16 Pharmacological Interventions for Sialorrhoea in Parkinson’s Disease: A Systematic Review

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
A Reid ◽  
C Smyth ◽  
J Reid ◽  
M Bailey
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Pharmacological Therapy ◽  
Risk Of Bias ◽  
Cochrane Central Register ◽  
Idiopathic Parkinson’S Disease ◽  
Idiopathic Parkinson's Disease ◽  
Movement Disorder Society

Abstract Introduction We looked at patients with Idiopathic Parkinson’s disease and reviewed articles that used any pharmacological therapy to attempt to reduce the volume or burden of sialorrhoea. The control was patients on placebo or receiving usual best care. The primary outcome was symptom burden of sialorrhoea. Method The review was registered on Prospero (CRD42016042470.) 7 electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS) were searched until April 2019 using search terms for sialorrhoea and Parkinson’s disease. We additional searched through the last 6 years of abstracts from the International Movement Disorder Conference, Movement Disorder Society International Congress and World Parkinson’s Congress. Hand searching was performed of published journals from the Movement Disorder Journal of the Movement Disorder Society and Neurology. Inclusion criteria included patients aged over 18; patients with a diagnosis of Idiopathic Parkinson’s disease; patients with the complication of sialorrhoea and any pharmacological therapy aimed at reducing sialorrhoea. All articles were assessed for risk of bias independently by two assessors using the Cochrane risk of bias tool. Results 7 articles were included from the 1,015 screened citations. 3 studies used Botox B as an intervention with clear objective measures and low risk of bias. These studies did show a significant reduction in sialorrhoea however the largest study showed some reporting bias and the others had small numbers and a short follow up period. 1 study looked at Botox A which showed significant improvement in sialorrhoea but had short follow-up. Conclusion Most studies have very small numbers and were followed up for only 1 month. There was significant heterogeneity in outcome measures but little evidence of significant harm from from the treatments studied. Overall, more robust evidence is required in order to achieve a gold standard in the treatment of sialorrhoea.

Clinical features predicting dementia in idiopathic Parkinson's disease: A follow-up study

Neurology ◽  
1990 ◽  
Vol 40 (8) ◽  
pp. 1222-1222 ◽  
Author(s):  
K. P. Ebmeier ◽  
S. A. Calder ◽  
J. R. Crawford ◽  
L. Stewart ◽  
J.A.O. Besson ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Features ◽  
Idiopathic Parkinson’S Disease ◽  
Follow Up Study ◽  
Idiopathic Parkinson's Disease

scholarly journals Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247354
Author(s):  
Sohyun Jeong ◽  
Hyemin Cho ◽  
Yun Joong Kim ◽  
Hyeo-Il Ma ◽  
Sunmee Jang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Strong Predictor ◽  
Idiopathic Parkinson’S Disease ◽  
Drug Induced ◽  
Idiopathic Parkinson's Disease ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Comorbidity Index

Background Although Idiopathic Parkinson’s disease (IPD) develops in considerable patients with drug-induced Parkinsonism (DIP), the association hasn’t been well defined. We aimed to evaluate the underlying association and risk factors of DIP and IPD. Methods A retrospective cohort study using National Health Insurance Claims data in 2011–2016 was conducted. New-onset DIP patients in 2012 were selected and matched with active controls having diabetes mellitus at a 1:4 ratio by age, sex, and Charlson’s Comorbidity Index score. Comorbidity, causative drugs, and prescription days were evaluated as covariates. Results A total of 441 DIP were selected. During the 4-year follow up, 14 IPD events in the DM group but 62 events in the DIP group were observed (adjusted hazard ratio, HR: 18.88, 95% CI, 9.09–39.22, adjusting for comorbidities and causative drugs). IPD diagnosis in DIP was observed high in males compared to females (15.58/13.24%). The event was the most within the 1st year follow-up, mean days 453 (SD 413.36). Subgroup analysis in DIP showed calcium channel blocker (verapamil, diltiazem, and flunarizine) was significantly associated with increased IPD risk (HR: 2.24, 95% CI, 1.27–3.93). Conclusion Increased IPD in DIP patients might not be from the causal toxicity of antidopaminergic effects but from a trigger by the causative drugs on the DIP patients who already had subclinical IPD pathology. DIP can serve as a strong proxy for IPD incidence. Subjects who develop DIP should be monitored carefully for potential IPD incidence.

