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)

Bladder function was studied in 24 patients with a diagnosis of parkinsonism using cystometry, sphincter electromyography, flowmetry and electromyelography. A high incidence of disturbances in detrusor function and sphincter control was documented and the signal tracing studies showed prolonged conduction times, giving evidence of peripheral neuropathy. The abnormalities of detrusor function were ascribed to the lesion of the basal ganglia, whereas the sphincter disturbances indicate impairment of the corticospinal tract as a result of Parkinson's disease.
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PMID:Cystometric, sphincter and electromyelographic abnormalities in Parkinson's disease. 13 35

During the years 1970-1974, a total of 44 patients referred by neurologists to the Urological Laboratory were classified in the following groups: paralysis agitans (27), postencephalitic parkinsonism (5), cerebral arteriosclerosis and parkinsonism (7) and cerebral arteriosclerosis and parkinsonism, suspected (5). Bladder function was assessed on the basis of cystometry and urodynamic investigation. A high frequency of supranuclear bladder paresis (SNP) was found, although unequally distributed in the different diagnostic groups. Stereotactic operations on the thalamic nuclei seemed to be correlated with SNP. The question was raised whether SNP was part of the parkinsonian syndrome or merely signs and symptoms related to ageing.
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PMID:Disturbances of micturition in Parkinson's disease. 126 66

Urinary bladder disorders often occur, sometimes very early, during the course of Parkinson's disease. Careful analysis of symptoms including clinical examination, urodynamic studies and radiographic data is essential before choosing a treatment, especially before prostatic surgery. We studied 41 parkinsonian patients. Bladder hyperreflexia occurred in 88% and bladder hyporeflexia in only 12%. In 16 patients, we tested bladder activity after a subcutaneous injection of apomorphine. All patients with hyperreflexia were improved whereas hyporeflexic patients remained unchanged. These findings and data from the literature suggest that in Parkinson's disease detrusor hyperreflexia is the consequence of dopamine nigrostriatal depletion. The physiopathology of bladder hyporeflexia is less understood. The practical care of parkinsonians with urinary disorders is detailed.
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PMID:[Vesical sphincter disorders in Parkinson disease]. 800 45

Lower urinary tract symptoms are frequency report in Parkinson's disease. Whether these are causally related to Parkinson's disease rather than the known effects of age on the urinary tract is unknown. In this study we compared urodynamic data from 1864 women and 357 men with no neurological disease with data from 34 women and 42 men with Parkinson's disease, 96 women and 75 men with cerebrovascular disease and 42 women and 16 men with dementia. We examined isometric and isotonic detrusor contractile function and urethral outflow. Bladder capacity was reduced in both men and women with Parkinson's disease in comparison with patients of similar to that measured in patients without neurological disease and we found no evidence of obstruction in patients with Parkinson's disease. Disease-specific changes were not identified in patients with cerebrovascular disease or dementia. These findings contradict previous reports suggesting specific changes in lower urinary tract function in association with Parkinson's disease.
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PMID:Lower urinary tract dysfunction in Parkinson's disease: changes relate to age and not disease. 883 86

Although patients with Parkinson's disease (PD) experience pelvic organ dysfunction of the urinary bladder, bowel and genital organs, an accurate incidence of the dysfunction and its characteristics have yet to be ascertained. We devised a detailed questionnaire on these three pelvic organ functions in PD patients and control subjects, in our search for a hallmark that would distinguish between the two groups. The PD group comprised 115 patients; 52 men and 63 women, age range 35-69 (average 59) years old, average duration of illness 6 years, median Hoehn and Yahr stage 3. All were taking levodopa with/without dopamine agonists. The control group comprised 391 local individuals who were undergoing an annual health survey; 271 men and 120 women, age range 30-69 (average 48) years old. The questionnaire had three parts: bladder (nine questions), bowel (four questions), and sexual (three questions for women, five for men) function. Each question was scored from 0 (none) to 3 (severe) with an additional quality of life (QOL) index scored from 0 (satisfied) to 3 (extremely dissatisfied). The completion rate was 100% for bladder and bowel functions, whereas for sexual function, it was 95% (control) and 88% (PD) for men and 82% (control) and 60% (PD) for women. As compared with the control group, the frequency of dysfunction in the PD group was significantly higher for urinary urgency (women 42%, men 54%), daytime frequency (28%, 16%), nighttime frequency (53%, 63%), urgency incontinence (25%, 28%), retardation (44% of men), prolongation/poor stream (men 70%), straining (women 28%); constipation (63%, 69%), difficulty in expulsion (men 57%), diarrhea (men 21%); decrease in libido (84%, 83%), decrease in sexual intercourse (55%, 88%), decrease in orgasm (men 87%), and in men, decreases in erection (79%) and ejaculation (79%). The QOL index for the PD patients was significantly higher for bladder (27%, 28%) and bowel (46%, 59%) but not for sexual dysfunction, despite the group's high prevalence of sexual dysfunction. In the PD patients, fecal incontinence was associated with urinary incontinence. Stress urinary incontinence and a decrease in libido were more common in women than in men. Bladder and bowel dysfunction, but not sexual dysfunction increased with the Hoehn and Yahr stage. Sexual dysfunction, but neither bladder nor bowel dysfunction, increased with age. Patients taking levodopa and bromocriptine more frequently had bladder (voiding phase) dysfunction than those taking levodopa only. The findings show that bladder, bowel and sexual dysfunction are all prominent in patients with PD. Amelioration of pelvic organ dysfunction, particularly bowel dysfunction which most affects the quality of life, therefore should be a primary target in the treatment of patients with PD.
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PMID:Questionnaire-based assessment of pelvic organ dysfunction in Parkinson's disease. 1157 Jul 7

