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Radiation Therapy for Hypersalivation: A Prospective Study in 50 Amyotrophic Lateral Sclerosis Patients. Int J Radiat Oncol Biol Phys 2014; 88:589-95. [DOI: 10.1016/j.ijrobp.2013.11.230] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 10/31/2013] [Accepted: 11/17/2013] [Indexed: 11/22/2022]
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52
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Nicaretta DH, Rosso AL, Mattos JPD, Maliska C, Costa MMB. Dysphagia and sialorrhea: the relationship to Parkinson's disease. ARQUIVOS DE GASTROENTEROLOGIA 2013; 50:42-9. [PMID: 23657306 DOI: 10.1590/s0004-28032013000100009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 01/31/2013] [Indexed: 12/16/2022]
Abstract
CONTEXT Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. OBJECTIVE The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. METHOD Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, RESULTS Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients. CONCLUSIONS Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia.
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Affiliation(s)
- Denise Hack Nicaretta
- Movement Disorders Sector, Wards 24 and 25, Hospital Geral da Santa Casa de Misericórdia, Rio de Janeiro, RJ, Brazil
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53
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Bee TS, Allison W. The Effects of Parkinson's Disease on Caregivers and People with Parkinson's Disease: A Literature Review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2013. [DOI: 10.1177/201010581302200306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Parkinson's disease (PD) is a complex, slowly progressive, neurodegenerative, neurological condition characterised by a wide range of motor problems such as movement disorders, issues with gait and balance, and difficulty with swallowing and speech. In addition, sufferers also experience non-motor symptoms such as disorder of sleep, postural hypotension, mood alterations, lethargy, and cognitive dysfunction. As PD progresses to an advanced stage, people experience periods of debilitating physical and neurological problems and their caregivers face increasing complexity of care. Many people with PD require the support of a caregiver to attend to activities of daily living. This paper will review the literature on the effects of Parkinson's disease on both the patient and caregiver. Findings highlight the progressive nature of the disease affecting both functional and affective domains, and the need for caregiver support to enable the delivery of quality of care to this group throughout the disease trajectory.
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Affiliation(s)
- Tan Siok Bee
- Nursing Division, Singapore General Hospital, Singapore
| | - Williams Allison
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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Rana AQ, Khondker S, Kabir A, Owalia A, Khondker S, Emre M. Impact of cognitive dysfunction on drooling in Parkinson's disease. Eur Neurol 2013; 70:42-5. [PMID: 23711510 DOI: 10.1159/000348571] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 01/13/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is commonly characterized by its motor symptoms such as resting tremor, rigidity, bradykinesia and postural instability; however, some of the most debilitating symptoms of this disease are non-motor ones such as dementia and sialorrhea (drooling). Drooling is caused by impaired swallowing and it can have a significant impact on the quality of life. However, it is still unclear whether cognitive dysfunction could exacerbate drooling. We wanted to examine if any relationship existed between drooling and dementia in PD patients. Identifying the correlation will aid physicians to screen and initiate early management of drooling in the course of PD. This can possibly lead to improvements in the quality of life in these patients. METHODS In this retrospective study, we investigated the prevalence of drooling in 314 PD patients and further compared the difference in the prevalence of drooling in patients with dementia and without dementia. In addition, we studied the impact of gender on drooling in this patient population. RESULTS Our results show that a significant correlation exists between drooling and dementia in our sample of PD patients. Furthermore, in males, the correlation between the prevalence of drooling and dementia was found to be clinically significant as compared to the female population. CONCLUSION Our findings suggest that drooling is a major concern in the course of PD and should therefore be addressed early and more aggressively in patients with dementia.
