scholarly journals The Effect of Pramipexole Therapy on Balance Disorder and Fall Risk in Parkinson’s Disease at Early Stage: Clinical and Posturographic Assessment

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sibel Güler ◽  
Levent Sinan Bir ◽  
Beyza Akdag ◽  
Fusun Ardıc

The aim of this study was to determine balance problems and severity and ratio of postural instability of newly diagnosed, early stage Parkinson’s patients who did not receive any antiparkinson treatment before, to evaluate fall risk clinically and posturographically and to examine the effects of pramipexole on these signs and symptoms. Detailed posturographic assessments which involved central vestibular, visual, peripheric vestibular somatosensory field tests were applied to both patient and control subjects and fall risk was determined. There was not statistically significant difference between patients and control subjects before and after drug therapy in the assesment of fall risk in posturography and there was not any improvement with drug usage in the patient group. However, in the analysis of subsystems separately, only the involvement in central vestibular field was more severe and could appear at all positions in Parkinson’s patients comparing with the control group, and pramipexole was partially effective in improving this disorder. Central vestibular field is the subsystem that should be examined with first priority. Posturography is relatively reliable in defining fall risk and postural instability ratio in Parkinson’s disease. But it should be considered that clinical assessment tools can be more sensitive in the evaluation of balance and postural disorders and in the follow-up of the response to drug therapy.

2020 ◽  
Author(s):  
Mahmut Atum ◽  
Bekir Enes Demiryurek

Abstract Background: The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. Methods: The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. Results: The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p = 0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Conclusion: Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.


2021 ◽  
Vol 74 (1-2) ◽  
pp. 57-63
Author(s):  
Mahmut Atum ◽  
Bekir Enes Demiryürek

The study aims to investigate the relationship between the progression of idiopathic Parkinson’s disease (IPD) and retinal morphology. The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson’s Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.


2012 ◽  
Vol 108 (3) ◽  
pp. 915-924 ◽  
Author(s):  
Jaebum Park ◽  
Yen-Hsun Wu ◽  
Mechelle M. Lewis ◽  
Xuemei Huang ◽  
Mark L. Latash

In this study, we tested several hypotheses related to changes in finger interaction and multifinger synergies during multifinger force production tasks in Parkinson's disease. Ten patients with Parkinson's disease, mostly early stage, and 11 healthy control subjects participated in the study. Synergies were defined as covaried adjustment of commands to fingers that stabilized the total force produced by the hand. Both Parkinson's disease patients and control subjects performed accurate isometric force production tasks with the fingers of both the dominant and nondominant hands. The Parkinson's disease patients showed significantly lower maximal finger forces and higher unintended force production (enslaving). These observations suggest that changes in supraspinal control have a major effect on finger individuation. The synergy indexes in the patients were weaker in both steady-state and cyclic force production tasks compared with the controls. These indexes also were stronger in the left (nondominant) hand in support of the dynamic-dominance hypothesis. Half of the patients could not perform the cyclic task at the highest frequency (2 Hz). Anticipatory adjustments of synergies prior to a quick force pulse production were delayed and reduced in the patients compared with the controls. Similar differences were observed between the asymptomatic hands of the patients with symptoms limited to one side of the body and matched hands of control subjects. Our study demonstrates that the elusive changes in motor coordination in Parkinson's disease can be quantified objectively, even in patients at a relatively early stage of the disease. The results suggest an important role of the basal ganglia in synergy formation and demonstrate a previously unknown component of impaired feedforward control in Parkinson's disease reflected in the reduced and delayed anticipatory synergy adjustments.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Natália Pessoa Rocha ◽  
Paula Luciana Scalzo ◽  
Izabela Guimarães Barbosa ◽  
Mariana Soares Souza ◽  
Isabela Boechat Morato ◽  
...  

Cognitive impairment and depressive symptoms are of great interest in Parkinson’s disease (PD), since they are very common and lead to increased disability with poor quality of life. Inflammatory mechanisms have been implicated in PD and its nonmotor symptoms. In the current pilot study, we aimed to evaluate plasma levels of chemokines in PD patients and to analyze the putative association of chemokines with depressive symptoms and cognitive performance. We hypothesized that higher chemokines levels are associated with worse cognitive performance and increased depressive symptoms in PD. For this purpose, 40 PD patients and 25 age- and gender-matched controls were subjected to a clinical evaluation including cognitive and mood tests. Peripheral blood was drawn and plasma levels of CCL2/MCP-1, CCL11/eotaxin, CCL24/eotaxin-2, and CXCL10/IP-10 were measured by enzyme-linked immunosorbent assay. PD patients and control individuals presented comparable plasma concentrations of all the evaluated chemokines. In PD patients, CXCL10/IP-10 plasma levels correlated positively with Hoehn and Yahr staging scale. In addition, the higher CXCL10/IP-10 levels, the worse performance on cognitive tests. Although there was no significant difference between PD patients and control individuals regarding chemokines levels, our preliminary results showed that CXCL10/IP-10 may be associated with cognitive status in PD.


