26th January 2012 - New research

DUODENAL L-DOPA CAN CAUSE POLYNEUROPATHY

Journal of Neurology [2012] Jan 24 [Epub ahead of print] (Santos-García D, de la Fuente-Fernández R, Valldeoriola F, Palasí A, Carrillo F, Grande M, Mir P, De Fabregues O, Casanova J.) Complete abstract 

Neurology [2011] 77 (22) : 1947-1950 (Y.A.Rajabally, J.Martey) Complete abstract

Reports have emerged describing the occurrence of polyneuropathy related to vitamin B12 deficiency and Guillain-Barré syndrome in people with Parkinson's Disease who are being treated with continuous duodenal L-dopa infusion. Duodenal L-dopa is administered as a gel throughout the day using a portable pump directly into the small intestine through a surgically placed tube. This ensures a flow of L-dopa that can be adjusted according to the patient's needs. For  more information on polyneuropathy go to Polyneuropathies.

At least 12 cases of polyneuropathy related to vitamin B12 deficiency, and a case of Guillain-Barré syndrome have been reported in people with Parkinson's Disease treated with duodenal L-dopa infusion. L-dopa gel infusion may cause a decrease in vitamin B12 levels, leading to peripheral neuropathy. Other detrimental effects include alterations related to the metabolism of L-dopa, abnormal L-dopa absorption, and direct neurotoxicity of L-dopa at high doses. Vitamin B12 supplements may need to be considered in people with Parkinson's Disease on duodenal L-dopa infusion therapy, because vitamin B12 deficiency in people on duodenal L-dopa infusion therapy may be more frequent than the published data suggest.

In another new study, over a third (37%) of people with Parkinson's Disease were found to have neuropathy. Vitamin B12 deficiency was the most common cause. This could be made more likely by the long term use of L-dopa in any form. Many people with Parkinson's Disease who have neuropathy or Vitamin B12 deficiency are unaware of it. In order to refer to this article on its own click here. 

24th January 2012 - New research

DEMENTIA IS LINKED TO INSULIN RESISTANCE IN PARKINSON'S DISEASE

Journal of Neurological Science [2012] Jan 20. [Epub ahead of print] (Bosco D, Plastino M, Cristiano D, Colica C, Ermio C, De Bartolo M, Mungari P, Fonte G, Consoli D, Consoli A, Fava A.)  Complete abstract

Dementia has been found to be associated with insulin resistance in Parkinson's Disease. Dementia commonly occurs in Parkinson's Disease when Parkinson's Disease progresses. This is not inevitable because the biochemistry of Parkinson's Disease and Dementia are completely distinct. There is therefore no reason why they should coincide. Their common association has never been fully explained apart from the fact that Dementia and Parkinson's Disease are both far more common with age.

People who have Parkinson's Disease and dementia were assessed for their resistance to insulin. When insulin is produced in order to prevent high blood glucose levels, insulin sometimes does not have affect. This can be due to insulin resistance, which is the inability of insulin to stimulate the insulin receptors. Brain function largely requires glucose in order to function. Nearly two thirds (62%) of people with Parkinson's Disease who had dementia were found to have insulin resistance. 30% of them also had impaired glucose tolerance. These percentages were significantly higher when the disease duration was longer and when the movement disability was worse. So dementia in Parkinson's Disease appears to be affected by the inability to make use of glucose rather than be a direct result of Parkinson's Disease. In order to refer to this article on its own click here. 

