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991.
Christopher G. Goetz MD Glenn T. Stebbins PhD Kathryn A. Chung MD Robert A. Hauser MD MBA Janis M. Miyasaki MD Anthony P. Nicholas MD PhD Werner Poewe MD Klaus Seppi MD Olivier Rascol MD PhD Mark A. Stacy MD John G. Nutt MD Caroline M. Tanner MD PhD Alison Urkowitz MPA Jean A. Jaglin RN Song Ge MS 《Movement disorders》2013,28(3):341-346
Numerous scales assess dyskinesia in Parkinson's disease (PD), variably focusing on anatomical distribution, phenomenology, time, severity, and disability. No study has compared these scales and their relative ability to detect change related to an established treatment. We conducted a randomized placebo‐controlled trial of amantadine, assessing dyskinesia at baseline and at 4 and 8 weeks using the following scales: Unified Dyskinesia Rating Scale (UDysRS), Lang‐Fahn Activities of Daily Living Dyskinesia Rating Scale (LF), 26‐Item Parkinson's Disease Dyskinesia scale (PDD‐26), patient diaries, modified Abnormal Involuntary Movements Scale (AIMS), Rush Dyskinesia Rating Scale (RDRS), dyskinesia items from the Movement Disorder Society–sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS), and Clinical Global Impression (severity and change: CGI‐S, CGI‐C). Scale order was randomized at each visit, but raters were aware of each scale as it was administered. Sensitivity to treatment was assessed using effect size. Sixty‐one randomized dyskinetic PD subjects (31 amantadine, 30 placebo) completed the study. Four of the 8 scales (CGI‐C, LF, PDD‐26, and UDysRS) detected a significant treatment. The UDysRS Total Score showed the highest effect size (η2 = 0.138) for detecting treatment‐related change, with all other scales having effect sizes < 0.1. No scale was resistant to placebo effects. This study resolves 2 major issues useful for future testing of new antidyskinesia treatments: among tested scales, the UDysRS, having both subjective and objective dyskinesia ratings, is superior for detecting treatment effects; and the magnitude of the UDysRS effect size from amantadine sets a clear standard for comparison for new agents. © 2012 Movement Disorder Society 相似文献
992.
David R. Lynch MD PhD Massimo Pandolfo MD Jorg B. Schulz MD Susan Perlman MD Martin B. Delatycki MD PhD R. Mark Payne MD Robert Shaddy MD Kenneth H. Fischbeck MD Jennifer Farmer MS Paul Kantor MD Subha V. Raman MD Lisa Hunegs MSW MPH Joanne Odenkirchen MPH Kristy Miller MPH Petra Kaufmann MD MSC 《Movement disorders》2013,28(2):190-195
To reduce study start‐up time, increase data sharing, and assist investigators conducting clinical studies, the National Institute of Neurological Disorders and Stroke embarked on an initiative to create common data elements for neuroscience clinical research. The Common Data Element Team developed general common data elements, which are commonly collected in clinical studies regardless of therapeutic area, such as demographics. In the present project, we applied such approaches to data collection in Friedreich's ataxia (FRDA), a neurological disorder that involves multiple organ systems. To develop FRDA common data elements, FRDA experts formed a working group and subgroups to define elements in the following: ataxia and performance measures; biomarkers; cardiac and other clinical outcomes; and demographics, laboratory tests, and medical history. The basic development process included identification of international experts in FRDA clinical research, meeting by teleconference to develop a draft of standardized common data elements recommendations, vetting of recommendations across the subgroups, and dissemination of recommendations to the research community for public comment. The full recommendations were published online in September 2011 at http://www.commondataelements.ninds.nih.gov/FA.aspx . The subgroups′ recommendations are classified as core, supplemental, or exploratory. Template case report forms were created for many of the core tests. The present set of data elements should ideally lead to decreased initiation time for clinical research studies and greater ability to compare and analyze data across studies. Their incorporation into new, ongoing studies will be assessed in an ongoing fashion to define their utility in FRDA. © 2012 Movement Disorder Society 相似文献
993.
