1,721,098 research outputs found
Multi-target strategy for Parkinsonian patients: the role of deep brain stimulation in the centromedian-parafascicularis complex.
No full textBrain Res Bull. 2009 Feb 16;78(2-3):113-8. doi: 10.1016/j.brainresbull.2008.08.007. Epub 2008 Sep 21.
Multi-target strategy for Parkinsonian patients: the role of deep brain stimulation in the centromedian-parafascicularis complex.
Stefani A, Peppe A, Pierantozzi M, Galati S, Moschella V, Stanzione P, Mazzone P.
SourceIRCCS Fondazione S. Lucia, Roma, Italy. [email protected]
Abstract
The intra-laminar (IL) thalamic complex, composed of centromedian (CM) and parafascicular (Pf) nucleus, is a strategic crossroad for the activity of the basal ganglia and is recently regaining its position has a putative neurosurgical target for Parkinsonian syndromes. The multi-target approach we have encouraged since the late nineties has allowed the combined implantation of a standard target (the subthalamic nucleus-STN or the internal pallidus-GPi) plus an innovative one (CM/Pf) in well-identified Parkinson's disease (PD) patients; hence, it is possible to study, in the same PD patients, the specific target-mediated effects on different clinical signs. Here, we focus on the potential usefulness of implanting the CM/Pf complex when required in the management of contra-lateral tremor (resistant to standard deep brain stimulation-DBS - in STN - , n=2) and disabling involuntary movements, partially responsive to GPi-DBS (n=6). When considering global UPDRS scores, CM/Pf-DBS ameliorate extra-pyramidal symptoms but not as strongly as STN (or GPi) does. Yet, CM/Pf acts very powerfully on tremor and contributes to the long-term management of l-Dopa-induced involuntary movements. The lack of cognitive deficits and psychic impairment associated with the improvement of their quality of life, in our small cohort of CM/Pf implanted patients, reinforces the notion of CM/Pf as a safe and attractive area for surgical treatment of advanced PD, possibly affecting not only motor but also associative functions
Dopamine and cognitive functioning in de novo subjects with Parkinson's disease: effects of pramipexole and pergolide on working memory
No full textVery few studies have investigated the relationship between dopaminergic therapy and working memory (WM) functioning in Parkinson's disease (PD) patients. The aim of the present study was to explore the effects of pharmacological treatment with pergolide (a D1+D2 receptor agonist) and pramipexole (a D2+D3 receptor agonist) on performance in visual-spatial, visual-object, and verbal WM tasks in PD patients. Participants included 19 "de novo" PD patients and 13 healthy controls (HC). The experimental task consisted of an n-back paradigm with verbal, visual-object, or visual-spatial stimuli. PD patients performed the task twice: after 18-24 h of therapy wash-out and after administration of pergolide (nine patients) or pramipexole (ten patients). HCs performed the task only once, without drug administration. Depending on how they performed in the "Off" and "On" therapy conditions, the nine PD patients each were classified into groups of low performers (i.e., performance on the n-back paradigm was below the median value of the experimental sample) and high performers (i.e., performance was above the median value). One PD patient was excluded from the analysis because his performance pattern clearly revealed that he was an outlier. In the low performer PD patients, administration of both pergolide and pramipexole improved accuracy on all WM tasks. No effect of the drugs was found in the high performer patients. The results of the present study show that stimulation of dopaminergic receptors improves high-level WM processes in PD patients, possibly by modulating activity in frontal-striatal circuits
Modifications of Apomorphine test response in Parkinson{'}s disease patients during bilaterally GPi stimulation
No full textMajor and minor depression in Parkinson's disease: a neuropsychological investigation
No full textPrevious studies have failed to distinguish the differential contribution of major and minor depression to cognitive impairment in patients with idiopathic Parkinson's disease (PD). This study was aimed at investigating the relationships among major depression (MD), minor depression (MiD) and neuropsychological deficits in PD. Eighty-three patients suffering from PD participated in the study. MD and MiD were diagnosed by means of a structured interview (SCID-I) based on the DSM-IV criteria, and severity of depression was evaluated by the Beck Depression Inventory. For the neuropsychological assessment, we used standardized scales that measure verbal and visual episodic memory, working memory, executive functions, abstract reasoning and visual-spatial and language abilities. MD patients performed worse than PD patients without depression on two long-term verbal episodic memory tasks, on an abstract reasoning task and on three measures of executive functioning. The MiD patients' performances on the same tests fell between those of the other two groups of PD patients but did not show significant differences. Our results indicate that MD in PD is associated with a qualitatively specific neuropsychological profile that may be related to an alteration of prefrontal and limbic cortical areas. Moreover, the same data suggest that in these patients MiD and MD may represent a gradual continuum associated with increasing cognitive deficits
