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1.
Arch Ital Biol ; 157(2-3): 89-101, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31821532

RESUMO

OBJECTIVES: to update understanding of the effectiveness of transcranial direct current stimulation (tDCS) on motor dysfunction in Parkinson's disease, since the last review was published in 2016. METHODS: in order to identify suitable publications for inclusion, an online search of the Pubmed, Scopus and Cochrane databases was carried out. Searches of relevant full-text articles were performed through specific keywords. The final database check was performed in July 2019. Papers were restricted to studies investigating motor rehabilitative effects of tDCS in adult patients with Parkinson's disease. Studies involving either single or repeated tDCS sessions with a sham or controlled trial type design (which incorporated outcomes on motor performance measures) were considered. As studies varied widely in terms of methodology, a qualitative analysis of the selected studies was performed using the Newcastle-Ottawa Quality Assessment Scale or the Delphi list (depending on the study design). RESULTS: twenty-nine studies were retained in this systematic review. Of the studies included, fifteen involved single tDCS session (patients = 256) and fourteen involved repeated tDCS sessions (patients = 294). Eight investigations of single tDCS and ten investigations of repeated tDCS demonstrated significant results. Studies involving multi- target stimulation demonstrated significant improvements on mobility (p=0.006), balance (by 50.9%), gait velocity (by 29%), fall reduction (p0.05) compared to mono-target stimulations. CONCLUSIONS: despite increasing evidence that tDCS may improve motor symptoms, the results showed that fully optimized tDCS protocols are not yet established.


Assuntos
Doença de Parkinson , Estimulação Transcraniana por Corrente Contínua , Adulto , Marcha , Humanos , Doença de Parkinson/terapia
2.
Zhonghua Yi Xue Za Zhi ; 99(44): 3471-3476, 2019 Nov 26.
Artigo em Chinês | MEDLINE | ID: mdl-31826564

RESUMO

Objective: To analyze the correlation between intracranial air and electrode displacement after deep brain stimulation. Compared the accuracy of the electrodes on both sides while bilateral intracranial air. Methods: A total of 133 patients with bilateral DBS from February 2017 to February 2019 in neurosurgery department of the General Hospital of Northern Theater Command were included. A total of 266 electrodes were implanted, including 160 sides of subthalamic nucleus, 2 sides of ventromedial nucleus of thalamus and 104 sides of Globus pallidus interior. All patients underwent three-dimensional reconstruction of the head 2 hours after operation and 1 week after operation, which was fused with the preoperative surgical plan.The volume of the intracranial air is obtained by summing up the CT layer-by-layer measurements after surgery. The distance between the implanted electrode and the preoperative target on the X and Y axes in the target plane is measured.Values were expressed as means±SEM,and the t test was performed. Bivariate correlation analysis using linear correlation analysis.P<0.05 was considered statistically significant. Results: There was no statistically significant difference in the fusion error of the electrode between 2 hours and 1 week after surgery on the X-axis. But there was significant difference on the Y-axis. The difference between intracranial air volume and two fusion errors was not linearly correlated on X axis, but linearly positively correlated on Y axis. Conclusion: Intracranial air volume is an important factor affecting the accuracy of DBS surgery. The larger intracranial air volume, the larger the displacement of electrodes on Y axis.


Assuntos
Estimulação Encefálica Profunda , Núcleo Subtalâmico , Eletrodos Implantados , Globo Pálido , Humanos , Imagem por Ressonância Magnética , Doença de Parkinson/terapia
3.
Zhen Ci Yan Jiu ; 44(12): 873-7, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31867905

