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[PMID]:29377959
[Au] Autor:Figura M; Kusmierska K; Bucior E; Szlufik S; Koziorowski D; Jamrozik Z; Janik P
[Ad] Endereço:Department of Neurology, Faculty of Heath Sciences, Medical University of Warsaw, Warsaw, Poland.
[Ti] Título:Serum amino acid profile in patients with Parkinson's disease.
[So] Source:PLoS One;13(1):e0191670, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Amino acids play numerous roles in the central nervous system, serving as neurotransmitters, neuromodulators and regulators of energy metabolism. The free amino acid profile in serum of Parkinson's disease (PD) patients may be influenced by neurodegeneration, mitochondrial dysfunction, malabsorption in the gastroenteric tract and received treatment. The aim of our study was the evaluation of the profile of amino acid concentrations against disease progression. We assessed the amino acid profile in the serum of 73 patients divided into groups with early PD, late PD with dyskinesia and late PD without dyskinesia. Serum amino acid analysis was performed by high-pressure liquid chromatography with fluorescence detection. We observed some significant differences amongst the groups with respect to concentrations of alanine, arginine, phenylalanine and threonine, although no significant differences were observed between patients with advanced PD with and without dyskinesia. We conclude that this specific amino acid profile could serve as biochemical marker of PD progression.
[Mh] Termos MeSH primário: Aminoácidos/sangue
Doença de Parkinson/sangue
[Mh] Termos MeSH secundário: Cromatografia Líquida de Alta Pressão
Seres Humanos
Espectrometria de Fluorescência
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Amino Acids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191670


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[PMID]:29345156
[Au] Autor:Svetel M; Tomic A; Kresojevic N; Kostic V
[Ad] Endereço:a Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine , University of Belgrade , Belgrade , Serbia.
[Ti] Título:Pharmacokinetic drug evaluation of opicapone for the treatment of Parkinson's disease.
[So] Source:Expert Opin Drug Metab Toxicol;14(3):353-360, 2018 Mar.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Opicapone (OPC) is a novel, potent, reversible, and purely peripheral third-generation COMT inhibitor, which provides an enhancement in levodopa (L-Dopa) availability. It represents adjunctive therapy for L-Dopa treated patients with PD and motor fluctuations. Areas covered: The purpose of this study was to evaluate pharmacokinetic of OPC for the treatment of PD. Expert commentary: Oral OPC exhibits linear, dose-dependent absorption. However, following concomitant ingestion of a high-fat, high-calorie meal, the maximum plasma concentration will be decreased. A once-daily bedtime administration of OPC 1 h after the last daily L-Dopa/AADCi, are considered to avoid any interaction during the L-Dopa absorption phase. There are no clinically relevant effects of age (in adults), renal impairment or race on the pharmacokinetics of OPC. OPC dose adjustment is not needed in patients with mild to moderate chronic hepatic impairment. Opicapone exhibits the lowest potential for cytotoxicity in comparison with other COMT inhibitors. It significantly decreases COMT activity, with half-life of COMT inhibition in human erythrocytes of 61.6 h and increases systemic exposure to L-Dopa. This provides an enhancement in L-Dopa availability that translates into clinical benefit for PD patients in terms of significant decrease of OFF periods and increase in ON-time without troublesome dyskinesia.
[Mh] Termos MeSH primário: Antiparkinsonianos/administração & dosagem
Oxidiazóis/administração & dosagem
Doença de Parkinson/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Animais
Antiparkinsonianos/efeitos adversos
Antiparkinsonianos/farmacocinética
Inibidores de Catecol O-Metiltransferase/administração & dosagem
Inibidores de Catecol O-Metiltransferase/farmacocinética
Relação Dose-Resposta a Droga
Quimioterapia Combinada
Interações Alimento-Droga
Meia-Vida
Seres Humanos
Levodopa/administração & dosagem
Levodopa/farmacocinética
Oxidiazóis/efeitos adversos
Oxidiazóis/farmacocinética
Doença de Parkinson/fisiopatologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Catechol O-Methyltransferase Inhibitors); 0 (Oxadiazoles); 46627O600J (Levodopa); Y5929UIJ5N (opicapone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2018.1430138


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[PMID]:28462393
[Au] Autor:Pathak D; Berthet A; Bendor JT; Yu K; Sellnow RC; Orr AL; Nguyen MK; Edwards RH; Manfredsson FP; Nakamura K
[Ad] Endereço:Gladstone Institute of Neurological Disease, San Francisco, CA 94158.
