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[PMID]:27770681
[Au] Autor:Tangen GG; Bergland A; Engedal K; Mengshoel AM
[Ad] Endereço:Department of Health Sciences, University of Oslo, Pb 1089 Blindern, 0317 Oslo, Norway; Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Pb 2136, 3103 Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Pb 4956 Nydalen, 0424 Oslo, Norway. Elec
[Ti] Título:The importance of parkinsonian signs for gait and balance in patients with Alzheimer's disease of mild degree.
[So] Source:Gait Posture;51:159-161, 2017 01.
[Is] ISSN:1879-2219
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Parkinsonian signs are common in patients with Alzheimer's disease (AD) of mild degree and predict functional decline, but their relationship with gait speed and balance is unclear. The aims of this study were to describe characteristics of patients with parkinsonian signs among 98 patients with AD of mild degree (with no comorbid Parkinson's disease), and to examine associations between parkinsonian signs with gait speed and balance. A cross sectional study at a memory clinic was conducted. Presence of each parkinsonian sign (bradykinesia, rigidity and tremor) was derived from the UPDRS, regular gait speed was recorded over 10m and balance were assessed using the Mini-Balance Evaluation Systems Test (Mini-BESTest). Bradykinesia was present in 30.6% of the sample, rigidity in 13.3% and tremor only in one patient. Patients with bradykinesia were older, had worse cognitive impairment and worse gait and balance performance than those without bradykinesia. More men than women had rigidity. Bradykinesia was significantly associated with mini-BESTest after adjusting for demographic factors (p<0.001, explaining 13.3% of the variance), but was not significantly associated with gait speed. Rigidity was not associated with either gait speed or balance. We conclude that assessment of bradykinesia should be included in examination of balance control in patients with AD of mild degree.
[Mh] Termos MeSH primário: Doença de Alzheimer/fisiopatologia
Transtornos Neurológicos da Marcha/fisiopatologia
Marcha
Hipocinesia/fisiopatologia
Doença de Parkinson/fisiopatologia
Equilíbrio Postural
[Mh] Termos MeSH secundário: Idoso
Doença de Alzheimer/complicações
Estudos Transversais
Feminino
Transtornos Neurológicos da Marcha/complicações
Seres Humanos
Hipocinesia/complicações
Masculino
Doença de Parkinson/complicações
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:28672395
[Au] Autor:Gaura V; Lavisse S; Payoux P; Goldman S; Verny C; Krystkowiak P; Damier P; Supiot F; Bachoud-Levi AC; Remy P
[Ad] Endereço:Commissariat à l'Energie Atomique et aux Energies Alternatives, Département des Sciences du Vivant, Institut d'Imagerie Biomédicale, MIRCen, Fontenay-aux-Roses, France.
[Ti] Título:Association Between Motor Symptoms and Brain Metabolism in Early Huntington Disease.
[So] Source:JAMA Neurol;74(9):1088-1096, 2017 Sep 01.
