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Objective To compare the characteristics of sleep disorder and its effect on health-related quality of life in patients with Parkinson's disease (PD) between early-stage and middleand late-stages.Methods One hundred and fifty-one patients collected in our hospital from September 2014 to May 2016 were divided into PD patients at early stage (grading 1-2,n=82) and PD patients at middle-and late-stages (grading 3-5,n=69) according to Hoehn-Yahr (H-Y) grading.Mini-Mental Status Examination (MMSE),Hamilton Anxiety Rating (HAM-A) scale and Hamilton Depression Rating (HAM-D) scale,Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ),H-Y grading,Non-motor Symptoms Questionnaire (NMS) and Parkinson's Disease Sleep Scale (PDSS) were used to evaluate cognition states,emotion states,movement functions,disease severity,nonmotor symptoms and sleep disturbances of patients from the two groups.The 39-item Parkinson's Disease Questionnaire (PDQ-39)was used to evaluate the quality of life of PD patients.Results The incidence of sleep disorder in PD patients at middle-and late-stages was significantly higher than that in PD patients at early stage (P<0.05),and the total scores of PDSS in PD patients at middle-and late-stages were significantly lower than those in PD patients at early stage (P<0.05).Fragmented sleep (31.7% and 47.8%) and excessive sleepiness at daytime (38.7% and 43.5%) were the most common problems in patients from the two groups.Sleep disorder was negatively correlated with duration,and scores of HAM-A,HAM-D,UPDRSⅢ and H-Y grading,while it was positively correlated with MMSE scores in patients from the two groups (P<0.05).Sleep disorder was negatively correlated with NMS scores and daily levodopa equivalent dose in PD patients at middle-and late-stages (P<0.05).Multivariate regression analysis indicated that PDSS total scores were negatively correlated with HAMD scores and positively correlated with MMSE scores in all patients (P<0.05).PDSS total scores were negatively correlated with duration in PD patients at middle-and late-stages (P<0.05).Sleep disorder was negatively correlated with total scores of PDQ39,mobility,activity of daily living,communication ability and body discomfort in PD patients at middle-and late-stages (P<0.05).Conclusions The quality of sleep disorder in PD patients at middleand late-stages is worse than that in PD patients at early stage,and the quality of life is further reduced than that in PD patients at early stage.The course of disease has a great influence in sleep disorder of PD patients.
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Objective To explore the application of olfactory assessment and substantia nigra ultrasonography in early diagnosis of Parkinson's disease (PD).Methods Thirty PD patients,admitted to our hospital from March 2015 to March 2017,were served as PD group and 30 healthy subjects were served as control group.Olfactory assessment tool Sniffm Sticks-1 6 and substantia nigra ultrasonography were performed;the sensitivity,specificity and positive predictive value of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD were calculated,respectively.Correlations of results of olfactory assessment,transcranial ultrasonography with age,gender,course of disease,and Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) scores were analyzed.Results There were 25 PD patients with olfactory test (SS-16) scores≤ 10 and 22 control subjects;the olfactory test (SS-16) scores in PD patients were 7.83±2.23,which were significantly lower as compared with those in control subjects (12.03±1.96,P<0.05);the incidence of olfactory dysfunction in PD group was 83.33% and that in control group was 26.67%,with statistical significance (P<0.05).There were 23 PD patients with area of substantia nigra hyperecho≥ 0.20 cm2 and 26 control subjects;area of substantia nigra hyperecho was (0.22±0.06) cm2 in PD group,which was signfciantly increased as compared with control group ([0.11 ±0.07] cm2,P<0.05);the incidence of pathological substantia nigra hyperecho in PD group was 76.67% and that in control group was 13.33%,with significant difference (P<0.05).The sensitivity of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD was 83.33%,76.67%,86.67%,indicating that combined measurement had significantly higher sensitivity that the other two method (P<0.05).SS-16 scores and area of substantia nigra hyperecho were unrelated with gender,age,duration and UPDRS Ⅲ scores (P>0.05).Conclusion Combination of olfactory test and substantia nigra hyperecho can improve the diagnosis sensitivity of PD.
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Objective To compare the effect of mirror therapy (MT) supplemented by early rehabilitative intervention and acupunture therapy on recovery of hemiplegic limb function versus routine occupational training in post-stroke elderly patients.Methods Totally 120 acute-stroke elderly patients with limb paralysis were randomly divided into two groups:MT group and control group (n=60,each).All 120 patients received routine rehabilitative intervention and acupunture therapy except for 30 minutes mirror therapy daily as add-on therapy to the MT group,all patients were assessed with Chinese Stroke Scale(CSS) and the Barthel index(BI) before and after treatment 1 and 3 months.Results At the end of 1 and 3 months of treatment,CSS in the MT groups was (15.6±8.5)scores,(11.6±7.2)scores,ADL was (75.3±13.9)scores,(80.1±13.0)scores;CSS in the control group was (16.2±5.8)scores,(14.8±6.1)scores,ADL was (68.2±13.5)scores,(70.5±12.9)scores.Before treatment,CSSandADLwas (21.3±7.1)scores,(63.7±12.6)scoresin the MT group; (20.8 ± 7.6) scores,(61.7 ± 11.4) scores in the control group.There were significant differences in CSS and ADL between groups,except CSS after 1 month (t=1.40,2.38,-3.27,-3.47; P=0.166,0.019,0.001,0.001,respectively).After 3 months of treatment,CSS and ADL in the MT group had considerably outperformed those of the control group(t=2.40,-3.47,P<0.05 or 0.01).Conclusions Mirror therapy is better than routine occupational training in improving the motor function of limbs and activities of daily living(ADL) ability 3 months after stroke,on the basis of early rehabilitative intervention and acupunture therapy.
