Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.507
Filtrar
1.
Int. j. med. surg. sci. (Print) ; 8(1): 1-10, mar. 2021. tab
Artigo em Espanhol | LILACS | ID: biblio-1151569

RESUMO

La sexualidad es un aspecto importante en la calidad de vida de la mujer, sin embargo, los estudios sobre sexualidad dedicados a las mujeres de 60 años y más son escasos. El objetivo de este estudio fue determinar la prevalencia de la disfunción sexual femenina y sus dominios en mujeres de 60 años y más, e identificar la asociación entre enfermedades asociadas y consumo de medicamentos con la disfunción sexual. Se realizó un estudio descriptivo y transversal, en mujeres de 60 años y más, de La Habana, Cuba. Participaron 112 mujeres a las cuales se les aplicaron dos encuestas: el Índice de Función Sexual Femenino (IFSF) y otra que recogía antecedentes médicos y sociales. El 66,1% de las mujeres presentó algún grado de disfunción sexual, la prevalencia aumentaba con la edad. Los dominios más afectados fueron el deseo, la excitación y la lubricación. Se identificó una fuerte asociación entre la enfermedad de Parkinson, la depresión y la artrosis con la aparición de disfunción sexual en la población estudiada, así como el uso de antidepresivos, hipoglicemiantes orales y diuréticos. La disfunción sexual estuvo presente en el 100% de las mujeres octogenarias. Todas las mujeres con enfermedad de Parkinson presentaron disfunción sexual.


Sexuality is an important aspect in women's quality of life, however, sexuality studies dedicated to women age 60 and older are scarce. The objective of this study was to determine the prevalence of female sexual dysfunction and its domains in women age 60 and older, and to identify the association between diseases and drug use with sexual dysfunction. A descriptive and cross-cutting study was conducted, in women 60 years and older, in Havana, Cuba. Two surveys participated in 112 women: The Female Sexual Function Index (IFSF) and another who collected a medical and social history. 66.1% of women had some degree of sexual dysfunction, the prevalence increased with age. The domains most affected were desire, excitement, and lubrication. A strong association between Parkinson's disease, depression and osteoarthritis was identified with the onset of sexual dysfunction in the studied population, as well as the use of antidepressants, oral hypoglycemics and diuretics. Sexual dysfunction was present in 100% of octogenary women. All women with Parkinson's disease had sexual dysfunction.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Fisiológicas/epidemiologia , Sexualidade/psicologia , Disfunções Sexuais Psicogênicas , Doença de Parkinson/complicações , Qualidade de Vida , Prevalência , Inquéritos e Questionários , Distribuição por Idade , Cuba/epidemiologia , Depressão/complicações
2.
Arq Neuropsiquiatr ; 79(1): 38-43, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33656110

RESUMO

BACKGROUND: Restless legs syndrome or Willis-Ekbom disease is a disorder characterized by unpleasant sensations associated with the need to mobilize the lower limbs. In Parkinson disease patients, restless legs syndrome is associated with worse quality of life and excessive sleepiness. Regarding other factors, results of different studies are controversial. OBJECTIVE: To determine the factors associated with the restless legs syndrome presence in Parkinson disease patients. METHODS: A cross-sectional study was conducted in 88 consecutive Parkinson disease patients from the outpatient clinic for 21 months. Participants underwent a clinical interview, assessment based on standardized scales (Epworth Sleepiness Scale, Parkinson Disease Questionnaire - 39, Pittsburgh Sleep Quality Index, International Restless Legs Syndrome Study Group rating scale), and video-polysomnography. RESULTS: Out of the 88 participants, 25 had restless legs syndrome. In the multivariate analysis, restless legs syndrome in Parkinson disease has been associated with the symptom of smell loss and quality of sleep and life. In the univariate analysis, restless legs syndrome in Parkinson disease has occurred more frequently in women with higher frequency of insomnia, constipation, and anosmia than in the group without restless legs syndrome. CONCLUSION: Restless legs syndrome is a prevalent condition in patients with Parkinson disease and is associated with specific characteristics in this group of patients.