RESUMO

OBJECTIVE: To observe the effect of electroacupuncture (EA) on expression of eukaryotic initiation factor 2α (EIF2α), activating transcription factor 4 (ATF4), glucose regulator protein-78 / immunoglobulin heavy-chain-binding protein (GRP78/Bip) in the substantia nigra (SN) in rats with Parkinson's disease (PD), so as to explore its mechanism underlying improvement of PD. METHODS: Forty-eight male SD rats were randomly divided into control, sham-operation, model and EA groups (n=12 in each group). The PD model was established by 28-day consecutive subcutaneous injection of rotenone (1 mg/kg dissolved in dimethyl sulfoxide and normal saline) at the back shoulder. EA (2 Hz, 1 mA) was applied to "Fengfu" (GV16) and "Taichong" (LR3) for 30 min, once daily for 2 weeks. The behavio-ral changes of rats in each group were measured and scored at 28th day and 44th day, respectively. The expressions of tyrosine hydroxylase (TH) and α-synuclein (α-syn) in the SN were observed by immunohistochemistry, and the expressions of EIF2α, ATF4 and GRP78/Bip were detected by Western blot. RESULTS: Following modeling and compared with the control and sham-operation groups, the behavioral scores of rats in the model group were elevated (P<0.01), which were significantly decreased by EA intervention (P<0.01). The expression of TH decreased whereas the α-syn, EIF2α, ATF4 and GRP78/Bip increased in the rats of model group, and EA intervention reversed these changes (all P<0.01). CONCLUSION: EA at GV16 and LR3 can improve PD rats' behavioral changes, which is probably related with its effects in up-regulating the expression of TH in the SN and down-regulating the expression of α-syn and EIF2α-ATF4-GRP78/Bip signaling.


Assuntos
Eletroacupuntura , Doença de Parkinson , Fator 4 Ativador da Transcrição , Animais , Masculino , Doença de Parkinson/terapia , Ratos , Ratos Sprague-Dawley , Substância Negra
4.
Artigo em Russo | MEDLINE | ID: mdl-31880760

RESUMO

BACKGROUND: Parkinson's disease is a neurodegenerative disease manifested by a whole group of motor, cognitive, affective, and other disorders. Many of them cannot be controlled by modern pharmacotherapy in full measure. New treatments, including nondrug ones, are needed. OBJECTIVE: To evaluate the impact of rhythmic transcranial magnetic stimulation on motor, cognitive, and affective disorders in Parkinson's disease. MATERIAL AND METHODS: The investigation enrolled 55 patients with Stage III Parkinson's disease according to the Hoehn and Yahr scale. The patients were randomly divided into 2 groups: a study group (n=35) and a control one (n=20). The groups were matched for age, disease type and duration, and symptom severity. The basic therapy for Parkinson's disease included Levodopa in combination with dopamine receptor agonists and monoamine oxidase B inhibitors. All the patients in the study group underwent a cycle of therapeutic transcranial magnetic stimulation. Both patient groups underwent clinical and neurological examinations and tests using various scales. All the patients were followed up for 6 months. RESULTS: The patients who had undergone a cycle of magnetic stimulation showed a significant improvement in motor functions. There was a decrease in the total MDS-UPDRS-III scores by an average of 6.4 (p<0.05) and that in the GABS scores by 5.9 (p<0.05). CONCLUSION: Rhythmic transcranial magnetic stimulation can be considered as an additional treatment for Parkinson's disease. No significant side effects were noted during and after stimulation.


Assuntos
Doença de Parkinson/terapia , Estimulação Magnética Transcraniana , Humanos , Doença de Parkinson/fisiopatologia , Resultado do Tratamento
5.
Medicine (Baltimore) ; 98(52): e18406, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31876713

RESUMO

As an anesthetic reversal agent, there are concerns with cholinesterase inhibitors regarding worsening of Parkinson's disease (PD)-related symptoms. Sugammadex, a relatively new reversal agent, does not inhibit acetylcholinesterase and does not require co-administration of an antimuscarinic agent. The present study compared the recovery profiles of 2 agents initially administered for reversal of neuromuscular blockade in patients with advanced PD who underwent deep brain stimulator implantation.A total of 121 patients with PD who underwent deep brain stimulator implantation were retrospectively analyzed. Patients were divided into 1 of 2 groups according to the type of neuromuscular blockade reversal agent (pyridostigmine vs sugammadex) initially administered. Recovery profiles reflecting time to extubation, reversal failure at first attempt, and hemodynamic stability, including incidence of hypertension or tachycardia during the emergence period, were compared.Time to extubation in the sugammadex group was significantly shorter (P < .001). In the sugammadex group, reversal failure at first attempt did not occur in any patient, while it occurred in seven (9.7%) patients in the pyridostigmine group (P = .064), necessitating an additional dose of pyridostigmine (n = 3) or sugammadex (n = 4). The incidence of hemodynamic instability during anesthetic emergence was significantly lower in the sugammadex group than in the pyridostigmine group (P = .019).Sugammadex yielded a recovery profile superior to that of pyridostigmine during the anesthesia emergence period in advanced PD patients. Sugammadex is also likely to be associated with fewer adverse effects than traditional reversal agents, which in turn would also improve overall postoperative management in this patient population.


