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1.
Alerta (San Salvador) ; 4(3): 150-143, jul. 29, 2021.
Article in Spanish | LILACS, BISSAL | ID: biblio-1282991

ABSTRACT

La enfermedad de Parkinson es la segunda patología neurodegenerativa más recurrente, progresiva y crónica que perjudica a pacientes y cuidadores. Es fundamental describir la calidad de vida en pacientes y cuidadores posterior a la terapia de rehabilitación cognitiva. Por ello se elaboró un artículo de revisión mediante una búsqueda en bases de datos, PubMed, Google Scholar, SciELO, empleando artículos originales, ensayos clínicos, de revisión, entre otros, publicados en los últimos cinco años en español e inglés. El deterioro cognitivo en los pacientes de forma prematura conlleva a mayor riesgo de demencia, que se manifiesta con repercusión en las actividades de la vida diaria, como en la calidad de vida pacientecuidador. Mientras más avanzado se encuentre el estadio de la enfermedad, los pacientes con deterioro cognitivo generan mayor dependencia de sus cuidadores, empeorando la calidad de vida de ambos. La terapia de rehabilitación cognitiva pretende mejorar la calidad de vida de pacientes con enfermedad de Parkinson y sus cuidadores; actualmente se describen terapias de rehabilitación cognitiva basada en ejercicio físico. Al fortalecer la cognición mediante terapias de rehabilitación basadas en actividad física, el paciente presenta mayor independencia, lo cual disminuye la carga del cuidador, generando mayor empatía entre ambos


Parkinson's disease is the second most recurrent, progressive and chronic neurodegenerative pathology that harms patients and caregivers. It is essential to describe the quality of life in patients and caregivers after cognitive rehabilitation therapy. For this reason, a review article was prepared through a search in databases, PubMed, Google Scholar, SciELO, using original articles, clinical trials, review, among others, published in the last five years in Spanish and English. Cognitive deterioration in patients prematurely leads to an increased risk of dementia, which manifests itself with repercussions on activities of daily living, as well as on the quality of life of the patient-caregiver. The more advanced the stage of the disease is, the patients with cognitive impairment generate greater dependence on their caregivers, worsening the quality of life for both. Cognitive rehabilitation therapy aims to improve the quality of life of patients with Parkinson's disease and their caregivers; Cognitive rehabilitation therapies based on physical exercise are currently being described. By strengthening cognition through rehabilitation therapies based on physical activity, the patient has greater independence, which reduces the burden on the caregiver, generating greater empathy between both


Subject(s)
Humans , Parkinson Disease , Patients , Quality of Life , Caregivers , Cognition
3.
Dement. neuropsychol ; 15(1): 51-59, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1286183

ABSTRACT

ABSTRACT. Pharmacological treatments for mild cognitive impairment (MCI), are lacking, and alternative approaches have been implemented, including cognitive training (CT). Objective: To determine the impact of CT on cognitive and quality of life measures in patients with Parkinson's disease (PD) who were seen a hospital neurorehabilitation program. Methods: Thirty-nine individuals with MCI-PD, according to the Movement Disorder Society, were randomly distributed into two groups: experimental and control group, matched for demographic and clinical characteristics. Both groups were assessed for cognition and quality of life at the beginning of the study and at the end of the intervention protocol. The following instruments were used to assess cognition and quality of life: Addenbrooke's Cognitive Examination III, Digit Span, Trail Making Test (TMT, A and B) and Parkinson disease quality of life questionnaire. The experimental group (EG) engaged in CT, whereas the control group (CG) underwent activities of the general rehabilitation program. Results: No baseline evaluation differences were found. Intergroup analysis showed differences in measures, such as total score (1.977, p=0.0480) and visuospatial domain (-2.636, p=0.0084) of the ACE-III, with the EG performing better, in addition to better performance in TMT-B mistakes (-1.928, p=0.0439). Intragroup analysis revealed that the EG showed significant improvement in almost all the cognitive variables, well as in self-reported quality of life (total score and mobility, activities of daily living, body discomfort dimensions). Conclusions: Engagement in cognitive activities was associated with better cognitive abilities in PD-MCI. Future studies should consider the long-term effect of this type of intervention and impact on functional activities.


