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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]:28462674
[Au] Autor:Rehan Youssef A; Gumaa M
[Ad] Endereço:a Faculty of Physical Therapy , Cairo University , Giza , Egypt.
[Ti] Título:Validity and reliability of smartphone applications for clinical assessment of the neuromusculoskeletal system.
[So] Source:Expert Rev Med Devices;14(6):481-493, 2017 Jun.
[Is] ISSN:1745-2422
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Clinicians increasingly use smartphone medical applications. There is no evidence to support the validity and reliability of applications used to assess the neuromusculoskeletal system. The aim of this study was to systematically review the quality of studies as well as the validity and reliability of using a smartphone as a clinical assessment tool for the neuromusculoskeletal system. Areas covered: PubMed, CINAHL and Embase were searched. A manual search was also conducted. Additionally, forward snowballing of relevant articles was performed in Scopus and Web of Science. Two reviewers independently selected the articles, extracted the data using a standardized form and assessed the articles quality based on a scoring system Expert commentary: Thirty-four articles were found eligible and were categorized into four groups: Range of Motion (ROM), posture and deformity, tremors and reflexes, and gait and mobility. Only the ROM category supported the validity and reliability of using smartphone applications as assessment tools. Regarding quality assessment scores, the articles in ROM and posture and deformity categories ranged from poor to good quality, whereas those in the tremors and reflexes and gait and mobility categories had poor quality.
[Mh] Termos MeSH primário: Aplicativos Móveis
Fenômenos Fisiológicos Musculoesqueléticos
Fenômenos Fisiológicos do Sistema Nervoso
Smartphone
[Mh] Termos MeSH secundário: Marcha/fisiologia
Seres Humanos
Postura/fisiologia
Amplitude de Movimento Articular/fisiologia
Reflexo/fisiologia
Reprodutibilidade dos Testes
Tremor/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1080/17434440.2017.1325319


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[PMID]:28747452
[Au] Autor:Fasano A; Llinas M; Munhoz RP; Hlasny E; Kucharczyk W; Lozano AM
[Ad] Endereço:From the Morton and Gloria Shulman Movement Disorders Clinic and Edmond J. Safra Program in Parkinson's Disease (A.F., R.P.M.), Toronto Western Hospital-UHN, Division of Neurology, University of Toronto; Krembil Research Institute (A.F.); Division of Neurosurgery (M.L., A.M.L.), Department of Surger
[Ti] Título:MRI-guided focused ultrasound thalamotomy in non-ET tremor syndromes.
[So] Source:Neurology;89(8):771-775, 2017 Aug 22.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To report the 6-month single-blinded results of unilateral thalamotomy with MRI-guided focused ultrasound (MRgFUS) in patients with tremors other than essential tremor. METHODS: Three patients with tremor due to Parkinson disease, 2 with dystonic tremor in the context of cervicobrachial dystonia and writer's cramp, and 1 with dystonia gene-associated tremor underwent MRgFUS targeting the ventro-intermedius nucleus (Vim) of the dominant hemisphere. The primary endpoint was the reduction of lateralized items of the Tremor Rating Scale of contralateral hemibody assessed by a blinded rater. RESULTS: All patients achieved a statistically significant, immediate, and sustained improvement of the contralateral tremor score by 42.2%, 52.0%, 55.9%, and 52.9% at 1 week and 1, 3, and 6 months after the procedure, respectively. All patients experienced transient side effects and 2 patients experienced persistent side effects at the time of last evaluation: hemitongue numbness and hemiparesis with hemihypoesthesia. CONCLUSIONS: Vim MRgFUS is a promising, incision-free, but nevertheless invasive technique to effectively treat tremors other than essential tremor. Future studies on larger samples and longer follow-up will further define its effectiveness and safety. CLINICALTRIALSGOV IDENTIFIER: NCT02252380. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with tremor not caused by essential tremor, MRgFUS of the Vim improves the tremor of the contralateral hemibody at 6 months.