Manuela Rosa MS Manuela Fumagalli PsyD Gaia Giannicola MS Sara Marceglia MS PhD Claudio Lucchiari PsyD PhD Domenico Servello MD Angelo Franzini MD Claudio Pacchetti MD Luigi Romito MD PhD Alberto Albanese MD Mauro Porta MD Gabriella Pravettoni PsyD PhD Alberto Priori MD PhD 《Movement disorders》2013,28(12):1644-1652
Pathological gambling develops in up to 8% of patients with Parkinson's disease. Although the pathophysiology of gambling remains unclear, several findings argue for a dysfunction in the basal ganglia circuits. To clarify the role of the subthalamic nucleus in pathological gambling, we studied its activity during economics decisions. We analyzed local field potentials recorded from deep brain stimulation electrodes in the subthalamic nucleus while parkinsonian patients with (n = 8) and without (n = 9) pathological gambling engaged in an economics decision‐making task comprising conflictual trials (involving possible risk‐taking) and non conflictual trials. In all parkinsonian patients, subthalamic low frequencies (2–12 Hz) increased during economics decisions. Whereas, in patients without gambling, low‐frequency oscillations exhibited a similar pattern during conflictual and non conflictual stimuli, in those with gambling, low‐frequency activity increased significantly more during conflictual than during non conflictual stimuli. The specific low‐frequency oscillatory pattern recorded in patients with Parkinson's disease who gamble could reflect a subthalamic dysfunction that makes their decisional threshold highly sensitive to risky options. When parkinsonian patients process stimuli related to an economics task, low‐frequency subthalamic activity increases. This task‐related change suggests that the cognitive‐affective system that drives economics decisional processes includes the subthalamic nucleus. The specific subthalamic neuronal activity during conflictual decisions in patients with pathological gambling supports the idea that the subthalamic nucleus is involved in behavioral strategies and in the pathophysiology of gambling. © 2013 International Parkinson and Movement Disorder Society 相似文献
994.
MPTP‐induced dopamine neuron degeneration and glia activation is potentiated in MDMA‐pretreated mice
Giulia Costa MS Lucia Frau PhD Jadwiga Wardas PhD Annalisa Pinna PhD Antonio Plumitallo MS Micaela Morelli PhD 《Movement disorders》2013,28(14):1957-1965
Clinical observations report a greater propensity to develop Parkinson's disease (PD) in amphetamine users. 3,4‐Methylenedioxymethamphetamine (MDMA; “ecstasy”) is an amphetamine‐related drug that is largely consumed by adolescents and young adults, which may have neuroinflammatory and neurotoxic effects. Here, the objective was to evaluate in mice whether consumption of MDMA during adolescence might influence the neuroinflammatory and neurotoxic effects of 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP), a toxin known to induce PD in humans. The activation of astroglia and microglia by glial fibrillary acidic protein (GFAP) and complement receptor type 3 (CD11b) immunohistochemistry and the degeneration of dopaminergic neurons by tyrosine hydroxylase (TH) immunohistochemistry were evaluated. MPTP (20 mg/kg × 4) was administered to mice treated from ages 8 weeks to 17 weeks with MDMA (10 mg/kg twice daily, two times a week). In mice that were chronically treated with MDMA, administration of MPTP induced a higher microglial and astroglial response in both the striatum and the substantia nigra pars compacta (SNc) compared with vehicle‐treated or vehicle + MPTP‐treated mice. Inflammatory changes were associated with a decrease in TH immunoreactivity in the SNc of MDMA‐treated mice and with a further decrease in the striatum and the SNc of MDMA + MPTP‐treated mice compared with vehicle‐treated, MDMA‐treated, and MPTP‐treated mice. The results demonstrate that chronic administration of MDMA during late adolescence in mice exacerbates the neurodegeneration and neuroinflammation caused by MPTP, suggesting that MDMA may constitute a risk factor for dopaminergic neuron degeneration. © 2013 International Parkinson and Movement Disorder Society 相似文献
995.