[Is] ISSN:2168-6157
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Brain hypometabolism is associated with the clinical consequences of the degenerative process, but little is known about regional hypermetabolism, sometimes observed in the brain of patients with clinically manifest Huntington disease (HD). Studying the role of regional hypermetabolism is needed to better understand its interaction with the motor symptoms of the disease. Objective: To investigate the association between brain hypometabolism and hypermetabolism with motor scores of patients with early HD. Design, Setting, and Participants: This study started in 2001, and analysis was completed in 2016. Sixty symptomatic patients with HD and 15 healthy age-matched control individuals underwent positron emission tomography to measure cerebral metabolism in this cross-sectional study. They also underwent the Unified Huntington's Disease Rating Scale motor test, and 2 subscores were extracted: (1) a hyperkinetic score, combining dystonia and chorea, and (2) a hypokinetic score, combining bradykinesia and rigidity. Main Outcomes and Measures: Statistical parametric mapping software (SPM5) was used to identify all hypo- and hypermetabolic regions in patients with HD relative to control individuals. Correlation analyses (P < .001, uncorrected) between motor subscores and brain metabolic values were performed for regions with significant hypometabolism and hypermetabolism. Results: Among 60 patients with HD, 22 were women (36.7%), and the mean (SD) age was 44.6 (7.6) years. Of the 15 control individuals, 7 were women (46.7%), and the mean (SD) age was 42.2 (7.3) years. In statistical parametric mapping, striatal hypometabolism was significantly correlated with the severity of all motor scores. Hypermetabolism was negatively correlated only with hypokinetic scores in the cuneus (z score = 3.95, P < .001), the lingual gyrus (z score = 4.31, P < .001), and the crus I/II of the cerebellum (z score = 3.77, P < .001), a region connected to associative cortical areas. More severe motor scores were associated with higher metabolic values in the inferior parietal lobule, anterior cingulate, inferior temporal lobule, the dentate nucleus, and the cerebellar lobules IV/V, VI, and VIII bilaterally corresponding to the motor regions of the cerebellum (z score = 3.96 and 3.42 in right and left sides, respectively; P < .001). Conclusions and Relevance: Striatal hypometabolism is associated with clinical disease severity. Conversely, hypermetabolism is likely compensatory in regions where it is associated with decreasing motor scores. Hypermetabolism might be detrimental in other structures in which it is associated with more severe motor symptoms. In the cerebellum, both compensatory and detrimental contributions seem to occur. This study helps to better understand the motor clinical relevance of hypermetabolic brain regions in HD.
[Mh] Termos MeSH primário: Cerebelo/metabolismo
Córtex Cerebral/metabolismo
Doença de Huntington/metabolismo
Hipercinese/metabolismo
Hipocinesia/metabolismo
[Mh] Termos MeSH secundário: Adulto
Núcleos Cerebelares/diagnóstico por imagem
Núcleos Cerebelares/metabolismo
Cerebelo/diagnóstico por imagem
Córtex Cerebral/diagnóstico por imagem
Estudos Transversais
Feminino
Seres Humanos
Doença de Huntington/complicações
Doença de Huntington/diagnóstico por imagem
Hipercinese/diagnóstico por imagem
Hipercinese/etiologia
Hipocinesia/diagnóstico por imagem
Hipocinesia/etiologia
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1001/jamaneurol.2017.1200


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[PMID]:28233705
[Au] Autor:Grabli D
[Ad] Endereço:Université de la Sorbonne, UPMC Paris 06 UMR S 1127, institut du cerveau et de la moelle, Inserm U 1127 et CIC-1422, CNRS UMR 7225, 75013 Paris, France; AP-HP, hôpital Pitié-Salpêtrière, département des maladies du système nerveux, 75013 Paris, France. Electronic address: david.grabli@psl.aphp.fr.
[Ti] Título:Maladie de Parkinson et syndromes parkinsoniens : les signes moteurs..
[So] Source:Presse Med;46(2 Pt 1):187-194, 2017 Mar.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Parkinsonian syndrome is the clinical expression of a lesion within the nigro-striatal dopaminergic pathway. Akinesia is the main manifestation of parkinsonism. The clinical analysis of motor symptoms may guide clinical diagnosis. Parkinson's disease is characterized by a pure asymmetric parkinsonian syndrome, responsive to dopaminergic treatment. The evolution of Parkinson's disease is characterized by the occurrence of motor complications (dyskinesia and fluctuations). Gait disturbances (postural instability and freezing) are late in Parkinson's disease. When early (within the first three years), they point to atypical parkinsonian syndrome.