RESUMO. A falta de evidência de tratamentos farmacológicos, especificamente para pacientes com comprometimento cognitivo leve na doença de Parkinson (CCL-DP), leva à implementação de abordagens alternativas, incluindo a reabilitação cognitiva. Objetivo: Determinar o impacto do treino cognitivo (TC) em medidas cognitivas e da qualidade de vida em pacientes com DP, que participavam de um programa de reabilitação neurológica hospitalar. Métodos: Total de 39 indivíduos com CCL-DP, de acordo com a Sociedade de Distúrbios do Movimento, foram distribuídos aleatoriamente em dois grupos: experimental e controle, pareados por características demográficas e clínicas. Ambos os grupos foram avaliados quanto à cognição e qualidade de vida no início do estudo e ao final do protocolo de intervenção. Os seguintes instrumentos foram utilizados para avaliar a cognição e a qualidade de vida: Exame Cognitivo III de Addenbrooke, teste de dígitos, TMT (A e B) e questionário de qualidade de vida da doença de Parkinson. O grupo experimental foi submetido ao treino cognitivo, ao passo que o grupo controle passou por atividades do programa de reabilitação. Resultados: Não foram encontradas diferenças na avaliação basal. A análise intergrupo mostrou diferenças em medidas, como escore total (1,977, p=0,0480) e domínio visuoespacial (-2,636, p=0,0084) da ACE-III, tendo o grupo experimental melhor desempenho, além de desempenho superior em TMT-B erros (-1,928, p=0,0439). A análise intragrupo revelou que o grupo experimental mostrou melhora significativa em quase todas as variáveis cognitivas, assim como na percepção de qualidade de vida (escore total e dimensões de mobilidade, atividades da vida diária e desconforto corporal). Conclusões: O envolvimento em atividades cognitivas foi associado a melhores habilidades cognitivas em pacientes com CCL-DP. Estudos futuros devem considerar o efeito a longo prazo desse tipo de intervenção e o impacto nas atividades funcionais.


Subject(s)
Humans , Parkinson Disease , Quality of Life , Rehabilitation , Cognition
4.
Dement. neuropsychol ; 15(1): 105-111, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1286179

ABSTRACT

ABSTRACT. Cross-sectional studies show an association of decline in mental flexibility and inhibitory control with reduced gait speed and falls, as well as divided attention deficit and difficulty in initiating gait. Objective: To investigate the relationships between cognitive function and gait performance in patients with Parkinson's disease (PD) who participated in a hospital neurorehabilitation program. Methods: A total of 107 patients (79 males, 28 females; mean age 61.00±8.2 years; mean schooling 11.7±4.1 years) with idiopathic PD (mean disease duration 5.5±4.1 years) were recruited for this study. Among them, 78.50% were in stages I and II of the Hoehn & Yahr Scale. Cognitive functions were evaluated through the Digit Span test, Trail Making Test, and Addenbrooke's Cognitive Examination III. Motor function was assessed with the 10-Meter Walk Test, the short version of the Balance Evaluation Systems Test (Mini-BESTest), and the Timed Up and Go Test. Results: Balance skills were significantly correlated with global cognition and specific domains, including divided attention, verbal fluency, and visuospatial function. Functional mobility showed a significant association with all cognitive tests, except for the number of errors on TMT-A. Gait speed presented a significant correlation with global cognition scores, memory, and attention, including divided attention. Conclusions: These findings might help early identification of cognitive deficits or motor dysfunctions in PD patients who may benefit from rehabilitation strategies, as well as facilitate fall risk assessments and strategies to prevent falls. Future prospective studies are needed to investigate the effects of cognitive training on motor performance, since the difficulty in motor rehabilitation may be more related to cognitive loss than to motor damage.


RESUMO. Estudos transversais mostram associação entre declínio da flexibilidade mental e controle inibitório com redução da velocidade de marcha e quedas, assim como déficit de atenção dividida e dificuldade para iniciar a marcha. Objetivo: Investigar as relações entre a função cognitiva e o desempenho da marcha em pacientes com Doença de Parkinson (DP) que participaram de um programa de reabilitação hospitalar. Métodos: Um total de 107 pacientes (79 homens, 28 mulheres; idade média de 61,00±8,2 anos, média de escolaridade 11,7±4,1) apresentando DP idiopática (duração média da doença: 5,5±4,1 anos) foram recrutados para o estudo. Desses, 78,50% estavam nos estágios I e II da Hoehn e Yahr. As funções cognitivas foram avaliadas por meio do teste de Dígitos Spam, Teste de Trilhas e Exame Cognitivo de Addenbrooke (terceira versão). A função motora foi examinada por meio do teste de caminhada de 10 metros, Mini BESTest e teste Timed Up and Go. Resultados: As análises de correlação mostraram que as habilidades de equilíbrio estavam significativamente correlacionadas com a cognição global e com domínios específicos, incluindo atenção dividida, fluência verbal e função visuoespacial. Além disso, a mobilidade funcional apresentou correlação significativa com todos os testes cognitivos, exceto TMT-A (erro). A velocidade da marcha mostrou correlação significativa com escores globais de cognição, memória e atenção, incluindo atenção dividida. Conclusões: Esses achados podem ajudar na identificação precoce de déficits cognitivos ou disfunções motoras em pacientes com DP que podem se beneficiar de estratégias de reabilitação, facilitar avaliações de risco de queda e estratégias de prevenção de queda. Estudos prospectivos futuros são necessários para investigar os efeitos do treino cognitivo no desempenho motor, uma vez que a dificuldade na reabilitação motora pode estar mais relacionada à perda cognitiva do que aos prejuízos motores.


