We aimed to investigate the characteristics of Parkinsonian features assessed by the unified Parkinson's disease rating scale (UPDRS) and determine their correlations with the computed tomography (CT) findings in patients with idiopathic normal pressure hydrocephalus (iNPH). The total score and the scores for arising from chair, gait, postural stability, and body hypokinesia in the motor examination section of UPDRS were significantly improved after shunt operations. Stepwise multiple regression analysis revealed that postural stability was the determinant of the gait domain score of the iNPH grading scale. The canonical correlation analysis between the CT findings and the shunt-responsive Parkinsonian features indicated that Evans index rather than midbrain diameters had a large influence on the postural stability. Thus, the pathophysiology of postural instability as a cardinal feature of gait disturbance may be associated with impaired frontal projections close to the frontal horns of the lateral ventricles in the iNPH patients.

Mitsuaki Ishii

Toshio Kawamata

Ichiro Akiguchi

Hideo Yagi

Yuko Watanabe

Toshiyuki Watanabe

Hideaki Mashimo

Parkinsonian Symptomatology May Correlate with CT Findings before and after Shunting in Idiopathic Normal Pressure Hydrocephalus

Although dual-task interference has previously been demonstrated to have a significant effect on postural control among individuals with Parkinson's disease, the impact of speech complexity on postural control has not been demonstrated using quantitative biomechanical measures. The postural stability of twelve participants with idiopathic Parkinson's disease and twelve healthy age-matched controls was evaluated under three conditions: (1) without a secondary task, (2) performing a rote repetition task and (3) generating a monologue. Results suggested a significant effect of cognitive load on biomechanical parameters of postural stability. Although both groups increased their postural excursion, individuals with Parkinson's disease demonstrated significantly reduced excursion as compared with that of healthy age-matched controls. This suggests that participants with Parkinson's disease may be overconstraining their postural adjustments in order to focus attention on the cognitive tasks without losing their balance. Ironically, this overconstraint may place the participant at greater risk for a fall.

J. D. Holmes

M. E. Jenkins

A. M. Johnson

S. G. Adams

S. J. Spaulding

Dual-Task Interference: The Effects of Verbal Cognitive Tasks on Upright Postural Stability in Parkinson's Disease

Deep brain stimulation (DBS) is a common surgical procedure used for the treatment of Parkinson&#39;s disease (PD) and essential tremor. A potential complication of this procedure is hardware failure. The authors report a case of DBS hardware failure in which repeated fractures of the extension wire were caused by abnormal rotational movements of the IPG placed in the loose subclavicular tissue of an overweight female. Implantation of the IPG in the suprascapular area prevented further extension wire fractures. This strategy may be especially relevant in overweight females with loose subclavicular tissue.

Ankur Garg

Avinash L. Mohan

P. Charles Garell

Placement of the Internal Pulse Generator for Deep Brain Stimulation in the Upper Back to Prevent Fracture of the Extension Wire due to Generator Rotation: Case Report

Xiaoyun Meng

Larissa A. Munishkina

Anthony L. Fink

Vladimir N. Uversky

Effects of Various Flavonoids on the <svg style="vertical-align:-0.1638pt" height="7.9499998" version="1.1" viewBox="0 0 9.7749996 7.9499998" width="9.7749996" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.017,-0,0,-.017,.062,7.675)"><path id="x1D6FC" d="M545 106q-67 -118 -134 -118q-24 0 -40 37.5t-30 129.5h-2q-47 -72 -103 -119.5t-108 -47.5q-47 0 -76 45.5t-29 119.5q0 113 85 204t174 91q47 0 70 -33.5t43 -119.5h3q32 47 80 140l55 13l10 -9q-47 -80 -138 -201q17 -99 27.5 -136t22.5 -37q23 0 69 61zM333 204&#xD;&#xA;q-14 98 -31 149.5t-50 51.5q-49 0 -94 -70t-45 -164q0 -55 15.5 -86t40.5 -31q70 0 164 150z" /></g></svg>-Synuclein Fibrillation Process

Myocardial MIBG scintigraphy is established in the diagnosis and differential diagnosis of Parkinson&#39;s disease (PD). Numerous studies address the pathophysiological impact of myocardial MIBG scintigraphy: the myocardial MIBG uptake correlates with the clinical phenotype of PD; the background of this phenomenon is unclear. Furthermore MIBG scintigraphy enables to study the extracranial Lewy body type-degeneration. In combination with cerebral dopamine transporter imaging, MIBG scintigraphy allows to correlate cerebral and extracranial Lewy body type-degeneration in PD.