Assuntos
Doença de Parkinson , Síndrome das Pernas Inquietas , Estudos Transversais , Feminino , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Polissonografia , Qualidade de Vida , Síndrome das Pernas Inquietas/epidemiologia , Síndrome das Pernas Inquietas/etiologia
3.
Arq Neuropsiquiatr ; 79(2): 156-166, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33759983

RESUMO

Parkinson's disease (PD) has heterogeneous clinical manifestations and prognoses. It is accompanied by a group of motor and non-motor symptoms ranging from independence to total disability, limiting work and personal care activities. Currently, disease subtype markers for informing prognosis remain elusive. However, some studies have reported an association between rapid eye movement (REM) sleep behavior disorder (RBD) and faster motor and non-motor symptom progression, including autonomic dysfunction and cognitive decline. Moreover, since autonomic dysfunction has been described in idiopathic forms of RBD, and they share some central regulatory pathways, it remains unclear whether they have a primary association or if they are more severe in patients with PD and RBD, and thus are a disease subtype marker. This article aimed at critically reviewing the literature on the controversies about the prevalence of RBD in PD, the higher incidence of PD non-motor symptoms associated with RBD, the evidence of faster motor worsening in parkinsonian patients with this parasomnia, and the main pathophysiological hypotheses that support these findings.


Assuntos
Doenças do Sistema Nervoso Autônomo , Disfunção Cognitiva , Doença de Parkinson , Transtorno do Comportamento do Sono REM , Transtornos do Sono-Vigília , Doenças do Sistema Nervoso Autônomo/etiologia , Humanos , Doença de Parkinson/complicações , Transtorno do Comportamento do Sono REM/etiologia
4.
Rev Neurol (Paris) ; 177(3): 272-274, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33610345

RESUMO

BACKGROUND: Governments around the world have imposed varied containment measures to curb the spread of the COVID-19 infection. The psychological impact could be highly negative in patients with neurologic condition like Parkinson's Disease (PD). METHODS: We prospectively evaluated symptoms of depression and anxiety in 50 (26 females; mean age at 60.4) non demented Moroccan PD patients, using Hospital Anxiety and Depression Scale (HADS), at the beginning and after 6 weeks of a full confinement. RESULTS: At the first evaluation, 28% of patients had depression while 32% had anxiety. After 6 weeks of confinement, some patients got worse and others got better scores but no significant statistical difference for both troubles was seen. CONCLUSION: Our results show that there is no significant impact of 6 weeks of confinement on overall anxiety and depression scores. However, confinement could have an unexpected positive psychological impact on a significant number of PD patients.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Pandemias , Doença de Parkinson/epidemiologia , Quarentena/psicologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Doença de Parkinson/complicações , Doença de Parkinson/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 100(5): e24348, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592882

RESUMO

ABSTRACT: Gait automaticity is reduced in patients with Parkinson disease (PD) due to impaired habitual control. The aim of this study was to investigate the effect of robot-assisted gait training (RAGT) on gait automaticity as well as gait speed and balance in patients with PD.This study was a prospective, open-label, single-arm, pilot study. We planned to recruit 12 patients with idiopathic PD. Participants received 12 sessions of RAGT using exoskeleton-type robotic device. Sessions were 45-minute each, 3 days a week, for 4 consecutive weeks using an exoskeleton-type gait robot. The primary outcome was the percentage of dual-task interference measured by the 10-Meter Walk Test (10MWT) under single and dual-task (cognitive and physical) conditions. Secondary outcomes were the Berg Balance Scale and Korean version of the Falls Efficacy Scale-International. All measures were evaluated before treatment (T0), after treatment (T1), and 1-month post-treatment (T2).Twelve patients were enrolled and 1 dropped out. Finally, 11 patients with idiopathic PD were analyzed. The mean age of 11 patients (5 males) was 66.46 ±â€Š5.66 years, and disease duration was 112.91 ±â€Š50.19 months. The Hoehn and Yahr stages were 2.5 in 8 patients and 3 in 3 patients. Linear mixed-effect model analysis showed a significant change over time only in single-task gait speed of the 10MWT (P = .007), but not in dual-task gait speed, dual-task interferences, and Korean version of the Falls Efficacy Scale-International. Cognitive dual-task interference significantly increased (P = .026) at T1, but not at T2 (P = .203). No significant changes were observed for physical dual-task interference at T1 and T2. Single-task gait speed of the 10MWT was significantly increased at T1 (P = .041), but not at T2 (P = .445). There were no significant changes in the dual-task gait speed of 10MWT. A significant improvement was observed in Berg Balance Scale score at T1 and T2 (P = .004 and P = .024, respectively).In this pilot study, despite improvement in walking speed and balance, gait automaticity in patients with PD was not improved by RAGT using an exoskeleton-type robot. Additional therapeutic components may be needed to improve gait automaticity using RAGT in patients with PD.


