Parkinsonism & related disorders
-
Parkinsonism Relat. Disord. · Jan 2014
Prodromal Parkinson's disease--using REM sleep behavior disorder as a window.
REM sleep behavior disorder (RBD) is characterized by loss of REM atonia of sleep, such that patients act out the contents of their dreams. Perhaps the most important facet of idiopathic RBD is that it is a powerful prodromal marker of Parkinson's disease (PD) and other synucleinopathies. Several prospective studies have now established that patients with idiopathic RBD have up to an 80% risk of developing a defined neurodegenerative synucleinopathy. ⋯ Third, assessing epidemiology of RBD allows us to study the epidemiology of PD and dementia with Lewy bodies 10-15 years earlier, reducing bias and opening new hypotheses as to the mechanism of action of selected risk factors. Finally, by prospectively observing RBD patients as they transition to full neurodegenerative synucleinopathy, one has an unprecedented window in which to directly observe evolution of PD from its prodromal stages. The evidence for RBD as a marker of prodromal PD and all these implications will be discussed.
-
Parkinsonism Relat. Disord. · Jan 2014
Genetic analysis of the fused in sarcoma gene in Chinese Han patients with Parkinson's disease.
Exome sequencing in a large essential tremor (ET) family identified a novel nonsense mutation (p.Q290X) in the fused in sarcoma gene (FUS) as the cause of this family. Because of the clinical overlap between ET and Parkinson's disease (PD), the role of FUS in an independent cohort of PD patients from China mainland was evaluated. ⋯ The FUS gene is not a genetic risk factor for PD in the population of Chinese Han ethnicity.
-
Parkinsonism Relat. Disord. · Jan 2014
Unexplained lower limb pain in Parkinson's disease: a phenotypic variant of "painful Parkinson's disease".
Unexplained pain is a key non-motor symptom (NMS) of Parkinson's disease (PD) that is prevalent throughout the condition and often unrecognized and under treated. We have identified a cluster of patients with unexplained refractory and intrusive lower limb pain. ⋯ We believe that unexplained lower limb pain is a specific non-motor phenotype in Parkinson's disease that is problematic and often undisclosed. This may be a variant of central pain and merits recognition.
-
Parkinsonism Relat. Disord. · Dec 2013
Case ReportsTreating post-traumatic tremor with deep brain stimulation: report of five cases.
Post-traumatic tremor is one of the most common movement disorders resulting from severe head trauma. However, literature regarding successful deep brain stimulation (DBS) treatment is scarce, resulting in ambiguity regarding the optimal lead location. Most cases support the ventral intermediate nucleus, but there is evidence to defend DBS of the zona incerta, ventral oralis anterior/posterior, and/or a combination of these targets. We report five patients with disabling post-traumatic tremor treated with DBS of the ventral intermediate nucleus and of the globus pallidus internus. ⋯ Unilateral or bilateral DBS of the ventral intermediate nucleus and bilateral DBS of the globus pallidus internus may be effective and safe treatment modalities for intractable post-traumatic tremor. Further studies are needed to clarify the optimal target for surgical treatment of post-traumatic tremor.
-
Parkinsonism Relat. Disord. · Nov 2013
Randomized Controlled TrialUsing virtual reality to explore the role of conflict resolution and environmental salience in freezing of gait in Parkinson's disease.
The freezing phenomenon is among the most disabling symptoms of Parkinson's disease (PD) manifesting most commonly as Freezing of Gait with a paroxysmal cessation of effective stepping. Recent studies have suggested that freezing is related to both impairments in conflict resolution as well as the processing of environmentally salient information. ⋯ These results suggest that deficits in conflict resolution and visuospatial processing may reflect some of the neural mechanisms associated with freezing behavior and that these can be probed in a virtual reality environment.