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)

To control frequency, urgency and urge incontinence, transcutaneous electrical stimulation was applied to the tibial nerve, the pudendal nerve or the anal sphincter in 79 patients. All patients were refractory to any medications for the control of frequency, nocturia, urgency and urge incontinence from a variety of causes including disk protrusion, Parkinson's disease and idiopathic conditions. The parameters of stimulation were 0.1 to 0.5 msec. duration for each stimulus, frequency 10 to 40 Hz, amplitude 5 to 500 voltage. Cystometrography was repeated during and after electrical stimulation and showed increased bladder capacity, measured at first and/or at maximum desire to void, increased compliance, decreased bladder pressure and/or disappearance of uninhibited contractions in 79% of the patients examined. At least one of these changes was observed in 64, 72 and 85% of the patients who underwent stimulation of the tibial nerve, the pudendal nerve and the anal sphincter, respectively. In some patients inhibition of bladder contraction persisted for more than 2 or 3 days after stimulation. Electromyographic activity of the pelvic floor muscles increased in all of the patients during the stimulation of the pudendal nerve or the anal sphincter, but did not increase and rather decreased during stimulation of the tibial nerve. Urethral pressure measured during electrical stimulation, did not change in many cases. Clinical success was also obtained in 19 of 22 patients who underwent two electrical stimulation program; one was continuous daily use of a portable stimulator, and the other was periodic anal stimulation once or twice a week.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transcutaneous electrical stimulation for the control of frequency and urge incontinence]. 661 Feb 98

Patients with Parkinson's disease (PD) are known to experience autonomic nervous system dysfunction: this disruptive symptomatology includes urinary urgency, frequency, and nocturnal polyuria. Anticholinergic and tricyclic medications can be beneficial in controlling these urinary symptoms, but have unpleasant side effects in some patients. Desmopressin has been used to treat nocturnal polyuria successfully in a number of conditions, such as central diabetes insipidus, enuresis, and autonomic failure. The purpose of the present study was to assess the efficacy of desmopressin in patients with PD with significant nocturia. Eight patients were recruited into the study. They were first asked to establish a baseline of number of nocturnal voids; the patients were then prescribed the intranasal form of desmopressin and asked to continue to record the number of nocturnal voids. The five patients who completed the trial demonstrated clinically and statistically significant reductions in the frequency of nocturnal voids. One patient became hyponatremic and confused during desmopressin administration; his symptoms resolved soon after the desmopressin was discontinued. Two patients failed to complete the trial due to compliance problems. Thus, desmopressin appears to be a safe and effective medication for nocturnal polyuria in PD.
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PMID:Beneficial effect of intranasal desmopressin for nocturnal polyuria in Parkinson's disease. 765 53

The objective of this questionnaire-based survey was to evaluate the prevalence and causes of sleep disturbances in 90 nondepressive patients with Parkinson's disease (PD) and 71 age-matched healthy subjects. We also assessed the prevalence and characteristics of excessive daytime sleepiness (both groups) and excessive fatigue (PD patients). A high prevalence of sleep disturbances in PD patients was found; this is to a large extent probably the result of aging. As compared with controls, patients had a more severely disturbed sleep maintenance because of nycturia, pain, stiffness, and problems with turning in bed. The prevalence of excessive dreaming is similar in both groups, but altered dream experiences almost exclusively occurred in PD. Patients rated themselves more often to be morning-types than controls. This finding may account for the reported adaptation effects in experimental settings and the reduced REM latency in PD patients. The prevalence of daytime sleepiness was similar in both groups. Excessive daytime sleepiness showed a clear diurnal pattern with a peak in the early afternoon. As for excessive fatigue, the majority of the patients did not report a preferential time for this symptom. Our findings further argue against an association of fatigue with any circadian factor, and instead suggest a relationship with the motor deficits of PD.
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PMID:Sleep, excessive daytime sleepiness and fatigue in Parkinson's disease. 836 3

Sleep disorders occur in 74-98% of patients with idiopathic Parkinson's disease (PD), adversely affecting their quality of life. Sleep disruption takes the form of sleep fragmentation with frequent and prolonged awakenings and daytime sleepiness. Nocturia, difficulty in turning over in bed, painful leg cramps, vivid dreams/nightmares, back pain, limb/facial dystonia and leg jerks are the main causes of nocturnal awakening in PD patients. Sleep disturbance gradually worsens with disease progression, suggesting that it is related to the severity of the disease. Sleep disturbances may be generally considered as part of the normal aging process, being more common in the elderly. However, no significant associations between sleep disturbances and either age or disease duration was found in a survey of 100 PD patients. Disturbed sleep maintenance in PD patients was more severe than in age-matched controls, and nocturnal awakening was frequently caused by nocturia, pain, stiffness and difficulty in turning over in bed. Sleep disturbance is also a complication of chronic levodopa therapy. Recent data suggest that controlled-release levodopa is less likely to cause nocturnal symptoms than standard levodopa, particularly in mild-to-moderate disease. Depression, which is common in PD patients, contributes to sleep disturbance but has a lesser influence than the disease process itself. Hypnotic and sedative agents, as well as anti-depressants if required, are useful in ameliorating sleep disturbances in PD patients; intranasal desmopressin appears to be effective in reducing nocturia.
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PMID:Sleep disorder related to Parkinson's disease. 911 82

