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[PMID]:29390334
[Au] Autor:Lee HD; Chang MC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
[Ti] Título:Degeneration of the corticofugal tract from the secondary motor area in a Parkinson's disease patient with limb-kinetic apraxia: A case report.
[So] Source:Medicine (Baltimore);96(50):e9195, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: In this case report, we describe a Parkinson's disease (PD) patient with limb-kinetic apraxia (LKA) in whom degeneration of the corticofugal tract (CFT) from the supplementary motor area (SMA) was observed in diffusion tensor tractography (DTT). PATIENT CONCERNS: A 63-year-old woman presented with a loss of dexterity in both upper extremities, which indicated LKA, and typical PD-related symptoms, including a gait disturbance with a short step, resting tremor in both upper extremities, and rigidity, and these symptoms had been present for 2 years. The F-florinated-N-3-fluoropropyl-2-ß-carboxymethoxy-3-ß-(4-lodophenyl) nortropane positron emission tomography scanning findings were consistent with PD. Based on the clinical symptoms and imaging findings, we diagnosed the patient with PD. In a coin-rotation test that was used to evaluate the severity of the LKA, the patient's results significantly decreased compared to the results of the normal controls. DIAGNOSES: The DTT showed that the CFTs from the SMAs in both hemispheres were partially torn and thinned. The fractional anisotropy values and CFT volumes in both SMAs were >2 standard deviations lower than those of the normal controls. INTERVENTIONS: The patient was treated with an initial dose of 150/37.5 mg/day of levodopa/benserazide, and the dose was gradually increased to 400/100 mg/day. OUTCOMES: After treatment, although the bradykinesia, rigidity, and resting tremor of the patient significantly decreased, the dexterity of the patient's hands did not improve. LESSONS: These observations indicated degeneration of the CFTs from the SMAs in both hemispheres in the patient. This degeneration might have, at least in part, contributed to the patient's LKA. The results of this study suggest that CFT degeneration could be one of the pathological mechanisms underlying LKA in patients with PD.
[Mh] Termos MeSH primário: Córtex Motor/patologia
Doença de Parkinson/patologia
[Mh] Termos MeSH secundário: Anisotropia
Antiparkinsonianos/uso terapêutico
Benserazida/uso terapêutico
Imagem de Tensor de Difusão
Combinação de Medicamentos
Feminino
Seres Humanos
Levodopa/uso terapêutico
Meia-Idade
Córtex Motor/diagnóstico por imagem
Rigidez Muscular/diagnóstico por imagem
Rigidez Muscular/tratamento farmacológico
Rigidez Muscular/patologia
Atrofia Muscular Espinal/diagnóstico por imagem
Atrofia Muscular Espinal/tratamento farmacológico
Atrofia Muscular Espinal/patologia
Doença de Parkinson/diagnóstico por imagem
Doença de Parkinson/tratamento farmacológico
Tomografia por Emissão de Pósitrons
Tremor/diagnóstico por imagem
Tremor/tratamento farmacológico
Tremor/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (benserazide, levodopa drug combination); 46627O600J (Levodopa); 762OS3ZEJU (Benserazide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009195


  2 / 1849 MEDLINE  
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[PMID]:28592451
[Au] Autor:Rajput AH; Rajput ML; Ferguson LW; Rajput A
[Ad] Endereço:From the Division of Neurology (A.H.R., A.R.), Saskatoon Health Region/University of Saskatchewan, Rosthern; and Movement Disorders Program (M.L.R.) and College of Medicine (L.W.F.), University of Saskatchewan, Saskatoon, Canada. ali.rajput@saskatoonhealthregion.ca.
[Ti] Título:Baseline motor findings and Parkinson disease prognostic subtypes.
[So] Source:Neurology;89(2):138-143, 2017 Jul 11.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify the significance of baseline motor features to the lifelong prognostic motor subtypes in a Parkinson disease (PD) cohort. METHODS: In a previous study of 166 PD cases, we observed different prognosis in tremor-dominant, akinetic-rigid, and mixed subtypes. This study includes the same cases, but we excluded 10 cases with symptoms of ≥15 years duration at baseline. Relative severity of tremor, bradykinesia/akinesia, and rigidity at baseline were evaluated as predictors of the motor subtypes, which are known to have different prognosis. RESULTS: The most common motor subtype was mixed, followed by akinetic-rigid and then the tremor-dominant. Seventy cases were not receiving antiparkinsonian drugs at baseline. The prognostic subtypes could be predicted at baseline in 85% of all and in 91% of the treatment-naive cases. Sensitivity, specificity, and positive predictive values were strong for the mixed and the akinetic-rigid but weak for the tremor-dominant subtype. CONCLUSIONS: Our data show that motor profile at baseline can predict prognosis in most PD cases. These findings can be incorporated into clinical practice.
[Mh] Termos MeSH primário: Progressão da Doença
Rigidez Muscular/diagnóstico
Doença de Parkinson/classificação
Doença de Parkinson/diagnóstico
Tremor/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Rigidez Muscular/etiologia
Rigidez Muscular/fisiopatologia
Doença de Parkinson/complicações
Doença de Parkinson/fisiopatologia
Valor Preditivo dos Testes
Prognóstico
Sensibilidade e Especificidade
Tremor/etiologia
Tremor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170719
[Lr] Data última revisão:
170719
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004078