[Mh] Termos MeSH primário: Ablação por Ultrassom Focalizado de Alta Intensidade
Imagem por Ressonância Magnética Intervencionista
Tálamo/diagnóstico por imagem
Tálamo/cirurgia
Tremor/diagnóstico por imagem
Tremor/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Lateralidade Funcional
Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Índice de Gravidade de Doença
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170728
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004268


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[PMID]:29188984
[Au] Autor:Pekkonen E
[Ti] Título:Treatment of tremor - deep brain stimulation as remedy for severe cases.
[So] Source:Duodecim;132(20):1850-6, 2016.
[Is] ISSN:0012-7183
[Cp] País de publicação:Finland
[La] Idioma:eng
[Ab] Resumo:Tremor is a common motor disorder, in many diseases. Healthy persons may have low-amplitude physiological action tremor without any functional handicap, contrary to the disabling pathologic tremor. There are numerous types of tremor, and their etiology is poorly known. Tremor can at best be alleviated by drug therapy, but the response may abate with time. Deep brain stimulation has recently been increasingly utilized in the treatment of drug-resistant tremor in various neurologic diseases.
[Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos
Tremor/etiologia
Tremor/terapia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:29068990
[Au] Autor:Jang SH; Kwon HG
[Ad] Endereço:aDepartment of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu bDepartment of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Republic of Korea.
[Ti] Título:Aggravation of an injured dentato-rubro-thalamic tract in a patient with mild traumatic brain injury: A case report.
[So] Source:Medicine (Baltimore);96(43):e8253, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report on a patient with mild traumatic brain injury (TBI) by follow-up diffusion tensor tractography (DTT), and observed for approximately nine monthsby serial diffusion tensor tractography (DTT). PATIENT CONCERNS: A 66-year-old male patient was injured in a car crash. Approximately four weeks after the crash, he developed a tremor in the right hand and leg. His symptoms worsened over time. DIAGNOSES: Approximately six months after the crash, he developed a mild tremor in the left hand. Nine months after the crash, he manifested severe tremor in his right hand, mild resting and intentional tremor in his left hand and both legs, and mild trunkal ataxia. INTERVENTIONS: N/A. OUTCOMES: On 3-week DTT, well reconstructed DRTTs were observed in both hemispheres, except for the thinned lower portion of the right DRTT. On 9-month DTT, the right lower DRTT had thinned compared with the 3-week DTT and showed a disruption at the upper portion. The left DRTT showed thinning in the lower portion and tearing in the upper portion compared with 3-week DTT. LESSONS: Aggravation of an injured DRTT was demonstrated in a patient with mild TBI, using serial DTT examination.
[Mh] Termos MeSH primário: Concussão Encefálica/complicações
Núcleos Cerebelares/lesões
Tálamo/lesões
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Idoso
Ataxia/etiologia
Concussão Encefálica/diagnóstico por imagem
Núcleos Cerebelares/diagnóstico por imagem
Imagem de Tensor de Difusão
Vias Eferentes/diagnóstico por imagem
Vias Eferentes/lesões
Seguimentos
Mãos/fisiopatologia
Seres Humanos
Perna (Membro)/fisiopatologia
Masculino
Tálamo/diagnóstico por imagem
Tremor/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008253


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[PMID]:28857524
[Au] Autor:Lechpammer M; Martínez Cerdeno V; Hunsaker MR; Hah M; Gonzales H; Tisch S; Joffe R; Pamphlett R; Tassone F; Hagerman PJ; Bolitho SJ; Hagerman RJ
[Ad] Endereço:Mirna Lechpammer, Department of Pathology and Laboratory Medicine, UC Davis Health System, 4400 V St. Sacramento, CA 95817, USA, mlechpammer@ucdavis.edu.
[Ti] Título:Concomitant occurrence of FXTAS and clinically defined sporadic inclusion body myositis: report of two cases.
[So] Source:Croat Med J;58(4):310-315, 2017 Aug 31.
