Dynamics of levodopa-therapy in patients with Parkinson’s disease afterunilateral pallidotomy

Objective — to investigate the dynamics of levodopa-therapy in patients with Parkinson's disease (PD) after unilateral stereotactic radiofrequency pallidotomy (USRP). Materials and methods. From 2008 to 2016 USRP was performed in 16 patients (7 men and 9 women from 48 to 73 years old, average — 56 years) with PD complicated by levodopa-induced dyskinesias and motor fluctuations (MF). The dynamics of the disease symptoms was interpreted on the basis of separate sections and points of the UPDRS. The levodopa-equivalent dose (LED) was calculated using standard conventers. Patients were evaluated before, one week and then one year after surgery. Results. One week after the USRP 43.2 % reduction of average daily LED was noted. The decrease of severity of MF and motor symptoms of the OFF-period on the contralateral side was traced. After 1 year of follow up the rate of reduction decline of the average daily LED compared to its preoperative level was 22.3 %. The recurrence of the MF and the steady positive effects on the motor symptoms of the OFF-period on the contralateral side were observed. Conclusions. Primary reduction of the daily LED effects of USRP decrease during one year of observation in the background of the MF recurrence, despite the steady positive effects on the motor symptoms of the OFF-period on the contralateral side.

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Change in Non-motor Symptoms in Parkinson’s Disease and Essential Tremor Patients: A One-year Follow-up Study

Tremor and Other Hyperkinetic Movements ◽

10.5334/tohm.189 ◽

2014 ◽

Vol 4 (0) ◽

pp. 216 ◽

Cited By ~ 4

Author(s):

Maurizio Giorelli ◽

Junia Bagnoli ◽

Luigi Consiglio ◽

Pasquale Difazio ◽

Daniela Zizza ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Essential Tremor ◽

Motor Symptoms ◽

Follow Up Study ◽

One Year ◽

Non Motor Symptoms

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Pilot Study of Mindfulness Training on the Self-Awareness of Motor Symptoms in Parkinson’s Disease – A Randomized Controlled Trial

Frontiers in Psychology ◽

10.3389/fpsyg.2021.763350 ◽

2021 ◽

Vol 12 ◽

Author(s):

Timo Marcel Buchwitz ◽

Franziska Maier ◽

Andrea Greuel ◽

Franziska Thieken ◽

Kenan Steidel ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Control Group ◽

Motor Symptoms ◽

Self Awareness ◽

Disease Symptoms ◽

Waitlist Control ◽

Sleeping Problems ◽

Waitlist Control Group ◽

Insight Into

Objective: This study aims to evaluate feasibility and effects of a newly developed mindfulness intervention tailored to specific needs of patients with Parkinson’s disease (PD).Background: The phenomenon of impaired self-awareness of motor symptoms (ISAm) in PD might be reduced by increasing patients’ mindfulness. A PD-specific mindfulness intervention has been developed and evaluated as a potential treatment option: IPSUM (“Insight into Parkinson’s Disease Symptoms by using Mindfulness”).Methods: IPSUM’s effectiveness is evaluated by comparing an intervention with a waitlist-control group. Applying a pre-post design, patients were assessed before, directly after and 8weeks after treatment. The primary outcome was the change in a quantitative ISAm score from baseline to post-assessment. Secondary outcome measures were PD-related affective changes and neuropsychological test performance. Feasibility was evaluated via feedback forms.Results: In total, 30 non-depressed and non-demented PD patients were included (intervention: n=14, waitlist-control: n=16). ISAm score did not change significantly, but the training group showed greater performance in sustained attention and language tasks over time. Additional changes included greater mindfulness as well as less sleeping problems and anxiety. Cognitive disturbances, apathy, and sleeping problems worsened only in the waitlist-control group. Patients’ feedback regarding the training concept and material was excellent.Conclusion: Insight into Parkinson’s Disease Symptoms by using Mindfulness has not been capable of reducing ISAm in PD patients but appears to be a feasible and effective concept to, among others, support mental health in the mid-term. It has to be noted though that the study was stopped beforehand because of the SARS CoV-2 pandemic. The lack of findings might therefore be caused by a lack of statistical power. The need for further research to better understand the mechanisms of ISAm and its connection to mindfulness in PD is highlighted.

