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1.
J Integr Neurosci ; 22(1): 18, 2023 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-36722243

RESUMEN

BACKGROUND AND PURPOSE: REM sleep behavior disorder (RBD) in Parkinson's disease (PD) is associated with characteristic clinical subtypes and prognosis. In addition, nigrostriatal pathway, the most vulnerable anatomical area in PD, formed neuronal network interplaying with cortical and subcortical structures, and which may cause PD clinical phenotype. We evaluated the regional selectivity of presynaptic striatal dopaminergic denervation associated with RBD in PD. METHODS: We compared two groups (n = 16) of PD patients with and without RBD in terms of specific binding ratios (SBR) in subregions of the striatum, which were measured using positron emission tomography with 18F-FP-CIT. SBRs of the anterior and posterior caudate, ventral striatum, and posterior and ventral putamen regions were measured in more or less affected side, and right or left side, or bilateral sum of the striatum. RESULTS: Age, disease duration, and severity of parkinsonism were not significantly different between groups. Although group differences in all areas were not significant with multiple comparison corrections, SBR of the ventral striatum and anterior caudate in sum of both sides was significantly less in the RBD than in the non-RBD group without correction (p < 0.05). In the right anterior caudate and left ventral striatum, SBR was also lower in the RBD than in the non-RBD group without correction (p < 0.05). Attention function was impaired in the RBD group compared with the non-RBD group (p < 0.05). However, these statistical significances were not definite after correction of multiple comparisons (p > 0.05). CONCLUSIONS: There is a possibility that RBD in early PD may be associated with presynaptic dopaminergic denervation in the ventral striatum and anterior caudate, which may explain decreased attention in our RBD group. RBD in PD may imply a distinct pathological progression. However, further study using large numbers of participants or longitudinal observation is necessary for the statistical conclusion because of small sample size.


Asunto(s)
Enfermedad de Parkinson , Trastorno de la Conducta del Sueño REM , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Trastorno de la Conducta del Sueño REM/diagnóstico por imagen , Trastorno de la Conducta del Sueño REM/etiología , Cuerpo Estriado/diagnóstico por imagen , Dopamina
2.
J Integr Neurosci ; 22(1): 11, 2023 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-36722246

RESUMEN

BACKGROUND: Camptocormia is one of the most common postural disorders of Parkinson's disease (PD) which has limited treatment options. In this review, we summarize the efficacy of deep brain stimulation (DBS) for camptocormia in PD. METHODS: The PubMed (https://pubmed.ncbi.nlm.nih.gov/) and EMBASE databases (https://www.embase.com/) were searched for the terms "Parkinson Disease" and "camptocormia" in combination with "deep brain stimulation". We then explored the efficacy of DBS for camptocormia by statistical analysis of the bending angle, the Unified Parkinson's Disease Rating Scale III (UPDRS-III) and L-dopa equivalent daily dose (LEDD), and by evaluating the prognosis after DBS. RESULTS: Twenty articles that reported results for 152 patients were included in this review. These comprised 136 patients from 16 studies who underwent subthalamic nucleus deep brain stimulation (STN-DBS), and 13 patients from 3 studies who underwent globus pallidus internus deep brain stimulation (GPi-DBS). One study used both STN-DBS (2 patients) and GPi-DBS (one patient). After 3-21 months of follow-up, the mean bending angle during the Off-period was significantly reduced compared to pre-DBS (31.5 ± 21.4 vs. 53.6 ± 22.7, respectively; p < 0.0001). For the STN-DBS trials, the mean post-operative bending angles during both Off- and On-periods were significantly reduced compared to pre-operative (32.1 ± 22.7 vs. 55.4 ± 24.1, p = 0.0003; and 33.1 ± 21.5 vs. 43.7 ± 20.6, p = 0.0003, respectively). For GPi-DBS, the mean bending angle post-DBS during the Off-period was considerably lower than pre-DBS (28.5 ± 10.7 vs. 42.9 ± 9.9, p < 0.001). The decrease in bending angle after DBS was negatively correlated with the duration of camptocormia (R = - 0.433, p = 0.013), whereas positively associated with the pre-bending angle (R = 0.352, p = 0.03). CONCLUSIONS: DBS is an effective treatment for camptocormia in PD. Patients in the early stage of camptocormia with more significant bending angle may benefit more from DBS.