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[PMID]:28352939
[Au] Autor:Apeldoorn AT; Kamper SJ; Kalter J; Knol DL; van Tulder MW; Ostelo RW
[Ad] Endereço:Rehabilitation department, Noordwest Ziekenhuisgroep, NL-1815 JD Alkmaar, The Netherlands. a.t.apeldoorn@nwz.nl.
[Ti] Título:Rigid shoulder taping with physiotherapy in patients with subacromial pain syndrome: A randomized controlled trial.
[So] Source:J Rehabil Med;49(4):347-353, 2017 Apr 06.
[Is] ISSN:1651-2081
[Cp] País de publicação:Sweden
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the effectiveness of individualized physiotherapy in combination with rigid taping compared with individualized physiotherapy alone in patients with subacromial pain syndrome. DESIGN: A prospective randomized trial with concealed allocation. PATIENTS: A total of 140 patients between 18 and 65 years of age from primary physiotherapy settings. METHODS: The intervention group received individualized physiotherapy and shoulder taping. The control group received individualized physiotherapy only. Primary outcomes were: pain intensit (numerical rating scale) and functioning (Simple Shoulder Test). Secondary outcomes were: global perceived effect and patient-specific complaints. Data were collected at baseline, and at 4, 12 and 26 weeks' follow-up. RESULTS: During the 6-month follow-up period multilevel analysis showed a significant difference between groups favouring the control group on pain intensity (p = 0.02), but not on functioning. Regarding secondary outcomes, a significant difference between groups was found favouring the intervention group for global perceived effect (p = 0.02), but not for patient-specific complaints. CONCLUSION: Rigid shoulder taping, as used in this study, cannot be recommended for improving physiotherapy outcomes in people with subacromial pain syndrome.
[Mh] Termos MeSH primário: Rigidez Muscular/terapia
Síndrome de Colisão do Ombro/terapia
Dor de Ombro/reabilitação
Ombro/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Modalidades de Fisioterapia
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.2340/16501977-2214


  4 / 1849 MEDLINE  
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[PMID]:28044038
[Au] Autor:Mitchell L; Adams W; Aspesberro F
[Ad] Endereço:Madigan Army Medical Center, Tacoma WA.
[Ti] Título:Case 6: Episodic Stiffness in a 30-month-old Girl.
[So] Source:Pediatr Rev;38(1):52-53, 2017 Jan.
[Is] ISSN:1526-3347
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Rigidez Muscular/diagnóstico
Músculos do Pescoço/patologia
Tétano/diagnóstico
[Mh] Termos MeSH secundário: Anti-Infecciosos/uso terapêutico
Pré-Escolar
Diagnóstico Diferencial
Feminino
Seres Humanos
Metronidazol/uso terapêutico
Tétano/tratamento farmacológico
Antitoxina Tetânica/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Tetanus Antitoxin); 140QMO216E (Metronidazole)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170104
[St] Status:MEDLINE
[do] DOI:10.1542/pir.2014-0142


