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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

74 inpatients and outpatients (mean age 71.9 years) with idiopathic Parkinson's disease, a vascular pseudo-parkinsonian syndrome or a Parkinson-associated dementia were analysed by present-state clinical rating with regard to use and needs of physical and speech therapy. 55% of the patients had physical therapy whatsoever, 32% of them on a daily schedule. 58% of patients without everyday physical therapy indicated to do less physical therapy than one year ago or that they have quite any exercise. This item showed significant correlations with: age of disease onset over 70 years, Hoehn-Yahr stage of 3 and over, activities of daily living according to Schwab-England of less than 60%, diagnosis of vascular pseudoparkinsonian syndrome or Parkinson-associated dementia, more frequent use of community support services for the ambulatory elderly. Only 8% of the patients had ever had speech therapy. Using both ratings of complaints and clinical findings, about 30% of patients had moderate to severe impairment of speech, 80% of these had also considerable memory disturbances. The study suggests that the need for physical therapy might be derived more from patient's assessment of reduced daytime motor activities than from a scaled item rating of an external observer. Use and continuity of physical and speech therapy in Parkinsonism seems to be limited largely by cognitive disturbances and social variables. Speech therapy appears to be useful only for a subgroup of Parkinsonian patients.
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PMID:[Physical therapy and speech therapy in Parkinson syndrome--a status assessment]. 142 53

We examined the abilities of 15 patients with dementia of the Alzheimer type (DAT), 22 patients with Parkinson's Disease (PD), and 141 healthy subjects (ranging in age from 30 to 79 years) to detect and correct their own speech errors. Each subject was shown the Cookie Theft picture of the BDAE (Goodglass & Kaplan, 1972. The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger.) and instructed to tell the examiner the "...story of what's happening in the picture." Self-monitoring performance was assessed by tabulating the number of uncorrected errors as well as repaired errors. We divided repairs into two types based on the psycholinguistics literature (van Wijk & Kempen, 1987. Cognitive Psychology, 19, 403-440). Speech corrections were judged to be lemma repairs when the reparandum was a single word, and reformulation repairs when a new syntactic constituent was added to the reparandum. Patients with DAT corrected only 24% of their total errors and patients with PD only 25%. Healthy subjects, by contrast, corrected from 72 to 92% of their total errors. Patients with DAT tended to rely on reformulation repairs while patients with PD used both repair types about equally often. While healthy elderly Ss (in the 70s group) utilized lemma repairs more often than the reformulation strategy, all other healthy Ss used both strategies about equally often. Across all groups naming performance correlated negatively with numbers of undetected errors. Results point to a previously unrecognized communication disorder associated with PD and DAT and manifested by an impairment in the ability to correct output errors. This impairment may be related to attentional and frontal dysfunction in the two patient groups.
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PMID:Speech monitoring skills in Alzheimer's disease, Parkinson's disease, and normal aging. 154 68

The apolipoprotein E gene (Apo E) type 4 allele is a genetic risk factor influencing the development and age of onset of Alzheimer's disease. Because Parkinson's disease shares many characteristics of Alzheimer's disease, we studied the frequencies of Apo E genotypes in a cohort of 52 Parkinson's disease patients with dementia and 61 patients without dementia. Dementia was determined per National Institute of Neurological and Communicative Disorders and Stroke criteria and Mattis Dementia Rating Scale (DRS) < 126. Normal cognition was defined as DRS > 132. Apo E genotype and allele frequencies did not differ between demented and nondemented parkinsonian patients. Neither group's genotype and allele frequencies differed from that of a nondemented population of 78 controls. We conclude that the Apo E epsilon 4 allele influences neither the development of Parkinson's disease nor the dementia associated with Parkinson's disease.
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PMID:Apolipoprotein E genotypes in Parkinson's disease with and without dementia. 784 65

The relationship between extrapyramidal sign (EPS) severity and cognitive function was investigated in 184 patients with idiopathic Parkinson's disease (PD) and 301 normal elderly individuals from a community-dwelling cohort in northern Manhattan, New York City. Fifty-six of the patients with PD met criteria for dementia of the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised, and of the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association. EPS were rated according to the Unified Parkinson's Disease Rating Scale. Cognitive function was assessed by neuropsychological tests of memory, orientation, abstract reasoning, language, construction, and psychomotor speed. Significant associations were found between EPS and neuropsychological performance in PD patients without dementia. Yet EPS severity was unable to account for the pronounced cognitive impairment in PD dementia. Individuals in the normal group with subtle EPS, but without overt idiopathic PD, showed widespread cognitive changes, including impairment in most of the tests that differentiated PD patients from normal subjects. Prospective follow-up of these individuals will determine whether this represents a preclinical stage of PD or constitutes an early manifestation of dementia.
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PMID:Relationships between extrapyramidal signs and cognitive function in a community-dwelling cohort of patients with Parkinson's disease and normal elderly individuals. 849 10