2016 ◽  
Vol 6 (4) ◽  
pp. 761-770 ◽  
Author(s):  
Thomas G. Beach ◽  
Anne-Gaëlle Corbillé ◽  
Franck Letournel ◽  
Jeffrey H. Kordower ◽  
Thomas Kremer ◽  
...  

Geriatrics ◽  
2021 ◽  
Vol 6 (4) ◽  
pp. 105
Author(s):  
Mathieu Dallaire ◽  
Guillaume Gagnon ◽  
Émilie Fortin ◽  
Josée Nepton ◽  
Anne-France Severn ◽  
...  

Introduction: Parkinson’s disease is most prevalent among elderly people, 65 years and over, and leads to an alteration in motor control associated with postural instability. Current evidence shows that postural control decreases with the aging process. In addition, postural control is more altered in healthy aged men than in women. Until today, few studies have evaluated the combined impact of Parkinson’s disease and sex on postural control. This review has allowed to evaluate the impact of Parkinson’s disease and sex on postural control measurements in elderly people. Methodology: Studies have been selected from two main databases: PubMed and EBSCO using the keywords “Parkinson”, “postural control OR balance” and “sex”. Articles related to the evaluation of postural control, including men and women with Parkinson’s aged over 65 years old, regardless of stage, were included (n = 179). Articles were excluded if not written in French or English or not presenting original content. Results: Ten (10) studies out of 179 that fulfilled inclusion and exclusion criteria were reported in the final analysis, which cumulates a total of 944 individuals with Parkinson’s (410 women). In general, results show greater postural instability among people with Parkinson’s compared to healthy subjects, and this according to different objective measurements using stabilographic parameters from force platforms. Only two studies out of ten evaluated postural control while briefly considering distinctions between sex, but without showing a significant difference between men and women with Parkinson’s. Parkinson’s severity, length of time of Parkinson’s disease and cognitive state of the person are the three variables with a negative impact on postural control. Conclusion: Older people with Parkinson’s disease have greater postural instability. Sex does not seem to influence the postural control of elderly people with Parkinson’s, although more studies are necessary.


2020 ◽  
Vol 14 (2) ◽  
pp. 171-177
Author(s):  
Gisele Saraiva Reis de Oliveira ◽  
Lúcia Bressan ◽  
Fernanda Balarini ◽  
Raquel Silveira Jesuino e Silva ◽  
Manuelina Mariana Capellari Macruz Brito ◽  
...  

ABSTRACT. Cognitive impairment is common in patients with Parkinson’s disease (PD), and evaluation of functional abilities is crucial for diagnosis of dementia. Objective: We evaluated differences between direct and indirect functional assessment methods to evaluate functional abilities in PD patients. Methods: We evaluated 32 patients with PD and suspected mild dementia using direct and indirect assessment methods. Results: There was a significant difference between the scores of direct and indirect methods of assessment. Patients and close informants usually overestimated their abilities in many ADL. However, all functional assessment tools used in this study had a relatively good accuracy to predict abnormal performance in a global cognitive scale. Patients with normal cognition according to scores in a global cognitive scale may have some functional impairment in ADL. Direct Assessment of Functional Ability (DAFA) scores correlated linearly with scores in global cognitive scales, and especially with scores in the domains of memory and concentration. Conclusion: Patients and close informants usually overestimate their instrumental abilities in ADL. The direct assessment of daily functioning was more reliable than indirect tools to assess functional losses in patients with PD. Finally, some patients with PD but no dementia may present functional losses in ADL.


2021 ◽  
Author(s):  
Vladimir Kovalzon ◽  
Aleksandr Ambaryan ◽  
Aleksandr Revishchin ◽  
Galina Pavlova ◽  
Ekaterina Rybalkina ◽  
...  

Abstract We have previously shown that the aqueous extract of the Ulomoides dermestoides darking beetle (the Tenebrionidae family) biomass contains a powerful complex of antioxidant substances of protein and non-protein nature. Considering the crucial role of ROS in the development of neurodegeneration, we set out to test the biological activity of this extract in a mouse neurotoxic model of Parkinson's disease. The beetle extracts were administrated continuously with food and their effects on parkinsonism caused by twice injected defoliant paraquat to experimental mice was evaluated. The motor activity of the animals was analyzed in behavioral tests using a rotarod and a vertical pole. The number of tyrosine hydroxylase-immunopositive neurons in the ventral part of the substantia nigra of the midbrains of experimental and control mice was studied by immunohistochemistry. In the model in vitro system with SH-SY5Y human neuroblastoma, the effect of the extracts on cell proliferation was examined in the absence and presence of the neurotoxin MPP+. The isolation of biologically active substances from raw biomass using cavitation effects made it possible to obtain extracts with protective properties in the model of an early stage of Parkinson's disease used in this study.


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