[Mh] Termos MeSH primário: Transtornos Parkinsonianos/fisiopatologia
[Mh] Termos MeSH secundário: Antiparkinsonianos/efeitos adversos
Antiparkinsonianos/uso terapêutico
Transtornos da Articulação/etiologia
Transtornos da Articulação/fisiopatologia
Corpo Estriado/fisiopatologia
Transtornos de Deglutição/etiologia
Transtornos de Deglutição/fisiopatologia
Progressão da Doença
Agonistas de Dopamina/efeitos adversos
Agonistas de Dopamina/uso terapêutico
Neurônios Dopaminérgicos/patologia
Neurônios Dopaminérgicos/fisiologia
Transtornos Neurológicos da Marcha/etiologia
Transtornos Neurológicos da Marcha/fisiopatologia
Seres Humanos
Hipocinesia/etiologia
Hipocinesia/fisiopatologia
Levodopa/efeitos adversos
Levodopa/uso terapêutico
Movimento/fisiologia
Hipertonia Muscular/etiologia
Hipertonia Muscular/fisiopatologia
Doença de Parkinson/complicações
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/fisiopatologia
Transtornos Parkinsonianos/complicações
Transtornos Parkinsonianos/tratamento farmacológico
Equilíbrio Postural
Transtornos das Sensações/etiologia
Transtornos das Sensações/fisiopatologia
Substância Negra/fisiopatologia
Tremor/etiologia
Tremor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Dopamine Agonists); 46627O600J (Levodopa)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170406
[Lr] Data última revisão:
170406
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:28222539
[Au] Autor:Hasan H; Athauda DS; Foltynie T; Noyce AJ
[Ad] Endereço:UCL Institute of Neurology, Queen Square, London, UK.
[Ti] Título:Technologies Assessing Limb Bradykinesia in Parkinson's Disease.
[So] Source:J Parkinsons Dis;7(1):65-77, 2017.
[Is] ISSN:1877-718X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The MDS-UPDRS (Movement Disorders Society - Unified Parkinson's Disease Rating Scale) is the most widely used scale for rating impairment in PD. Subscores measuring bradykinesia have low reliability that can be subject to rater variability. Novel technological tools can be used to overcome such issues. OBJECTIVE: To systematically explore and describe the available technologies for measuring limb bradykinesia in PD that were published between 2006 and 2016. METHODS: A systematic literature search using PubMed (MEDLINE), IEEE Xplore, Web of Science, Scopus and Engineering Village (Compendex and Inspec) databases was performed to identify relevant technologies published until 18 October 2016. RESULTS: 47 technologies assessing bradykinesia in PD were identified, 17 of which offered home and clinic-based assessment whilst 30 provided clinic-based assessment only. Of the eligible studies, 7 were validated in a PD patient population only, whilst 40 were tested in both PD and healthy control groups. 19 of the 47 technologies assessed bradykinesia only, whereas 28 assessed other parkinsonian features as well. 33 technologies have been described in additional PD-related studies, whereas 14 are not known to have been tested beyond the pilot phase. CONCLUSION: Technology based tools offer advantages including objective motor assessment and home monitoring of symptoms, and can be used to assess response to intervention in clinical trials or routine care. This review provides an up-to-date repository and synthesis of the current literature regarding technology used for assessing limb bradykinesia in PD. The review also discusses the current trends with regards to technology and discusses future directions in development.
[Mh] Termos MeSH primário: Tecnologia Biomédica/instrumentação
Extremidades/fisiopatologia
Hipocinesia/diagnóstico
Neurologia/instrumentação
Doença de Parkinson/diagnóstico
[Mh] Termos MeSH secundário: Seres Humanos
Hipocinesia/etiologia
Doença de Parkinson/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.3233/JPD-160878


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[PMID]:28204860
[Au] Autor:Boissier F; Razazi K; Seemann A; Bedet A; Thille AW; de Prost N; Lim P; Brun-Buisson C; Mekontso Dessap A
[Ad] Endereço:AP-HP, Hôpitaux universitaires Henri Mondor, DHU A-TVB, Service de Réanimation Médicale, 94010, Créteil, France.
[Ti] Título:Left ventricular systolic dysfunction during septic shock: the role of loading conditions.
[So] Source:Intensive Care Med;43(5):633-642, 2017 May.