Assuntos
Terapia por Exercício/instrumentação , Exoesqueleto Energizado , Transtornos Neurológicos da Marcha/terapia , Doença de Parkinson/terapia , Robótica/instrumentação , Idoso , Terapia por Exercício/métodos , Feminino , Marcha/fisiologia , Análise da Marcha , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Projetos Piloto , Estudos Prospectivos , República da Coreia , Robótica/métodos , Resultado do Tratamento
6.
PLoS One ; 16(1): e0245864, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33481879

RESUMO

The worsening of neuropsychiatric symptoms such as depression, anxiety, and insomnia in patients with Parkinson's disease (PD) has been a concern during the COVID-19 pandemic, because most people worked in self-isolation for fear of infection. We aimed to clarify the impact of social restrictions imposed due to the COVID-19 pandemic on neuropsychiatric symptoms in PD patients and to identify risk factors associated with these symptoms. A cross-sectional, hospital-based survey was conducted from April 22, 2020 to May 15, 2020. PD patients and their family members were asked to complete paper-based questionnaires about neuropsychiatric symptoms by mail. PD patients were evaluated for motor symptoms using MDS-UPDRS part 2 by telephone interview. A total of 71 responders (39 PD patients and 32 controls) completed the study. Although there was no difference in the age distribution, the rate of females was significantly lower in PD patients (35%) than controls (84%) (P < 0.001). Participants with clinical depression (PHQ-9 score ≥ 10) were more common in PD patients (39%) than controls (6%) (P = 0.002). Multivariate logistic regression analysis revealed that an MDS-UPDRS part 2 score was correlated with the presence of clinical depression (PHQ-9 score ≥ 10) and clinical anxiety (GAD-7 score ≥ 7) (clinical depression: OR, 1.31; 95% CI, 1.04-1.66; P = 0.025; clinical anxiety: OR, 1.36; 95% CI, 1.07-1.72; P = 0.013). In the presence of social restrictions, more attention needs to be paid to the neuropsychiatric complications of PD patients, especially those with more severe motor symptoms.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno Depressivo/etiologia , Doença de Parkinson/complicações , Distúrbios do Início e da Manutenção do Sono/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão/epidemiologia , Masculino , Fatores de Risco
7.
BMC Neurol ; 21(1): 46, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-33516182

RESUMO

BACKGROUND: Many patients with Parkinson's disease (PD) who receive carbidopa/levodopa experience symptom reemergence or worsening, or "OFF" episodes. This study assessed the association of "OFF" episodes with health-related quality of life (HRQoL). METHODS: US-specific data from the 2017 and 2019 Adelphi Real World Disease Specific Programme for PD, a real-world cross-sectional survey, were used. Neurologists provided data for 10-12 consecutive patients with PD who completed the 39-item Parkinson's Disease Questionnaire (PDQ-39) and the EuroQol 5-Dimension (EQ-5D). Data were grouped by patients who experienced "OFF" episodes versus those who did not and by average hours of daily "OFF" time. Differences between patient groups were assessed for demographics and clinical characteristics; regression analyses were used to model the relationship between HRQoL and "OFF" episodes with age, sex, body mass index, current PD stage on the Hoehn and Yahr scale, and number of concomitant conditions related and unrelated to mobility as covariates. RESULTS: Data from 722 patients were analyzed. Overall, 321 patients (44%) had "OFF" episodes (mean of 2.9 h of daily "OFF" time). Patients who experienced "OFF" episodes were less likely to work full-time and more likely to live with family members other than their spouse/partner or reside in a long-term care facility than those without "OFF" episodes. The presence of "OFF" episodes, regardless of the average hours of daily "OFF" time, was significantly associated with high scores (reflecting poor HRQoL) on most PDQ-39 dimensions and the summary index and low scores (reflecting poor health status) on the EQ-5D health utility index, visual analog scale (VAS), and all dimensions. Furthermore, increased average hours of daily "OFF" time was significantly correlated with higher scores for all PDQ-39 dimensions and the summary index, as well as with the EQ-5D health utility index and VAS scores. Patients with "OFF" episodes experienced reduced HRQoL even after correcting for potentially confounding variables. CONCLUSIONS: This study demonstrated that the occurrence of "OFF" episodes in patients with PD is associated with reduced HRQoL and that the impact on HRQoL increased incrementally with increasing average hours of daily "OFF" time.