[Is] ISSN:1332-8166
[Cp] País de publicação:Croatia
[La] Idioma:eng
[Ab] Resumo:This report describes unique presentations of inclusion body myositis (IBM) in two unrelated patients, one male and one female, with genetically and histologically confirmed fragile X-associated tremor/ataxia syndrome (FXTAS). We summarize overlapping symptoms between two disorders, clinical course, and histopathological analyses of the two patients with FXTAS and sporadic IBM, clinically defined per diagnostic criteria of the European Neuromuscular Centre. In case 1, a post-mortem analysis of available brain and muscle tissues is also described. Histopathological features (rimmed vacuoles) consistent with clinically defined IBM were detected in both presented cases. Postmortem testing in case 1 revealed the presence of an FMR1 premutation allele of 60 CGG repeats in both brain and skeletal muscle samples. Case 2 was a premutation carrier with 71 CGG repeats who had a son with FXS. Given that FXTAS is associated with immune-mediated disorders among premutation carriers, it is likely that the pathogeneses of IBM and FXTAS are linked. This is, to our knowledge, the first report of these two conditions presenting together, which expands our understanding of clinical symptoms and unusual presentations in patients with FXTAS. Following detection of a premutation allele of the FMR1 gene, FXTAS patients with severe muscle pain should be assessed for IBM.
[Mh] Termos MeSH primário: Ataxia/complicações
Síndrome do Cromossomo X Frágil/complicações
Miosite de Corpos de Inclusão/complicações
Tremor/complicações
[Mh] Termos MeSH secundário: Idoso
Evolução Fatal
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE


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[PMID]:28841506
[Au] Autor:Hirschmann J; Schoffelen JM; Schnitzler A; van Gerven MAJ
[Ad] Endereço:Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany. Electronic address: Jan.Hirschmann@med.uni-duesseldorf.de.
[Ti] Título:Parkinsonian rest tremor can be detected accurately based on neuronal oscillations recorded from the subthalamic nucleus.
[So] Source:Clin Neurophysiol;128(10):2029-2036, 2017 Oct.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the possibility of tremor detection based on deep brain activity. METHODS: We re-analyzed recordings of local field potentials (LFPs) from the subthalamic nucleus in 10 PD patients (12 body sides) with spontaneously fluctuating rest tremor. Power in several frequency bands was estimated and used as input to Hidden Markov Models (HMMs) which classified short data segments as either tremor-free rest or rest tremor. HMMs were compared to direct threshold application to individual power features. RESULTS: Applying a threshold directly to band-limited power was insufficient for tremor detection (mean area under the curve [AUC] of receiver operating characteristic: 0.64, STD: 0.19). Multi-feature HMMs, in contrast, allowed for accurate detection (mean AUC: 0.82, STD: 0.15), using four power features obtained from a single contact pair. Within-patient training yielded better accuracy than across-patient training (0.84vs. 0.78, p=0.03), yet tremor could often be detected accurately with either approach. High frequency oscillations (>200Hz) were the best performing individual feature. CONCLUSIONS: LFP-based markers of tremor are robust enough to allow for accurate tremor detection in short data segments, provided that appropriate statistical models are used. SIGNIFICANCE: LFP-based markers of tremor could be useful control signals for closed-loop deep brain stimulation.
[Mh] Termos MeSH primário: Estimulação Encefálica Profunda/métodos
Magnetoencefalografia/métodos
Neurônios/fisiologia
Doença de Parkinson/fisiopatologia
Núcleo Subtalâmico/fisiopatologia
Tremor/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Estimulação Encefálica Profunda/instrumentação
Eletrodos Implantados
Feminino
Seres Humanos
Magnetoencefalografia/instrumentação
Masculino
Cadeias de Markov
Meia-Idade
Doença de Parkinson/diagnóstico
Tremor/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170826
[St] Status:MEDLINE


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[PMID]:28814538
[Au] Autor:Wheeler A; Raspa M; Hagerman R; Mailick M; Riley C
[Ad] Endereço:RTI International, Research Triangle Park, North Carolina; acwheeler@rti.org.
[Ti] Título:Implications of the Premutation for Children, Adolescents, Adults, and Their Families.
