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)

We studied the features of dystonia in 9 patients with untreated idiopathic Parkinson's disease and in 56 patients on sustained treatment with L-dopa. Dystonia was seen as an initial symptom in patients with both early- and late-onset Parkinson's disease and included action dystonia of the limbs and cranial dystonia. Although the coexistence of parkinsonism and dystonia suggests a common pathophysiology, antiparkinsonian drugs did not consistently influence dystonic spasms. L-dopa-induced dystonia was seen as an off-period, biphasic, or peak-dose phenomenon. Each type showed a distinctive pattern of localization of dystonic spasms, possibly reflecting neurochemical aspects of basal ganglia somatotopy. Neuropharmacological studies performed in 12 patients suggest that off-period dystonia is genuinely induced by L-dopa and best relieved by antiparkinsonian agents.
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PMID:Dystonia in Parkinson's disease: clinical and pharmacological features. 334 68

We studied fifteen patients with hemiparkinsonism and ipsilateral hemiatrophy (HP/HA) to better characterize the clinical features of this syndrome and its rate of progression. Patients were distinguished by highly asymmetric parkinsonism with predominant signs on the side of HA, early age of onset (43.7 years versus 60.2 years in our control population of idiopathic Parkinson's disease [IPD], abnormal birth history (7/15), and dystonia occurring prior to levodopa therapy (10/15). In six patients, the mean duration of disease until the initiation of levodopa therapy was 14.2 years, as compared with 4.1 years in our control population of IPD. The slow progression of disease underscores the relatively favorable prognostic significance of HP/HA and its distinction from IPD.
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PMID:Hemiparkinsonism with hemiatrophy. 335 4

Madopar Hydrodynamically Balanced System (HBS), a new sustained-release levodopa preparation, was used to control severe nightly disabilities in 15 outpatients suffering from Parkinson's disease in an advanced state and with long-term levodopa therapy. This medication was given ante noctem in addition to an otherwise unchanged daily regimen of levodopa administration. In 13 patients a considerable diminution in nocturnal akinesia and in the frequency of waking up was reached with a mean dosage of 308 mg of Madopar HBS. Early morning akinesia was only slightly alleviated in four patients. The nocturnal off-period pain disappeared in one patient. Adverse effects consisted of nocturnal dyskinesia in two patients and early morning dystonia in another two patients. The regular use of sleeping pills was clearly reduced after Madopar HBS therapy.
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PMID:Madopar HBS in Parkinson patients with nocturnal akinesia. 335 32

We compared 46 patients having onset of Parkinson's disease before age 45 years with 52 having onset after age 70. Young-onset cases more often presented with muscular stiffness (43%) and old-onset with difficulty walking (33%). One-third of young-onset cases had off-period dystonia, mostly affecting the legs, but no dystonia was recorded in old-onset cases. Presentation with rest tremor occurred in 41% of young-onset and 63% of old-onset. There were no differences in the number of affected relatives, endocrine disease, personality characteristics, dementia, or dyskinesia. A pathological study of 12 young-onset and 22 old-onset cases showed 24% greater nigral cell loss in the young, but no differences in the basic Lewy body pathology. Median disease duration in young cases was 5 years longer in the clinical study and 12 years longer in the pathological study. These studies show that the Parkinson's disease process is similar in young- and old-onset cases.
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PMID:A comparison of clinical and pathological features of young- and old-onset Parkinson's disease. 341 87

In an open pilot study, 10 patients with Parkinson's disease and nocturnal and/or early-morning disabilities were given Madopar HBS (hydrodynamically balanced system; mean dose 250 mg) shortly before retiring in addition to their usual daytime antiparkinsonian treatment. Eight patients derived worthwhile improvement; the most gratifying responses were seen in the relief of nocturnal bradykinesia, rigidity and tremor. Early-morning symptoms were also improved in 3 out of 5 patients, possibly as a secondary response to an improved nights sleep. Cramps, early-morning dystonia and pain, however, responded poorly. Overall results are sufficiently encouraging to warrant further controlled studies with Madopar HBS in what has been a relatively neglected area of distress for many patients with Parkinson's disease.
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PMID:A sustained-release formulation of L-dopa (Madopar HBS) in the treatment of nocturnal and early-morning disabilities in Parkinson's disease. 342 6

