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Latest & greatest articles for parkinson's disease
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-motor symptoms in Parkinson'sdisease. Eur J Neurol 2008;15:14-20. Postuma RB, Iranzo A, Hogl B, et al. Risk factors for neurodegeneration in idiopathic rapid eye movement sleep behavior disorder: a multicenter study. Ann Neurol 2015;77:830-839. Seppi K, Ray Chaudhuri K, Coelho M, et al. Update on treatments for nonmotor symptoms of Parkinson'sdisease-an evidence-based medicine review. Mov Disord 2019;34:180-198. Bega D, Simuni T, Okun MS, et al. Medicinal cannabis for Parkinson'sdisease (...) : practices, beliefs, and attitudes among providers at National Parkinson Foundation Centers of excellence. Mov Disord Clin Pract 2017;4:90-95. Carroll CB, Bain PG, Teare L, et al. Cannabis for dyskinesia in Parkinsondisease: a randomized double-blind crossover study. Neurology 2004;63:1245-1250. Show all 43 references Associated data ClinicalTrials.gov/NCT03769896 Actions Related information Grant support LinkOut - more resources Full Text Sources Medical Research Materials Miscellaneous Full-text links
GLP-1 receptor agonists for Parkinson'sdisease. Parkinson'sdisease (PD) is a progressive disorder characterised by both motor and non-motor problems. Glucagon-like peptide-1 (GLP-1) receptor agonists, licensed for treatment of type 2 diabetes, work by stimulating GLP-1 receptors in the pancreas, which triggers the release of insulin. GLP-1 receptors have been found in the brain. Insulin signalling in the brain plays a key role in neuronal metabolism and repair and in synaptic efficacy (...) at 14 months and 24 months following absence of exenatide for 2 months and 12 months, respectively. These trials had low risk of bias, except risk of performance bias was high for Aviles-Olmos 2013. Exenatide versus placebo Primary outcomes We found low-certainty evidence suggesting that exenatide improves motor impairment as assessed by the Movement Disorder Society-Unified Parkinson'sDisease Rating Scale (MDS-UPDRS) Part III in the off-medication state (mean difference (MD) -3.10, 95% confidence
Opicapone (Ongentys) - To treat patients with Parkinson’sdisease experiencing “off” episodes Drug Approval Package: ONGENTYS U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: ONGENTYS Company: Neurocrine Biosciences, Inc. Application Number: 212489 Approval Date: 04/24/2020 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review
Personalized iPSC-Derived Dopamine Progenitor Cells for Parkinson'sDisease. We report the implantation of patient-derived midbrain dopaminergic progenitor cells, differentiated in vitro from autologous induced pluripotent stem cells (iPSCs), in a patient with idiopathic Parkinson'sdisease. The patient-specific progenitor cells were produced under Good Manufacturing Practice conditions and characterized as having the phenotypic properties of substantia nigra pars compacta neurons; testing (...) in a humanized mouse model (involving peripheral-blood mononuclear cells) indicated an absence of immunogenicity to these cells. The cells were implanted into the putamen (left hemisphere followed by right hemisphere, 6 months apart) of a patient with Parkinson'sdisease, without the need for immunosuppression. Positron-emission tomography with the use of fluorine-18-L-dihydroxyphenylalanine suggested graft survival. Clinical measures of symptoms of Parkinson'sdisease after surgery stabilized or improved
Isradipine Versus Placebo in Early ParkinsonDisease: A Randomized Trial. Studies suggest that dihydropyridine calcium-channel blockers may be associated with reduced risk for Parkinsondisease (PD).To assess the effect of isradipine, a dihydropyridine calcium-channel blocker, on the rate of clinical progression of PD.Multicenter, randomized, parallel-group, double-blind, placebo-controlled trial. (ClinicalTrials.gov: NCT02168842).57 Parkinson Study Group sites in North America.Patients (...) with early-stage PD (duration <3 years) who were not taking dopaminergic medications at enrollment.5 mg of immediate-release isradipine twice daily or placebo for 36 months.The primary outcome was change in the Unified Parkinson'sDisease Rating Scale (UPDRS) parts I to III score measured in the antiparkinson medication "ON" state between baseline and 36 months. Secondary outcomes included time to initiation and use of antiparkinson medications, time to onset of motor complications, change in nonmotor
