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Query: UMLS:C0030567 (
Parkinson's disease
)
63,064
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We analyzed parkinsonian features in multiple system atrophy (MSA) compared with age- and disease duration-matched
Parkinson's disease
(PD) patients, and assessed the applicability of the Unified
Parkinson's Disease
Rating Scale (UPDRS) -III motor scale as a means of rating their severity. Cross-sectional analysis of parkinsonism was done using UPDRS-III, International Cerebellar Atatia Rating Scale, and disability scales (Hoehn and Yahr [H&A], Schwab and England, Katz and Lawton) in 50 unselected MSA patients and in 50 matched PD patients. At symptom onset, falls occurred 10 times more frequently in MSA, whereas limb tremor was 10 times more common in PD. At first visit (10.2 months),
hemiparkinsonism
and pill-rolling rest tremor were less common in MSA. Hypomimia, atypical rest, postural or action tremor, as well as postural instability were more frequent in MSA. At study examination (62.4 months), parkinsonian signs in MSA patients were more frequently symmetrical and associated with axial rigidity, antecollis and postural instability. A levodopa response of >50% was seen in <10% of MSA patients. Modified H&Y stages (3.2 +/- 1.3 vs. 2.2 +/- 0.78) and UPDRS-III scores (48.14 +/- 19.5 vs. 31.74 +/- 12.9) were significantly (P = 0.0001) higher in MSA. The internal consistency of the UPDRS-III was fair in MSA patients (Cronbach's alpha >0.90), and correlated well with marked dependency on the Schwab and England and Katz and Lawton scales. Factor structure analysis of UPDRS-III in MSA showed five clinically distinct subscores accounting for 74% of the variance, differing from PD by the dependency of the face-speech and limb bradykinesia items and independence of the postural-action tremor from the rest tremor items. There was a significant correlation (R(2) = 0.70, P = 0.001) between ICARS ataxia and UPDRS-III scores in MSA patients. Results confirm a distinct profile of parkinsonism in MSA and greater severity and disability compared with PD. It also indicates that the UPDRS-III provides a useful severity measure of parkinsonism in MSA, albeit contaminated by additional cerebellar dysfunction.
...
PMID:Parkinsonism in multiple system atrophy: natural history, severity (UPDRS-III), and disability assessment compared with Parkinson's disease. 1221 Aug 59
The question of whether
Parkinson's disease
(PD) patients who have left (LPD) or right (RPD) motor predominance also exhibit cognitive differences is controversial. We examined this issue using a neuropsychological battery designed to provide a balanced sampling of both right- and left-hemispheric functions. RPD patients were impaired relative to LPD patients on verbally mediated tasks (left hemisphere function), but there was no group difference for visuospatial tasks (right-hemispheric function). In addition, there was a significant correlation between the extent of right side motor predominance and performance on verbal tasks, but there was no relationship between left side motor symptoms and performance on visuospatial tasks. The controversy related to cognitive differences in
hemiparkinsonism
may be due to the balance of the assessment procedure, the severity of motor asymmetry, or both.
...
PMID:Asymmetrical cognitive differences associated with hemiparkinsonism. 1459 98
In schizophrenia and
Parkinson's disease
, cortical and subcortical motor organization is influenced by primary disease conditions and neuroleptic treatment. Using functional magnetic resonance imaging patients with schizophrenia were compared, according to Diagnostic and Statistical Manual of Mental Disorders (4th edn), under stable treatment with olanzapine (n = 7; OL) or haloperidol (n = 7; HA) to healthy controls (n = 7; HC), patients with schizophrenia without any neuroleptic treatment (n = 7; UN) and to patients with left (n = 7; LHP)- and right (n = 7; RHP)-sided
hemiparkinsonism
. All subjects performed a unilateral left-handed fingertapping task. All groups had significant activation in the contralateral motor cortex and the putamen (P < 0.001). Different activation patterns between groups within cortical and subcortical regions of interest were revealed. In particular, different subcortical activation patterns were found between OL- and HA-treated patients with schizophrenia. Activation of the contralateral putamen was increased in right-sided
hemiparkinsonism
. Significant thalamus activation was found in patients under neuroleptic treatment as well as in
hemiparkinsonism
, whereas the thalamus was not activated in untreated patients with schizophrenia and in healthy controls. Comparing dopaminergic depletion in
hemiparkinsonism
and dopaminergic blockade in HA-treated patients, an increase in activation was found within the contralateral primary motorcortex, in the ipsilateral putamen and the contralateral thalamus in
hemiparkinsonism
. In contrast, activation of the contralateral putamen differed between OL and HA, LHP and RHP. These findings confirm that cortical and subcortical motor-related brain loop functions are influenced by both primary neuropsychiatric conditions as well as by treatment effects. It is hypothesized that dopaminergic depletion in
hemiparkinsonism
and dopaminergic blockade under neuroleptic agents influence basal ganglia activity in a different way; in particular regarding functional connectivity. Basal ganglia and thalamic interaction seems to have a key role in cortical-subcortical interaction.
