scholarly journals Possible Treatment Concepts for the Levodopa-Related Hyperhomocysteinemia

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Thomas Müller
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Dopamine Metabolism ◽  
Vitamin Supplementation ◽  
Motor Complication ◽  
Therapeutic Approaches ◽  
Comt Inhibition ◽  
Culture Studies ◽  
Mao B ◽  
Treatment Concepts

The saga of harmful levodopa (LD) in the treatment of Parkinson's disease (PD) resulted from outcomes of animal—and cell culture studies and the clinical observation of motor complication related to the short half life of LD. Further aspects of LD long term application, the LD associated homocysteine increase and its emerging consequences on progression, and onset of neuropsychiatric symptoms and of vascular disease are only partially considered. Therapeutic approaches for this LD-mediated neurotoxic homocysteine increase are vitamin supplementation or LD application with an inhibitor of catechol-O-methyltransferase (COMT). However, forcing central dopamine metabolism further down the methylation path by central blocking of COMT and MAO-B may reduce oxidative stress and homocysteine levels. But it may also increase N-methylation of tetrahydroisoquinolines to neurotoxic N-methylated tetrahydroisoquinolines. These compounds were observed in cerebrospinal fluid and plasma of long term LD-treated PD patients. Therefore LD application with peripheral COMT inhibition may be safer.

scholarly journals Progress in Understanding and Treating Parkinson's Disease

1976 ◽  
Vol 3 (2) ◽  
pp. 81-84 ◽  
Author(s):  
André Barbeau
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Long Term Results ◽  
Accelerated Ageing ◽  
Therapeutic Approaches ◽  
Mao B ◽  
New Therapeutic Approaches ◽  
Neuronal Systems

SUMMARY:This review evaluates the long-term results of Levodopa therapy in Parkinson's disease upon quality of life, prolongation of survival and excess mortality. It also focuses on recent and new therapeutic approaches: Levodopa in comhindation with a Dopa-decarboxylase inhibitor or MAO-B inhibitor, dopamine agonists and an active tripeptide: L-prolyl-L-leucylglycine amide (M1F-I). It ends by looking at new avenues of etiological research in Parkinson's disease which may indicate specific accelerated ageing of catecholaminergic (pigmented) neuronal systems.

scholarly journals Detection of Prions in Brain Homogenates and CSF Samples Using a Second-Generation RT-QuIC Assay: A Useful Tool for Retrospective Analysis of Archived Samples

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 750
Author(s):  
Tibor Moško ◽  
Soňa Galušková ◽  
Radoslav Matěj ◽  
Magdalena Brůžová ◽  
Karel Holada
Keyword(s):  
Retrospective Analysis ◽  
Prion Disease ◽  
Second Generation ◽  
Prion Diseases ◽  
Neuropsychiatric Symptoms ◽  
Final Diagnosis ◽  
Post Mortem ◽  
Long Term Storage ◽  
Archived Samples

The possibilities for diagnosing prion diseases have shifted significantly over the last 10 years. The RT-QuIC assay option has been added for neuropsychiatric symptoms, supporting biomarkers and final post-mortem confirmation. Samples of brain homogenates used for final diagnosis, archived for many years, provide the possibility for retrospective studies. We used a second-generation RT-QuIC assay to detect seeding activity in different types of sporadic and genetic prion diseases in archival brain homogenates and post-mortem CSF samples that were 2 to 15 years old. Together, we tested 92 archival brain homogenates: 39 with definite prion disease, 28 with definite other neurological disease, and 25 with no signs of neurological disorders. The sensitivity and specificity of the assay were 97.4% and 100%, respectively. Differences were observed in gCJD E200K, compared to the sporadic CJD group. In 52 post-mortem CSF samples—24 with definite prion disease and 28 controls—we detected the inhibition of seeding reaction due to high protein content. Diluting the samples eliminated such inhibition and led to 95.8% sensitivity and 100% specificity of the assay. In conclusion, we proved the reliability of archived brain homogenates and post-mortem CSF samples for retrospective analysis by RT-QuIC after long-term storage, without changed reactivity.

scholarly journals The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study

2019 ◽  
Vol 216 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Audun Osland Vik-Mo ◽  
Lasse Melvaer Giil ◽  
Miguel Germán Borda ◽  
Clive Ballard ◽  
Dag Aarsland
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Personalised Medicine ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Psychotic Symptoms ◽  
Primary Inclusion ◽  
The Individual