[Is] ISSN:1432-1238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown. METHODS: Hemodynamic and echocardiographic data with tissue Doppler and speckle tracking were prospectively recorded on the first 3 days of human septic shock. Hypokinesia, normokinesia, and hyperkinesia were defined as a left ventricular ejection fraction (LVEF) of <45, 45-60, and >60%, respectively. Twelve hemodynamic indices exploring contractility and loading conditions were assessed and analyzed. RESULTS: Two hundred and ninety-seven echocardiographies were performed in 132 patients. During the first 24 h (H ), 48 (36.4%) patients were hyperkinetic, 55 (41.7%) were normokinetic, and 29 (22.0%) patients were hypokinetic. Thirteen patients had a secondary hypokinesia absent at H but present at H or H , for an overall incidence of 42 (31.8%) during the first 3 days. Despite a limited feasibility (<50%), global LV longitudinal peak systolic strain was impaired in a majority (>70%) of the patients assessed, including all those with depressed LVEF, and declined early in patients whose LVEF secondarily deteriorated. Most contractility indices were inversely correlated with afterload indices. Hyperkinetic patients exhibited the worst reduction in afterload indices. Hospital mortality was significantly higher in patients with LV hyperkinesia than in their counterparts: 30 (62.5%) vs. 35 (41.7%), p = 0.02. CONCLUSIONS: Speckle tracking-derived strain was reduced in the majority of patients with septic shock, revealing covert septic myocardial dysfunction, but had poor feasibility. We found an inverse correlation between most of the contractility and afterload indices. Precise evaluation of afterload is crucial for adequate interpretation of LV systolic function in this setting.
[Mh] Termos MeSH primário: Choque Séptico/fisiopatologia
Disfunção Ventricular Esquerda/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Comorbidade
Ecocardiografia
Feminino
Seres Humanos
Hipocinesia
Masculino
Meia-Idade
Prevalência
Estudos Prospectivos
Choque Séptico/complicações
Choque Séptico/diagnóstico por imagem
Choque Séptico/mortalidade
Estatísticas não Paramétricas
Disfunção Ventricular Esquerda/diagnóstico por imagem
Disfunção Ventricular Esquerda/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE
[do] DOI:10.1007/s00134-017-4698-z


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[PMID]:28131197
[Au] Autor:Sringean J; Anan C; Thanawattano C; Bhidayasiri R
[Ad] Endereço:Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
[Ti] Título:Time for a strategy in night-time dopaminergic therapy? An objective sensor-based analysis of nocturnal hypokinesia and sleeping positions in Parkinson's disease.
[So] Source:J Neurol Sci;373:244-248, 2017 Feb 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Nocturnal hypokinesia is a common night-time symptom in patients with Parkinson's disease (PD). However, there is still little understanding of the nature, and variations of severity of this symptom. OBJECTIVES: To evaluate the severity of nocturnal hypokinesia and sleep positions in PD patients using multisite wearable sensors. METHODS: Nocturnal parameters and sleep positions in 18 PD couples were assessed and compared using wearable sensors (limbs and trunk) for one night in their homes. Nocturnal parameters included number, velocity, acceleration, degree, limb movements and the number of times they got out of bed. RESULTS: PD patients had significantly fewer episodes of turns in bed than their spouses (p=0.043), which was associated with significantly slower speed (p=0.005), acceleration (p=0.005) and fewer degrees (p=0.017). When we split the night into the first and second half, significant findings were mainly demonstrated in the second half of the night, including significantly fewer turns (p=0.02) with smaller degrees (p=0.017), slower speed (p=0.005) and acceleration (p=0.007). No significant differences in these parameters were shown in the first half of the night except for smaller degrees of turn in bed in PD patients (p=0.028) and slower acceleration (p=0.037). In addition, PD patients spent significantly more time in a supine position compared to their spouses (p=0.031) with significantly less time in a prone position (p=0.041). CONCLUSION: Nocturnal hypokinesia gets worse as the night progresses. Treatment of nocturnal hypokinesia should aim at providing a continuous dopaminergic delivery that can achieve a sustained therapeutic level of dopamine throughout the night.
