Comorbid conditions associated with Parkinson's disease: A longitudinal and comparative study with Alzheimer disease and control subjects.

Background And Objective: To study what comorbid conditions were present at baseline and 3years later in a cohort of Spanish Parkinson's disease (PD) patients, to compare comorbidity with both Alzheimer's disease (AD) and control groups and to analyze the role of comorbidity as predictor of mortality.

Methods: One hundred and forty-seven non-demented PD patients (57.1% males; 70.

Causes and factors related to dopamine agonist withdrawal in Parkinson's disease.

Background: Although dopamine agonists (DAs) are useful in Parkinson's disease (PD), they are not frequently used in elderly patients due to adverse effects. However, there is a lack of evidence because few elderly PD patients are enrolled in clinical trials.

Aims Of The Study: The aims of this study were to analyze the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice and to identify the related factors.

Treadmill training improves overground walking economy in Parkinson's disease: a randomized, controlled pilot study.

Gait disturbances are one of the principal and most incapacitating symptoms of Parkinson's disease (PD). In addition, walking economy is impaired in PD patients and could contribute to excess fatigue in this population. An important number of studies have shown that treadmill training can improve kinematic parameters in PD patients.

Factors contributing to caregivers' stress and burden in Parkinson's disease.

Background And Objective: To analyze the main determinants of burden and stress in caregivers of Spanish Parkinson's disease (PD) patients.

Methods: One-hundred and twenty-one non-demented patients with PD (57.9% males; 70.

A predictive model of neurodegeneration in idiopathic REM-sleep behavior disorder.

Objective: To investigate whether Parkinson's disease (PD) and dementia are competing risks in subjects with idiopathic rapid-eye-movement sleep behavior disorder (RBD).

Methods: The number of incidental PD cases observed in 11 longitudinal RBD studies was compared with the corresponding expected number as estimated by a simple mathematical model based on population parameters for PD age-of-onset.

Results: The expected number of incidental PD cases exceeded observed PD cases (p-value < 0.

Impact of non-motor symptoms on health-related and perceived quality of life in Parkinson's disease.

Objective: To investigate the impact of non-motor symptoms on health-related and perceived quality of life in Parkinson's disease (PD).

Methods: One hundred and fifty PD patients (57.3% males; 70.

Imaging of Dopamine in PD and Implications for Motor and Neuropsychiatric Manifestations of PD.

Parkinson's disease (PD) is characterized by dopamine depletion in the putamen, which leads to motor dysfunction. As the disease progresses, a substantial degree of dopamine depletion also occurs in caudate and nucleus accumbens. This may explain a number of neuropsychiatric manifestations, including depression, apathy, and cognitive decline.

The powerful pre-treatment effect: placebo responses in restless legs syndrome trials.

Objective: To investigate whether dopaminergic pre-treatment alters placebo and dopamine agonist responses in restless legs syndrome (RLS).

Methods: Two large, multi-centre trials (SP790 and SP792; registration numbers NCT00136045 and NCT00135993) on the efficacy of rotigotine in RLS reported supplemental International RLS (IRLS) sum score data for pre-treated and drug-naïve patients, allowing for the estimation of the regression slope of the clinical response (change in the IRLS sum score) on baseline IRLS sum score.

Results: In both trials, patients pre-treated with dopaminergic medications tended to have blunted responses after placebo administration compared with drug-naïve patients.

Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease.

Objective: To test whether adherence to non-ergot, once-daily dopamine agonist (ODDA) therapy depends upon concomitant levodopa daily dose in Parkinson's disease (PD).

Methods: Consecutive levodopa-treated PD patients on ODDA therapy were invited to participate in the study. ODDA adherence was measured using subjective (Morisky-Green test, MGT) and objective (electronic monitoring of refill compliance, IANUS) methods.

Role of DaTSCAN and clinical diagnosis in Parkinson disease.

Objective: To assess the role of DaTSCAN in the diagnosis of Parkinson disease (PD).

Methods: Using the sensitivity and specificity values obtained in the 2 studies that recently led the US Food and Drug Administration to approve the use of DaTSCAN for the diagnosis of PD, calculations were carried out to estimate the accuracy of the clinical diagnosis taking DaTSCAN findings as the standard of truth.

Results: In early PD, a clinical diagnosis of "possible" or "probable" PD has a sensitivity of 98% and a specificity of 67%.

Polyneuropathy while on duodenal levodopa infusion in Parkinson's disease patients: we must be alert.

Some reports have emerged describing the occurrence of Guillain-Barré syndrome and polyneuropathy related to vitamin B(12) deficiency in some patients with Parkinson's disease (PD) treated with continuous duodenal levodopa infusion. We describe five PD patients who developed axonal polyneuropathy and vitamin B(12) deficiency while on treatment with duodenal levodopa infusion, review other cases reported in the literature, discuss potential etiologic factors, and suggest a possible algorithm for the management and prevention of this complication. One case of Guillain-Barré syndrome and at least 12 cases of polyneuropathy related to vitamin B(12) deficiency have been reported in PD patients treated with duodenal levodopa infusion.