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Gender differences in non-motor symptoms in early Parkinson's disease: A 2-years follow-up study on previously untreated patients

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2014.04.023 ◽

2014 ◽

Vol 20 (8) ◽

pp. 850-854 ◽

Cited By ~ 31

Author(s):

Marina Picillo ◽

Roberto Erro ◽

Marianna Amboni ◽

Katia Longo ◽

Carmine Vitale ◽

...

Keyword(s):

Parkinson’S Disease ◽

Gender Differences ◽

Parkinson's Disease ◽

Motor Symptoms ◽

Follow Up Study ◽

Non Motor Symptoms ◽

Early Parkinson’S Disease

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Impulsive and compulsive behaviors in Parkinson's disease: A one-year follow-up study

Journal of the Neurological Sciences ◽

10.1016/j.jns.2011.05.044 ◽

2011 ◽

Vol 310 (1-2) ◽

pp. 197-201 ◽

Cited By ~ 17

Author(s):

Asunción Ávila ◽

Xavier Cardona ◽

Montse Martín-Baranera ◽

Juan Bello ◽

Francesc Sastre

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Follow Up Study ◽

Compulsive Behaviors ◽

One Year

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Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

Parkinson s Disease ◽

10.1155/2016/6762528 ◽

2016 ◽

Vol 2016 ◽

pp. 1-23 ◽

Cited By ~ 23

Author(s):

Andrée-Anne Poirier ◽

Benoit Aubé ◽

Mélissa Côté ◽

Nicolas Morin ◽

Thérèse Di Paolo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gastrointestinal Symptoms ◽

Motor Symptoms ◽

Therapeutic Approaches ◽

Medical Treatments ◽

Disease Symptoms ◽

Comprehensive Picture ◽

Neuronal Types ◽

The Central Nervous System

A diagnosis of Parkinson’s disease is classically established after the manifestation of motor symptoms such as rigidity, bradykinesia, and tremor. However, a growing body of evidence supports the hypothesis that nonmotor symptoms, especially gastrointestinal dysfunctions, could be considered as early biomarkers since they are ubiquitously found among confirmed patients and occur much earlier than their motor manifestations. According to Braak’s hypothesis, the disease is postulated to originate in the intestine and then spread to the brain via the vagus nerve, a phenomenon that would involve other neuronal types than the well-established dopaminergic population. It has therefore been proposed that peripheral nondopaminergic impairments might precede the alteration of dopaminergic neurons in the central nervous system and, ultimately, the emergence of motor symptoms. Considering the growing interest in the gut-brain axis in Parkinson’s disease, this review aims at providing a comprehensive picture of the multiple gastrointestinal features of the disease, along with the therapeutic approaches used to reduce their burden. Moreover, we highlight the importance of gastrointestinal symptoms with respect to the patients’ responses towards medical treatments and discuss the various possible adverse interactions that can potentially occur, which are still poorly understood.

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Improvement of non-motor symptoms and quality of life after DBS stimulation for dystonia: one-year follow-up

10.5327/1516-3180.253 ◽

2021 ◽

Author(s):

Clarice Listik ◽

Rubens Gisbert Cury ◽

Sara Carvalho Barbosa Casagrande ◽

Eduardo Listik ◽

Debora Arnaut ◽

...