Assuntos
Inibidores da Colinesterase/uso terapêutico , Estimulação Encefálica Profunda , Eletrodos Implantados , Bloqueio Neuromuscular/métodos , Doença de Parkinson/terapia , Implantação de Prótese , Brometo de Piridostigmina/uso terapêutico , Sugammadex/uso terapêutico , Período de Recuperação da Anestesia , Estimulação Encefálica Profunda/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bloqueio Neuromuscular/efeitos adversos , Implantação de Prótese/métodos , Estudos Retrospectivos
6.
Nervenarzt ; 90(12): 1279-1291, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31776592

RESUMO

Due to their high prevalence, Parkinson's syndromes are exemplary geriatric syndromes. In addition to idiopathic Parkinson's disease, drug-induced and vascular Parkinson's syndromes are especially relevant in older age. A comprehensive anamnesis, thorough clinical neurological examination and rational additional diagnostics ensure the correct differential diagnostic classification. The multidimensional geriatric assessment is used to quantify the syndrome-specific ability impairments. The primary therapeutic objective in old age is the preservation of everyday competences. Drug treatment is centered around L­dopa because of its favorable effect-side effect ratio. In cases of motor fluctuations, entacapone, opicapone or safinamide can be added, whereas dopamine agonists are generally unsuitable. Rivastigmine is indicated in mild to moderate Parkinson's dementia and furthermore can possibly improve gait stability. Speech therapy, as well as physical and occupational therapy, including the Parkinson's disease-specific Lee Silverman voice treatment are indispensable components of the multiprofessional treatment concept.


Assuntos
Doença de Parkinson , Idoso , Alemanha/epidemiologia , Humanos , Levodopa , Doença de Parkinson/diagnóstico , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapia , Fonoterapia , Síndrome
7.
Nervenarzt ; 90(12): 1232-1238, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31654235

RESUMO

The idiopathic Parkinson's disease (iPD) is a progressive neurodegenerative disorder primarily resulting in impaired movement execution. In the course of the disease symptom fluctuation is common and makes adequate treatment difficult. In this overview the current approaches using modern and especially mobile technologies for diagnosis, monitoring and treatment of iPD are presented. Currently, there are no medical aids ready for point of care application; however, the development of these technologies has great potential for improving care for patients suffering from iPD.


Assuntos
Doença de Parkinson , Consulta Remota , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Consulta Remota/tendências
8.
Med Clin North Am ; 103(6): 1055-1075, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582004

RESUMO

This article presents a nongeneticist's guide to understanding the genetics of Parkinson disease (PD), including clinical diagnostic criteria, differential diagnoses, symptom management, when to suspect a hereditary factor, a summary of autosomal dominant and recessive PD genes, and proposed algorithm for genetic testing. There is increasing availability of genetic testing for PD but there are few recommendations on how these tests should be used in clinical practice. This article guides clinicians on the overall management of patients with PD, with emphasis on determining which patients should have genetic testing and how to interpret the results.