Assuntos
Doença de Parkinson/complicações , Qualidade de Vida , Exacerbação dos Sintomas , Idoso , Carbidopa/uso terapêutico , Estudos Transversais , Combinação de Medicamentos , Feminino , Nível de Saúde , Humanos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Análise de Regressão , Inquéritos e Questionários , Estados Unidos
8.
Curr Opin Psychiatry ; 34(2): 177-185, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33395100

RESUMO

PURPOSE OF REVIEW: Over 70 million people worldwide, including those with neurodegenerative disease (NDD), have been diagnosed with coronavirus disease 2019 (COVID-19) to date. We review outcomes in patients with NDD and COVID-19 and discuss the hypothesis that due to putative commonalities of neuropathogenesis, COVID-19 may unmask or trigger NDD in vulnerable individuals. RECENT FINDINGS: Based on a systematic review of published literature, patients with NDD, including dementia, Parkinson's disease, and multiple sclerosis (MS) make up a significant portion of hospitalized COVID-19 patients. Such patients are likely to present with altered mental status or worsening of their preexisting neurological symptoms. Patients with NDD and poor outcomes often have high-risk comorbid conditions, including advanced age, hypertension, diabetes, obesity, and heart/lung disease. Patients with dementia including Alzheimer's disease are at higher risk for hospitalization and death, whereas those with preexisting Parkinson's disease are not. MS patients have good outcomes and disease modifying therapies do not increase the risk for severe disease. Viral infections and attendant neuroinflammation have been associated with the pathogenesis of Alzheimer's disease, Parkinson's disease, and MS, suggesting that COVID-19 may have the potential to incite or accelerate neurodegeneration. SUMMARY: Since patients with Alzheimer's disease are at higher risk for hospitalization and death in the setting of COVID-19, additional precautions and protective measures should be put in place to prevent infections and optimize management of comorbidities in this vulnerable population. Further studies are needed to determine whether COVID-19 may lead to an increased risk of developing NDD in susceptible individuals.


Assuntos
/complicações , Demência/complicações , Hospitalização , Esclerose Múltipla/complicações , Doença de Parkinson/complicações , Humanos , Prognóstico , Fatores de Risco
11.
BMC Neurol ; 21(1): 2, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397315

RESUMO

BACKGROUND: Nocturnal symptoms in Parkinson's disease are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we analyzed the characteristics and burden of nocturnal symptoms from patients' perspectives and explored their changes over time. Overall symptoms (occurring at day or night) were collected to compare whether the unmet needs related to nocturnal symptoms and to overall symptoms are different. METHODS: We used a Social Listening big-data technique to analyze large amounts of Parkinson's disease symptoms in dialogues available from social media platforms in 2016 to 2018. These symptoms were classified as either overall symptoms or nocturnal symptoms. We used share of voice (SOV) of symptoms as a proportion of total dialogues per year to reflect the characteristics of symptoms. Negative sentiment score of symptoms was analyzed to find out their related burden. RESULTS: We found the SOV for overall motor symptoms was 79% and had not increased between 2016 and 2018 (79%, p = 0.5). The SOV for non-motor symptoms was 69% and had grown by 7% in 2018 (p <  0.01). The SOV for motor complications was 9% and had increased by 6% in 2018 (p <  0.01). The SOV of motor symptoms was larger than non-motor symptoms and motor complications (p <  0.01). The SOV of non-motor symptoms was larger than motor complications (p <  0.01). For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% (p <  0.01). The SOV for nocturnal-occurring motor symptoms was higher than most non-motor symptoms. However, non-motor symptoms had the higher increases and evoked higher negative sentiment regardless of whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day. CONCLUSIONS: The growing SOV and the greater negative sentiment of nocturnal symptoms suggest management of nocturnal symptoms is an unmet need of patients. A greater emphasis on detecting and treating nocturnal symptoms with 24-h care is encouraged.