Asunto(s)
Enfermedad de Parkinson , Núcleo Subtalámico , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/terapia , Levodopa , Bases de Datos Factuales , Pruebas de Estado Mental y Demencia
3.
J Integr Neurosci ; 22(1): 20, 2023 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-36722247

RESUMEN

The SH-SY5Y cell line is a simple and inexpensive in vitro experimental model for studying Parkinson disease (PD). This experimental model is a useful tool for elucidating pathophysiological mechanisms of PD and in the development of new pharmacological therapies. In this review, we aim to summarize current protocols for SH-SY5Y cell culturing and differentiation and PD experimental designs derived from the SH-SY5Y cell line. The most efficient protocol for differentiation of the SH-SY5Y cell line into dopaminergic neurons seems to be the addition of retinoic acid to the growth medium, followed by 12-O-tetradecanoylphorbol-13-acetate (TPA) addition in a low concentration of fetal bovine serum. PD pathological changes, such as neuronal apoptosis and the intraneuronal alpha-synuclein aggregation, can be reproduced in the SH-SY5Y cell line either by the use of neurotoxic agents [such as rotenone, 1-methyl-4-phenylpyridinium (MPP+), 6-hydroxydopamine] or by genetic modification (transfection of the alpha-synuclein wild-type or mutant gene, genetic manipulation of other genes involved in PD). In addition, compounds with a potential neuroprotective role may be tested on neurotoxicity-induced SH-SY5Y models. The cell line can also be used for testing PD pathophysiological mechanisms such as the prion-like neuronal transmission of alpha-synuclein or the microbiota influence in PD. In conclusion, the use of the SH-SY5Y cell line represents a basic but consistent first step in experiments related to PD, but which must be followed by the confirmation of the results through more complex in vitro and in vivo experimental models.


Asunto(s)
Neuroblastoma , Enfermedad de Parkinson , Humanos , alfa-Sinucleína , Línea Celular , 1-Metil-4-fenilpiridinio
4.
Artículo en Inglés | MEDLINE | ID: mdl-36673709

RESUMEN

INTRODUCTION: Parkinson's disease (PD) is a neurodegenerative disease characterized by motor symptoms and gait impairments. Among them, freezing of gait (FOG) is one of the most disabling manifestations. Backward walking (BW) is an activity of daily life that individuals with PD might find difficult and could cause falls. Recent studies have reported that gait impairments in PD were more pronounced in BW, particularly in people presenting FOG. However, to the best of our knowledge, no systematic review has synthetized the literature which compared BW performance in PD patients with and without FOG. OBJECTIVE: The aim of this study was to evaluate the differences in BW performance between PD patients with FOG and PD patients without FOG. METHODS: Two databases, PubMed and Web of Science, were systematically searched to identify studies comparing BW performance in PD patients with and without FOG. The National Institutes of Health (NIH) tool was used to assess the quality of the studies included. RESULTS: Seven studies with 431 PD patients (179 PD with FOG and 252 PD without FOG) met the inclusion criteria and were included in this review. Among them, 5 studies reported walking speed, 3 studies step length, stride length and lower limb range of motion, 2 studies functional ambulation profile, toe clearance height, swing, and stance percent and 1 study reported the decomposition index and stepping coordination. Compared to PD patients without FOG, PD patients with FOG showed slower walking speed and reduced step length in 3 studies, shorter stride length, lower functional ambulation profile and decreased ankle range of motion in 2 studies, and smaller swing percent, higher stance percent, worse stepping coordination, greater decomposition between movements, and lower toe clearance height in one study. CONCLUSION: Despite the small number of included studies, the findings of this review suggested that PD patients with FOG have worse gait performance during the BW task than PD without FOG.


Asunto(s)
Trastornos Neurológicos de la Marcha , Enfermedades Neurodegenerativas , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/complicaciones , Trastornos Neurológicos de la Marcha/etiología , Marcha , Caminata
5.
Artículo en Inglés | MEDLINE | ID: mdl-36673738

