Stereotactic pallidotomy lengthens the transcranial magnetic cortical stimulation silent period in Parkinson's disease

Neurology ◽  
1997 ◽  
Vol 49 (5) ◽  
pp. 1278-1283 ◽  
Author(s):  
M. S. Young ◽  
W. J. Triggs ◽  
D. Bowers ◽  
M. Greer ◽  
W. A. Friedman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Globus Pallidus ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Cortical Stimulation ◽  
Abductor Pollicis Brevis ◽  
Inhibitory Circuits ◽  
Before And After ◽  
Transcranial Magnetic Cortical Stimulation

We compared the duration of the EMG cortical stimulation silent period(CSSP) elicited in abductor pollicis brevis using transcranial magnetic stimulation (TMS) before and after stereotactic unilateral globus pallidus internus pallidotomy (PAL) in 12 patients with Parkinson's disease. We used TMS stimulus intensities of 200, 150, 120, and 100% of motor evoked potential(MEP) threshold before and after (86 ± 25 days) PAL. PAL increased CSSP duration at stimulus intensities of 200% of MEP threshold in the hand contralateral to the stereotactic lesion. In a subset of five patients able to remain at rest during pre-PAL testing sessions, PAL decreased the resting MEP/M-wave area ratio in the hand contralateral to the lesion at a stimulus intensity of 120% of MEP threshold. PAL did not significantly modify the effects of TMS in the hand ipsilateral to the globus pallidus lesion. The results suggest that PAL improves the function of cortical motor inhibitory circuits in Parkinson's disease.

scholarly journals Neurocognitive and psychosocial correlates of ventroposterolateral pallidotomy surgery in Parkinson's disease

1997 ◽  
Vol 2 (3) ◽  
pp. E9 ◽  
Author(s):  
Henry J. Riordan ◽  
Laura A. Flashman ◽  
David W. Roberts
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Globus Pallidus ◽  
Cognitive Flexibility ◽  
Psychosocial Functioning ◽  
Surgical Outcome ◽  
Verbal Learning ◽  
Objective Evidence ◽  
Before And After

The purpose of this study was to characterize the neuropsychological and psychosocial profile of patients with Parkinson's disease before and after they underwent unilateral left or right pallidotomy, to assess specific cognitive and personality changes caused by lesioning the globus pallidus, and to predict favorable surgical outcome based on these measures. Eighteen patients underwent comprehensive neuropsychological assessment before and after left-sided pallidotomy (10 patients) or right-sided pallidotomy (eight patients). The findings support the presence of frontosubcortical cognitive dysfunction in all patients at baseline and a specific pattern of cognitive impairment following surgery, with side of lesion being an important predictor of pattern and degree of decline. Specifically, patients who underwent left-sided pallidotomy experienced a mild decline on measures of verbal learning and memory, phonemic and semantic verbal fluency, and cognitive flexibility. Patients who underwent right-sided pallidotomy exhibited a similar decline in verbal learning and cognitive flexibility, as well as a decline in visuospatial construction abilities; however, this group also exhibited enhanced performance on a delayed facial memory measure. Lesioning the globus pallidus may interfere with larger cognitive circuits needed for processing executive information with disruption of the dominant hemisphere circuit, resulting in greater deficits in verbal information processing. The left-sided pallidotomy group also reported fewer symptoms of depression and anxiety following surgery. This enhanced mood functioning was not seen for the right-sided pallidotomy group. No relationships were noted between cognitive impairment or advanced age at baseline and surgical outcome. This study provides objective evidence for specific changes in neurocognitive and psychosocial functioning following left- and right-sided pallidotomy.