Subject(s)
Humans , Parkinson Disease , Proprioception , Executive Function , Cognitive Dysfunction , Gait
5.
Dement. neuropsychol ; 15(1): 41-50, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286171

ABSTRACT

ABSTRACT. Clinical trials of the effects of physical activity have reported improvements in symptoms and quality of life in patients with Parkinson's disease (PD). Additionally, morphological brain changes after exercising were reported in PD animal models. However, these lifestyle-related changes were not evaluated in postmortem brain tissue. Objective: We aimed to evaluate, by immunohistochemistry, astrocytes, tyrosine hydroxylase (TH) and structural proteins expression (neurofilaments and microtubules — MAP2) changes in postmortem brain samples of individuals with Lewy body pathology. Methods: Braak PD stage≥III samples, classified by neuropathology analysis, from The Biobank for Aging Studies were classified into active (n=12) and non-active (n=12) groups, according to physical activity lifestyle, and paired by age, sex and Braak staging. Substantia nigra and basal ganglia were evaluated. Results: Groups were not different in terms of age or gender and had similar PD neuropathological burden (p=1.00). We observed higher TH expression in the active group in the substantia nigra and the basal ganglia (p=0.04). Astrocytes was greater in the non-active subjects in the midbrain (p=0.03) and basal ganglia (p=0.0004). MAP2 levels were higher for non-active participants in the basal ganglia (p=0.003) and similar between groups in the substantia nigra (p=0.46). Neurofilament levels for non-active participants were higher in the substantia nigra (p=0.006) but not in the basal ganglia (p=0.24). Conclusion: Active lifestyle seems to promote positive effects on brain by maintaining dopamine synthesis and structural protein expression in the nigrostriatal system and decrease astrogliosis in subjects with the same PD neuropathology burden.


RESUMO. Estudos dos efeitos da atividade física relataram melhora nos sintomas e na qualidade de vida de pacientes com doença de Parkinson (DP). Além disso, alterações morfológicas do cérebro após o exercício físico foram relatadas em modelos animais da DP. No entanto, essas mudanças relacionadas ao estilo de vida não foram avaliadas em tecido cerebral post-mortem. Objetivo: Avaliar a expressão de astrócitos, tirosina hidroxilase (TH) e a expressão de proteínas estruturais (neurofilamentos e microtúbulos — MAP2) por imuno-histoquímica, em amostras cerebrais post-mortem de indivíduos com corpos de Lewy. Métodos: Amostras com estágio de Braak para DP≥III, classificação neuropatológica, fornecidas pelo biobanco de estudos do envelhecimento foram classificadas em grupos ativos (n=12) e não ativos (n=12), de acordo com o estilo de vida (atividade física), e pareados por idade, sexo e estadiamento de Braak. Analisou-se a substância negra e gânglios da base. Resultados: Idade, sexo e classificação para DP foram semelhantes (p=1,00). Observou-se maior expressão de TH no grupo ativo (p=0,04). Amostras de não ativos revelaram maior expressão de astrócitos no mesencéfalo (p=0,03) e nos gânglios da base (p=0,0004); MAP2 nos gânglios da base (p=0,003); os níveis de neurofilamentos foram maiores na substância negra (p=0,006). Conclusão: O estilo de vida ativo parece promover efeitos positivos no cérebro, mantendo a síntese de dopamina e a expressão estrutural de proteínas no sistema nigrostriatal e com diminuição da ativação de astrócitos em indivíduos com a mesma classificação neuropatológica para a DP.


Subject(s)
Humans , Parkinson Disease , Lewy Bodies , Autopsy , Aging , Dopamine , Astrocytes , Life Style
6.
Int. j. med. surg. sci. (Print) ; 8(1): 1-10, mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1151569

ABSTRACT

La sexualidad es un aspecto importante en la calidad de vida de la mujer, sin embargo, los estudios sobre sexualidad dedicados a las mujeres de 60 años y más son escasos. El objetivo de este estudio fue determinar la prevalencia de la disfunción sexual femenina y sus dominios en mujeres de 60 años y más, e identificar la asociación entre enfermedades asociadas y consumo de medicamentos con la disfunción sexual. Se realizó un estudio descriptivo y transversal, en mujeres de 60 años y más, de La Habana, Cuba. Participaron 112 mujeres a las cuales se les aplicaron dos encuestas: el Índice de Función Sexual Femenino (IFSF) y otra que recogía antecedentes médicos y sociales. El 66,1% de las mujeres presentó algún grado de disfunción sexual, la prevalencia aumentaba con la edad. Los dominios más afectados fueron el deseo, la excitación y la lubricación. Se identificó una fuerte asociación entre la enfermedad de Parkinson, la depresión y la artrosis con la aparición de disfunción sexual en la población estudiada, así como el uso de antidepresivos, hipoglicemiantes orales y diuréticos. La disfunción sexual estuvo presente en el 100% de las mujeres octogenarias. Todas las mujeres con enfermedad de Parkinson presentaron disfunción sexual.


Sexuality is an important aspect in women's quality of life, however, sexuality studies dedicated to women age 60 and older are scarce. The objective of this study was to determine the prevalence of female sexual dysfunction and its domains in women age 60 and older, and to identify the association between diseases and drug use with sexual dysfunction. A descriptive and cross-cutting study was conducted, in women 60 years and older, in Havana, Cuba. Two surveys participated in 112 women: The Female Sexual Function Index (IFSF) and another who collected a medical and social history. 66.1% of women had some degree of sexual dysfunction, the prevalence increased with age. The domains most affected were desire, excitement, and lubrication. A strong association between Parkinson's disease, depression and osteoarthritis was identified with the onset of sexual dysfunction in the studied population, as well as the use of antidepressants, oral hypoglycemics and diuretics. Sexual dysfunction was present in 100% of octogenary women. All women with Parkinson's disease had sexual dysfunction.


