Parkinson’s Disease

2021 ◽  
pp. 13-43
Author(s):  
Allan Hugh Cole
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Disease Process ◽  
Disease Diagnosis ◽  
Future Research ◽  
Vigorous Exercise ◽  
Surgical Interventions ◽  
Lifestyle Practices

This chapter provides an introduction to Parkinson’s disease (PD) for the nonmedical specialist reader. It covers the history and prevalence of PD, the disease process and its symptoms (motor and non-motor), disease diagnosis, the stages of Parkinson’s, rates of progression, and treatment approaches. Although no form of treatment stops the disease process, there are treatments that can ease its symptoms. These approaches include pharmacological options, such as carbidopa/levodopa; technological devices, surgical interventions, such as deep brain stimulation; and lifestyle practices, such as regular vigorous exercise. The latter has also been shown to slow disease progression. The chapter concludes with a description of current and future research into treating and possibly stopping the progression of Parkinson’s disease.

scholarly journals A Preliminary Report on Disordered Speech with Deep Brain Stimulation in Individuals with Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Christopher Dromey ◽  
Suzy Bjarnason
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Electrode Placement ◽  
Future Research ◽  
Negative Effects ◽  
Average Spectrum ◽  
Vowel Formants ◽  
Deep Brain

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has proven effective in treating the major motor symptoms of advanced Parkinson's disease (PD). The aim of this study was to learn which laryngeal and articulatory acoustic features changed in patients who were reported to have worse speech with stimulation. Six volunteers with PD who had bilateral STN electrodes were recorded with DBS turned on or off. Perceptual ratings reflected poorer speech performance with DBS on. Acoustic measures of articulation (corner vowel formants, diphthong slopes, and a spirantization index) and phonation (perturbation, long-term average spectrum) as well as verbal fluency scores showed mixed results with DBS. Some speakers improved while others became worse on individual measures. The magnitude of DBS effects was not predictable based on the patients' demographic characteristics. Future research involving adjustments to stimulator settings or electrode placement may be beneficial in limiting the negative effects of DBS on speech.

Influence of deep brain stimulation and levodopa on signs and symptoms in Parkinson's disease

2009 ◽  
Vol 36 (S 02) ◽  
Author(s):  
J Gierthmühlen ◽  
P Arning ◽  
G Wasner ◽  
A Binder ◽  
J Herzog ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Signs And Symptoms ◽  
Deep Brain

Visual Effects of Deep Brain Stimulation in a Patient with Parkinson’s Disease

2019 ◽  
pp. 158-173
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Visual System ◽  
Brain Stimulation ◽  
Neurodegenerative Disorder ◽  
Initial Examination ◽  
Before And After ◽  
Deep Brain ◽  
Cover Test

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system. Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance alternating cover test showed exophoria with a right hyperphoria. Near alternating cover test revealed a significantly larger exophoria accompanied by a reduced near point of convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence tomography (OCT) of the nerve and macula were unremarkable. The patient underwent DBS implantation five weeks after initial examination, and the device was activated four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged. Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.

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