Parkinsonism & related disorders
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Parkinsonism Relat. Disord. · Mar 2013
Multicenter StudyLevodopa-carbidopa intestinal gel in advanced Parkinson's disease open-label study: interim results.
Levodopa-carbidopa intestinal gel (LCIG) delivered continuously via percutaneous endoscopic gastrojejunostomy (PEG-J) tube has been reported, mainly in small open-label studies, to significantly alleviate motor complications in Parkinson's disease (PD). A prospective open-label, 54-week, international study of LCIG is ongoing in advanced PD patients experiencing motor fluctuations despite optimized pharmacologic therapy. Pre-planned interim analyses were conducted on all enrolled patients (n = 192) who had their PEG-J tube inserted at least 12 weeks before data cutoff (July 30, 2010). ⋯ Four (2.1%) patients died (none deemed related to LCIG). Interim results from this advanced PD cohort demonstrate that LCIG produced meaningful clinical improvements. LCIG was generally well-tolerated; however, device and procedural complications, while generally of mild severity, were common.
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Parkinsonism Relat. Disord. · Mar 2013
How precise are activities of daily living scales for the diagnosis of Parkinson's disease dementia? A pilot study.
Beside the presence of cognitive deficits, impaired activities of daily living (ADL) are crucial for the diagnosis of dementia in Parkinson's disease (PD). Several scales can be used to evaluate PD patients' ADL (dys)function. However, only a few of them sufficiently discriminate between demented and non-demented PD patients. It is well-known that the diagnostic accuracy of ADL scales for Parkinson's disease dementia (PDD) is influenced by confounding variables such as motor worsening. ⋯ Standardized activities of daily living assessments like the Pill Questionnaire accompanied by neuropsychological testing can be a helpful tool for the diagnosis of PDD. Further studies are needed to verify these first results in larger cohorts.
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Parkinsonism Relat. Disord. · Mar 2013
Multicenter Study Clinical TrialAmantadine improves gait in PD patients with STN stimulation.
In advanced Parkinson's disease (PD), axial symptoms such as speech, gait, and balance impairment often become levodopa-unresponsive and they are difficult to manage, even in patients with subthalamic nucleus deep brain stimulation (STN-DBS). We anecdotally observed that oral administration of amantadine was very effective in treating both residual and stimulation-induced axial symptoms after bilateral STN-DBS in one PD patient. Therefore, we conducted a prospective multicenter observational study to evaluate the effects of amantadine on speech, gait and balance in PD patients with STN-DBS and incomplete axial benefit. ⋯ Gait scores significantly improved (from 1.51 ± 0.89 to 1.11 ± 0.92, P = 0.015) with amantadine treatment, whereas postural stability and speech scores were similar before and after treatment. Thirty-five (76.1%) patients reported subjective improvement in speech, gait or balance with amantadine, whereas thirty (65.2%) patients reported improvement in gait and balance. In conclusion, our data suggest that amantadine may have new beneficial effects on axial symptoms in PD patients with STN-DBS.
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Parkinsonism Relat. Disord. · Mar 2013
Marked N-acetylaspartate and choline metabolite changes in Parkinson's disease patients with mild cognitive impairment.
The mild cognitive impairment in Parkinson's disease (PD-MCI) has received increasing attention, of which the diagnosis is challenging. To analyze the possible biomarkers for the early diagnosis, we investigated the metabolite changes in different brain regions of PD-MCI patients as well as appropriate controls by proton magnetic resonance spectroscopy (MRS). ⋯ The metabolite changes in the occipital lobe and posterior cingulate occur in the early cognitive impairment phase of PD patients. Such variations can be used as the marker for the detection of PD-MCI.
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Parkinsonism Relat. Disord. · Mar 2013
Case ReportsNovel SPG11 mutations in Chinese families with hereditary spastic paraplegia with thin corpus callosum.
Hereditary spastic paraplegia is a clinically and genetically heterogeneous neurodegenerative disorder characterized by progressive spasticity of the lower limbs. Mutations in SPG11 gene have been recently identified as a major cause of hereditary spastic paraplegia with thin corpus callosum. ⋯ This study widens the spectrum of mutations in SPG11. The application of detailed neuropsychological tests and diffusion tensor imaging could detect cerebral subtle involvement even in early stage of the disease.