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)

A double-blind crossover study was performed in 12 patients with idiopathic parkinsonism to compare their response to bromocriptine with their response to previous optimal drug treatment, including levodopa. There was a 26 percent overall improvement with bromocriptine; rigidity, tremor, and facial expression showed the greatest response. Seven of eight patients who were taking levodopa at the beginning of the study was taken off the drug completely. Adverse reactions were transient and dose-dependent. Bromocriptine promises to be an effective new therapeutic agent in the treatment of idiopathic parkinsonism.
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PMID:Studies with bromocriptine. Part 2. Double-blind comparison with levodopa in idiopathic parkinsonism. 77 55

Seventeen patients with either Parkinson's disease or post-encephalitic parkinsonism were treated with Piribedil, an apomorphine-like drug, in single blind conditions for a period ranging from five weeks to twenty-four months. The analysis of the results shows that Piribedil modifies the extrapiramidal symptomatology being specially effective against the tremor either when used alone or in association with L-Dopa. The side effects noticed during treatment with Piribedil are similar to those of Apomorphine, and are dose-dependent.
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PMID:[Piribedil in the treatment of Parkinson disease (author's transl)]. 77 98

A new drug, elantrine, blocks the tremorogenic effect of exotremorine, nicotine and harmine in animals. A double blind study compared elantrine with trinhexyphenidyl and against a baseline placebo period, in a group of Parkinson patients. Both, elantrine and trihexyphenidyl treatment, reduced tremor scores at the conclusion of the respective treatment periods, but closer analysis revealed 65% of patients receiving elantrine had lower tremor scores compared to their baseline (placebo) opposed to only 53% receiving trihexyphenidyl. Both drugs produced aequal effect on rigidity. Another group of Parkinson patients receiving clinically optimal doses of L-dopa were treated with either elantrine or placebo, in blind fashion. Analysis of both tremor and rigidity revealed mean scores significantly lower (P less than 0.05) for those patients receiving elantrine than placebo. Also, there was a statistically significant difference in average total symptom scores favoring the elantrine group. Significant improvement with elantrine administration began after the second week for rigidity and after the third week for tremor. Elantrine is a safe, well tolerated agent which is effective alone in the treatment of parkinsonism but significantly enhances the effectiveness of L-dopa, particularly with respect to tremor and rigidity.
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PMID:Elantrine in the treatment of parkinsonism. 79 27

Postural or Parkinson-like tremor, which results from the impairment of mechanisms which are predominantly lateralized in the brain, is most likely related to the combined impairment of the dopaminergic nigrostriatal pathway and the corresponding rubro-olivo-cerebello-rubral loop (without excluding the possiblity that other nervous mechanisms interconnected with these structures may represent an alternative disturbance). The integrity of the internal division of the pallidum and the ventrolateral area of the thalamus and their efferent fibers as well as the motor cortex and certain of its cortico-subcortico-spinal pathways (Figures 1 and 2) is apparently an essential feature for the elaboration of the rhythmic bursts associated with the appearance of postural tremor. The integrity of the spinal sensory roots and the rubro-tegmentospinal tract is not a prerequisite for the expression of postural tremor, a condition which seems essential for the production of rigidity. The latter facts suggest that the disturbances which subserve these two types of motor impairment, often concomitantly present in Parkinsonism, partially involve the impairment of different mechanisms although the loss of the DA fibers originating in the substantia nigra and ending in the neostriatum (Figure 1) appears to represent a disturbance common to both types of disorders. Bradykinesia which may be associated with an impairment of catecholamine metabolism (and more especially the neostriatal DA mechanisms) on both sides of the brain may also result from bilateral lesions of the pallidum or of its outflow corresponding, in the main, to the pallidothalamic fibers ending in the ventrolateral thalamus. The latter types of lesion most likely exclude the influence of the monoaminergic, cholinergic and gabaminergic activities normally originating in the striopallidal system and influencing the activity transmitted to other CNS mechanisms. Severe akinesia, however, apparently depends on more profound and generalized disturbances of brain monoamine metabolism with or without the involvement of other ill-defined mechanisms. At any rate the impairment of the brain DA mechanisms (and especially those of the neostriatum) seems to represent a major feature in the production of the Parkinsonian type of akinesia. Further work is needed to establish the relative importance of the loss of catecholaminergic mechanisms other than those of the neostriatum in the production of akinesia.
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PMID:Physiopathology of experimental Parkinsonism in the monkey. 80 27

The author treated 83 patients with parkinsonism by analouges of amantadin--the Soviet preparation midantan and Swiss preparation simmetril. Twenty patients received only Amantadin and 63 Amantadin in combination with other antiparkinsonic drugs. Optimal doses of other antiparkinsonic drugs were determined prior to amantadin treatment. The preparation exerted a higher influence on such symptoms of parkinsonism as akinesis and rigidity and less on tremor. In 1/3 of the cases a positive effect of the treatment was temporary and disappeared altogether after 2--4 weeks despite the continuation of therapy. The preparation was well tolerated. Side effects observed in 32 of the 83 patients were usually expressed very midly and disappeared without special treatment. The author compares such preparations al 1-Dopa and Amantadin (Midantan).
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PMID:[The effectiveness of amantadine (midantan) in the treatment of the parkinsonian syndrome]. 94 14

