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 order to investigate the neuronal basis of cognitive disorders in Parkinson's disease, the neuropsychological performance of 120 patients with idiopathic Parkinson's disease was analysed in relation to motor symptoms as a function of their response to levodopa. Cognitive impairment was poorly correlated with akinesia and rigidity, symptoms which respond well to levodopa treatment, and was not correlated at all with that part of the patients' motor score that could be improved by the drug. In contrast, strong correlations were found between all neuropsychological test scores and axial symptoms such as gait disorder and dysarthria, which respond little if at all to levodopa treatment. The neuropsychological test scores were also strongly correlated with the motor score of patients estimated when clinical improvement was maximal under levodopa treatment. This score is assumed to represent residual non-dopaminergic motor dysfunctions. The correlations suggest that much of the cognitive impairment in Parkinson's disease results from the dysfunction of non-dopaminergic neuronal systems.
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PMID:Does cognitive impairment in Parkinson's disease result from non-dopaminergic lesions? 270 38

This study addressed the question of whether or not speaking rate influences articulatory hypokinesia in dysarthria associated with Parkinson's disease. Analyses of parkinsonian speech samples revealed mean speaking rates consistent with normal controls. Thus, speaking rate was not abnormal overall in this group of dysarthric subjects. Kinematic analyses of labial displacement amplitude, peak instantaneous velocity, and movement time were made during repetitive syllable production spoken at two speaking rates: 3-5 syllables/sec and 5-7 syllables/sec. The results suggested that labial movements were normal at the slower of the two speaking rates. Conversely, labial movements became hypokinetic as speaking rate increased to the rate consistent with conversational speech. These findings provide a physiologic basis for the perception of hypokinetic dysarthria in Parkinson's disease and suggest that speaking rate may be an important control variable contributing to articulatory hypokinesia in Parkinson's disease. Moreover, these findings provide quantitative evidence that articulatory hypokinesia plays a dominant role in the perception of parkinsonian dysarthria.
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PMID:The influence of speaking rate on articulatory hypokinesia in parkinsonian dysarthria. 270 50

Iterative dysarthria is a speech disorder which bears some resemblance to stuttering. It is commonly found in Parkinson's disease but has so far received little attention to. We report the case of a 67 year old female parkinsonian patient with a severe dysarthria of the iterative type. The characteristic features of iterative dysarthria are described and the relevant literature is reviewed.
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PMID:[Iterative dysarthria in Parkinson disease]. 305 96

The hypokinetic dysarthria of Parkinson's disease (PD) has been described extensively. In contrast, patterns of hesitation and the language structure in spontaneous speech of the PD patient have not been investigated, although several studies have shown language-related abnormalities in word naming, word generation, and verbal recall. In the present study, 10 male Parkinson's patients and 10 normal male speakers were compared in a reading and spontaneous speaking paradigm for acoustic and linguistic features. Among acoustic measures, fundamental frequency and relative intensity differentiated PD from control subjects, consistent with reported features of hypokinetic dysarthria. The striking observations among linguistic measures differentiating PD from control subjects were an increase in the number of (a) silent hesitations per minute, (b) abnormally long silent hesitations, (c) words per silent hesitation, (d) open class phrases, and (e) optional open phrases per speech sample, and a decrease in the number of modalizations and interjections. An increase in the number of filled hesitations occurring per minute, as well as a decrease in syntactic complexity separated moderate from mild Parkinson's patients. Our interpretation of the data favors the hypothesis that changes in the structure of spontaneous language production with increasing severity of dysarthria reflect PD patients' adaptation to their disease.
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PMID:Language production in Parkinson's disease: acoustic and linguistic considerations. 334 16

Speech and language alterations were assessed in 51 patients with Parkinson's disease (PD) and 10 patients with dementia of the Alzheimer type (DAT). Thirty-five of the PD patients had no evidence of intellectual impairment on a conventional mental status questionnaire and 16 of the PD patients had dementia syndromes of comparable severity to the DAT patients. DAT produced significantly greater language disturbances, including anomia, decreased information content of spontaneous speech, and diminished word list generation. PD patients had significantly decreased phrase length, impaired speech melody, dysarthria, and agraphia. The results suggest that the dementia of PD is distinguishable from that of DAT:PD patients have prominent motor speech abnormalities, whereas DAT patients exhibit more profound language alterations.
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PMID:Alzheimer's disease and Parkinson's disease: comparison of speech and language alterations. 336 62

