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

For the stereotactic treatment of Parkinson's disease, the target is usually located in the thalamus; this point is related to nearby structures (third ventricle). Then the position is controlled by electrophysiological recordings. The lesion of the target results in permanent suppression of the contralateral tremor and/or rigidity but it changes neither the course of the disease nor the akinesia. Owing to the risk of dysarthria with bilateral procedures, the main indication for surgery is parkinsonism with unilateral tremor or rigidity. Particularly interesting for the future are the possibilities of stimulation through implanted chronic electrodes.
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PMID:[Stereotaxic treatment in Parkinson's disease]. 265 87

Seventy five patients affected by senile dementia of the Alzheimer type (mean age 82) have been submitted to a standardized neurological examination of 88 items. Gait abnormalities were present in 57% of the cases. Extrapyramidal symptoms (akinesia or rigidity or tremor) were noticed in 64% of the cases but they were rarely associated with a typical parkinsonian syndrome. Myoclonus was observed in only 4 patients. The gait abnormalities were significantly associated with the presence of rigidity and grasp reflex but not with other primitive reflexes. The only symptoms to be correlated with dementia severity as assessed by the Mini Mental State were rigidity and optokinetic nystagmus abolition. Tremor and amyotrophy of the hands appeared to be negatively correlated to dementia severity.
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PMID:[Standardized neurologic study in senile dementia of Alzheimer's type]. 268 Apr 61

This open trial is a study of the effect of adding bromocriptine (BC) to the treatment of patients who had taken a dopa-containing preparation (LD) for many years. Sixty-five patients entered the trial at an average age of 66.6 years. The mean duration of Parkinson's disease was 12.74 years and LD had been taken by one-half of them for more than 10 years and by an additional 27% for longer than 5 years. The duration of treatment with BC exceeded 2 years in 45% of cases and the average dose of BC was 19.27 mg/day. On the Hoehn and Yahr scale 70.8% of patients were classified as between stages II and IV, 24.6% were in stage I and 4.6% were in stage V. Dopa-induced involuntary movements were observed in 60% of patients at the beginning of the trial but were present in only 25% at the completion, due to the dopa-sparing effect of BC allowing a reduction of the dose of LD by an average of 34%. End-of-dose failure was reduced only slightly and on-off oscillations were not influenced by the addition of BC to LD. Tremor, rigidity, akinesia and dysarthria improved in 22% of all patients but BC offered no beneficial effect on the various gait disorders of Parkinson's disease. The conclusion of the study is that 47.7% of patients felt that the addition of BC to LD had reduced their involuntary movements and the disabilities of their disease.
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PMID:The addition of bromocriptine to long-term dopa therapy in Parkinson's disease. 270 77

Brain atrophy with mental and neurologic deterioration developing a few months after radiation therapy in patients without residual or recurrent brain tumors has been recognized. Two illustrative case reports of this pathologic entity are presented. Six autopsy cases with this entity including the two cases were reviewed neurologically, radiographically, and histopathologically. All patients presented progressive disturbances of mental status and consciousness, akinesia, and tremor-like involuntary movement. Computerized tomography (CT) demonstrated marked enlargement of the ventricles, moderate widening of the cortical sulci, and a moderately attenuated CT number for the white matter in all six patients. Four of the six patients had CSF drainage (ventriculoperitoneal shunt or continuous lumbar drainage), however, none of them improved. Histologic examination demonstrated swelling and loss of the myelin sheath in the white matter in all patients, and reactive astrocytosis in three of the six patients. Neither prominent neuronal loss in the cerebral cortex or basal ganglia, nor axonal loss in the white matter was generally identified. The blood vessels of the cerebral cortex and white matter were normal. Ependymal layer and the surrounding brain tissue were normal in all patients. These findings suggested that this pathologic condition results from demyelination secondary to direct neurotoxic effect of irradiation. The authors' previous report was reviewed and the differential diagnoses, the risk factors for this pathologic entity, and the indication for radiation therapy in aged patients with a malignant brain tumor are discussed.
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PMID:Subacute brain atrophy after radiation therapy for malignant brain tumor. 270 69

The frequency of shoulder disturbances, particularly frozen shoulder, has not been assessed previously in Parkinson's disease. In a survey of 150 patients compared with 60 matched control subjects a significantly higher incidence of both a history of shoulder complaints (43% vs. 23%) and frozen shoulder (12.7% vs. 1.7%) was found in the Parkinson's disease population. Those developing a frozen shoulder had initial disease symptoms indicative of akinesia twice as frequently as tremor while the ratio was reversed in those without frozen shoulder. In at least 8% of the patients frozen shoulder was the first symptom of disease, occurring 0-2 years prior to the onset of more commonly recognised features. Parkinson's disease should be added to the list of causes of frozen shoulder, and clinicians must be aware that the latter is often the presenting symptom of Parkinson's disease.
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PMID:Frozen shoulder and other shoulder disturbances in Parkinson's disease. 270 37

The study was carried out to clarify whether levodopa should be started early or late in the course of Parkinson's disease. In this study, 122 patients treated with levodopa over 14 years were included. The time course of each of the four major signs (rigidity, static tremor, akinesia and postural instability) and Yahr stage was investigated in three groups, Yahr stage I/II group, Yahr stage III group and Yahr stage IV/V group, taking into consideration the time period preceding the initiation of levodopa therapy. When the time periods in years since onset of symptoms were matched, no significant differences were recognized among the three groups. There seemed to be no benefit in delaying levodopa therapy but, rather, levodopa therapy should be started as early as possible. The declining efficacy often recognized during levodopa therapy was thought probably due to progression of Parkinson's disease itself rather than to levodopa.
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PMID:Should levodopa therapy for Parkinson's disease be started early or late? Clinical course of the major tetrad in 122 parkinsonian patients treated with levodopa over 14 years. 272 44

