Parkinsonism & related disorders
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Parkinsonism Relat. Disord. · Sep 2012
Reduced muscle strength is the major determinant of reduced leg muscle power in Parkinson's disease.
Reduced muscle power (speed × strength) is associated with increased fall risk and reduced walking speed in people with Parkinson's disease (PD) as well as in the general older population. This study aimed to determine the relative contribution of motor impairments (bradykinesia, tremor, rigidity and weakness) to reduced leg muscle power in people with PD. ⋯ The findings that reduced strength and bradykinesia contribute to reduced muscle power in people with PD tested "on" medication suggest that these impairments are potential targets for physical interventions.
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Parkinsonism Relat. Disord. · Aug 2012
GPi and STN deep brain stimulation can suppress dyskinesia in Parkinson's disease.
To compare subthalamic nucleus (STN) to globus pallidus internus (GPi) deep brain stimulation (DBS) for control of motor fluctuations and for potential dyskinesia-suppressing qualities. ⋯ The overall clinical outcome of STN and GPi DBS for control of dyskinesia and motor fluctuations was similar. STN and GPi DBS both had some direct dyskinesia suppression effects.
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Parkinson's disease (PD) has been known as "the shaking palsy" as well as "paralysis agitans", yet clinically apparent weakness is not a feature of the disorder. Relative weakness, and early muscle fatigue may be demonstrated on testing but frank weakness should not be apparent on routine clinical examination. ⋯ Self perceived weakness was reported by 43.8%. Self perceived weakness was associated with fatigue but not with bradykinesia, tremor or total motor score (motor severity). SPW is common in PD but affects less than half the studied population. SPW appears to be related to fatigue, a major determinant of quality of life in PD, and therefore is an important symptom to understand.
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Parkinsonism Relat. Disord. · Jul 2012
Changes in brain glucose metabolism in subthalamic nucleus deep brain stimulation for advanced Parkinson's disease.
Despite its large clinical application, our understanding about the mechanisms of action of deep brain stimulation of the subthalamic nucleus is still limited. Aim of the present study was to explore cortical and subcortical metabolic modulations measured by Positron Emission Tomography associated with improved motor manifestations after deep brain stimulation in Parkinson disease, comparing the ON and OFF conditions. ⋯ Deep brain stimulation seems to operate modulating the neuronal network rather than merely exciting or inhibiting basal ganglia nuclei. Correlations with Parkinson Disease cardinal features suggest that the improvement of specific motor signs associated with deep brain stimulation might be explained by the functional modulation, not only in the target region, but also in surrounding and remote connecting areas, resulting in clinically beneficial effects.