[Mh] Termos MeSH primário: Antiparkinsonianos/uso terapêutico
Dopaminérgicos/uso terapêutico
Hipocinesia/fisiopatologia
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/fisiopatologia
Transtornos do Sono-Vigília/fisiopatologia
[Mh] Termos MeSH secundário: Actigrafia/instrumentação
Idoso
Antiparkinsonianos/efeitos adversos
Dopaminérgicos/efeitos adversos
Feminino
Seres Humanos
Hipocinesia/etiologia
Masculino
Meia-Idade
Movimento/efeitos dos fármacos
Movimento/fisiologia
Doença de Parkinson/complicações
Postura
Índice de Gravidade de Doença
Sono/efeitos dos fármacos
Sono/fisiologia
Transtornos do Sono-Vigília/etiologia
Cônjuges
Fatores de Tempo
Tecnologia sem Fio/instrumentação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Dopamine Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170130
[St] Status:MEDLINE


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[PMID]:28268681
[Au] Autor:Patel V; Burns M; Pourfar M; Mogilner A; Kondziolka D; Vinjamuri R
[Ti] Título:QAPD: an integrated system to quantify symptoms of Parkinson's disease.
[So] Source:Conf Proc IEEE Eng Med Biol Soc;2016:1822-1825, 2016 08.
[Is] ISSN:1557-170X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The complex prevalence of Parkinson's disease (PD) symptoms has pushed research towards assessment tools that can assist in their quantification. There remains a need for a system capable of measuring symptoms during various tasks at multiple motor levels (kinematics and electromyography). In this paper, we present the development and initial validation of a quantitative assessment tool for Parkinson's disease (QAPD), a system designed to assist researchers and clinicians in the study of PD. The system integrates motion tracking, data gloves, and electromyography to collect movement related data from multiple body parts. As part of the system, a custom MATLAB® based toolbox has been designed to quantify bradykinesia, tremor, micrographia, and muscle rigidity using both standard and contemporary data analysis techniques. We believe this system can be a useful assessment tool to assist clinicians and researchers in diagnosing and estimating movement dysfunction in individuals with PD.
[Mh] Termos MeSH primário: Doença de Parkinson/diagnóstico
Avaliação de Sintomas
[Mh] Termos MeSH secundário: Seres Humanos
Hipocinesia/diagnóstico
Movimento
Rigidez Muscular/diagnóstico
Doença de Parkinson/fisiopatologia
Tremor/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171120
[Lr] Data última revisão:
171120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1109/EMBC.2016.7591073


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[PMID]:28268413
[Au] Autor:Eskofier BM; Lee SI; Daneault JF; Golabchi FN; Ferreira-Carvalho G; Vergara-Diaz G; Sapienza S; Costante G; Klucken J; Kautz T; Bonato P
[Ti] Título:Recent machine learning advancements in sensor-based mobility analysis: Deep learning for Parkinson's disease assessment.
[So] Source:Conf Proc IEEE Eng Med Biol Soc;2016:655-658, 2016 08.
[Is] ISSN:1557-170X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The development of wearable sensors has opened the door for long-term assessment of movement disorders. However, there is still a need for developing methods suitable to monitor motor symptoms in and outside the clinic. The purpose of this paper was to investigate deep learning as a method for this monitoring. Deep learning recently broke records in speech and image classification, but it has not been fully investigated as a potential approach to analyze wearable sensor data. We collected data from ten patients with idiopathic Parkinson's disease using inertial measurement units. Several motor tasks were expert-labeled and used for classification. We specifically focused on the detection of bradykinesia. For this, we compared standard machine learning pipelines with deep learning based on convolutional neural networks. Our results showed that deep learning outperformed other state-of-the-art machine learning algorithms by at least 4.6 % in terms of classification rate. We contribute a discussion of the advantages and disadvantages of deep learning for sensor-based movement assessment and conclude that deep learning is a promising method for this field.