Physical measures as adjuvant therapy in Parkinson's disease have so far received insufficient investigation from the viewpoint of either their clinical effectiveness or of their theoretical rationale, although they are widely prescribed in practice and contribute a substantial cost factor to the overall treatment. Most attention has been devoted to movement therapy, which may admittedly only achieve minor improvements in motor performance but contributes substantially to subjective improvement of the well-being of the patients and to the maintenance of their physiological functions. Speech therapy seems to be effective only for patients who are highly motivated and have not suffered any psychological deficits and who continue exercising on their own. Massage, ergonomic treatment approaches and the nowadays fashionable area of various relaxation techniques have received very little attention. Our own trials with vibro-massage (swing-exbusar) for the loosening of muscular rigidity have led to no sustained improvement, and our attempts to improve speech defects in Parkinsonian patients by the application of laser acupuncture have likewise not resulted in improvement.
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PMID:The current significance of physiotherapeutic measures in the treatment of Parkinson's disease. 882 Oct 81

Parkinson's disease is not only a disorder affecting locomotion, but often also causes speech problems. Functional impairment of articulation, phonation, prosody and also respiration may occur. Speech disorder is frequent in Parkinson's disease and often has an impact on the quality of life. Speech therapy is by no means offered as a matter of course to these patients. This article outlines the different approaches of speech therapy regarding respiration, loudness, articulation, prosody, and intonation. Speech therapy seems to be useful in patients with Parkinson's disease only if there is no cognitive impairment; success also depends on motivation and eventual frequent repetition of therapy series.
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PMID:[Speech disorders in Parkinson patients]. 961 59

The Neurological Information Network (NIN) of the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) was a loosely structured assemblage of a variety of information-transfer activities that existed for approximately 20 years, starting in the early 1960s. These activities included the Neurosciences Research Program at the Massachusetts Institute of Technology, the Parkinson's Disease Information Center at Columbia University, the Brain Information Service at UCLA, the Information Center for Hearing, Speech, and Disorders of Human Communication at the Johns Hopkins Medical Institutions, the Clinical Neurology Information Center at the University of Nebraska, the Cerebrovascular Disease Abstracts generated at the Mayo Foundation and appearing in the journal Stroke, and Epilepsy Abstracts published by Excerpta Medica. The article discusses primarily the sociopolitical factors that govern the creation and life of activities of the type enumerated.
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PMID:The Neurological Information Network. 1028 Sep 18

Few studies were made on the intrinsic and co-intrinsic vowel characteristics in neurologic dysarthrias. This work evaluates these parameters in a group of 4 subjects with cerebellar dysarthria suffering from a cerebellar degenerative syndrome and a group of 4 subjects with Parkinson disease suffering from parkinsonian dysarthria. These subjects were compared with 10 control subjects. An intensive speech treatment inspired from the Lee Silverman voice treatment (LSVT) was applied to one of the parkinsonian subjects of the study, with assessment before and after rehabilitation. The acoustic measures assessed the duration and the frequency of the vowels [a, i, ul indifferent contexts as well as their formant frequency and sentence duration. The results show different impairments according to the type of the dysarthria, and some forms of contrast transposition. Speech therapy restores subnormal contrasts.
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PMID:[Intrinsic and co-intrinsic vowel characteristics in cerebellar and parkinsonian dysarthrias]. 1277 65

This article will review types of perseveration from a neurolinguistic perspective. During the course of the article, continuous, stuck-in-set, and recurrent perseveration will be placed in contradistinction to several other types of repetitive behaviors commonly associated with neurogenic communication disorders. These include echolalia in mixed transcortical aphasia; conduite d'approche and conduite d'ecart in fluent aphasias; lexical and nonlexical automatisms in nonfluent aphasias; palilalia in neuromotor disorders, such as Parkinson's disease (PD); and sound, syllable, word, and phrase repetitions in neurogenic stuttering. When differentiating these phenomena from perseveration, it is helpful to consider the salient factors that condition observed behaviors in individual patients, such as overall speech fluency, inventory of available utterances, nature of eliciting tasks, and propositionality of responses. Information such as communication disorder diagnosis, underlying etiology, and known sites of lesion from each patient's total clinical profile may also assist with differentiation.
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PMID:Perseveration and other repetitive verbal behaviors: functional dissociations. 1559 20

This paper presents recommendations deriving from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, concerning the clinical diagnosis of dementia. There are currently no universally accepted biological or radiological markers of dementia. In the absence of these, the diagnosis of dementia remains a clinical exercise aiming to integrate all available clinical and laboratory information. It is proposed that the currently used National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRA) criteria for diagnosis of Alzheimer's disease (AD) be retained. The currently available vascular dementia (VaD) diagnostic criteria have variable accuracy. An integrative approach to VaD diagnosis based on all the available evidence (history, vascular risk factors, physical exam, clinical course, neuroimaging, cognitive impairment pattern) is recommended. The separation of Lewy body dementia (DLB) from Parkinson's disease dementia (PDD) is based on the dominant clinical presenting feature of each syndrome, and relies on the duration of this feature: long duration of parkinsonian "motor" syndrome preceding dementia for PDD versus early/initial dementia accompanied by extrapyramidal symptoms for DLB. It is recognized that it is impossible clinically to characterize DLB with (pathologically) coexisting AD changes. The Frontotemporal group of dementia syndromes are discussed in regards to their typical clinical pictures, recognizing that their neuropathological substrate are not predictable from their mode of presentation. Finally, the particular rapid time sequence of evolution of the dementias due to prior disease is recognized as the clinically most useful distinguishing feature of these syndromes.
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PMID:Clinical diagnosis of dementia. 1959 50


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