A influência imediata de estímulos auditivos na marcha de idosos com e sem a doença de Parkinson

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Avaliar a influência imediata dos estímulos auditivos na marcha em idosos com e sem a Doença de Parkinson (DP). Metodologia: Amostra composta por 6 idosos com DP (77,67 ± 6,65 anos; 25,58 ± 2,07 kg/m2) e 6 idosos sem DP (80 ± 7,46 anos; 25,66 ± 1,18 kg/m2). Aos 12 participantes foram aplicados a Escala Unificada de Avaliação da DP, Berg Balance Scale, avaliação da cadência, e aplicação do Timed Up and Go Test (TUG), este último com e sem estímulo auditivo, de forma aleatória, verificando o tempo, o comprimento do passo e da passada. Resultados: Os idosos com DP apresentaram uma cadência superior à dos idosos sem DP, de forma significativa. Verificou-se melhoria significativa do tempo na realização do TUG, aumento do passo e da passada, quando se associa o estímulo auditivo à marcha, em idosos com ou sem a DP (0,027<p<0,028). Conclusão: A aplicação imediata de estímulos auditivos na marcha em idosos com e sem a DP tem um impacto positivo, melhorando o tempo e o comprimento do passo e da passada na marcha.Objective: To evaluate the immediate auditory cues on gait training in elderly people with and without Parkinson’s Disease (PD). Methodology: The study was composed by a sample of 6 elderly people with PD (77,67 ± 6,65 years; 25,58 ± 2,07 kg/m2) and 6 without PD (80 ± 7,46 years; 25,66 ± 1,18 kg/m2). The study consisted of applying the following tests in the 12 participants: United PD Rating Scale, Berg Balance Scale, cadence evaluation, and Timed Up and Go Test (TUG), this last test with or without auditory cues, analyzing the time, step length and stride during the gait. Results: Elderly people with PD have a higher cadence to the elderly without PD significantly. We can verify a significant increase of time in TUG and an increase of length in step and stride, when combining auditory cues to march in the elderly participants with or without PD (0,027<p<0,028). Conclusion: The immediate application of auditory cues in gait in elderly with or without PD has a positive effect, by increasing the cadence, the length of step and of stride

Glucocerebrosidase Mrna Is Diminished In Brain Of Lewy Body Diseases And Changes With Disease Progression In Blood

Parkinson disease (PD) and dementia with Lewy bodies (DLB) are Lewy body diseases characterized by abnormal alpha-synuclein deposits and overlapping pathological features in the brain. Several studies have shown that glucocerebrosidase (GBA) deficiency is involved in the development of LB diseases. Here, we aimed to find out if this deficiency starts at the transcriptional level, also involves alternative splicing, and if GBA expression changes in brain are also detectable in blood of patients with LB diseases. The expression of three GBA transcript variants (GBAtv1, GBAtv2 and GBAtv5) was analyzed in samples from 20 DLB, 25 PD and 17 control brains and in blood of 20 DLB, 26 PD patients and 17 unaffected individuals. Relative mRNA expression was determined by real-time PCR. Expression changes were evaluated by the Delta Delta Ct method. In brain, specific expression profiles were identified in the temporal cortex of DLB and in the caudate nucleus of PD. In blood, significant GBA mRNA diminution was found in both DLB and PD patients. Early PD and early-onset DLB patients showed lowest GBA levels which were normal in PD patients with advanced disease and DLB patients who developed disease after 70 years of age. In conclusion, disease group specific GBA expression profiles were found in mostly affected areas of LBD. In blood, GBA expression was diminished in LB diseases, especially in patients with early onset DLB and in patients with early PD. Age of disease onset exerts an opposite effect on GBA expression in DLB and PD

A influência imediata de estímulos auditivos na marcha de idosos com e sem a doença de Parkinson

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Avaliar a influência imediata dos estímulos auditivos na marcha em idosos com e sem a Doença de Parkinson (DP). Metodologia: Amostra composta por 6 idosos com DP (77,67 ± 6,65 anos; 25,58 ± 2,07 kg/m2) e 6 idosos sem DP (80 ± 7,46 anos; 25,66 ± 1,18 kg/m2). Aos 12 participantes foram aplicados a Escala Unificada de Avaliação da DP, Berg Balance Scale, avaliação da cadência, e aplicação do Timed Up and Go Test (TUG), este último com e sem estímulo auditivo, de forma aleatória, verificando o tempo, o comprimento do passo e da passada. Resultados: Os idosos com DP apresentaram uma cadência superior à dos idosos sem DP, de forma significativa. Verificou-se melhoria significativa do tempo na realização do TUG, aumento do passo e da passada, quando se associa o estímulo auditivo à marcha, em idosos com ou sem a DP (0,027<p<0,028). Conclusão: A aplicação imediata de estímulos auditivos na marcha em idosos com e sem a DP tem um impacto positivo, melhorando o tempo e o comprimento do passo e da passada na marcha. Objective: To evaluate the immediate auditory cues on gait training in elderly people with and without Parkinson’s Disease (PD). Methodology: The study was composed by a sample of 6 elderly people with PD (77,67 ± 6,65 years; 25,58 ± 2,07 kg/m2) and 6 without PD (80 ± 7,46 years; 25,66 ± 1,18 kg/m2). The study consisted of applying the following tests in the 12 participants: United PD Rating Scale, Berg Balance Scale, cadence evaluation, and Timed Up and Go Test (TUG), this last test with or without auditory cues, analyzing the time, step length and stride during the gait. Results: Elderly people with PD have a higher cadence to the elderly without PD significantly. We can verify a significant increase of time in TUG and an increase of length in step and stride, when combining auditory cues to march in the elderly participants with or without PD (0,027<p<0,028). Conclusion: The immediate application of auditory cues in gait in elderly with or without PD has a positive effect, by increasing the cadence, the length of step and of stride