14th January 2012 - New research

THE PREVALENCE OF PAIN IN PARKINSON'S DISEASE

Movement Disorders [2012] Jan 9 [Epub ahead of print] (M.P.Broen, M.M.Braaksma, J.Patijn, W.E.Weber) Complete abstract

Pain has been found to occur in over two thirds of people with Parkinson's Disease. Pain has been studied more intensely as a symptom of Parkinson's Disease in recent years. However, studies on the characteristics and prevalence of pain in Parkinson's Disease have given conflicting results, prompting a systematic review of the medical literature. In the relevant studies, the frequency of pain in Parkinson's Disease ranged from 40% to 85% with an average of 67% (just over two thirds of people). Pain in Parkinson's Disease is most frequently located in the legs, with almost a half (46%) of all people with Parkinson's Disease complaining about musculoskeletal pain. The pain fluctuates with on-off periods. A lot of the pain suffered is unrelated to the biochemistry of Parkinson's Disease, and is therefore not due to it. Surprisingly, only just over half (52%) of people with Parkinson's Disease  with pain used analgesics (pain killers). This means that a lot people with Parkinson's Disease who suffer pain are going without any treatment for it. In order to refer to this article on its own click here. 

11th January 2012 - New book

PSYCHIATRY OF PARKINSON'S DISEASE

K.P.Ebmeier, J. O'Brien, J.-P. Taylor, W. F. Gattaz, W.P.Kaschka

Publisher's description : This book assembles short reviews from experts in the field to chart the various psychiatric syndromes known in Parkinson's disease, their presentation, etiology and management. Presented are special topics on epidemiology of psychiatric symptoms, and other topics. Rarely discussed issues are also reviewed. This publication is essential reading for old age psychiatrists, gerontologists and neurologists who work with patients suffering from Parkinson's disease. Health practitioners who deal with senior patients, as well as scientists who need a quick update on the progress in this important clinical field will find this volume a helpful reference. Click here for more details. For more books concerning Parkinson's Disease go to Parkinson's Disease Books. In order to refer to this article on its own click here. 

7th January 2012 - New research

URINARY DYSFUNCTION IN PARKINSON'S DISEASE

Journal of Neurological and Neurosurgical Psychiatry [2011] 82 (12) : 1382-1386 (T.Uchiyama, R.Sakakibara, T.Yamamoto, T.Ito, C.Yamaguchi, Y.Awa, M.Yanagisawa, Y.Higuchi, Y.Sato, T.Ichikawa, T.Yamanishi, T.Hattori, S.Kuwabara) Complete abstract

Urinary dysfunction is common in Parkinson's Disease, but little is known about urinary dysfunction in early and untreated Parkinson's Disease. Nearly two thirds (64%) of people with Parkinson's Disease complain of urinary symptoms. However, there were found to be actual urinary problems in 85% of people with Parkinson's Disease. All of the 64% of people complaining of urinary symptoms had difficulty controlling the retention of urine, or lost control of urinary retention (storage abnormalities). Over a quarter (28%) had difficulty in urinating. Over half (58%) had detrusor overactivity. The detrusor muscle is the muscle that contracts when urinating to squeeze out urine. However, whilst urinating, detrusor underactivity rather than overactivity occurred in half of people.

These urinary symptoms were not correlated with gender, severity of Parkinson's Disease, or the type of motor symptom. Urinary dysfunction, manifested primarily as storage abnormalities, and with subclinical voiding difficulties commonly occurs in early and untreated Parkinson's Disease.  For more information concerning urinary function go to Urinary System. In order to refer to this article on its own click here. 

7th January 2012 - New book

DEEP BRAIN STIMULATION

Kelvin L. Chou, Susan Grube, Parag Patil

Publisher's description : Deep brain stimulation has dramatically changed the lives of many patients with uncontrollable tremors. Patients often can resume normal activities, such as feeding and dressing themselves. The need for anti-tremor medications is often reduced or eliminated. Though it's no longer considered experimental, DBS is, for now, still used as a second- or third-line treatment, reserved for patients with more advanced cases of the disease and those for whom medication alone is inadequate or can't be adjusted precisely enough to keep their tremors and writhing under control. Deep Brain Stimulation is the first book to be written by a team of experts that clearly explains the benefits, pros, and cons of this revolutionary new treatment.  Click here for more details. For more books concerning Parkinson's Disease go to Parkinson's Disease Books.