[Ti] Título:Loss of α-Synuclein Does Not Affect Mitochondrial Bioenergetics in Rodent Neurons.
[So] Source:eNeuro;4(2), 2017 Mar-Apr.
[Is] ISSN:2373-2822
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Increased α-synuclein (αsyn) and mitochondrial dysfunction play central roles in the pathogenesis of Parkinson's disease (PD), and lowering αsyn is under intensive investigation as a therapeutic strategy for PD. Increased αsyn levels disrupt mitochondria and impair respiration, while reduced αsyn protects against mitochondrial toxins, suggesting that interactions between αsyn and mitochondria influences the pathologic and physiologic functions of αsyn. However, we do not know if αsyn affects normal mitochondrial function or if lowering αsyn levels impacts bioenergetic function, especially at the nerve terminal where αsyn is enriched. To determine if αsyn is required for normal mitochondrial function in neurons, we comprehensively evaluated how lowering αsyn affects mitochondrial function. We found that αsyn knockout (KO) does not affect the respiration of cultured hippocampal neurons or cortical and dopaminergic synaptosomes, and that neither loss of αsyn nor all three (α, ß and γ) syn isoforms decreased mitochondria-derived ATP levels at the synapse. Similarly, neither αsyn KO nor knockdown altered the capacity of synaptic mitochondria to meet the energy requirements of synaptic vesicle cycling or influenced the localization of mitochondria to dopamine (DA) synapses . Finally, αsyn KO did not affect overall energy metabolism in mice assessed with a Comprehensive Lab Animal Monitoring System. These studies suggest either that αsyn has little or no significant physiological effect on mitochondrial bioenergetic function, or that any such functions are fully compensated for when lost. These results implicate that αsyn levels can be reduced in neurons without impairing (or improving) mitochondrial bioenergetics or distribution.
[Mh] Termos MeSH primário: Mitocôndrias/metabolismo
Neurônios/metabolismo
Sinapses/metabolismo
alfa-Sinucleína/metabolismo
[Mh] Termos MeSH secundário: Animais
Dopamina/metabolismo
Hipocampo/metabolismo
Camundongos Knockout
Doença de Parkinson/metabolismo
alfa-Sinucleína/deficiência
alfa-Sinucleína/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Snca protein, mouse); 0 (alpha-Synuclein); VTD58H1Z2X (Dopamine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28741230
[Au] Autor:Velayudhan L; Ffytche D; Ballard C; Aarsland D
[Ad] Endereço:Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, Box PO 70, De Crespigny Park, London, SE5 8AF, UK.
[Ti] Título:New Therapeutic Strategies for Lewy Body Dementias.
[So] Source:Curr Neurol Neurosci Rep;17(9):68, 2017 Sep.
[Is] ISSN:1534-6293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias. Disease-modifying approaches are aimed at preventing, slowing or ameliorating the production, aggregation and deposition of pathological proteins, including immunotherapy targeting α-synuclein and an ongoing trial using ambroxol which increases glucocerebrosidase activity to lower the levels of the protein alpha-synuclein. Other disease-modifying clinical trials are using agents to augment insulin signalling, stem cell therapy, reducing amyloid pathology and gene therapy.