We studied the effect of adding low-dose bromocriptine to levodopa/carbidopa (Sinemet) in 26 patients suffering from progressive Parkinson's disease with loss of levodopa effectiveness or levodopa-induced fluctuations. Despite the high incidence of drug intolerance and low response rates, a significant proportion of patients with the wearing-off effect and dystonia improved. Low-dose, slow-increase bromocriptine is warranted as adjunctive therapy in these patient subgroups.
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PMID:Low-dose, slow-increase bromocriptine in patients with progressive Parkinson's disease and complications of levodopa therapy. 345 44

Mean-age of onset of Parkinson's disease is 56 years. The older the patient is the more rapid is on average the progression of disability. In the early phase the motor symptoms respond well to therapy. Later, variations of response to therapy and side-effects of therapy occur (wearing-off, end-of-dose akinesia, end-of-dose dystonia, dopaminergic abnormal involuntary movements, pharmacogenic psychoses etc.). Due to the modern pharmacologic treatment of Parkinson's disease with dopaminergic substances disabling stages of the disease occur mean 3 to 5 years later than before levodopa-substitution was initiated. The incidence of depression, distinct cognitive deficits (impairment of memory, visuospatial deficits) and dementia increases in the course of the disease. The tremulous form of Parkinson's disease generally leads to less motor impairment than the rigid-akinetic form. Parkinson's disease of early onset (onset before the age of 40), may be regarded as a subtype of Parkinson's disease. Benign and malignant types of Parkinson's disease may be distinguished, as well as overlaps with multisystem atrophies.
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PMID:Nosography of Parkinson's disease. 346 66

Six non-human primates received doses of MPTP sufficient to produce a severe parkinsonian syndrome. Levodopa therapy reversed parkinsonian features in all animals, but resulted in dose-dependent choreoathetoid movements of the lower limbs of 3, together with akathisia and dystonia in 2. 'End-of-dose deterioration' was common to all animals, although 'on-off' periods were only seen in 3. Preliminary observations using a clinical rating scale and automatic activity counters demonstrate that both the motor response to levodopa and the complications of therapy are readily quantifiable. We suggest that this is a useful experimental model for testing new strategies in the management of idiopathic Parkinson's disease, particularly with regard to the prevention of drug-induced involuntary movements.
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PMID:Levodopa-induced dyskinesia and response fluctuations in primates rendered parkinsonian with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). 349 42

In 58 patients with progressive supranuclear palsy (PSP), 19 (32.8%) had CT, MRI, or autopsy evidence of a multi-infarct (MI) state. The clinical findings in the infarct syndrome were similar to idiopathic PSP. Five MI-PSP patients had had a stroke, four had focal dystonia, two had hemiparesis, and one had an intention tremor of recent onset. In contrast, only 5.9% (12.9% of those with CT or MRI) of 426 Parkinson's disease patients had evidence of strokes. One case of PSP studied pathologically was attributed to cerebral amyloid angiopathy.
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PMID:Progressive supranuclear palsy and a multi-infarct state. 356 71

Two hundred consecutive patients affected by essential tremor (ET), referred to the Movement Disorders Center of the University of Bologna between January 1977 and December 1981, were studied to identify the different clinical features of this disorder, and its associated neurological signs. In this series, 169 patients suffered from typical essential tremor (TET); in the other 31 cases uncommon clinical features were detected: 25 presented postural, action and rest tremor (continuous tremor: CT); 5 had orthostatic tremor (OT) and 1 was affected by writing tremor (WT). Buccolinguofacial dyskinesias (BLFD) were associated with ET in 19 cases; 2 presented dystonia, and in 6 mild extrapyramidal signs were detected. Uncommon types of tremor: ET plus BLFD and ET associated with extrapyramidal signs had an higher incidence in older people. No patient developed Parkinson's disease (PD) during the follow-up period (2-5 years).
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PMID:Different clinical features of essential tremor: a 200-patient study. 357 75


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