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Management of parkinson's Diseases with Microelectrode-guided stereotactic Pallidotomy and Thalamotomy

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中国组织工程研究 2001年第10期15卷 154-155页

作者：崔高宇冯华王宪荣吴国材陈志 southwest Hospital Third Military Medical University

Objective To study the methods and outcome of 71 patients with parkinson’s disease treated with microelectrode－guided stereotactic pallidotomy and thalamotomy.Method Pallidal and thalamal target sites are chosen by supervision of microelectrode recording technique in 71 patients with parkinson’s disease.The UPDRs motor score was used to evaluate the outcomes 12 weeks before and after operation.Result After 12 months follow－up,tremor disappeared completely or nearly completely in 12 patients who underwent unilateral and 1 bilateral ventrolateral thalamotomy.Dramatic improvement of tremor,rigidity,bradykinesia were observed in 57 patients underwent posteroventral pallidotomy,including 6 underwent bilateral posteroventral pallidotomy.Intracerebral hemorrhage was observed in 1 patient.Conclusion Microelectrode－guided stereotactic pallidotomy and thalamotomy are effective in treatmenting parkinson’s disease,but with serious complications accompanied.

关键词： parkinson’s disease stereotactic surgery microrecording

Updates in the pathophysiological mechanisms of parkinson's disease: Emerging role of bone marrow mesenchymal stem cells

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World Journal of stem Cells 2016年第3期8卷 106-117页

作者： Hanaa H Ahmed Ahmed M salem Hazem M Atta Emad F Eskandar Abdel Razik H Farrag Mohamed A Ghazy Neveen A salem Hadeer A Aglan Department Medical Research Division National Research Centre Biochemistry Department Faculty of Science Ain Shams University Clinical Biochemistry Department Faculty of Medicine King Abdulaziz University Medical Biochemistry and Molecular Biology Department Faculty of Medicine Cairo University Pathology Department Medical Research Division National Research Centre Narcotics Ergogenic aids and Poisons Department Medical Research Division National Research Centre

AIM: To explore the approaches exerted by mesenchymal stem cells(MsCs) to improve parkinson's disease(PD) pathophysiology.METHODs: MsCs were harvested from bone marrowof femoral bones of male rats, grown and propagated in culture. Twenty four ovariectomized animals were classified into 3 groups: Group(1) was control, Groups(2) and(3) were subcutaneously administered with rotenone for 14 d after one month of ovariectomy for induction of PD. Then, Group(2) was left untreated, while Group(3) was treated with single intravenous dose of bone marrow derived MsCs(BM-MsCs). sRY gene was assessed by PCR in brain tissue of the female rats. serum transforming growth factor beta-1(TGF-β1), monocyte chemoattractant protein-1(MCP-1) and brain derived neurotrophic factor(BDNF) levels were assayed by ELIsA. Brain dopamine DA level was assayed fluorometrically, while brain tyrosine hydroxylase(TH) and nestin gene expression were detected by semi-quantitative real time PCR. Brain survivin expression was determined by immunohistochemical procedure. Histopathological investigation of brain tissues was also done.REsULTs: BM-MsCs were able to home at the injured brains and elicited significant decrease in serum TGF-β1(489.7 ± 13.0 vs 691.2 ± 8.0, P s 112.1 ± 1.9, P s associated with significant increase in serum BDNF(3663 ± 17.8 vs 2905 ± 72.9, P s 599 ± 9.8, P s as well as brain TH(1.18 ± 0.004 vs 0.54 ± 0.009, P stin(1.29 ± 0.005 vs 0.67 ± 0.006, P s expression levels. In addition to, producing insignificant increase in the number of positive cells for survivin(293.2 ± 15.9 vs 271.5 ± 15.9, P > 0.05) expression. Finally, the brain sections showed intact histological structure of the striatum as a result of treatment with BM-MsCs. CONCLUsION: The current study sheds light on the therapeutic potential of BM-MsCs against PD pathophysiology via multi-mechanistic actions.