[Mh] Termos MeSH primário: Gerenciamento Clínico
Doença por Corpos de Lewy/diagnóstico
Doença por Corpos de Lewy/terapia
[Mh] Termos MeSH secundário: Inibidores da Colinesterase/uso terapêutico
Terapia Genética/tendências
Seres Humanos
Doença por Corpos de Lewy/imunologia
Doença de Parkinson/diagnóstico
Doença de Parkinson/imunologia
Doença de Parkinson/terapia
Piperidinas/uso terapêutico
Transplante de Células-Tronco/tendências
Ureia/análogos & derivados
Ureia/uso terapêutico
alfa-Sinucleína/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cholinesterase Inhibitors); 0 (Piperidines); 0 (alpha-Synuclein); 8W8T17847W (Urea); JZ963P0DIK (pimavanserin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1007/s11910-017-0778-2


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[PMID]:28452905
[Au] Autor:Regidor I; Benita V; Del Álamo de Pedro M; Ley L; Martinez Castrillo JC
[Ad] Endereço:*Unit of Functional Neurosurgery, †Service of Neurophysiology, ‡Service of Gastroenterology, §Service of Neurosurgery, and ∥Service of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
[Ti] Título:Duodenal Levodopa Infusion for Long-Term Deep Brain Stimulation-Refractory Symptoms in Advanced Parkinson Disease.
[So] Source:Clin Neuropharmacol;40(3):103-107, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study assesses the effect of levodopa/carbidopa intestinal infusion gel (LCIIG) as an additional treatment in patients with advanced idiopathic Parkinson disease (PD) previously treated with deep brain stimulation (DBS). METHODS: Prospective study of advanced PD patients, satisfactorily treated with bilateral DBS of the subthalamic nucleus, who had developed refractory symptoms and LCIIG was added. Controls were advanced PD patients treated with LCIIG. Measurements included the Unified Parkinson Disease Rating Scale (UPDRS)-III and the UPDRS axial compound. RESULTS: There were 19 patients in the DBS-LCIIG therapy group and 21 in the control group. The DBS-LCIIG patients were younger and had disease duration longer than controls. The median time from DBS to gastrostomy was 7.8 years (range, 2-12 years). In both study groups, the mean scores of the UPDRS-III and UPDRS axial subscales improved significantly after LCIIG treatment (DBS-LCIIG group: UPDRS-III, 62.0 [15.7] vs 30.9 [12.1]; UPDRS axial, 24.7 [4.9] vs 10.2 [2.7]; P < 0.0005 for all comparisons). There were no differences in adverse events between the groups. In the follow-up of the DBS-LCIIG group. 5 patients discontinued DBS-LCIIG therapy and returned to DBS, 5 discontinued DBS and were maintained with LCIIG, and the remaining 9 continued with DBS-LCIIG therapy. Mean time until discontinuation in the double DBS-LCIIG group was 891 days. The main risk factors for discontinuation were age at the beginning of LCIIG and severity of the UPDRS axial subscale. CONCLUSIONS: Levodopa/carbidopa intestinal infusion gel therapy may be a valuable option in selected patients with advanced PD who develop refractory symptoms after long-term subthalamic nucleus-DBS.
[Mh] Termos MeSH primário: Antiparkinsonianos/administração & dosagem
Carbidopa/administração & dosagem
Estimulação Encefálica Profunda
Gastrostomia
Levodopa/administração & dosagem
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/terapia
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Antiparkinsonianos/efeitos adversos
Antiparkinsonianos/uso terapêutico
Carbidopa/efeitos adversos
Carbidopa/uso terapêutico
Terapia Combinada/efeitos adversos
Estimulação Encefálica Profunda/efeitos adversos
Combinação de Medicamentos
Duodeno
Feminino
Seguimentos
Gastrostomia/efeitos adversos
Géis
Seres Humanos
Intubação Gastrointestinal
Levodopa/efeitos adversos
Levodopa/uso terapêutico
Masculino
Meia-Idade
Doença de Parkinson/fisiopatologia
Pacientes Desistentes do Tratamento
Estudos Prospectivos
Índice de Gravidade de Doença
Espanha
Núcleo Subtalâmico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (Gels); 0 (carbidopa, levodopa drug combination); 46627O600J (Levodopa); MNX7R8C5VO (Carbidopa)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000216


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[PMID]:29489651
[Au] Autor:Xu JJ; Yang ST; Sha Y; Ge YY; Wang JM
[Ad] Endereço:Department of Geriatrics, the First Hospital of Jilin University, Changchun, China.
