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)

When making discrete aiming movements, patients with Parkinson's disease show greater inherent variability in the endpoints of their movements than do normal subjects. Endpoint variability can be reduced, by moving more slowly, by utilizing visual guidance, and by making small amplitude movements. The greater variability of patients is not a universal finding, but depends on the conditions of movement. For small movements the performance of patients equates to that of controls. For larger movements the results indicate that if sufficient time is available, patients can use visual guidance (if available) to reduce the variability of their movements to the level of normals. Patients can generate fast and/or large amplitude arm movements if required, but they are erratic if made in the dark or over a short duration. Their difficulty lies not so much in the magnitude of muscle force available to them, but rather in an inability to produce it consistently for any given movement attempted. Bradykinesia may in part result from this inherent variability in that parkinsonian patients, in order to maintain accuracy within acceptable limits, are forced to increase the duration of their movements to a level where they can make use of visual guidance. In any event, theoretical explanations for the movement disorder in Parkinson's disease advanced in the literature need to take some account of this increased variability of movement.
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PMID:Movement variability and bradykinesia in Parkinson's disease. 239 87

Treatment of common marmosets with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 1-4 mg/kg for up to 4 days) caused a profound parkinsonian state. Ten days from the start of MPTP treatment, all animals showed marked motor impairment, consisting of bradykinesia and akinesia, limb rigidity, postural abnormalities, loss of vocalisation and blink reflex, and, on occasions, postural tremor. Measurement of caudate-putamen monoamine content at this time showed a profound loss in 3,4-dihydroxyphenylethylamine, homovanillic acid, and 3,4-dihydroxyphenylacetic acid concentrations. Measurement of neuropeptide concentrations in the caudate-putamen, internal and external segments of the globus pallidus, nucleus accumbens, substantia nigra, frontal cortex, and hippocampus showed met-enkephalin, leu-enkephalin, and cholecystokinin (CCK-8) concentrations to be unaffected by MPTP treatment. There was a small decrease in the substance P content of frontal cortex, but otherwise the content of this neuropeptide was unaltered. Parkinsonism in the marmoset, induced by MPTP treatment 10 days earlier, does not alter neuropeptide concentrations in the manner observed in Parkinson's disease.
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PMID:Lack of change in basal ganglia neuropeptide content following subacute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine treatment of the common marmoset. 242 37

Bradyphrenia is considered the mental equivalent of bradykinesia in Parkinson's disease. Patients are described as inattentive and "slow thinking," but not demented. We compared the performance of three groups: parkinsonians age-matched controls, and mildly impaired patients with probable Alzheimer's disease in tests of general intellect, memory reaction time, and in a continuous performance task measuring attention and vigilance. Metabolites of the major biogenic amine in CSF were also measured. The parkinsonians formed two distinct groups. In one, intellectual function and CSF measures were similar to that of controls. The other group of parkinsonians had significantly more omission errors and fewer correct response on the continuous performance task than did controls or patients with Alzheimer's disease. We considered this second group to have bradyphrenia. Their performance on measures of general intellectual and memory function was similar to that of the patients with Alzheimer's disease. CSF-MHPG, the major metabolite of norepinephrine, correlated with the continuous performance task and reaction time in all parkinsonians, and those with bradyphrenia had the highest CSF-MHPG levels. Our data suggest that bradyphrenia is an impairment of attention and vigilance, unique to Parkinson's disease, that may be associated with dementia and with an alteration in norepinephrine metabolism.
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PMID:Clinical and biochemical correlates of bradyphrenia in Parkinson's disease. 243 47

Encouraged by the recent reports on the beneficial effects obtained with open transplantation of autologous adrenal medullary grafts into striatal structures in case with resistent Parkinson's disease, our team used this procedure in a 63-year-old man presenting with severe bradykinesia and rigidity resistent to all pharmacological attempts. In this case through a laparotomy the right adrenal gland was removed and stored in oxygenated Collins and bicarbonated Ringer solution mixtures while a F2 transventricular approach to the head of the caudatum was done. With the surgical microscope the medullary part of the adrenal gland was dissected and four pieces of mm3 of tissue selected, implanting them in a bed previously carved in the caudatum. Endocrinologic and hydroelectrolytic problems appeared during the immediate postoperative period. In the following 5 months no clinical benefit nor electroneurophysiological changes were observed.
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PMID:Critical approach to intrastriatal medullary adrenal implants via open surgery in parkinsonism. Case report. 247 3

In Parkinson's disease there is degeneration of neurons in the substantia nigra, with consequent depletion of the neurotransmitter dopamine. The triad of tremor, rigidity and bradykinesia is the clinical hallmark. Drugs currently used for palliative therapy fall into three categories: anticholinergic agents, dopamine precursors (levodopa combined with extracerebral decarboxylase inhibitors) and artificial dopamine agonists. It has been argued, on theoretical grounds, that some drugs slow the progress of Parkinson's disease, although no firm evidence has supported this. Treatment must be individualized, and more than one type of drug can be given concurrently after a careful build-up in dosage. We review the adverse effects of various drugs and consider new developments such as slow-release preparations, selective D-1 and D-2 agonists and transplants of dopaminergic cells into the brain. The treatment of Parkinson's disease can be demanding, rewarding and sometimes frustrating, but it remains a most challenging exercise in pharmacotherapy.
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PMID:Parkinson's disease. 272 May 9

