Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

198 patients with Parkinson's disease on long-term treatment with L-dopa were evaluated for the presence of dyskinesias and psychiatric side-effects of the treatment. Dyskinesias were present in 53% of the patients. In a majority of them they appeared already during the first 2 years of the treatment. Younger patients seemed more susceptible to develop dyskinesias. Hallucinations, confusion, or delusions were observed in 22.2% of the patients. Older patients seemed more susceptible to develop these side-effects of the treatment. It seems that parkinsonian patients with later and earlier onset of the disease have different type of neuronal lesion responsible for the central side-effects of L-dopa.
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PMID:[Central side effects of long-term treatment of Parkinson disease with levodopa preparations]. 180 54

Ninety-four patients with early Parkinson's disease were investigated in a double-blind, placebo-controlled evaluation of MK-458 [hydroxypropyl methylcellulose/lactose matrix (HPMC)], a sustained release formulation of a novel naphthoxazine compound with selective D-2 dopamine receptor agonism. Patients were previously untreated with dopaminergic drugs. Efficacy was assessed by clinical rating scales and by patient self-evaluation. MK-458 (HPMC) caused a significant decrease in most parkinsonian symptoms. Though disability rating scores were lowered by the drug, the scores did not differ significantly from placebo. However, statistically significant improvement occurred with MK-458 (HPMC) on both the physician and the patient global assessments. Adverse reactions such as nausea and vomiting, sedation, confusion, and hallucinations occurred more with MK-458 (HPMC) than with placebo. MK-458 (HPMC) possesses antiparkinsonian efficacy in early Parkinson's disease; however, side-effects are frequently associated with its use. Selective D-2 receptor agonists, such as MK-458 (HPMC), may not be the ideal treatment as monotherapy for Parkinson's disease.
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PMID:Effect of MK-458 (HPMC) in Parkinson's disease previously untreated with dopaminergic drugs. A double-blind, placebo-controlled multicenter study. 191 99

A dementing syndrome has been identified in a group of psychiatric cases aged 71-90 years, presenting initially with a subacute/acute confusional state, often fluctuating and associated with visual hallucinations and behavioural disturbances. Clinically, these cases did not meet criteria for a diagnosis of Alzheimer's disease, and many were assigned to the multiinfarct dementia group, although no significant ischaemic lesions were evident at autopsy. Mild extrapyramidal features were apparent in a number of cases but the characteristic clinical triad of Parkinson's disease, i.e., tremor, rigidity, and akinesia, was absent. Detailed neuropathological examination revealed Lewy body formation and selective neuronal loss in brain stem and other subcortical nuclei, accompanied by Lewy body formation in neo- and limbic cortex, at densities well below those previously reported in diffuse Lewy body disease. A variable degree of senile degenerative change was present; numerous senile plaques and minimal neurofibrillary tangles in most cases. Neither the clinical nor the neuropathological features of this group are typical of Parkinson's or Alzheimer's disease, but suggest a distinct neurodegenerative disorder, part of the Lewy body disease spectrum, in which mental symptoms predominate over motor disabilities and lead to eventual psychogeriatric hospital admission. In a sequential series of autopsies conducted on clinically assessed demented patients, neuropathological analysis has indicated that such cases may comprise up to 20% of a hospitalized population of demented old people over the age of 70 years, an observation clearly relevant to the diagnosis and management of dementia in the elderly.
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PMID:Senile dementia of Lewy body type. A clinically and neuropathologically distinct form of Lewy body dementia in the elderly. 215 23

Analyses of brain tissue in a recently identified group of elderly demented patients suggest a neurochemical basis for some of the clinical features. Senile dementia of the Lewy body type (SDLT) can be distinguished from classical Alzheimer disease (AD) clinically by its acute presentation with confusion frequently accompanied by visual hallucinations, and neuropathologically by the presence of Lewy bodies and senile plaques (but not generally neurofibrillary tangles) in the cerebral cortex. Reductions in the cortical cholinergic enzyme choline acetyltransferase were more pronounced in individuals with (80%) compared to those without (50%) hallucinations and correlated strongly with mental test scores in the group as a whole. In the caudate nucleus, dopamine levels were related to the number of neurons in the substantia nigra, there being a 40-60% loss of both in SDLT--probably accounting for mild extrapyramidal features in some of these cases--compared with an 80% loss in Parkinson disease and no change in AD. The cholinergic correlates of mental impairment in SDLT together with the relative absence of cortical neurofibrillary tangles and evidence for postsynaptic cholinergic receptor compensation raise the question of whether this type of dementia may be more amenable to cholinotherapy than classical AD.
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PMID:Cholinergic and dopaminergic activities in senile dementia of Lewy body type. 235 41

