scholarly journals Doença de Parkinson: Revisão Clínica e Atualização

2019 ◽  
Vol 32 (10) ◽  
pp. 661
Author(s):  
Verónica Cabreira ◽  
João Massano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Clinical Findings ◽  
Disease Biomarkers ◽  
The Past ◽  
Non Motor Symptoms ◽  
Deep Brain

Parkinson’s disease is the second most common neurodegenerative disorder, and a significant increase in its prevalence in the past three decades has been documented. Environmental and genetic factors contribute to the pathophysiology of this disease, and 5% – 10% of cases have a monogenic cause. The diagnosis relies on clinical findings, supported by adequate testing. There is no absolute method to diagnose Parkinson’s disease in vivo, except for genetic testing in specific circumstances, whose usefulness is limited to a minority of cases. New diagnostic criteria have been recently proposed with the aim of improving diagnostic accuracy, emphasizing findings that might point to other causes of parkinsonism. The available therapeutic options are clinically useful, as they improve the symptoms as well as the quality of life of patients. After the introduction of levodopa, deep brain stimulation emerged as the second therapy with an important symptomatic impact in the treatment of Parkinson’s disease. Non-motor symptoms and motor complications are responsible for a large proportion of disability, so these should be identified and treated. Current scientific research is focused on the identification of disease biomarkers allowing correct and timely diagnosis, and on creating more effective therapies, thus fulfilling current clinical unmet needs. This paper presents an updated review on Parkinson’s disease, guiding the readership through current concepts, and allowing their application to daily clinical practice.

scholarly journals A Narrative Review of Lifestyle Factors Associated with Parkinson’s Disease Risk and Progression

2019 ◽  
Vol 19 (2) ◽  
pp. 51-59 ◽  
Author(s):  
Nupur Nag ◽  
George A. Jelinek
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Disease Risk ◽  
Lifestyle Behaviours ◽  
Beneficial Effects ◽  
Individualized Care ◽  
Non Motor Symptoms

Parkinson’s disease is a complex slowly progressive neurodegenerative disorder with motor and non-motor symptoms affecting daily living. Despite effective symptomatic treatments, with various degrees of side effects, no disease-modifying therapeutic options presently exist. Symptoms progress, with an accumulating burden, reducing the quality of life and forming the impression that medications are no longer effective. Adopting positive lifestyle behaviours can empower patients, improve the quality of life, alleviate symptoms, and potentially slow disease progression. Lifestyle behaviours including nutrition, cognitive enrichment, physical activity, and stress management have beneficial effects on brain health and quality of life. While some evidence of an association of lifestyle with Parkinson’s disease risk and progression exists, the sparse and often conflicting data make it difficult to provide clinical recommendations. Herein, we highlight studies showing promising associations between lifestyle and Parkinson’s disease. Given the increasing aging of populations worldwide and the prevalence of neurological disorders, further research into self-management through adoption of positive lifestyle behaviours is clearly warranted to better enable individualized care.

Emerging Pharmacotherapies for Motor Symptoms in Parkinson’s Disease

2021 ◽  
Vol 34 (4) ◽  
pp. 263-273
Author(s):  
Mohammad Al Majali ◽  
Michael Sunnaa ◽  
Pratap Chand
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Review Article ◽  
Treatment Goals ◽  
Motor Symptoms ◽  
Adequate Treatment ◽  
Advanced Therapies ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is the second commonest neurodegenerative disorder in the older adult and is characterized by progressive disabling motor symptoms of bradykinesia, tremor, rigidity, postural instability and also non motor symptoms that affect quality of life. The pharmacotherapy of PD consists of oral, transdermal, and subcutaneous medications, as well as invasive advanced therapies at later stages of the disease. PD medications are often started as monotherapy but with the progression of the illness often there is a need to add more medications and frequently comprises of a challenging polypharmacotherapy. Adverse effects of pharmacotherapy often add to the problems of adequate treatment. Patients and physicians have to prioritize treatment goals on the most disabling symptoms and the safest and most effective treatments. Almost every year newer medications and modes of delivery continue to be researched and added to the therapeutic armamentarium. This review article outlines existing and emerging pharmacotherapies for motor symptoms in PD.

scholarly journals The Pathology of Parkinson’s Disease and Potential Benefit of Dietary Polyphenols

