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medical management of Parkinson

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https://www.readbyqxmd.com/read/28344656/levodopa-carbidopa-enteral-suspension-in-advanced-parkinson-s-disease-clinical-evidence-and-experience
#1
REVIEW
Johan Virhammar, Dag Nyholm
The duration of action of oral levodopa becomes shorter as Parkinson's disease (PD) progresses. Patients with advanced PD may develop potentially disabling motor fluctuations and abnormal involuntary movement (dyskinesia), which cannot be managed with optimized oral or transdermal PD medications. The progressively worsening symptoms can have a substantial impact on the patient quality of life (QoL). Levodopa-carbidopa intestinal gel (LCIG) is delivered continuously via a percutaneous endoscopic gastrostomy with a jejunal extension (PEG-J)...
March 2017: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/28339403/dopamine-transporter-imaging-has-no-impact-on-functional-outcomes-in-de-novo-probable-parkinson-s-disease
#2
Patrick T Hickey, Maragatha Kuchibhatla, Burton Scott, Lisa Gauger, Mark A Stacy
BACKGROUND: Parkinson's disease (PD) is among the most prevalent neurodegenerative conditions. While motor and non-motor aspects of this disease have been well characterized, no objective biomarker exists to support an accurate clinical diagnosis. However, newer imaging techniques, including [123I]-FP-CIT (DaTSCAN), have demonstrated utility in differentiating between PD and non-neurodegenerative tremor disorders. OBJECTIVE: DaTSCAN has been primarily investigated in situations where diagnostic confusion exists, and in these instances has been shown to significantly impact clinical management...
March 20, 2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28331322/the-role-of-deep-brain-stimulation-in-parkinson-s-disease-an-overview-and-update-on-new-developments
#3
REVIEW
John Y Fang, Christopher Tolleson
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of neuronal dopamine production in the brain. Oral therapies primarily augment the dopaminergic pathway. As the disease progresses, more continuous delivery of therapy is commonly needed. Deep brain stimulation (DBS) has become an effective therapy option for several different neurologic and psychiatric conditions, including PD. It currently has US Food and Drug Administration approval for PD and essential tremor, as well as a humanitarian device exception for dystonia and obsessive-compulsive disorder...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28320164/impact-of-stn-dbs-on-mood-drive-anhedonia-and-risk-of-psychiatric-side-effects-in-the-population-of-pd-patients
#4
Anna Antosik-Wójcińska, Łukasz Święcicki, Monika Dominiak, Emilia Sołtan, Przemyslaw Bieńkowski, Tomasz Mandat
BACKGROUND: DBS is a surgical method of choice for various movement disorders, especially for Parkinson's disease (PD). Many publications showing improvement in motor symptoms and quality of life have been presented while there is little comprehensive research evaluation of the impact of DBS on mental state and psychiatric side-effects. OBJECT: The purpose of this study was to assess the impact of DBS on mood, drive, anhedonia and psychotic symptoms in the group of PD patients...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28293679/research-conference-summary-from-the-2014-international-task-force-on-atp1a3-related-disorders
#5
Hendrik Rosewich, Matthew T Sweney, Suzanne DeBrosse, Kevin Ess, Laurie Ozelius, Eva Andermann, Frederick Andermann, Gene Andrasco, Alice Belgrade, Allison Brashear, Sharon Ciccodicola, Lynn Egan, Alfred L George, Aga Lewelt, Joshua Magelby, Mario Merida, Tara Newcomb, Vicky Platt, Dominic Poncelin, Sandra Reyna, Masayuki Sasaki, Marcio Sotero de Menezes, Kathleen Sweadner, Louis Viollet, Mary Zupanc, Kenneth Silver, Kathryn Swoboda
OBJECTIVE: ATP1A3-related neurologic disorders encompass a broad range of phenotypes that extend well beyond initial phenotypic criteria associated with alternating hemiplegia of childhood (AHC) and rapid-onset dystonia parkinsonism. METHODS: In 2014, the Alternating Hemiplegia of Childhood Foundation hosted a multidisciplinary workshop intended to address fundamental challenges surrounding the diagnosis and management of individuals with ATP1A3-related disorders...
April 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28279509/-medical-and-surgical-treatment-of-parkinson-s-disease
#6
Luc Defebvre, Caroline Moreau
The treatment of Parkinson's disease is symptomatic with the use of dopaminergic medications: levodopa, dopaminergic agonists and enzymatic inhibitors. At the initial stage, the main goals are to improve the quality of life of patients and delay the onset of motor complications, using a combination of these therapies taking into account both clinical disability and tolerance of different treatments. At the stage of motor and non-motor fluctuations inhibitors of MAO-B and COMT are proposed; amantadine may limit moderate dyskinesias...
