Gene/Protein Disease Symptom Drug Enzyme Compound
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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parkinson's disease (PD) is traditionally regarded as a movement disorder. In recent years, however, non-motor symptoms have been considered significant factors of disability at all stages of the illness. Behavioral and psychological symptoms or neuropsychiatric syndromes associated with PD are frequent and may represent a challenge in the management of these patients. They include anxiety, depression, psychosis, sleep, sexual and impulse control disorders, apathy and cognitive dysfunction. Their pathogenesis in PD is complex, involving neurodegenerative, drug-related and psychological mechanisms. We will review the current knowledge of this growing field, also focusing on the management of theses syndromes.
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PMID:Neuropsychiatry of Parkinson's disease. 1983 36

Fatigue is common in Parkinson's disease (PD), occurring in up to 42% of patients (2). There is no recognized treatment. This is a study of modafinil for Parkinson's disease related fatigue. Ethical approval was given. Patients with idiopathic PD were recruited from a Movement Disorders clinic. Those with depression, dementia, and other causes for fatigue were excluded. Patients were assessed using the Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), self-rating of improvement, Epworth Sleepiness Scale (ESS), and UPDRS. Modafinil was titrated up over 4 weeks to maximum of 400 mg/day. There followed a 5 week maintenance phase before reassessment. Thirteen patients participated. No significant change was seen in any safety measure. The FSS did not change significantly, however those on modafinil rated an improvement in their fatigue compared to placebo. The Modafinil group had a statistically significant improvement on ESS (p < 0.05). This is a small study of modafinil in selected PD patients. There is a suggestion of improvement on the global clinical impression scale for fatigue, but no significant change on FSS. A larger study is needed to further evaluate this drug in PD fatigue. This study highlights the problems with recruitment when trialing treatments of non-motor symptoms in PD. A significant improvement in EDS was seen.
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PMID:Modafinil for Parkinson's disease fatigue. 1984 11

Parkinson's disease (PD) is the second most common neurodegenerative disease and primarily considered as a movement disorder defined by the presence of motor symptoms, such as bradykinesia, tremor and rigidity. However, it is nowadays widely recognized that in addition there is impairment of cognitive function, mood and the autonomic nervous system in a high percentage of PD patients, which is sometimes even more harming quality of life. These symptoms not only occur during the course of the disease but may even precede the onset of motor symptoms. Typical examples of non-motor features of PD are depression, constipation, REM sleep behaviour disorder, and hyposmia.
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PMID:Non-motor features of Parkinson's disease: depression and dementia. 2008 17

Psychogenic movement disorders (PMD) are a diagnostic fascinating challenge in both neurologic and psychiatric setting. Many factors influence response to treatment, but few treatment strategies are available. Physical activity proves to be effective in the treatment of depression, anxiety, and other psychiatric disorders, but the effects of regular walking exercise on patients with PMD have never been investigated in a single-blind study. Sixteen outpatients [13 women; mean age 33.0 years (range 22-51)] with primarily mild-to-moderate PMD completed a thrice-weekly, 12-weeks mild walking program. Assessments included DSM-IV interview, the Psychogenic Movement Disorder Rating Scale (PMDRS), Beck Anxiety Inventory (BAI), Hamilton Depression Scale (HDS), V02 Max, and body mass index (BMI). Changes in total score on the PMDRS were the primary endpoint. A comparison of all measures taken at study onset and after completing the exercise program indicates statistically significant improvements. We observed a relevant improvement in 10 of 16 patients (62%). The mean difference for the primary outcome (PMDRS total) corresponded to about 70%. Compliance was good, and there were no adverse effects. This study provides preliminary evidence for regular low-medium intensity exercise as a safe, adequate, and pleasing intervention for PMD. Furthermore, well-designed studies appear justified to confirm these findings.
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PMID:The effects of physical activity on psychogenic movement disorders. 2010 57

