Clinical Application of the K-Style Acupuncture Score (KSAS): Towards the Establishment of a Novel Rating Scale for Depression in Acupuncture Medicine

Abstract BACKGROUND Pedunculopontine nucleus (PPN) stimulation is a novel therapy for Parkinson disease. However, controversies remain regarding the clinical application of this new therapy, including patient selection, electrode positioning, and how best to assess outcomes. OBJECTIVE To clarify the clinical application of PPN stimulation in Parkinson disease. METHODS Five consecutive patients with Parkinson disease complicated by severe gait freezing, postural instability, and frequent falls (all persisting even while the patient was on medication) received bilateral stimulation of the mid-lower PPN without costimulation of other brain targets. Outcomes were assessed prospectively over 2 years with gait-specific questionnaires and the Unified Parkinson Disease Rating Scale (part III). RESULTS The primary outcome, the Gait and Falls Questionnaire score, improved significantly with stimulation. Benefits were maintained over 2 years. Unified Parkinson Disease Rating Scale (part III) items assessing gait and posture were relatively insensitive to these treatment effects. Beneficial effects often appeared to outlast stimulation for hours or longer. Thus, single-session on- vs off-stimulation assessments may be susceptible to “delayed washout effects.” Stimulation of the PPN did not change akinesia scores or dopaminergic medication requirements. CONCLUSION Bilateral stimulation of the mid-lower PPN (more caudal than previous reports) without costimulation of other brain targets may be beneficial for the subgroup of patients with Parkinson disease who experience severe gait freezing and postural instability with frequent falls, which persist even while on medication. Choosing appropriate outcome measures and accounting for the possibility of prolonged stimulation washout effects appear to be important for detecting the clinical benefits.

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Methods — Construction and Clinical Application of the Hamburg Rating Scale for Psychic Disturbances (HRPD)

Impact of Cardiac Surgery on the Quality of Life ◽

10.1007/978-1-4613-0647-4_2 ◽

1990 ◽

pp. 9-18 ◽

Cited By ~ 1

Author(s):

Paul Gotze ◽

Bernhard Dahme ◽

Ulrich Lamparter ◽

Sabine Falck

Keyword(s):

Clinical Application ◽

Rating Scale

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Psychometric Assessment and Clinical Application of the Correa-Barrick Depression Rating Scale

Clinical Nursing Research ◽

10.1177/105477302237450 ◽

2002 ◽

Vol 11 (4) ◽

pp. 363-381 ◽

Cited By ~ 3

Author(s):

Christina B. Barrick ◽

Dianne E. Taylor ◽

Elsa I. Correa

Keyword(s):

Clinical Application ◽

Rating Scale ◽

Psychometric Assessment

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The clinical application of ABCB1 genotyping in antidepressant treatment: a pilot study

CNS Spectrums ◽

10.1017/s1092852913000436 ◽

2013 ◽

Vol 19 (2) ◽

pp. 165-175 ◽

Cited By ~ 37

Author(s):

Barbara Breitenstein ◽

Sandra Scheuer ◽

Hildegard Pfister ◽

Manfred Uhr ◽

Susanne Lucae ◽

...

Keyword(s):

Treatment Outcome ◽

Hospital Stay ◽

Clinical Application ◽

Clinical Decision Making ◽

Rating Scale ◽

Antidepressant Treatment ◽

Nucleotide Polymorphisms ◽

Abcb1 Gene ◽

Duration Of Hospital Stay ◽

Remission Rates

BackgroundThe gene product of the ABCB1 gene, the P-glycoprotein, functions as a custodian molecule in the blood–brain barrier and regulates the access of most antidepressants into the brain. Previous studies showed that ABCB1 polymorphisms predicted the response to antidepressants that are substrates of the P-gp, while the response to nonsubstrates was not influenced by ABCB1 polymorphisms. The aim of the present study was to evaluate the clinical application of ABCB1 genotyping in antidepressant pharmacotherapy.MethodsData came from 58 depressed inpatients participating in the Munich Antidepressant Response Signature (MARS) project, whose ABCB1 gene test results were implemented into the clinical decision making process. Hamilton Depression Rating Scale (HAM-D) scores, remission rates, and duration of hospital stay were documented with dose and kind of antidepressant treatment.ResultsPatients who received ABCB1 genotyping had higher remission rates [χ2(1) = 6.596, p = 0.005, 1-sided] and lower Hamilton sores [t(111) = 2.091, p = 0.0195, 1-sided] at the time of discharge from hospital as compared to patients without ABCB1 testing. Among major allele homozygotes for ABCB1 single nucleotide polymorphisms (SNPs) rs2032583 and rs2235015 (TT/GG genotype), an increase in dose was associated with a shorter duration of hospital stay [rho(28) = –0.441, p = 0.009, 1-sided], whereas other treatment strategies (eg, switching to a nonsubstrate) showed no significant associations with better treatment outcome.DiscussionThe implementation of ABCB1 genotyping as a diagnostic tool influenced clinical decisions and led to an improvement of treatment outcome. Patients carrying the TT/GG genotype seemed to benefit from an increase in P-gp substrate dose.ConclusionResults suggest that antidepressant treatment of depression can be optimized by the clinical application of ABCB1 genotyping.

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Cut-off Values of Blessed Dementia Rating Scale and Its Clinical Application in Elderly Taiwanese

The Kaohsiung Journal of Medical Sciences ◽

10.1016/s1607-551x(09)70326-2 ◽

2006 ◽

Vol 22 (8) ◽

pp. 377-384 ◽

Cited By ~ 6

Author(s):

Yuan-Han Yang ◽

Chiou-Lian Lai ◽

Ruey-Tay Lin ◽

Chih-Ta Tai ◽

Ching-Kuan Liu

Keyword(s):

Clinical Application ◽

Rating Scale ◽

Dementia Rating Scale

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Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1610470t ◽

2016 ◽

Vol 144 (9-10) ◽

pp. 470-473 ◽

Cited By ~ 2

Author(s):

Slavoljub Tomic ◽

Ivana Simic ◽

Mihael Stanojevic ◽

Svetlana Jankovic ◽

Ljubomir Todorovic

Keyword(s):

Clinical Application ◽

Nerve Block ◽

Visual Analog Scale ◽

Local Anesthetic ◽

Rating Scale ◽

Extraction Methods ◽

Injection System ◽

Analog Scale ◽

Pain Ratings ◽

Computer Controlled

Introduction. The anterior and middle superior alveolar nerve block was claimed to be unpredictably efficient for clinical application. Objective. The aim of this report was to establish the efficacy of the anterior and middle superior alveolar nerve block, applied with a computer-controlled injection system or a conventional syringe, for upper premolars extraction. Methods. Sixty healthy adults were divided into two groups regarding the device used as follows: the first group was injected by a computer-controlled injection system, and the second group by a conventional syringe. Pain ratings were obtained via a visual analog scale (VAS) and a verbal rating scale (VRS). Results. Anterior and middle superior alveolar injection enabled a painless extraction in all patients, regardless of the local anesthetic or injection system used. It was slightly less painful when administered by a computer-controlled injection system, but insignificantly when evaluated by VRS. Conclusion. The anterior and middle superior alveolar nerve block may be recommended if maxillary permanent premolars have to be extracted.

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