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Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P < 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P < 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.
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Objective To explore the effect of atorvastatin combined with aspirin on therapeutic efficacy of acute cerebral infarction, and on the changes in neurologic impairment, blood lipids and carotid plaque, et al. Methods The 80 patients with acute cerebral infarction were randomly divided into the treatment group (n=40) and the control group (n = 40)who took atorvastatin combined with aspirin and aspirin alone respectively. The defect degree of nerve function, curative effect, changes of blood lipids and cervical vascular ultrasound parameters were compared between the two groups, and they were followed up for 6 months to observe the recurrence of cerebral infarction.Results Compared with the control group, the levels of TG, TC, HDL-C and LDL-C, internal diameter of common carotid artery, size of plaque, drag index, pulsatility index and neurological function deficit scale (NFDS) were significantly lower in treatment group [(1.36 ± 0.33) mmol/L vs.(1.77±0.80) mmol/L, (5.21±0.32) mmol/L vs. (5.80±0.37) mmol/L, (1.20±0.10) mmol/L vs. (1.43±0.16) mmol/L, (1.31±0.37) mmol/L vs. (1.57±0.39) mmol/L, (6.43±0.71) mm vs. (6.67±0.47) mm, (40.39±8.94) mm3 vs. (54.26±8.25) mm3, (0.70±0.06) vs. (0.82±0.08), (2.12±0.37) vs. (2.18±0.54), (10.24±3.31) scores vs. (14.69±3.23) scores, all P<0.05 or <0.01]. The intima-media thickness and peak systolic velocity of carotid artery were higher in treatment group than in control group [(1.66±0.50) mm vs. (1.50±0.68) mm, (71.34±15.01)an/s vs. (68.97 ± 18.21 ) an/s, both P< 0.01]. The total effective rate was higher in treatment group than in control group (92.5% vs. 75.0%, P<0.05), and there were no recurrence of cerebral infarction within 6 months. Conclusions Atorvastatin combined with aspirin in treatment of acute cerebral infarction is beneficial to resume neurological function, improve prognosis, decrease the volume of carotid atherosclerotic plaque, stabilize plaque and reduce blood lipids, and it play an positive action in the intervention of cerebral infarction recurrence, and it can be used to treatment acute cerebral infarction as combination therapy.
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Objective To explore the effects of lamotrigine (LTG) on cognitive function and the quality of life (QOL) in patients with partial epilepsy. Methods Twenty six patients with newly diagnosed partial epilepsy were randomly divided into 2 different groups using oral administration of LTG and carbamazepine (CBZ) respectively. By neuropsychological test scores and the Quality of Life in Epilepsy Inventory (QOLIE-31) The cognitive function and QOL were assessed before and 16 weeks after the treatment. A battery of neuropsychological tests comprised WAIS digital span test (WDST), verbal fluency test (VFT), trail making test (TMT, parts A and B), stroop color word test (SCWT), Wisconsin card sorting test (WCST), delayed logical memory test, delayed optical memory test, arithmetic ability and digital symbol conversion test. Results The repeated assessments for the patients taking LTG were associated with significant improvements in many domains. When comparing the results at the end of 16 weeks with the baseline results, the verbal fluency were improved, the time of trail making test parts A and B were shortened, the WCST correct number and classification were improved, and the persistent error number and operation time of WCST were declined as well, digital symbol conversion was increased, delayed logic memory and optical memory were improved (t=3. 043, -3. 287,-2. 543,3. 167,3. 028,-2. 191, -3. 216,3. 061,3. 036, 3. 021 ,all P<0. 01 or P<0. 05). When comparing the efficacy of LTG with the CBZ group, the time of stroop color word test was shortened, digital symbol conversion was increased and arithmetic ability was improved (t= 3. 167,2. 142,2. 101, P<0.01 or P<0. 05). Compared with the baseline, both LTG group and CBZ group showed that the overall QOL, overall health, cognitive function and social function scores were improved (LTG group: t= 3. 321,2. 462,3. 294,3. 512;CBZ group: t=3. 314, 3. 149,3. 294,3. 202,all P<0.05). When comparing LTG group with CBZ group after therapy, cognitive function and social function scores were obviously improved (t = 2. 257,2. 140, both P< 0. 05), and the worry about seizure declined (t=2. 147,P<0. 05). Conclusions LTG may improve the cognitive function and QOL in patients with newly diagnosed partial epilepsy.
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@#ObjectiveTo evaluate the clinical effect of Buyang Huanwu decoction on motion functions and complications of stroke patients.Methods86 acute stroke patients were randomly divided into the therapy group (n=46) and control group (n=40). Despite of routing neurological medicine, rehabilitation therapy including decubitus position, neurodevelopmental therapy and activities of daily living (ADL) and low frequency electronic stimulation on both two groups, Buyang Huanwu decoction was used on the therapy group. Patients of two groups were evaluated with Fugl-Meyere motion index and modified Barthel index before and after therapy, and complications of all cases were observed, including shoulder pain, joints motion limitation, sensation disorder and stembrocker syndrome.ResultsThe motion functions of patients in two groups were improved significantly after therapy (P<0.01). While effect of the therapy group was better than that of the control group (P<0.01), and the accidence of complications in the therapy group was lower than that in the control group (P<0.01).ConclusionBuyang Huanwu decoction can improve the motion function and ADL, and decrease the complications of acute stroke patients.