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Motor fluctuations

Benjamin N Conrad, Robert L Barry, Baxter P Rogers, Satoshi Maki, Arabinda Mishra, Saakshi Thukral, Subramaniam Sriram, Aashim Bhatia, Siddharama Pawate, John C Gore, Seth A Smith
Patients with multiple sclerosis present with focal lesions throughout the spinal cord. There is a clinical need for non-invasive measurements of spinal cord activity and functional organization in multiple sclerosis, given the cord's critical role in the disease. Recent reports of spontaneous blood oxygenation level-dependent fluctuations in the spinal cord using functional MRI suggest that, like the brain, cord activity at rest is organized into distinct, synchronized functional networks among grey matter regions, likely related to motor and sensory systems...
April 10, 2018: Brain: a Journal of Neurology
Ana Lígia Silva de Lima, Luc J W Evers, Tim Hahn, Nienke M de Vries, Margaret Daeschler, Babak Boroojerdi, Dolors Terricabras, Max A Little, Bastiaan R Bloem, Marjan J Faber
BACKGROUND: People with PD (PWP) have an increased risk of becoming inactive. Wearable sensors can provide insights into daily physical activity and walking patterns. RESEARCH QUESTIONS: (1) Is the severity of motor fluctuations associated with sensor-derived average daily walking quantity? (2) Is the severity of motor fluctuations associated with the amount of change in sensor-derived walking quantity after levodopa intake? METHODS: 304 Dutch PWP from the Parkinson@Home study were included...
March 28, 2018: Gait & Posture
Jessica E Kim, Daniel S Reynolds, Muhammad H Zaman, Michael Mak
Cellular processes, such as cell migration, adhesion, and proliferation depend on the interaction between the intracellular environment and the extracellular matrix (ECM). While many studies have explored the role of the microenvironment on cell behavior, the influence of 3D matrix mechanics on intracellular activity is not completely understood. To characterize the relationship between the mechanical components of the microenvironment and intracellular behavior, we use particle-tracking microrheology of metastatic breast cancer cells embedded in 3D collagen gels to quantify the intracellular activity from which the molecular motor activity and stiffness can be determined...
April 5, 2018: Integrative Biology: Quantitative Biosciences From Nano to Macro
Jian Sun, Ruochen Lan, Yanzi Gao, Meng Wang, Wanshu Zhang, Ling Wang, Lanying Zhang, Zhou Yang, Huai Yang
Dynamic controllability of self-organized helical superstructures in spatial dimensions is a key step to promote bottom-up artificial nanoarchitectures and functional devices for diverse applications in a variety of areas. Here, a light-driven chiral overcrowded alkene molecular motor with rod-like substituent is designed and synthesized, and its thermal isomerization reaction exhibits an increasing structural entropy effect on chemical kinetic analysis in anisotropic achiral liquid crystal host than that in isotropic organic liquid...
February 2018: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
Irene Katsaiti, John Nixon
BACKGROUND: A qualified consensus suggests that a combination of levodopa with a peripherally acting dopa decarboxylase inhibitor continues to present the gold standard treatment of Parkinson's disease (PD). However, as the disease progresses the therapeutic window of levodopa becomes narrowed. Pharmacological strategies for motor fluctuations are focused on providing less pulsatile and more continuous dopaminergic stimulation. Peripheral catechol-O-methyltransferase (COMT) inhibition improves the bioavailability of levodopa and results in a prolonged response...
March 26, 2018: Journal of Parkinson's Disease
Jared T Hinkle, Kate Perepezko, Zoltan Mari, Laura Marsh, Gregory M Pontone
OBJECTIVE: On/off motor fluctuations in Parkinson disease (PD) can be associated with extreme mood fluctuations and severe dysphoria. The impact of these affective symptoms may be overlooked in the treatment of motor fluctuations. Our goal was to examine the relationship between motor fluctuations, their treatment status, and suicidality in PD participants. METHODS: We analyzed data from the Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study of 223 individuals with PD...
January 31, 2018: American Journal of Geriatric Psychiatry
Matthew Hopgood, Gavin Reynolds, Richard Barker
We use computational fluid dynamics to compare the shear rate and turbulence in an advanced in vitro gastric model (TIMagc) during its simulation of fasted state Migrating Motor Complex phases I and II, with the United States Pharmacopeia Paddle Dissolution Apparatus II (USPII). A specific focus is placed on how shear rate in these apparatus effects erosion-based solid oral dosage forms. The study finds that tablet surface shear rates in TIMagc are strongly time-dependant and fluctuate between 0.001 and 360 s-1 ...