Subject(s)
Humans , Female , Middle Aged , Aged , Aged, 80 and over , Sexual Dysfunction, Physiological , Sexual Dysfunction, Physiological/epidemiology , Sexuality/psychology , Sexual Dysfunctions, Psychological , Parkinson Disease/complications , Quality of Life , Prevalence , Surveys and Questionnaires , Age Distribution , Cuba/epidemiology , Depression/complications
7.
Rev. bras. ativ. fís. saúde ; 26: 1-7, mar. 2021. fig
Article in English | LILACS | ID: biblio-1223187

ABSTRACT

This non-randomized clinical trial aimed to analyze the impact of the Brazilian samba training protocol on the balance and quality of life of people with Parkinson's disease. Forty-seven individuals participated, with a mean age of 68 ± 9.3 years-old, 24 from the control group (CG) and 23 from the experimental group (EG). The CG was formed by those who did not participate in the interven-tion, and the EG by individuals who participated in the Brazilian samba dance protocol. This study was divided into pre-intervention (before 12 weeks) and post-intervention (after 12 weeks) with a questionnaire consisting of: Mini Mental State Examination (MMSE); Unified Parkinson's Disease Rating Scale (UPDRS); Quality of life (PDQ-39); Berg's Balance Scale; Perception of perceived changes. The results point to a significant improvement after the intervention in the UPDRS (p < 0.001) and balance (p = 0.006) of the EG; in the quality of life of the EG after intervention in the mobility (p = 0.009) and total (p = 0.034) domains; and in the post-intervention period in the cog-nitive (p = 0.025) and communication (p = 0.032) domains of the EG and CG. Thus, it is concluded that the Brazilian samba rhythm has been shown to be effective in improving the total UPDRS, balance and quality of life, as well as in mobility, cognition and communication


Esse ensaio clínico não randomizado teve como objetivo analisar o impacto do protocolo de treinamento de samba brasileiro no equilíbrio e na qualidade de vida de pessoas com a doença de Parkinson. Participaram quarenta e sete indivíduos, média de idade de 68 ± 9,3 anos, 24 do grupo controle (GC) e 23 do grupo experimental (GE). O GC foi formado por aqueles que não participaram da intervenção, e o GE por indivíduos que participaram do protocolo de dança do samba brasileiro. Este estudo foi dividido em pré-intervenção (antes das 12 semanas) e pós-intervenção (após as 12 semanas) com um questionário composto por: Mini Exame do Estado Mental (MEEM); Escala Unificada de Avaliação de Doença de Parkinson (UPDRS); Qualidade de vida (PDQ-39); Escala de Equilíbrio de Berg; Percepção das mudanças percebidas. Os resul-tados apontam para uma melhora significativa após a intervenção no UPDRS (p < 0,001) e equilíbrio (p = 0,006) do GE; na qualidade de vida do GE pós intervenção nos dominios mobilidade (p = 0,009) e total (p = 0,034); e no período pós intervenção nos domínios cognitivos (p = 0,025) e comunicação (p = 0,032) do GE e GC. Desta forma conclui-se que o ritmo samba brasileiro tem se mostrado eficaz na melhora do UPDRS total, do equilíbrio e da qualidade de vida, como na mobilidade, cognição e comunicação


Subject(s)
Humans , Male , Female , Parkinson Disease , Quality of Life , Music
8.
Rev. Pesqui. Fisioter ; 11(1): 50-58, Fev. 2021. ilus
Article in English, Portuguese | LILACS | ID: biblio-1252878

ABSTRACT

OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da terapia comportamental associada à neuromodulação na bexiga e intestino neurogênicos na Doença de Parkinson. MÉTODOS: Trata-se de um estudo piloto. Os participantes, após assinarem o termo de consentimento, foram submetidos à avaliação das funções eliminatórias, qualidade de vida e estágio da doença por meio de instrumentos específicos. Os sujeitos realizaram dezesseis sessões de neuromodulação parassacral e acompanhamento da terapêutica comportamental. RESULTADOS: Na reavaliação apresentaram melhoras dos sintomas urinários, evacuatórios e dos domínios de qualidade de vida. Foi apresentado também aumento da capacidade vesical que embora não significativos já expressam melhora do quadro clínico expresso pelo paciente. Também observou-se melhora para frequência evacuatória, consistência das fezes e eliminação do esforço para evacuar. CONCLUSÃO: Sugere-se que a neuromodulação acrescida da terapêutica comportamental é uma técnica de baixo custo e com resultados significativos para os sintomas urinários e melhora dos valores de atividade de vida diária, bem-estar emocional, estigma, suporte social, cognição, comunicação e desconforto corporal medidos para qualidade de vida.