  5 / 1849 MEDLINE  
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[PMID]:27848084
[Au] Autor:Hou Y; Luo C; Yang J; Ou R; Liu W; Song W; Gong Q; Shang H
[Ad] Endereço:Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
[Ti] Título:Default-mode network connectivity in cognitively unimpaired drug-naïve patients with rigidity-dominant Parkinson's disease.
[So] Source:J Neurol;264(1):152-160, 2017 Jan.
[Is] ISSN:1432-1459
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Parkinson's disease (PD) with akinetic rigidity (PD ) is more likely to develop cognitive deficits compared to PD with tremor-dominant symptoms (PD ). The default mode network (DMN) is highly relevant for cognitive processes, so this study tested the functional connectivity (FC) of DMN in cognitively unimpaired PD patients. Resting-state fMRI data were collected in 21 cognitively unimpaired early stage drug-naïve patients with PD and 21 healthy controls (HC). PD patients were matched closely to HCs for demographic and cognitive variables. FC of DMN was evaluated by seed-based correlation approach. Compared to HCs, despite comparable cognitive performance and no statistically discernible GM volume differences, a disruption in the DMN of PD subjects was detected. A decreased FC of DMN was found, specifically prominent in the posterior DMN. We also found a significantly increased FC of the anterior DMN. Three parts of left medial prefrontal regions (anterior, ventral, and dorsal) had significantly increased FC with the cerebellum. In addition, increased FC values of the anterior and ventral parts were negatively correlated with cognitive scores. An evident decline of FC of posterior DMN and enhanced compensatory FC of anterior DMN suggested an early functional disruption of DMN in PD prior to clinical evidence of cognitive impairment. It could be hypothesized that the dysfunction of DMN connectivity may have a role in the development of cognitive decline in PD. However, further longitudinal studies are warranted to understand the underlying neural mechanisms and their relevance to clinical and cognitive outcomes in PD subtype.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Encéfalo/fisiopatologia
Rigidez Muscular/diagnóstico por imagem
Rigidez Muscular/fisiopatologia
Doença de Parkinson/diagnóstico por imagem
Doença de Parkinson/fisiopatologia
[Mh] Termos MeSH secundário: Mapeamento Encefálico
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Rigidez Muscular/psicologia
Vias Neurais/diagnóstico por imagem
Vias Neurais/fisiopatologia
Testes Neuropsicológicos
Doença de Parkinson/psicologia
Descanso
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161117
[St] Status:MEDLINE
[do] DOI:10.1007/s00415-016-8331-9


  6 / 1849 MEDLINE  
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[PMID]:27696490
[Au] Autor:Choe S; Choi BM; Lee YH; Lee SH; Lee EK; Kim KS; Noh GJ
[Ad] Endereço:Department of Clinical Pharmacology and Therapeutics, Pusan National University Hospital, Pusan, Korea.
[Ti] Título:Response surface modelling of the pharmacodynamic interaction between propofol and remifentanil in patients undergoing anaesthesia.
[So] Source:Clin Exp Pharmacol Physiol;44(1):30-40, 2017 Jan.
[Is] ISSN:1440-1681
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:This study describes the pharmacodynamic interaction between propofol and remifentanil. Sixty patients who were scheduled for elective surgery under general anaesthesia (30 males/30 females) were enrolled. Patients were randomly allocated to receive one of 15 combinations of drug levels. Baseline electroencephalograms (EEGs) were recorded for 5 minutes prior to administering the drugs. Patients received a target-controlled infusion at one of four predefined doses of propofol (high, 3 µg/mL; medium, 1.5 µg/mL; low, 0.5 µg/mL; or no drug) and of remifentanil (high, 6 or 8 ng/mL; medium, 4 ng/mL; low, 2 ng/mL; or no drug). The occurrence of muscle rigidity, apnoea, and loss of consciousness (LOC) was monitored, and EEGs were recorded during the drug administration phase. Electroencephalographic approximate entropy (ApEn) and temporal linear mode complexity (TLMC) parameters at baseline and under steady state conditions were calculated off-line. Response surfaces were developed to map the interaction between propofol and remifentanil to the probability of occurrence for quantal responses (muscle rigidity, apnoea, LOC) and ApEn and TLMC measurements. Model parameters were estimated using non-linear mixed effects modelling. The response surface revealed infra-additive and synergistic effects for muscle rigidity and apnoea, respectively. The effects of the combined drugs on LOC and EEG parameters (eg, ApEn and TLMC) were additive. The C estimates of remifentanil (ng/mL) and propofol (µg/mL) were 9.11 and 130 000 for muscle rigidity, 8.99 and 6.26 for apnoea, 13.9 and 3.04 for LOC, 23.4 and 10.4 for ApEn, and 14.8 and 6.51 for TLMC, respectively. The probability of occurrence for muscle rigidity declined when propofol was combined with remifentanil.
[Mh] Termos MeSH primário: Anestesia Intravenosa
Piperidinas/administração & dosagem
Piperidinas/metabolismo
Propofol/administração & dosagem
Propofol/metabolismo
[Mh] Termos MeSH secundário: Anestesia Intravenosa/tendências
Anestésicos Intravenosos
Relação Dose-Resposta a Droga
Interações Medicamentosas/fisiologia
Quimioterapia Combinada
Procedimentos Cirúrgicos Eletivos/tendências
Eletroencefalografia/efeitos dos fármacos
Eletroencefalografia/métodos
Feminino
Seres Humanos
Masculino
Modelos Biológicos
Rigidez Muscular/induzido quimicamente
Rigidez Muscular/metabolismo
Piperidinas/efeitos adversos
Propofol/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Intravenous); 0 (Piperidines); P10582JYYK (remifentanil); YI7VU623SF (Propofol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161004
[St] Status:MEDLINE
[do] DOI:10.1111/1440-1681.12677