Cognitive training interventions for dementia and mild cognitive impairment in Parkinson'sdisease. Approximately 60% to 80% of people with Parkinson'sdisease (PD) experience cognitive impairment that impacts on their quality of life. Cognitive decline is a core feature of the disease and can often present before the onset of motor symptoms. Cognitive training may be a useful non-pharmacological intervention that could help to maintain or improve cognition and quality of life for people (...) and trial registers, searched relevant reviews in the area and conference proceedings. We also contacted experts for clarifications on data and ongoing trials.We included randomised controlled trials where the participants had PDD or PD-MCI, and where the intervention was intended to train general or specific areas of cognitive function, targeting either a single domain or multiple domains of cognition, and was compared to a control condition. Multicomponent interventions that also included motor
Diagnosis and Treatment of ParkinsonDisease: A Review. Parkinsondisease is the most common form of parkinsonism, a group of neurological disorders with Parkinsondisease-like movement problems such as rigidity, slowness, and tremor. More than 6 million individuals worldwide have Parkinson disease.Diagnosis of Parkinsondisease is based on history and examination. History can include prodromal features (eg, rapid eye movement sleep behavior disorder, hyposmia, constipation), characteristic (...) movement difficulty (eg, tremor, stiffness, slowness), and psychological or cognitive problems (eg, cognitive decline, depression, anxiety). Examination typically demonstrates bradykinesia with tremor, rigidity, or both. Dopamine transporter single-photon emission computed tomography can improve the accuracy of diagnosis when the presence of parkinsonism is uncertain. Parkinsondisease has multiple disease variants with different prognoses. Individuals with a diffuse malignant subtype (9%-16
, but rarely involves the head, neck, or voice. Is absent in up to 30% of people at disease onset. Balance problems and/or gait disorders. Postural instability is suggested by the 'pull test' — a tendency to fall backwards after a sharp pull from the examiner. This may be suggestive of Parkinson'sdisease if unrelated to primary visual, cerebellar, vestibular, or proprioceptive dysfunction. These clinical features are usually unilateral in early disease, but are progressive and may become bilateral (...) Guidelines Network (SIGN) clinical guideline Diagnosis and pharmacological management of Parkinson'sdisease [ ], and an evidence-based review article European Federation of Neurological Societies (EFNS)/ Movement Disorder Society-European Section (MDS-ES) recommendations for the diagnosis of Parkinson'sdisease [ ], a case-control study on pre-diagnostic presentations of Parkinson'sdisease [ ], and expert opinion in a review article on Parkinson'sdisease [ ]. The NICE clinical guideline recommends
: Affiliations 1 Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Clintrex, Sarasota, FL, USA. Electronic address: firstname.lastname@example.org. 2 Department of Neurology, Emory University, Atlanta, GA, USA. 3 Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA. 4 Department of Neurology, University of South Florida, Tampa, FL, USA. 5 Barrow Neurological Institute, Phoenix, AZ, USA. 6 Parkinson'sDisease and Movement Disorders (...) and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA. 7 University of Kansas Medical Center, University of Kansas, Kansas City, KS, USA. 8 Clintrex, Sarasota, FL, USA. 9 Sunovion, Marlborough, MA, USA. PMID: 31818699 DOI: Item in Clipboard Full-text links Cite Abstract Background: Many patients with Parkinson'sdisease have potentially disabling off episodes that are not predictably responsive to levodopa. In this study, we assessed the safety and efficacy of apomorphine sublingual film
Integrated Analysis of Droxidopa for the Treatment of Neurogenic Orthostatic Hypotension in Patients with ParkinsonDisease. Neurogenic orthostatic hypotension (nOH) is associated with neurodegenerative conditions, may cause symptoms of end-organ hypoperfusion, increases fall risk, and can negatively impact quality of life. Droxidopa is approved for the treatment of symptomatic nOH in adults. As the largest subpopulation of patients with nOH has a diagnosis of Parkinsondisease (PD