RESUMEN

The literature has shown contradictory results so far about the use of posturography, especially static posturography, to evaluate balance performance in Parkinson's disease (PD) populations. This study aimed to investigate the use of static posturography as a valid method to evaluate balance in a PD population. Fifty-two participants diagnosed with PD (Hoehn & Yahr stage: 1-3) were included in this cross-sectional study. All participants completed the following assessments: Hoehn and Yahr scale, Movement Disorder Society-Unified Parkinson's Disease Rating Scale, Tinetti Scale, Berg Balance Scale, Activities-specific Balance Confidence scale, Timed Up and Go test, and Functional Reach Test. Sway parameters were analyzed with a baropodometric platform, under eyes open (EO) and eyes closed (EC) conditions, in a bipodal stance. Small to large correlations were observed between clinical balance tests and static posturography parameters, although the majority of these parameters correlated moderately. Considering posturographic variables, the highest correlation values were detected for total excursion (TE), mean velocity (MV), mean (X-mean), and root-mean-square (X-RMS) displacements in the medio-lateral directions. It was observed that posturographic parameters worsened as the disease progresses, although differences were only significant between the stages 1 and 3 in the H&Y scale (p < 0.05). Regarding the test condition, the visual deprivation worsened significantly all the static posturography parameters (p < 0.05), except the antero-posterior mean displacement (Y-Mean). Comparing visual conditions, the EC presented slightly higher correlation values with the clinical balance tests. Static posturography could be used as an objective complementary tool to clinical balance tests in order to assess and control balance performance, mainly to detect postural instability problems.


Asunto(s)
Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico , Equilibrio Postural , Estudios Transversales , Estudios de Tiempo y Movimiento , Postura
6.
Artículo en Inglés | MEDLINE | ID: mdl-36673802

RESUMEN

This systematic review and meta-analysis examined previous studies on music-based interventions for individuals with Parkinson's disease (PD). The effectiveness of the interventions on various motor and non-motor outcomes was evaluated. This review was conducted by searching PubMed, CINAHL, PsycINFO, and Cochrane Library CENTRAL prior to June 2022 for randomized controlled trial (RCT) and controlled clinical trial (CCT) studies published in English. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was used for heterogeneity. The initial search identified 745 studies, and 13 studies involving 417 participants with PD which met the inclusion criteria included in this review. The results of the meta-analysis revealed that music-based interventions can significantly improve walking velocity (MD = 0.12, 95% CI = 0.07~0.16, p < 0.00001), stride length (MD = 0.04, 95% CI = 0.02~0.07, p = 0.002), and mobility (MD = -1.05, 95% CI = -1.53~-0.57, p < 0.0001). However, the results did not support significant effects for music-based interventions on cadence (MD = 3.21, 95% CI = -4.15~10.57, p = 0.39), cognitive flexibility (MD = 20.91, 95% CI = -10.62~52.44, p = 0.19), inhibition (SMD = 0.07, 95% CI = -0.40~0.55, p = 0.76), and quality of life (SMD = -0.68, 95% CI= -1.68~0.32, p = 0.18). The findings suggest that music-based interventions are effective for the improvement of some motor symptoms, but evidence for non-motor symptoms is limited. Further high-quality studies with a larger sample size are required to obtain the robust effects of music-based interventions on various outcomes among patients with PD.


Asunto(s)
Musicoterapia , Música , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/psicología , Musicoterapia/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto
7.
Neurosci Lett ; 795: 137051, 2023 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-36603736

RESUMEN

Parkinson's disease (PD) is a progressive neurodegenerative disorder with a complex etiology. Presence of autosomal mutations in PARK7/DJ-1 gene has been associated with early-onset PD. Growing evidence has suggested that DJ-1 acts as a putative sensor of oxidative stress. Reduced levels of DJ-1 protein have been reported in the cerebrospinal fluid of sporadic PD patients. Several case-control association studies have identified DJ-1 g.168_185del (rs200968609) variants conferring susceptibility towards PD pathogenesis. Similarly, among the PD patients in eastern India, the deletion allele (g.168_185) of this DJ-1 promoter polymorphism was found to be associated with PD. Hence, we aimed to find out the functional contribution of this promoter variant of DJ-1 in PD pathogenesis. The expression of DJ-1 was observed to be significantly reduced in the presence of both deletion and duplication sequences as identified from the luciferase promoter activity assay. The transcription factor binding prediction tool identified DJ-1 promoter 18 bp insertion polymorphism as the only binding partner of REST (RE1 Silencing Transcription Factor). Transient Chromatin Immuno-precipitation (ChIP) assay further confirmed this prediction. Previous reports have highlighted the role of REST in regulating the expression of stress-responsive genes. Our study has identified the functional involvement of DJ-1 promoter variants and REST-mediated regulation of DJ-1 expression in PD pathogenesis.


