Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The EMG interference pattern, built up of single motor unit action potentials, may be analyzed subjectively, or objectively by computer aided, quantitative methods, like counting of zero-crossings, counting of spikes, amplitude measurements, integration of the area under the curve, decomposition techniques, power spectrum analysis and turn/amplitude analysis. Since the shape of the interference pattern of healthy muscles is dependent on age, sex, force, muscle, temperature, fatigue, fitness level, recording site and surrounding tissue, electrode type, sensitivity, filters, sampling frequency and threshold level, all methods of analyzing the IP have to be standardized. Quantitative methods of analyzing the EMG interference pattern may be used for monitoring botulinum toxin therapy of dystonia and spasticity, quantifying spontaneous activity, assessment of chronic muscle pain, neuro-urological and proctological function, and diagnosing neuromuscular disorders. For diagnostic purposes, the methods favored are those that use needle electrodes and do not require measurement or monitoring of muscle force. The most well-evaluated methods are those using turn/amplitude analysis, like the cloud methods and the peak-ratio analysis. Peak-ratio analysis has the advantage that reference limits are easy to obtain and that its utility is well established and confirmed by several investigations. Overall, automatic methods of EMG interference pattern analysis are powerful tools for diagnostic and non-diagnostic purposes.
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PMID:EMG-interference pattern analysis. 1153 94

Sleep-related problems are common in Parkinson's disease (PD) and may occur due to the disease process, alteration in sleep architecture or nocturnal motor problems such as akinesia and dystonia. Neuropsychiatric problems and nocturia can also cause significant sleep disruption in PD. Poor sleep may lead to daytime consequences such as excessive daytime sleepiness or fatigue. As there are no PD-specific sleep scales, we have devised a simple visual analogue scale - the Parkinson's disease sleep scale (PDSS) which is aimed at formal quantification of various aspects of nocturnal sleep disturbance in PD. In this paper, we discuss the development of this scale, its clinical use and how the scale could be used to devise targeted treatment strategies for nocturnal problems in PD.
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PMID:Achieving 24-hour control of Parkinson's disease symptoms: use of objective measures to improve nocturnal disability. 1174 Oct 97

Muscle fatigue induced by a previous sustained contraction temporarily decreases the motor output, transiently worsening motor performance. Whether muscle fatigue alters motor performance also in dystonia-a disorder whose main pathophysiological abnormality is motor overflow-remains unknown. To assess the effects of muscle fatigue in patients with focal occupational upper limb dystonia, we studied the effect of a previous maximum fatiguing voluntary contraction on motor performance in 10 musicians with focal occupational dystonia, in 3 musicians with hand motor impairment due to non-dystonic disorders, and in 5 normal musicians. The fatiguing task consisted of grasping a spring handgrip as long as possible until the task failed. In dystonic musicians, a fatiguing contraction significantly improved motor performance. The improvement lasted less than 5 minutes and appeared only after fatigue of the affected upper limb. In contrast, in musicians with non-dystonic motor impairment, motor performance remained unchanged or worsened, and normal musician performance consistently worsened.
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PMID:Transient improvement induced by motor fatigue in focal occupational dystonia: the handgrip test. 1174 50

Direct intramuscular injection of doxorubicin results in permanent myofiber loss. A previous phase I trial demonstrated that such injections could successfully treat blepharospasm and hemifacial spasm. Our previous in vitro study demonstrated that doxorubicin resulted in a dose-dependent reduction in isometric force generation in sternocleidomastoid muscle in rabbits. This present study examined alterations in force generation in these treated muscles in situ, i.e., with the blood and nerve supply intact. Two months after a single doxorubicin injection, functional changes in peak twitch, tetanic force generation, and fatigue rate were assessed in control and doxorubicin-treated sternocleidomastoid muscles in rabbits. Peak force measurements were reduced in the treated muscles. These reductions in muscle strength were significantly greater at tetanic peak amplitudes. Fatigue rate was not altered by doxorubicin treatment of the sternocleidomastoid muscles. These findings support the potential clinical use of doxorubicin chemomyectomy for the treatment of patients with cervical dystonia.
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PMID:Muscle strength following direct injection of doxorubicin into rabbit sternocleidomastoid muscle in situ. 1199 69

Migraine is a chronic headache disorder manifesting in attacks lasting 4-72 hours. Characteristics of headache are unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity, and association with nausea, photophobia and phonophobia. The migraine aura is a complex of neurological symptoms, which occurs just before or at the onset of migraine headache. Botulinum toxin A represents a completely new option for patients with chronic pain conditions. Numerous retrospective open-label chart reviews and 4 double-blind, placebo-controlled studies have demonstrated that botulinum toxin type A is significantly effective in migraine prophylaxis and reduces the frequency, severity, and disability associated with migraine headaches. Studies have generally reported a good and consistent efficacy. The differential therapeutic use of botulinum toxin appears to be worth attempting in migraine patients with the following characteristic features: (1) Muscular stress as migraine trigger, e. g., in craniocervical dystonia, pericranial painful muscular trigger points or tender points, oromandibular dysfunction, (2) concurrent chronic tension-type headache with the aggravating factors of muscular stress or oromandibular dysfunction, (3) chronic migraine with frequent migraine attacks on more than 15 days per month for longer than 3 months and if other therapeutic options have been either ineffective or have not been tolerated. The use of the agent does not cause CNS side effects. Migraine patients in particular, often suffer greatly, as a result of the adverse effects of the drugs used, from fatigue, dizziness, reduced concentration, loss of appetite, weight gain, hair loss and changes in libido. These side effects are not known in association with botulinum toxin A. To date, neither organic damage nor allergic complications have been reported. Thus, both the tolerability and the safety of this therapeutic measure are high. The mode of action by which botulinum toxin is effective in migraine prophylaxis is not fully understood and is under investigation. Currently, a number of other randomized, placebo-controlled, clinical trials are being conducted to evaluate the efficacy, optimal dosing, and side-effect profile of botulinum toxin type A in the prophylaxis of migraine and other headache entities.
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PMID:Botulinum toxin in migraine prophylaxis. 1499 36