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Affiliation(s)
- Abdul Qayyum Rana
- Parkinson's Clinic of Eastern Toronto, Scarborough, Ont., Canada. ranaaq @ yahoo.com
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55
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Hobson EV, McGeachan A, Al-Chalabi A, Chandran S, Crawley F, Dick D, Donaghy C, Ealing J, Ellis CM, Gorrie G, Hanemann CO, Harrower T, Jung A, Majeed T, Malaspina A, Morrison K, Orrell RW, Pall H, Pinto A, Talbot K, Turner MR, Williams TL, Young CA, Shaw PJ, McDermott CJ. Management of sialorrhoea in motor neuron disease: A survey of current UK practice. Amyotroph Lateral Scler Frontotemporal Degener 2013; 14:521-7. [DOI: 10.3109/21678421.2013.790452] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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56
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Perez-Lloret S, Rey MV, Pavy-Le Traon A, Rascol O. Emerging drugs for autonomic dysfunction in Parkinson's disease. Expert Opin Emerg Drugs 2013; 18:39-53. [DOI: 10.1517/14728214.2013.766168] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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57
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JG K. Management of dysphagia and drooling in patients with Parkinson’s disease. Neurodegener Dis Manag 2013. [DOI: 10.2217/nmt.12.77] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
SUMMARY Dysphagia and drooling are frequently reported consequences of Parkinson’s disease (PD) and this article aims to review their management. Several PD-specific and validated instruments are available for the screening and evaluation of dysphagia and drooling, including the Swallowing Disturbance Questionnaire (SDQ), Sialorrhea Clinical Scale for Parkinson’s disease (SCS-PD), Radboud Oral Motor Inventory for Parkinson’s Disease (ROMP), subscales for swallowing and saliva, and non-motor questionnaires that include items on dysphagia and drooling (e.g., Scales for Outcomes in Parkinson’s disease-Autonomic [SCOPA-AUT]; Non-motor Symptoms Questionnaire for Parkinson’s disease [PD-NMSQuest]; and Non-motor Symptoms Assessment Scale for Parkinson’s disease [NMSS]). For the behavioral treatment of dysphagia traditional techniques are helpful, however, exercise training might be more effective. Dysphagia appears to be resistant to drug treatment, but dysphagic patients may benefit from deep brain stimulation. For the treatment of drooling, swallow compensations should be tried, but when saliva reduction is required, botulinum-toxin injections are currently the best option. Overall, there is an urgent need for new approaches to treat dysphagia and drooling in PD.
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Affiliation(s)
- Kalf JG
- Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Speech–Language Pathology, PO Box 9101, Internal code 898, 6500 HB Nijmegen, The Netherlands
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Gastrointestinale Störungen beim idiopathischen Parkinson-Syndrom. DER NERVENARZT 2012; 83:1282-91. [DOI: 10.1007/s00115-012-3575-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Del Tredici K, Duda JE. Peripheral Lewy body pathology in Parkinson's disease and incidental Lewy body disease: Four cases. J Neurol Sci 2011; 310:100-6. [DOI: 10.1016/j.jns.2011.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 05/27/2011] [Accepted: 06/01/2011] [Indexed: 01/01/2023]
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Pathological correlates of gastrointestinal dysfunction in Parkinson's disease. Neurobiol Dis 2011; 46:559-64. [PMID: 22048068 DOI: 10.1016/j.nbd.2011.10.014] [Citation(s) in RCA: 185] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 10/11/2011] [Accepted: 10/16/2011] [Indexed: 12/11/2022] Open
Abstract
Gastrointestinal dysfunction is a prominent manifestation of Parkinson's disease (PD). Gastrointestinal symptoms in PD include reduced salivation, dysphagia, impaired gastric emptying, constipation, and defecatory dysfunction. Constipation may precede the development of somatic motor symptoms of PD for several years. Neuropathological studies show early accumulation of abnormal alpha-synuclein (α-SYN) containing inclusions (Lewy neurites) in the enteric nervous system (ENS) and dorsal motor nucleus of the vagus (DMV) both in PD and in incidental Lewy body disease (ILBD). These findings provided the basis for the hypothesis that α-SYN pathology progresses in a centripetal, prion-like fashion, from the ENS to the DMV and then to more rostral areas of the central nervous system. Colonic biopsies may show accumulation α-SYN immunoreactive Lewy neurites in the submucosal plexus of PD patients. Salivary gland involvement is prominent in PD and α-SYN pathology can be detected both at autopsy and in minor salivary gland biopsies.