[So] Source:Pediatrics;139(Suppl 3):S172-S182, 2017 Jun.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Given the nature of gene expansions, most biological mothers, and often multiple other family members of children with fragile X syndrome (FXS), will have a premutation, which may increase individual and family vulnerabilities. This article summarizes important gaps in knowledge and notes potential implications for pediatric providers with regard to developmental and medical risks for children and adolescents with an premutation, including possible implications into adulthood. METHODS: A structured electronic literature search was conducted on pre- and full mutations, yielding a total of 306 articles examined. Of these, 116 focused primarily on the premutation and are included in this review. RESULTS: Based on the literature review, 5 topic areas are discussed: genetics and epidemiology; phenotypic characteristics of individuals with the premutation; implications for carrier parents of children with FXS; implications for the extended family; and implications for pediatricians. CONCLUSIONS: Although the premutation phenotype is typically less severe in clinical presentation than in FXS, premutation carriers are much more common and are therefore more likely to be seen in a typical pediatric practice. In addition, there is a wide range of medical, cognitive/developmental, and psychiatric associated features that individuals with a premutation are at increased risk for having, which underscores the importance of awareness on the part of pediatricians in identifying and monitoring premutation carriers and recognizing the impact this identification may have on family members.
[Mh] Termos MeSH primário: Expansão das Repetições de DNA/genética
Proteína do X Frágil de Retardo Mental/genética
Síndrome do Cromossomo X Frágil/genética
Predisposição Genética para Doença/genética
[Mh] Termos MeSH secundário: Adolescente
Adulto
Ataxia/diagnóstico
Ataxia/genética
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico
Transtorno do Deficit de Atenção com Hiperatividade/genética
Transtorno do Espectro Autista/diagnóstico
Transtorno do Espectro Autista/genética
Criança
Comorbidade
Variações do Número de Cópias de DNA/genética
Função Executiva
Feminino
Síndrome do Cromossomo X Frágil/diagnóstico
Síndrome do Cromossomo X Frágil/epidemiologia
Triagem de Portadores Genéticos
Testes Genéticos
Seres Humanos
Lactente
Fenótipo
Insuficiência Ovariana Primária/diagnóstico
Insuficiência Ovariana Primária/genética
Fatores de Risco
Tremor/diagnóstico
Tremor/genética
Repetições de Trinucleotídeos/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (FMR1 protein, human); 139135-51-6 (Fragile X Mental Retardation Protein)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1542/peds.2016-1159D


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[PMID]:28813484
[Au] Autor:Na ES; De Jesús-Cortés H; Martinez-Rivera A; Kabir ZD; Wang J; Ramesh V; Onder Y; Rajadhyaksha AM; Monteggia LM; Pieper AA
[Ad] Endereço:Department of Psychology & Philosophy, Texas Woman's University, Denton, TX, United States of America.
[Ti] Título:D-cycloserine improves synaptic transmission in an animal mode of Rett syndrome.
[So] Source:PLoS One;12(8):e0183026, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rett syndrome (RTT), a leading cause of intellectual disability in girls, is predominantly caused by mutations in the X-linked gene MECP2. Disruption of Mecp2 in mice recapitulates major features of RTT, including neurobehavioral abnormalities, which can be reversed by re-expression of normal Mecp2. Thus, there is reason to believe that RTT could be amenable to therapeutic intervention throughout the lifespan of patients after the onset of symptoms. A common feature underlying neuropsychiatric disorders, including RTT, is altered synaptic function in the brain. Here, we show that Mecp2tm1.1Jae/y mice display lower presynaptic function as assessed by paired pulse ratio, as well as decreased long term potentiation (LTP) at hippocampal Schaffer-collateral-CA1 synapses. Treatment of Mecp2tm1.1Jae/y mice with D-cycloserine (DCS), an FDA-approved analog of the amino acid D-alanine with antibiotic and glycinergic activity, corrected the presynaptic but not LTP deficit without affecting deficient hippocampal BDNF levels. DCS treatment did, however, partially restore lower BDNF levels in the brain stem and striatum. Thus, treatment with DCS may mitigate the severity of some of the neurobehavioral symptoms experienced by patients with Rett syndrome.