AIMS: The study aims to evaluate the effects of behavioral therapy associated with neuromodulation at neurogenic bladder and bowel on Parkinson's disease. METHODS: It is a pilot study. After signing consent forms, the participants had an evaluation of elimination functions, quality of life, and Parkinson's staging through specific instruments. Subjects had sixteen sessions of parasacral neuromodulation and cognitive behavioral therapy attendance. RESULTS: Revaluation showed improvement of urinary and evacuatory symptoms and quality of life domain. There was also an increase in bladder capacity which, although not significant, expresses improvement in the clinical condition expressed by the patient. Improvements at evacuatory frequency, feces consistency, and evacuation strain were also found. CONCLUSION: The study results suggest that neuromodulation associated with behavioral therapy is a low-cost procedure that shows significant results to urinary symptoms and improvements to the quality of life measurements to domains of activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort.


Subject(s)
Parkinson Disease , Urinary Incontinence , Transcutaneous Electric Nerve Stimulation
9.
Säo Paulo med. j ; 139(1): 30-37, Jan.-Feb. 2021. tab
Article in English | LILACS | ID: biblio-1156960

ABSTRACT

ABSTRACT BACKGROUND: Knowing the epidemiological profile is relevant for improving healthcare practices. Movement disorders are neurological disorders characterized by the presence of involuntary movements. They have a negative impact on patients' quality of life. OBJECTIVES: To outline the frequencies of the different diagnoses seen among patients, along with their demographic characteristics, at a hospital in São Paulo (SP), Brazil, and to highlight the clinical aspects of those with Parkinson's disease. DESIGN AND SETTING: Retrospective descriptive epidemiological analysis at a specialized outpatient clinic in a state public hospital in São Paulo. METHODS: Patients treated at this clinic over a four-year period were analyzed. Diagnoses, demographic variables and associations with clinical aspects of Parkinson's disease were evaluated. RESULTS: Out of the 680 medical records analyzed, 58.4% related to females. Most patients were over 60 years of age, white, married and teachers. The most frequent diagnosis was Parkinson's disease, followed by essential tremor and dystonia. Parkinson's disease presented in the mixed clinical form; the most common initial symptom was tremor. The akinetic-rigid clinical form occurred in younger individuals and mostly presented with postural instability and freezing of gait in the early years of disease. CONCLUSIONS: Parkinson's disease, essential tremor and dystonia were the most frequent diagnoses. Characteristics like sex, frequency of other pathological conditions and the clinical and demographic aspects of Parkinson's disease were consistent with the data in the relevant literature.


Subject(s)
Humans , Female , Middle Aged , Aged , Parkinson Disease/epidemiology , Gait Disorders, Neurologic , Quality of Life , Brazil/epidemiology , Retrospective Studies
10.
Article in Chinese | WPRIM | ID: wpr-879245

ABSTRACT

For speech detection in Parkinson's patients, we proposed a method based on time-frequency domain gradient statistics to analyze speech disorders of Parkinson's patients. In this method, speech signal was first converted to time-frequency domain (time-frequency representation). In the process, the speech signal was divided into frames. Through calculation, each frame was Fourier transformed to obtain the energy spectrum, which was mapped to the image space for visualization. Secondly, deviations values of each energy data on time axis and frequency axis was counted. According to deviations values, the gradient statistical features were used to show the abrupt changes of energy value in different time-domains and frequency-domains. Finally, KNN classifier was applied to classify the extracted gradient statistical features. In this paper, experiments on different speech datasets of Parkinson's patients showed that the gradient statistical features extracted in this paper had stronger clustering in classification. Compared with the classification results based on traditional features and deep learning features, the gradient statistical features extracted in this paper were better in classification accuracy, specificity and sensitivity. The experimental results show that the gradient statistical features proposed in this paper are feasible in speech classification diagnosis of Parkinson's patients.


Subject(s)
Cluster Analysis , Humans , Parkinson Disease/diagnosis , Speech
11.
Acta Physiologica Sinica ; (6): 89-102, 2021.
Article in Chinese | WPRIM | ID: wpr-878239

ABSTRACT

Parkinson's disease (PD), one of the most frequent neurodegenerative disorders, is characterized by the selective loss of dopaminergic neurons in the substantia nigra (SN). Genetic vulnerability, aging, environmental insults are believed to contribute to the pathogenesis of PD. However, the cellular and molecular mechanism of dopaminergic neurons degeneration remains incompletely understood. Dopamine (DA) metabolism is a cardinal physiological process in dopaminergic neurons, which is closely related to the loss of dopaminergic neurons in the SN. DA metabolism takes part in several pathological processes of PD neurodegeneration, such as iron metabolism disturbance, α-synuclein mis-folding, endoplasmic reticulum stress, protein degradation dysfunction, neuroinflammatory response, etc. In this review, we will describe altered DA metabolism and its contributions to PD pathogenesis.