Normal voluntary movements are considered to be of two kinds, or to involve two components, (i) a ballistic or "open-loop" type, which are preprogrammed and executed without reference to current sensory information and (ii) a corrective or "closed-loop" type, whose course or termination are regulated by such information. In a previous paper it was suggested that Parkinsonism disrupted the first kind of movement, but intention tremor did not. In the present paper three experiments designed to test this hypothesis are described. Subjects were tested on an acquisition-tracking task using an oscilloscope display and joystick control, and measurements were made of the duration, velocity and error of their initial movements to acquire the target. Parkinsonian movements were found to be considerably different from normal in that (a) most movements by this group lasted longer than the reaction time for their initiation, as if including some secondary correction in their execution, (b) the rate of movement was not varied for different amplitudes (so keeping the duration fairly constant) as in normal subjects, but rather movements of all amplitudes were made at a constant slow rate, so that duration increased markedly with the larger steps, (c) error increased disproportionately as the velocity of movement increased; in particular any movements completed in one reaction time or less tended to be wildly inaccurate, (d) removing either the target or the response marker from the screen at the beginning of a movement had a significant effect, making it shorter in duration and smaller in amplitude than those usually produced with both markers visible all the time. Parkinsonian subjects showed no improvement in performance with repeated attempts at one movement over a whole sequence, so their deficit appears to be stable even after practice on a known fixed task. These results are interpreted as supporting the hypothesis that Parkinsonism interferes with the generation of accurate ballistic action which are characteristic of normal skilled movement. Tremor subjects in general resembled normal control subjects in their initial acquistion movements, but their accuracy was less with the larger steps.
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PMID:Visual "closed-loop" and "open-loop" characteristics of voluntary movement in patients with Parkinsonism and intention tremor. 99 Aug 99

Thirty-seven untreated Parkinsonism patients showed significant positive correlations among decreased excretion of free dopamine, MMPI scores indicative of schizophrenic-like looseness of thinking, and the severity of all Parkinsonism signs except tremor. The data could indicate that abnormalities of dopamine metabolism may underlie both the motor and mental abnormalities of Parkinsonism.
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PMID:Dopamine correlates of neurological and psychological status in untreated Parkinsonism. 100 40

Nine patients with Parkinsonism were studied before and after treatment with piribedil, a dopamine-receptor stimulator. Piribedil appeared to have a slight anti-Parkinsonism effect upon bradykinesia, and possibly upon tremor, but did not improve rigidity. The chief toxic effects were drowsiness and confusion, and two patients experienced nausea. Changes in homovanillic acid in the cerebrospinal fluid indicated that the drug reduced the turnover of endogenous dopamine. In spite of this definite neuropharmacological action, no clear-cut associated clinical benefit was demonstrated. The significance of these findings is discussed.
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PMID:Clinical and pharmacological evaluation of the effects of piribedil in patients with parkinsonism. 109 Nov 22

Twenty-two patients with Parkinsonism were treated with levoamphetamine and 12 of these with dextroamphetamine. Levoamphetamine resulted in a significant improvement in disability from Parkinsonism, although the reduction in total disability, tremor, akinesia, and rigidity scores was slight (ca 20 percent). Dextroamphetamine in lower dosage also reduced disability by some 17 percent. The most disabled patients, including those also on levodopa, showed the greatest response to amphetamines. Previously, amphetamines have been reported to be a selective treatment for the oculogyric crises of post-encephalitic Parkinsonism. Amphetamines are thought to cause the release of catecholamines from central neurones. Their action in Parkinson's disease may be limited because of pre-existing striatal dopamine deficiency. Side-effects of amphetamines, anorexia, and CNS stimulation are different from those caused by levodopa in patients with Parkinson's disease.
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PMID:Amphetamines in the treatment of Parkinson's disease. 109

An increasing number of parkinsonian patients in whom levodopa fails to relieve tremor are being referred for thalamotomy. The literature suggests that in as many as 50 percent of patients treated with levodopa, there is no relief of tremor because of refractoriness to the medication or intractable side effects which limit dosage. Thalamotomy abolishes contralateral tremor in 90 percent of patients, with an associated mortality rate of 1 to 2 percent and morbidity of 6 percent. The relative merits and complications of levodopa and thalamotomy were reviewed and a therapeutic regimen designed in which the two approaches to treatment are combined to most effectively deal with all the symptoms of parkinsonism.
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PMID:Management of parkinson's disease--combined therapy with levodopa and thalamotomy. 110 24


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