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[PMID]:27653852
[Au] Autor:Chan DW; Thomas T; Lim M; Ling S; Woodhall M; Vincent A
[Ad] Endereço:Paediatric Neurology, KK Women's and Children's Hospital, Singapore. Electronic address: Derrick.Chan.W.S@singhealth.com.sg.
[Ti] Título:Focal status epilepticus and progressive dyskinesia: A novel phenotype for glycine receptor antibody-mediated neurological disease in children.
[So] Source:Eur J Paediatr Neurol;21(2):414-417, 2017 Mar.
[Is] ISSN:1532-2130
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antibody-associated disorders of the central nervous system are increasingly recognised in adults and children. Some are known to be paraneoplastic, whereas in others an infective trigger is postulated. They include disorders associated with antibodies to N-methyl-d-aspartate receptor (NMDAR), voltage-gated potassium channel-complexes (VGKC-complex), GABA receptor or glycine receptor (GlyR). With antibodies to NMDAR or VGKC-complexes, distinct clinical patterns are well characterised, but as more antibodies are discovered, the spectra of associated disorders are evolving. GlyR antibodies have been detected in patients with progressive encephalopathy with rigidity and myoclonus (PERM), or stiff man syndrome, both rare but disabling conditions. CASE REPORT: We report a case of a young child with focal seizures and progressive dyskinesia in whom GlyR antibodies were detected. Anticonvulsants and immunotherapy were effective in treating both the seizures and movement disorder with good neurological outcome and with a decline in the patient's serum GlyR-Ab titres. CONCLUSION: Glycine receptor antibodies are associated with focal status epilepticus and seizures, encephalopathy and progressive dyskinesia and should be evaluated in autoimmune encephalitis.
[Mh] Termos MeSH primário: Discinesias/tratamento farmacológico
Discinesias/imunologia
Receptores da Glicina/imunologia
Estado Epiléptico/tratamento farmacológico
Estado Epiléptico/imunologia
[Mh] Termos MeSH secundário: Anticonvulsivantes/uso terapêutico
Autoanticorpos/sangue
Pré-Escolar
Discinesias/complicações
Seres Humanos
Imunoglobulinas Intravenosas/uso terapêutico
Masculino
Metilprednisolona/uso terapêutico
Rigidez Muscular/complicações
Rigidez Muscular/tratamento farmacológico
Rigidez Muscular/imunologia
Mioclonia/complicações
Mioclonia/tratamento farmacológico
Mioclonia/imunologia
Fenótipo
Estado Epiléptico/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Autoantibodies); 0 (Immunoglobulins, Intravenous); 0 (Receptors, Glycine); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170411
[Lr] Data última revisão:
170411
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160923
[St] Status:MEDLINE


  8 / 1849 MEDLINE  
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[PMID]:27595173
[Au] Autor:Vien A; Chhabra N
[Ad] Endereço:Department of Emergency Medicine, University of Illinois at Chicago, 808 South Wood Street M/C 724, Chicago, IL 60612. Electronic address: Albertcvien@gmail.com.
[Ti] Título:Ketamine-induced muscle rigidity during procedural sedation mitigated by intravenous midazolam.
[So] Source:Am J Emerg Med;35(1):200.e3-200.e4, 2017 Jan.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anestésicos Dissociativos/efeitos adversos
Fraturas do Tornozelo/terapia
Hipnóticos e Sedativos/uso terapêutico
Luxações Articulares/terapia
Ketamina/efeitos adversos
Midazolam/uso terapêutico
Rigidez Muscular/induzido quimicamente
[Mh] Termos MeSH secundário: Idoso
Sedação Consciente/métodos
Feminino
Seres Humanos
Manipulação Ortopédica/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 0 (Hypnotics and Sedatives); 690G0D6V8H (Ketamine); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160906
[St] Status:MEDLINE