scholarly journals Retrospective Assessment of Movement Disorder Society Criteria for Mild Cognitive Impairment in Parkinson’s Disease

2015 ◽  
Vol 21 (2) ◽  
pp. 137-145 ◽  
Author(s):  
Andrea M. Loftus ◽  
Romola S. Bucks ◽  
Meghan Thomas ◽  
Robert Kane ◽  
Caitlin Timms ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Movement Disorder ◽  
Rating Scale ◽  
Neuropsychological Testing ◽  
Simulation Method ◽  
Movement Disorder Society

AbstractA Movement Disorder Society (MDS) taskforce recently proposed diagnostic criteria for Parkinson’s disease with features of mild cognitive impairment (PD-MCI). This study first examined the prevalence and nature of PD-MCI in a non-demented cohort using the MDS criteria. Using the generic Monte Carlo simulation method developed by Crawford and colleagues (2007), this study then estimated the base rate of the representative population who would demonstrate PD-MCI due to chance alone. A total of 104 participants with idiopathic PD underwent extensive motor and neuropsychological testing at baseline and 2 years later. The Unified Parkinson’s Disease Rating Scale (UPDRS) was used to assess motor symptoms of PD and a range of established neuropsychological tests was used to assess PD-MCI in accord with MDS criteria. In accord with MDS criteria, 38% of this cohort demonstrated PD-MCI at baseline and 48% at follow-up. Of the 36 participants in the multiple-domain PD-MCI subtype at time-1, 9 (25%) demonstrated no PD-MCI at follow up. Analysis revealed that approximately 13% of the representative population would demonstrate abnormally low scores for 2 of the 9 tests used, thereby meeting MDS criteria for PD-MCI. Clinicians and researchers need to approach a single diagnosis (i.e., based on one assessment) of PD-MCI with considerable caution. (JINS, 2015, 21, 137–145)

scholarly journals Unilateral Combined Stereotactic Radiofrequency Pallidotomy And Thalamotomy For Idiopathic Parkinson’s Disease’. A Prospective Observational Study With 24-Month Follow-Up

2021 ◽  
Author(s):  
Mohamed Khaled Elkazaz ◽  
Ali Salah Khedr ◽  
Maha Abd El Fattah
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Assessment ◽  
Prospective Observational Study ◽  
Idiopathic Parkinson’S Disease ◽  
Idiopathic Parkinson's Disease ◽  
Yahr Scale ◽  
The Mean ◽  
Csf Leaks

Abstract Study Design: Prospective study Objective: To report efficacy of unilateral combined stereotactic radiofrequency pallidotomy and thalamotomy for Idiopathic Parkinson’s disease.Methods: Between June 2017 to December 2019, 62 patients with idiopathic Parkinson’s disease underwent stereotactic radiofrequency pallidotomy and thalamotomy. Pre-operatively clinical assessment using the UPDRS and Hoen and Yahr scale for PD. Post-operatively clinical assessment using the UPDRS and Hoen and Yahr scale for PD, complications in 1,6,12 and 24 months.Results: 60 patients completed two-year follow-up and fulfilled our criteria were recruited. The mean age was 57.47±9.90. The average UPDRS off motor assessment results showed reduction after 1 month from 60.16 to 30.88 and at 24-month follow-up was 41.6. The average Yahr and Hoen scale 3.63 to 1.19 after 1-month and 24 months was 1.87. The average UPDRS constancy of tremors improved after 1-month from 3.53 to 0.75. Improvement in constancy of tremors reached 75% of cases after 24-month with average 1.62. the average UPDRS rigidity score improved at 1-month follow-up from 3.31 to 1.21. Total improvement of rigidity reached 63% after 24-month. 2 patients had post-operative thalamic hematoma presented with hemiplegia, which was conservatively managed, and improved after 1-month with little deficit. 51.6% had gait imbalance at 6-month follow-up. 22.5% showed dysarthria immediately while 12.9% totally resolved after 1-month follow-up. No recorded cases of infection, CSF leaks or cognitive dysfunction. Conclusion: Our data suggest that Unilateral combined stereotactic radiofrequency pallidotomy and thalamotomy for Idiopathic PD is effective procedure.

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