Assuntos
Mineração de Dados/métodos , Doença de Parkinson/complicações , Avaliação de Sintomas/métodos , Idoso , Big Data , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Mídias Sociais , Fatores de Tempo
12.
BMC Neurol ; 21(1): 16, 2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33430806

RESUMO

BACKGROUND: Parkinson's disease (PD), frequently accompanied by cognitive impairments, is associated with systemic oxidative stress and abnormal structural changes on brain images. We aimed to identify the correlation between systemic oxidative stress and cognitive function in PD patients with different periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). METHODS: A total of 146 participants with idiopathic PD underwent brain MRI, which revealed PWMH and DWMH. The number of lesions were evaluated using the Fazekas criteria. Systemic oxidative stress was determined as early or late phase changes in leukocyte apoptosis and its subsets by flow cytometry. Cognitive functions, including attention, executive function, memory, language, and visual space, were assessed. RESULTS: For different DWMH, the leukocyte apoptosis and its subsets were significantly different.. However, there were no significant differences in oxidative stress biomarkers in PD patients with different PWMH. Attention and memory were significantly decreased in patients with more advanced DWMH injuries. Attention, memory, and language were significantly impaired in patients with worse PWMH lesions. CONCLUSION: Significant oxidative stress biomarker alternations in PD patients with DWMH, but not PWMH, might be associated with white matter injury. Systemic inflammatory responses may contribute to deep white matter damage in PD. Further, more cognitive deficits were seen in PD patients with worse deep white matter lesions, especially in moderate to severe periventricular white matter injury. TRIAL REGISTRATION: Retrospective study.


Assuntos
Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Estresse Oxidativo/fisiologia , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Idoso , Feminino , Humanos , Leucoaraiose/etiologia , Leucoaraiose/patologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodos , Estudos Retrospectivos , Substância Branca/patologia
13.
Rev. medica electron ; 42(6): 2644-2658, nov.-dic. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1150044

RESUMO

RESUMEN La enfermedad de Parkinson según la Organización Mundial de Salud, en el año 2016, afectó una persona por cada 100 mayores de 60 años, siendo en cifras absolutas 6,3 millones de personas, y para el año 2030 serán aproximadamente 12 millones de personas en todo el mundo con dicha patología. Este desorden neurodegenerativo, caracterizado por la degradación nigro-estriatal y potenciación de la vía indirecta del circuito motor de los Ganglios Basales sumado al acúmulo de Cuerpos de Lewy en diversas estructuras del Sistema Nervioso Central, afecta progresiva e inevitablemente la calidad de vida de los pacientes, los procederes ablativos del núcleo subtalámico constituyen una alternativa que propicia efecto y seguridad probada en el control de los síntomas de esta enfermedad. Por lo cual se decide describir la ablación del Núcleo subtalámico como tratamiento de la Enfermedad de Parkinson avanzada (AU).


Summary According to the World Health Organization, in 2016 Parkinson's disease affected one person per every 100 people elder 60 years, meaning 6.3 millions of people, and by 2030 it will be around 12 million persons across the world. This neurodegenerative disorder, characterized by the nigro-striatal degradation and potentiation of the indirect route of the basal ganglia motor circuit, added to the accumulation of Lewy bodies in several structures of the Central Nervous System, progressively and inevitably affects the life quality of patients. The ablative procedures of the subthalamic nucleus are an alternative that propitiates proven effect and safety in the control of this disease symptoms. Therefore, the authors decided to describe the subthalamic nucleus ablation as a treatment for advanced Parkinson's disease (AU).