Assuntos
Testes Genéticos/métodos , Doença de Parkinson , Algoritmos , Gerenciamento Clínico , Predisposição Genética para Doença , Humanos , Doença de Parkinson/diagnóstico , Doença de Parkinson/genética , Doença de Parkinson/terapia
9.
J Altern Complement Med ; 25(12): 1225-1237, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31556689

RESUMO

Objectives: Falls are common in Parkinson's disease (PD). Exercise interventions can prevent falls. This review aims to (1) explore the existing evidence regarding the cost-effectiveness of exercise-based fall prevention programs for people with PD and (2) discuss the implications of the review findings for future research and clinical practice. Design: Databases AMED Allied and Complementary Medicine, CINAHL, CRD, EBSCO, EMBASE, MEDLINE, PubMed, Scopus, and Web of Science were searched from their inception until June 2019. Randomized and nonrandomized trials that included an economic evaluation of fall prevention programs for people with PD were considered. Quality of the economic evaluation was assessed using the Consensus on Health Economic Criteria list (CHEC-list), and the methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) and Cochrane risk of bias tool. Results: Nine hundred and sixty-five studies were screened to include three studies involving 556 participants. Quality of economic evaluation assessed using CHEC-list was high. The methodological quality was high for two studies and low for one study. Tested interventions included Tai Ji Quan, physiotherapist-led, supervised, weekly and monthly balance, and strengthening exercises. The duration of the interventions ranged from 10 weeks to 6 months, while the intervention frequency ranged from two sessions per week to one session per month. Treatment sessions lasted for 60 min in all three studies. One high economic and methodological quality study comparing Tai Ji Quan with resistance and stretching exercises reported least cost resource use among Tai Ji Quan group (USD 80,441) and greater incremental number of falls prevented. All three tested interventions had an 80% probability of being cost-effective with the corresponding country-specific threshold incremental cost-effectiveness ratio values. Conclusions: The findings provide some evidence for exercise-based intervention as a cost-effective treatment option for preventing falls in PD; however, due to the limited number of available studies, heterogeneity of the interventions, and diversity of assessment settings, a firm conclusion cannot be established. Additional studies evaluating the cost-effectiveness of fall prevention programs involving larger samples and using different treatment parameters in various settings are warranted.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício , Doença de Parkinson/terapia , Idoso , Análise Custo-Benefício , Terapia por Exercício/economia , Terapia por Exercício/métodos , Terapia por Exercício/estatística & dados numéricos , Feminino , Humanos , Masculino , Tai Ji
10.
J Clin Neurosci ; 69: 281-284, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31477464

RESUMO

We have evaluated an 82 years old PD patient who has acutely developed VH secondary to acute visual loss that was associated with increased electroencephalographic activity in the gamma range over the parietal, occipital and frontal regions. In this respect, we have tested the therapeutic effect of occipital lobe oriented rTMS application and its electrophysiological correlates that led to significant improvement in the hallucinatory symptomatology of the patient after two weeks. We have revealed that the improved hallucinatory symptoms after rTMS application resolved completely after switching from the pramipexole treatment to L-Dopa indicating that there could be a combined therapeutic effect of L-Dopa and rTMS. Furthermore, Quantitative-Electroencephalography analysis has shown that the therapeutic effects of rTMS and L-Dopa were seen with the improvement of impaired gamma power spectrum. Although the main limitation of this report is that this a single case study and that these findings need to be replicated in a larger sample, e.g., as part of a controlled trial, our present findings help us to enlighten the unknown pathophysiological overlapping between the visual hallucinations in PD and Charles Bonnet Syndrome. Finally, our study revealed increased gamma coherence and power spectrum which is seen with visual hallucinations and improved after the application of 1 Hz rTMS on the occipital lobe. These findings together suggest that rTMS could be used as a therapeutic tool for parkinsonian complex VH and probably due affecting gamma coherence and power spectrum.


