scholarly journals The Effect of L-dopa on Postural Stability in Parkinson’s Disease Patients

2019 ◽  
Vol 9 (3) ◽  
pp. 409 ◽  
Author(s):  
Jacek Wilczyński ◽  
Natalia Habik

The aim of the study was to evaluate the effects of L-dopa on postural stability in Parkinson’s disease patients. In the study, we examined a group of 13 patients, members of the Parkinson’s Association. The majority of subjects were women: 8 (61.538%), while 5 (38.462%) were men. These were patients with advanced, idiopathic Parkinson’s disease. The study was performed at the Posturology Laboratory of the Faculty of Medicine and Health Sciences, UJK, Kielce (Poland). The duration of the illness was longer than 5 years. The daily L-dopa dose was between 600 and 1000 mg/d. Patients were tested for postural stability prior to taking the morning dose and again, 1 h after the 200-mg dose (Madopar 250 Tablets). The Biodex Balance System was applied in order to perform Postural Stability Testing. No statistically significant differences were found for the distribution of postural stability results before or after L-dopa administration. Nonetheless, it should be noted that all variables in the Postural Stability Test were slightly improved following L-dopa administration. The highest percentage (% Time in Zone) was noted in Zone A (the best), before (85.77%) and after L-dopa administration (95.23%). The highest % Time in Quadrant was in Quadrant IV (right posterior) both before (41.43%) and after L-dopa administration (49.54%). When comparing the distribution of postural stability variables before and after L-dopa administration, there were no significant differences between women and men.

Author(s):  
Ugnė Brusokaitė ◽  
Eglė Lendraitienė ◽  
Vidas Bružas

Research background. Parkinson’s disease is the second most common neurodegenerative disease. As the incidence of Parkinson’s disease is increasing, more and more new and exciting physical therapy methods are being sought to help reduce the symptoms of the disease. Currently, training sessions for preparatory boxing exercises are becoming increasingly popular. The aim. In this study our goal was to determine the influence of preparatory boxing exercises in physical therapy on the postural stability and hands psychomotor ability in patients with Parkinson’s disease. Methods. 22 volunteers with Parkinson’s disease participated in this research. Patients were divided into 2 groups: intervention group (n = 11) and control group (n = 11). Intervention group had preparatory boxing exercise for twice every week, for four months. No intervention was applied for control group. The Biodex Balance System was chosen to evaluate the postural stability and the RA-1 Reactiometer was used to assess the hand psychomotor reaction. Results. The four-month preparatory boxing exercises in physical therapy have signifcantly improved the statistical parameters of postural stability and hand psychomotor reaction in people with Parkinson’s disease (p < 0.05). In subjects with Parkinson’s disease, the indicators in the non-attendance program did not change. Conclusions. According to the results, along with the knowledge that all volunteers had completed the research, we can state that preparatory boxing exercise in physiotherapy is safe and effective for patients with Parkinson’s disease, thus the inclusion of boxing excercise to be included in the physical therapy course is recommended.Keywords: Parkinson’s disease, preparatory boxing exercises, postural stability, hand psychomotor reaction.


2019 ◽  
pp. 158-173

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.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-yi Kuai ◽  
Xiao-han Yao ◽  
Li-juan Xu ◽  
Yu-qing Zhou ◽  
Li-ping Zhang ◽  
...  

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.


2021 ◽  
Author(s):  
Shengfang Song ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Xuemei Huang ◽  
Eric J. Shiroma ◽  
...  

2010 ◽  
Vol 12 (5) ◽  
pp. 446-454 ◽  
Author(s):  
Christopher Dromey ◽  
Eon Jarvis ◽  
Stuart Sondrup ◽  
Shawn Nissen ◽  
K. Bo Foreman ◽  
...  

2021 ◽  
pp. 1-10
Author(s):  
Keran Wang ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Xuemei Huang ◽  
Eric J. Shiroma ◽  
...  

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.


2005 ◽  
Vol 63 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Lucia Figueiredo Mourão ◽  
Patrícia Maria de Carvalho Aguiar ◽  
Fernando Antônio Patriani Ferraz ◽  
Mara Suzana Behlau ◽  
Henrique Ballalai Ferraz

Long-term complications in levodopa treated Parkinson's disease (PD) patients caused a resurgence of interest in pallidotomy as an option of treatment. However, postoperative complications such as speech disorders can occur. PURPOSE: The aim of this study is to evaluate the acoustic voice in PD patients, before and after posteroventral pallidotomy. METHOD: Twelve patients with PD were submitted to neurological and voice assessments during the off and on phases, in the pre-operative, 1st and 3rd post-operative months. The patients were evaluated with the UPDRS and the vocal acoustic parameters - f0, NHR, jitter, PPQ, Shimmer, APQ (using the software MultiSpeech - Kay Elemetrics - 3700). RESULTS: The off phase UPDRS scores revealed a tendency to improvement at the 1st month and the off phase worsened. The shimmer and APQ improved. CONCLUSION: This study shows that pallidotomy has little improvement on functional use of communication of PD patients.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Oriol De Fabregues ◽  
Alex Ferré ◽  
Odile Romero ◽  
Manuel Quintana ◽  
José Álvarez-Sabin

Background. Sleep problems in patients with advanced Parkinson’s disease (PD) have a deleterious impact on quality of life. Objective. To assess the effect of levodopa-carbidopa intestinal gel (LCIG) infusion on sleep quality in advanced PD patients. Methods. Seven patients participated in a prospective pilot study. Before and after 6 months of LCIG infusion, an overnight polysomnography was performed and the Epworth Sleepiness Scale, fatigue scale, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Hamilton Anxiety Rating Scale were administered. Results. PSG showed low sleep efficiency. REM sleep without atony was found in 5 patients. After 6 months of LCIG infusion, the percentage of REM sleep decreased as well as the number of arousals especially due to reduction of spontaneous arousals and periodic leg movements during REM sleep, but differences were not statistically significant. Also, scores of all study questionnaires showed a tendency to improve. Conclusion. The results show a trend toward an improvement of sleep quality after 6 months of LCIG infusion, although differences as compared to pretreatment values were not statistically significant. The sleep architecture was not modified by LCIG. Further studies with larger study samples are needed to confirm these preliminary findings.


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