Asunto(s)
Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/genética , Enfermedad de Parkinson/metabolismo , Polimorfismo Genético , Regiones Promotoras Genéticas , Mutación , Factores de Transcripción/genética , Proteína Desglicasa DJ-1/genética , Proteína Desglicasa DJ-1/metabolismo
8.
Int J Mol Sci ; 24(2)2023 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-36674652

RESUMEN

Parkinson's disease (PD) is the second most common neurodegenerative disease in older individuals worldwide. Pharmacological treatment for such a disease consists of drugs such as monoamine oxidase B (MAO-B) inhibitors to increase dopamine concentration in the brain. However, such drugs have adverse reactions that limit their use for extended periods; thus, the design of less toxic and more efficient compounds may be explored. In this context, cheminformatics and computational chemistry have recently contributed to developing new drugs and the search for new therapeutic targets. Therefore, through a data-driven approach, we used cheminformatic tools to find and optimize novel compounds with pharmacological activity against MAO-B for treating PD. First, we retrieved from the literature 3316 original articles published between 2015-2021 that experimentally tested 215 natural compounds against PD. From such compounds, we built a pharmacological network that showed rosmarinic acid, chrysin, naringenin, and cordycepin as the most connected nodes of the network. From such compounds, we performed fingerprinting analysis and developed evolutionary libraries to obtain novel derived structures. We filtered these compounds through a docking test against MAO-B and obtained five derived compounds with higher affinity and lead likeness potential. Then we evaluated its antioxidant and pharmacokinetic potential through a docking analysis (NADPH oxidase and CYP450) and physiologically-based pharmacokinetic (PBPK modeling). Interestingly, only one compound showed dual activity (antioxidant and MAO-B inhibitors) and pharmacokinetic potential to be considered a possible candidate for PD treatment and further experimental analysis.


Asunto(s)
Enfermedades Neurodegenerativas , Enfermedad de Parkinson , Humanos , Anciano , Enfermedad de Parkinson/tratamiento farmacológico , Inhibidores de la Monoaminooxidasa/farmacología , Inhibidores de la Monoaminooxidasa/uso terapéutico , Inhibidores de la Monoaminooxidasa/química , Relación Estructura-Actividad , Enfermedades Neurodegenerativas/tratamiento farmacológico , Antioxidantes/farmacología , Monoaminooxidasa/metabolismo
9.
Int J Mol Sci ; 24(2)2023 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-36674772

RESUMEN

Biometals are all metal ions that are essential for all living organisms. About 40% of all enzymes with known structures require biometals to function correctly. The main target of damage by biometals is the central nervous system (CNS). Biometal dysregulation (metal deficiency or overload) is related to pathological processes. Chronic occupational and environmental exposure to biometals, including iron and copper, is related to an increased risk of developing Parkinson's disease (PD). Indeed, biometals have been shown to induce a dopaminergic neuronal loss in the substantia nigra. Although the etiology of PD is still unknown, oxidative stress dysregulation, mitochondrial dysfunction, and inhibition of both the ubiquitin-proteasome system (UPS) and autophagy are related to dopaminergic neuronal death. Herein, we addressed the involvement of redox-active biometals, iron, and copper, as oxidative stress and neuronal death inducers, as well as the current metal chelation-based therapy in PD.


Asunto(s)
Enfermedad de Parkinson , Oligoelementos , Humanos , Enfermedad de Parkinson/patología , Cobre , Metales , Hierro , Estrés Oxidativo , Oxidación-Reducción , Neuronas Dopaminérgicas/patología , Quelantes/farmacología , Quelantes/uso terapéutico
10.
Int J Geriatr Psychiatry ; 38(1): e5870, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36703272

RESUMEN

OBJECTIVE: Parkinson's disease (PD) is a progressive neurodegenerative disease that can reduce quality of life (QOL). Previous research has explored patient specific factors that influence QOL; but understanding external factors that may also affect patient QOL, such as caregiver characteristics, can provide additional intervention targets that may improve QOL for both the person with PD and their caregiver. METHODS: We conducted a systematic review of existing literature on caregiver factors that are related to QOL for the person with PD. We developed a tailored search strategy in six databases and performed a screening procedure according to PRISMA guidelines. We synthesized findings from articles that met inclusion criteria using a narrative approach and identified themes categorizing caregiver factors associated with PD QOL. RESULTS: We found 32 full-text articles that fulfilled the inclusion criteria and passed the quality appraisal. Seven themes were identified, including: (1) burden, (2) strain, (3) QOL and satisfaction, (4) demographic factors, (5) psychological factors, (6) relationship factors, and (7) caregiver input. CONCLUSIONS: Our review presents critical insights into the role of the caregiver in the QOL of a person with PD. Findings reveal several targets for intervention to improve QOL in this population.