Abnormal responses to paired magnetic transcramai stimuli in de novo Parkinson{'}s Disease patients are reversed by Apomorphine
No full textAuditory cue based on the golden ratio can improve gait patterns in people with parkinson’s disease
Full text linkThe harmonic structure of walking relies on an irrational number called the golden ratio (φ): in healthy subjects, it coincides with the stride-to-stance ratio, and it is associated with a smooth gait modality. This smoothness is lost in people with Parkinson’s disease (PD), due to deficiencies in the execution of movements. However, external auditory cues seem to facilitate movement, by enabling the timing of muscle activation, and helping in initiating and modulating motor output. Based on a harmonic fractal structure of gait, can the administration of an auditory cue based on individual’s φ-rhythm improve, in acute, gait patterns in people with PD? A total of 20 participants (16 males, age 70.9 ± 8.4 years, Hoehn and Yahr stage-II) were assessed through stereophotogrammetry: gait spatio-temporal parameters, and stride-to-stance ratio were computed before, during, and after the φ-rhythm administration. Results show improvements in terms of stride length (p = 0.018), walking speed (p = 0.014), and toe clearance (p = 0.013) when comparing gait patterns before and after the stimulus. Furthermore, the stride-to-stance ratio seems to correlate with almost all spatio-temporal parameters, but it shows the main changes in the before–during rhythm comparison. In conclusion, φ-rhythm seems an effective cue able to compensate for defective internal rhythm of the basal ganglia in PD
Attività fisica adattata: Taiji-Quan: una proposta di metodo di lavoro per le persone con Malattia di Parkinson
Full text linkIl governo dell’Ontario considera prioritaria l’integrazione della assistenza virtuale, per consentire una maggiore accessibilità alle cure da parte di utenti, spesso penalizzati da barriere sociodemografiche. A partire dal 27 aprile 2020 per 3 settimane, è stato condotto in Ontario un sondaggio intervistando 365 soggetti durante la pandemia Covid-19, per valutare l’esperienza maturata dai fisioterapisti con la Teleriabilitazione. Sono emersi vantaggi (continuità di cure, contenimento di costi e spostamenti da parte dei pazienti e criticità (insostituibilità della modalità in presenza per valutazioni o terapie manuali, esigenza di una adeguata alfabetizzazione digitale, scarsa disponibilità di adeguamento delle polizze assicurative).
In conclusione, ribadita l’insostituibilità della modalità “in presenza” soprattutto per quel che concerne alcune procedure, la Teleriabilitazione si candida come una modalità utile a ridurre il peso sulle strutture ospedaliere, garantire continuità terapeutica, per la sua capacità di enfatizzare l’apprendimento, lo spirito cooperativo e la partecipazione attiva e consapevole del paziente.
Parole chiave: Riabilitazione, Fisioterapista, Teleriabilitazione, Pandemia Covid-19, prospettive.
Abstract
La Malattia di Parkinson è la seconda malattia neurodegenerativa più diffusa al mondo dopo l’Alzheimer. Le persone affette sono ad alto rischio di caduta, con conseguenti disabilità fisiche e psicologiche, con aumento della paura di cadere e di uscire di casa, e riduzione dell’autonomia individuale. I disturbi dell’equilibrio rispondono in maniera incompleta al trattamento farmacologico, mentre si fanno sempre più numerose le evidenze scientifiche che dimostrano come la pratica del Taiji-Quan quale “attività fisica adattata” sia efficace nel migliorare l’equilibrio e dunque la qualità di vita delle persone con Malattia di Parkinson. Il presente lavoro vuole proporre un Programma di Allenamento Adattato di Taiji-Quan, ben definito, ripetibile, completo di significato rieducativo specifico per ogni singolo esercizio, da associare al Programma Farmacologico nel Progetto Riabilitativo Individuale delle persone con Malattia di Parkinson. Tale protocollo è attuabile anche in modalità telematica come tele-riabilitazione
Attività fisica adattata: Taiji-Quan: una proposta di metodo di lavoro per le persone con malattia di Parkinson
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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