Impact of neuroprotective therapy on cognition and oxidative stress in the early stages of Parkinson’s disease

The aim of this study was to investigate the clinical and biochemical efficiency of citicoline in cognitive improvement and changes of glutathione peroxidase (GPx) blood plasma levels in patients at early stages of Parkinson’s disease (PD). Materials and methods. We recruited 42 patients at I–II Hoehn and Yahr PD stages and 20 controls. The Montreal Cognitive Assessment test (MoCA) was used to assess several cognitive domains in PD patients (before citicoline treatment, after intravenous therapy and after pills therapy) and controls (once). Plasma was collected once in controls and twice in PD patients (on the first and the last days of observation). Citicoline was administrated to 23 of 42 PD patients in addition to basic antiparkinsonian therapy intravenously during 10 days and with pills during next 30 days. The rest 19 of 42 PD patients had been taking basic antiparkinsonian treatment only (comparison group). Results. We observed significant improvement of MoCA scores in PD patients with citicoline course (PD-Cs) in each check day. But in spite of such an improvement in PD patients, who were left on the basic antiparkinsonian treatment (PD-Bs), on the 10th day of observation, patients of this group did not keep it to the last day of the research (P < 0.001). After the treatment the GPx level in plasma of PD-Cs was significantly higher than in PD-Bs (P < 0.001). Furthermore, the activity of GPx plasma level after citicoline course was significantly higher than before additional neuroprotective therapy, which wasn’t observed in PD patients on basic treatment only. Conclusion. The cognition of PD patients (according to MoCA scores) at the early stages of the disease was significantly improved after citicoline treatment. Citicoline treatment had significant positive influence on the increasing antioxidant GPx plasma activity in PD patients at the early stages of the disease.

Pain in Parkinson’s disease: analysis of 50 cases in a clinic of movement disorders

INTRODUCTION: Pain is a common symptom in Parkinson's disease (PD), and is often related to the illness itself. OBJECTIVE: To prospectively establish the ocurrence of pain in PD patients. METHOD: This study was conducted within a population composed of 50 patients with PD to evaluate the presence of pain. RESULTS: Twenty-eight patients reported pain; comparing the group with pain and the group without pain, there were no differences related to the beginning of the illness and the motor symptoms of PD. However, many patients related an improvement of pain when antiparkinsonian therapy was initiated or adjusted. CONCLUSION: The use of techniques for analgesia and the adjustment of PD medication contribute to improve the manifestations of pain and the life quality of patients with PD.