Familial paroxysmal nonkinesigenic dyskinesia (Mount and Reback syndrome) is characterized by episodes of dystonia and chorea, which are precipitated by fatigue, emotional stress, alcohol, or foods. We report two children from a large kindred with this condition who responded to sublingual lorazepam.
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PMID:Sublingual lorazepam in the treatment of familial paroxysmal nonkinesigenic dyskinesia. 1516 43

We report on two sisters with a childhood-onset form of predominantly axial dystonia with marked diurnal fluctuations. Onset of clinical features was at approximately 6 years of age. Associated features included marked fatigue, slight facial dysmorphism, short stature, obesity, and learning disability*. Dystonia and fatigue responded to 3,4-dihydroxyphenylalanine (DOPA) therapy, with recurrence of symptoms upon withdrawal; the efficacy has been maintained over 7 years. Other symptoms were not influenced. There was no other case in the family (which included an older, healthy brother), except for non-specific fatigue without dystonia in the mother, and there was no significant family history except for obesity on the father's side. These observations are discussed in relation to the classical descriptions of Segawa syndrome, and to more recent reports of childhood onset, age-related, and transient benign paroxysmal tonic upgaze and ataxia. The combination of symptoms, their sensitivity to DOPA, and their persistence throughout childhood constitute, to our knowledge, a new clinical entity, which we propose to categorize as a DOPA-sensitive dystonia-plus syndrome.
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PMID:DOPA-sensitive dystonia-plus syndrome. 1573 26

The analysis of event-related desynchronization (ERD) and event-related synchronization (ERS) provides information on the dynamics of cortical activation during cognitive and motor tasks and has been applied in a variety of neurological and psychiatric disorders. In this chapter, we focus on studies concerning movement-related activity, which showed changes in amount, topography, or time course in relation to not only involvement of the motor system--such as Parkinson's disease (PD), dystonia, and stroke affecting the sensorimotor (SM) pathways--but also physiological aging, degenerative dementia, obsessive-compulsive disorder (OCD), and fatigue associated with multiple sclerosis (MS). In these disorders, the extent of abnormality in the pattern of ERD/ERS is related to the severity of the underlying pathology. Moreover in MS, a correlation with the severity of brain tissue has been found. While there is consistency in changes related to ipokinetic disorders, mainly consisting of delayed appearance of ERD to movement preparation, changes occurring in other brain disorders need to be replicated or raise doubts on the specificity of changes across different diseases. Further studies are needed in order to validate the usefulness of this methodology in the assessment of the single patient for diagnosis and monitoring of the natural course of the disease and of treatment efficacy.
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PMID:Movement-related event-related desynchronization in neuropsychiatric disorders. 1707 Dec 42

The frequency of symptomatic dystonia in relatives of patients with idiopathic focal dystonia (IFD) is higher than expected from epidemiologic studies implying that genetic factors may be involved. Perception of the vibration-induced illusion of movement (VIIM) is subnormal in patients with IFD compared with healthy volunteers and the abnormality corrects with volitional fatigue of the vibrated arm. The aim of the study was to establish the heritability of the abnormality of VIIM. The perception of illusion of movement elicited by vibration of the biceps brachii tendon before and after fatigue of the muscles was investigated in 30 patients with torticollis, 57 of their first degree relatives, and 19 healthy volunteers. VIIM did not change after fatigue in healthy controls. Before fatiguing the muscles, patients' perception of VIIM was less than healthy controls, (P < 0.01, unpaired t-test). After fatigue, the illusion of movement perceived by patients increased, so that it did not differ any more from that of the healthy control subjects (P < 0.05, repeated measures ANOVA). First degree relatives' response to vibration varied; 45% of parents, 60.7% of siblings, and 63.6% of children had an "abnormal" response to vibration compared with 21% of healthy volunteers. In contrast to patients' response, the "abnormality" did not correct after volitional fatigue of the vibrated arm. The results suggest that abnormal VIIM may represent an endophenotypic marker for IFD, which interacts with other factors including central motor learning and compensation mechanisms in the expression of the dystonic phenotype.
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PMID:Abnormal vibration-induced illusion of movement in idiopathic focal dystonia: an endophenotypic marker? 1804 15

Paroxysmal non-kinesigenic dyskinesia (PNKD) is a clinical syndrome of sudden involuntary movements, mostly of dystonic type, which may be triggered by alcohol or coffee intake, stress and fatigue. The attacks of PNKD may consist of various combinations of dystonia, chorea, athetosis and balism. They can be partial and unilateral, but mostly the hyperkinetic movements are bilateral and generalized. We present a large Polish family with 7 symptomatic members of the family in 6 generations. In all affected persons, the onset of clinical symptoms was in early childhood. All male cases showed an increase in severity and frequency of the attacks with ageing, while the only living female patient noticed an improvement of PNKD during both her pregnancies and also after menopause. In addition, at the age of 55 years, she developed symptoms of Parkinson's disease with good response to levodopa treatment.
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PMID:Paroxysmal non-kinesigenic dyskinesia caused by the mutation of MR-1 in a large Polish kindred. 1894 99


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