scholarly journals Gold Standard of Symptomatic treatment in Parkinson disease: Carbidopa / Levodopa

2018 ◽  
pp. 63-68 ◽  
Author(s):  
Aslam Pathan ◽  
Abdulrahman Alshahrani
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Gold Standard ◽  
Signs And Symptoms ◽  
Symptomatic Treatment ◽  
Short Term ◽  
Neurologic Disorders ◽  
Pharmacological Data

Parkinson's disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The goal of the medical management of Parkinson's disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Levodopa coupled with a peripheral decarboxylase inhibitor (PDI), such as carbidopa, remains the gold standard of symptomatic treatment of motor features of Parkinson's disease. It provides the greatest antiparkinsonian benefit with the fewest adverse effects in the short term. However, its long-term use is associated with the development of fluctuations and dyskinesias. This review article is written to summarize the clinical and pharmacological data of carbidopa and levodopa which will be helpful to neurologists and physicians.

scholarly journals Possible management of non-motor symptoms of Parkinson’s Disease

2018 ◽  
pp. 69-76
Author(s):  
Aslam Pathan ◽  
Abdulrahman Alshahrani
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Neuronal Degeneration ◽  
Signs And Symptoms ◽  
Motor Symptoms ◽  
Neurologic Disorders ◽  
Non Motor Symptoms

Parkinson's disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The goal of the medical management of Parkinson's disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Parkinson’s disease (PD) is classically considered as a motor disease, with tremor, rigidity, bradykinesia and gait problems as the classic motor features. However, non-motor manifestations (NMM) of PD have become increasingly recognized – they can often be more disabling than the motor symptoms. Non-motor manifestations of PD result from neuronal degeneration in widespread areas of the brainstem. Unfortunately, NMM is often underrecognized, and therefore, undertreated. The goal of this article is to provide a guide to recognizing and managing these NMM so that quality of life of the patient with PD can improve.

Balancing Short-Term Symptom Control and Long-Term Functional Outcomes in Patients with Parkinson's Disease

CNS Spectrums ◽  
2007 ◽  
Vol 12 (4) ◽  
pp. 275-286 ◽  
Author(s):  
James W. Tetrud
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Outcomes ◽  
Symptom Control ◽  
Symptomatic Treatment ◽  
Term Therapy ◽  
Motor Complications ◽  
Short Term ◽  
Long Term Therapy

ABSTRACTLevodopa has played a central role in the treatment of Parkinson's disease for nearly 40 years and remains the single most effective symptomatic treatment for the disease. However, the response to levodopa therapy changes over time, and its long-term use is commonly associated with disabling motor complications. For this reason, the appropriate role of levodopa in the treatment of Parkinson's disease—in particular, the question of when to initiate therapy with the drug—has been a matter of controversy. Because levodopa is the most effective treatment for Parkinson's disease, the management of this disease becomes a matter of balancing short-term symptom control with long-term functional outcomes. This article provides an overview of the basis for levodopa-associated motor complications and their impact on patients' clinical function and quality of life, followed by a discussion of strategies for managing these complications to achieve optimum symptom control while minimizing the adverse effects of long-term therapy.

scholarly journals Technology-Assisted Rehabilitation of Writing Skills in Parkinson’s Disease: Visual Cueing versus Intelligent Feedback

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Evelien Nackaerts ◽  
Alice Nieuwboer ◽  
Elisabetta Farella
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Visual Cues ◽  
Healthy Controls ◽  
Short Term ◽  
Future Studies ◽  
Visual Cueing ◽  
Sensory Modalities ◽  
Larger Sample

Recent research showed that visual cueing can have both beneficial and detrimental effects on handwriting of patients with Parkinson’s disease (PD) and healthy controls depending on the circumstances. Hence, using other sensory modalities to deliver cueing or feedback may be a valuable alternative. Therefore, the current study compared the effects of short-term training with either continuous visual cues or intermittent intelligent verbal feedback. Ten PD patients and nine healthy controls were randomly assigned to one of these training modes. To assess transfer of learning, writing performance was assessed in the absence of cueing and feedback on both trained and untrained writing sequences. The feedback pen and a touch-sensitive writing tablet were used for testing. Both training types resulted in improved writing amplitudes for the trained and untrained sequences. In conclusion, these results suggest that the feedback pen is a valuable tool to implement writing training in a tailor-made fashion for people with PD. Future studies should include larger sample sizes and different subgroups of PD for long-term training with the feedback pen.

scholarly journals Short- and Long-Term Effects of DBS on Gait in Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Hana Brozova ◽  
Isabelle Barnaure ◽  
Evzen Ruzicka ◽  
Jan Stochl ◽  
Ron Alterman ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Repeated Measures ◽  
Rating Scale ◽  
Long Term Effects ◽  
Short Term ◽  
Short And Long Term ◽  
Mean Time ◽  
Stn Dbs

The aim was to compare the short and long-term effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on gait dysfunction and other cardinal symptoms of Parkinson's disease (PD). Two groups of patients were studied. The first group (short-term DBS, n = 8) included patients recently implanted with STN DBS (mean time since DBS 15.8 months, mean age 58.8 years, PD duration 13 years); the second group (long-term DBS, n = 10) included patients with at least 5 years of DBS therapy (mean time since DBS 67.6 months, mean age 61.7 years, PD duration 17.1 years). Both groups were examined using the Unified Parkinson's Disease Rating Scale (UPDRS) and Gait and Balance scale (GABS) during four stimulation/medication states (ON/OFF; OFF/OFF; OFF/ON; ON/ON). Data were analyzed using repeated measures ANOVA with time since implantation (years) between groups and medication or DBS effect (ON, OFF) within groups. In the short-term DBS group, stimulation improved all UPDRS subscores similar to dopaminergic medications. In particular, average gait improvement was over 40% (p = 0.01), as measured by the UPDRS item 29 and GABS II. In the long-term DBS group, stimulation consistently improved all clinical subscores with the exception of gait and postural instability. In these patients, the effect of levodopa on gait was partially preserved. Short-term improvement of gait abnormalities appears to significantly decline after 5 years of STN DBS in PD patients, while effectiveness for other symptoms remains stable. Progressive non-dopaminergic (non-DBS responsive) mechanisms or deleterious effects of high frequency STN stimulation on gait function may play a role.

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