Assuntos
Humanos , Masculino , Feminino , Doença de Parkinson/cirurgia , Núcleo Subtalâmico/cirurgia , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico , Qualidade de Vida , Procedimentos Cirúrgicos Operatórios/métodos , Terapêutica/métodos , Sistema Nervoso Central/anormalidades
15.
PLoS One ; 15(12): e0244680, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382780

RESUMO

OBJECTIVE: We determined the effectiveness of a multi-strain probiotic (Hexbio®) containing microbial cell preparation MCP®BCMC® on constipation symptoms and gut motility in PD patients with constipation. METHODS: PD patients with constipation (ROME III criteria) were randomized to receive a multi-strain probiotic (Lactobacillus sp and Bifidobacterium sp at 30 X 109 CFU) with fructo-oligosaccaride or placebo (fermented milk) twice daily for 8 weeks. Primary outcomes were changes in the presence of constipation symptoms using 9 items of Garrigues Questionnaire (GQ), which included an item on bowel opening frequency. Secondary outcomes were gut transit time (GTT), quality of life (PDQ39-SI), motor (MDS-UPDRS) and non-motor symptoms (NMSS). RESULTS: Of 55 recruited, 48 patients completed the study: 22 received probiotic and 26 received placebo. At 8 weeks, there was a significantly higher mean weekly BOF in the probiotic group compared to placebo [SD 4.18 (1.44) vs SD 2.81(1.06); (mean difference 1.37, 95% CI 0.68, 2.07, uncorrected p<0.001)]. Patients in the probiotic group reported five times higher odds (odds ratio = 5.48, 95% CI 1.57, 19.12, uncorrected p = 0.008) for having higher BOF (< 3 to 3-5 to >5 times/week) compared to the placebo group. The GTT in the probiotic group [77.32 (SD55.35) hours] reduced significantly compared to placebo [113.54 (SD 61.54) hours]; mean difference -36.22, 95% CI -68.90, -3.54, uncorrected p = 0.030). The mean change in GTT was 58.04 (SD59.04) hour vs 20.73 (SD60.48) hours respectively (mean difference 37.32, 95% CI 4.00, 70.63, uncorrected p = 0.028). No between-groups differences were observed in the NMSS, PDQ39-SI, MDS-UPDRS II and MDS-UPDRS III scores. Four patients in the probiotics group experienced mild reversible side effects. CONCLUSION: This study showed that consumption of a multi-strain probiotic (Hexbio®) over 8 weeks improved bowel opening frequency and whole gut transit time in PD patients with constipation.


Assuntos
Constipação Intestinal/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/efeitos dos fármacos , Doença de Parkinson/fisiopatologia , Probióticos/uso terapêutico , Idoso , Constipação Intestinal/etiologia , Constipação Intestinal/fisiopatologia , Método Duplo-Cego , Feminino , Motilidade Gastrointestinal/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Probióticos/administração & dosagem , Inquéritos e Questionários , Resultado do Tratamento
17.
Zhonghua Yi Xue Za Zhi ; 100(43): 3397-3401, 2020 Nov 24.
Artigo em Chinês | MEDLINE | ID: mdl-33238668

RESUMO

Objective: To investigate the association of age-related white matter hyperintensity (WMH) with brain atrophy and cognitive impairment in patients with Parkinson's disease (PD). Methods: Consecutive samples of a prospective PD cohort with complete 3-dimensional magnetic resonance imaging in the Department of Movement Disorders in Beijing Tiantan Hospital, Capital Medical University, from October 2018 to August 2019 was retrospectively analyzed. Cognition was evaluated by Mini-Mental State Scale (MMSE) and Montreal Cognitive Assessment (MoCA). The severity of WMH was semi-quantitatively measured by Fazekas scale (0-6 points), and the mean cortical thickness and thalamus volume were calculated by FreeSurfer software. The demographic and disease characteristics, the severity of WMH, the mean cortical thickness and thalamus volume were respectively compared between PD patients with and without dementia. Moreover, univariate and multivariate generalized linear models were used to analyze the correlation of the severity of WMH with brain atrophy and MoCA. Results: A total of 225 patients with PD were included in the study, with a median age of 66 years old. Comparisons between groups suggested that patients with dementia were with severer WMH, older, and had lower levels of serum cholesterol and low-density lipoprotein and more reduced mean cortical thickness than those without dementia (all P<0.05), but no significant difference in the thalamus volume was found between the two groups. The generalized linear model showed that the cognitive impairment of PD patients was significantly correlated with WMH (ß=-0.021, 95%CI:-0.040--0.002, P=0.032), but independent of age, cortical thickness, and levels of serum cholesterol and low-density lipoprotein. Conclusion: WMH may worsen PD cognitive impairment independent of brain atrophy. Clinical prevention and treatment of cerebral small vessel disease may have protective effects on cognitive function in patients with PD.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Substância Branca , Idoso , Atrofia/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Humanos , Imagem por Ressonância Magnética , Testes Neuropsicológicos , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Estudos Prospectivos , Estudos Retrospectivos , Substância Branca/patologia
18.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10. Vyp. 2): 67-73, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33205933