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

The quality of life of people with Parkinson's disease (PD) and their carers is often made worse by impaired sleep. Sleep problems are common in PD and there are several causative factors in their aetiology including the ageing process, anti-Parkinson's disease medication, the disease process itself, and concomitant factors such as nocturia, anxiety and immobility. Non-pharmacological approaches are the most desirable method to treat sleep-related problems. The nurse can have an important role in assessing sleep, providing support, offering practical advice, and making appropriate referrals. This article will discuss the various sleep problems experienced in PD, the underlying aetiology, and the role of the nurse.
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PMID:Sleep disorders in Parkinson's disease: the nursing role. 1217 Apr 84

Disorders of sleep and daytime alertness are frequent in Parkinson's disease patients and arise from a number of diverse factors. The most common complaint of night-time sleep disturbance in Parkinson's disease is sleep fragmentation. Sleep fragmentation can be associated with recurrent parkinsonian symptoms, the effect of medications, concomitant medical disorders such as nocturia, or psychiatric disorders such as depression or anxiety. Likewise, nocturnal sleep disturbance may arise from sleep apnea, periodic limb movements of sleep, or rapid eye movement (REM) sleep behavior disorder. Nocturnal sleep deprivation may lead to excessive daytime sleepiness. Other potential sources of daytime sleepiness include the effects of medications or disruption of central sleep mechanisms due to the pathologic processes of Parkinson's disease itself. Diagnosis of sleep disturbances and daytime sleepiness requires a direct interview of the patient and the caregiver, and may involve consultation with the sleep specialist or medical physician. Treatment is aimed toward improving night-time sleep and daytime drowsiness by addressing the causative factors.
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PMID:Sleep disturbances in Parkinson's disease. 1258 48

The authors present a cross-sectional study involving 61 patients with idiopathic Parkinson's disease (PD) who were consecutively examined and compared to a control group with 74 subjects. Only patients who fulfilled the standard diagnostic criteria for PD and whose brain magnetic resonance imaging was normal were included. The objective of the study was to evaluate the prevalence of inferior urinary tract symptoms in PD and to study the possible association between clinical factors to urinary dysfunction. ln the patient group, 39.3% presented urinary symptoms when compared to 10.8% in the control group. All symptomatic patients presented irritative symptoms. The most common irritative symptom PD was nocturia, followed by frequency and urinary incontinence. Around 25% of the patients presented functional obstructive symptoms determined by the disease. The most frequent obstructive symptom was incomplete emptying of the bladder. Only the age of the patients and control group were correlated with urinary dysfunction.
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PMID:Urinary symptoms in Parkinson's disease: prevalence and associated factors. 1289 67

Most Parkinson's patients complain about sleep problems. The subjective effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on nocturnal disabilities and sleep quality was elucidated by the recently established Parkinson's disease sleep scale (PDSS). The DBS-treated group obtained significant improvement of motor function assessed by the Unified Parkinson's Disease Rating Scale. The mean total PDSS improved significantly after surgery whereas no change was found for the control group. Significant improvements of individual questions were obtained for overall sleep quality and motor symptoms whereas nocturia and daytime sleepiness did not change despite significant reduction of parkinsonian medication.
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PMID:Improvement of sleep quality in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nucleus. 1497 76

We started the subject screening from over 400 patients with Parkinson's disease using strict selection criteria to identify the patients with nocturia who would allow accurate and efficient evaluation of the pergolide effects. The subjects were confined to female patients to exclude patients with potential prostate hypertrophy. The patients treated with bromocriptine at 7.5-15 mg/day adjunctive to l-dopa were selected to replace bromocriptine with pergolide of the equivalent dosage approved in Japan. The nocturia was defined as having more than two episodes of urination during sleep per night on average. The subjects received the urinary sediment test before and during the study for screening urinary tract infection and the study was discontinued when urinary tract infection was found. As a result, we identified total 11 patients with nocturia and three of those completed the 12-week study of switching dopamine agonist from bromocriptine to pergolide. We observed a decrease in nocturia frequency in all three patients, a decrease in irritative urinary symptoms in two and an improvement of sleep QOL in two. The effect of pergolide on nocturia was independent of improvement of parkinsonian symptoms, suggesting a distinct mechanism from that of anti-parkinsonian effects. Our study also suggests that switching from bromocriptine to pergolide improves nocturia, thereby improving sleep status of patients with Parkinson's disease.
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PMID:Effects of pergolide on nocturia in Parkinson's disease: three female cases selected from over 400 patients. 1503 75


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