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61
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Cersosimo MG, Benarroch EE. Autonomic involvement in Parkinson's disease: pathology, pathophysiology, clinical features and possible peripheral biomarkers. J Neurol Sci 2011; 313:57-63. [PMID: 22001247 DOI: 10.1016/j.jns.2011.09.030] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 09/21/2011] [Accepted: 09/22/2011] [Indexed: 12/14/2022]
Abstract
Autonomic nervous system involvement occurs at early stages in both Parkinson's disease (PD) and incidental Lewy body disease (ILBD), and affects the sympathetic, parasympathetic, and enteric nervous systems (ENS). It has been proposed that alpha-synuclein (α-SYN) pathology in PD has a distal to proximal progression along autonomic pathways. The ENS is affected before the dorsal motor nucleus of the vagus (DMV), and distal axons of cardiac sympathetic nerves degenerate before there is loss of paravertebral sympathetic ganglion neurons. Consistent with neuropathological findings, some autonomic manifestations such as constipation or impaired cardiac uptake of norepinephrine precursors, occur at early stages of the disease even before the onset of motor symptoms. Biopsy of peripheral tissues may constitute a promising approach to detect α-SYN neuropathology in autonomic nerves and a useful early biomarker of PD.
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Affiliation(s)
- Maria G Cersosimo
- Parkinson's Disease and Movement Disorder Unit, Hospital de Clínicas, University of Buenos Aires, Argentina
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62
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Perez-Lloret S, Nègre-Pagès L, Ojero-Senard A, Damier P, Destée A, Tison F, Merello M, Rascol O. Oro-buccal symptoms (dysphagia, dysarthria, and sialorrhea) in patients with Parkinson’s disease: preliminary analysis from the French COPARK cohort. Eur J Neurol 2011; 19:28-37. [DOI: 10.1111/j.1468-1331.2011.03402.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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63
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Wishart S, Macphee GJA. Evaluation and management of the non-motor features of Parkinson's disease. Ther Adv Chronic Dis 2011; 2:69-85. [PMID: 23251743 PMCID: PMC3513877 DOI: 10.1177/2040622310387847] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Parkinson's disease (PD) is traditionally viewed as a motor disorder with a characteristic triad of tremor, rigidity and bradykinesia. There is now increasing awareness that PD is a complex systemic disorder with many nonmotor symptoms (NMS) which include autonomic dysfunction, sleep disorders, sensory and neuropsychiatric features. NMS become more common in severity and frequency with advancing disease when neuropsychiatric features such as cognitive impairment and psychosis dominate the clinical picture. NMS are strongly correlated with quality of life for patients and their families as well as institutional care placement. Despite their importance, NMS are poorly recognized by clinicians and often undeclared by patients. Use of a validated screening tool NMSQuest followed by specific symptom assessment instruments strengthens the recognition and holistic management of NMS in PD. Some NMS such as mood disturbance, anxiety, pain and insomnia may be improved by optimization of dopaminergic therapy. Conversely, psychosis, excess daytime somnolence or impulse control disorder (ICD) may be triggered by dopaminergic drugs. Other NMS such as dementia and severe depression may be unresponsive to dopaminergic treatment and may reflect perturbations in cholinergic, serotonergic or noradrenergic neurotransmitter function. These symptoms are more challenging to manage but may be ameliorated to some extent by agents such as acetylcholinesterase inhibitor or antidepressant drugs. This contribution reviews the evidence for the evaluation and management of key NMS in PD (apathy, anxiety, depression, psychosis, dementia, ICD, sleep disturbance, autonomic dysfunction, pain) and highlights the urgent need for both novel therapies and more controlled trials for current therapeutic strategies.
