Determining the impact of specialized care on health outcomes and health care utilization in Parkinsonism.

Background: Although care of Parkinsonism (PKM) is assumed to be optimally provided by movement disorder neurologists within an interdisciplinary clinic model, there is a paucity of published data to support this.

Objectives: To investigate the impact of movement disorder neurologist care of individuals with Parkinsonism (PKM).

Methods: A retrospective exposure design was adopted using administrative data.

Changes in Metabolic Activity and Gait Function by Dual-Task Cognitive Game-Based Treadmill System in Parkinson's Disease: Protocol of a Randomized Controlled Trial.

Balance and gait impairments, and consequently, mobility restrictions and falls are common in Parkinson's disease (PD). Various cognitive deficits are also common in PD and are associated with increased fall risk. These mobility and cognitive deficits are limiting factors in a person's health, ability to perform activities of daily living, and overall quality of life.

Imaging Cerebral Glucose Metabolism during Dual-Task Walking in Patients with Parkinson's disease.

Background And Purpose: Gait impairment is a hallmark of Parkinson's disease (PD). Natural walking involves more cognitive demand than treadmill walking or in-laboratory walking tests because patients have to actively work on navigation and top-down cognitive control which taxes cognitive reserve in the prefrontal cortex. To mimic the prefrontal engagement occurring with natural walking in a controlled and safe environment, dual-task (DT) treadmill walking has been developed.

Elevated caudate connectivity in cognitively normal Parkinson's disease patients.

Mild cognitive impairment (MCI) is common in Parkinson's disease patients. However, its underlying mechanism is not well understood, which has hindered new treatment discoveries specific to MCI. The aim of this study was to investigate functional connectivity changes of the caudate nucleus in cognitively impaired Parkinson's patients.

Blood Flow and Glucose Metabolism Dissociation in the Putamen Is Predictive of Levodopa Induced Dyskinesia in Parkinson's Disease Patients.

The forefront treatment of Parkinson's disease (PD) is Levodopa. When patients are treated with Levodopa cerebral blood flow is increased while cerebral metabolic rate is decreased in key subcortical regions including the putamen. This phenomenon is especially pronounced in patients with Levodopa-induced dyskinesia (LID).

Educational Needs and Considerations for a Visual Educational Tool to Discuss Parkinson's Disease.

Background: In our clinical experience, people with Parkinson's disease (PwP) and their caregivers have difficulty understanding the complexities of the disease, which has a multitude of symptoms and involved therapies. We undertook a needs assessment to understand the need for, and to guide the development of, an educational tool.

Methods: We invited PwP, caregivers and health care providers (HCP) from across Canada to participate in an online survey to determine the need and desired content for such a tool.

Distinct brain metabolic patterns separately associated with cognition, motor function, and aging in Parkinson's disease dementia.

We explored whether patients with Parkinson's disease dementia (PDD) show a distinct spatial metabolic pattern that characterizes cognitive deficits in addition to motor dysfunction. Eighteen patients with PDD underwent 3 separate positron emission tomography sessions with [F]fluorodeoxyglucose (for glucose metabolism), fluorinated N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane (for dopamine transporter density) and Pittsburgh compound-B (for beta-amyloid load). We confirmed in PDD versus normal controls, overall hypometabolism in the posterior and prefrontal brain regions accompanied with hypermetabolism in subcortical structures and the cerebellar vermis.

Healthcare utilization in patients with Parkinson's disease: a population-based analysis.

Purpose: To investigate factors associated with healthcare utilization and prescription drug use for Parkinson's disease (PD) patients and matched controls.

Methods: A retrospective matched-group design was adopted using administrative data from Manitoba, Canada. PD cases (N = 1469) were identified from diagnoses in hospital records and physician billing claims and matched to controls (N = 2938) on age, sex, and region of residence.

Asymmetry in parkinsonism, spreading pathogens and the nose.

Parkinson's disease, as well as many other parkinsonisms, including most toxic, neurodegenerative and familial types are typically asymmetric. No explanation for this phenomenon exists. A summary of the frequency of asymmetry in a spectrum of parkinsonian disorders is provided.

Socioeconomic variations in the prevalence and incidence of Parkinson's disease: a population-based analysis.

Background: For many chronic conditions, lower socioeconomic status is associated with higher rates of disease. Previous research has not investigated whether this inverse relationship exists for Parkinson's disease (PD). The purpose was to investigate the association between socioeconomic status and prevalence and incidence of PD.

Long-term treatment of sleep breathing disorder in a patient with Huntington's disease.

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder. An association with sleep breathing disorder has not previously been established in the literature. We report the case of a 45-year-old woman with HD, presenting with snoring and observed apnea.

Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group.

Context: Somnolence is a recognized adverse effect of dopamine agonists. Two new dopamine agonists, pramipexole and ropinirole, have been reported to cause sudden-onset sleep spells in patients with Parkinson disease (PD) while they were driving. The frequency of these spells and whether driving should be restricted has yet to be established.