Asunto(s)
Enfermedades Neurodegenerativas , Enfermedad de Parkinson , Humanos , Calidad de Vida/psicología , Enfermedad de Parkinson/psicología , Cuidadores/psicología , Depresión/psicología
11.
Clin Neurophysiol ; 146: 97-108, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36608531

RESUMEN

OBJECTIVE: Freezing of gait (FOG) in Parkinson's disease (PD) is characterized by the inability to initiate stepping, despite the intention to do so. This study used a startling acoustic stimulus paradigm to examine if the capacity to select, prepare and initiate gait under simple and choice reaction time conditions are impaired in people with PD and FOG. METHODS: Thirty individuals (10 PD with FOG, 10 PD without FOG, and 10 controls) performed an instructed-delay gait initiation task under simple and choice reaction time conditions. In a subset of trials, a startle stimulus (124 dB) was presented 500 ms before the time of the imperative go-cue. Anticipatory postural adjustments preceding and accompanying gait initiation were quantified. RESULTS: The presentation of a startling acoustic stimulus resulted in the rapid initiation of an anticipatory postural adjustment sequence during both the simple and choice reaction time tasks in all groups. CONCLUSIONS: The neural capacity to prepare the spatial and temporal components of gait initiation remains intact in PD individuals with and without FOG. SIGNIFICANCE: The retained capacity to prepare anticipatory postural adjustments in advance may explain why external sensory cues are effective in the facilitation of gait initiation in people with PD with FOG.


Asunto(s)
Trastornos Neurológicos de la Marcha , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/complicaciones , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/etiología , Cognición , Tiempo de Reacción/fisiología , Marcha/fisiología
12.
Sci Rep ; 13(1): 10, 2023 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-36593254

RESUMEN

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a powerful treatment in Parkinson's disease (PD), which provides a positive effect on motor symptoms although the way it operates on high cognitive processes such as metacognition remains unclear. To address this issue, we recorded electroencephalogram (EEG) of PD patients treated with STN-DBS that performed a reversal learning (RL) paradigm endowed with metacognitive self-assessment. We considered two stimulation conditions, namely DBS-ON (stimulation on) and DBS-OFF (stimulation off), and focused our EEG-analysis on the frontal brain region due to its involvement on high cognitive processes. We found a trend towards a significant difference in RL ability between stimulation conditions. STN-DBS showed no effect on metacognition, although a significant association between accuracy and decision confidence level held for DBS OFF, but not in the case of DBS ON. In summary, our study revealed no significant effect of STN-DBS on RL or metacognition.


Asunto(s)
Estimulación Encefálica Profunda , Metacognición , Enfermedad de Parkinson , Núcleo Subtalámico , Humanos , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/psicología , Núcleo Subtalámico/fisiología , Aprendizaje
13.
Curr Opin Psychiatry ; 36(2): 119-125, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-36705010

RESUMEN

PURPOSE OF REVIEW: Dementia is a syndrome with several possible pathologies. To date, definitive methods for diagnosis and treatment of sub-types of dementia have not been established. Emerging evidence suggests that exosomes can provide important information for the diagnosis and treatment of several subtypes of dementia. This article reviews recent studies on the application of exosomes in dementia. RECENT FINDINGS: Exosomes are involved in the pathogenesis of Alzheimer's disease (AD) and Parkinson's disease (PD) through transporting toxic proteins such as amyloid beta (Aß), tau, and α-synuclein. Exosomal microRNAs (miR) and proteins reflect the disease state, and therefore, exosomes can be used as diagnostic markers for diseases such as AD, PD, Huntington's disease (HD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD). Mesenchymal stem cell (MSC)-derived exosomes have been shown to ameliorate disease pathology, and improve cognitive function in AD, PD, and VAD. SUMMARY: Recent studies have shown that exosomes could be novel diagnostic agents for dementia because they contain molecules that could be potential biomarker candidates indicative of the type and stage of dementia. Therapeutic application of exosomes in dementia has revealed that exosomes only, or exosomes loaded with an active pharmaceutical ingredient (API), ameliorate disease phenotype of dementia. Further work is needed to exploit this potential.