[Ti] Título:Hyperbaric oxygen treatment for Parkinson's disease with severe depression and anxiety: A case report.
[So] Source:Medicine (Baltimore);97(9):e0029, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Patients with Parkinson's disease (PD) frequently suffer from psychiatric disorders, and treating these symptom whereas managing the motor symptoms associated with PD can be a therapeutic challenge. PATIENT CONCERNS: We report a case of PD patient with severe depression and anxiety that refused to be treated with dopaminagonists or SSRIs, the most common treatments for PD patients suffering from psychiatric symptoms. DIAGNOSES: Parkinson's disease with severe depression and anxiety. INTERVENTIONS: This man was treated with hyperbaric oxygen treatment for 30 days. OUTCOMES: Clinical assessment scores for depression and anxiety, including Unified Parkinson's Disease Rating ScaleI (UPDRS I), UPDRS II, Hanmilton Depression Rating Scale, and Hamiliton Anxiety Rating Scale, were improved following the hyperbaric oxygen treatment. LESSONS: Hyperbaric oxygen treatment may be a potential therapeutic method for PD patient suffering from depression and anxiety. Further research is needed to validate this finding and explore a potential mechanism.
[Mh] Termos MeSH primário: Ansiedade/terapia
Depressão/terapia
Oxigenação Hiperbárica
Doença de Parkinson/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010029


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[PMID]:28454042
[Au] Autor:Rajan R; Popa T; Quartarone A; Ghilardi MF; Kishore A
[Ad] Endereço:Comprehensive Care Center for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India. Electronic address: drrooparajan@gmail.com.
[Ti] Título:Cortical plasticity and levodopa-induced dyskinesias in Parkinson's disease: Connecting the dots in a multicomponent network.
[So] Source:Clin Neurophysiol;128(6):992-999, 2017 06.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Levodopa-induced dyskinesias are motor complications following long term dopaminergic therapy in Parkinson's disease (PD). Impaired brain plasticity resulting in the creation of aberrant motor maps intended to encode normal voluntary movement is proposed to result in the development of dyskinesias. Traditionally, the various nodes in the motor network like the striato-cortical and the cerebello-thalamic loops were thought to function independent of each other with little communication among them. Anatomical evidence from primates revealed the existence of reciprocal loops between the basal ganglia and the cerebellum providing an anatomical basis for communication between the motor network loops. Dyskinetic PD patients reveal impaired brain plasticity within the motor cortex which may be modulated by cortico-cortical, cerebello-cortical or striato-cortical connections. In this article, we review the evidence for altered plasticity in the multicomponent motor network in the context of levodopa induced dyskinesias in PD. Current evidence suggests a pivotal role for the cerebellum in the larger motor network with the ability to integrate sensorimotor information and independently influence multiple nodes in this network. Targeting the cerebellum seems to be a justified approach for future interventions aimed at attenuating levodopa-induced dyskinesias.
[Mh] Termos MeSH primário: Cerebelo/fisiopatologia
Conectoma
Discinesia Induzida por Medicamentos/fisiopatologia
Levodopa/uso terapêutico
Plasticidade Neuronal
Doença de Parkinson/fisiopatologia
[Mh] Termos MeSH secundário: Corpo Estriado/fisiopatologia
Discinesia Induzida por Medicamentos/etiologia
Seres Humanos
Levodopa/efeitos adversos
Córtex Motor/fisiopatologia
Doença de Parkinson/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
46627O600J (Levodopa)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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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


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[PMID]:29390272
[Au] Autor:Shi J; Tian J; Li T; Qin B; Fan D; Ni J; Wei M; Zhang X; Liu N; Liu J; Li Y; Liu W; Wang Y
[Ad] Endereço:Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine.
[Ti] Título:Efficacy and safety of SQJZ herbal mixtures on nonmotor symptoms in Parkinson disease patients: Protocol for a randomized, double-blind, placebo-controlled trial.