[Mh] Termos MeSH primário: Ciclosserina/farmacologia
Síndrome de Rett/fisiopatologia
Transmissão Sináptica/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Apneia
Tronco Encefálico/metabolismo
Tronco Encefálico/fisiopatologia
Fator Neurotrófico Derivado do Encéfalo/metabolismo
Corpo Estriado/metabolismo
Corpo Estriado/fisiopatologia
Ciclosserina/administração & dosagem
Modelos Animais de Doenças
Marcha/efeitos dos fármacos
Hipocampo/efeitos dos fármacos
Hipocampo/fisiopatologia
Locomoção/efeitos dos fármacos
Masculino
Proteína 2 de Ligação a Metil-CpG/genética
Camundongos
Camundongos Transgênicos
Força Muscular/efeitos dos fármacos
Síndrome de Rett/tratamento farmacológico
Síndrome de Rett/genética
Síndrome de Rett/metabolismo
Tremor
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Brain-Derived Neurotrophic Factor); 0 (Methyl-CpG-Binding Protein 2); 95IK5KI84Z (Cycloserine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183026


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[PMID]:28789780
[Au] Autor:Mittal SO; Machado D; Richardson D; Dubey D; Jabbari B
[Ad] Endereço:Department of Neurology, Mayo Clinic, Rochester, MN. Electronic address: shivamommittal@gmail.com.
[Ti] Título:Botulinum Toxin in Parkinson Disease Tremor: A Randomized, Double-Blind, Placebo-Controlled Study With a Customized Injection Approach.
[So] Source:Mayo Clin Proc;92(9):1359-1367, 2017 Sep.
[Is] ISSN:1942-5546
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In essential tremor and Parkinson disease (PD) tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor, but many patients (30%-70%) develop moderate to severe hand weakness, limiting the use of onabotulinumtoxinA in clinical practice. OBJECTIVE: To evaluate the safety and efficacy of incobotulinumtoxinA (IncoA) injection for the treatment of tremor in PD. PATIENTS AND METHODS: In this double-blind, placebo-controlled, crossover trial, 30 patients each received 7 to 12 (mean, 9) IncoA injections into hand and forearm muscles using a customized approach. The study was performed from June 1, 2012, through June 30, 2015, and participants were followed for 24 weeks. Treatment efficacy was evaluated by the tremor subsets of the Unified Parkinson's Disease Rating Scale and the Patient Global Impression of Change 4 and 8 weeks after each of the 2 sets of treatments. Hand strength was assessed using an ergometer. RESULTS: There was a statistically significant improvement in clinical rating scores of rest tremor and tremor severity 4 and 8 weeks after the IncoA injection and of action/postural tremor at 8 weeks. There was a significant improvement in patient perception of improvement at 4 and 8 weeks in the IncoA group. There was no statistically significant difference in grip strength at 4 weeks between the 2 groups. CONCLUSION: Injection of IncoA via a customized approach improved PD tremor on a clinical scale and patient perception, with a low occurrence of significant hand weakness. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02419313.
[Mh] Termos MeSH primário: Toxinas Botulínicas Tipo A/administração & dosagem
Doença de Parkinson/tratamento farmacológico
Tremor/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Toxinas Botulínicas Tipo A/efeitos adversos
Toxinas Botulínicas Tipo A/uso terapêutico
Connecticut
Estudos Cross-Over
Método Duplo-Cego
Feminino
Seres Humanos
Injeções Intramusculares
Masculino
Meia-Idade
Neurotoxinas/administração & dosagem
Neurotoxinas/efeitos adversos
Neurotoxinas/uso terapêutico
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Doença de Parkinson/fisiopatologia
Índice de Gravidade de Doença
Perfil de Impacto da Doença
Tremor/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Neurotoxins); EC 3.4.24.69 (Botulinum Toxins, Type A); EC 3.4.24.69 (incobotulinumtoxinA)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE



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