Duodenal levodopa/carbidopa infusion therapy in patients with advanced Parkinson's disease leads to improvement in caregivers' stress and burden.

Background: Continuous duodenal levodopa infusion (DLI) is an effective therapy that improves quality of life (QoL) in advanced Parkinson's disease (PD). However, the impact of DLI on caregivers' stress and burden has not been reported.

Methods: We evaluated prospectively open-label seven advanced PD patients (65.

Frontostriatal cognitive staging in Parkinson's disease.

Cognitive impairment and behavioural disorders are often encountered in subjects with Parkinson's disease (PD). A simple PD-related frontostriatal cognitive dysfunction (PDFCD) staging is proposed. Executive dysfunction and mental fatigue (stage I), depression/anxiety (stage IIa), apathy/pain (stage IIb), and dementia (stage III) reflect a sequential process of dopamine depletion occurring in different regions of the striatum (stages I and II) and the frontal cortex (stage III).

Long-term exposure to duodenal levodopa/carbidopa infusion therapy improves quality of life in relation especially to mobility, activities of daily living, and emotional well-being.

Background: Continuous duodenal levodopa infusion (DLI) is an effective therapy that improves quality of life (QoL) in advanced Parkinson's disease (PD). However, in which aspects improve the patients their QoL has been poorly documented.

Methods: We evaluated 39-item Parkinson's disease Quality of Life Questionnaire Summary Index score (PDQ-39SI) changes analyzing its different domains in nine patients with advanced PD treated with DLI.

[Crohn's disease: the usefulness of MR enterography in the detection of recurrence after surgery].

Objectives: To determine the usefulness of MR enterography in the detection of recurrence in the ileocolonic anastomosis in patients with Crohn's disease that have undergone intestinal resection.

Material And Methods: We used MR enterography and ileocolonoscopy to study 30 patients with Crohn's disease who had undergone intestinal resection. To determine the degree of relapse, the findings at MR enterography were quantified using our own index of Crohn's disease activity and the findings at ileocolonoscopy were quantified using the Rutgeerts scale.

Contextual processing deficits in Parkinson's disease: the role of the frontostriatal system.

Objective: We investigated the role of the frontostriatal system in contextual processing, by examining neural correlates of local contextual processing in Parkinson's disease (PD). Local context was defined as the occurrence of a short predictive series of visual stimuli occurring before delivery of a target event.

Methods: EEG was recorded in eight PD patients and eight controls.

[Descriptive analysis of the use of atypical antipsychotics under compassionate-use in a health area in Ferrol (La Coruña, Spain)].

Background And Objective: Although atypical antipsychotics (AA) provoke fewer extra-pyramidal symptoms (ES) than classic antipsychotics, their use in patients greater than or equal to 75 years old with dementia must be under compassionate-use. This is an important limitation. We performed a descriptive analysis of the use of atypical antipsychotics under compassionate-use (AACU) in the Ferrol health area.

Ileal Crohn's disease: MRI with endoscopic correlation.

Purpose: To evaluate activity staging of Crohn's disease (CD) measured with MR-enterography using ileoscopy as reference standard.

Materials And Methods: A prospective study was made of 61 patients with CD. All patients underwent MR-enterography and ileoscopy.

Multiple cranial neuropathy associated with herpes simplex virus infection and anti-GM2 immunoglobulin M antibodies.

Antiganglioside antibodies can appear after several acute infections and are often associated with various clinical patterns of Guillain-Barré syndrome. Thus, for example, cytomegalovirus infection has been associated with anti-GM2 antibodies and Guillain-Barré syndrome variants with severe sensory loss and cranial nerve involvement. We report on a patient who developed multiple cranial neuropathy associated with herpes simplex virus infection and anti-GM2 immunoglobulin M antibodies.

Impact of neuroprotection on incidence of Alzheimer's disease.

Converging evidence suggests that high levels of education and intellectual activity increase the cognitive reserve and reduce the risk of dementia. However, little is known about the impact that different neuroprotective strategies may have on the incidence of Alzheimer's disease. Using a simple mathematical regression model, it is shown here that age-specific counts of basic cognitive units (surrogate of neurons or synapses) in the normal population can be estimated from Alzheimer's incidence rates.

Placebo effect and dopamine release.

The placebo effect can be encountered in a great variety of medical conditions, but is particularly prominent in pain, depression and Parkinson's disease. It has been shown that placebo responses play a part in the effect of any type of treatment for Parkinson's disease, including drug therapy, deep brain stimulation and dopamine tissue transplantation. Recent studies have demonstrated that the placebo effect in Parkinson's disease is related to the release of substantial amounts of endogenous dopamine in both the dorsal and ventral striatum.