28th December 2014 - New research

EFFECT OF PRAMIPEXOLE ER FOR PARKINSON'S DISEASE

The long term use of pramipexole as a once-daily extended-release oral formulation in early or advanced Parkinson's Disease demonstrated efficacy, but also adverse events. Pramipexole is a dopamine agonist that is most widely sold as Mirapex ER. For more information go to : Mirapex ER

In early Parkinson's Disease the main adverse events of extended release pramipexole were somnolence (15%), peripheral edema (11%) and back pain (10%). In advanced Parkinson's Disease the main adverse events were dyskinesia (27%) and somnolence (13%).

Parkinson's Disease symptom scores (using the UPDRS) were improved in early Parkinson's Disease, with reductions of 6.6 and 6.3 points. In advanced Parkinson's Disease the scores were reduced even further, by 11.5 and 9.1 points after over two years.

These results support the long-term efficacy of pramipexole ER in early and advanced Parkinson's Disease. Adverse Events were typical for dopaminergic medications. UPDRS (Parkinson's Disease) scores suggested sustained symptomatic benefit.

Reference : European Journal of Neurology [2014] 21 (5) : 736-743 (R.A.Hauser, A.H. Schapira, P.Barone, Y.Mizuno, O.Rascol, M.Busse, C.Debieuvre, M.Fraessdorf, W.Poewe) Complete abstract  In order to refer to this article on its own click here

27th December 2014 - New book

NON-MOTOR SYMPTOMS OF PARKINSON'S DISEASE

K.Ray Chaudhuri, Eduardo Tolosa, Anthony H.V.Schapira, Werner Poewe

Publisher's description : Patients with Parkinson's disease (PD) are known to suffer from motor symptoms, but also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment are readily available. Researchers have recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated. NMS have an impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. Some NMS can be improved with available treatments, but others will require research into novel therapies. This new edition summarizes the current understanding of NMS in Parkinson's disease and future research. 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

22nd December 2014 - New research

LONG TERM EFFECTS OF DBS ON PARKINSON'S DISEASE

Deep Brain Stimulation of the Subthalamic Nucleus (STN-DBS) is an effective treatment for Parkinson's Disease, but in the long term Parkinson's Disease symptoms have been found to still deteriorate very significantly. DBS involves the use of electrodes that are implanted into the brain and connected to a small electrical device called a pulse generator that can be externally programmed. For more information go to : Deep Brain Stimulation

After 11 years, DBS significantly improved the motor symptoms of people with Parkinson's Disease by 35%. Motor complications were well controlled, with an 84% improvement of dyskinesias and a 65% improvement of motor fluctuations. Despite this, the Parkinson's Disease symptom score (the UPDRS-II-on score) worsened by 88%, mainly for the worsening of poorly L-dopa-responsive symptoms. More than 70% of the patients performed in the normal range in most of the neuropsychological tests, despite the development of dementia in 22% of them.

The study confirmed the long-term safety of STN-DBS in Parkinson's Disease. However, the functionality of patients worsens over time, mainly for the onset and progression of L-dopa-resistant and non-motor symptoms. The role of PD-subtype seems to be relevant in the long-term outcome.

Reference : Parkinsonism Related Disorders [2014] 20 (4) : 376-381 (M.G.Rizzone, A. Fasano, A.Daniele, M.Zibetti, A.Merola, L.Rizzi, C.Piano, C.Piccininni, L.M.Romito, L. Lopiano, A.Albanese) Complete abstract  In order to refer to this article on its own click here

12th December 2014 - New research

AMPHETAMINES INCREASE THE RISK OF PARKINSON'S DISEASE

Previous neurotoxicity findings raised concerns that Amphetamines and Methamphetamines might damage dopaminergic neurons, resulting in dopamine-related medical disorders such as Parkinson's Disease. However, despite widespread use of methamphetamines and other amphetamine type stimulants little was known about the long-term medical consequences of their abuse and dependence.