Assuntos
Alucinações/etiologia , Alucinações/terapia , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Estimulação Magnética Transcraniana/métodos , Idoso de 80 Anos ou mais , Antiparkinsonianos/uso terapêutico , Eletroencefalografia , Humanos , Levodopa/uso terapêutico , Masculino , Pramipexol/uso terapêutico
11.
Complement Ther Clin Pract ; 36: 12-17, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383428

RESUMO

OBJECTIVE: To investigate whether the dance therapy was more beneficial than non-dance therapy on cognitive and mood symptoms in patients with Parkinson's disease (PD). METHODS: MEDLINE, CINAHL, Embase and the Cochrane Central Register of Controlled Trials were searched from inception to December 11, 2018. Risk of bias for the included trials was assessed using criteria in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Seven randomized controlled trials were identified on cognitive and mood symptoms in patients with PD. There were significant differences in favor of dance in executive function (WMD = 1.17, 95% CI:0.39 to 1.95, P = 0.003; I2 = 0%, P = 0.45), but not in outcomes of global cognitive function, depression and apathy. CONCLUSIONS: Dance therapy is beneficial in improving executive function for adults with PD. However, there are no positive effects were founded on global cognitive function, depression and apathy for PD.


Assuntos
Afeto/fisiologia , Cognição/fisiologia , Terapia através da Dança , Doença de Parkinson/terapia , Humanos
12.
J Clin Neurosci ; 68: 55-61, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31383472

RESUMO

Deep brain stimulation (DBS) is still a highly effective treatment option that significantly improves motor function in advanced PD. Moreover, previous findings have shown that Olfactory dysfunction (OD) has been found in a majority of patients with Parkinson's Disease (PD). Despite this, the effect of DBS on the olfactory function is not fully understood. Here we aimed to determine the effect of STN DBS on OD by evaluating the olfactory functions in the preoperative and postoperative early stages (1st and 3rd months) in forty-five PD patients and 40 healthy controls. The therapeutic effect of DBS on the improvement of motor functions was parallelly investigated. We have observed that there was a significant improvement in OI in the 1st month and in all olfactory parameters (OT, ODI, OI, and TDI) in the 3rd month. In evaluating the motor functional scores, we have revealed a statistically significant (p < 0.001) difference between preoperative UPDRS-motor score (23 ±â€¯7.3) and the postoperative 3rd month score (11.1 ±â€¯5.1). Although Beck Depression and Anxiety scores were improved to a certain level in the 3rd month, this improvement was not at a statistically significant level (p > 0.05). As a conclusion, we have shown that STN-DBS improves the smell functions in PD within three months suggesting that the therapeutic effects of DBS might have a wide range of therapeutic spectrum. Despite some limitations (i.e., short follow-up period) our study gives a critical message that future studies are needed to evaluate the functional correlates of STN-DBS treatment in PD patients.


Assuntos
Estimulação Encefálica Profunda/métodos , Transtornos do Olfato/etiologia , Transtornos do Olfato/terapia , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Núcleo Subtalâmico/fisiopatologia , Resultado do Tratamento
13.
PLoS Comput Biol ; 15(8): e1006575, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393880

RESUMO

Deep brain stimulation (DBS) is known to be an effective treatment for a variety of neurological disorders, including Parkinson's disease and essential tremor (ET). At present, it involves administering a train of pulses with constant frequency via electrodes implanted into the brain. New 'closed-loop' approaches involve delivering stimulation according to the ongoing symptoms or brain activity and have the potential to provide improvements in terms of efficiency, efficacy and reduction of side effects. The success of closed-loop DBS depends on being able to devise a stimulation strategy that minimizes oscillations in neural activity associated with symptoms of motor disorders. A useful stepping stone towards this is to construct a mathematical model, which can describe how the brain oscillations should change when stimulation is applied at a particular state of the system. Our work focuses on the use of coupled oscillators to represent neurons in areas generating pathological oscillations. Using a reduced form of the Kuramoto model, we analyse how a patient should respond to stimulation when neural oscillations have a given phase and amplitude, provided a number of conditions are satisfied. For such patients, we predict that the best stimulation strategy should be phase specific but also that stimulation should have a greater effect if applied when the amplitude of brain oscillations is lower. We compare this surprising prediction with data obtained from ET patients. In light of our predictions, we also propose a new hybrid strategy which effectively combines two of the closed-loop strategies found in the literature, namely phase-locked and adaptive DBS.