Supra-pontine lesions resulting from neurological disorders such as vascular disease, Parkinson's disease, or Alzheimer type senile dementia lead to an increase in bladder activity. This is due in part to the removal at the cortical inhibitory control of the micturition center in the brain stem - i.e. the pontine micturition center (PMC) - and in part to facilitation of excitatory control. These inhibitory or excitatory controls consist of several neurotransmitter systems, including glutamate, dopamine, gamma-aminobutyric acid (GABA), and acetylcholine. Bladder overactivity caused by cerebral infarction is mediated by upregulation of N-methyl-D-aspartate (NMDA) glutamatergic and D2 dopaminergic excitatory mechanisms, and by downregulation of NMDA glutamatergic and Ml muscarinic inhibitory mechanisms in the brain. Bladder overactivity associated with Parkinson's disease is reportedly induced by a loss of input to the D1 dopaminergic receptor. Furthermore, bladder overactivity caused by Alzheimer type dementia is thought to be mediated by downregulation of M1 muscarinic inhibitory mechanisms. Development of bladder overactivity following cerebral infarction is mediated by activation of the NMDA receptor and accompanied by an increase in c-fos, zif268 and COX-2 mRNA expression in the dorsal pontine tegmentum.
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PMID:Overactive bladder--experimental aspects. 1247 19

This paper provides an overview of electrical stimulation of the nervous system as a treatment option for urodynamic dysfunction and of some of the recent results in this field. The set-up used in our studies for improved bladder filling in spinal cord injured patients by conditional stimulation of the dorsal penile/clitoral nerve is a highly efficient way to limit neurogenic detrusor overactivity and increase bladder capacity. Ongoing studies suggest that recording of bladder nerve activity is stable over time and may be a technique for chronic monitoring of bladder activity. Bladder emptying exploiting an anodal blocking technique permits bladder emptying without simultaneous urethral-perineal contraction, thus enabling a physiological voiding pattern in one continuous sequence. In patients with supraspinal lesions, deep brain electrical stimulation is established only as treatment for a subgroup of patients suffering from Parkinson's disease. Yet, with improved electrode designs and increased clinical experience and experimental results, probably other groups of patients may be candidates for deep brain stimulation. In our study in pigs there was a trend towards increased bladder capacity and compliance in response to stimulation, which is encouraging as several neurological diseases are accompanied by overactive bladder with reduced capacity.
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PMID:Electrostimulation: a future treatment option for patients with neurogenic urodynamic disorders? 1287 49

Sonography of the bladder was performed before and after voluntary voiding in 20 subjects with possible/probable multiple system atrophy (MSA), 20 patients with idiopathic Parkinson's disease (PD), and 20 healthy controls. Mean residual volume was 173 ml (SD, 194) in MSA and significantly increased compared to both PD (21 ml; SD, 49) and controls (13 ml; SD, 12). Incomplete voiding (>100 ml of residual volume) was found in 11 subjects with MSA but only in 1 patient with PD. Positive predictive value of increased residual volume for MSA was 91.6% in this study, whereas negative predictive value was only 67.8. Bladder sonography is an objective, simple, and safe tool that allows one to screen for urinary retention, which is highly suggestive but incompletely sensitive for MSA. Because sonography is easily accessible and rapidly performed, it is feasible for routine assessment of atypical Parkinsonism.
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PMID:Sonographic assessment of urinary retention in multiple system atrophy and idiopathic Parkinson's disease. 1603 12

Parkinson's disease is a common neurodegenerative disease that shows not only movement disorder, but also profound urinary dysfunction. Bladder hyperactivity is the major urodynamic abnormality. Therefore, the basal ganglia have been thought to modulate the micturition reflex. In six male adult cats under ketamine anesthesia, in which spontaneous isovolumetric micturition reflexes had been generated, we measured levels of striatal dopamine, in micturition and storage phases, using in vivo microdialysis. The striatal dopamine level significantly increased in the storage phase as compared with that in the micturition phase. It is suggested that striatal dopamine may inhibit the micturition reflex via the dopamine D1 receptor-GABAergic direct striatal output pathway, and that disruption of this pathway may be what leads to bladder hyperactivity in patients with Parkinson's disease.
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PMID:Striatal dopamine level increases in the urinary storage phase in cats: an in vivo microdialysis study. 1611 28

Patients with Parkinson's disease (PD) often have lower urinary tract symptoms (LUTS). Studies have indicated a correlation between dopaminergic degeneration and LUTS and presence of overactive bladder. We evaluated 18 patients with Parkinson's disease using single-photon emission computerized tomography (SPECT) imaging of the dopamine transporter with [(123)I]-FP-CIT, and bladder symptoms were assessed using questionnaires and full urodynamic evaluation both in medicated state and after cessation. Bladder symptoms correlated with age, stage and severity of disease but not with uptake of the ligand in the striatum. Patients with bladder symptoms had a significant lower uptake in the striatum compared with patients without LUTS. In patients with severe bladder dysfunction, LUTS correlated with putamen/caudate ratio. The specific binding of the ligand did not correlate with urodynamics parameters or any change in these after wash-out. Our findings suggest that the presence of LUTS is associated with the degeneration of the total number of nigrostriatal dopaminergic neurones, whilst the severity of bladder dysfunction is correlated with the relative degeneration of the caudate nucleus. The effects of medication on bladder control, as evaluated by urodynamics are believed to involve structures outside the basal ganglia.
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PMID:Relationship between nigrostriatal dopaminergic degeneration, urinary symptoms, and bladder control in Parkinson's disease. 1624 72


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