The parkinsonian syndrome rests on the clinical tripod: akinesia, rigidity, tremor. Akinesia is the key symptom, broadly defined as a difficulty in initiating and performing movements in proportion to their complexity (sophisticated, simultaneous movements) and their duration (repetitive movements). The most frequent cause of the syndrome is Parkinson's disease. Although this diagnosis needs to be confirmed in pathological terms by the loss of neurons and the presence of Lewy's bodies in the substantia nigra, some clinical data enable it to be envisaged with a minimum of errors; these are pure parkinsonian triad, good response to dopatherapy and asymmetrical symptoms. The other causes of parkinsonian syndrome are usually related to the administration of neuroleptic drugs and to degenerative diseases with lesions that are more diffuse than those of Parkinson's disease. In Steele-Richardson-Olzewski disease a parkinsonian syndrome is associated with supranuclear ophthalmoplegia. Multiple systematized atrophy presents under three different clinical aspects: a parkinsonian syndrome without tremor and resistant to L-dopa, suggesting atrophy of the strionigral tract; a parkinsonian syndrome associated with a cerebellar syndrome, suggesting olivo-cerebellar-pontine atrophy, and Shy-Drager disease which includes primary dysautonomy and other neurological syndromes.
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PMID:[Parkinson's disease and parkinsonian syndromes]. 272 71

1. We quantitatively assessed deficits in the initiation and execution of arm movements occurring after destruction of nigrostriatal dopamine neurons by systemic administration of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) (Sigma). Three monkeys performed a reaction time task in which they reached toward a single and constant target for food reward. 2. After administration of MPTP, all three monkeys showed hypokinesia necessitating dopamine precursor or receptor agonist treatment. The partial recovery of one animal from initial akinesia after 19 days permitted discontinuation of dopaminergic drug therapy, although marked hypokinesia remained present. The two other animals displayed additional, intermittent phases of rigidity and activation tremor and needed continuous dopaminergic drug therapy for most of the postlesion period. 3. Administration of MPTP significantly prolonged EMG reaction time in prime mover muscles and arm movement reaction time by 47-225% and 18-129%, respectively, on the six sides of the three animals, compared with control measurements before the lesion. EMG and arm movement reaction time increased over consecutive trials in most sessions comprising 110-130 movements, the first 20 movements showing almost normal values. The delay time between onsets of EMG and arm movement showed unsystematic changes. These deficits in movement initiation were observed both with and without dopamine precursor therapy. They lasted during the whole testing period of several months. 4. Linear correlations between arm movement onset and EMG onset in the two prime mover muscles, the extensor digitorum communis and the biceps, showed coefficients of mostly 0.7-0.9, both before and after MPTP. These data suggest that the temporal relationship between onsets of arm movement and EMG were not substantially affected by MPTP. 5. Arm movement time was divided into two phases. The duration of movement between the resting key and the target, a small food-containing box located ahead of the animal, was denoted as reaching movement time. The following hand manipulation inside the food box was measured as box movement time. After MPTP, both measures were significantly prolonged by 10-103% and 12-251%, respectively, on the six sides of the three monkeys. These deficits in movement execution were observed both with and without dopaminergic drug therapy and during the whole testing period. 6. Task performance after MPTP treatment was studied in one monkey in the absence of dopaminergic drug therapy. EMG and arm movement reaction times recovered partially over several weeks, while the prolongations in reaching and box movement times remained unchanged.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Deficits in reaction times and movement times as correlates of hypokinesia in monkeys with MPTP-induced striatal dopamine depletion. 278 68

We examined correlates of depression in patients whose onset of Parkinson's disease (PD) began before age 55 (early-onset group) compared with patients whose onset was after age 55 (late-onset group). The early-onset group showed a significantly higher frequency of depression than the late-onset group. When both groups were matched for duration of the disease, the early-onset group still showed a significantly higher frequency of depression, whereas tremor, akinesia, and rigidity were significantly more severe in the late-onset group. A stepwise regression analysis showed that in the early-onset group, depression scores were significantly correlated with scores of cognitive impairment and duration of the disease, while in the late-onset group, depression scores were significantly correlated with impairments in activities of daily living. These data suggest that depression in patients with early-onset PD may have a different etiology than in patients with late-onset PD.
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PMID:Depression in patients with early versus late onset of Parkinson's disease. 234 6

Six monkeys treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine developed a Parkinsonian syndrome (rigidity, akinesia, flexed posture and tremor). In both high and low dose groups, neurons in the substantia nigra were selectively damaged. At high dose levels, nigral neurons were severely damaged, but because the monkeys died, the evolution of the pathology could not be studied. At low dose levels, some nigral neurons survived, and a significant number of these nerve cells showed reductions in the immunoreactivity of tyrosine hydroxylase. Axonal pathology was conspicuous in the nigrostriatal pathway. Loss of the immunoreactivity of tyrosine hydroxylase in perikarya may represent a retrograde axonal reaction, a potentially reversible response. The 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine model should prove useful for investigating abnormalities occurring as a consequence of dysfunction of the nigrostriatal system, for examining processes associated with repair of damaged neuronal systems, and for developing and testing therapeutic approaches designed to prevent or ameliorate the Parkinsonian syndrome.
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PMID:Injury of nigral neurons exposed to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine: a tyrosine hydroxylase immunocytochemical study in monkey. 287 15


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