scholarly journals Consensus-Based Recommendations for Advance Directives of People with Parkinson’s Disease in Regard to Typical Complications by German Movement Disorder Specialists

2020 ◽  
Vol 9 (2) ◽  
pp. 449
Author(s):  
Martin Klietz ◽  
Johanna M. Berndt ◽  
Florian Wegner ◽  
Nils Schneider ◽  
Günter U. Höglinger ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Health Professionals ◽  
Delphi Study ◽  
Oral Therapy ◽  
Response Rate ◽  
Expert Panel ◽  
Evidence Based ◽  
Disease Course ◽  
Dopaminergic Therapy

A huge proportion of people with Parkinson’s disease (PwP) in Germany have written an advance directive (AD). However, the content of these forms in regard to specific Parkinson’s disease (PD)-related complications is rather low. There is an urgent need to specify ADs of PwP and consequently to improve decision-making concerning end-of-life aspects for affected patients. Evidence- and consensus-based PD-specific recommendations for ADs might help to close this gap. A Delphi study with two online Delphi rounds was initiated. Initial recommendations were built on findings from previous studies and derived from evidence-based literature. Consensus on recommendations was defined as ≥80% concordance regarding clarity of formulated aspects and relevance for clinical practice. A total of 22 experts (15.2% response rate) predominantly from the workgroup ‘neuro-palliative care’ in Germany performed two Delphi rounds. Consensus was achieved for 14 of 24 initially presented recommendations. Recommendations relating to dopaminergic therapy as well as to non-oral therapy options were considered important by the expert panel. The recommendations should be taken into account when developing and giving advice on ADs for PwP. Health professionals should be trained in counselling ADs of PwP and in integrating these recommendations in ADs during the disease course of PD.

Evidence-Based Aquatic Therapy Guidelines for Parkinson’s Disease: An International Consensus Stud

2021 ◽  
pp. 1-17
Author(s):  
Louise M. Carroll ◽  
Meg. E. Morris ◽  
William T. O’Connor ◽  
Daniele Volpe ◽  
Jon Salsberg ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Content Analysis ◽  
Patient Preferences ◽  
Delphi Study ◽  
Response Rate ◽  
Evidence Based ◽  
Aquatic Therapy ◽  
Therapy Guidelines ◽  
Consensus Statements

Background: Aquatic therapy is one therapy option for people living with Parkinson’s disease (PD). However, the optimal prescription, dosage, and delivery remain unclear. Objective: i) To generate consensus statements, ii) to establish evidence-based clinical practice aquatic therapy guidelines for PD. Methods: Seventy-three international experts were invited to participate in a 3-step modified Delphi study. Gaps in the aquatic therapy evidence, patient preferences, and stakeholder engagement were considered when developing the initial list of 43-statements identified by the research development group. Practice experts rated each statement on an 11-point Likert scale. Consensus for inclusion was set at a priori of ≥70%of respondents scoring an item ≥7. Two rounds of Delphi questionnaires were completed online, and the expert comments were analyzed using content analysis. An online consensus meeting with an expert subgroup (n = 10) then advised on the guideline’s acceptability and debated items until consensus for inclusion was reached. Results: Fifty experts participated in the Delphi round one (83%response rate) and 45 in round two (90%response rate), representing 15 countries. In round one, 35 statements met the criteria for consensus. Content analysis informed the revised statements in round two, where 12 of the remaining 16 statements met consensus. The final agreed aquatic therapy guidelines include key information about dosage, content, safety, contraindications, and the optimal aquatic therapy delivery throughout the disease course. Conclusion: Stakeholders, including international practice experts, informed a rigorous evidence-based approach to integrate the best available evidence, patient preferences, and practice expertise to inform these guidelines.

Dopaminergic therapy does not affect body weight in Parkinson's disease patients

2006 ◽  
Vol 33 (S 1) ◽  
Author(s):  
C.G. Bachmann ◽  
C. Werner ◽  
E. Brunner ◽  
C. Trenkwalder
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Body Weight ◽  
Dopaminergic Therapy ◽  
Affect Body Weight

scholarly journals Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

2021 ◽  
Vol 11 (4) ◽  
pp. 416
Author(s):  
Carla Piano ◽  
Francesco Bove ◽  
Delia Mulas ◽  
Enrico Di Stasio ◽  
Alfonso Fasano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Cortex ◽  
Clinical Outcome ◽  
Motor Cortex Stimulation ◽  
Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

Neurotrophic factors in Parkinson's disease are regulated by exercise: Evidence-based practice

2016 ◽  
Vol 363 ◽  
pp. 5-15 ◽  
Author(s):  
Paula Grazielle Chaves da Silva ◽  
Daniel Desidério Domingues ◽  
Litia Alves de Carvalho ◽  
Silvana Allodi ◽  
Clynton Lourenço Correa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurotrophic Factors ◽  
Evidence Based Practice ◽  
Evidence Based

THE ROLE OF CIRCADIAN REGULATION OF GHRELIN LEVELS IN PARKINSON’S DISEASE (LITERATURE REVIEW)

2021 ◽  
Vol 74 (7) ◽  
pp. 1750-1753
Author(s):  
Kateryna A. Tarianyk ◽  
Nataliya V. Lytvynenko ◽  
Anastasiia D. Shkodina ◽  
Igor P. Kaidashev
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clock Genes ◽  
Biological Rhythms ◽  
Circadian Regulation ◽  
Diurnal Changes ◽  
Dopaminergic Therapy ◽  
Peripheral Oscillators ◽  
Genes Expression

The paper is aimed at the analysis of the role of the circadian regulation of ghrelin levels in patients with Parkinson’s disease. Based on the literature data, patients with Parkinson’s disease have clinical fluctuations in the symptoms of the disease, manifested by the diurnal changes in motor activity, autonomic functions, sleep-wake cycle, visual function, and the efficacy of dopaminergic therapy. Biological rhythms are controlled by central and peripheral oscillators which links with dopaminergic neurotransmission – core of the pathogenesis of Parkinson`s disease. Circadian system is altered in Parkinson`s disease due to that ghrelin fluctuations may be changed. Ghrelin is potential food-entrainable oscillator because it is linked with clock genes expression. In Parkinson`s disease this hormone may induce eating behavior changing and as a result metabolic disorder. The “hunger hormone” ghrelin can be a biomarker of the Parkinson’s disease, and the study of its role in the pathogenesis, as well as its dependence on the period of the day, intake of levodopa medications to improve the effectiveness of treatment is promising.

scholarly journals Impulse Control Disorders in Parkinson's Disease: Epidemiology, Pathogenesis and Therapeutic Strategies

2021 ◽  
Vol 12 ◽  
Author(s):  
Jun-Fang Zhang ◽  
Xi-Xi Wang ◽  
Ya Feng ◽  
Robert Fekete ◽  
Joseph Jankovic ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Broad Spectrum ◽  
Impulse Control ◽  
Compulsive Buying ◽  
Therapeutic Strategies ◽  
Impulse Control Disorders ◽  
Dopaminergic Therapy ◽  
Disease Epidemiology ◽  
Tremendous Impact

Impulse control disorders (ICDs) in Parkinson's disease (PD) are aberrant behavior such as pathological gambling, hypersexuality, binge eating, and compulsive buying, which typically occur as a result of dopaminergic therapy. Numerous studies have focused on the broad spectrum of ICDs-related behaviors and their tremendous impact on patients and their family members. Recent advances have improved our understanding of ICDs. In this review, we discuss the epidemiology, pathogenesis and treatment of ICDs in the setting of PD.

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