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)

In cases of Parkinson's disease, a high incidence of dementia and simultaneous pathologic changes of Alzheimer's type have been reported. X-ray CT and MRI have such good spatial resolution that they can be expected to be useful for evaluation of brain atrophy. Positron emission tomography (PET) used with 18F-2-deoxy-2-fluoro-D-glucose is considered to reflect regional function. By these techniques, brain atrophy and local cerebral metabolic rate of glucose (LCMR-glc) in patients with Parkinsonism with dementia was studied, and also compared with age-matched normal controls and senile dementia of Alzheimer type. In seven cases of Parkinson's disease with dementia, LCMRs-glc were statistically decreased in all regions in comparison with ten normal controls. LCMRs-glc in six Parkinson's disease without dementia were higher than those of demented Parkinson's disease, but significantly lower than normal controls in all regions except basal ganglia. Some aged normal controls presented cortical atrophy and a significant difference could not be seen in evaluation by MRI among these three groups. There was also no correlation between LCMR-glc and cortical atrophy. There was no significant difference of LCMR-glc between six Guamnian cases of Parkinsonism-Dementia complex (PD complex) without ALS and four cases of PD complex with ALS, and these values were significantly lower than five Guamanian and ten Caucasian normal controls. In PD complex with and without ALS, remarkable cortical atrophy and ventricular dilatation were recorded in comparison with normal controls, and correlation between decrement of LCMR-glc and cortical atrophy was indicated in frontal, parietal and temporal lobe. In Parkinson's disease with dementia and PD complex in Guam, LCMRs-glc in all regions of brain were generally lower than normal controls. These findings were different from Alzheimer's disease in which LCMR-glc have been reported to be low especially in cerebral cortex. On the other hand, cortical atrophy and ventricular dilatation evaluated by MRI and CT was apparent in PD complex, but these changes were not remarkable in Parkinson's disease. Cortical atrophy did not always correlate with the decrease of LCMR-glc and changes of LCMR-glc could reflect clinical signs such as Parkinsonism and dementia. Both PET as a functional imaging method and MRI, CT as an anatomical imaging method are useful to access the study of these diseases.
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PMID:[Comparison study of positron emission tomography, X-ray CT and MRI in parkinsonism with dementia]. 279 56

The authors report a patient whose Parkinson's disease and mania both responded well to electroconvulsive therapy (ECT) after failing to respond to chemotherapy. The authors review the literature and suggest that ECT is a safe and effective treatment for affective syndromes associated with Parkinsonism. The presence of dementia in these patients appears to be an indicator of poor prognosis. This paper is believed to be the first report of successful use of ECT in mania occurring together with Parkinsonism.
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PMID:Electroconvulsive therapy in parkinsonism with affective disorder. 316 8

Local cerebral blood flow (LCBF) and local tissue:blood partition, coefficient (L lambda) values were measured during CT scanning while patients with different types of Parkinson's syndrome (N = 14) inhaled a contrast mixture of 35-37 per cent stable xenon gas in oxygen. Single-compartment analysis fitted to infinity was used to calculate L lambda and LCBF values. Results were compared with results from normal age-matched volunteers (N = 24). Mean hemispheric (p less than 0.05) and subcortical (p less than 0.05) gray matter LCBF values were reduced in idiopathic Parkinson's disease (N = 11), compared to values from age-matched normals. Regionally, LCBF reductions included frontal (p less than 0.001), parietal cortex (p less than 0.05), caudate (p less than 0.05), lentiform nuclei (p less than 0.001) and thalamus (p less than 0.05) reductions. L lambda values were normal. Unilateral tremor and/or rigidity correlated directly with reduced LCBF in contralateral lentiform (p less than 0.01) and caudate (p less than 0.01) nuclei. In postencephalitic Parkinsonism (N = 1) LCBF reductions were diffuse, with normal L lambda values. In the akinetic form of Parkinsonism (N = 1) associated with lacunar infarcts, LCBF and L lambda reductions were patchy. In Parkinsonism following carbon monoxide poisoning (N = 1), LCBF values of gray and white matter were diffusely reduced and L lambda values were reduced in both pallidal regions. When dementia was present together with Parkinsonism (N = 3), LCBF reductions were more diffuse and severe. Dopaminergic deficiency correlated directly with reduced LCBF values, reflecting the severity of Parkinsonism.
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PMID:Xenon contrast CT-CBF measurements in parkinsonism and normal aging. 399 51

Sleep and respiration during sleep were studied in patients with idiopathic Parkinson's disease, patients with Parkinsonism with autonomic disturbance, and normal age and sex matched controls. Patients with idiopathic Parkinson's disease showed significantly reduced REM sleep, and more frequent and prolonged waking throughout the night. Hypoventilation and sleep apnoea did not occur in the idiopathic Parkinson's disease or normal groups, but respiration was disorganised with frequent central and obstructive apnoeas in the autonomic disturbance group. Respiratory rate during non rapid eye movement sleep was similar in the idiopathic Parkinson's disease and normal groups, but patients with idiopathic Parkinson's disease showed tachypnoea awake and during REM sleep.
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PMID:Respiration and sleep in Parkinson's disease. 408 99

