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)

The advent of functional imaging methods has increased our understanding of the neural control of the bladder. This review examines current concepts of the role of brain function in urinary control with particular emphasis on the putative role of dopamine receptors. Dopaminergic mechanisms play a profound role in normal bladder control and the dysfunction of these may result in symptoms of overactive bladder in Parkinsonism. The importance of this nonmotor disorder has been overlooked. We address the problem of bladder dysfunction as it presents to patients and their neurologist. The prevalence of bladder symptoms in Parkinson's disease is high; the most common complaint is nocturia followed by frequency and urgency. In multiple-system atrophy, the combination of urge and urge incontinence and poor emptying may result in a complex combination of complaints. The management of bladder dysfunction in Parkinsonism addresses treatment of overactive detrusor as well as incontinence.
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PMID:Bladder dysfunction in Parkinsonism: mechanisms, prevalence, symptoms, and management. 1657 Feb 99

The aim of this research was to quantify sleep problems in patients suffering from Parkinson's disease by means of the new Parkinson's Disease Sleep Scale (PDSS) and to correlate such problems with the possible influence of current drug treatment. A total of 70 patients (36 men and 34 women) with a diagnosis of Parkinson's disease were enrolled. Their mean age was 69.7 +/- 8.2 years, and duration of disease was 7.4 +/- 4.8 years. All patients completed the PDSS and the Unified Parkinson's Disease Rating Scale (UPDRS Parts I-IV). Drug consumption and doses were registered. The mean score on the PDSS scale was 109.23 +/- 19.75 and on the UPDRS III scale was 25.24 +/- 11.35. The lowest scores were obtained in Item 3 (sleep fragmentation): 5.53 (2.46); and in Item 8 (nocturia): 5.75 (2.91). There was a weak correlation between the PDSS and UPDRS III (cc = -0.355, P = 0.003), PDSS and UPDRS I (cc = -0.272, P = 0.02), and PDSS and UPDRS IV (cc = -0.416, P < 0.001). Motor conditions, mental state, and drug complications influence sleep quality. Although this effect was significant, it was not of a great magnitude. Dopaminergic drugs did not increase daytime sleepiness. As a whole, sleep quality in patients who took dopaminergic agonists did not differ from that of patients who took levodopa in monotherapy.
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PMID:Sleep complaints and their relation with drug treatment in patients suffering from Parkinson's disease. 1660 12

In this study we have explored the nature and range of sleep dysfunction that occurs in untreated Parkinson's disease (PD) comparing data obtained from the use of the Parkinson's disease sleep scale (PDSS) in an untreated PD patient group compared to advanced PD and healthy controls. 25 untreated (drug-naive, DNPD) PD patients (mean age 66.9 years, range 53-80, 18 males) completed the validated Parkinson's disease sleep scale (PDSS), mean duration of PD was 2.1 years (1-10, up to 4 years in all except one patient with tremulous PD reporting tremor duration of 10 years) and mean Hoehn and Yahr score 1.9 (1-3). Data were compared to 34 advanced PD (mean age 70.2 years, range 51-88, 23 male), mean duration of PD 11 years (range 4-22), mean Hoehn and Yahr score 3.4 (3-5) and PDSS data obtained from 131 healthy controls (mean age 66.6 years, range 50-93, 56 males). Total PDSS scores and PDSS sub-items, except PDSS item 2, were highly significantly different (p<0.001) between DNPD, advanced PD and controls. Controls reported higher mean PDSS scores than both groups of patients, and advanced cases reported lower (mean+/-S.D.) PDSS scores (86.95+/-20.78) than drug-naive (105.72+/-21.5) (p<0.001). Logistic regression analysis showed that items PDSS8 (nocturia), PDSS11 (cramps), PDSS12 (dystonia), PDSS13 (tremor), and PDSS15 (daytime somnolence) were significantly impaired in DNPD compared to controls while PDSS7 (nighttime hallucinations) additionally separated advanced PD from DNPD. In a subgroup of 11 advanced PD cases (mean age 62 years, range=49-84 years, mean Hoehn and Yahr score 2.5, range=1-3) with high Epworth Sleepiness Scale (ESS) scores (mean 14.5), low item 15 PDSS score (mean 4.7) and complaints of severe daytime sleepiness, underwent detailed overnight polysomnography (PSG) studies, all showing abnormal sleep patterns. We conclude that nocturia, nighttime cramps, dystonia, tremor and daytime somnolence seem to be the important nocturnal disabilities in DNPD and some of these symptoms may be reminiscent of "off" period related symptoms even though patients are untreated. Furthermore, polysomnography in "sleepy" PD patients may help diagnose unrecognised conditions such as periodic limb movement of sleep (PLMS), obstructive sleep apnoea (OSA) and REM Sleep Behaviour Disorder.
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PMID:The range and nature of sleep dysfunction in untreated Parkinson's disease (PD). A comparative controlled clinical study using the Parkinson's disease sleep scale and selective polysomnography. 1678 Aug 88

