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Background and Purpose. To determine whether the pattern of iron deposition in the fascicula nigrale in patients with Parkinson's disease would be different from age-matched controls by utilizing quantitative susceptibility mapping to measure susceptibility change. Methods. MRIs of the brain were obtained from 34 subjects, 18 with Parkinson's disease and 16 age- and gender-matched controls. Regions of interest were drawn around the fascicula nigrale and substantia nigra using SWI mapping software by blinded investigators. Statistical analyses were performed to determine susceptibility patterns of both of these regions. Results. Measurements showed significantly increased susceptibility in the substantia nigra in Parkinson's patients and an increased rostral-caudal deposition of iron in the fascicula nigrale in all subjects. This trend was exaggerated with significant correlation noted with increasing age in the Parkinson group. Conclusion. The pattern of an exaggerated iron deposition gradient of the fascicula nigrale in the Parkinson group could represent underlying tract dysfunction. Significant correlation of increasing iron deposition with increasing age may be a cumulative effect, possibly related to disease duration.
RESUMEN
Background. Novel rehabilitation strategies have demonstrated potential benefits for motor and non-motor symptoms of Parkinson's disease (PD). Objective. To compare the effects of Lee Silverman Voice Therapy BIG (LSVT BIG therapy) versus a general exercise program (combined treadmill plus seated trunk and limb exercises) on motor and non-motor symptoms of PD. Methods. Eleven patients with early-mid stage PD participated in the prospective, double-blinded, randomized clinical trial. Both groups received 16 one-hour supervised training sessions over 4 weeks. Outcome measures included the Unified Parkinson's Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Modified Fatigue Impact Scale (MFIS). Five patients performed general exercise and six patients performed LSVT BIG therapy. Post-intervention evaluations were conducted at weeks 4, 12 and 24. Results. The combined cohort made improvements at all follow-up evaluations with statistical significance for UPDRS total and motor, BDI, and MFIS (P < 0.05). Conclusion. This study demonstrated positive effects of general exercise and LSVT BIG therapy on motor and non-motor symptoms of patients with PD. Our results suggest that general exercise may be as effective as LSVT BIG therapy on symptoms of PD for patients not able to readily access outpatient LSVT BIG therapy.
RESUMEN
OBJECTIVE: Repetition of suicide-related behavior (SRB) is a risk factor for further suicidal behavior and death. The purpose of this study was to compare characteristics of patients with and without repeated episodes of SRB to determine whether characteristics of suicide attempt, psychopathology, and psychiatric comorbidity differ between groups, and if specific aspects of core suicidality may help guide screening of individuals at risk of further suicidal behaviors. METHODS: Thirty-five patient with repeated episodes of SRB and 49 with a single episode who came to the emergency room of two Qazvin referral hospitals after an episode of SRB were compared on demographic and background characteristics, the circumstances of the suicide attempts, levels of suicidality (i.e., ideation), and psychological characteristics. RESULTS: Patients with repeated episodes were more depressed, hopeless, and impulsive, had higher scores on factors associated with expected outcome and planning activities of the Suicide Intent Scale. They displayed greater suicidality, psychiatric comorbidity, and reported more negative life events, dissatisfaction with life, and poorer perceive social support. CONCLUSIONS: Some of the characteristics of patients with repeated suicide-related behavior propose major clinical challenges that should be addressed in an endeavor to reduce suicide risk.