Parkinson's disease (PD) is a common neurodegenerative movement disorder afflicting millions of people in the United States. The advent of transgenic technologies has contributed to the development of several new mouse models, many of which recapitulate some aspects of the disease; however, no model has been demonstrated to faithfully reproduce the full constellation of symptoms seen in human PD. This may be due in part to the narrow focus on the dopamine-mediated motor deficits. As current research continues to unmask PD as a multi-system disorder, animal models should similarly evolve to include the non-motor features of the disease. This requires that typically cited behavioral test batteries be expanded. The major non-motor symptoms observed in PD patients include hyposmia, sleep disturbances, gastrointestinal dysfunction, autonomic dysfunction, anxiety, depression, and cognitive decline. Mouse behavioral tests exist for all of these symptoms and while some models have begun to be reassessed for the prevalence of this broader behavioral phenotype, the majority has not. Moreover, all behavioral paradigms should be tested for their responsiveness to L-DOPA so these data can be compared to patient response and help elucidate which symptoms are likely not dopamine-mediated. Here, we suggest an extensive, yet feasible, battery of behavioral tests for mouse models of PD aimed to better assess both non-motor and motor deficits associated with the disease.
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PMID:Behavioral phenotyping of mouse models of Parkinson's disease. 2021 55

Sydenham's chorea is a rare movement disorder associated with streptococcal infection. The co-occurrence of neuropsychiatric symptoms has raised the question of whether streptococcal infection could trigger these symptoms without chorea. This study evaluated the prevalence of behavioral diagnoses before, during, and after the onset of chorea in a cohort of children with a history of Sydenham's chorea for whom demographic and clinical data were available. In all, 28 Sydenham's chorea patients were evaluated, with a mean age of 10.3 years. Retrospective analysis was performed for subject demographics, streptococcal titers, and presence of arthritis and carditis. Structured diagnostic interviews were performed on 14 available patients and parents. Streptococcal titers and duration of treatment for chorea were compared between groups. The prevalence of attention deficit hyperactivity disorder before and after chorea was 30 and 37%, respectively. The proportion of children meeting combined, subthreshold, and suprathreshold criteria before, during, and after Sydenham's chorea was 71, 79, and 79% for anxiety and 19, 69, and 44% for depression. Streptococcal antibody titers and duration of treatment did not correlate with attention deficit hyperactivity disorder, depression, or anxiety disorders. During and after the diagnosis of Sydenham's chorea, clinicians should be vigilant for signs and symptoms of anxiety, depression, and attention deficit hyperactivity disorder.
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PMID:The prevalence of neuropsychiatric disorders in Sydenham's chorea. 2030 26

Pseudobulbar affect (PBA) is an affective disinhibition syndrome characterized by sudden, involuntary outbursts of inappropriate crying or laughing. We have previously reported the prevalence of PBA in movement disorders using an interviewer-administered questionnaire that had not been validated. In the current study, a validated self-administered screening instrument, the Center for Neurologic Study-Lability Scale (CNS-LS), was used to study the prevalence of PBA, its association with mood symptoms, and the quality of life impact. Two hundred sixty-nine patients met inclusion criteria (consent, age > 18 years, formal diagnosis, and completion of the CNS-LS). The CNS-LS was used to assess PBA at a cutoff score of 17 (utilized from multiple sclerosis studies). The Beck Depression Inventory (BDI) scale and Parkinson's disease questionnaire (PDQ-39) were used to assess depressive symptoms and quality of life. Logistic regression analysis was used to predict associations with PBA. PBA was prevalent in 7.1% (n = 19) of movement disorder patients. No significant difference in prevalence was observed by patient diagnosis: 7.1% (12/168) in Parkinson's disease (PD), 11.4% (4/35) in essential tremor, 0% (0/13) in dystonia, 0% (0/16) in psychogenic movement disorders, and 10.7% (3/28) in patients with other movement disorders. Patients with PBA had higher BDI depression scores (p < 0.0001) and lower PDQ-39 emotional well-being subscores (p < 0.0001). Patients taking antidepressant medications had significantly higher rates of PBA (p = 0.0008). The prevalence of PBA symptoms was 7.1% in PD and all movement disorders patients. Patients with PBA tend to have more depressive symptoms and poorer quality of life.
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PMID:Pseudobulbar affect: prevalence and quality of life impact in movement disorders. 2037 75