[Mh] Termos MeSH primário: Aprendizado de Máquina
Doença de Parkinson/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Extremidades/fisiologia
Feminino
Seres Humanos
Hipocinesia/diagnóstico
Hipocinesia/fisiopatologia
Masculino
Meia-Idade
Doença de Parkinson/diagnóstico
Doença de Parkinson/reabilitação
Índice de Gravidade de Doença
Software
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171111
[Lr] Data última revisão:
171111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.1109/EMBC.2016.7590787


  9 / 1137 MEDLINE  
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[PMID]:27797341
[Au] Autor:Pan MK; Kuo SH; Tai CH; Liou JY; Pei JC; Chang CY; Wang YM; Liu WC; Wang TR; Lai WS; Kuo CC
[Ti] Título:Neuronal firing patterns outweigh circuitry oscillations in parkinsonian motor control.
[So] Source:J Clin Invest;126(12):4516-4526, 2016 Dec 01.
[Is] ISSN:1558-8238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neuronal oscillations at beta frequencies (20-50 Hz) in the cortico-basal ganglia circuits have long been the leading theory for bradykinesia, the slow movements that are cardinal symptoms in Parkinson's disease (PD). The beta oscillation theory helped to drive a frequency-based design in the development of deep brain stimulation therapy for PD. However, in contrast to this theory, here we have found that bradykinesia can be completely dissociated from beta oscillations in rodent models. Instead, we observed that bradykinesia is causatively regulated by the burst-firing pattern of the subthalamic nucleus (STN) in a feed-forward, or efferent-only, mechanism. Furthermore, STN burst-firing and beta oscillations are two independent mechanisms that are regulated by different NMDA receptors in STN. Our results shift the understanding of bradykinesia pathophysiology from an interactive oscillatory theory toward a feed-forward mechanism that is coded by firing patterns. This distinct mechanism may improve understanding of the fundamental concepts of motor control and enable more selective targeting of bradykinesia-specific mechanisms to improve PD therapy.
[Mh] Termos MeSH primário: Relógios Biológicos
Neurônios
Doença de Parkinson/fisiopatologia
Núcleo Subtalâmico/fisiopatologia
[Mh] Termos MeSH secundário: Animais
Estimulação Encefálica Profunda
Hipocinesia/patologia
Hipocinesia/fisiopatologia
Hipocinesia/terapia
Masculino
Doença de Parkinson/patologia
Doença de Parkinson/terapia
Ratos
Ratos Wistar
Núcleo Subtalâmico/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161101
[St] Status:MEDLINE


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[PMID]:27759801
[Au] Autor:Teive HA; Bertucci DC; Munhoz RP
[Ad] Endereço:Universidade Federal do Paraná, Hospital de Clínicas, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Curitiba PR, Brasil.
[Ti] Título:Unusual motor and non-motor symptoms and signs in the early stage of Parkinson's disease.
[So] Source:Arq Neuropsiquiatr;74(10):781-784, 2016 Oct.
[Is] ISSN:1678-4227
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Objective: Patients with Parkinson's disease (PD) may present with unusual motor and non-motor symptoms and signs in the early stage of the disease. Methods: Cases were collected over a five-year period at two tertiary movement disorders clinics. All had a diagnosis of PD with unusual presentations defined retrospectively as the presence of complaints not objectively related to any of the classic cardinal signs of parkinsonism or the typical early non-motor features of PD. Results: A total of 15 early PD patients fulfilled the proposed criteria, presenting with symptoms such as atypical tremors, shoulder pain, signs related to the rigid akinetic syndrome, as well as cases of asthenia, rhinorrhea, parosmia, dysgeusia, nocturnal sialorrhea, and color discrimination disorders. Conclusions: Unusual motor and non-motor symptoms and signs in the early stage of PD can be difficult to interpret. Specialists should be aware of these conditions as clues to a potential diagnosis.
[Mh] Termos MeSH primário: Transtornos Motores/diagnóstico
Transtornos Motores/fisiopatologia
Doença de Parkinson/diagnóstico
Doença de Parkinson/fisiopatologia
Avaliação de Sintomas
[Mh] Termos MeSH secundário: Idoso
Brasil
Diagnóstico Precoce
Feminino
Seres Humanos
Hipocinesia/diagnóstico
Hipocinesia/fisiopatologia
Masculino
Meia-Idade
Atividade Motora/fisiologia
Estudos Retrospectivos
Tremor/diagnóstico
Tremor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE



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