Assessment of an Objective Method of Dyskinesia Measurement in Parkinson'sDisease. The goal of this study was to validate an objective method of measuring levodopa induced dyskinesia in Parkinson'sdisease (PD).To characterize agreement between the clinician-based measure and a force plate, we assessed dyskinesia in PD subjects participating in a randomized and blinded clinical trial of an adenosine A2A anatagonist. Convergent validity and intra-class correlations were evaluated between
and Uncertainties Conclusions and Reasons Analysis of Condition ? The condition treated was advanced Parkinson'sdisease which is operationally defined as patients taking levodopa and experiencing OFF episodes. Istradefylline was given to these patients as adjunctive treatment. The pivotal trials were adequate for investigating effects on istradefylline on adult patients with advanced Parkinson'sdisease. Current Treatment Options ? There are many approved treatments as adjunctive therapy for patients (...) Istradefylline (Nourianz) - Parkinson'sdisease CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 022075Orig1s000 CLINICAL REVIEW(S) (b) (4) Clinical Review Natalie Branagan, MD NDA 022075 Nourianz/istradefylline CLINICAL REVIEW Application Type NDA Application Number(s) 022075 Priority or Standard Class 2 Resubmission Submit Date(s) February 27, 2019 Received Date(s) February 27, 2019 PDUFA Goal Date August 27, 2019 Division/Office DNP Reviewer Name(s) Natalie Branagan, MD Review
of group assignments. Both interventions were home based, requiring 30-45 min training three times per week for 6 months. Both groups received a motivational app and remote supervision. Home trainers were enhanced with virtual reality software and real-life videos providing a so-called exergaming experience (ie, exercise enhanced by gamified elements). The primary outcome was the between-group difference in the Movement Disorders Society-Unified Parkinson'sDisease Rating Scale (MDS-UPDRS) motor (...) Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson'sdisease: a double-blind, randomised controlled trial High-intensity aerobic exercise might attenuate the symptoms of Parkinson'sdisease, but high-quality evidence is scarce. Moreover, long-term adherence remains challenging. We aimed to evaluate the effectiveness of aerobic exercise-gamified and delivered at home, to promote adherence-on relieving motor symptoms in patients with Parkinson'sdisease with mild
with Parkinson’sdisease, the cells in the brain that produce dopamine, a neurotransmitter important for controlling movement, begin to die and the amount of dopamine in the brain decreases. Inbrija contains levodopa which converts into dopamine in the brain and helps to restore dopamine levels, thereby improving the symptoms of the condition. Because Inbrija is inhaled, it can supply extra levodopa (and hence dopamine) quickly when needed during an ‘off’ period. What benefits of Inbrija have been shown (...) malignant syndrome or rhabdomyolysis. For the full list of side effects and restrictions, see the package leaflet. Why is Inbrija authorised in the EU? Studies show that Inbrija is effective at reducing symptoms during ‘off’ periods in patients with Parkinson’sdisease on levodopa/dopa-decarboxylase-inhibitor treatment. The safety of the medicine is in line with other similar medicines. Because it is inhaled, Inbrija provides rapid relief of symptoms, which improves patients’ quality of life
and written form. n Discussions should aim to achieve a balance between providing realistic information and promoting optimism. n Families and caregivers should be informed about the condition and available support services. DIAGNOSIS AND PROGRESSION n Parkinsondisease should be suspected in anyone with tremor, stiness, slowness, balance problems or gait disorders. n CT or MRI brain scanning should not be routinely used to diagnose Parkinsondisease. n Patients, especially young, who request genetic (...) to achieve a balance between providing realistic information and promoting optimism. n Families and caregivers should be informed about the condition and available support services. DIAGNOSIS AND PROGRESSION n Parkinsondisease should be suspected in anyone with tremor, stiness, slowness, balance problems or gait disorders. n CT or MRI brain scanning should not be routinely used to diagnose Parkinsondisease. n Patients, especially young, who request genetic testing should be assessed by a movement