypical antipsychotics, clozapine and quetiapine are preferred. The purpose of this study is to determine the frequency with which potentially inappropriate antipsychotics are dispensed to older adults in Nova Scotia who are on levodopa-containing medications. In this cohort, 59.9% were dispensed a preferred atypical antipsychotic and 12.6% a potentially harmful typical antipsychotic...
May 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28478699/management-of-lower-urinary-tract-symptoms-in-parkinson-s-disease-in-the-neurology-clinic
#14
Arina Madan, Sudeshna Ray, Daniel Burdick, Pinky Agarwal
This clinical review aims to evaluate lower urinary tract symptoms (LUTS) in Parkinson's disease (PD) patients and the current treatment options available for these symptoms in a neurology setting. The review also addresses when referral to urology is appropriate. A literature search was conducted using the keywords 'LUTS', 'non-motor symptoms', 'overactive bladder', 'Parkinson's disease' and 'urinary symptoms' using the Medline/Pubmed search engine. Data collected ranged from 2000 to present with emphasis on recent publications...
May 25, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28459677/continuous-assessment-of-levodopa-response-in-parkinson-s-disease-using-wearable-motion-sensors
#15
Christopher L Pulliam, Dustin A Heldman, Elizabeth B Brokaw, Thomas O Mera, Zoltan K Mari, Michelle A Burack
OBJECTIVE: Fluctuations in response to levodopa in Parkinson's disease (PD) are difficult to treat as tools to monitor temporal patterns of symptoms are hampered by several challenges. The objective was to use wearable sensors to quantify the dose response of tremor, bradykinesia, and dyskinesia in individuals with PD. METHODS: Thirteen individuals with PD and fluctuating motor benefit were instrumented with wrist and ankle motion sensors and recorded by video. Kinematic data were recorded as subjects completed a series of activities in a simulated home environment through transition from OFF to ON medication...
April 25, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28447217/swallowing-disorders-in-schizophrenia
#16
REVIEW
Deepika P Kulkarni, Vandan D Kamath, Jonathan T Stewart
Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications...
April 26, 2017: Dysphagia
https://www.readbyqxmd.com/read/28433105/symptomatic-treatment-of-neurologic-symptoms-in-wilson-disease
#17
Tomasz Litwin, Petr Dušek, Anna Członkowska
Wilson disease (WD) is a potentially treatable neurodegenerative disorder. In the majority of cases, treatment with drugs that induce a negative copper balance (usually chelators or zinc salts) leads to improvements in liver function and neurologic signs. However, some patients show severe neurologic symptoms at diagnosis, such as tremor, dystonia, parkinsonism, and chorea. In this patient group, some neurologic deficits may persist despite adequate treatment, and further neurologic deterioration may be observed after treatment initiation...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28419875/falls-in-people-with-parkinson-s-disease-a-prospective-comparison-of-community-and-home-based-falls
#18
Robyn M Lamont, Meg E Morris, Hylton B Menz, Jennifer L McGinley, Sandra G Brauer
BACKGROUND: Falls are common and debilitating in people with Parkinson's disease (PD) and restrict participation in daily activities. Understanding circumstances of falls in the community and at home may assist clinicians to target therapy more effectively. OBJECTIVE: To compare the characteristics of community and home fallers and the circumstances that contribute to falls in people living with PD. METHODS: People with mild-moderately severe PD (n=196) used a daily falls diary and telephone hotline to report prospectively the occurrence, location and circumstances of falls over 14 months...
April 4, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28416144/feasibility-of-spirography-features-for-objective-assessment-of-motor-function-in-parkinson-s-disease
#19
Aleksander Sadikov, Vida Groznik, Martin Možina, Jure Žabkar, Dag Nyholm, Mevludin Memedi, Dejan Georgiev
OBJECTIVE: Parkinson's disease (PD) is currently incurable, however proper treatment can ease the symptoms and significantly improve the quality of life of patients. Since PD is a chronic disease, its efficient monitoring and management is very important. The objective of this paper was to investigate the feasibility of using the features and methodology of a spirography application, originally designed to detect early Parkinson's disease (PD) motoric symptoms, for automatically assessing motor symptoms of advanced PD patients experiencing motor fluctuations...
March 31, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28394266/is-decompressive-surgery-for-cervical-spondylotic-myelopathy-effective-in-patients-suffering-from-concomitant-multiple-sclerosis-or-parkinson-s-disease
#20
REVIEW
Taylor E Purvis, Daniel Lubelski, Thomas E Mroz
A subset of patients with a demyelinating disease suffer from concurrent cervical spondylotic myelopathy, both of which evince similar symptomatology. Differentiating the cause of these symptoms is challenging, and little research has been done on patients with coexisting diseases. This review explores the current literature on the appropriate surgical management of patients with concurrent multiple sclerosis (MS) and cervical spondylotic myelopathy (CSM), and those with both Parkinson's disease (PD) and CSM...
April 10, 2017: Brain Sciences
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