Mucuna beans administered through hydrogen-infused superheated steam in advanced Parkinson's disease.

This retrospective review on patients with Parkinson's disease, focusing on using mucuna beans (MB), its dosing, and administration methods. Two hundred patients taking 1-3 g of MP dissolved in hot water daily orally. Besides, MB administration via enema may be viable, especially when oral L-dopa efficacy is insufficient.

Influence of current and previous smoking on current phenotype in Parkinson's disease.

INTRODUCTION: Although an inverse correlation between smoking and Parkinson's disease (PD) has been reported, research into the effect of smoking on current clinical progression remains limited for PD patients. Elucidation of a specific PD population who would benefit from smoking is challenging. METHODS: We evaluated 110 consecutive PD patients (mean age; 71.0 ± 8.0 years) at a single neurology clinic between 2010 and 2018. The association with smoking status was evaluated in sex- and age-matched controls (non-PD). This study assessed the impact of previous smoking exposure on the outcome of current PD-related parameters, along with any confounders, in addition to assessing fluctuation of parkinsonism induced by smoking exposure. RESULTS: The current smoking rate was significantly lower in PD versus non-PD (5.5% vs. 15.5%, P = 0.026), while there were similar rates between former and never smokers. Among the former smokers, most PD patients (97.3%) quit smoking prior to the onset of PD. There were no differences between PD patients with and without a history of smoking for current clinical parameters. Three PD patients with the mean onset age of 51.0 ± 5.3 y reported transient deterioration of their parkinsonism when smoking. Negative mood during cigarette smoke exposure was significantly increased over the entire life in PD patients with a history of smoking than those without (p < 0.001). CONCLUSIONS: Although previous smoking history reportedly had a neuroprotective effect prior to onset, the association between the previous history and current phenotype in PD was not visible in the present study. However, the possibility that current nicotine intake might modify the parkinsonism deterioration will need to be further evaluated, especially in non-elderly patients. Cigarette smoke-related negative mood could be a confounder for quitting smoking in PD patients.

Establishing diagnostic criteria for Perry syndrome.

OBJECTIVE: To establish international diagnostic criteria for Perry syndrome, a disorder characterised by clinical signs of parkinsonism, depression/apathy, weight loss, respiratory symptoms, mutations in the DCTN1 gene and TAR DNA-binding protein 43 (TDP-43) pathology. METHODS: Data from the published literature and newly identified patients were gathered and analysed during and after the International Symposium on Perry syndrome in Tokyo to identify diagnostic criteria for Perry syndrome. RESULTS: Eighty-seven patients with Perry syndrome carrying DCTN1 mutations from 20 families were included in this study, and common signs of the disorder were identified, including parkinsonism (95.2% of patients), depression/apathy (71.4%), respiratory symptoms (66.7%) and weight loss (49.2%). CONCLUSIONS: Based on our findings, we propose the following definitive diagnostic criteria for Perry syndrome: the presence of four cardinal signs of Perry syndrome, accompanied by a mutation in DCTN1; or a family history of the disease, parkinsonism and a mutation in DCTN1; or the presence of four cardinal signs and pathological findings that include nigral neuronal loss and TDP-43 pathology. As patients with Perry syndrome present with uniform clinical, genetic and pathological features, we further propose the disorder be termed 'Perry disease.'

Communication aid device utilizing event-related potentials for patients with severe motor impairment.

The purpose of the present study was to develop a communication aid device utilizing event-related potentials (ERPs) for patients with severe motor disabilities. Preliminary experiments were performed on eight healthy volunteers to determine the optimal methods of presentation of visual stimuli and an off-line analysis of electroencephalography signals. Three clinical experiments were performed online on 17 healthy volunteers, 5 patients with amyotrophic lateral sclerosis, and 1 patient with olivopontocerebellar atrophy. First, one of four vertically aligned short expressions ("yes definitely," "yes," "no," and "don't know") was presented in a random sequence to determine the target. Second, a systematic table of 50 Japanese syllables, and third, 16 pictorial symbols in four columns were presented, with each column presented at random. The target was identified by the maximum sum of the 2-5 Hz power spectrum after fast Fourier transform of averaged ERPs. A high correct response rate was obtained in the clinical experiments of almost 100% in "yes or no" and pictorial symbol paradigms using seven averaged samples. These results indicate that such devices may be used to communicate with patients who have lost all ability to interact other than directly via the brain.

[Optimum dosage of pergolide in patients with Parkinson's disease].

For the purpose of determining the optimal dose, pergolide was administered to patients with Parkinson's disease using a dose-escalation protocol up to the maximum dosage permissible in Japan. The study was completed in 16 subjects with Parkinson's disease. Prior to the start of the dose-escalation study, the daily dose of pergolide was 500 microg in 6 patients and 750 microg in 10 patients. The daily dose was raised by 250 microg at 4-week intervals up to the approved maximum dose of 1,250 microg/day, which was used as the final level. Just before the start of study and after administration for 4 weeks at each dose level, UPDRS-III and PDQ-39 assessments were performed. The mean UPDRS-III score was 28.6 +/- 7.9 before the start of the study and 17.3 +/- 8.3 after the end, indicating an improvement (improvement rate, 39.3%; p < 0.01). The mean PDQ-39 score was 45.2 +/- 21.8 before the start and 37.3 +/- 17.8 after the end, indicating an improvement (improvement rate, 17.5%; p < 0.05). Clinical conditions including their QOL improved significantly after dose-escalation up to the 1,250 microg.

[Communication device utilizing event-related potentials].

We had developed a communication system using a theory of P300 through a computer. 17 healthy subjects participated in all 3 experiments, while 4 ALS and 1 OPCA patients took part in the first 2 experiments only. In the 1st experiment, 4 short sentences of 'yes very much', 'yes' 'no' and 'can't answer' were shown on the display. The subjects were asked to select one of them as target. During the experiment 1, color of background was randomly changed for each sentence as the stimulation for the period of 300 msec and the interstimulus interval was 1,500 msec. In the 2nd experiment, 46 letters of Japanese character and several symbols were shown on the display (5 columns x 10 rows). In the 3rd experiment, we used 16 pictures together with X (4 columns x 5 rows). During recordings, the color of background was randomly changed for each row and then for each letter/picture of column containing target in experiment 2 as well as in experiment 3. The subjects were asked to start counting and when the target was stimulated, they were instructed to stop the counting process and repeat counting again until they encountered the stimulation of target again. This was repeated for the entire recordings. Computer defined a target by a biggest positive voltage between 300 and 600 msec and/or by the most powerful spectrum in 2-5 Hz after Fast Fourier transform in an averaged P300 (averaging number = 5-7). We then calculated the percentage of correct target by comparing the result and actual target. Results indicate that this communication aids can be used conveniently in patients with severe motor disabilities.