The mean velocity of posterior cerebral artery and basilar artery in Parkinson's disease with sleep disorders

Parkinson’s disease affects over one million people in the United States. Although there have been remarkable advances in uncovering the pathogenesis of this disabling disorder, the etiology is speculative. Medical treatment and operative procedures provide symptomatic relief only. Compression of the cerebral peduncle of the midbrain by the posterior cerebral artery in a patient with Parkinson’s Disease (Parkinson’s Disease) was noted on magnetic resonance imaging (MRI) scan and at operation in a patient with trigeminal neuralgia. Following the vascular decompression of the trigeminal nerve, the midbrain was decompressed by mobilizing and repositioning the posterior cerebral artery The patient's Parkinson's signs disappeared over a 48-hour period. They returned 18 months later with contralateral peduncle compression. A blinded evaluation of MRI scans of Parkinson's patients and controls was performed. MRI scans in 20 Parkinson's patients and 20 age and sex matched controls were evaluated in blinded fashion looking for the presence and degree of arterial compression of the cerebral peduncle. The MRI study showed that 73.7 percent of Parkinson's Disease patients had visible arterial compression of the cerebral peduncle. This was seen in only 10 percent of control patients (two patients, one of whom subsequently developed Parkinson’s Disease); thus 5 percent. Vascular compression of the cerebral peduncle by the posterior cerebral artery may be associated with Parkinson’s Disease in some patients. Microvascular decompression of that artery away from the peduncle may be considered for treatment of Parkinson’s Disease in some patients.

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The posterior thalamoperforating artery (the main perforating trunk from P1) microsurgical study

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA ◽

10.22290/jbnc.v3i4.77 ◽

2017 ◽

Vol 3 (4) ◽

pp. 103-107

Author(s):

Aziz Rassi Neto ◽

Ápio Cláudio Martins Antunes ◽

Fernando Menezes Braga

Keyword(s):

Cerebral Artery ◽

Basilar Artery ◽

Posterior Cerebral Artery ◽

Neurosurgical Procedures ◽

Microsurgical Anatomy ◽

Deep Knowledge ◽

The Mean ◽

Human Brains

Thirty fresh human brains were studied regarding to the anatomy of the posterior thalamoperforating arteries (PThPA): origin, number, diameter, traject, distance from the basilar artery bifurcation, type of distribution and correspondent area of vascularization. Most of the PThPAs originated proximally in the posterior cerebral artery (PCA), irrigating the cerebral, peduncles, mammilary bodies, ventral portion of midbrain and, through the posterior perforated substance, the medial portion of thalamus. The mean number of PThPAs per hemisphere was 1.51, mean proximal diameter 0.60 mm and mean distance from PCA origin 2.47 mm. A deep knowledge of the microsurgical anatomy of PThPAs is stressed, as devastating lesions can develop after arterial compromise during neurosurgical procedures.

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Sleep Disorders in Parkinson’s Disease

Parkinson's Disease ◽

10.1201/9780203508596.ch21 ◽

2004 ◽

Author(s):

Svenja Happe

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disorders

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Frequency of non-motor symptoms in Peruvian patients with Parkinson's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130005 ◽

2013 ◽

Vol 71 (4) ◽

pp. 216-219 ◽

Cited By ~ 14

Author(s):

Carlos Cosentino ◽

Yesenia Nuñez ◽

Luis Torres

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Progressive Increase ◽

Motor Symptoms ◽

Number Of Patients ◽

Progression Of Disease ◽

The Mean ◽

Relationship Of ◽

The Relationship ◽

Non Motor Symptoms

Introduction: Non-motor symptoms in Parkinson's disease are often not well recognized in clinical practice. Non-motor symptoms questionnaire (NMSQuest) is a simple instrument that allows patients or caregivers to report non-motor symptoms in a practical manner. Objective: We attempted to determine the prevalence of non-motor symptoms in three hundred Parkinson's disease outpatients. Results: The mean total non-motor symptoms was 12.41, ranging from 0 to 27 of a maximum of 30. At least one was present in 99.3% of patients. A progressive increase in mean total score was observed across each 5-year interval. Depression domain scored the most “positive” answers while urinary and anxiety /memory were secondly and thirdly most prevalent respectively. Conclusion: The large number of patients included in this study allowed evaluation of the occurrence of non-motor symptoms in early and advanced disease in addition to the relationship of these kinds of symptoms with progression of disease.

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Stability of MDS-UPDRS Motor Subtypes Over Three Years in Early Parkinson's Disease

Frontiers in Neurology ◽

10.3389/fneur.2021.704906 ◽

2021 ◽

Vol 12 ◽

Author(s):

Abhijeet K. Kohat ◽

Samuel Y. E. Ng ◽

Aidan S. Y. Wong ◽

Nicole S. Y. Chia ◽

Xinyi Choi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Area Under The Curve ◽

