Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical picture of Parkinson's disease (PD) can be so varied that absolute clinical diagnosis may not always be possible. Several diverse entities (including toxins, pharmacologic agents, and multisystem atrophies and other degenerative diseases) can produce clinical syndromes almost indistinguishable from those of PD. Nevertheless, a sufficient number of guiding criteria--such as the presence of at least two of three motor signs (tremor, bradykinesia, and rigidity), persistence of these signs for several years, and responsiveness to levodopa--may serve to clarify and specify diagnosis, at least until such time as a biologic marker of PD is discovered. However, currently the clinical diagnosis of PD remains difficult.
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PMID:How accurately can Parkinson's disease be diagnosed? 154 3

Short-term synchrony between the discharges of motor units has been assessed in Parkinson's disease (PD) and normal man. The discharges of single motor units were recorded in the extensor digitorum communis (EDC) muscle of the forearm or the tibialis anterior (TA) muscle of the leg during weak, voluntary isometric contraction. Short-term synchrony was defined as a narrow peak (total width less than 25 ms) in cross-correlograms constructed from the discharges of pairs of motor units. There was no difference in the incidence of short-term synchrony between PD and normal age-matched subjects for either the EDC or TA muscle. On average, 60% of pairs of motor units exhibited synchrony, but this varied between 0% and 100% for both groups. The amount of short-term synchrony was assessed as the probability (above chance) of discharge of one motor unit with respect to the other. In TA, but not EDC, this index was greater for PD than for normal subjects. The high indices of synchrony in TA in PD were not related to lower discharge rates of motor units. Parkinson's disease subjects, but not normal subjects, also showed broad correlations that were invariably associated with periodic discharges in the range 4-6 Hz. In some instances, a peak of short-term synchrony was observed superimposed on the broad correlation. The periodic correlograms were often associated with overt tremor which accompanied the contraction. Motor units occasionally discharged paired impulses (doublet discharges) with short interspike intervals of 5-15 ms (normal and PD) or, as a more persistent feature in PD, longer interspike doublets (20-60 ms) associated with periodic synchrony (4-6 Hz). The abnormal discharge characteristics of motor units are discussed in relation to the bulbospinal control of presynaptic drive to motor neurons in PD.
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PMID:Short-term synchrony of motor unit discharge during weak isometric contraction in Parkinson's disease. 155 49

Spinal anesthesia was given to a patient with right femur fracture and Parkinson's disease (PD). Although sufficient analgesia was obtained up to L1 level after spinal anesthesia, the muscular rigidity remained. Furthermore, tremor of the upper extremities continued. After administering dantrolene sodium (DT) intravenously, these untoward features were abolished. These findings suggest that DT abolishes rigidity and tremor in PD, and is useful for the management of anesthesia for a patient with PD.
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PMID:[Rigidity abolished by intravenous dantrolene in a patient with Parkinson's disease under spinal anesthesia]. 156 May 88

The neurologic states and activities of daily life of patients with Parkinson's disease were evaluated using a rating scale with subitems, and subsequently the neurologic disturbance scores and the daily activity impairment scores were obtained. Subjects consisted of 19 normal controls, and 55 ambulatory patients without marked dyskinesia who were on various anti-parkinsonian drugs. Blink reflex was elicited by paired electrical stimulation over the supraorbital nerve. The interval time between the conditioning stimulation and the test stimulation was set at 200 ms, and 5 serial ipsilateral maximal R2 amplitudes on the stimulated side were measured. The mean of the paired maximal R2 amplitude ratio (test/conditioning), expressed as a percentage, was defined as the habituation index. The habituation indices in normal controls and those with Parkinson's disease were 17.1 +/- 7.6 and 51.9 +/- 29.3, respectively (P less than 0.01). The degree of akinesia, rigidity, balance/gait and dysarthria was positively correlated with the habituation index (P less than 0.01), while tremor was not. On the whole the habituation index was found to have a significant correlation not only with the neurologic disturbance score but also with the daily activity impairment score (P less than 0.01).
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PMID:A correlation study between blink reflex habituation and clinical state in patients with Parkinson's disease. 156 13

It was the purpose of the present study to quantify the expected motor deficit in parkinsonian patients with the computer assisted Motor Performance Test Series (MPS), version 05.87 by Schuhfried (1987) and to examine which of the motor test variables found correlate at a significance level of p less than 0.01 with items of "motor examination" recorded at neurological examination and "activities of daily living" of the Unified Parkinson's Disease Rating Scale (UPDRS), version 3.0. 38 patients with idiopathic Parkinson's disease (PD) stages I-IV according to Hoehn and Yahr, aged 41 to 73 years were studied. The study design, i.e. initial rating by the physician followed immediately by testing of motor function with MPS was strictly adhered to in each patient. Physician's rating of rigor and the scores of the semiquantitative tests (finger taps, hand movements and alternating movements) as expression of hypokinesia and the "activities of daily living" correlated with the 3 factors of the Motor Performance Test Series at a highly significant level independent of disease stage. Tremor is only partly and never significantly reflected in the motor data measured. Stages I-II and II-IV (Hoehn and Yahr) differ significantly in the representative data of the Motor Performance Test Series. The results of the study support the assumption that MPS is a valid instrument for quantitative measurement of the motor deficit in parkinsonian patients, but that only some subtests are "pathognomonic".
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PMID:Quantification of motor deficit in Parkinson's disease with a motor performance test series. 157 Oct 77