Parkinson hastalığındaki psikotik süreçlerde florodeoksiglukoz pozitron emisyon tomografi bulguları

Parkinson hastalığı (PH) sık görülen nörodejeneratif hastalıklardan biridir. Primer bulguları olan motor bulguların ön planda olması dışında non-motor (otonomik, davranışsal, bilişsel ve duysal) bulgular da birey hayatında etkilidir. Bu çalışmada, psikotik belirtileri olan ve olmayan PH olgularında metabolik olarak etkilenen beyin bölgelerini tespit etmek ve bunların klinik ve demografik özellikler ile ilişkilerini saptamak amaçlandı. Başkent Üniversitesi Dr. Turgut Noyan Adana Uygulama ve Araştırma Merkezi Nöroloji kliniğine Ocak 2014- Mayıs 2016 tarihleri arasında başvuran PH tanısı almış olgulardan psikoz bulguları olan 13, psikozu olmayan 15 olgu alındı. Nörolojik muayene, Standardize Mini Mental Test (SMMT), Montreal Bilişsel Değerlendirme Ölçeği (MOBİD), Birleşik Parkinson Hastalığı Değerlendirme Ölçeği (BPHDÖ) ve Hoehn&Yahr bulguları kaydedildi. Psikotik belirtiler psikiyatri uzmanı tarafından varsanı, sanrı, davranış bozukluğu, düşünce ve duygudurum bozukluğu şekilde sınıflandırıldı. F18-FDG PET/BT bulguları psikozu olan ve olmayan hastalarda, psikozu olanlarda ise belirti durumuna göre karşılaştırıldı. Sonuçlar değerlendirildiğinde demografik verilerde psikoz grubu ile kontrol grubu arasında anlamlı fark saptanmadı. Görme varsanısı varlığı ile hastalık süresi arasında pozitif ilişki bulundu. MOBİD toplam puan ve alt gruplarında lisan, dikkat ve yönelim puanları, BPHDÖ toplam ve alt gruplarından mental durum, günlük aktivite, motor bölümleri, anksiyete ve depresyon ölçekleri artan puanları ile psikoz varlığı ilişkili bulundu. Parkinson hastalığı tanısı daha uzun süredir olan hastalarda nörodejenerasyonun artması tüm bu motor ve non-motor belirti ve bulguların artmış olarak ortaya çıkmasının sebebi olarak değerlendirilebilir. Psikoz belirtileri olan ve olmayan hastaların PET/BT bulgularının karşılaştırmasında tespit edilen fark anlamlı düzeye ulaşmadı. Bu bulguların görsel değerlendirmeden ziyade sayısal değerlendirme ile işlenmesi halinde anlamlılık düzeyine ulaşacağı düşünülmektedir. Parkinson’s disease (PD) is one of the frequently seen neurodegenerative diseases. Besides its motor symptoms which are the primary findings and more apparent, also non-motor symptoms (autonomic, behavioral, cognitive and sensory) are effective on the individual’s life. In the present study, locating the metabolically affected brain regions in PD patients with and without psychotic symptoms, and determining the relation of these with the clinical and demographic characteristics. From the patients who presented to the Neurology Clinic of Başkent University, Dr. Turgut Noyan Adana Research and Application Center between January 2014 and May 2016 and were diagnosed with PD, 13 patients with psychotic symptoms and 15 patients without psychosis were included. Neurological examination, Standardized Mini Mental Test (SMMT), Montreal Cognitive Assessment Scale (MOCA), Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn&Yahr results were recorded. Psychotic symptoms were classified by a psychiatrist as hallucination, delusion, behavioral disorder, and thought and mood disorders. The F18-FDG PET/CT findings were compared between the patients with and without psychosis and by symptoms within those with psychosis. An assessment of the results showed no significant difference between the psychotic group and the control group with respect to demographic data. A positive correlation was found between visual hallucination and duration of disease. Positive correlation between presence of psychosis and the MOCA overall score and its language, attention and orientation subgroup scores, the UPDRS overall score and its increasing mental status, daily activities, motor sections subgroup scores, anxiety and depression scores were found. Increased neurodegeneration in patients who had a diagnosis of PD for a longer time might be estimated as a cause of worsening of all these motor and non-motor symptoms. The difference found in the comparison of the PET/CT findings of the patients with and without psychotic symptoms did not reach the level of significance. We think that the level of significance can be reached if these findings are processed numerical rather than visual

The relationship between executive function, postural instability and gait disturbance in Parkinson's disease

The thesis investigated the relationships between executive function, balance and gait using assessments of cognitive and executive function, a wide range of clinical and biomedical measures of balance and gait, and different dual task paradigms in people with Parkinson's disease (PD) and healthy controls. Furthermore, functional association between executive function and brain activation in the prefrontal cortex was explored using functional near-infrared spectroscopy. The study has revealed greater postural instability and profound changes of gait parameters under dual-tasking for people with PD. Improving executive function may be an effective intervention to improve balance and gait in people with PD