ABSTRACT
Given the increasing incidence of neurodegenerative disease (ND), recent research efforts have intensified the search for curative treatments. Despite significant research, however, existing therapeutic options for ND can only slow down the progression of the disease, but not provide a cure. Light therapy (LT) has been used to treat some mental and sleep disorders. This review illustrates recent studies of the use of LT in patients with ND and highlights its potential for clinical applications. The literature was collected from PubMed through June 2020. Selected studies were primarily English articles or articles that could be obtained with English abstracts and Chinese main text. Articles were not limited by type. Additional potential publications were also identified from the bibliographies of identified articles and the authors' reference libraries. The identified literature suggests that LT is a safe and convenient physical method of treatment. It may alleviate sleep disorders, depression, cognitive function, and other clinical symptoms. However, some studies have reported limited or no effects. Therefore, LT represents an attractive therapeutic approach for further investigation in ND. LT is an effective physical form of therapy and a new direction for research into treatments for ND. However, it requires further animal experiments to elucidate mechanisms of action and large, double-blind, randomized, and controlled trials to explore true efficacy in patients with ND.
Subject(s)
Animals , Humans , Neurodegenerative Diseases/therapy , Phototherapy , Randomized Controlled Trials as TopicABSTRACT
<p><b>Objective</b>Excessive daytime sleepiness (EDS) is one of the most common sleep abnormalities in patients with Parkinson's disease (PD), yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.</p><p><b>Data Sources</b>English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms: "sleepiness", "sleep and Parkinson's disease", and "Parkinson's disease and treatment".</p><p><b>Study Selection</b>Original research articles and critical reviews related to EDS in PD were selected.</p><p><b>Results</b>EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic (i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation) and pharmacologic (i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine) treatments may be effective in treating EDS in PD.</p><p><b>Conclusions</b>EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.</p>
Subject(s)
Female , Humans , Male , Parkinson Disease , Quality of Life , Sleep Wake DisordersABSTRACT
Objective This study aimed to investigate whether more intensive induction regimen plus autologous bone marrow transplantation and 13-cis-retinoic acid can alter the extremely poor prognosis of high-risk neuroblastoma patients.Methods Five children with stage Ⅳ neuroblastoma were studied. One was under one year old, which was founded by neuroblastoma screening. The oldest one was 5 year old. The duration of illness before admission was from 7 days to 4 months. Primary site of the disease was adrenal gland in four patients and retroperitoneal in one. All of the patients had multiple metastasis. Urine VMA/Cr was more than normal in two patients. NSE elevated in all 5 patients. The MYCN amplification more than 10 copies in three patients. All of the patients received high-dose chemotherapy, radical removal of the original tumor and metastatic retroperitoneal lymph nodes, local radiation, plus supralethal preconditioning regimen followed by autologous bone marrow transplantation as well as 13-cis-retinoic acid.Results All the five patients got a complete response after the induction regimen. Follow-up 4-33 months, five patients keep complete responses and three patients disease-free survival, two patients had mild renal failure.Conclusions High-dose induction chemotherapy plus autologous bone marrow transplantation as well as 13-cis-retinoic acid may can improve the prognosis of high-risk neuroblastoma patients.