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4382
Author(s):  
Sunisha Aryal ◽  
Taylor Skinner ◽  
Bronwyn Bridges ◽  
John T. Weber
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Experimental Models ◽  
Dietary Polyphenols ◽  
Olfactory Impairment ◽  
Impaired Sleep ◽  
Non Motor Symptoms ◽  
Positive Effect

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that is characterized by a loss of dopaminergic neurons, leading to bradykinesia, rigidity, tremor at rest, and postural instability, as well as non-motor symptoms such as olfactory impairment, pain, autonomic dysfunction, impaired sleep, fatigue, and behavioral changes. The pathogenesis of PD is believed to involve oxidative stress, disruption to mitochondria, alterations to the protein α-synuclein, and neuroinflammatory processes. There is currently no cure for the disease. Polyphenols are secondary metabolites of plants, which have shown benefit in several experimental models of PD. Intake of polyphenols through diet is also associated with lower PD risk in humans. In this review, we provide an overview of the pathology of PD and the data supporting the potential neuroprotective capacity of increased polyphenols in the diet. Evidence suggests that the intake of dietary polyphenols may inhibit neurodegeneration and the progression of PD. Polyphenols appear to have a positive effect on the gut microbiome, which may decrease inflammation that contributes to the disease. Therefore, a diet rich in polyphenols may decrease the symptoms and increase quality of life in PD patients.

scholarly journals Impact of Motor and Non-Motor Symptoms on Quality of Life in Parkinson’s Disease - A Questionnaire Based Observational Study from Karad, India

2021 ◽  
Vol 10 (27) ◽  
pp. 1966-1970
Author(s):  
Samruddhi Sunil Kandharkar ◽  
Neha Arvind Kashid ◽  
Suraj Bhimrao Kanase ◽  
Dhirajkumar A. Mane
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Study ◽  
Neurodegenerative Disorder ◽  
Motor Symptoms ◽  
Age Group ◽  
The Impact ◽  
Non Motor Symptoms

BACKGROUND Parkinson’s disease is a chronic neurodegenerative disorder with a prevalence rate of 108 - 257 per 100,000 people, occurring in later half of life and affecting both genders equally. The progressive nature of the disease is associated with growing disability and has a considerable impact on quality of life. Quality of life (QOL) is an important goal in every rehabilitation process and its impact on disease process, stage and prognosis is closely associated, which often gets neglected. Thus, it was necessary to conduct this study to establish actual impact of Parkinson’s disease on quality of life, emphasizing on disease duration. METHODS A questionnaire based observational study was carried out among patients with Parkinson’s disease in Maharashtra. The survey was conducted in Parkinson’s Association Group by handing over the hard copies of questionnaires to 120 patients and their respective care takers. Questionnaire used was ‘The Parkinson’s Disease Questionnaire (PDQ39)’. It had 39 items grouped into 8 domains. Statistical analysis of the collected data was carried out using InStat software and Microsoft excel. RESULTS In motor symptom-based questions, the impact on quality of life was more significant i.e., 54 % (P < 0.0001) compared to non-motor symptoms which was 46 % (P < 0.0001). Maximum number of subjects were from age group 71 to 80 while minimum number of subjects were from 91 to 100 yrs. CONCLUSIONS There was significant impact of motor as well as non-motor symptoms on patient’s quality of life; but motor symptoms like tremors and slowness of movement had greater impact compared to non-motor symptoms which included speech difficulty and social stigma. There was no co-relation between specific age group and incidence of disease. KEY WORDS Parkinson’s Disease, PDQ - 39 Questionnaire, Quality of Life (QOL), Motor and NonMotor Symptoms, Activities of Daily Living

scholarly journals In vivo, in vitro and pharmacologic models of Parkinson's disease

2019 ◽  
pp. 17-24 ◽  
Author(s):  
S. Salari ◽  
M. Bagheri
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Behavioral Problems ◽  
Neurodegenerative Disorder ◽  
Freezing Of Gait ◽  
Motor Symptoms ◽  
Symptomatic Management ◽  
Non Motor Symptoms

Parkinson's disease (PD), which is the second most common neurodegenerative disorder after Alzheimer's disease, is firstly defined after James Parkinson's report. It carries motor symptoms such as resting tremor, bradykinesia and rigidity of skeletal muscle and freezing of gait. Furthermore, non-motor symptoms such as cognitive and behavioral problems, besides sensory impairments are seen in the patients. However, they may also suffer from sleep disorders or autonomic dysfunction. Although there are some medications in order to symptomatic management, but unfortunately, scientist could not have found exact approaches to cure this disease. Hence, producing a model which can express the most pathophysiologic and behavioral aspects of the disease is a desire. In this paper, we aimed to describe the different models of Parkinson's disease in brief.