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998.
Jacklyn Cho BS Brittany Toffey MD Ariel F. Silva NP Ariel Shalev MD Monika M. Safford MD Erica Phillips MD MS Ann Lee BS Faith Wiggins BS MS Elissa Kozlov PhD Emma K. Tsui PhD MPH Nicola Dell PhD Ariel C. Avgar PhD Susan J. Andreae PhD MPH Madeline R. Sterling MD MPH MS 《Health services research》2023,58(3):697-704
999.
Aileen Chou PT DPT Joshua K. Johnson DPT PhD Daniel B. Jones PhD Tracey Euloth MPT Beth A. Matcho PT Andrew Bilderback MS Janet K. Freburger PT PhD 《Health services research》2023,58(Z1):51-62
Objective
To assess the effectiveness of a hospital physical therapy (PT) referral triggered by scores on a mobility assessment embedded in the electronic health record (EHR) and completed by nursing staff on hospital admission.Data Sources
EHR and billing data from 12 acute care hospitals in a western Pennsylvania health system (January 2017–February 2018) and 11 acute care hospitals in a northeastern Ohio health system (August 2019–July 2021).Study Design
We utilized a regression discontinuity design to compare patients admitted to PA hospitals with stroke who reached the mobility score threshold for an EHR-PT referral (treatment) to those who did not (control). Outcomes were hospital length of stay (LOS) and 30-day readmission or mortality. Control variables included demographics, insurance, income, and comorbidities. Hospital systems with EHR-PT referrals were also compared to those without (OH hospitals as alternative control). Subgroup analyses based on age were also conducted.Data Extraction
We identified adult patients with a primary or secondary diagnosis of stroke and mobility assessments completed by nursing (n = 4859 in PA hospitals, n = 1749 in OH hospitals) who completed their inpatient stay.Principal Findings
In the PA hospitals, patients with EHR-PT referrals had an 11.4 percentage-point decrease in their 30-day readmission or mortality rates (95% CI −0.57, −0.01) relative to the control. This effect was not observed in the OH hospitals for 30-day readmission (β = 0.01; 95% CI −0.25, 0.26). Adults over 60 years old with EHR-PT referrals in PA had a 26.2 percentage-point (95% CI −0.88, −0.19) decreased risk of readmission or mortality compared to those without. Unclear relationships exist between EHR-PT referrals and hospital LOS in PA.Conclusions
Health systems should consider methodologies to facilitate early acute care hospital PT referrals informed by mobility assessments. 相似文献1000.
Xiaoxia Zhou MD Zhenhua Liu MD PhD Xiaoting Zhou MD Yaqin Xiang MD Zhou Zhou MD Yuwen Zhao MD Hongxu Pan MD Qian Xu MD PhD Yase Chen MD PhD Qiying Sun MD PhD Xinyin Wu PhD Hongzhuan Tan PhD Bin Li PhD Kai Yuan PhD Yali Xie MD Weihua Liao MD PhD Shuo Hu PhD Jianping Zhu BS Xuehong Wu PhD Jianhua Li MS Chunyu Wang MD PhD Lifang Lei MD PhD Jiayu Tang MD Yonghong Liu MD Heng Wu MD Wei Huang MD Tao Wang MD Zheng Xue MD Puqing Wang MD Zhentao Zhang MD PhD Ping Xu MD Ling Chen MD Qing Wang MD PhD Xuejing Wang MD PhD Oumei Cheng MD Yuefei Shen MD Weiguo Liu MD Min Ye MD Yong You MD PhD Jinchen Li PhD Xinxiang Yan MD Jifeng Guo MD PhD Beisha Tang MD for Parkinson's Disease & Movement Disorders Multicenter Database Collaborative Network in China 《Movement disorders》2022,37(7):1335-1345