Ten male patients with parkinsonism secondary to Parkinson's disease or progressive supranuclear palsy had clinical neurological, speech, and acoustical speech evaluations. In addition, seven of the patients were evaluated by x-ray computed tomography (CT) and (F-18)-fluorodeoxyglucose (FDG) positron emission tomography (PET). Extensive variability of speech features, both clinical and acoustical, were found and seemed to be independent of the severity of any parkinsonian sign, CT, or FDG PET. In addition, little relationship existed between the variability across each measured speech feature. What appeared to be important for the appearance of abnormal acoustic measures was the degree of overall severity of the dysarthria. These observations suggest that a better understanding of hypokinetic dysarthria may result from more extensive examination of the variability between patients. Emphasizing a specific feature such as rapid speaking rate in characterizing hypokinetic dysarthria focuses on a single and inconstant finding in a complex speech pattern.
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PMID:Clinical and acoustical variability in hypokinetic dysarthria. 349 Apr 98

The motor score with and without levodopa was estimated in 193 parkinsonian patients with variable length of evolution. The effect of levodopa on akinesia, rigidity, and tremor remained quite stable during the course of the disease. In contrast, the aggravation of gait disorder, postural instability, and dysarthria was more severe, with decreased percentage of improvement on levodopa in patients with longer evolution. It is suggested that aggravation of Parkinson's disease mainly results from increasing severity of cerebral nondopaminergic lesions.
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PMID:Does long-term aggravation of Parkinson's disease result from nondopaminergic lesions? 362 54

L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS) was administered at a maintenance dose of 600-900 mg/day, in 10 patients with Parkinson's disease who exhibited a notable freezing phenomenon under the medication of L-DOPA/DCI (DOPA-decarboxylase inhibitor). Changes in clinical symptoms were examined after 8 weeks of treatment. Frozen gait and dysarthria were markedly alleviated by L-threo-DOPS administration, and the rigidity persisting under conventional medication was also relieved. Marked improvement in frozen gait was observed in 1-2 weeks, and that of dysarthria in 2-3 weeks, after the initiation of L-threo-DOPS administration. Nine of the 10 patients were treated with a combination of DOPA and DCI, and the L-threo-DOPS/benserazide ratio and L-threo-DOPS/carbidopa ratio were 9.2 and 26.3, respectively. The effect of L-threo-DOPS were enhanced in one patient in whom DCI was changed from carbidopa to benserazide, suggesting the necessity of further studies on the type and dose of DCI to be combined with L-threo-DOPS.
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PMID:L-threo-3, 4-dihydroxyphenylserine treatment of Parkinson's disease. 393 72

A 77-year-old man with Parkinson's disease of long standing, under treatment with L-DOPA and benserazide, was administered DL-threo-3, 4-dihydroxyphenylserine (DL-threo-DOPS), a precursor of norepinephrine, for 10 days. With this administration the patient's freezing phenomenon was remarkably improved, and his dysarthria also showed improvement. When DL-threo-DOPS was suspended, the frozen gait returned on the third day to almost the former level, even though he continued to receive L-DOPA and benserazide. After administration of DL-threo-DOPS, the CSF level of 3-methoxy-4-hydroxyphenylglycol (MHPG), a major metabolite of norepinephrine, was 127.5% of the pretreatment level. These observations suggest that DL-threo-DOPS can pass through the blood-brain barrier and change to norepinephrine, and that DL-threo-DOPS may be beneficial in the treatment of the freezing phenomenon of Parkinson's disease.
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PMID:Improvement in freezing phenomenon of Parkinson's disease after DL-threo-3, 4-dihydroxyphenylserine. 643 55

Sixty-five cases of clinically diagnosed multiple lacunar state have been analysed. The clinical course of multiple lacunar state is usually progressive in nature, simulating degenerative diseases, in contrast with the mode of acute onset seen in the other vascular diseases. Average age at the initial visit was 63.8 year-old, and sex ratio showed marked male preponderance, being 12 for males and 1 for females. Gait disturbance and speech disturbance are the most frequent initial symptoms, followed by slow motion, emotional lability and swallowing difficulty. Neurological manifestations are dysarthria, short-stepped and apraxic gait, hyperreflexia, positive Babinski and Chaddock reflexes, minimal spasticity, dementia, positive palmo-mental reflex, emotional lability, fixed face, rigidity, bradykinesia, foot grasping, dysphagia, positive Myerson's sign and tremor, in the order described. The important point is that the rigidity is paratonic and the tremor is action or postural, not the cogwheel rigidity or resting tremor like Parkinson's disease. The appearance of pathological reflexes (Babinski and Chaddock reflexes) are quite important, especially Chaddock reflex, which can frequently become positive despite negative or equivocal Babinski reflex. Hypertension, especially longstanding in nature, is the major contributing factor in this disorder. CT scan showed the presence of one or more lacunes in 52 out of 65 cases (80.0%). The detection of lacune can be influenced by the quality of CT scan, and the high resolution CT scanner is greatly useful for that purpose. It is stressed that the detailed neurological and computed tomographic evaluations will make it possible to reach the clinical diagnosis and appropriate treatment of multiple lacunar state.
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PMID:[Clinical studies on multiple lacunar state]. 674 15


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