50 de novo patients with Parkinson's disease were investigated in a retrospective study after selegiline (-)deprenyl monotherapy and a combination of (-)deprenyl and levodopa. The study involved subjects with different Hoehn-Yahr stages (I, II, III, IV). During the treatment period the distribution of age (below 60 yr or above 60 yr) among the Hoehn-Yahr stages was similar to that of the baseline period, while the clinical disability for the patients starting with hypokinesis meant a more severe state compared to the cases with tremor. The sex ratio was similar during the baseline period but later, during the administration of deprenyl, the progression of males was slower than that of females. (-)Deprenyl was effective in decreasing the hypokinesis, while the rigidity was improved less by this drug. The reduction of parkinsonian symptoms developed slowly and was independent of the severity of Parkinson's disease. The maintenance of deprenyl monotherapy showed a high individual variation but the average period was about one year. The termination of the effect of deprenyl was rapid, however, not progressive. The time of the appearance of the side effects of additional levodopa was not delayed by deprenyl treatment. After five years the severity of disease was similar to the baseline disability scores in spite of the combined therapy with levodopa and deprenyl.
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PMID:Some new aspects of the effect of (-)deprenyl in Parkinson's disease--a retrospective study. 157 Oct 79

The causes of symptomatic parkinsonism are enumerated and discussed including drug-induced, vascular, toxic, postencephalitic and posttraumatic parkinsonism. The environmental hypothesis and the concept of oxidative stress in the pathogenesis of Parkinson's disease are illustrated. The clinical diagnosis, the differential diagnosis and the possible diagnostic errors originating from the cardinal symptoms akinesia, rigor und tremor in the early stages of the disease are delineated. At last the contributions of EEG, CCT, evoked potentials, MRI, PET und the apomorphine test to the diagnosis especially early diagnosis are evaluated.
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PMID:[Current aspects in diagnosis of Parkinson disease]. 158 88

The response of postural wrist tremors to brief mechanical displacements was compared in two groups of patients, one with classical hereditary essential tremor (n = 18) and another with typical Parkinson's disease (n = 13). These groups were compared with an additional group of normal subjects mimicking wrist tremor (n = 9). The degree to which brief mechanical displacements of the wrist produced by torque pulses of three different sizes could modulate the timing of rhythmic electromyographic bursts in the forearm flexor muscles was quantified by deriving a resetting index, which could range between 0 (no phase resetting) and 1 (complete phase resetting). In all three groups of subjects studied, the resetting index varied significantly with the size of the mechanical perturbation and, in an inverse fashion, with the ongoing tremor amplitude. When due allowance for these factors was made, the difference in mean resetting indexes between the three groups of patients and subjects was reduced to the extent that no definitive statement could be made as to whether brief mechanical perturbations had more effect on essential tremor than parkinsonian tremor. The method is therefore unlikely to be useful in differentiating the common causes of postural wrist tremors.
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PMID:"Resetting" of postural tremors at the wrist with mechanical stretches in Parkinson's disease, essential tremor, and normal subjects mimicking tremor. 159 86

Chronic thalamic-VIM stimulation was performed in 9 parkinsonian patients with disabling tremor and poor response to drugs. Neuropsychological assessment was performed before and after deep brain electrode implantation and stimulation. Mild cognitive disorders were observed prior to thalamic implantation. Neuropsychological testing failed to show intellectual function worsening after implantation and stimulation. We conclude that thalamic stimulation could be an appropriate treatment of untractable tremor as this could provide less neuropsychological side-effects than thalamotomy, especially in Parkinson's disease.
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PMID:[Neuropsychological evaluation before and after thalamic stimulation in 9 patients with Parkinson disease]. 160 21

In the past, stereotactic surgery was a regular treatment for prominent unilateral tremor in Parkinson's disease (PD), but follow-up studies were usually short-term and always unblinded. We examined 17 PD patients in long-term follow-up (mean, 10.9 years after surgery) and used videotapes and the Unified Parkinson's Disease Rating Scale to blindly compare tremor ipsilateral and contralateral to the side of surgery. Since the patients were specifically selected for stereotactic surgery because of asymmetric tremor, and the surgical side chosen was contralateral to the predominant tremor, a sign of long-term efficacy would be current postoperative reversal of tremor side predominance. Upper extremity tremor was significantly better contralateral to the surgery compared with the ipsilateral side. We conclude that stereotactic surgery improved the absolute magnitude of tremor or ameliorated its rate of progression. Since asymmetric bradykinesia and dyskinesia were not a prerequisite for the choice of surgical side, we cannot make any conclusion about long-term impact of surgery on these features.
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PMID:Blinded evaluation confirms long-term asymmetric effect of unilateral thalamotomy or subthalamotomy on tremor in Parkinson's disease. 162 Mar 40


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