Subject(s)
Dopamine , Dopaminergic Neurons , Humans , Parkinson Disease/etiology , Substantia Nigra , alpha-Synuclein/metabolism
12.
Article in Chinese | WPRIM | ID: wpr-877643

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture on swallowing function and nutritional status of patients with Parkinson's disease (PD) dysphagia.@*METHODS@#A total of 56 patients with PD dysphagia were randomly divided into an observation group and a control group, 28 cases in each one. Both groups were given conventional treatment and swallowing function rehabilitation training.On the basis, the observation group was treated with acupuncture (filiform needling and tongue picking acupuncture). The acupoints of filiform needling were Lianquan (CV 23), Shanglianquan (Extra), Yifeng (TE 17), etc.; and the tongue picking acupuncture was applied at Jinjin (EX-HN 12), Yuye (EX-HN 13) and posterior pharyngeal wall. Rehabilitation training and acupuncture were performed once a day for 5 consecutive days a week, 2 weeks as a course of treatment, 3 courses in total. The swallowing function [oral transit time (OTT), swallowing response time (SRT), pharyngeal transit time (PTT), laryngeal closure duration (LCD)] and nutritional indexes [body mass index (BMI), serum albumin (ALB), serum prealbumin (PA), hemoglobin (Hb)] in the two groups were evaluated before and after treatment, and the clinical effects were compared.@*RESULTS@#After treatment, the paste and liquid OTT, SRT, PTT, LCD in the two groups were shorter than those before treatment (@*CONCLUSION@#Acupuncture-assisted rehabilitation training can improve the swallowing function and nutritional status in patients with Parkinson's disease swallowing disorders.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Deglutition Disorders/therapy , Humans , Parkinson Disease/therapy , Stroke , Treatment Outcome
13.
Frontiers of Medicine ; (4): 125-138, 2021.
Article in English | WPRIM | ID: wpr-880937

ABSTRACT

This study aimed to define the most consistent white matter microarchitecture pattern in Parkinson's disease (PD) reflected by fractional anisotropy (FA), addressing clinical profiles and methodology-related heterogeneity. Web-based publication databases were searched to conduct a meta-analysis of whole-brain diffusion tensor imaging studies comparing PD with healthy controls (HC) using the anisotropic effect size-signed differential mapping. A total of 808 patients with PD and 760 HC coming from 27 databases were finally included. Subgroup analyses were conducted considering heterogeneity with respect to medication status, disease stage, analysis methods, and the number of diffusion directions in acquisition. Compared with HC, patients with PD had decreased FA in the left middle cerebellar peduncle, corpus callosum (CC), left inferior fronto-occipital fasciculus, and right inferior longitudinal fasciculus. Most of the main results remained unchanged in subgroup meta-analyses of medicated patients, early stage patients, voxel-based analysis, and acquisition with 30 diffusion directions. The subgroup meta-analysis of medication-free patients showed FA decrease in the right olfactory cortex. The cerebellum and CC, associated with typical motor impairment, showed the most consistent FA decreases in PD. Medication status, analysis approaches, and the number of diffusion directions have an important impact on the findings, needing careful evaluation in future meta-analyses.


Subject(s)
Anisotropy , Brain/diagnostic imaging , Corpus Callosum , Diffusion Tensor Imaging , Humans , Parkinson Disease/diagnostic imaging , White Matter/diagnostic imaging
14.
Rev. Esc. Enferm. USP ; 55: e03748, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1279645

ABSTRACT

RESUMO Objetivo: Avaliar a contribuição de gerontotecnologias no cuidado gerontológico de enfermagem ao idoso com Doença de Parkinson, visando à prevenção de quedas. Método: Pesquisa Convergente Assistencial, mediante a construção e a avaliação de gerontotecnologias focadas na prevenção de quedas em idosos com Doença de Parkinson. Realizaram-se avaliação clínica, entrevistas e oficinas com idosos, bem como análise e julgamento dos materiais desenvolvidos por dez juízes titulados em gerontologia pela Sociedade Brasileira de Geriatria e Gerontologia. Resultados: Os idosos necessitam de no mínimo seis anos de estudo para compreender a gerontotecnologia educacional desenvolvida. Os objetivos relacionados a conteúdo, compreensão do texto, ilustração, apresentação, motivação e adaptação cultural foram alcançados. Conclusão: A gerontotecnologia educacional desenvolvida tem conteúdo relevante, podendo ser utilizada pelos idosos, familiares e cuidadores, a fim de gerar esclarecimento de questões sobre a temática prevenção de quedas para os idosos com Doença de Parkinson.


RESUMEN Objetivo: Evaluar la contribución de las gerontecnologías en los cuidados de la enfermería gerontológica de los adultos mayores con Parkinson, con el objetivo de prevenir las caídas. Método: Se trata de una Investigación Convergente Asistencial, a través de la construcción y evaluación de gerontecnologías enfocadas en la prevención de caídas de adultos mayores con Parkinson. Se llevó a cabo una evaluación clínica, además de entrevistas y talleres con los adultos mayores, así como el análisis y el juicio de los materiales desarrollados por diez jueces graduados en gerontología por la Sociedad Brasileña de Geriatría y Gerontología. Resultados: Las personas mayores necesitan al menos seis años de estudio para comprender la gerontecnología educativa. Se cumplieron los objetivos relacionados con el contenido, la comprensión del texto, la ilustración, la presentación, la motivación y la adaptación cultural. Conclusión: La gerontología educativa desarrollada tiene un contenido relevante que puede ser utilizado por los mayores, los familiares y los cuidadores con el fin de obtener claridad en el tema de la prevención de caídas de los adultos mayores con la enfermedad de Parkinson.