March 6, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28276746/further-explorations-of-illness-uncertainty-carers-experiences-of-parkinson-s-disease
#7
Catherine S Hurt, Sophie Cleanthous, Stanton P Newman
OBJECTIVE: Dominant models of illness uncertainty define uncertainty as 'an inability to determine the meaning of illness-related events'. Recent research has shown patient uncertainty to be multidimensional encompassing personal issues indirectly affected by illness. The nature of carer uncertainty has yet to be fully explored. The present study aimed to investigate the nature of illness uncertainty in the carers of patients with Parkinson's disease (PD). DESIGN: Eighteen carers of a spouse with PD participated in semistructured interviews...
February 7, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28269640/automatic-assessment-of-medication-states-of-patients-with-parkinson-s-disease-using-wearable-sensors
#8
Murtadha D Hssayeni, Michelle A Burack, Behnaz Ghoraani
Motor fluctuations are a major focus of clinical managements in patients with mid-stage and advance Parkinson's disease (PD). In this paper, we develop a new patient-specific algorithm that can classify those fluctuations during a variety of activities. We extract a set of temporal and spectral features from the ambulatory signals and then introduce a semi-supervised classification algorithm based on K-means and self-organizing tree map clustering methods. Two different types of cluster labeling are introduced: hard and fuzzy labeling...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263926/dopamine-depletion-impairs-gait-automaticity-by-altering-cortico-striatal-and-cerebellar-processing-in-parkinson-s-disease
#9
Moran Gilat, Peter T Bell, Kaylena A Ehgoetz Martens, Matthew J Georgiades, Julie M Hall, Courtney C Walton, Simon J G Lewis, James M Shine
Impairments in motor automaticity cause patients with Parkinson's disease to rely on attentional resources during gait, resulting in greater motor variability and a higher risk of falls. Although dopaminergic circuitry is known to play an important role in motor automaticity, little evidence exists on the neural mechanisms underlying the breakdown of locomotor automaticity in Parkinson's disease. This impedes clinical management and is in great part due to mobility restrictions that accompany the neuroimaging of gait...
March 3, 2017: NeuroImage
https://www.readbyqxmd.com/read/28239781/validation-of-the-promis-%C3%A2-measures-of-self-efficacy-for-managing-chronic-conditions
#10
Ann L Gruber-Baldini, Craig Velozo, Sergio Romero, Lisa M Shulman
PURPOSE: The Patient-Reported Outcomes Measurement Information System(®) (PROMIS(®)) was designed to develop, validate, and standardize item banks to measure key domains of physical, mental, and social health in chronic conditions. This paper reports the calibration and validation testing of the PROMIS Self-Efficacy for Managing Chronic Conditions measures. METHODS: PROMIS Self-Efficacy for Managing Chronic Conditions item banks comprise five domains, Self-Efficacy for Managing: Daily Activities, Symptoms, Medications and Treatments, Emotions, and Social Interactions...
February 26, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28227898/automatic-assessment-of-medication-states-of-patients-with-parkinson-s-disease-using-wearable-sensors
#11
Murtadha D Hssayeni, Michelle A Burack, Behnaz Ghoraani, Murtadha D Hssayeni, Michelle A Burack, Behnaz Ghoraani, Behnaz Ghoraani, Michelle A Burack, Murtadha D Hssayeni
Motor fluctuations are a major focus of clinical managements in patients with mid-stage and advance Parkinson's disease (PD). In this paper, we develop a new patient-specific algorithm that can classify those fluctuations during a variety of activities. We extract a set of temporal and spectral features from the ambulatory signals and then introduce a semi-supervised classification algorithm based on K-means and self-organizing tree map clustering methods. Two different types of cluster labeling are introduced: hard and fuzzy labeling...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#12
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28168537/hyperkinetic-movement-disorder-emergencies
#13
REVIEW
Giovanni Cossu, Carlo Colosimo
A movement disorder emergency has been defined by Fahn and Frucht as "any neurological disorder evolving acutely or subacutely, in which the clinical presentation is dominated by a primary movement disorder, and in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality." In this review, we discuss the most common situations in which hyperkinetic movement disorders, including chorea, ballism, dystonia, myoclonus, tics, as well as psychogenic disorders, can present as emergencies...
