Parkinsonism & related disorders
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Parkinsonism Relat. Disord. · Jan 2012
ReviewEpidemiology, diagnosis and differential diagnosis in Parkinson's disease tremor.
The epidemiology of tremor in Parkinson's disease is not well examined. The prevalence of Parkinson's disease is about 100-300 per 100,000, and the majority (70-100%) of these patients may develop tremor during the course of the disorder. The expression of tremor is also influenced by the genetic background of selected patients. ⋯ Misdiagnoses between Parkinson tremor and essential tremor are relatively common. Electrophysiological and functional imaging examinations can be useful in the distinction of the two, but both approaches suffer from some limitations. In general, essential tremor and other tremor forms can be distinguished from Parkinson tremor by their frequency and their expression with different activation.
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Parkinsonism Relat. Disord. · Jan 2012
Unilateral subthalamic nucleus deep brain stimulation improves sleep quality in Parkinson's disease.
Sleep disturbances are common in Parkinson's disease (PD). Bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is superior to best medical therapy in the treatment of motor symptoms in advanced PD, and observational studies suggest that bilateral STN DBS improves sleep in these patients as well. Unilateral STN DBS also improves motor function in PD, but its effects on sleep have not been extensively investigated. ⋯ This prospective case series study provides evidence that unilateral STN DBS improves subjective sleep quality in patients with PD at up to 6 months post-operatively as measured by the PSQI.
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Parkinsonism Relat. Disord. · Dec 2011
Review Meta AnalysisPrevalence of orthostatic hypotension in Parkinson's disease: a systematic review and meta-analysis.
Although orthostatic hypotension (OH) is recognized as one of the main non-motor symptoms of Parkinson's disease (PD), there is inconsistent evidence about the prevalence of OH in PD. To estimate the prevalence of OH in PD more precisely we conducted a systematic review of the literature. ⋯ The estimated prevalence of OH in PD is 30%. However, due to the large heterogeneity between studies this pooled estimate should be interpreted with caution. More data from unselected population-based cohorts are needed.
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Parkinsonism Relat. Disord. · Nov 2011
ReviewUpdates on the antinociceptive mechanism hypothesis of botulinum toxin A.
Botulinum toxin A has been traditionally viewed as a motor nerve specific treatment. However, clinical uses for botulinum toxin A have continued to expand, with increased use in conditions implicating sensory pain nerve dysfunction. Chronic pain is associated with excess pain fiber activity. ⋯ During this state, excess pain signaling reaches the central nervous system, which can then lead to a condition of central sensitization, manifesting as the symptoms associated with chronic pain (i.e. burning, electric pain, lowered pain threshold to normal stimuli, etc). Experimentally, botulinum toxin type A has been shown to reduce neuropeptides and neurotransmitter release from treated cells or nerve endings and to attenuate nociception in both neuropathic and non-neuropathic pain models. This review summarizes the literature to update the hypothesis for the mechanism by which botulinum toxin type A can modulate chronic pain.
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Parkinsonism Relat. Disord. · Nov 2011
Differentiating Parkinson's disease from multiple system atrophy by [123I] meta-iodobenzylguanidine myocardial scintigraphy and olfactory test.
We aimed to study whether either [(123)l] myocardial meta-iodobenzylguanidine (MIBG) myocardial scintigraphy or the odor stick identification test for Japanese (OSIT-J) is effective in differentiating Parkinson's disease (PD) from multiple system atrophy (MSA). We compared the MIBG accumulation and olfactory score between 42 PD and 42 MSA (19 MSA-P and 23 MSA-C) patients in the early stages. [(123)l] MIBG myocardial scintigraphy showed higher sensitivity and the olfactory test higher specificity in differentiating PD from MSA. There were significant differences between PD and MSA-C (p = 0.0019) instead of MSA-P (p > 0.05) in the MIBG accumulation, while there were significant differences between PD and MSA-P (p = 0.0003) or MSA-C (p = 0.0003) in the OSIT-J score. Our data suggest that the olfactory test can be useful as a clinical tool with its higher specificity in differentiating PD from MSA in the early stages and, moreover, support the discrimination of PD from MSA-P.