Shortened silent period produced by magnetic cortical stimulation in patients with Parkinson's disease

1995 ◽  
Vol 130 (2) ◽  
pp. 209-214 ◽  
Author(s):  
Kenji Nakashima ◽  
Yuping Wang ◽  
Manabu Shimoda ◽  
Kenji Sakuma ◽  
Kazuro Takahashi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Silent Period ◽  
Cortical Stimulation

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.

scholarly journals Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-yi Kuai ◽  
Xiao-han Yao ◽  
Li-juan Xu ◽  
Yu-qing Zhou ◽  
Li-ping Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Before And After ◽  
Non Motor Symptoms

AbstractParkinson’s disease (PD) is a neurodegenerative disorder and 70–80% of PD patients suffer from gastrointestinal dysfunction such as constipation. We aimed to assess the efficacy and safety of fecal microbiota transplantation (FMT) for treating PD related to gastrointestinal dysfunction. We conducted a prospective, single- study. Eleven patients with PD received FMT. Fecal samples were collected before and after FMT and subjected to 16S ribosomal DNA (rDNA) gene sequencing. Hoehn-Yahr (H-Y) grade, Unified Parkinson's Disease Rating Scale (UPDRS) score, and the Non-Motion Symptom Questionnaire (NMSS) were used to assess improvements in motor and non-motor symptoms. PAC-QOL score and Wexner constipation score were used to assess the patient's constipation symptoms. All patients were tested by the small intestine breath hydrogen test, performed before and after FMT. Community richness (chao) and microbial structure in before-FMT PD patients were significantly different from the after-FMT. We observed an increased abundance of Blautia and Prevotella in PD patients after FMT, while the abundance of Bacteroidetes decreased dramatically. After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.

Changes in Body Composition Before and After Parkinson's Disease Diagnosis

2021 ◽  
Author(s):  
Shengfang Song ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Xuemei Huang ◽  
Eric J. Shiroma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Body Composition ◽  
Disease Diagnosis ◽  
Before And After

Noninvasive cortical stimulation with transcranial direct current stimulation in Parkinson's disease

2006 ◽  
Vol 21 (10) ◽  
pp. 1693-1702 ◽  
Author(s):  
Felipe Fregni ◽  
Paulo S. Boggio ◽  
Marcelo C. Santos ◽  
Moises Lima ◽  
Adriana L. Vieira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cortical Stimulation ◽  
Direct Current Stimulation

Blood Cholesterol Decreases as Parkinson’s Disease Develops and Progresses

2021 ◽  
pp. 1-10
Author(s):  
Keran Wang ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Xuemei Huang ◽  
Eric J. Shiroma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Confidence Interval ◽  
Total Cholesterol ◽  
Cholesterol Level ◽  
Disease Diagnosis ◽  
Inverse Association ◽  
Prodromal Stage ◽  
Before And After ◽  
Blood Total Cholesterol

Background: Literature shows an inverse association of circulating cholesterol level with the risk of Parkinson’s disease (PD); this finding has important ramifications, but its interpretation has been debated. Objective: To longitudinally examine how blood total cholesterol changes during the development of PD. Methods: In the Health, Aging and Body Composition study (n = 3,075, 73.6±2.9 years), blood total cholesterol was measured at clinic visit years 1, 2, 4, 6, 8, 10, and 11. We first examined baseline cholesterol in relation to PD risk, adjusting for potential confounders and competing risk of death. Then, by contrasting the observed with expected cholesterol levels, we examined the trajectory of changes in total cholesterol before and after disease diagnosis. Results: Compared to the lowest tertile of baseline total cholesterol, the cumulative incident ratio of PD and 95%confidence interval was 0.41 (0.20, 0.86) for the second tertile, and 0.69 (0.35, 1.35) for the third tertile. In the analysis that examined change of total cholesterol level before and after PD diagnosis, we found that its level began to decrease in the prodromal stage of PD and became statistically lower than the expected values∼4 years before disease diagnosis (observed-expected difference, –6.68 mg/dL (95%confidence interval: –13.14, –0.22)). The decreasing trend persisted thereafter; by year-6 post-diagnosis, the difference increased to –13.59 mg/dL (95%confidence interval: –22.12, –5.06), although the linear trend did not reach statistical significance (p = 0.10). Conclusion: Circulating total cholesterol began to decrease in the prodromal stage of PD, which may in part explain its reported inverse association with PD.

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