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Affiliation(s)
- Steven Wishart
- Medicine for the Elderly/Movement Disorders Clinic, Southern General Hospital, Glasgow, Scotland G51 4TF, UK
| | - Graeme J. A. Macphee
- Medicine for the Elderly/Movement Disorders Clinic, Southern General Hospital, Glasgow, Scotland G51 4TF, UK
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64
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Bakke M, Larsen SL, Lautrup C, Karlsborg M. Orofacial function and oral health in patients with Parkinson’s disease. Eur J Oral Sci 2011; 119:27-32. [DOI: 10.1111/j.1600-0722.2010.00802.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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65
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Respiratory problems in neurologic movement disorders. Parkinsonism Relat Disord 2010; 16:628-38. [DOI: 10.1016/j.parkreldis.2010.07.004] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 07/03/2010] [Accepted: 07/07/2010] [Indexed: 01/31/2023]
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66
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Warnecke T, Oelenberg S, Teismann I, Hamacher C, Lohmann H, Ringelstein EB, Dziewas R. Endoscopic characteristics and levodopa responsiveness of swallowing function in progressive supranuclear palsy. Mov Disord 2010; 25:1239-45. [PMID: 20629130 DOI: 10.1002/mds.23060] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Dysphagia is a frequent and early symptom in progressive supranuclear palsy (PSP) predisposing patients to aspiration pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) has emerged as a valuable apparative tool for objective evaluation of neurogenic dysphagia. This is the first study using FEES to investigate the nature of swallowing impairment in PSP. Eighteen consecutive PSP patients (mean age 69.7 +/- 9.0 years) were included. The salient findings of FEES in PSP patients were compared with those of 15 patients with Parkinson's disease (PD). In 7 PSP patients, a standardized FEES protocol was performed to explore levodopa (L-dopa) responsiveness of dysphagia. Most frequent abnormalities detected by FEES were bolus leakage, delayed swallowing reflex, and residues in valleculae and piriformes. Aspiration events with at least one food consistency occurred in nearly 30% of PSP patients. Significant pharyngeal saliva pooling was observed in 4 PSP patients. We found no difference of salient endoscopic findings between PSP and PD patients. Endoscopic dysphagia severity in PSP correlated positively with disease duration, clinical disability, and cognitive impairment. No correlation was found with dysarthria severity. In early PSP patients, swallowing dysfunction was solely characterized by liquid leakage with the risk of predeglutitive aspiration during the oral phase of swallowing. Two PSP patients showed relevant improvement of swallowing function after L-dopa challenge. Chin tuck-maneuver, hard swallow, and modification of food consistency were identified as the most effective therapeutic interventions. In conclusion, FEES assessment can deliver important findings for the diagnosis and refined therapy of dysphagia in PSP patients.
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Affiliation(s)
- Tobias Warnecke
- Department of Neurology, University Hospital of Münster, Münster, Germany.
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67
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Berry AL, Foltynie T. Gene therapy: a viable therapeutic strategy for Parkinson's disease? J Neurol 2010; 258:179-88. [PMID: 20963433 DOI: 10.1007/s00415-010-5796-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/21/2010] [Accepted: 10/07/2010] [Indexed: 12/23/2022]
Abstract
Gene therapy represents a potentially useful additional technique to ameliorate the motor symptoms of Parkinson's disease (PD), and the motor complications of its treatment. The neurodegenerative process itself, as well as the non-motor symptoms of PD, both remain less amenable to most of the current gene therapy approaches. This review presents an overview of the four gene therapies in phase I/II clinical trials, outlines some of the challenges they face, and proposes additional alternative strategies that might improve the clinical prospects of gene therapy for PD. In so doing, we hope to highlight the issue of the current absence of effective treatment for non-motor symptoms of PD and the potential of further candidate targets for gene therapy intervention that might improve upon this, for both specific individuals with genetic forms of PD as well as "sporadic" PD patients.
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Affiliation(s)
- Alexander L Berry
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
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68
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Müller B, Larsen JP, Wentzel-Larsen T, Skeie GO, Tysnes OB. Autonomic and sensory symptoms and signs in incident, untreated Parkinson's disease: Frequent but mild. Mov Disord 2010; 26:65-72. [DOI: 10.1002/mds.23387] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 04/22/2010] [Accepted: 07/13/2010] [Indexed: 11/07/2022] Open
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69
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Pfeiffer RF. Gastrointestinal dysfunction in Parkinson's disease. Parkinsonism Relat Disord 2010; 17:10-5. [PMID: 20829091 DOI: 10.1016/j.parkreldis.2010.08.003] [Citation(s) in RCA: 185] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Accepted: 08/04/2010] [Indexed: 02/06/2023]
Abstract
In recent years, an increasingly detailed picture of gastrointestinal dysfunction in the setting of Parkinson's disease has emerged. Abnormalities of function may occur at virtually all levels of the gastrointestinal tract. Weight loss, dental deterioration, salivary excess, dysphagia, gastroparesis, decreased bowel movement frequency, and anorectal dysfunction all may occur. The pathophysiologic basis for this dysfunction entails both central and enteric nervous system involvement.