  9 / 1849 MEDLINE  
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[PMID]:27255673
[Au] Autor:Ramani L; Malek N; Patterson J; Nissen T; Newman EJ
[Ad] Endereço:University of Glasgow School of Medicine, Glasgow, UK.
[Ti] Título:Relationship between [ I]-FP-CIT SPECT and clinical progression in Parkinson's disease.
[So] Source:Acta Neurol Scand;135(4):400-406, 2017 Apr.
[Is] ISSN:1600-0404
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The demonstration of presynaptic dopaminergic deficiency on [ I]-FP-CIT SPECT imaging is a useful ancillary tool in the diagnosis of Parkinson's disease (PD). Whilst there is evidence of a cross-sectional relationship between the degree of dopaminergic deficiency and severity of bradykinesia and rigidity, longitudinal studies are rare. Moreover, the relationship between motor subtypes and their dopaminergic deficient state is not well characterized. AIM: Our primary aim was to assess the correlations between dopaminergic deficiency on baseline [ I]-FP-CIT SPECT imaging with the progression of motor severity in patients classified by motor subtype, and the development of motor complications. Our secondary aim was to assess the correlation between UPDRS-III subscores and the time to onset of motor complications. METHODS: 42 PD patients with abnormal baseline [ I]-FP-CIT SPECT scans and at least 3 years of clinical follow-up were classified by motor subtype: akinetic-rigid, tremor-dominant or mixed. UPDRS-III scores at baseline and at 3-year follow-up, and time to onset of motor complications were recorded. RESULTS: [ I]-FP-CIT uptake ratios were inversely correlated with UPDRS-III scores at 3 years only in akinetic-rigid patients (r=-.51, P=.04). Time to onset of motor complications was inversely correlated with UPDRS-III subscores for bradykinesia and rigidity at baseline (r=-.52, P=.02) and at 3 years (r=-.54, P=.01). CONCLUSION: The degree of dopaminergic deficiency on baseline [ I]-FP-CIT SPECT inversely correlates with motor severity at 3-year follow-up in akinetic-rigid patients only. Furthermore, UPDRS-III subscores for bradykinesia and rigidity at baseline show an inverse correlation with time to onset of motor complications across all PD subtypes.
[Mh] Termos MeSH primário: Rigidez Muscular/etiologia
Doença de Parkinson/diagnóstico por imagem
Tomografia Computadorizada de Emissão de Fóton Único
[Mh] Termos MeSH secundário: Idoso
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Doença de Parkinson/complicações
Doença de Parkinson/patologia
Compostos Radiofarmacêuticos
Tropanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 0 (Tropanes); 155797-99-2 (2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170508
[Lr] Data última revisão:
170508
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1111/ane.12613


  10 / 1849 MEDLINE  
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[PMID]:28269575
[Au] Autor:Assis S; Costa P; Rosas MJ; Vaz R; Silva Cunha JP
[Ti] Título:An adaptive model approach for quantitative wrist rigidity evaluation during deep brain stimulation surgery.
[So] Source:Conf Proc IEEE Eng Med Biol Soc;2016:5809-5812, 2016 08.
[Is] ISSN:1557-170X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intraoperative evaluation of the efficacy of Deep Brain Stimulation includes evaluation of the effect on rigidity. A subjective semi-quantitative scale is used, dependent on the examiner perception and experience. A system was proposed previously, aiming to tackle this subjectivity, using quantitative data and providing real-time feedback of the computed rigidity reduction, hence supporting the physician decision. This system comprised of a gyroscope-based motion sensor in a textile band, placed in the patients hand, which communicated its measurements to a laptop. The latter computed a signal descriptor from the angular velocity of the hand during wrist flexion in DBS surgery. The first approach relied on using a general rigidity reduction model, regardless of the initial severity of the symptom. Thus, to enhance the performance of the previously presented system, we aimed to develop models for high and low baseline rigidity, according to the examiner assessment before any stimulation. This would allow a more patient-oriented approach. Additionally, usability was improved by having in situ processing in a smartphone, instead of a computer. Such system has shown to be reliable, presenting an accuracy of 82.0% and a mean error of 3.4%. Relatively to previous results, the performance was similar, further supporting the importance of considering the cogwheel rigidity to better infer about the reduction in rigidity. Overall, we present a simple, wearable, mobile system, suitable for intra-operatory conditions during DBS, supporting a physician in decision-making when setting stimulation parameters.
[Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos
Monitorização Neurofisiológica Intraoperatória
Rigidez Muscular/diagnóstico
Doença de Parkinson/terapia
Punho
[Mh] Termos MeSH secundário: Seres Humanos
Doença de Parkinson/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171127
[Lr] Data última revisão:
171127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1109/EMBC.2016.7592048



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