ABSTRACT Objective: To assess the contribution of gerontotechnologies in nursing care to older adults with Parkinson's disease, aiming at the prevention of falls. Method: Convergent Assistance Research, through the development and evaluation of gerontechnologies focused on the prevention of falls in older adults with Parkinson's Disease. Clinical evaluation, interviews and workshops with older adults were carried out, as well as analysis and judgment of the materials developed by ten judges certified in gerontology by the Brazilian Society of Geriatrics and Gerontology. Results: Older adults need at least six years of study to understand the educational gerontotechnology development. The objectives related to the content, understanding of the text, illustration, presentation, motivation and cultural adaptation were achieved. Conclusion: The educational gerontotechnology developed has relevant content, which can be used by older adults, family members and caregivers, to generate clarification of questions on the theme of fall prevention for older adults with Parkinson's Disease.


Subject(s)
Parkinson Disease , Nursing Care , Aged , Multimedia
15.
17.
Braz. arch. biol. technol ; 64: e21180392, 2021. graf
Article in English | LILACS | ID: biblio-1249216

ABSTRACT

ABSTRACT The therapeutic effect of adipose tissue-derived stem cells (ADSCs) or RE on hippocampal neurogenesis and memory in Parkinsonian rats were investigated. Male rats were lesioned by bilateral intra-nigral injections of 6-OHDA and divided into six groups: 1. Lesion 2 and 3: RE and water groups were lesioned rats pretreated with RE or water, from 2weeks before neurotoxin injection and treated once a day for 8weeks post lesion. 4&5: Cell and α-MEM (α-minimal essential médium) received intravenous injection of BrdU-labeled ADSCs or medium, respectively from 10days post lesion until 8weeks later. 6: Sham was injected by saline instead of neurotoxin. Memory was assessed using Morris water Maze (MWM), one week before and at 1, 4 and 8weeks post 6-OHDA lesion. After the last probe, the animals were sacrificed and brain tissue obtained. Paraffin sections were stained using cresyl violet, anti-BrdU (Bromodeoxyuridine / 5-bromo-2'-deoxyuridine), anti-GFAP (Glial fibrillary acidic protein) and anti-TH antibodies. There was a significant difference of time spent in the target quadrant between groups during probe trial at 4 and 8 weeks' post- lesion. Cell and RE groups spent a significantly longer period in the target quadrant and had lower latency as compared with lesion. Treated groups have a significantly higher neuronal density in hippocampus compared to water, α-MEM and lesion groups. BrdU positive cells were presented in lesioned sites. The GFAP (Glial fibrillary acidic protein) positive cells were reduced in treated and sham groups compared to the water, α-MEM and lesion groups. Oral administration of RE (Rosemary extract) or ADSCs injection could improve memory deficit in the Parkinsonian rat by neuroprotection.


Subject(s)
Parkinson Disease/physiopathology , Rosmarinus , Stem Cell Transplantation , Memory Disorders/therapy , Morris Water Maze Test , Hippocampus
18.
Einstein (Säo Paulo) ; 19: eAO5940, 2021. tab, graf
Article in English | LILACS | ID: biblio-1286296

ABSTRACT

ABSTRACT: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. Methods: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.


RESUMO Objetivo: Avaliar os efeitos do treinamento resistido nas respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo em pacientes com doença de Parkinson. Métodos: Vinte e quarto pacientes com doença de Parkinson (estágios 2 a 3 de Hoehn e Yahr modificado) foram aleatoriamente randomizados em dois grupos: Controle e Treinamento Resistido. O Grupo Treinamento Resistido realizou, duas vezes por semana, cinco exercícios resistidos, duas a quatro séries, seis a 12 repetições máximas por série. O Grupo Controle manteve seu estilo de vida. No início e após 12 semanas, consumo de oxigênio, pressão arterial sistólica e frequência cardíaca foram avaliados em repouso e durante um teste de esforço cardiopulmonar máximo realizado em um cicloergômetro. As avaliações durante o exercício foram realizadas nas intensidades submáximas (a inclinação da regressão linear entre as variáveis fisiológicas e as cargas absolutas), nas intensidades submáximas relativas (limiar anaeróbico e ponto de compensação respiratória) e na intensidade máxima (pico do exercício). Adicionalmente, foi avaliada a força muscular. Resultados: Comparado com o início, o consumo de oxigênio pico aumentou, de forma semelhante, em ambos os grupos após 12 semanas. A frequência cardíaca e a pressão arterial sistólica avaliadas nas intensidades submáximas absolutas e relativas, assim como no pico do exercício, não se modificaram em nenhum dos grupos. Finalmente, diferente do Grupo Controle, a força muscular aumentou no Grupo Treinamento Resistido após 12 semanas. Conclusão: Em pacientes com doença de Parkinson sem comorbidades cardiovasculares, o treinamento resistido aumenta a força muscular, mas não modifica as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo.


