RESUMO
Objective@#Using telemedicine is a way to improve the accessibility of specialists for patients with Parkinson’s disease (PD); however, it is not widely used in Japan. We investigated the efficacy of telemedicine in PD by using a single-center cross-sectional questionnaire survey. @*Methods@#We sent a questionnaire to patients who agreed to participate from among 52 patients with PD who had used telemedicine services at Juntendo University Hospital from October 2017 to November 2018. Caregivers were asked to respond to one question separately. @*Results@#A total of 38 patients responded to the questionnaire. Most patients were satisfied with the telemedicine consultation (7.8 ± 1.9), reporting that it was effective in reducing their travel burden. Twenty-one patients attended a telemedicine consultation with their caregivers, and their satisfaction was high (8.4 ± 1.8). @*Conclusion@#In a specific cohort in Japan, patients with PD and their caregivers were mostly satisfied with the telemedicine service.
RESUMO
Objective@#The long-term efficacy of deep brain stimulation (DBS) for motor fluctuations in advanced Parkinson’s disease (PD) has been well established; however, motor fluctuations may recur over time despite multiple adjustments of DBS settings and medications. @*Methods@#We conducted a retrospective chart review of three patients for whom levodopa-carbidopa intestinal gel (LCIG) was additionally administered as a rescue therapy for secondary DBS failure due to the recurrence of motor fluctuations. @*Results@#The three patients had advanced PD with a disease duration of 14–19 years, and had undergone DBS for motor fluctuations refractory to standard medical management. LCIG was administered to the patients because of symptom recurrence years after DBS and provided complementary effects in all patients. @*Conclusion@#The cases presented here show that rescue LCIG therapy may be a complementary treatment option for patients with post-DBS advanced PD who have a recurrence of troublesome motor complications.
RESUMO
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, characterized by increasingly morbid motor dysfunction with advancing age. Recently, various antiparkinsonian agents and surgical intervention have been developed that, when used in combination, greatly promote sustained improvements in activities of daily living, leading to the establishment of a treatment algorithm. However, since all of these interventions are symptomatic therapies, it is difficult to resolve motor dysfunction completely. Recent evidence has revealed that exercise might enhance neuroplasticity and improve motor and cognitive behavioral impairment in PD. In this article, we reviewed recent therapeutic strategies for PD.