Neuropatía periférica en la enfermedad de Parkinson. estudio caso-control / Peripheral neuropathy in Parkinson's disease. case control study

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.

Clinical Significance of 123I-IPT SPECT for the Diagnosis of the Parkinson's Disease

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.