...
PMID:Schizophrenia and Parkinson's disease lead to equal motor-related changes in cortical and subcortical brain activation: an fMRI fingertapping study. 1462 3
We examined in Sprague-Dawley rats whether intranigral administration of complex-I inhibitor, rotenone, produces biochemical lesions in the striatum similar to those observed in
Parkinson's disease
(PD). Unilateral stereotaxic infusion of rotenone (2-12 mug in 1 mul) into substantia nigra (SN) pars compacta caused significant inhibition of complex-I activity and increased production of hydroxyl radicals in vivo as measured employing spectrophotometric and HPLC-electrochemical procedures, respectively. It also caused a significant time- and dose-dependent reduction of dopamine level, but not serotonin, in the ipsilateral striatum when assayed using an HPLC electrochemical method. This effect was found to be progressive for 90 days. A dose-dependent decrease in nigral glutathione level, as measured fluorimetrically, was also observed to be progressive till 90th day. A significant decrease in tyrosine hydroxylase immunoreactivity in the striatum (73 +/- 8.4% as assessed by densitometric studies) or in SN ipsilateral to the side of infusion suggested nigrostriatal neuronal degeneration. A dose of rotenone (6 microg in 1 microl) that caused 55% striatal dopamine depletion when infused into the SN failed to affect serotonin levels in the terminal regions when infused into the nucleus raphe dorsalis, indicating rotenone's specificity of action towards dopaminergic neurons. Our findings suggest that unilateral infusion of rotenone reproduces neurochemical and neuropathological features of
hemiparkinsonism
in rats and indicate an active involvement of oxidative stress in rotenone-induced nigrostriatal neurodegeneration. The present study also demonstrates more sensitivity of dopaminergic neurons towards rotenone and establishes mitochondrial complex-I damage as one of the major contributory components of neurodegeneration in PD. The progressive nature of pathology in this model closely mimics idiopathic PD, and absence of mortality warrants the use of this model in drug discovery programs.
...
PMID:Acute intranigral infusion of rotenone in rats causes progressive biochemical lesions in the striatum similar to Parkinson's disease. 1593 33
Vascular parkinsonism (VP) is a heterogeneous clinical entity. The idea of a relationship between cerebral vascular disease and parkinsonism may be traced back to the 1920s, when the diagnostic unit called "arteriosclerotic parkinsonism", a predecessor of VP, was established. This review is concerned with historical and contemporary views regarding the possible vascular genesis of parkinsonism. Confusion persists as a result of vaguely defined diagnostic criteria. The following types of simultaneous occurrence of parkinsonism and cerebral vascular disease (CVD) may be recognised: 1. gait disorders of the lower body parkinsonism type are caused mostly by white matter lesions in the frontal lobes; such disorders may require a diagnosis of vascular origin. We suggest replacing the term "lower body parkinsonism" with a more appropriate term not including the word "parkinsonism": an alternative term could be "cerebrovascular gait disorder"; 2. if the signs and symptoms are typical for idiopathic
Parkinson's disease
(IPD), the coincidence of IPD and CVD should be considered; 3. if the symptoms of parkinsonism are neither typical for IPD nor for VP, and there are clinical or MR signs of CVD, VP should be regarded as possible when alternative causes are excluded; 4. if the symptoms of parkinsonism and clinical and MR signs are typical for VP, VP should be regarded as probable; 5. if a stroke affecting the contralateral basal ganglia is followed by the occurrence of
hemiparkinsonism
, the diagnosis of VP is unambiguous. Vascular parkinsonism (VP) is probably one of the most frequently erroneous neurological diagnoses. The reason for this misdiagnosis is that both cerebral vascular disease (CVD) and parkinsonism usually occur at the same age. Due to the high incidence of CVD, it is possible for CVD and idiopathic
Parkinson's disease
(IPD) to coincide in some cases. Another reason for the misdiagnosis is that the concept of VP lacks clarity. This review aims to contribute to an improved understanding of VP in clinical practice. In this context, the term "CVD" is understood in the broad sense of a brain impairment caused by cerebral vessel pathology. It covers various concepts, as some authors use the term CVD to mean a manifestation of vascular lesions in pathologico-anatomical material or in the imaging techniques; others mean the history and clinical manifestation of cerebral ischaemia, or, more rarely, haemorrhage. The term CVD may cover large vessel disease as well as small vessel disease. This means that territorial and lacunar infarcts and white matter lesions (WML) are all considered as CVD.