IntroductionUnderstanding the natural course of neuropsychiatric symptoms (NPS) in dementia is important for planning patient care and trial design, but few studies have described the long-term course of NPS in individuals.MethodPrimary inclusion of 223 patients with suspected mild dementia from general practice were followed by annual assessment, including the Neuropsychiatric Inventory (NPI), for up to 12 years. Total and item NPI scores were classified as stable, relapsing, single episodic or not present based on 4.96 (s.d. 2.3) observations (98% completeness of longitudinal data) for 113 patients with Alzheimer's disease and 84 patients with LBD (68 dementia with Lewy bodies and 16 Parkinson's disease dementia).ResultsWe found that 80% had stable NPI total ≥1, 50% had stable modest NPI total ≥12 and 25% had stable NPI total ≥24 scores. Very severe NPS (≥48) were mostly single episodes, but 8% of patients with Alzheimer's disease had stable severe NPS. Patients with Alzheimer's disease and the highest 20% NPI total scores had a more stable or relapsing course of four key symptoms: aberrant motor behaviour, aggression/agitation, delusions and irritability (odds ratio 55, P < 0.001). This was not seen in LBD. Finally, 57% of patients with Alzheimer's disease and 84% of patients with LBD had reoccurring psychotic symptoms.ConclusionsWe observed a highly individual course of NPS, with most presenting as a single episode or relapsing; a stable course was less common, especially in LBD. These findings demonstrate the importance of an individualised approach (i.e. personalised medicine) in dementia care.

scholarly journals Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

2016 ◽  
Vol 42 (3-4) ◽  
pp. 186-197 ◽  
Author(s):  
Maartje S. Klapwijk ◽  
Monique A.A. Caljouw ◽  
Marjoleine J.C. Pieper ◽  
Jenny T. van der Steen ◽  
Wilco P. Achterberg
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Pulmonary Diseases ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Term Care

Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

Effect of Relocation on Neuropsychiatric Symptoms in Elderly Adults Living in Long-Term Care

2018 ◽  
Vol 66 (11) ◽  
pp. 2183-2187 ◽  
Author(s):  
Kamal El Haddad ◽  
Philipe de Souto Barreto ◽  
Stephane Gerard ◽  
Aurelie Prouff ◽  
Bruno Vellas ◽  
...  
Keyword(s):  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Elderly Adults ◽  
Term Care

Memory Reconsolidation as a Common Change Process

2020 ◽  
pp. 328-360
Author(s):  
Rhonda Goldman ◽  
Alyssa Fredrick-Keniston
Keyword(s):  
Change Process ◽  
Memory Model ◽  
Memory Reconsolidation ◽  
Future Research ◽  
Therapeutic Approaches ◽  
Therapeutic Modalities ◽  
Change Mechanisms ◽  
Definition Of ◽  
Constituent Elements

Memory reconsolidation is considered as a common change process that exists across the major individual therapeutic modalities that are aimed at promoting and sustaining long- term, enduring change. The integrative memory model is reviewed in terms of how it may provide the field of psychotherapy integration with a description of a process that all individual therapies seek to achieve. First, the change mechanisms underlying each of the major therapeutic approaches including behavioral, cognitive-behavioral, psychodynamic and emotion-focused therapies are examined to determine the degree to which they describe a memory reconsolidation process. Next, some of the newer, modern integrative therapeutic approaches are reviewed to consider whether they too are promoting a memory reconsolidation process, although not necessarily naming it as such. The memory reconsolidation model and its constituent elements are then examined in depth to determine the degree to which the various therapy models promote and encourage relative aspects of the memory reconsolidation process. Finally, a potentially clarifying definition of terms is proposed and future research is suggested that would help the field determine the degree to which memory reconsolidation is a common change process and if so, how it can best be promoted.

scholarly journals Neuropsychiatric symptoms in Tanzanian HIV-infected children receiving long-term efavirenz treatment: a multicentre, cross-sectional, observational study

2019 ◽  
Vol 6 (4) ◽  
pp. e250-e258 ◽  
Author(s):  
Lisa Van de Wijer ◽  
Deborah N Mchaile ◽  
Quirijn de Mast ◽  
Blandina T Mmbaga ◽  
Nanda N J Rommelse ◽  
...  
Keyword(s):  
Observational Study ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional
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