Parkinsonism & related disorders
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Parkinsonism Relat. Disord. · Nov 2014
Randomized Controlled TrialRandomized, placebo-controlled trial of trimethobenzamide to control nausea and vomiting during initiation and continued treatment with subcutaneous apomorphine injection.
Nausea and vomiting can occur in Parkinson's disease (PD) patients initiated on apomorphine subcutaneous injections and antiemetic prophylaxis is recommended per product labeling. Data suggest long-term antiemetic prophylaxis may not be needed, although this has not been systematically studied. ⋯ Our data suggest that trimethobenzamide helps reduce nausea/vomiting during the first 8 weeks of apomorphine therapy, but is generally not needed thereafter. Trimethobenzamide did not worsen parkinsonism nor affect "on" response after apomorphine injection.
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Parkinsonism Relat. Disord. · Nov 2014
Comparative StudyComparison of voluntary and reflex cough effectiveness in Parkinson's disease.
Multiple airway protective mechanisms are impacted with Parkinson's disease (PD), including swallowing and cough. Cough serves to eject material from the lower airways, and can be produced voluntarily (on command) and reflexively in response to aspirate material or other airway irritants. Voluntary cough effectiveness is reduced in PD however it is not known whether reflex cough is affected as well. The goal of this study was to compare the effectiveness between voluntary and reflex cough in patients with idiopathic PD. ⋯ Cough PEFR and CEV are indicative of cough effectiveness in terms of the ability to remove material from the lower airways. Differences between these two cough types likely reflect differences in the coordination of the respiratory and laryngeal subsystems. Clinicians should be aware that evaluation of cough function using voluntary cough tasks overestimates the PEFR and CEV that would be achieved during reflex cough in patients with PD.
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Parkinsonism Relat. Disord. · Nov 2014
Montreal Cognitive Assessment for the screening and prediction of cognitive decline in early Parkinson's disease.
Early diagnosis of cognitive impairment in PD would allow appropriate monitoring and timely intervention to reduce the progression to dementia (PDD). ⋯ MoCA is a reliable tool in predicting cognitive decline in early PD. A MoCA score of ≤26 significantly increases the risk for progressive cognitive decline.
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Parkinsonism Relat. Disord. · Nov 2014
Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS.
Non-motor complications of Parkinson's disease (PD), specifically cognitive impairment, sleep disturbances, and fatigue, are recognized as important contributors to poor patient outcomes and quality of life. How sleep problems and fatigue interrelate and impact cognitive function, however, has not systematically been investigated across the stages of PD. The aim of our study was to investigate the relationships among cognitive impairment, night-time sleep problems, daytime sleepiness, and fatigue across all severities of PD. ⋯ Given this association of daytime sleepiness and fatigue with cognitive impairment, clinical monitoring for these problems should be considered across all points in the PD spectrum, from early to more advanced disease.
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Parkinsonism Relat. Disord. · Nov 2014
A potential target for the treatment of Parkinson's disease: effect of lateral habenula lesions.
Parkinson's disease (PD) is a progressive neurodegenerative movement disorder that is caused predominantly by the degeneration of the nigrostriatal dopaminergic pathway. Lateral habenula (LHb) has efferent projections that terminate in the substantia nigra pars compacta (SNpc) and electrical stimulation of the LHb effectively suppresses the activity of dopamine-containing neurons in the SNpc. This study was aimed to investigate whether LHb lesions can ameliorate the syndromes of PD via affecting the activities of SNpc neurons in 6-hydroxydopamine (6-OHDA)-induced PD model rats. ⋯ Therefore, we speculate that the LHb lesions induced a significant amelioration in motor disorders via increasing the DA levels in the striatum, which may lead to a potential therapeutic strategy for the treatment of PD.