Hemifacial spasm (HFS) is a chronic movement disorder which presents as clonic and/or tonic facial muscle contractions frequently accompanied by many other sensory (visual or auditory disturbances, pain), motor (facial weakness, trismus, bruxism, dysarthria) and/or autonomic (lacrimation, salivation) symptoms. The aim of the study was to assess the occurrence of HFS non-motor and motor-related symptoms and their responsiveness to botulinum toxin type A (BTX-A) therapy. 56 HFS patients were included in the open-label design study. Patients were examined three times: before BTX-A injection, and 2 and 12 weeks later. The occurrence of non-motor and motor-related symptoms was assessed by a special questionnaire, and the severity of HFS was rated by the Clinical Global Impression-Severity scale (CGI-S) and depression symptoms by the Beck Depression Inventory (BDI). Over 81% of the patients before BTX-A therapy reported HFS non-motor and motor-related symptoms. Almost 50% of the patients reported more than three symptoms. The most frequent symptoms were: tearing (44.5%), eye irritation (39.3%), facial paraesthesia (26.8%) and hearing of a "clicking" sound (25.0%). 2 weeks after BTX-A injection 75% of the patients did not report any symptoms and 20% reported only one or two. 3 months later the number of symptoms had increased again, with 57% of patients reporting at least one. The number of HFS non-motor and other symptoms did not correlate with the patients' age, disease duration and the presence of neuro-vascular conflict, but were positively correlated with the CGI-S and BDI scores. This study showed that muscle contractions in HFS patients are commonly accompanied by non-motor and other motor-related symptoms and most of them are reduced following BTX-A treatment.
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PMID:Hemifacial spasm non-motor and motor-related symptoms and their response to botulinum toxin therapy. 2046 63

A substantial literature characterizes pediatric restless legs syndrome (RLS), which occurs in about 1.9% of individuals between 8 and 18years of age. Diagnostic interview techniques and an updated inventory of pediatric RLS mimics are presented. Evidence for comorbidity of pediatric RLS with attention-deficit/hyperactivity disorder, depression, and anxiety is reviewed as is the relationship to periodic limb movements in sleep and periodic limb movement disorder. The role of relative iron deficiency in pediatric RLS is discussed, along with new data indicating the benefit of iron therapy in reducing symptoms. Five genetic variants have been linked to RLS, an important finding in a condition that is highly familial in early-onset cases. Numerous case reports and case series indicate benefit for moderate to severe pediatric RLS with medication. However, to date, there have been no double-blind, placebo-controlled studies of therapy for pediatric RLS published. These and other recent advances relevant to pediatric RLS research are reviewed.
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PMID:Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment. 2062 Jan 5

Restless legs syndrome (RLS) is a frequent sleep-related movement disorder with disturbed sleep and quality of life. RLS patients complain about increased daytime sleepiness, but there are only few and inconsistent reports about cognitive functioning in this group. We compared cognitive performance of 23 unmedicated RLS patients to that of 23 healthy controls matched individually for age, gender, and educational level. Cognitive tasks were chosen to assess short-term attention, working memory, learning and memory, verbal fluency, and executive functioning. RLS patients performed worse than controls in the area of attention and verbal fluency, and performance in these tasks was associated with RLS severity, sleep quality, depression scores, and memory. There was no difference for working memory, memory, learning, cognitive flexibility, and abstract reasoning. We conclude that there is evidence for deficits in short-term attention and verbal fluency in RLS patients.
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PMID:Short-term attention and verbal fluency is decreased in restless legs syndrome patients. 2083 34


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