Seeing

2021 ◽  
pp. 119-128
Author(s):  
Allan Hugh Cole
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Staging Area ◽  
Vatican City ◽  
The Many

This chapter recounts an experience of the author’s family taking a summer trip to Italy, approximately eight months after his diagnosis, and the many questions and struggles he experienced related to having Parkinson’s disease. He recalls an experience of existential angst and spiritual questioning while in Vatican City and visiting St. Peter’s Square, and a subsequent experience of watching an older Italian man craft a beautiful decorative metal handrail working from the back of his small car, which encouraged the author. Through that man, the author saw that significant, even beautiful works can be created with rather modest resources. The chapter ends with the memory of his family happening upon an outdoor fashion show in Florence and his watching the lead designer drive up to the staging area and being helped out of his car and into a wheelchair by a woman (presumably his wife), which also encouraged him and showed that those with disabilities make significant contributions.

scholarly journals Receptor Ligands as Helping Hands to L-DOPA in the Treatment of Parkinson’s Disease

Biomolecules ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 142 ◽  
Author(s):  
Fabio Bello ◽  
Mario Giannella ◽  
Gianfabio Giorgioni ◽  
Alessandro Piergentili ◽  
Wilma Quaglia
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Elevated Liver Enzyme ◽  
Therapeutic Potential ◽  
Motor Complication ◽  
Receptor Ligands ◽  
Dopaminergic Drugs ◽  
The Many ◽  
Non Motor Symptoms

Levodopa (LD) is the most effective drug in the treatment of Parkinson’s disease (PD). However, although it represents the “gold standard” of PD therapy, LD can cause side effects, including gastrointestinal and cardiovascular symptoms as well as transient elevated liver enzyme levels. Moreover, LD therapy leads to LD-induced dyskinesia (LID), a disabling motor complication that represents a major challenge for the clinical neurologist. Due to the many limitations associated with LD therapeutic use, other dopaminergic and non-dopaminergic drugs are being developed to optimize the treatment response. This review focuses on recent investigations about non-dopaminergic central nervous system (CNS) receptor ligands that have been identified to have therapeutic potential for the treatment of motor and non-motor symptoms of PD. In a different way, such agents may contribute to extending LD response and/or ameliorate LD-induced side effects.

scholarly journals Treatment of Parkinson’s disease with agents other than Levodopa and Dopamine Agonists: controversies and new approaches

1984 ◽  
Vol 11 (S1) ◽  
pp. 210-220 ◽  
Author(s):  
Anthony E. Lang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
New Approaches ◽  
Wide Range ◽  
The Many ◽  
Treatment Alternatives

ABSTRACTParkinson’s disease is associated with a variety of neurotransmitter disturbances which may be further altered by its treatment with dopamine agonists. Based on this information a wide range of pharmacological approaches have been used in search of newer treatment alternatives and in hopes of reducing complications of long-term levodopa use. This paper reviews the various therapies which have had some success in the management of Parkinson’s disease, other than levodopa and dopamine agonists. Special emphasis is placed on the many unresolved questions and controversies that exist in this area of neuropharmacology.

scholarly journals Digital Health Technology to Measure Drug Efficacy in Clinical Trials for Parkinson’s Disease: A Regulatory Perspective

2021 ◽  
pp. 1-5
Author(s):  
Leonard Sacks ◽  
Elizabeth Kunkoski
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Trials ◽  
Digital Health ◽  
Clinical Manifestations ◽  
Drug Efficacy ◽  
Health Technology ◽  
Environmental Sensors ◽  
Wide Range ◽  
The Many

Digital health technology (DHT), including wearable and environmental sensors, video cameras and other electronic tools, has provided new opportunities for the measurement of movement and functionality in Parkinson’s disease. Compared to current standards for evaluation of the disease (MDS-UPDRS), DHT may offer new possibilities for more frequent objective measurements of the duration, severity and frequency of disease manifestations over time, that may provide more information than periodic clinic visits. However, DHT measurement are only scientifically and medically useful if they are accurate, reliable and clinically meaningful. Verification and validation, also known as analytical validation and clinical validation, of DHT performance is important to ensure the accuracy and precision of measurements, and the specificity of findings. Given the wide range of clinical manifestations associated with Parkinson’s disease and the many tools and metrics to assess them, the challenge is to identify those that may represent a standard for use in clinical trials, and to confirm when digital measurements succeed or fall short of capturing meaningful benefits during drug development.

scholarly journals Neurological commentary addressing the article titled “Guidance for switching from off-label antipsychotics to pimavanserin for Parkinson’s disease psychosis: an expert consensus”

CNS Spectrums ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 352-354
Author(s):  
Neal Hermanowicz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Options ◽  
Symptom Control ◽  
Expert Consensus ◽  
Efficacy Data ◽  
Off Label ◽  
Frequent Monitoring ◽  
Proven Efficacy ◽  
The Many

Parkinson’s disease psychosis (PDP) occurs commonly and can comprise the most troubling symptoms among the many that occur with this illness. Prior treatment options for PDP have been limited and unsatisfactory due to uneven efficacy data, burdensome monitoring, and lack of a specific FDA indication coupled with warnings of increased mortality. Pimavanserin, approved for the treatment of PDP by the FDA in 2016, overcomes some of these obstacles, with data proven efficacy and without the frequent monitoring required for clozapine. This presents an opportunity to transition patients with PDP to pimavanserin from older therapies. Black and colleagues provide their thoughtful recommendations on how to achieve this transition to pimavanserin while maintaining symptom control and minimizing disruptions that might occur with a medication change.