Baseline Factors ◽

Prospective Cohorts ◽

The Mean ◽

The Stability ◽

Early Parkinson’S Disease ◽

Levodopa Equivalent Daily Dose

Background: Various classifications have been proposed to subtype Parkinson's disease (PD) based on their motor phenotypes. However, the stability of these subtypes has not been properly evaluated.Objective: The goal of this study was to understand the distribution of PD motor subtypes, their stability over time, and baseline factors that predicted subtype stability.Methods: Participants (n = 170) from two prospective cohorts were included: the Early PD Longitudinal Singapore (PALS) study and the National Neuroscience Institute Movement Disorders Database. Early PD patients were classified into tremor-dominant (TD), postural instability and gait difficulty (PIGD), and indeterminate subtypes according to the Movement Disorder Society's Unified PD Rating Scale (MDS-UPDRS) criteria and clinically evaluated for three consecutive years.Results: At baseline, 60.6% patients were TD, 12.4% patients were indeterminate, and 27.1% patients were PIGD subtypes (p < 0.05). After 3 years, only 62% of patients in TD and 50% of patients in PIGD subtypes remained stable. The mean levodopa equivalent daily dose (LEDD) was higher in the PIGD subtype (276.92 ± 232.91 mg; p = 0.01). Lower LEDD [p < 0.05, odds ratio (OR) 0.99, 95% confidence interval (CI): 0.98–0.99] and higher TD/PIGD ratios (p < 0.05, OR 1.77, 95% CI: 1.29–2.43) were independent predictors of stability of TD subtype with an area under the curve (AUC) of 0.787 (95%CI: 0.669–0.876), sensitivity = 57.8%, and specificity = 89.7%.Conclusion: Only 50–62% of PD motor subtypes as defined by MDS-UPDRS remained stable over 3 years. TD/PIGD ratio and baseline LEDD were independent predictors for TD subtype stability over 3 years.

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The Experiences of Patients with Deep Brain Stimulation in Parkinson’s Disease: Challenges, Expectations, and Accomplishments

Acta Medica Academica ◽

10.5644/ama2006-124.281 ◽

2020 ◽

Vol 49 (1) ◽

pp. 36

Author(s):

Özlem İbrahimoğlu ◽

Sevinc Mersin ◽

Eda Akyol

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Healthcare Professionals ◽

Focus Group Interviews ◽

The Mean ◽

Group Interviews ◽

Deep Brain

Objectives. Deep brain stimulation (DBS) is a safe and effective alternative treatment of some movement disorders such as Parkinson's disease. Although DBS is an effective treatment for Parkinson's disease, because of the necessity of surgical intervention, follow-up and the effects on symptoms, this study was carried out to determine the challenges, expectations and accomplishments of patients with DBS in Parkinson’s disease.Materials and Methods. This qualitative study was carried out at the Neurosurgery Department of a research hospital in Turkey with seven patients who underwent DBS between 2008 and 2018. In the study, the challenges, expectations, and accomplishments of patients were investigated by using three focus group interviews in October 2018.Results. Among the participants, six patients were male, and one patient was female. The mean age of the patients was 56.85}16.48. Three main themes were revealed in the study. These were (1) Reborn; decrease in dependence, sense of accomplishment, enjoyment of life, (2) Prejudice; perceived as severely ill by others and (3) Fear; not being accustomed to the device, loss of device function.Conclusion. The results obtained from this study can be used in the process of adaptation to this process by discussing and evaluating the challenges, expectations and accomplishments of the Parkinson's patient in DBS with healthcare professionals and other patients.

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Treatment of the Sleep Disorders Associated with Parkinson’s Disease

Neurotherapeutics ◽

10.1007/s13311-013-0236-z ◽

2013 ◽

Vol 11 (1) ◽

pp. 68-77 ◽

Cited By ~ 35

Author(s):

Lynn Marie Trotti ◽

Donald L. Bliwise

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disorders

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Effects of various factors on sleep disorders and quality of life in Parkinson’s disease

Acta Neurologica Belgica ◽

10.1007/s13760-015-0478-0 ◽

2015 ◽

Vol 115 (4) ◽

pp. 615-621 ◽

Cited By ~ 4

Author(s):

Srdjana Telarovic ◽

Dragana Mijatovic ◽

Irma Telarovic

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disorders

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Outcomes following deep brain stimulation lead revision or reimplantation for Parkinson’s disease

Journal of Neurosurgery ◽

10.3171/2018.1.jns171660 ◽

2019 ◽

Vol 130 (6) ◽

pp. 1841-1846 ◽

Cited By ~ 1

Author(s):

Leonardo A. Frizon ◽

Sean J. Nagel ◽

Francis J. May ◽

Jianning Shao ◽

Andres L. Maldonado-Naranjo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Device Failure ◽

Suboptimal Outcome ◽

Number Of Patients ◽

The Mean ◽

Lead Location ◽

Deep Brain

OBJECTIVEThe number of patients who benefit from deep brain stimulation (DBS) for Parkinson’s disease (PD) has increased significantly since the therapy was first approved by the FDA. Suboptimal outcomes, infection, or device failure are risks of the procedure and may require lead removal or repositioning. The authors present here the results of their series of revision and reimplantation surgeries.METHODSThe data were reviewed from all DBS intracranial lead removals, revisions, or reimplantations among patients with PD over a 6-year period at the authors’ institution. The indications for these procedures were categorized as infection, suboptimal outcome, and device failure. Motor outcomes as well as lead location were analyzed before removal and after reimplant or revision.RESULTSThe final sample included 25 patients who underwent 34 lead removals. Thirteen patients had 18 leads reimplanted after removal. There was significant improvement in the motor scores after revision surgery among the patients who had the lead revised for a suboptimal outcome (p = 0.025). The mean vector distance of the new lead location compared to the previous location was 2.16 mm (SD 1.17), measured on an axial plane 3.5 mm below the anterior commissure–posterior commissure line. When these leads were analyzed by subgroup, the mean distance was 1.67 mm (SD 0.83 mm) among patients treated for infection and 2.73 mm (SD 1.31 mm) for those with suboptimal outcomes.CONCLUSIONSPatients with PD who undergo reimplantation surgery due to suboptimal outcome may experience significant benefits. Reimplantation after surgical infection seems feasible and overall safe.

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