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)

To determine why parkinsonian patients (PP) present some difficulties to initiate locomotion, a diagonal step has been investigated in two tasks in five control subjects (CS) and in ten PP. In the first task, the subjects had to perform one diagonal step without change in their orientation (WR); in the second task, they had to perform one diagonal step with a body rotation in the step direction (RO). The defended hypothesis is that the gait initiation deficits in Parkinson disease are a consequence of their difficulties to coordinate al the component of a complex movement. The analysed parameters were the duration of the postural and movement phases, the step length and velocity, and the amplitude of the horizontal ground reaction forces during each phase. Compared to CS, the PP showed a lengthening of the postural phase, a decrease in the step length and velocity and a reduction of the horizontal forces. The comparisons between the performances obtained in the WR versus those obtained the RO show in CS that the performances remained unchanged, whereas in PP the performances were significantly more altered in the RO. It illustrates the specific deficit occurring in PP while performing complex tasks where coordination between several components has to be achieved simultaneously.
Gait Posture 2003 Dec
PMID:Coordination of axial rotation and step execution: deficits in Parkinson's disease. 1466 48

Gait and Balance Scale (GABS) consists of historical information and examination of 14 different gait and balance parameters designed to assess the severity of these functional domains. Thirty-five patients with Parkinson's disease (PD), Hoehn and Yahr stages 1-3, were tested during their "off" period. GABS items were compared to quantitative data from two computerized gait analysis instruments, GAITRite and Pro Balance Master. Intra-class correlation coefficients were calculated to establish reliability. Intra-rater test-retest reliability was determined using Cohen's Kappa statistic. Concurrent validity was derived using the Spearman's rho test with the items from GABS, GAITRite and Balance Master. Intra-rater reliability was high with k>0.41 (k=kappa statistic) for 17 items, 6 had k>0.61. When performing validity measurements, a number of items on the GABS had a correlation coefficient significant at p<0.01 (2-tailed). Posture, pull test, balance during stance, single limb stance, tandem stance, turning, toe walking and functional reach had significant correlation with Balance Master data (R=0.46-1). Gait, arm swing, gait speed, steps/5 m, 'up-and-go test', modified performance oriented assessment of gait scale and provocative testing had significant correlation with the GAITRite items (R=0.51-0.83). GABS is an easy-to-use comprehensive clinical scale with high intra-rater and internal item reliability. We have shown concurrent validity with two computerized gait analysis instruments. We expect GABS to have a particular utility in clinical trials designed to modify functional impairment associated with abnormalities in gait and balance.
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PMID:Clinical gait and balance scale (GABS): validation and utilization. 1517 29

In the advanced phase of Parkinson's disease (PD), high frequency electrical stimulation (HFS) of the subthalamic nucleus (STN) can represent a good therapeutic option, whose effects on walking have been recently quantified by kinematic and dynamic gait analysis. The goal of the present study was to compare, in a group of PD patients, the effects of STN stimulation and of L-dopa on trunk kinematics during walking. The additive effect of these two treatments was investigated as well. Ten idiopathic PD patients implanted bilaterally with a STN stimulation system and ten age-matched controls were studied using a three dimensional motion analyser. Four conditions were considered: with (s+) and without (s-) STN stimulation and with (m+) and without (m-) L-dopa administration. The results showed that both stimulation alone and L-dopa alone significantly increased the stride length and the gait speed, with an additional effect if applied simultaneously. Cadence was more influenced by L-dopa. The range of lateral bending and torsion of the trunk, which were reduced in s-/m-, increased similarly in s-/m+ and in s+/m- conditions. The exaggerated forward inclination of the trunk reduced towards control values in all therapeutic conditions. There was a tendency for L-dopa to increase trunk movements in the frontal plane, similar to events seen in quiet stance. Due to the presence of additive and synergistic effects, we concluded that the mechanisms of action of the two treatments are likely to be different.
Gait Posture 2004 Apr
PMID:Effects of subthalamic nucleus stimulation and L-dopa in trunk kinematics of patients with Parkinson's disease. 1501 5