[So] Source:Medicine (Baltimore);96(50):e8824, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: As a multisystemic neurodegenerative disorder, Parkinson disease (PD) has a broad spectrum of symptoms including motor and nonmotor symptoms (NMS). As shown in studies, NMS can also impact patient's quality of life, and many of them often go untreated. Chinese herbal medicines with multiconstituent may alleviate NMS in PD patients. This research is carried out to assess the efficacy and safety of a Chinese herbal formula for NMS, with its Chinese name acronym of SQJZ. METHODS/DESIGN: It will be a multicenter, randomized, double-blind, placebo-controlled trial. Idiopathic PD with a Hoehn and Yahr scale score ≤4, aged 18 to 80 years, will be involved. About 240 patients will be randomly assigned to either SQJZ or placebo in a 2:1 ratio. There is a 2-week run-in period before the randomization, and the follow-up will be 24 weeks, including 12-week treatment period, with visit once every 4 weeks and 12-week washout follow-up. All participants are asked to maintain the regular medication schedule. SQJZ formula will consist of Chinese herbs with effects for insomnia, constipation, anxiety, and so on. The primary outcome will be measured using NMS scale, and secondary outcomes will include unified PD rating scale, PD sleep scale, the Parkinson fatigue scale, the constipation severity instrument, and PD Questionnaire-39. The primary efficacy analysis will be based on the intention-to-treat method, and mixed-model repeated-measures analyses will be used. DISCUSSION: The findings from this research might provide evidence of the efficacy and safety of SQJZ Chinese herbal formula for treating NMS in PD patients. The results will sustain the broader use of SQJZ formula in PD.
[Mh] Termos MeSH primário: Medicamentos de Ervas Chinesas/uso terapêutico
Doença de Parkinson/tratamento farmacológico
Projetos de Pesquisa
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Protocolos Clínicos
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal)
[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.0000000000008824


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[PMID]:29390267
[Au] Autor:Delli Pizzi S; Bellomo RG; Carmignano SM; Ancona E; Franciotti R; Supplizi M; Barassi G; Onofrj M; Bonanni L; Saggini R
[Ad] Endereço:Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara.
[Ti] Título:Rehabilitation program based on sensorimotor recovery improves the static and dynamic balance and modifies the basal ganglia neurochemistry: A pilot 1H-MRS study on Parkinson's disease patients.
[So] Source:Medicine (Baltimore);96(50):e8732, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rehabilitation interventions represent an alternative strategy to pharmacological treatment in order to slow or reverse some functional aspects of disability in Parkinson's disease (PD). To date, the neurophysiological mechanisms underlying rehabilitation-mediated improvement in PD patients are still poorly understood. Interestingly, growing evidence has highlighted a key role of the glutamate in neurogenesis and brain plasticity. The brain levels of glutamate, and of its precursor glutamine, can be detected in vivo and noninvasively as "Glx" by means of proton magnetic resonance spectroscopy (H-MRS). In the present pilot study, 7 PD patients with frequent falls and axial dystonia underwent 8-week rehabilitative protocol focused on sensorimotor improvement. Clinical evaluation and Glx quantification were performed before and after rehabilitation. The Glx assessment was focused on the basal ganglia in agreement with their key role in the motor functions. We found that the rehabilitation program improves the static and dynamic balance in PD patients, promoting a better global motor performance. Moreover, we observed that the levels of Glx within the left basal ganglia were higher after rehabilitation as compared with baseline. Thus, we posit that our sensorimotor rehabilitative protocol could stimulate the glutamate metabolism in basal ganglia and, in turn, neuroplasticity processes. We also hypothesize that these mechanisms could prepare the ground to restore the functional interaction among brain areas deputed to motor controls, which are affected in PD.
[Mh] Termos MeSH primário: Gânglios da Base/metabolismo
Doença de Parkinson/reabilitação
Equilíbrio Postural/fisiologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Ácido Glutâmico/metabolismo
Glutamina/metabolismo
Seres Humanos
Masculino
Doença de Parkinson/fisiopatologia
Projetos Piloto
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0RH81L854J (Glutamine); 3KX376GY7L (Glutamic Acid)
[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.0000000000008732



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