ABSTRACT
One hundred ten patients with Parkinson′s disease(PD)and 110 age-matched healthy controls were enrolled in the study.The non-motor symptoms(NMS)were assessed with Non-motor symptoms of Parkinson′s disease questionnaire(PDNMSQ30).The PD patients were classified as gait abnormality posture type(PIGD, n=73)and tremor type(TD, n=37).The non-motor symptoms were compared between two groups.Results showed that the NMS in PD patients was higher than that in healthy controls[(35.2 ±3.0)vs.(6.0 ±2.0)symptoms, t=6.43, P=0.01].The NMS score of PIGD group was higher than that of TD group[(28.9 ±1.1)vs.(6.2 ±0.7)symptoms, t=2.73, P<0.01]; Mini-mental state examination(MMSE)and Montreal cognitive assessment scale(MoCA)scores of TD group were significantly higher than those of PIGD group(t=11.52,P<0.01; t=8.79,P<0.01).The results indicate that for PD patients with different motor types,their NMS are different,and PD patients with PIGD have more axial involvement,and more NMS.
ABSTRACT
BACKGROUND AND PURPOSE: The aim of this paper was to investigate the utility of 18F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) positron emission tomography (PET) for evaluating the severity of Parkinson's disease (PD) according to various clinical stages, and to identify the relationship between the striatal substructure and the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, cognitive symptoms through 18F-FP-CIT PET. METHODS: We retrospectively identified 542 patients with various clinical stages of PD who underwent an 18F-FP-CIT PET at our clinics. The difference between the 18F-FP-CIT PET according to the Hoehn-Yahr stage, correlation between 18F-FP-CIT PET and the UPDRS III grouped motor items, and the Korean Mini-Mental State Examination (K-MMSE) were investigated. RESULTS: As disease progressed, the right caudate and both the anterior putamen and caudate/putamen ratios exhibited a significantly lower uptake. The uptake of all striatal substructures was significantly correlated with the UPDRS total motor score. The right caudate nucleus was significantly related to both the UPDRS tremor items and the right UPDRS akinesia-rigidity items. The left caudate nucleus was related to both the UPDRS tremor items and UPDRS akinesia-rigidity items. The right anterior putamen was related to the axial items, right tremor and akinesia-rigidity items; while the left anterior putamen was related to the right tremor and right akinesia-rigidity items. Both of the posterior putamens were related to the axil items, left tremor and left akinesia rigidity items. K-MMSE was not significantly related to any striatal substructures. CONCLUSIONS: The UPDRS total motor score was significantly correlated with the uptake of all striatal substructures. However, the 18F-FPCIT uptake in specific striatal substructures was rather complexly correlated with the UPDRS motor grouped items and was not significantly related to K-MMSE. These results suggest the possibility of the complex pathophysiology of motor symptoms of PD and limitation of 18F-FPCIT PET for the evaluation of the severity of PD motor and cognitive symptoms.
Subject(s)
Humans , Caudate Nucleus , Electrons , Neurobehavioral Manifestations , Parkinson Disease , Positron-Emission Tomography , Putamen , Retrospective Studies , TremorABSTRACT
Objetivos: Determinar las características y prevalencia de la neuropatía periférica en la Enfermedad de Parkinson (EP). Metodos: Estudio caso-control de 23 pacientes con EP, con clínica de neuropatía periférica. Se realizaron pruebas neurofisiológicas y aplicaron las escalas de Hoehn-Yahr (H-Y) y Actividades de la Vida Diaria (AVD) de Schwab-England. Resultados: El promedio de edad de los pacientes con EP fue 66,1+/-11,7 años y de los controles 66.6+/-10,8 años, el promedio del tiempo de enfermedad fue 7,7+/-7,5 años. La neuropatía motora axonal o mixta se presentó en 39,1% de los pacientes con EP, y 17,4% de los controles (OR: 3,05), la neuropatía estuvo relacionada con el tiempo de enfermedad (>7 años)(p=0,042) y el estadio 3-4 de H-Y (p=0,049). Conclusiones: Se ha observado una alta prevalencia de neuropatía periférica en la EP, su causalidad no está bien establecida, pero sin embargo sus efectos asociados al tiempo de enfermedad inciden en la discapacidad del paciente afectando su calidad de vida.
Objectives: Determine the characteristics and prevalence of peripheral neuropathy in Parkinson's disease (PD). Methods: A study of 23 case-control PD patients and peripheral neuropathy clinic was conducted. Neurophysiologic tests were performed and applied the Hoehn-Yahr scales (HY) and Activities of Daily Living (ADL) of Schwab-England. Results: The average age of patients with PD was 66.1+/-10.8 years, the average disease duration was 7.7+/-7.5 years. The motor axonal or mixed neuropathy was present in 39.1% of patients with PD, and 17.4% of controls (OR: 3.05), neuropathy was related to time of disease (>7years)(p=0.042) and the stage 3-4 of HY (p=0.049). conclusions: We observed a high prevalence of peripheral neuropathy in PD, its causality is not well established, yet the effects associate with the time of disease affecting the patient's disability affecting their quality of life.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Quality of Life , Parkinson Disease , Peripheral Nervous System Diseases , Prevalence , Case-Control StudiesABSTRACT
Parkinson's disease is an incurable nerve disease.<br>We treated two groups randomly assigned to therapy with medications, or therapy with medications and acupuncture in combination.<br>The first group included 95 patients prescribed L-dopa medications and dopaminergic drugs, and the second group included 103 patients prescribed L-dopa and acupuncture treatment twice a month. We conducted follow-ups using Hoehn-Yahr index surveys and the UPDRS II and III for 5 years from treatment start.<br>Mean changes in the L-dopa group were 2.1±0.8 for the H-Y index, 12.2±7.2 for the UPDRS II, and 18.2±9.8 for the UPDRS III, while changes in the acupuncture combination group were 1.3±0.4 for the H-Y index, 7.6±5.0 for the UPDRS II, and 11.9±6.8 for the UPDRS III after 5 years.<br>Each result indicated a significant difference with repetition decentralization and statistical analysis methods.<br>Therefore, we believe acupuncture is a treatment for Parkinson's disease able to control its progress.
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OBJECTIVE: N-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane(IPT) is a cocaine analogue which allows the presynaptic dopamine transporters. The aim of this study is to assess the imaging of dopamine transporters using 123I-IPT SPECT and its correlation with several clinical features of Parkinson's disease and Parkinson Plus syndrome. METHODS: Forty-two patients with Parkinson's disease(14 bilateral, 28 unilateral clinical features), three Parkinson Plus syndrome and five normal controls were studied. All patients with Parkinson's disease were evaluated with Hoehn-Yahr scale, UPDRS(on/off stage), duration, main symptoms(rigidity, tremor, bradykinesia), unilaterality and operation. The two statistical parameters were assessed with 123I-IPT SPECT. One is uptake ratio of basal ganglia and occipital cortex, basal ganglia and cerebellum. The other is three graded visual assessment. RESULTS: The uptake ratio of 123I-IPT SPECT in patients with Parkinson's disease were decreased with higher grade of Hoehn-Yahr scale, and more decreased in 2 hours than in 1 hour. But there was no statistical significance. The visual assessment was significantly correlated with Hoehn-Yahr scale(p<0.045). The early differential diagnosis between Parkinson's disease and Parkinson Plus syndrome could be allowed with visual assessment. But other clinical features of Parkinson's disease was not correlated with finding of 123I-IPT SPECT. CONCLUSION: The visual assessment of 123I-IPT SPECT imaging is useful in the early differential diagnosis and in confirming a clinical severity of Parkinson's disease.