A retrospective design was used to examine medical records from 1996 until 2011. Patients were divided between (1) Amphetamine and Methamphetamine users, (2) Cocaine users, (3) those people that have not been exposed to drugs or alcohol. They were assessed to see if they were at an increased risk of developing either (1) Parkinson's Disease, or (2) Parkinson's Disease / Parkinsonism / Essential Tremor when compared to people that did not take drugs. In Methamphetamine and Amphetamine users there was a nearly three fold increased risk of Parkinson's Disease, thereby indicating them as a cause of Parkinson's Disease. However, Cocaine users did not show any elevated risk of Parkinson's Disease.

The greatly increased likelihood of developing Parkinson's Disease probably occurs because of the long term effect of amphetamines on the dopamine receptors, which they affect.

Reference : Drug and Alcohol Dependence [2014] Nov 16 [Epub ahead of print] (K.Curtin, A.E.Fleckenstein, R.J.Robison, M.J.Crookston, K.R.Smith, G.R.Hanson) Complete abstract  In order to refer to this article on its own click here

7th December 2014 - New research

SIGNS OF PARKINSON'S DISEASE BEFORE DIAGNOSIS

By the time somebody has been diagnosed with Parkinson's Disease many people have already had Parkinson's Disease for years or have had symptoms that were progressing towards it.

Researchers compared those symptoms before diagnosis to their subsequent diagnosis. Those symptoms assessed were : motor features (tremor, rigidity, balance impairments, neck pain or stiffness, and shoulder pain or stiffness), autonomic features (constipation, hypotension, erectile dysfunction, urinary dysfunction, and dizziness), neuropsychiatric disturbances (memory problems, late-onset anxiety or depression, cognitive decline, and apathy), and fatigue, insomnia, anosmia, hypersalivation and REM sleep disorder) prior to diagnosis.

At 10 years before diagnosis the incidence of tremor was many times higher and constipation was higher in those who went on to develop Parkinson's Disease. At 5 years before diagnosis those who went on to develop Parkinson's Disease had a much higher incidence of tremor, a higher incidence of imbalance, constipation, hypotension, and a slightly higher incidence of erectile dysfunction, urinary dysfunction, dizziness, fatigue, depression, and anxiety. At 2 years before diagnosis the incidence of all studied features except neck pain or stiffness was higher in people who went on to develop Parkinson's Disease.

A range of symptoms can therefore be detected years before diagnosis of Parkinson's Disease, with tremor being especially common prior to diagnosis.

Reference : Lancet Neurology [2014] Nov 26 [Epub ahead of print] (A.Schrag, L.Horsfall, K.Walters, A.Noyce, I.Petersen) Complete abstract  In order to refer to this article on its own click here

2nd December 2014 - New research

SONOGRAPHY FOR DIAGNOSIS OF PARKINSON'S DISEASE

Transcranial sonography is a non-invasive diagnostic technique that makes use of sound waves to create a digital image to aid the diagnosis of Parkinson's Disease.

The sound waves are typically produced by a transducer. Strong, short electrical pulses from the ultrasound machine make the transducer ring at the desired frequency. Materials on the face of the transducer enable the sound to be transmitted efficiently into the body. The sound wave is partially reflected from layers between different tissues. Sound is reflected anywhere there are density changes in the body. Some of the reflections return to the transducer. The return sound wave vibrates the transducer, which turns the vibrations into electrical pulses that travel to the ultrasonic scanner where they are processed and transformed into a digital image. For more information go to Transcranial Sonography

The primary area of the brain concerning Parkinson's Disease is the substantia nigra. The substantia nigra echogenic area was found to be larger in those people with Parkinson's Disease. Substantia nigra echogenicity was also larger in males than in females. Age did not correlate with substantia nigra echogenicity in any group. After multivariate analysis, only the substantia nigra hyperechogenicity was associated with the diagnosis of Parkinson's Disease. Transcranial sonography consequently showed good diagnostic validity for the diagnosis of Parkinson's Disease. However, in a previous study the diagnostic accuracy in the early stages of Parkinson's Disease was not sufficient for routine clinical use.

Reference : Journal of Ultrasound in Medicine [2014] 33 (12) : 2069-2074 (A.Alonso- Cánovas, J.L.López-Sendón, J.Buisán, A.deFelipe-Mimbrera, M.Guillán, N.García-Barragán, I.Corral, M.C.Matute-Lozano, J.Masjuan, J.C.Martínez-Castrillo, U.Walter) Complete abstract  In order to refer to this article on its own click here