关键词： parkinson’s disease Pathophysiology Bone marrow derived mesenchymal stem cells Rotenone Antiinflamma

Gut dysfunction in parkinson's disease

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World Journal of Gastroenterology 2016年第25期22卷 5742-5752页

作者： Adreesh Mukherjee Atanu Biswas shyamal Kumar Das Department of Neurology Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research

Early involvement of gut is observed in parkinson's disease(PD) and symptoms such as constipation may precede motor symptoms. α-synuclein pathology is extensively evident in the gut and appears to follow a rostrocaudal gradient. The gut may act as the starting point of PD pathology with spread toward the central nervous system. This spread of the synuclein pathology raises the possibility of prion-like propagation in PD pathogenesis. Recently, the role of gut microbiota in PD pathogenesis has received attention and some phenotypic correlation has also been shown. The extensive involvement of the gut in PD even in its early stages has led to the evaluation of enteric α-synuclein as a possible biomarker of early PD. The clinical manifestations of gastrointestinal dysfunction in PD include malnutrition, oral and dental disorders, sialorrhea, dysphagia, gastroparesis, constipation, and defecatory dysfunction. These conditions are quite distressing for the patients and require relevant investigations and adequate management. Treatment usually involves both pharmacological and nonpharmacological measures. One important aspect of gut dysfunction is its contribution to the clinical fluctuations in PD. Dysphagia and gastroparesis lead to inadequate absorption of oral anti-PD medications. These lead to response fluctuations, particularly delayed-on and no-on, and there is significant relationship between levodopa pharmacokinetics and gastric emptying in patients with PD. Therefore, in such cases, alternative routes of administration or drug delivery systems may be required.

关键词： parkinson’s disease Gut dysfunction sialorrhea Dysphagia Gastroparesis Constipation Gut microbiota

Gastric emptying, postprandial blood pressure, glycaemia and splanchnic flow in parkinson's disease

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World Journal of Gastroenterology 2016年第20期22卷 4860-4867页

作者： Laurence G Trahair Thomas E Kimber Katerina Flabouris Michael Horowitz Karen L Jones Discipline of Medicine The University of Adelaide NHMRC Centre of Research Excellence in Translating Nutritional science to Good Health The University of Adelaide Neurology Unit Royal Adelaide Hospital

AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in parkinson's disease. METHODs: Twenty-one subjects(13 M, 8 F; age 64.2 ± 1.6 years) with mild to moderate parkinson's disease(Hoehn and Yahr score 1.4 ± 0.1, duration of known disease 6.3 ± 0.9 years) consumed a 75 g glucose drink, labelled with 20 MBq 99mTc-calcium phytate. Gastric emptying was quantified with scintigraphy, blood pressure and heart rate with an automated device, superior mesenteric artery blood flow by Doppler ultrasonography and blood glucose byglucometer for 180 min. Autonomic nerve function was evaluated with cardiovascular reflex tests and upper gastrointestinal symptoms by questionnaire. REsULTs: The mean gastric half-emptying time was 106 ± 9.1 min, gastric emptying was abnormally delayed in 3 subjects(14%). systolic and diastolic blood pressure fell(P senteric blood flow and blood glucose(P sed, following the drink. Three subjects(14%) had definite autonomic neuropathy and 8(38%) had postprandial hypotension. There were no significant relationships between changes in blood pressure, heart rate or mesenteric artery blood flow with gastric emptying. Gastric emptying was related to the score for autonomic nerve function(R = 0.55, P s an inverse relationship between the blood glucose at t = 30 min(R =-0.52, P se at t = 180 min was related directly(R = 0.49, P stric emptying. CONCLUsION: In mild to moderate parkinson's disease, gastric emptying is related to autonomic dysfunction and a determinant of the glycaemic response to oral glucose.