Asunto(s)
Enfermedad de Alzheimer , Exosomas , Enfermedad por Cuerpos de Lewy , Enfermedad de Parkinson , Humanos , Enfermedad por Cuerpos de Lewy/diagnóstico , Enfermedad por Cuerpos de Lewy/terapia , Enfermedad por Cuerpos de Lewy/metabolismo , Péptidos beta-Amiloides/metabolismo , Exosomas/metabolismo , Exosomas/patología , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/terapia , Enfermedad de Alzheimer/metabolismo , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/metabolismo , Proteínas tau/metabolismo , Biomarcadores/metabolismo
14.
Gastroenterol Nurs ; 46(1): 41-46, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36706141

RESUMEN

Intraduodenal infusion of levodopa-carbidopa intestinal gel by percutaneous endoscopic gastrostomy tube with jejunal extension is a treatment option to reduce motor and nonmotor complications in patients with advanced Parkinson's disease when oral therapy no longer provides sufficient benefit. Medication management is of central focus; however, there was no standardized patient education on stoma-site care and tube maintenance, leading to the development of stoma-site complications. As a quality improvement (QI) initiative, a standardized education and assessment pathway was developed and implemented in an urban academic outpatient clinic to enhance patient self-management and reduce stoma-site complications. A retrospective chart review was conducted to establish baseline incidence of cutaneous stoma-site complications. QI interventions were implemented using a rapid-cycle improvement model. Routine stoma assessments by a nurse who specializes in wound, ostomy, and continence care were implemented at set points, and patient education on PEG tube care and maintenance was reinforced at each session. Results demonstrated a significant reduction in moderate-to-severe tube and stoma-site-related complication. Implementation of a similar standardized education and assessment pathway in patients with percutaneous endoscopic gastrostomy tubes may lead to a decrease in stoma-site-related complications and overall better patient self-management.


Asunto(s)
Enfermedad de Parkinson , Automanejo , Humanos , Antiparkinsonianos/efectos adversos , Gastrostomía/efectos adversos , Gastrostomía/métodos , Estudios Retrospectivos , Mejoramiento de la Calidad
15.
Can Fam Physician ; 69(1): 20-24, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36693741

RESUMEN

OBJECTIVE: To provide family physicians an updated approach to the diagnosis of Parkinson disease (PD). SOURCES OF INFORMATION: Published guidelines on the diagnosis and management of PD were reviewed. Database searches were conducted to retrieve relevant research articles published between 2011 and 2021. Evidence levels ranged from I to III. MAIN MESSAGE: Diagnosis of PD is predominantly clinical. Family physicians should evaluate patients for specific features of parkinsonism, then determine whether symptoms are attributable to PD. Levodopa trials can be used to help confirm the diagnosis and alleviate motor symptoms of PD. "Red flag" features and absence of response to levodopa may point to other causes of parkinsonism and prompt more urgent referral. CONCLUSION: Access to neurologists and specialized clinics varies, and Canadian family physicians can be important players in facilitating early and accurate diagnosis of PD. Applying an organized approach to diagnosis and considering motor and nonmotor symptoms can greatly benefit patients with PD. Part 2 in this series will review management of PD.


Asunto(s)
Enfermedad de Parkinson , Trastornos Parkinsonianos , Humanos , Enfermedad de Parkinson/diagnóstico , Levodopa , Canadá , Pacientes
16.
Can Fam Physician ; 69(1): 6, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36693739
17.
Can Fam Physician ; 69(1): e8-e13, 2023 Jan.
Artículo en Francés | MEDLINE | ID: mdl-36693748

RESUMEN

OBJECTIF: Présenter aux médecins de famille une approche actualisée du diagnostic de la maladie de Parkinson (MP). SOURCES DE L'INFORMATION: Les lignes directrices sur le diagnostic et la prise en charge de la MP ont été passées en revue. Des recensions dans les bases de données ont été effectuées pour en extraire les articles de recherche publiés entre 2011 et 2021. Le niveau des données probantes varie entre I et III. MESSAGE PRINCIPAL: Le diagnostic de la MP est principalement d'ordre clinique. Les médecins de famille devraient évaluer les patients en fonction des caractéristiques particulières du parkinsonisme et déterminer ensuite si les symptômes sont attribuables à la MP. Des essais à la lévodopa peuvent servir à confirmer le diagnostic et à atténuer les symptômes moteurs de la MP. Des « signaux d'alerte ¼ et l'absence de réponse à la lévodopa pourraient indiquer d'autres causes du parkinsonisme et inciter à faire une demande de consultation plus urgente. CONCLUSION: L'accès à des neurologues et à des cliniques spécialisées est variable, et les médecins de famille canadiens peuvent être des acteurs importants pour faciliter un diagnostic précoce et exact de la MP. La mise en application d'une approche structurée du diagnostic, et la prise en compte des symptômes moteurs et non moteurs peuvent être grandement bénéfiques pour les patients atteints de la MP. La partie 2 de cette série portera sur la prise en charge de la MP.