January 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28159316/-de-novo-consultation-evaluation-of-an-outpatient-s-clinic-dedicated-to-early-diagnosis-of-parkinsonian-syndromes
#14
J Ruggeri, L-L Mariani, S Aix, A-M Bonnet, F Cormier, J-C Corvol, P Dodet, D Grabli, A Hartmann, C Hubsch, L Lacomblez, E Roze, M-L Welter, Y Worbe, M Vidailhet, B Degos
INTRODUCTION: In the absence of specific clinical signs, imaging or biomarkers, the differential diagnosis of degenerative parkinsonian syndromes may be difficult at early stages of the disease. To reduce the risk of misdiagnosis or delayed diagnosis and referral to multiple medical centers at disease onset, easier access to expert centers should be available. To improve the initial care of parkinsonian patients, the Parkinson's disease Expert Center (PEC) at Pitié-Salpêtrière Academic Hospital has set up a specific outpatients clinic with short waiting times dedicated to the diagnosis of early Parkinson's disease and related disorders...
January 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28126343/management-of-impulse-control-disorders-with-deep-brain-stimulation-a-double-edged-sword
#15
REVIEW
Chayut Kasemsuk, Genko Oyama, Nobutaka Hattori
Deep brain stimulation (DBS) is a surgical option for advanced Parkinson's disease. Although DBS is used to treat motor fluctuation, DBS may affect non-motor symptoms including mood disorders, cognitive dysfunction, and behavior problems. Impulse control disorders (ICDs) are abnormal behaviors with various manifestations such as pathological gambling, hypersexuality, compulsive shopping, and binge eating, which can affect the quality of life in patients with Parkinson's disease. The effect of DBS on ICD is controversial...
March 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28116784/management-of-sleep-disorders-in-parkinson-s-disease-and-multiple-system-atrophy
#16
REVIEW
Aleksandar Videnovic
Parkinson's disease (PD) and multiple system atrophy (MSA) are disorders associated with α synuclein-related neurodegeneration. Nonmotor symptoms are common hallmarks of these disorders, and disturbances of the sleep-wake cycle are among the most common nonmotor symptoms. It is only recently that sleep disturbances have received the attention of the medical and research community. Significant progress has been made in understanding the pathophysiology of sleep and wake disruption in alphasynucleinopathies during the past few decades...
January 24, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28116120/distant-delivery-of-a-mindfulness-based-intervention-for-people-with-parkinson-s-disease-the-study-protocol-of-a-randomised-pilot-trial
#17
A Bogosian, C S Hurt, D Vasconcelos E Sa, J V Hindle, L McCracken, P Cubi-Molla
BACKGROUND: Psychological difficulties, especially depression and anxiety, are the most prevalent non-motor symptoms in Parkinson's disease. Pharmacological treatments for these conditions appear relatively ineffective in Parkinson's disease. Mindfulness courses are increasingly popular and recognised as effective for managing emotional states, and there is growing evidence for the effectiveness of mindfulness courses for people with long-term medical conditions. With this exploratory pilot trial, we want to assess the feasibility of the procedures and processes, including recruitment, most appropriate outcome measure(s), acceptability of type and number of measures, potential nocebo effects, and potential effectiveness and cost-effectiveness of a specially adapted distance-delivered mindfulness-based intervention in people affected by Parkinson's disease...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28115853/the-role-and-structure-of-the-multidisciplinary-team-in-the-management-of-advanced-parkinson-s-disease-with-a-focus-on-the-use-of-levodopa-carbidopa-intestinal-gel
#18
REVIEW
Stephen W Pedersen, Martin Suedmeyer, Louis W C Liu, Dirk Domagk, Alison Forbes, Lars Bergmann, Koray Onuk, Ashley Yegin, Teus van Laar
A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28108265/palliative-care-and-parkinson-s-disease-meeting-summary-and-recommendations-for-clinical-research
#19
REVIEW
Benzi M Kluger, Siobhán Fox, Suzanne Timmons, Maya Katz, Nicholas B Galifianakis, Indu Subramanian, Julie H Carter, Miriam J Johnson, Edward W Richfield, David Bekelman, Jean S Kutner, Janis Miyasaki
INTRODUCTION: Palliative care is an approach to caring for patients and families affected by serious illnesses that focuses on the relief of suffering through the management of medical symptoms, psychosocial issues, advance care planning and spiritual wellbeing. Over the past decade there has been an emerging clinical and research interest in the application of palliative care approaches to Parkinson's disease (PD) and outpatient palliative care services are now offered by several movement disorders centers...
January 11, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28106066/the-psychosis-spectrum-in-parkinson-disease
#20
REVIEW
Dominic H Ffytche, Byron Creese, Marios Politis, K Ray Chaudhuri, Daniel Weintraub, Clive Ballard, Dag Aarsland
In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication...
February 2017: Nature Reviews. Neurology
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