RESUMO

Neuroendocrine and neurometabolic disorders, although occasionally noted in Parkinson's disease (PD), existed in the shadow of motor and non-motor symptoms (hypokinesia, rigidity, tremor, depression, constipation, etc.). In recent years, they are increasingly being diagnosed and are the subject of special research. These include, in particular, disorders of carbohydrate metabolism, changes in body weight, metabolic disorders in bone tissue, secretion, as well as the secretion of neurohormones, such as melatonin. They are associated with other non-motor symptoms, negatively affect patients' general condition and quality of life, but can be treatable. At the same time, treatment of neuroendocrine and neurometabolic disorders can favorably influence the rate of progression of the disease as a whole. This review discusses the pathophysiological mechanisms, clinical consequences, as well as pharmacological and non-pharmacological approaches to the treatment of neuroendocrine and neurometabolic disorders arising in PD, which have been relatively rarely covered in literature.


Assuntos
Doença de Parkinson , Progressão da Doença , Humanos , Hipocinesia , Doença de Parkinson/complicações , Qualidade de Vida , Tremor
19.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10. Vyp. 2): 74-79, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33205934

RESUMO

The asymmetry of motor symptoms in Parkinson's disease (PD) reflects the asymmetry of the degenerative process and death of nigrostriatal dopaminergic neurons in the substantia nigra, which is confirmed by the data of functional neuroimaging. This review discusses a possible effect of the asymmetry of substantia nigra lesions on other PD symptoms, primarily neuropsychological functions. The authors summarize the data obtained in a comparative analysis of cognitive impairments in PD patients with right-sided and left-sided predominance of motor symptoms. The association between the asymmetry of motor and cognitive symptoms indicates the variability of the profile of cognitive impairments in PD, as well as an important modulating role of subcortical structures on neuropsychological functions traditionally referred to as cortical. The effect of lateralization of symptoms on cognitive function should be considered when evaluating and treating PD patients.


Assuntos
Doença de Parkinson , Cognição , Neurônios Dopaminérgicos , Lateralidade Funcional , Humanos , Doença de Parkinson/complicações , Substância Negra
20.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10. Vyp. 2): 80-88, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33205935

RESUMO

Disturbances in sleep and wakefulness are important symptoms of Parkinson's disease (PD) and are associated with negative effects on patients' quality of life. The analysis of literature on the relationship between RLS and PD revealed three main hypotheses explaining the relatively high incidence of RLS in PD: (1) RLS can be considered as an early (prodromal) manifestation or a predictor of PD that can outpace its main symptoms by several years (by analogy with conduct disorder during sleep with REM); (2) the high incidence of RLS in the advanced stage of PD may be associated with augmentation of previously latent RLS symptoms during prolonged dopaminergic therapy of PD; (3) a significant proportion of RLS cases in PD patients are not «classical¼ RLS, but represent, for example, manifestations of motor or non-motor fluctuations or a special form of stereotypy in the legs. Further research is needed to determine if any of these statements are true.


Assuntos
Doença de Parkinson , Síndrome das Pernas Inquietas , Humanos , Perna (Membro) , Doença de Parkinson/complicações , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/epidemiologia , Qualidade de Vida , Síndrome das Pernas Inquietas/epidemiologia , Síndrome das Pernas Inquietas/etiologia , Sono
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...