Electric stimulation therapy is one of the surgical treatments for Parkinson's disease whereby a chronic stimulating electrode is placed on the subthalmic nucleus (STN). Because medical treatments centered around L-dopa have limitations in severe Parkinson's disease, electric stimulation therapy is regarded as an appropriate treatment modality. Most Parkinson's disease patients experience lower urinary tract disorders such as urgency, daytime frequency or nocturia, due to detrusor overactivity. We conducted an International Prostate Symptom Score (IPSS) analysis and a pressure flow study (PFS) on 6 patients before and after a chronic stimulating electrode was placed on the STN and evaluated how the subjective symptoms and bladder functions changed. As a result, the IPSS total value, involuntary detrusor contraction threshold volume and maximum bladder capacity were all found to significantly improve (P<0.05). The average IPSS decreased from 11.2 to 7.0. The average involuntary detrusor contraction threshold volume increased from 90.7 ml to 172.7 ml. The average maximal bladder capacity increased from 104.0 ml to 177.2 ml. These findings suggest that the STN the positively contributes to an improvement in urinary function.
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PMID:[Effects of deep brain stimulation on urodynamic findings in patients with Parkinson's disease]. 1793 34

Sleep disturbances in Parkinson's disease (PD) are a common problem. The aim of this study was to detail the frequency and nature of sleep disorders in a representative population of PD patients. A recently identified prevalent population, consisting of 161 PD patients were used as a representative population. Twenty-seven of 122 (22%) patients were identified as having marked sleep disorders, with sleep fragmentation and nocturia being the most commonly reported problems. Sleep scores worsened with higher Hoehn and Yahr stages. Sleep disturbances are a relatively common complication of PD and worsen with increasing Hoehn and Yahr stage.
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PMID:The frequency and nature of sleep disorders in a community-based population of patients with Parkinson's disease. 1804 41

The aim of this study was to explore the prevalence of nonmotor symptoms in Parkinson's disease (PD) and the patients' and family members' awareness of these symptoms. We evaluated 74 parkinsonian patients and 54 family members. Seventy-three patients had more than one symptom (12.4+/-5.5 out of 30 symptoms on average). Nocturia was the most common in men and feeling sad in women. The average number of symptoms which patients knew to be related to PD was 5.2+/-6.8 and to family members 7.7+/-6.5. Twenty-eight patients and five family members were unaware of the relationship between any of these symptoms and PD. For PD to be properly managed, nonmotor symptoms should be comprehensively assessed and patients and families informed that these are associated with PD.
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PMID:Nonmotor symptoms of Parkinson's disease: prevalence and awareness of patients and families. 1804 21

The aim of this study was to compare the results of the day-to-day self-evaluation of sleep quality by sleep logs with Parkinson's disease sleep scale (PDSS) in Parkinson's disease (PD) patients. Actigraphy was used as an independent analysis of nighttime activity interfering with sleep. A total of 71 idiopathic PD patients and 21 age- and sex-matched normal individuals lacking any type of sleep disturbance were recruited. Sleep was evaluated by PDSS, 7-d sleep log and actigraphy. Sleep logs and PDSS showed reduced sleep quality and daytime somnolence scores in moderate/severe PD patients as compared to healthy controls. Significant correlations were found between sleep quality in sleep logs and all domains of PDSS sleep quality, except for the presence of nocturia, which correlated with nocturnal activity. PD severity and depression were the only predictors of reduced sleep quality. The retrospective and day-to-day sleep self-evaluations were coincident. Reduced sleep quality was related to increased PD severity and depression scores.
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PMID:Parkinson's disease sleep scale, sleep logs, and actigraphy in the evaluation of sleep in parkinsonian patients. 1940 16