March 30, 2018: Journal of Pharmaceutical Sciences
Robert A Hauser, Aaron Ellenbogen, Sarita Khanna, Suneel Gupta, Nishit B Modi
Background: In patients with Parkinson's disease (PD), oral dosing of extended-release carbidopa-levodopa (Rytary, IPX066 [ER CD-LD]) achieves peak levodopa plasma concentrations within 1 hour and maintains them for 4-6 hours. Aims: To compare the onset and duration of ER CD-LD benefit with those of immediate-release carbidopa-levodopa (IR CD-LD) in PD patients with motor fluctuations, using crossover data, and to evaluate which threshold values of improvement in finger-tapping and Unified Parkinson's Disease Rating Scale (UPDRS) motor scores yield results most similar to those for trained raters' "on"/"off" assessments...
2018: Neuropsychiatric Disease and Treatment
Alessia Longo, Peter Federolf, Thomas Haid, Ruud Meulenbroek
In many daily jobs, repetitive arm movements are performed for extended periods of time under continuous cognitive demands. Even highly monotonous tasks exhibit an inherent motor variability and subtle fluctuations in movement stability. Variability and stability are different aspects of system dynamics, whose magnitude may be further affected by a cognitive load. Thus, the aim of the study was to explore and compare the effects of a cognitive dual task on the variability and local dynamic stability in a repetitive bimanual task...
March 27, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Andong Zhan, Srihari Mohan, Christopher Tarolli, Ruth B Schneider, Jamie L Adams, Saloni Sharma, Molly J Elson, Kelsey L Spear, Alistair M Glidden, Max A Little, Andreas Terzis, E Ray Dorsey, Suchi Saria
Importance: Current Parkinson disease (PD) measures are subjective, rater-dependent, and assessed in clinic. Smartphones can measure PD features, yet no smartphone-derived rating score exists to assess motor symptom severity in real-world settings. Objectives: To develop an objective measure of PD severity and test construct validity by evaluating the ability of the measure to capture intraday symptom fluctuations, correlate with current standard PD outcome measures, and respond to dopaminergic therapy...
March 26, 2018: JAMA Neurology
Stefano Zucca, Aya Zucca, Takashi Nakano, Sho Aoki, Jeffery Wickens
The cholinergic interneurons (CINs) of the striatum are crucial for normal motor and behavioral functions of the basal ganglia. Striatal CINs exhibit tonic firing punctuated by distinct pauses. Pauses occur in response to motivationally significant events, but their function is unknown. Here we investigated the effects of pauses in CIN firing on spiny projection neurons (SPNs) - the output neurons of the striatum - using in vivo whole cell and juxtacellular recordings in mice. We found that optogenetically-induced pauses in CIN firing inhibited subthreshold membrane potential activity and decreased firing of SPNs...
March 26, 2018: ELife
Susan H Fox, Regina Katzenschlager, Shen-Yang Lim, Brandon Barton, Rob M A de Bie, Klaus Seppi, Miguel Coelho, Cristina Sampaio
OBJECTIVE: The objective of this review was to update evidence-based medicine recommendations for treating motor symptoms of Parkinson's disease (PD). BACKGROUND: The Movement Disorder Society Evidence-Based Medicine Committee recommendations for treatments of PD were first published in 2002 and updated in 2011, and we continued the review to December 31, 2016. METHODS: Level I studies of interventions for motor symptoms were reviewed. Criteria for inclusion and quality scoring were as previously reported...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Angelo Antonini, Elena Moro, Clecio Godeiro, Heinz Reichmann
Advanced Parkinson's disease is characterized by the presence of motor fluctuations, various degree of dyskinesia, and disability with functional impact on activities of daily living and independence. Therapeutic management aims to extend levodopa benefit while minimizing motor complications and includes, in selected cases, the implementation of drug infusion and surgical techniques. In milder forms of motor complications, these can often be controlled with manipulation of levodopa dose and the introduction of supplemental therapies such as catechol-O-methyl transferase inhibitors, monoamine oxidase B inhibitors, and dopamine agonists including apomorphine...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Hubert H Fernandez, James T Boyd, Victor S C Fung, Mark F Lew, Ramon L Rodriguez, John T Slevin, David G Standaert, Cindy Zadikoff, Arvydas D Vanagunas, Krai Chatamra, Susan Eaton, Maurizio F Facheris, Coleen Hall, Weining Z Robieson, Janet Benesh, Alberto J Espay
BACKGROUND: Levodopa-carbidopa intestinal gel (designated as carbidopa-levodopa enteral suspension in the United States) provides stable plasma levodopa concentrations and reduces motor fluctuations in advanced Parkinson's disease patients through continuous delivery of levodopa via percutaneous endoscopic gastrojejunostomy. We report long-term safety and efficacy outcomes from an open-label phase 3 treatment program. METHODS: PD patients (n = 262) who completed a 12-week double-blind study and its 52-week open-label extension or a separate 54-week open-label study were enrolled in this ongoing phase 3 open-label, multinational study (NCT00660673)...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Yang Zheng, Xiaogang Hu
Transcutaneous electrical nerve stimulation can help individuals with neurological disorders to regain their motor function by activating muscles externally. However, conventional stimulation technique often induces near-simultaneous recruitment of muscle fibers, leading to twitch forces time-locked to the stimulation.