Nine subjects with Parkinson's disease, five subjects with electrodes implanted in the subthalamic nucleus (STN) and four with electrodes in the globus pallidus internus (GPi), were compared with a population of ten age-matched control subjects. The measures studied include a set of summary statistic scores, two stochastic parameters, the distribution of the center of pressure (CoP) displacement angles under each foot, and the distribution of bilateral patterns of CoP displacement angles. A Bayes classifier was designed to monitor the trend of postural performance in patients, with different treatments. Results suggested that the selected measures were sensitive to Parkinsonian postural sway abnormalities and highlight differences in response to treatments. Deep brain stimulation restored a more normal postural sway and levodopa increased sway abnormalities. Furthermore, the selected measures appear to detect different responses to levodopa between the STN and GPi groups: the negative side effects of levodopa on posture were less severe for STN than for GPi patients, perhaps due to the decreased need for levodopa intake in STN subjects. The measures proposed in this preliminary study may be useful adjuncts to evaluate balance and postural control strategies in patients with Parkinson's disease and may allow the comparison of DBS electrode sites, on stance posture.
Gait Posture 2004 Apr
PMID:Comparison between subthalamic nucleus and globus pallidus internus stimulation for postural performance in Parkinson's disease. 1501 6

Researchers have suggested that sensory cues can improve gait initiation in persons with Parkinson's disease (PD); however, there is little research that documents the effects of sensory cues on gait initiation. The purpose of this study was to examine the effects of auditory and cutaneous sensory cues on maximal speed gait initiation in person's with PD and healthy elderly. Seven persons with PD of moderate severity (mean age=69 years) and seven age, gender, and height matched healthy elders participated. Temporal, kinematic and center of pressure (COP) data were recorded as participants performed eight trials within four randomly ordered conditions (no cue (NC), a single auditory cue (SA), repetitive auditory cues (RA), and repetitive cutaneous cues (RC)). In each condition, participants were instructed to perform each gait initiation trial at their maximal speed. In all conditions, person's with PD reacted more slowly and moved less far than did the matched elders. Relative to conditions with NCs, sensory cueing resulted in decreased double limb support (DLS), and increased COP displacement and velocity in both groups. However, in both groups, displacements and velocities of the swing limb and sacrum during the sensory-cued conditions were less than those during the NC condition. These results suggest that when movement speed is a primary goal, sensory cues may interfere with swing limb and body movement outcomes during the gait initiation task in both person's with PD and healthy elders.
Gait Posture 2004 Jun
PMID:Sensory cueing effects on maximal speed gait initiation in persons with Parkinson's disease and healthy elders. 1512 10

We recently reported that the centromedian-parafascicular thalamic complex (CM-Pf) degenerates in Parkinson's disease and progressive supranuclear palsy. The contribution of such thalamic pathology to disease symptoms has not yet been established. The present study therefore investigated the behavioural impact of lesioning the corresponding thalamic region (termed Pf) on a range of behaviours present in rodents. There were four surgical groups: (1) sham medial forebrain bundle (mfb)+sham Pf, (2) 6-OHDA mfb lesion+sham Pf, (3) sham mfb+NMDA Pf lesion, (4) 6-OHDA+NMDA Pf lesions. Posture, sensory functions and apomorphine-induced rotational asymmetry were assessed before and after each surgery. Other assessments performed including a timed motivational task, grooming behaviours and piloerection. 6-OHDA lesions induced postural (ipsilateral curling and head position biases), sensorimotor (increased latency to respond to tactile stimulation of the contralateral side when eating or grooming) and rotational abnormalities (contralateral circling after apomorphine). The main effects of combined 6-OHDA+Pf lesions were improved performance in a motivational task (decreased latency to retrieve reward) but worsened piloerection, relative to animals with either 6-OHDA or Pf lesions alone. The thalamic zone common to all lesioned animals involved the posterior Pf. Our data suggests that the posterior CM-Pf may be involved in motivational responses and autonomic dysfunction in parkinsonian disorders.
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PMID:Behavioural effects of parafascicular thalamic lesions in an animal model of parkinsonism. 1597 Feb 17

Impaired gait initiation is one of the typical sign of advanced Parkinson's disease (PD). This is the first study to examine quantitatively the effect of deep brain stimulation of the subthalamic nucleus on the performance of gait initiation for patients with advanced PD. A total of 11 patients after surgery of bilateral deep brain stimulation of the subthalamic nucleus (STN) were tested in both the deep brain stimulation (DBS) ON and OFF conditions and/or in both the medication ON (i.e., with the usual dosage of antiparkinsonian medications administered) and OFF (i.e., with the usual dosage of antiparkinsonian medications withheld) conditions. DBS had no effect on the onset of anticipatory postural adjustment (APA). The effect of DBS approached significant level for the onset of swing foot lifting, but reached significant level for the delay of swing foot lifting. DBS significantly increased the amplitude of the APA, amplitude of reactive shear forces on both feet, and amplitude of COP in both anterior-posterior and medial-lateral directions. It is concluded that DBS significantly improved the performance of patients with advanced PD in gait initiation.
Gait Posture 2006 Jun
PMID:Bilateral subthalamic stimulation improves gait initiation in patients with Parkinson's disease. 1609 48