scholarly journals The many facets of motor learning and their relevance for Parkinson's disease

2017 ◽  
Vol 128 (7) ◽  
pp. 1127-1141 ◽  
Author(s):  
Lucio Marinelli ◽  
Angelo Quartarone ◽  
Mark Hallett ◽  
Giuseppe Frazzitta ◽  
Maria Felice Ghilardi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Learning ◽  
The Many

scholarly journals Cytokines, miRNAs, and Antioxidants as Combined Non-Invasive Biomarkers for Parkinson's Disease

2021 ◽  
Author(s):  
Amr Ghit ◽  
Hany El Deeb
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Serum Levels ◽  
Serum Samples ◽  
Single Measure ◽  
Locomotor System ◽  
Specificity And Sensitivity ◽  
Noninvasive Biomarkers ◽  
The Many ◽  
Considerable Work

Abstract Background:Parkinson's disease (PD) is one of the most common long-term degenerative disorders of the CNS that primarily affects the human locomotor system. Owing to the heterogeneity of PD etiology and the lack of appropriate diagnostic tests, blood-based biomarkers became the most promising method for diagnosing PD. Even though various biomarkers for PD have been found, their specificity and sensitivity are not optimum when used alone. Therefore, the aim of this study was directed to evaluate changes in a group of sensitive blood-based biomarkers in the same PD patients compared to healthy individuals. Serum samples were collected from 20 PD patients and 15 age-matched healthy controls. We analyzed serum levels of cytokines (IL10, IL12, and TNF-α), α-synuclein proteins, miRNAs (miR-214, miR-221, and miR-141) and antioxidants (UA, PON1, ARE).Results:Our results showed an increase in sera levels of cytokines in PD patients as well as a positive correlation among them. Also, we found a significant increase in sera levels of α-synuclein protein associated with a decrease in miR-214 which regulates its gene expression. Lastly, we observed a decrease in sera levels of miR-221, miR-141, UA, PON1, and ARE, which have a prominent role against oxidative stress.Conclusion:Because of the many etiologies of PD, a single measure is unlikely to become a useful biomarker. Therefore, to correctly predict disease state and progression, a mix of noninvasive biomarkers is required. Although considerable work has to be done, this study sheds light on the role of certain biomarkers in the diagnosis of PD.

scholarly journals Screening of Parkinson’s Disease Using Geometric Features Extracted from Spiral Drawings

2021 ◽  
Vol 11 (10) ◽  
pp. 1297
Author(s):  
Jay Chandra ◽  
Siva Muthupalaniappan ◽  
Zisheng Shang ◽  
Richard Deng ◽  
Raymond Lin ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Quantitative Methods ◽  
Low Cost ◽  
Archimedean Spiral ◽  
Drawing Task ◽  
Shape Selection ◽  
The Face ◽  
Drawing Tasks ◽  
The Many

Conventional means of Parkinson’s Disease (PD) screening rely on qualitative tests typically administered by trained neurologists. Tablet technologies that enable data collection during handwriting and drawing tasks may provide low-cost, portable, and instantaneous quantitative methods for high-throughput PD screening. However, past efforts to use data from tablet-based drawing processes to distinguish between PD and control populations have demonstrated only moderate classification ability. Focusing on digitized drawings of Archimedean spirals, the present study utilized data from the open-access ParkinsonHW dataset to improve existing PD drawing diagnostic pipelines. Random forest classifiers were constructed using previously documented features and highly-predictive, newly-proposed features that leverage the many unique mathematical characteristics of the Archimedean spiral. This approach yielded an AUC of 0.999 on the particular dataset we tested on, and more importantly identified interpretable features with good promise for generalization across diverse patient cohorts. It demonstrated the potency of mathematical relationships inherent to the drawing shape and the usefulness of sparse feature sets and simple models, which further enhance interpretability, in the face of limited sample size. The results of this study also inform suggestions for future drawing task design and data analytics (feature extraction, shape selection, task diversity, drawing templates, and data sharing).

scholarly journals Disrupted identities: movement, mind, and memory in Parkinson's disease

2017 ◽  
Vol 29 (6) ◽  
pp. 879-881 ◽  
Author(s):  
Iracema Leroi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Johns Hopkins Hospital ◽  
Motor Disorder ◽  
Emotional Processes ◽  
History Of ◽  
Clinical Description ◽  
The Many ◽  
Short Time

For the many clinicians au fait with the history of the clinical description of Parkinson's disease, they will be aware that the very earliest description of James Parkinson's “Shaking Palsy” in 1817 explicitly excluded the involvement of cognitive and emotional processes as manifestations of the disease. Within a short time following his treatise, it became all too clear to those in the field that Parkinson's disease is more than just a motor disorder, and as was aptly conceptualized by Paul McHugh, Professor of Psychiatry at Johns Hopkins Hospital from 1975 until 2001, Parkinson's disease is closer to being a “triadic disorder,” encompassing motor, cognitive, and psychiatric elements (McHugh, 1989). Even this notion is now outdated, with the triad being accompanied by autonomic, pain, and other non-motor syndromes.

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