The dopamine agonist, CQP 201-403, was administered to 10 patients in an open label fashion with rapid dosage escalation during hospitalization. Assessed over an average of 20 days, significant improvement occurred in bradykinesia, rigidity, and postural instability. Tremor did not occur in sufficient frequency in this group of patients to be accurately assessed. The most serious adverse effect encountered was prolonged confusion with psychosis. This study suggests that CQP 201-403 may be of value in the treatment of Parkinson's disease.
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PMID:CQP 201-403 in Parkinson's disease: an open-label pilot study. 257 Oct 83

Flunarizine hydrochloride (FZ), a calcium entry blockade, has been used nationwide in Japan as a cerebral active vasodilator since October, 1984. The present paper reports 31 cases of FZ-induced Parkinsonism, depression and akathisia, referred to our hospital between October 1986 and September 1988. Out of the 31 patients, four including two with Parkinson's disease and one each with progressive supranuclear palsy and olivopontocerebellar atrophy showed worsening of their parkinsonian symptoms within a few months after FZ administration. The remaining 27 patients (7 males and 20 females) newly developed Parkinsonism after treatment with FZ. Symptoms appeared one week to two years (mean: 6.1 months) after starting FZ of a daily dose of 10 mg. FZ had been used in 6 patients for cerebrovascular episodes confirmed by clinical history or brain CT, and in the remainder, for dizziness, light-headedness, hypertension, amnesia or hypochondric neurotic complaints. Akinesia and bradykinesia progressed rather rapidly after onset, and patients became unambulatory within several months. Symptoms had worsened, and L-dopa, anticholinergic drugs, and bromocriptine had been ineffective until FZ was discontinued. Their Parkinsonism was characterized by marked akinesia, bradykinesia, and moderate rigidity. Masked face was seen in most of them. Tremor was absent at rest, and induced in 12 patients by posture and/or action. Sixteen patients were accompanied by depression, and five, by akathisia. Improvement began several weeks after withdrawal of FZ, and most patients recovered almost completely within a few months although mild rigidity and bradykinesia remained in some.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Parkinsonism, depression and akathisia induced by flunarizine, a calcium entry blockade--report of 31 cases]. 258 81

One hundred de novo patients with Parkinson's disease (PD) were classified into two groups according to age of onset of symptoms. Seventy two patients were under 70 years and 28 were 70 years and over. All patients were given neurological and neuropsychological assessments, and the severity of the signs was rated on a modified Columbia scale. The neuropsychological assessment was also administered to 50 age-and-education-matched controls. The neuropsychological test battery included tests of verbal learning, visual memory, verbal fluency, visuospatial skill, simple and choice reaction time, language and maze learning. The late-onset patients had significant impairment in nonverbal reasoning, auditory verbal learning, visual memory and choice reaction time in contrast to early-onset patients and controls. A relationship was found between bradykinesia and widespread cognitive impairment. Severity of tremor was found to be significantly correlated with impairment in auditory verbal learning, visual memory and increased choice reaction time, while rigidity was found to be associated with cognitive impairment in verbal fluency and visuospatial skill. Using DSM II criteria, 39% of the late-onset and 8% of the early-onset group were classified as demented. Dementia was more common in patients with bilateral symmetrical disease and in those patients with marked tremor and bradykinesia. The pattern of cognitive impairment in PD was consistent with that associated with a subcortical dementia. This study confirms that the expression of PD is markedly influenced by the age of onset.
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PMID:The neuropsychology of de novo patients with idiopathic Parkinson's disease: the effects of age of onset. 226 12

The efficacy of controlled-release Sinemet was evaluated in a 52-week open trial involving 20 patients (14 men, 6 women; mean age 66 years, range 56 to 82) with idiopathic Parkinson's disease of 8 years' mean duration. The mean daily dosage of levodopa was 662.5 mg (200 to 1600 mg) on entering the study and 800 mg (200 to 2400 mg) after 52 weeks. The mean number of daily doses was reduced from 5.0 (2 to 16) at entry to 3.3 (1 to 6) after 52 weeks. Rigidity, tremor, and bradykinesia were scored at 3 intervals during baseline and 8 intervals during the study on controlled-release levodopa. All parameters improved, with maximum improvement seen at week 12. Side effects were less frequent on the controlled-release preparation. After 5 months, 1 patient developed protracted dyskinesia with freezing episodes and end-of-dose deterioration on dose frequency reduction.
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PMID:Sinemet CR in the treatment of patients with Parkinson's disease already on long-term treatment with levodopa. 258 67

We studied the onset of preparatory postural responses and subsequent voluntary movements by measuring soleus muscle activities in the standing position in 20 patients with Parkinson's disease. We measured the postural response in preparing to rise on tiptoe as the onset of the premotion silent period (PMSP). Our patients showed no delay when compared with age-matched healthy controls, but did show a significant delay in the onset of voluntary movement. The elongated PMSP (increased duration of the preparatory postural adjustments) was related to the severity of bradykinesia. Results indicate that the conventional reaction time is increased in patients with Parkinson's disease, even though there is no delay of central processing for the preparation of voluntary movements, and that there is bradykinesia of involuntary postural movements.
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PMID:Reaction times of movement preparation in patients with Parkinson's disease. 258 78


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