The study of human gait has expanded and diversified to the extent that it is now possible to identify a substantive literature concerning a variety of gait tasks, such as gait initiation [Halliday SE, Winter DA, Frank JS, Patla AE, Prince F. The initiation of gait in young, elderly, and Parkinson's disease subjects. Gait Posture 1998;8:8-14; Mickelborough J, van der Linden ML, Tallis RC, Ennos AR. Muscle activity during gait initiation in normal elderly people. Gait Posture 2004;19:50-57], stepping over and across obstacles [Patla AE, Prentice SD, Robinson C, Newfold J. Visual control of locomotion: strategies for changing direction and for going over obstacles. J Exp Psych 1991;17:603-34; Chen, HC, Ashton-Miller JA, Alexander NB, Schultz AB. Effect of age and available response time on ability to step over an obstacle. J Gerontol 1994;49:227-33; Sparrow WA, Shinkfield AJ, Chow S, Begg RK. Gait characteristics in stepping over obstacles. Hum Mov Sci 1996;15:605-22; Begg RK, Sparrow WA, Lythgo ND. Time-domain analysis of foot-ground reaction forces in negotiating obstacles. Gait Posture 1998;7:99-109; Patla AE, Rietdyk S. Visual control of limb trajectory over obstacles during locomotion: effect of obstacle height and width. Gait Posture 1993;1:45-60] negotiating raised surfaces such as curbs and stairs [Begg RK, Sparrow WA. Gait characteristics of young and older individuals negotiating a raised surface: implications for the prevention of falls. J Gerontol Med Sci 2000;55A:147-54; Mcfayden BJ, Winter DA. An integrated biomechanical analysis of normal stair ascent and descent. J Biomech 1988;21:733-44]. In addition, increasing research interest in age-related declines in gait that might predispose individuals to falls has engendered a very extensive literature concerning ageing effects on gait. While rapid locomotor adjustments are common in the course of daily activities there has been no previous review of the findings concerning gait adaptations when walking is terminated both rapidly and unexpectedly. The aims of this review were first, to summarise the key research findings and methodological considerations from studies of termination. The second aim was to demonstrate the effects of ageing and gait pathologies on termination with respect to the regulation of step characteristics, lower-limb muscle activation patterns and foot-ground reaction forces.
Gait Posture 2005 Dec
PMID:Gait termination: a review of experimental methods and the effects of ageing and gait pathologies. 1627 20

To achieve a unified assessment of postural instability in Parkinson's disease (PD) over a range of clinical stance and gait tasks, which may provide an insight into a tendency to fall, we measured trunk sway in the anterior-posterior and medial-lateral directions in freely moving PD patients and age-matched controls. We also measured task duration as time to complete the task or time to loss of balance. Patients had larger amplitudes of trunk sway velocities for stance tasks (e.g. mean pitch velocity when standing on two-legs eyes closed equalled 19.1 +/- 6.4 for PD patients on medication versus 4.8 +/- 0.3 degrees/s for controls, p = 0.0003) and for an expected (following prior warning) retropulsion test (mean roll angle equalled 4.3 +/- 0.5 degrees for PD patients versus 2.2 +/- 0.6 degrees for controls, p = 0.0003) than controls. Patients were more likely to fall earlier for stance tasks, and took longer to complete gait tasks (e.g. walking 3 m eyes closed, mean time 6.8 +/- 0.6 sees versus 4.9 +/- 0.1 sees, p = 0.0001). These differences between patients and controls were, in most cases, independent of medication. Based on these results we defined a simple test battery of stance and gait tasks that could discriminate between PD patients who had recent falls and controls. These results indicate that trunk sway measures recorded during stance and gait tasks provide useful information on balance deficits leading to falls in PD patients.
Gait Posture 2005 Nov
PMID:Trunk sway measurements during stance and gait tasks in Parkinson's disease. 1627 66

A new system for long-term monitoring of gait in Parkinson's disease (PD) has been developed and validated. The characteristics of every stride taken over 10-h epochs were acquired using a lightweight ankle-mounted sensor array that transmitted data wirelessly to a small pocket PC at a rate of 100 Hz. Stride was calculated from the vertical linear acceleration and pitch angular velocity of the leg with an accuracy of 5 cm. Results from PD patients (5) demonstrate the effectiveness of long-term monitoring of gait in a natural environment. The small, variable stride length characteristic of Parkinsonian gait, and fluctuations of efficacy associated with levodopa therapy, such as delayed onset, wearing off, and the 'off/on' effect, could reliably be detected from long-term changes in stride length.
Gait Posture 2007 Jul
PMID:Long-term monitoring of gait in Parkinson's disease. 1704 61


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