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Affiliation(s)
- Ronald F Pfeiffer
- Department of Neurology, University of Tennessee Health Science Center, 855 Monroe Avenue, Memphis, TN 38163, USA.
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70
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Del Tredici K, Hawkes CH, Ghebremedhin E, Braak H. Lewy pathology in the submandibular gland of individuals with incidental Lewy body disease and sporadic Parkinson's disease. Acta Neuropathol 2010; 119:703-13. [PMID: 20229352 DOI: 10.1007/s00401-010-0665-2] [Citation(s) in RCA: 212] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 02/26/2010] [Accepted: 02/26/2010] [Indexed: 02/07/2023]
Abstract
A retrospective autopsy-based study of the human submandibular gland, one of the three major salivary glands, together with anatomically related peripheral structures (cervical superior ganglion, cervical sympathetic trunk, vagal nerve at the level of the carotid bifurcation), was conducted on a cohort consisting of 33 individuals, including 9 patients with neuropathologically confirmed Parkinson's disease (PD), three individuals with incidental Lewy body disease (iLBD), 2 individuals with neuropathologically confirmed multiple system atrophy (MSA), and 19 controls, using alpha-synuclein immunohistochemistry in 100 mum polyethylene glycol-embedded tissue sections. Lewy pathology (LP) was present in the submandibular glands and cervical superior ganglia in PD (9/9 cases) and iLBD (2/3 cases) but not in MSA or controls. The cervical sympathetic trunk (7/9 PD cases, 2/3 iLBD cases) and peripheral vagal nerves (9/9 PD cases, 2/3 iLBD cases) also displayed LP. The results are discussed within the context of hyposmia as well as autonomic dysfunction in PD (sialorrhea, sialopenia, dysphagia). Potential disease-related changes in salivary volume, contents, and viscosity might make it possible, in combination with other tests, to employ human saliva as a biomarker.
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Affiliation(s)
- Kelly Del Tredici
- Clinical Neuroanatomy, Center for Clinical Research, Department of Neurology, University of Ulm, Helmholtzstrasse 8/1, 89081 Ulm, Germany.
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71
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Politis M, Wu K, Molloy S, G. Bain P, Chaudhuri KR, Piccini P. Parkinson's disease symptoms: The patient's perspective. Mov Disord 2010; 25:1646-51. [DOI: 10.1002/mds.23135] [Citation(s) in RCA: 394] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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72
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Mostile G, Jankovic J. Treatment of dysautonomia associated with Parkinson's disease. Parkinsonism Relat Disord 2009; 15 Suppl 3:S224-32. [DOI: 10.1016/s1353-8020(09)70820-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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73
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Plowman-Prine EK, Sapienza CM, Okun MS, Pollock SL, Jacobson C, Wu SS, Rosenbek JC. The relationship between quality of life and swallowing in Parkinson's disease. Mov Disord 2009; 24:1352-8. [PMID: 19425089 DOI: 10.1002/mds.22617] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Few studies exist in the literature investigating the impact of idiopathic Parkinson's Disease (IPD) on swallow-related quality of life. We therefore aimed in this project to: (1) evaluate swallow-specific quality of life in IPD; (2) delineate potential relationships between IPD duration and severity with swallow-specific quality of life; (3) investigate relationships between swallow-specific quality of life and general health-related quality of life; and (4) investigate relationships between swallow-specific quality of life and depression. Thirty-six patients diagnosed with IPD with and without dysphagia filled out self-report assessments of the SWAL-QOL, Parkinson's Disease Questionnaire-39 (PDQ-39), and Beck Depression Inventory (BDI). A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 10 SWAL-QOL domains. Spearman's Rho correlation analyses were performed between the SWAL-QOL and (1) PDQ-39; (2) Hoehn and Yahr stage; (3) PD disease duration; (4) UPDRS "on" score; and (5) the BDI. The dysphagia swallowing group reported significant reductions compared to the non-dysphagic group for the total SWAL-QOL score (P = 0.02), mental health domain score (P = 0.002) and social domain score (P = 0.002). No relationships existed between swallow-specific quality of life and disease duration or severity. Significant relationships existed between swallow-specific quality of life and general health-related quality of life (r(s) =-0.56, P = 0.000) and depression (r(s) = -0.48, P = 0.003). These exploratory data highlight the psychosocial sequelae that swallowing impairment can have in those with IPD and suggest a possible association between swallowing, social function, and depression.
