ABSTRACT
The article is of an overview nature and is devoted to movement disorders in Parkinson's disease. The article discusses the existing problems according to the latest literature data, a review on the treatment and rehabilitation of postural instability. Special attention in the article is paid to dopamine receptor agonists - namely, piribedil, prescribed for the correction of these disorders.
Subject(s)
Parkinson Disease , Humans , Parkinson Disease/complications , Piribedil , Dopamine Agonists , Walking , Postural BalanceABSTRACT
OBJECTIVE: To study tremor and olfactory dysfunction in patients with Parkinson's disease (PD), patients with essential tremor and healthy people for the differential diagnosis and to verify the hypothesis on the inverse dependence between tremor and olfactory dysfunction. MATERIAL AND METHODS: Olfactory dysfunction was studied in 45 patients with PD, 40 patients with essential tremor and 64 healthy controls. Tremor was studied in 90 people, including 30 controls and 30 patients with PD and essential tremor. The olfactory function was tested with Sniffin' Sticks test. Tremor parameters were studied with wireless monitoring instrument for electrophysiological signals record, where three essential data flows have been recorded: electromyogram, gyroscope and acceleration. The instrument recorded the frequency and amplitude of each parameter. The data were analyzed with IBM SPSS Statistica 2.3 software using standard methods. Besides, non-linear statistics using ViDaExpert software with elastic map technique was utilized. RESULTS AND CONCLUSION: The elastic map perfectly separated the patients with PD and essential tremor, as well as healthy controls. Three clusters were observed. The analysis of composition of the clusters proved the better quality of olfactory function of the patients with essential tremor compared to the patients with PD. This bias confirms the hypothesis on the inverse dependence between the tremor level and olfactory dysfunction.
Subject(s)
Essential Tremor , Parkinson Disease , Diagnosis, Differential , Essential Tremor/diagnosis , Humans , Parkinson Disease/complications , Parkinson Disease/diagnosis , Smell , Tremor/diagnosisABSTRACT
AIM: To study the efficacy of replacement of the single daily dose of two-component levodopa by three-component levodopa in work capable patients with Parkinson's disease with motor fluctuations during the most active working hours. MATERIAL AND METHODS: The study included 157 patients from 19 Russian centers specialized in extrapyramidal pathology. The period of highest working activity was analyzed in all patients. In these patients, the previous treatment with two-component levodopa was replaced by three-component levodopa in the equivalent dose. Other antiparkinsonian treatment remained unchanged during the study period. The duration of the study was 1 month. RESULTS AND CONCLUSION: The single replacement of two-component levodopa by stalevo allows increasing the optimal working activity by 19% and improving patient's state.
Subject(s)
Parkinson Disease , Antiparkinson Agents , Humans , Levodopa , RussiaABSTRACT
In this article, non-drug methods of treatment of Parkinson's disease are reviewed. Particular attention is given to the motor symptoms of disease, specifically to gait disorders. Information about objective methods of gait impairment is presented. Own results that confirm the effect of a method of tempo-rhythmical correction of walk in patients with Parkinson's disease (PD) and vascular parkinsonism as well as a device for assessment of gait parameters developed by the authors are analyzed. The efficacy of other methods of gait correction using external cues, study design and level of evidence are analyzed as well. Information about possibilities of physical therapy and ergotherapy for correction of different symptoms of Parkinson's disease is presented. Positive and negative results of transcranial magnetic stimulation, light therapy and transcranial micropolarization in PD are analyzed. Basis non-drug methods of PD treatment, which currently have insufficient level of evidence (methods of mental relaxation and auditory training, methods of whole body vibration (vibromassage), laser therapy (photoacoustic therapy), acupuncture), are described in brief. Perspectives of the method of gait recovery in PD using tempo-rhythmic correction are emphasized.