Asunto(s)
Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico
18.
Can Fam Physician ; 69(1): 7, 2023 Jan.
Artículo en Francés | MEDLINE | ID: mdl-36693755
19.
Bioorg Med Chem ; 78: 117147, 2023 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-36587551

RESUMEN

The naturally-occurring di-catechol lignan nordihydroguaiaretic acid (NDGA) and an analog without methyl groups on the butyl linker both undergo intramolecular cyclization at pH 7.4 to form dibenzocyclooctadienes. Both NDGA and these dibenzocyclooctadienes have been shown to prevent in vitro aggregation of α-synuclein, an intrinsically disordered protein associated with Parkinson's disease. NDGA possesses two vicinal methyl groups on the butyl linker and the presence of these methyl groups attenuates the rate of intramolecular cyclization versus the unsubstituted analog, in opposition to the anticipated Thorpe-Ingold effect, likely due to steric repulsions during cyclization. Numerous 1,2-bis-ethane di-catechols are known to inhibit α-synuclein aggregation in vitro and we hypothesize that these compounds undergo a similar intramolecular cyclization and the cyclized products may be responsible for the activity. To test this hypothesis we prepared a series of 1,2-bis-ethane di-catechols with 0, 2 and 4 methyl substituents on the linker. We have confirmed that these compounds undergo intramolecular cyclization to form dibenzocyclohexadienes and that steric interactions between the methyl substituents leads to an increase in the rate of intramolecular cyclization, which is in contrast to what was observed for lignan di-catechols. The rate of cyclization to form six-membered rings is 10-30 times more rapid than formation of eight membered rings and the dibenzocyclohexadienes also prevent in vitro aggregation of α-synuclein.


Asunto(s)
Enfermedad de Parkinson , alfa-Sinucleína , Humanos , alfa-Sinucleína/metabolismo , Masoprocol/metabolismo , Masoprocol/farmacología , Catecoles/química , Ciclización
20.
J Speech Lang Hear Res ; 66(1): 126-153, 2023 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-36608288

RESUMEN

PURPOSE: This study examined spontaneous, spoken-to-a-model, and two sung modes in speakers with Parkinson's disease (PD), speakers with cerebellar disease (CD), and healthy controls. Vocal performance was measured by intelligibility scores and listeners' perceptual ratings. METHOD: Participants included speakers with hypokinetic dysarthria secondary to PD, those with ataxic dysarthria secondary to CD, and healthy speakers. Participants produced utterances in four vocal modes: spontaneous speech, spoken-to-a-model, sung-to-a-model, and spontaneous singing. For spoken-to-a-model and sung-to-a-model modes, written material was provided the model. For spontaneous singing, participants sang songs that they endorsed as familiar. DEPENDENT VARIABLES: In Experiment I, listeners orthographically transcribed the audio samples of the first three vocal modes. In Experiment IIa, raters evaluated the accuracy of the pitch and rhythm of the spontaneous singing of familiar songs. Finally, familiar songs and sung-to-a-model utterances were rated on a competency scale by a second group of raters (Experiment IIb). RESULTS: Results showed increases in intelligibility during the spoken-to-a-model mode compared with the spontaneous mode in both PD and CD groups. Singing enhanced the vocal output of speakers with PD more than in speakers with CD, as measured by percent intelligibility. PD participants' pitch and rhythm accuracy and competency in singing familiar songs was rated more favorably than those produced by CD participants. CONCLUSIONS: The findings reveal a vocal task effect for spoken utterances in both groups. Sung exemplars, more impaired in CD, suggest a significant involvement of the cerebellum in singing. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21809544.


Asunto(s)
Música , Enfermedad de Parkinson , Canto , Ataxias Espinocerebelosas , Humanos , Inteligibilidad del Habla , Enfermedad de Parkinson/complicaciones , Disartria/etiología , Ataxias Espinocerebelosas/complicaciones
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