关键词： Gastric emptying Hypotension parkinson’s disease Blood pressure Glucose

Green Tea Consumption Reduces Oxidative stress in parkinson’s Disease Patients

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Journal of Behavioral and Brain science 2015年第6期5卷 194-202页

作者： D. Chen Y. Zhou K. E. Lyons R. Pahwa M. B. Reddy Department of Food science and Human Nutrition Iowa State University Ames USA Department of Neurology University of Kansas Medical Center Kansas City USA

Oxidative stress is one of the underlying causes of parkinson’s disease (PD). Because of its antioxidant effect, we hypothesize that green tea consumption (3 cups daily for 3 months) would improve antioxidant status and reduces oxidative damage in parkinson’s disease. Fifteen subjects who were within the first five years of PD, on stable PD medication, and not regular green tea consumers were recruited. Iron status, oxidative stress and PD status were evaluated before and after 3 months of green tea consumption. Hemoglobin, serum iron, iron saturation and ferritin concentrations were used to assess iron status. Antioxidant enzymes including catalase, superoxide dismutase (sOD), and glutathione peroxidase (GPx) were measured to determine antioxidant status. Lipid peroxidation and protein carbonyls were measured as oxidative damage markers. There were no changes in total motor scores of the Unified parkinson’s Disease Rating scale (UPDRs), PDQ-39 total scores and various iron status markers after 3 months. Catalase (p sOD activities (p sed significantly indicating an improvement of antioxidant status. Both lipid peroxidation and protein carbonyls decreased by ~52% (p sumption, indicating less oxidative stress. In conclusion, 3 cups of green tea consumption for 3 months can improve antioxidant status and reduce oxidative damage in PD patients. Further studies are needed to determine if these changes result in slowing the disease progression.

关键词： parkinson’s Disease Antioxidant Enzymes Oxidative stress Green Tea

A Report of 10 Cases of parkinson’s Disease Cured by Xifengzhizhan Pills and Xifengzhizhan Capsules

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Advances in parkinson's Disease 2019年第2期8卷 9-17页

作者： Weifan Wang TCM Internal Clinic Xinmi China

parkinson’s Disease (PD) is a chronic progressive degeneration disease of the central nervous system of extrapyramidal system. The main pathological changes are the degeneration of the substantia nigra striatum, lack of dopamine in the brain, causing clinical performance: static tremor, muscle rigidity, slow movement and abnormal posture. It is one of the worldwide medical problems;at present, modern medicine thinks that PD is an incurable and permanent disease. However, in my long-term clinical work, I have cured many cases of PD patients by using Xifengzhizhan pills and Xifenzhizhan capsules, and I have found and proved that Chinese Medicine can cure PD.

关键词： parkinson’s Disease Chinese Medicine Cure parkinson’s Disease parkinson’s Disease Case Report Xifengzhizhan Pills Xifengzhizhan Capsules

Alpha-Dihydroergocryptine vs. Pramipexole as Adjunct symptomatic Treatment of Idiopathic parkinson’s

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Advances in parkinson's Disease 2015年第1期4卷 1-8页

作者： Ulises Rodríguez Ortiz Daniel san- Juan Francesco scarci Movement Disorders Clinic and Neurophysiology Department Instituto Nacional de Neurología y Neurocirugía Mexico City Mexico scientific Department Polichem S.A. Lugano Switzerland

A randomized, double blind, and active reference-controlled study was carried out among 116 patients suffering from idiopathic parkinson’s disease (PD). The aim of the study was to compare the safety and efficacy of alpha-dihydroergocryptine (DHEC) vs. pramipexole (PRAM) as an adjunct symptomatic therapy to levodopa in PD patients. The motor symptoms, assessed by the Unified parkinson’s Disease Rating scale (UPDRs) III subscale, was identified as efficacy target. Fifty-six patients were randomized to DHEC and 60 to PRAM. Patients included were under constant levodopa dose for at least 3 months before entering the study, with baseline UPDRs III ≥14. They underwent a 16-week treatment. Out of the 116 included patients, 85 (39 in DHEC group and 46 in PRAM group, respectively) completed the study protocol. In DHEC group, UPDRs III decreased by 24.2% from baseline at week 10 and by 28.1% at week 16. In PRAM group, UPDRs III decreased by 27.1% from baseline at week 10 and by 29.2% at week 16. The data were highly significant