Assuntos
Estimulação Encefálica Profunda , Modelos Neurológicos , Encéfalo/fisiopatologia , Biologia Computacional , Estimulação Encefálica Profunda/métodos , Estimulação Encefálica Profunda/estatística & dados numéricos , Tremor Essencial/fisiopatologia , Tremor Essencial/terapia , Humanos , Neurônios/fisiologia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia
14.
J Clin Neurosci ; 69: 104-108, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31416732

RESUMO

This retrospective study aims to explore the clinical utility of microelectrode recording (MER) during subthalamic deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). We analyzed the data from 103 PD patients, who consecutively received bilateral subthalamic nucleus (STN) DBS at an experienced academic medical center. We collected demographic, clinical, and DBS related data, including intraoperative microelectrode recording data, electrode positioning, and clinical effects provided by intraoperative microstimulation. The 2 brain sides were independently analyzed and are described as first and second side (to be operated on); the first side is contralateral to motor symptoms onset. Patients were mostly men (64.1%). In both sides of the brain, percentage of agreement with the electrode final position was higher with clinical results than with intraoperative microelectrode recordings (98% vs 57% on the first implantation side, and 97% vs 58% on the second implantation side, respectively). Regarding electrode final implantation depth, 86% of electrodes were implanted between 0 mm and +2 mm in relation to anatomical target, and 95% of electrodes were implanted from -2 mm to +2 mm. Our study suggests that MER might not be necessary to achieve good clinical outcomes in PD patients undergoing STN DBS. These results support and inform the design of future prospective controlled research studies.


Assuntos
Estimulação Encefálica Profunda/métodos , Monitorização Neurofisiológica Intraoperatória/métodos , Doença de Parkinson/terapia , Eletrodos Implantados , Feminino , Humanos , Masculino , Microeletrodos , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Núcleo Subtalâmico/fisiologia
15.
Georgian Med News ; (291): 82-85, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31418736

RESUMO

Aim of the study - to assess the impact of physical therapy using musical elements, for Parkinson disease diagnosed people static and dynamic body balance thus psychological state. Research subjects were Parkinson disease diagnosed elderly people. Age 67-80 (67.5±12.5) years old, 9 men and 9 women, n=18. Research tools: Dynamic Gait Index (DGI) (Wrisley D., et al., 2003); Romberg's test - RT (Khasnis A, Gokula R.M, 2003); Burns Depression Checklist - BDC (Burns D., 2013). Microsoft Excel 2016, statistical significance level was set at p<0.05. BDC summarizing the research results, patients with PD tended to have less depression after the physical therapy with music elements sessions appliance. In terms of the DGI percentage decreased from 77.8% to 72.2% after physical therapy sessions. The evaluation of patients by RT, showed the positive results, compared in the beginning more than > 50 % of patients needed help or they could not complete the task. After classes - the percentage decreased. Patients static balance improved statistically significant.


Assuntos
Musicoterapia , Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia , Modalidades de Fisioterapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Marcha , Humanos , Masculino , Equilíbrio Postural
16.
Fortschr Neurol Psychiatr ; 87(8): 445-461, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31430812

RESUMO

At least 300,000 people with idiopathic Parkinson's disease are living in Germany. Due to the demographic change the number of affected patients is expected to increase continuously. This article presents the evidence-based diagnostics and therapy of idiopathic Parkinson's disease. It provides an overview especially on new findings and developments in recent years.


Assuntos
Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Alemanha/epidemiologia , Humanos , Doença de Parkinson/classificação , Doença de Parkinson/fisiopatologia
17.
Sheng Li Xue Bao ; 71(4): 547-554, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31440751