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Abstract
The cardinal characteristics of Parkinson disease (PD) include resting tremor, rigidity, and bradykinesia. Patients may also develop autonomic dysfunction, cognitive changes, psychiatric symptoms, sensory complaints, and sleep disturbances. The treatment of motor and non-motor symptoms of Parkinson disease is addressed in this article.
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Affiliation(s)
- Mark Stacy
- Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA.
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75
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Barichella M, Cereda E, Pezzoli G. Major nutritional issues in the management of Parkinson's disease. Mov Disord 2009; 24:1881-92. [DOI: 10.1002/mds.22705] [Citation(s) in RCA: 154] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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76
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Löhle M, Storch A, Reichmann H. Beyond tremor and rigidity: non-motor features of Parkinson’s disease. J Neural Transm (Vienna) 2009; 116:1483-92. [DOI: 10.1007/s00702-009-0274-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Accepted: 07/17/2009] [Indexed: 10/20/2022]
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Nóbrega AC, Rodrigues B, Melo A. Does botulinum toxin injection in parotid glands interfere with the swallowing dynamics of Parkinson's disease patients? Clin Neurol Neurosurg 2009; 111:430-2. [DOI: 10.1016/j.clineuro.2008.12.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 12/11/2008] [Accepted: 12/19/2008] [Indexed: 11/28/2022]
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78
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Reichmann H, Ziemssen T. Treatment strategies for nonmotor manifestations of Parkinson's disease. Expert Opin Pharmacother 2009; 10:773-84. [DOI: 10.1517/14656560902811605] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Bloem BR, Kalf JG, van de Kerkhof PCM, Zwarts MJ. Debilitating consequences of drooling. J Neurol 2009; 256:1382-3. [PMID: 19412723 PMCID: PMC2721959 DOI: 10.1007/s00415-009-5144-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 04/14/2009] [Accepted: 04/15/2009] [Indexed: 10/26/2022]
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80
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Abnormality of taste and smell in Parkinson's disease. Parkinsonism Relat Disord 2009; 15:232-7. [DOI: 10.1016/j.parkreldis.2008.05.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2008] [Revised: 05/12/2008] [Accepted: 05/13/2008] [Indexed: 11/20/2022]
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Dougall A, Fiske J. Access to special care dentistry, part 9. Special care dentistry services for older people. Br Dent J 2009; 205:421-34. [PMID: 18953303 DOI: 10.1038/sj.bdj.2008.891] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article looks at three common neurological conditions associated with later years: stroke, Parkinson's disease and dementia. All of them impact on oral health, access to dental services and delivery of dental care, and treatment goals need to be adapted to take into account patients' changing needs, medical status, pattern of recovery or the stage of dementia that they have reached. The article concludes by considering the topic of elder abuse. The dental team may have a role both in identifying abuse and ensuring appropriate action is taken.
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Affiliation(s)
- A Dougall
- Division One/Special Care Dentistry, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland
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Chitnis S. Optimizing therapeutic effects in patients with comorbidities: drug-resistant tremor, autonomic dysfunction, psychiatric disorders, and cognitive impairment. Neurol Clin 2008; 26:S29-44, v-vi. [PMID: 18774441 DOI: 10.1016/j.ncl.2008.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parkinsonism is a syndrome characterized by a combination of cardinal features including resting tremor, bradykinesia, rigidity, and loss of postural reflexes. The most common presentation of parkinsonism is the idiopathic variety first described by James Parkinson in 1817 now known as Parkinson's disease (PD). This article focuses on identifying the different subtypes of PD, with the recognition that treatment approaches may differ depending on the initial presenting feature. It also addresses issues related to the recognition and treatment of nonmotor comorbidities of PD, such as autonomic dysfunction and neuropsychiatric problems including depression and dementia.
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Affiliation(s)
- Shilpa Chitnis
- Clinical Center for Movement Disorders, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9036, USA.
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