关键词： Adjunct symptomatic Therapy Alpha-Dihydroergocryptine Pramipexole Idiopathic parkinson’s Disease Motor Complications UPDRs

Differences between Istradefylline Responders and Non-Responders in parkinson’s Disease

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Advances in parkinson's Disease 2017年第2期6卷 45-51页

作者： Asako Yoritaka Nobutaka Hattori Department of Neurology Juntendo University Koshigaya Hospital Saitama Japan Department of Neurology Juntendo University School of Medicine Tokyo Japan

Background: Istradefylline is a selective adenosine A2A receptor antagonist approved for parkinson’s disease (PD) patients with wearing-off symptoms. The Japanese phase III trial showed that 20 mg of orally administrated istradefylline decreased the Off-time. However, istradefylline showed prominent effects in some patients and no benefits in others. We examined the differences in characteristics between responders and non-responders who received 8 weeks of 20 mg/day istradefylline. Methods: Thirty-one patients were enrolled (age, 65.4 [sD 10.4] years;disease duration, 10.4 [sD 6.1] years;daily levodopa dosage, 553.2 [sD 228.7] mg;frequency of levodopa consumption, 4.7 [sD 1.5] times;levodopa equivalent dose, 811.2 [sD 307.5] mg). Results: There were significant differences (p Conclusions: Younger or female patients who are not excessively sleepy during daytime are better candidates for the istradefylline therapy.

关键词： parkinson’s Disease Istradefylline Adenosine A2A Receptor Antagonist Wearing-Off sleepiness

speech Analysis for Diagnosis of parkinson’s Disease Using Genetic Algorithm and support Vector Machine

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Journal of Biomedical science and Engineering 2014年第4期7卷 147-156页

作者： Mohammad shahbakhi Danial Taheri Far Ehsan Tahami Department of Biomedical Engineering Dezful Branch Islamic Azad University Dezful Iran Department of Biomedical Engineering Mashhad Branch Islamic Azad University Mashhad Iran

parkinson’s disease (PD) is the most common disease of motor system degeneration that occurs when the dopamine-producing cells are damaged in substantia nigra. To detect PD, various signals have been investigated, including EEG, gait and speech. since approximately 90 percent of the people with PD suffer from speech disorders, speech analysis is considered as the most common technique for this aim. This paper proposes a new algorithm for diagnosing of parkinson’s disease based on voice analysis. In the first step, genetic algorithm (GA) is undertaken for selecting optimized features from all extracted features. Afterwards a network based on support vector machine (sVM) is used for classification between healthy and people with parkinson. The dataset of this research is composed of a range of biomedical voice signals from 31 people, 23 with parkinson’s disease and 8 healthy people. The subjects were asked to pronounce letter “A” for 3 seconds. 22 linear and non-linear features were extracted from the signals that 14 features were based on F0 (fundamental frequency or pitch), jitter, shimmer and noise to harmonics ratio, which are main factors in voice signal. Because changing in these factors is noticeable for the people with PD, optimized features were selected among them. Of the various numbers of optimized features, the data classification was investigated. Results show that the classification accuracy percent of 94.50 per 4 optimized features, the accuracy percent of 93.66 per 7 optimized features and the accuracy percent of 94.22 per 9 optimized features, could be achieved. It can be observed that the best classification accuracy may be achieved using Fhi (Hz), Fho (Hz), jitter (RAP) and shimmer (APQ5).

关键词： parkinson’s Disease speech Analysis Genetic Algorithm support Vector Machine