Subject(s)
Humans , Parkinson Disease/therapy , Resistance Training , Anaerobic Threshold , Exercise Test , Heart Rate
19.
Rev. CEFAC ; 23(2): e11220, 2021. tab
Article in English | LILACS | ID: biblio-1155332

ABSTRACT

ABSTRACT Purpose: to analyze the predictors of temporomandibular disorder in people with Parkinson's disease, verifying their associations with sociodemographic aspects and stages of the disease. Methods: a study based on secondary data from research conducted in 2017 with 110 people with Parkinson's disease. They were assessed with the Research Diagnostic Criteria for Temporomandibular Disorders and the Parkinson's disease staging scale. The studied predictive variables for temporomandibular disorder were pain, crepitation, clicking, nighttime and daytime clenching/gnashing, uncomfortable/non-habitual bite, morning rigidity, and tinnitus. The sociodemographic aspects assessed were age, sex, schooling level, marital status, income, and stages 1 to 3 of the disease. The chi-squared odds ratio was used with a 95% confidence interval and significance level at p < 0.05. Results: an association was verified between nighttime clenching/gnashing and income (p = 0.006); tinnitus and income range from ½ to 3 (p = 0.003) and from 4 to 10 minimum wages (p = 0.004); and between tinnitus and stage 1 (p = 0.02). Conclusion: this study verified that the predictors associated with temporomandibular disorder in people with Parkinson's disease were pain, clicking, crepitation, uncomfortable/non-habitual bite, and morning rigidity. It was verified that income and stage 1 of the disease had an association with nighttime clenching/gnashing and tinnitus.


RESUMO Objetivo: analisar os preditores de disfunção temporomandibular em pessoas com doença de Parkinson (DP) verificando suas associações com aspectos sociodemográficos e estágios da doença. Métodos: estudo que utilizou fonte de dados secundários de uma pesquisa realizada em 2017, com 110 pessoas com DP que foram avaliadas pelo questionário para Pesquisa em Disfunção Temporomandibular (RDC/TMD) e pela escala de estadiamento da DP. As variáveis preditoras de DTM estudadas foram: dor, crepitação, estalido, apertamento/rangido noturno e diurno, mordida desconfortável/não habitual, rigidez matinal e zumbido. Os aspectos sociodemográficos avaliados foram: idade, sexo, escolaridade, estado civil, renda e estágios da doença de 1 a 3. Utilizou-se o Odds ratio do Qui-quadrado com intervalo de confiança de 95% e nível de significância de p<0,05. Resultados: verificou-se associação entre os preditores: apertamento/rangido noturno e renda (p=0,006); zumbido e grupos de renda ½ a 3 (p=0,003) e de 4 a 10 salários mínimos (p=0,004). Além da associação do zumbido e estágio 1 (p=0,02). Conclusão: nesse estudo verificou-se que os preditores associados com a DTM em pessoas com DP foram: dor, estalido, crepitação, mordida desconfortável/não habitual e rigidez matinal. E destes verificou-se associação entre renda e estágio 1 da doença com apertamento/rangido noturno e zumbido.


Subject(s)
Humans , Male , Female , Middle Aged , Parkinson Disease/physiopathology , Temporomandibular Joint Disorders/physiopathology , Socioeconomic Factors , Cross-Sectional Studies
20.
Rev. medica electron ; 42(6): 2644-2658, nov.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1150044

ABSTRACT

RESUMEN La enfermedad de Parkinson según la Organización Mundial de Salud, en el año 2016, afectó una persona por cada 100 mayores de 60 años, siendo en cifras absolutas 6,3 millones de personas, y para el año 2030 serán aproximadamente 12 millones de personas en todo el mundo con dicha patología. Este desorden neurodegenerativo, caracterizado por la degradación nigro-estriatal y potenciación de la vía indirecta del circuito motor de los Ganglios Basales sumado al acúmulo de Cuerpos de Lewy en diversas estructuras del Sistema Nervioso Central, afecta progresiva e inevitablemente la calidad de vida de los pacientes, los procederes ablativos del núcleo subtalámico constituyen una alternativa que propicia efecto y seguridad probada en el control de los síntomas de esta enfermedad. Por lo cual se decide describir la ablación del Núcleo subtalámico como tratamiento de la Enfermedad de Parkinson avanzada (AU).


Summary According to the World Health Organization, in 2016 Parkinson's disease affected one person per every 100 people elder 60 years, meaning 6.3 millions of people, and by 2030 it will be around 12 million persons across the world. This neurodegenerative disorder, characterized by the nigro-striatal degradation and potentiation of the indirect route of the basal ganglia motor circuit, added to the accumulation of Lewy bodies in several structures of the Central Nervous System, progressively and inevitably affects the life quality of patients. The ablative procedures of the subthalamic nucleus are an alternative that propitiates proven effect and safety in the control of this disease symptoms. Therefore, the authors decided to describe the subthalamic nucleus ablation as a treatment for advanced Parkinson's disease (AU).


Subject(s)
Humans , Male , Female , Parkinson Disease/surgery , Subthalamic Nucleus/surgery , Parkinson Disease/complications , Parkinson Disease/diagnosis , Quality of Life , Surgical Procedures, Operative/methods , Therapeutics/methods , Central Nervous System/abnormalities
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