Keyword(s):

Parkinson’S Disease ◽

Chronic Pain ◽

Parkinson's Disease ◽

Prospective Study ◽

Mcgill Pain Questionnaire ◽

Motor Symptoms ◽

One Year ◽

A Prospective Study ◽

Prospective Study Design ◽

Non Motor Symptoms

Background: DBS is an established treatment option in refractory dystonia, and motor outcomes have been extensively evaluated instead of the usually neglected NMS (e.g., pain). Objective: To describe the non-motor symptoms (NMS) after Deep Brain Stimulation (DBS) surgery for refractory generalized inherited/idiopathic dystonia in a prospective study. Design and setting: A prospective study that evaluated patients in the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. Methods: This study evaluated patients before and one year after DBS surgery. We applied the following scales: Burke-Fahn-Marsden Rating Scale (BFMRS), Hospital Anxiety and Depression Scale (HADS), Non-Motor Symptoms Scale for Parkinson’s Disease (NMSS-PD), Parkinson’s Disease Questionnaire-8 (PDQ8) Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and McGill pain questionnaire. Results: 11 patients (38.35 ± 11.30 years) underwent surgery (36.3% women). Motor BFMRS subscore was 64.36 ± 22.94 at baseline and 33.55 ± 17.44 after surgery (p=0.003, 47.9% improvement on motor symptoms). HADS scores remained unchanged. NMSS-PD had a significant change after DBS, from 70.91 ± 59.07 to 37.18 ± 55.05 (p=0.013, 47,5% improvement). Seven patients reported pain before DBS surgery, and after one year, four patients reported chronic pain (i.e., pain improved by 42.28%). BPI’s severity and interference scores were 4.61 ± 2.84 and 4.12 ± 2.67, respectively before surgery, and 2.79 ± 2.31 (0.00–6.25) and 1.12 ± 1.32 (0.00–3.00) after DBS (p=0.043 and p=0.028). NPSI total score was 15.29 ± 13.94 before DBS, and reduced to 2.29 ± 2.98 afterward (p=0.028). McGill’s total score was 9.00 ± 3.32 before DBS, achieving 2.71 ± 2.93 after surgery (p=0.028), mostly driven by the sensory sub-score. Conclusions: We found that DBS improves NMS in dystonia, including chronic pain, anxiety, gastrointestinal symptoms, besides the already established improvement in QoL and motor symptoms.

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Trait Anxiety as a Risk Factor for Impulse Control Disorders in de novo Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212959 ◽

2021 ◽

pp. 1-9

Author(s):

Pauline Waskowiak ◽

Vincent Koppelmans ◽

Marit F.L. Ruitenberg

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Risk Factor ◽

Trait Anxiety ◽

Impulse Control ◽

De Novo ◽

Impulse Control Disorders ◽

Motor Symptoms ◽

Depression And Anxiety

Background: In addition to the well-known motor symptoms, patients with Parkinson’s disease (PD) also frequently experience disabling non-motor symptoms including impulse control disorders (ICDs). ICDs are characterized by a loss of voluntary control over impulses, drives, or temptations regarding excessive hedonic behavior. Objective: The present study examined whether depression and anxiety in de novo PD patients predict the prospective development of ICDs. Methods: We selected 330 de novo PD patients from the Parkinson’s Progression Markers Initiative database who were free of ICDs at the start of the study. ICD presence at baseline and follow-up assessments was evaluated via the shortened version of the Questionnaire for Impulsive-Compulsive Disorders (QUIP-S). Baseline depression and anxiety were measured via the Geriatric Depression Scale (GDS-15) and State-Trait-Anxiety Inventory (STAI-Y), respectively. Results: A total of 149 participants (45.2%) developed an ICD at follow-up and average time of ICD onset was 35 months after baseline. Results of a Cox regression analysis showed that STAI-Y scores but not GDS-15 scores significantly predicted ICD presence. Specifically, scores reflecting higher trait anxiety were associated with an increased risk of developing an ICD. This effect was not confounded by age, gender or UPDRS motor score. We also replicated the well-established result that dopamine agonist use is predictive of ICDs. Conclusion: Our findings indicate that higher anxiety levels in de novo PD patients represent a risk factor for ICD development during the course of the disorder. This highlights the need for early and routine based anxiety screening in these patients.

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