The effects of levodopa on tests measuring auditory and visual perception, auditory, and visual short-term memory, verbal learning, and on attention and concentration were studied in 29 patients with Parkinsonism. Thirty-two control subjects matched with the Parkinsonism patients on age, educational level, and verbal IQ were administered the same tests to control for practice effects. Significant improvement occurred for the Parkinsonism patients in verbal learning (an intermediate memory test) and in auditory perception. These improvements were unrelated to changes in anticholinergic medications, increases in alertness or concentration, lessening of depression, or improved motor ability or control. There was no test evidence of levodopa improving visual perception, short-term auditory or visual memory, alertness or concentration. Thus, there is no objective test evidence for levodopa producing a generalized awakening or an alerting effect in Parkinsonism patients who are intellectually alert and well-orientated. Interpretation of the test findings suggests a specific awakening effect, that of improvement in intermediate memory but not in short-term memory. Overall, the Parkinsonism group scored below the control group on all tests, suggesting that cognitive impairment accompanies Parkinson's disease even in patients who are intellectually intact and well oriented.
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PMID:Levodopa's awakening effect on patients with Parkinsonism. 439 42

Fourteen slightly disabled patients with Parkinsonism were treated separately with benzhexol, amantadine, and levodopa. Benzhexol and amantadine both gave a 15% reduction in functional disability and levodopa a 36% reduction. Benzhexol lessened the rigidity and improved the flexion of posture of Parkinson's disease, but had little or no effect on akinesia and tremor. Amantadine and levodopa caused improvement in all these symptoms. The combination of benzhexol and amantadine was as effective after four weeks of treatment as levodopa was after six months.
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PMID:Comparative trial of benzhexol, amantadine, and levodopa in the treatment of Parkinson's disease. 483 13

Electrophysiological analysis of the blink reflex makes it possible to quantitate the reflex changes observed in pathology. The authors therefore propose a `habituation index' to be determined by recording the electromyographic reflex response during stimulation at controlled frequencies. Several populations of subjects were tested. It was confirmed that marked differences in blink reflex habituation exist between normals and patients with Parkinson's disease. It was also found that when patients with Parkinsonism were treated with the classical anticholinergic drugs their habituation index remained virtually unchanged. However, treatment with either l-dopa or amantadine caused a rise in the index in almost all patients tested. On the basis of these findings it is suggested that these two new drugs have a highly similar mechanism of action.
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PMID:Blink reflex studies in patients with Parkinsonism before and during therapy. 515 81

Reduction of dopamine concentrations in the brains of patients with Parkinsonism, together with reported clinical improvement after the administration of dihydroxyphenylalanine, has led to the hypothesis that impaired hydroxylation of tyrosine may be associated with the disease. To test this hypothesis oral loading tests with L-phenylalanine and tyrosine were carried out in patients and controls. After phenylalanine lower blood levels of this were found in Parkinsonian patients than in controls, but tyrosine levels were the same. After tyrosine lower levels of this were also found in patients compared with controls. It is suggested that these findings indicate a decreased rate of tyrosine utilization in Parkinson's disease together with intestinal malabsorption; the latter is supported by the finding of abnormal D-xylose tolerance in these patients.
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PMID:Oral phenylalanine and tyrosine tolerance tests in Parkinsonian patients. 576 91

Many patients with idiopathic Parkinson's disease treated with levodopa for more than five years develop fluctuations in their clinical response to this drug. Such fluctuations may be unpredictable, but more commonly occur in a regular pattern related to the size and timing of the levodopa dosage. Theories as to their cause have emphasised both the progression of the underlying Parkinson's disease and the possibility of a late side-effect of levodopa. We report two children with Parkinsonism, one after recurrent obstructive hydrocephalus and the other following an encephalitic illness. Both patients had striking improvement with levodopa, but developed predictable and unpredictable dramatic response fluctuations within weeks of starting levodopa therapy. This suggests that neither the pathology of idiopathic Parkinson's disease, nor the long-term use of levodopa are essential for the development of predictable or unpredictable fluctuations in response to levodopa therapy.
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PMID:Early onset of the "on-off" phenomenon in children with symptomatic Parkinsonism. 698 10

Parkinson's disease (PD) accounts for 58% of patients with Parkinsonism. The second most common cause is drug-induced Parkinsonism, diagnosed in 20% of patients. Levodopa remains as the mainstay of PD treatment. Although there is controversy regarding the timing for beginning levodopa, it should be used when the patient develops significant disability. Other drugs that may be used are anticholinergic agents, useful for tremor; amantadine, for rigidity and bradykinesia; dopamine agonists, for the management of levodopa complications; and selegiline which may be a neuroprotector agent. Problems in the management of PD include primary failure, secondary failure and levodopa complications. Antidopaminergic drugs, severe rest tremor and diagnosis error may lead to primary failure. Progression of PD is the most common explanation for secondary failure. The most important levodopa therapy complications are dyskinesias and fluctuations. Other common problems are dysautonomia, depression, psychosis and dementia. The author discusses the phenomenology and management of these complications. Future perspectives include brain repair surgeries.
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PMID:[Treatment of Parkinson disease]. 757 92


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