...
PMID:Vascular parkinsonism--an update. 1676 89
Glial cell line-derived neurotrophic factor (GDNF) is a potent neuroprotection and regeneration molecule for dopamine neurons in the substantia nigra. A recent clinical study showed that intraputaminal infusions of GDNF restored the striatal dopaminergic function, resulting in improvement in patients with
Parkinson disease
. To investigate the efficacy and the safety of this treatment, the histological changes associated with intraputaminal GDNF infusions were investigated in non-human primate models of
Parkinson disease
. Two types of
Parkinson disease
model were constructed: unilateral infusion of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridin (MPTP) into the internal carotid artery to induce
hemiparkinsonism
and intermittent systemic injection to induce
Parkinson disease
. GDNF (50 microg) was infused into the putamen on the day of the first MPTP treatment and 4 weeks later. The monkey brains were examined by immunohistochemistry 2-4 weeks after the second GDNF infusion. Losses of the nigral dopamine neurons were mild (30-50% loss) on the side of GDNF infusion, and moderate (approximately 70% loss) on the side of vehicle infusion in the
Parkinson disease
model. The dopamine fibers were thick and dense in the striatum around the GDNF infusion sites. Both GDNF- and vehicle-treated monkeys of the hemiparkinsonian model showed severe decrease of dopamine neurons to 10% of the intact side. Although reactive astrocytes proliferated around the GDNF infusion sites, the densities of striatal neurons involving GABAergic and cholinergic neurons were not affected. Intraputaminal infusions of GDNF have beneficial effects in parkinsonian monkeys, but dose control is required according to the severity of the disease. The specificity for dopamine neurons is quite high and there are no serious histological changes.
...
PMID:Histological effects of intraputaminal infusion of glial cell line-derived neurotrophic factor in Parkinson disease model macaque monkeys. 1679 46
Recently we showed that the neurotensin polyplex is a nanoparticle carrier system that targets reporter genes in nigral dopamine neurons in vivo. Herein, we report its first practical application in experimental parkinsonism, which consisted of transfecting dopamine neurons with the gene coding for human glial cell line-derived neurotrophic factor (hGDNF). Hemiparkinsonism was induced in rats by a single dose of 6-hydroxydopamine (30 microg) into the ventrolateral part of the striatum. We showed that transfection of the hGDNF gene into the substantia nigra of rats 1 week after the neurotoxin injection produced biochemical, anatomical, and functional recovery from
hemiparkinsonism
. RT-PCR analysis showed mRNA expression of exogenous hGDNF in the transfected substantia nigra. Western blot analysis verified transgene expression by recognizing the flag epitope added at the C-terminus of the hGDNF polypeptide, which was found mainly in dopamine neurons by double immunofluorescence techniques. These data indicate that the neurotensin polyplex holds great promise for the neuroprotective therapy of
Parkinson disease
.
...