RESUMO

The aim of the present study was to reveal the role of cortical-striatum postsynaptic dopamine D2 receptor (D2R) in improving motor behavioral dysfunction in Parkinson's disease (PD) mice by exercise. C57/BL6 male adult mice were randomly divided into control, PD and PD plus exercise groups. The mice were injected with 6-OHDA in striatum to establish a unilateral injury PD model. The exercise intervention program was uniform speed running (16 m/min, 40 min/d, 5 d per week for 4 weeks). Autonomic activity of mice was tested by open field test. Cortical-striatum synaptic transmission efficiency was assessed by peak amplitude of field excitatory postsynaptic potential (fEPSP) recorded from in vitro brain slides. Meanwhile, the effects of D2R agonist on autonomic activity and cortical-striatal synaptic transmission were observed. The results showed that, compared with PD group, PD plus exercise group exhibited significantly increased autonomic motor distance and proportion of fast-moving (P < 0.05), as well as decreased maximum amplitude of fEPSP under increasing stimulation intensity (0.75-3.00 pA) (P < 0.05) and slope of stimulus-response curve. Compared with PD mice without D2R agonist, the movement distance and rapid movement ratio of PD mice treated with D2R agonist were increased significantly (P < 0.05), whereas fEPSP peak amplitude (P < 0.05) and the slope of stimulus-response curve were decreased. These results indicate that either early exercise intervention or D2R agonist treatment can inhibit the abnormal increase of cortical-striatum synaptic transmission and improve the autonomic motor ability in PD mice, suggesting that the cortical-striatum synaptic D2R may be an important molecular target for exercise to improve the autonomic motor ability of PD mice.


Assuntos
Corpo Estriado/fisiologia , Doença de Parkinson/terapia , Condicionamento Físico Animal , Receptores de Dopamina D2/fisiologia , Transmissão Sináptica , Animais , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Oxidopamina , Doença de Parkinson/fisiopatologia , Distribuição Aleatória , Receptores de Dopamina D2/agonistas
18.
IEEE Int Conf Rehabil Robot ; 2019: 1167-1172, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374787

RESUMO

Parkinson disease (PD) is a common neurodegenerative disorders characterized by motor and non-motor impairments. Since the quality of life of PD patients becomes poor while pathology develops, it is imperative to improve the identification of personalized rehabilitation and treatments approaches based on the level of the neurodegeneration process. Objective and precise assessment of the severity of the pathology is crucial to identify the most appropriate treatments. In this context, this paper proposes a wearable system able to measure the motor performance of PD subjects. Two inertial devices were used to capture the motion of the lower and upper limbs respectively, while performing six motor tasks. Forty-one kinematic features were extracted from the inertial signals to describe the performance of each subjects. Three unsupervised learning algorithms (k-Means, Self-organizing maps (SOM) and hierarchical clustering) were applied with a blind approach to group the motor performance. The results show that SOM was the best classifier since it reached accuracy equal to 0.950 to group the instances in two classes (mild vs advanced), and 0.817 considering three classes (mild vs moderate vs severe). Therefore, this system enabled objective assessment of the PD severity through motion analysis, allowing the evaluation of residual motor capabilities and fostering personalized paths for PD rehabilitation and assistance.


Assuntos
Doença de Parkinson/fisiopatologia , Reabilitação , Algoritmos , Feminino , Humanos , Masculino , Doença de Parkinson/terapia , Qualidade de Vida , Aprendizado de Máquina não Supervisionado , Extremidade Superior/fisiopatologia
20.
IEEE Pulse ; 10(4): 6-11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31380738

RESUMO

The medical benefits of mild electrical stimulation of the cranium may seem like marketing hype, but decades of clinical research studies have verified that it does alleviate symptoms in a wide range of conditions. This method delivers very-low-frequency current to electrodes placed on the head, and that tiny current spreads across the brain to influence neurons and affect brain- network connectivity. Today, psychiatrists and neurologists commonly employ this technique as part of the therapy for people with anxiety, depression, posttraumatic stress disorder, epilepsy, Parkinson's disease, and a host of other conditions. Researchers are also reporting that stimulation can improvemental performance.


Assuntos
Transtornos de Ansiedade , Encéfalo/fisiopatologia , Estimulação Encefálica Profunda , Depressão , Eletrodos Implantados , Epilepsia , Doença de Parkinson , Transtornos de Estresse Pós-Traumáticos , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/terapia , Depressão/fisiopatologia , Depressão/terapia , Epilepsia/fisiopatologia , Epilepsia/terapia , Humanos , Doença de Parkinson/fisiopatologia , Doença de Parkinson/terapia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/terapia
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