Four cases of Parkinson's disease with advanced dementia are described. Postmortem examination revealed cell loss in the substantia nigra, with Lewy bodies present, and loss of cells in the basal nucleus of Meynert. A few tangles were observed in the hippocampus, but no senile plaques or neurofibrillary tangles were found in the neocortex. The authors note that a dramatic dementia syndrome may occur with Parkinson's disease alone, without the associated cytoskeletal markers of Alzheimer's disease. Cases were characterized by disorientation, episodic confusion and hallucinations persisting off medication, disturbed behavior, and the absence of aphasia.
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PMID:Dementia in Parkinson's disease: the problem of clinicopathological correlation. 213 56

Practically all drugs administered in large amounts can give rise to neurologic symptoms such as drowsiness, insomnia, confusion, seizures or coma and extrapyramidal disorders. In this study, five classes of agents are reviewed: antipsychotic drugs, drugs for Parkinson's disease, antiepileptic drugs, calcium antagonists and salts of bismuth.
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PMID:[Various encephalopathies caused by drugs]. 256 72

The dopamine agonist, CQP 201-403, was administered to 10 patients in an open label fashion with rapid dosage escalation during hospitalization. Assessed over an average of 20 days, significant improvement occurred in bradykinesia, rigidity, and postural instability. Tremor did not occur in sufficient frequency in this group of patients to be accurately assessed. The most serious adverse effect encountered was prolonged confusion with psychosis. This study suggests that CQP 201-403 may be of value in the treatment of Parkinson's disease.
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PMID:CQP 201-403 in Parkinson's disease: an open-label pilot study. 257 Oct 83

After a number of good years, most patients with Parkinson's disease are faced with various problems. Some of these are due to the progress of the underlying anatomico-biochemical process and others to interference of the disease with dopatherapy. Motor impairment takes multiple aspects: disturbances of equilibrium and gait, akinesia with unusual presentation, involuntary movements, fluctuations of the motor status. Mental disorders may appear as depressive syndrome, mental confusion and/or varying degrees of intellectual alterations. Despite these disorders, the treatments that are currently available give these patients a normal life expectancy.
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PMID:[Development of Parkinson's disease]. 272 72

The systematic study of cognitive functions in parkinsonian patients has demonstrated specific disturbances of memory, visuo-spatial function and frontal lobe activity. Global impairment of intellectual functions is less common (it occurs in 15 to 20 percent of the cases) and is observed mainly in elderly patients. Dementia differs in its neuropsychological set up from that of Alzheimer's disease. The most frequent psychiatric disorders are depressive state, signs of anxiety and side-effects of drugs, including visual hallucinations and confusion. This means that some of these drugs (e.g. anticholinergics, dopaminergic agonists) should be prescribed with extreme caution in elderly people and in those who show signs of intellectual degradation. The mental disorders of Parkinson's disease are of interest because of their frequency and pathogenesis: the principal lesions of the disease are located in subcortical structures, which calls for elucidation of the role played by these structures in the organization of affective and cognitive behaviours. For this reason, Parkinson's disease is a very good model for the study of such interactions.
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PMID:[The mental state of parkinsonian patients]. 272 73

Pergolide is a potent dopamine agonist and is known to have anti-Parkinson properties. We administered pergolide to patients with suboptimal control of Parkinson's disease who had a short-duration response to carbidopa-levodopa in a 6-month, double-blind study. Pergolide added to the carbidopa-levodopa regimen resulted in both subjective and objective improvement in comparison with placebo. In patients who tolerated pergolide, the median time spent in the "off" (parkinsonian) state was reduced from 5.0 to 2.2 hours daily (compared with a 0.3-hour reduction in the placebo group). These patients were able to decrease the median frequency of carbidopa-levodopa dosage from 7.5 to 5.0 doses daily (no change in the placebo group). Prolongation of the "on" response (optimal response to treatment) to single doses of drugs was corroborated by monitoring of the patients' Parkinson response cycle. The peak response was also improved in most patients. Of 25 patients randomized to the pergolide group, 7 were unable to tolerate this drug; confusion or hallucinations occurred in 4 of these patients, and chest pain, leukopenia, and nonspecific dizziness, respectively, developed in the other 3. All adverse events were reversible with reduction of the dose or discontinuation of the pergolide regimen. In conclusion, patients with Parkinson's disease who experience clinical fluctuations with carbidopa-levodopa may be helped by the addition of pergolide to the therapeutic regimen.
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PMID:Treatment of Parkinson's disease with pergolide: a double-blind study. 305 Mar


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