 Approach: To induce less synchronized activation of finger flexor muscles, we delivered clustered narrower pulses to the proximal segment of the median and ulnar nerves at a carrier frequency of either 10 kHz (with an 80 µs pulse width) or 7...
March 23, 2018: Journal of Neural Engineering
Lucie Jurek, Mathieu Herrmann, Mathilde Bonze, Sophie Brunet, Catherine Padovan, Jean-Michel Dorey
Dementia with Lewy bodies (DLB) is a common neurodegenerative disease, second in terms of prevalence after Alzheimer's disease (AD). DLB may be suspected according to three core features which are cognitive and motor fluctuations, early visual hallucinations and parkinsonism; and more recently, according to the new criteria, REM sleep behavior disorder (RBD). Behavorial and psychological symptoms associated with DLB are more frequent, more severe and appear earlier than those found in other neurodegenerative diseases...
March 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Christian Geny, Claudia Verna, Alexia Arifi, Ernestine Ferreira, Choukri Boubakri, Hubert Blain
Parkinson's disease (PD) is a common condition in nursing home (NH) residents. The primary treatment for Parkinson's disease is levodopa therapy to relieve motor symptoms and maximize physical function. Non-motor symptoms are highly prevalent in NH residents with Parkinson's disease and dramatically decrease quality of life. Choices in drug treatment need to take into account the complex interactions between aging, comorbidity and non-motor symptoms. Optimal management requires expertise and cooperative effort from prescribing neurologists and nursing home health professionals...
March 1, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Lazzaro di Biase, Susanna Summa, Jacopo Tosi, Fabrizio Taffoni, Massimo Marano, Angelo Cascio Rizzo, Fabrizio Vecchio, Domenico Formica, Vincenzo Di Lazzaro, Giovanni Di Pino, Mario Tombini
Background: In the last decades, several studies showed that wearable sensors, used for assessing Parkinson's disease (PD) motor symptoms and recording their fluctuations, could provide a quantitative and reliable tool for patient's motor performance monitoring. Objective: The aim of this study is to make a step forward the capability of quantitatively describing PD motor symptoms. The specific aims are: identify the most sensible place where to locate sensors to monitor PD bradykinesia and rigidity, and identify objective indexes able to discriminate PD OFF/ON motor status, and PD patients from healthy subjects (HSs)...
2018: Frontiers in Neurology
William H Curley, Peter B Forgacs, Henning U Voss, Mary M Conte, Nicholas D Schiff
Patients with severe brain injury are difficult to assess and frequently subject to misdiagnosis. 'Cognitive motor dissociation' is a term used to describe a subset of such patients with preserved cognition as detected with neuroimaging methods but not evident in behavioural assessments. Unlike the locked-in state, cognitive motor dissociation after severe brain injury is prominently marked by concomitant injuries across the cerebrum in addition to limited or no motoric function. In the present study, we sought to characterize the EEG signals used as indicators of cognition in patients with disorders of consciousness and examine their reliability for potential future use to re-establish communication...
March 19, 2018: Brain: a Journal of Neurology
Marco Janko, Michael Wiertlewski, Yon Visell
When we touch an object, complex frictional forces are produced, aiding us in perceiving surface features that help to identify the object at hand, and also facilitating grasping and manipulation. However, even during controlled tactile exploration, sliding friction forces fluctuate greatly, and it is unclear how they relate to the surface topography or mechanics of contact with the finger. We investigated the sliding contact between the finger and different relief surfaces, using high-speed video and force measurements...
March 20, 2018: Scientific Reports
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