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 The Parkinson’s Real-World Impact Assessment (PRISM) Study: A European Survey of the Burden of Parkinson’s Disease in Patients and their Carers

2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impact Assessment ◽  
Real World ◽  
European Countries ◽  
Life Questionnaire ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.

scholarly journals A mobile app for tracking non-motor symptoms of people with Parkinson’s disease: A usability study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 890-890
Author(s):  
JuHee Lee ◽  
Yujin Suh ◽  
Yielin Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Tracking System ◽  
Smart Phone ◽  
Telephone Counseling ◽  
Mobile App ◽  
Motor Symptoms ◽  
Hand Tremor ◽  
Non Motor Symptoms

Abstract Smart phone-based technology for people with Parkinson’s disease has been developed worldwide. Unmonitored non-motor symptoms decrease quality of life of people with Parkinson’s disease, so the needs for technology to manage non-motor symptoms are increasing. The technology is needed to detect subtle changes in non-motor symptoms by healthcare professional. There is no mobile app which manage comprehensive symptoms of Parkinson’s disease including non-motor symptoms. It is necessary to develop a new tracking system that can effectively manage non-motor symptoms as well as motor symptoms of Parkinson’s disease. We developed a prototype of mobile app for Android smartphones, with cooperation with Mazelone company. we also have shaped functions for monitoring of motor symptoms and medication adherence. It also provided a section for caregivers to use on behalf of people with Parkinson’s disease who have difficulty to use app due to hand tremor. Through Delphi technique, we obtained content validity from eight medical and nursing experts on the contents of the application. We provided regular telephone counseling to improve and encourage their app usage. Fifteen participants used the app for 6 weeks. To evaluate usability of mobile app, we provided constructed questionnaire and conducted individual telephone interview. A mobile app for tracking non-motor symptoms demonstrated high usability and satisfaction. We learned lessons about facilitators and barriers when implementing an app such as perception and acceptance of mobile technology. The mobile app will improve continuum of care. Future studies need to improve the contents and refine technical approach for people with Parkinson’s disease.

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.

scholarly journals How COVID-19 will boost remote exercise-based treatment in Parkinson’s disease: a narrative review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Agnes Langer ◽  
Lucia Gassner ◽  
Anna Flotz ◽  
Sebastian Hasenauer ◽  
Jakob Gruber ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Best Practice ◽  
Well Being ◽  
Functional Mobility ◽  
Physical Mobility ◽  
Conventional Physiotherapy ◽  
Difficult Times ◽  
Non Motor Symptoms

AbstractThe lack of physical exercise during the COVID-19 pandemic-related quarantine measures is challenging, especially for patients with Parkinson’s disease (PD). Without regular exercise not only patients, but also nursing staff and physicians soon noticed a deterioration of motor and non-motor symptoms. Reduced functional mobility, increased falls, increased frailty, and decreased quality of life were identified as consequences of increased sedentary behavior. This work overviews the current literature on problems of supplying conventional physiotherapy and the potential of telerehabilitation, allied health services, and patient-initiated exercise for PD patients during the COVID-19 period. We discuss recent studies on approaches that can improve remote provision of exercise to patients, including telerehabilitation, motivational tools, apps, exergaming, and virtual reality (VR) exercise. Additionally, we provide a case report about a 69-year-old PD patient who took part in a 12-week guided climbing course for PD patients prior to the pandemic and found a solution to continue her climbing training independently with an outdoor rope ladder. This case can serve as a best practice example for non-instructed, creative, and patient-initiated exercise in the domestic environment in difficult times, as are the current. Overall, many recent studies on telemedicine, telerehabilitation, and patient-initiated exercises have been published, giving rise to optimism that facilitating remote exercise can help PD patients maintain physical mobility and emotional well-being, even in phases such as the COVID-19 pandemic. The pandemic itself may even boost the need to establish comprehensive and easy-to-do telerehabilitation programs.

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