We performed a multicenter survey using a semistructured interview in 1,072 consecutive patients with Parkinson's disease (PD) enrolled during 12 months in 55 Italian centers to assess the prevalence of nonmotor symptoms (NMSs), their association with cognitive impairment, and the impact on patients' quality of life (QoL). We found that 98.6% of patients with PD reported the presence of NMSs. The most common were as follows: fatigue (58%), anxiety (56%), leg pain (38%), insomnia (37%), urgency and nocturia (35%), drooling of saliva and difficulties in maintaining concentration (31%). The mean number of NMS per patient was 7.8 (range, 0-32). NMS in the psychiatric domain were the most frequent (67%). Frequency of NMS increased along with the disease duration and severity. Patients with cognitive impairment reported more frequently apathy, attention/memory deficit, and psychiatric symptoms. Apathy was the symptom associated with worse PDQ-39 score but also presence of fatigue, attention/memory, and psychiatric symptoms had a negative impact on QoL. These findings further support a key role for NMS in the clinical frame of PD and the need to address them specifically in clinical trials using dedicated scales.
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PMID:The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. 1951 14

In Parkinson's disease (PD) the urinary dysfunction manifests primarily with symptoms of overactive bladder (OAB). The OAB questionnaire (OAB-q) is a measure designed to assess the impact of OAB symptoms on health-related quality of life. In this study, we quantified the urinary symptoms in a large cohort of PD patients by using the OAB-q short form. Possible correlations between the OAB-q and clinical features were tested. Three hundred and two PD patients were enrolled in the study. Correlations between the OAB-q and sex, age, Unified Parkinson's Disease Rating Scale part III (UPDRS-III), Hoehn-Yahr (H-Y) staging, disease duration, and treatment were analyzed. Data were compared with a large cohort of 303 age-matched healthy subjects. The OAB-q yielded significantly higher scores in PD patients than in healthy subjects. In the group of PD patients, all the variables tested were similar between men and women. Pearson's coefficient showed a significant correlation between mean age, disease duration, mean OAB-q scores, UPDRS-III scores, and H-Y staging. A multiple linear regression analysis showed that OAB-q values were significantly influenced by age and UPDRS-III. No statistical correlations were found between OAB-q scores and drug therapy or the equivalent levodopa dose, whilst the items relating to the nocturia symptoms were significantly associated with the equivalent levodopa dose. Our findings suggest that bladder dysfunction assessed by OAB-q mainly correlates with UPDRS-III scores for severity of motor impairment, possibly reflecting the known role of the decline in nigrostriatal dopaminergic function in bladder dysfunction associated with PD and patients' age. Our study also suggests that the OAB-q is a simple, easily administered test that can objectively evaluate bladder function in patients with PD.
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PMID:Bladder symptoms assessed with overactive bladder questionnaire in Parkinson's disease. 2031 46

Disorders of initiation and maintenance of sleep (DIMS), excessive daytime sleepiness (EDS) are common and clinically significant in patients with Parkinson's disease (PD). The aim of the study was the evaluation of the effects of the dopamine agonist pramipexole on DIMS and EDS in PD. Sixty-seven patients with PD (mean age 63.2+/-9.9 years old, mean illness duration 6.5+/-4.2 years) were enrolled in the study. Forty patients received pramipexole as add-on to the other antiparkinsonian medications in mean daily dosage 2.64+/-0.6 mg. Clinical symptoms were assessed using the UPDRS, the PDSS, the PSO, the ESS, the Beck Depression Inventory (BDI), the Spielberger's State Anxiety Inventory, the SCOPA-Cog, the PDQ-39. The most common sleep complaints were sleep fragmentation and early awakening. DIMS, EDS were the main factors which negatively influenced the overall quality of sleep. The administration of pramipexole significantly improved the overall quality of sleep, decreased sleep initiation difficulties and sleep fragmentation, night and early morning dystonia, early morning tremor; restlessness, troublesome sensations in extremities, nocturia. We speculate that the effects of therapy on DIMS are caused by the decrease of nocturnal PD motor (hypokinesia, dystonia, tremor) and nonmotor (nocturia, sensor disturbances) symptoms; 15% of patients had moderate ESS in the early treatment period.
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PMID:[Effects of the dopamine agonist mirapex (pramipexole) therapy on sleep disorders in Parkinson's disease]. 2051 25


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