PMID:Neurotensin polyplex as an efficient carrier for delivering the human GDNF gene into nigral dopamine neurons of hemiparkinsonian rats. 1701 39
Clostridial light chain (LC) inhibits synaptic transmission by digesting a vesicle-docking protein, synaptobrevin, without killing neurons. We here report the feasibility of creating a rat
hemiparkinsonism
model through LC gene expression in the substantia nigra (SN), inhibiting nigrostriatal transmission. 40 adult Sprague Dawley rats were divided into four groups for SN injections of PBS, 6-hydroxydopamine (6-OHDA), or adenoviral vectors for the expression of LC (AdLC), or GFP (AdGFP). Amphetamine and apomorphine induced rotations were assessed before and after SN injection, revealing significant rotational alterations at 8 or 10 days after injection in both AdLC and 6-OHDA but not PBS and AdGFP groups. Induced rotation recovered by one month in AdLC rats but persisted in 6-OHDA rats. Histological analysis of the SN revealed LC and GFP expression with corresponding synaptobrevin depletion in the LC, but not the GFP groups. Tyrosine hydroxylase (TH) and dopamine transporter (DAT) immunohistochemistry (IHC) showed markedly decreased staining in ipsilateral SN and striatum in 6-OHDA but not AdLC or AdGFP rats. Similarly, compared with contralateral, ipsilateral striatal dopamine level only decreased in 6-OHDA but not AdLC, AdGFP, or PBS treated rats. Thus, LC expression induces nigral synaptobrevin depletion with resulting inhibition of nigrostriatal synaptic transmission. Unlike 6-OHDA, LC expression inhibits synaptic activity without killing neurons. This approach, therefore, represents a potentially reversible means of nigrostriatal pathway inhibition as a model for
Parkinson's disease
. Such a model might facilitate transient and controlled nigral inhibition for studying striatal recovery, dopaminergic re-innervation, and normalization of striatal receptors following the recovery of nigrostriatal transmission.
...
PMID:Reversible unilateral nigrostriatal pathway inhibition induced through expression of adenovirus-mediated clostridial light chain gene in the substantia nigra. 1791 86
The tricarboxylic acid cycle rate (Vtca) and the rate of glutamine synthesis (Vgln) in the pre- and post-MPTP-treated cynomolgus monkey (Macaca fascicularis) brain were measured non-invasively using a 2 Tesla 13C-magnetic resonance spectroscopy (13C-MRS; multislice 1H-13C correlation heteronuclear single quantum coherence spectroscopy) system. Before the infusion of 1-methyl-4-phenyl-1,2,3,6-tertahydropyridine (MPTP) into three monkeys, spectra were obtained by 13C-MRS from each monkey under anesthesia after the bolus injection of [1-13C] glucose (99% atom excess, 0.28 g/kg) followed by the continuous infusion of [1-13C] glucose (99% atom excess, 0.72 g/kg) into the saphenous vein for 3 h. The average values of Vtca were 0.475+/-0.077 (mean+/-S.D.) and 0.472+/-0.073 micromol/g/min, and the average values of Vgln were 0.042+/-0.007 and 0.041+/-0.008 mumol/g/min on the left and on the right hemisphere, respectively. Three monkeys were induced
hemiparkinsonism
by intracarotid (left) infusion of MPTP (0.6 mg/kg) and then were employed in 13C-MRS studies for 2 (5, 14 days), 3 (3, 8, 71 days) or 4 (5, 11, 27, 78 days) times, respectively, after the MPTP treatment. The average ratios of Vtca and Vgln on the left hemisphere to those on the right hemisphere in pre- and post-MPTP-treated monkeys were 0.837+/-0.085 and 1.373+/-0.132, respectively. These results of non-invasive 13C-MRS analysis of the MPTP primate model of
Parkinson's disease
indicate that the loss of the dopaminergic innervation from the caudate putamen may modulate the overall glucose metabolism to glutamate and glutamine in the ipsilateral cerebrum.
...
PMID:Changes in the rates of the tricarboxylic acid (TCA) cycle and glutamine synthesis in the monkey brain with hemiparkinsonism induced by intracarotid infusion of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP): studies by non-invasive 13C-magnetic resonance spectroscopy. 1791 69
We describe a case with right
hemiparkinsonism
due to a frontal meningioma with surrounding edema compressing the basal ganglia. The initial diagnosis of idiopathic
Parkinson's disease
(PD) was made in another institution on the basis of the positive family history, the clinical symptoms and the asymmetric reduction of striatal tracer binding in a single photon emission computed tomography study for the dopamine transporter. The symptoms of parkinsonism resolved completely shortly after surgery for removal of the tumor. This case points to the significance of structural neuroimaging in the evaluation of parkinsonism even in cases that fulfill all the necessary clinical criteria for idiopathic PD.
...
PMID:Hemiparkinsonism due to frontal meningioma. 1857 86
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