J&#246;rg Spiegel

Diagnostic and Pathophysiological Impact of Myocardial MIBG Scintigraphy in Parkinson&#39;s Disease

The purpose was to determine the incidence of lead fracture in patients with DBS over a long period of time. We present a retrospective study of 208 patients who received 387 DBS electrodes. Fourteen patients had sixteen lead fractures (4&#37; of the implanted leads) and two patients suffered from 2 lead fractures. Of all lead fractures, five patients had the connection between the leads and the extension cables located in mastoids region, ten in cervical area and one in thoracic region. The mean distance from the connection between the electrode and the extension cable and the lead fracture was 10.7&#x2009;mm. The lead fracture is a common, although long-term complication in DBS surgery. In our experience, the most common site of electrode cable breakage is approximately between 9 and 13&#x2009;mm from the junction between the lead and the extension cable. The most important cause of lead fracture is the rotational movement of the lead-extension cable system. If we suspect lead fracture, we must check the impedance of the electrode and to evaluate the side effects of voltage. Finally, we must conduct a radiological screening.

Fernando Seijo Fern&#225;ndez

Marco Antonio Alvarez Vega

Aida Antu&#241;a Ramos

Fernando Fern&#225;ndez Gonz&#225;lez

Beatriz Lozano Aragoneses

Lead Fractures in Deep Brain Stimulation during Long-Term Follow-Up

The studies on the association between serum cholesterol level and the risks of neurodegenerative diseases risk are debated. Some prospective studies have found that high serum cholesterol may increase the risks of dementia/Alzheimer&#39;s disease and ischemic stroke. However, other studies have found no association or a decreased risk of hemorrhagic stroke with increasing levels of serum total cholesterol. Little is known about the association between serum total cholesterol or a history of hypercholesterolemia and Parkinson&#39;s disease (PD) risk. Only a few case-control studies and four prospective epidemiological studies have examined this association, but the results are inconsistent. An inverse association between serum total cholesterol and the risk of PD has been found in one prospective study; however, no significant association is reported in the case-control studies and other two prospective studies. Recently, one large prospective study from Finland suggests that high total cholesterol at baseline is associated with an increased risk of PD. Further studies, especially large clinical trials, are needed.

Gang Hu

Total Cholesterol and the Risk of Parkinson&#39;s Disease: A Review for Some New Findings

<i>Background</i>. Common but seldom published are Parkinson&#39;s disease (PD) medication errors involving late, extra, or missed doses. These errors can reduce medication effectiveness and the quality of life of people with PD and their caregivers. <i>Objective</i>. To explore lay perspectives of factors contributing to medication timing errors for PD in hospital and community settings. <i>Design and Methods</i>. This qualitative research purposively sampled individuals with PD, or a proxy of their choice, throughout New Zealand during 2008-2009. Data collection involved 20 semistructured, personal interviews by telephone. A general inductive analysis of the data identified core insights consistent with the study objective. <i>Results</i>. Five themes help to account for possible timing adherence errors by people with PD, their caregivers or professionals. The themes are the abrupt withdrawal of PD medication; wrong, vague or misread instructions; devaluation of the lay role in managing PD medications; deficits in professional knowledge and in caring behavior around PD in formal health care settings; and lay forgetfulness. <i>Conclusions</i>. The results add to the limited published research on medication errors in PD and help to confirm anecdotal experience internationally. They indicate opportunities for professionals and lay people to work together to reduce errors in the timing of medication for PD in hospital and community settings.

Stephen Buetow

Jenny Henshaw

Linda Bryant

Deirdre O&#39;Sullivan

Medication Timing Errors for Parkinson&#39;s Disease: Perspectives Held by Caregivers and People with Parkinson&#39;s in New Zealand

About this journal

<p><em>Parkinson’s Disease</em> publishes research related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.</p>


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<p>Chief Editor&nbsp;Dr Cristine Alves da Costa&nbsp;is based at Centre National de la Research Scientifique, France. Her research is focuses on Parkinson’s molecular and cell biology.</p>


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Parkinson’s Disease - Table of contents

title

Parkinson’s Disease publishes research related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.

Parkinson’s Disease