Botulinum Toxin--how A Poison Turned To A Fascinating Ally Against An Old Adversary.

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Botulinum toxin — how a poison turned to a fascinating ally against an old adversary

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Toxina botulínica ? de como um veneno transformou-se num fascinante aliado contra um velho adversário

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Depression in patients with Parkinson's disease: Impact on functioning

Depression is a frequently observed neuropsychiatric phenomenon in Parkinson's disease (PD) and it has been lately considered as a manifestation of such disease. The aim of the study was to investigate the relationship between depression and clinical aspects of PD and to assess the impact of the co-occurrence of such condition on the burden imposed by PD. Fifty Outpatients diagnosed with idiopathic PD according to the London Brain Bank criteria were examined. PD was evaluated using Hoehn & Yahr staging (H&Y), United Parkinson's Disease Rating Scale (UPDRS) and Schwab & England (S&E) functional capacity evaluation. A semi-structured clinical interview was used. The diagnosis of PD was made by neurologist experts on movement disorders, and the diagnosis of depression was trade by a psychiatrist, according to the ICD-10 diagnostic criteria. Depressive symptoms were additionally measured using the Montgomery-Asberg Depression Scale. The analysis of quantitative data was performed using descriptive statistics, Univariate linear regression, T-Student Test and ANOVA. Seventeen (34%) patients were diagnosed as clinically depressed and, when compared to the non-depressed ones, presented the following results: H&Y: 3.2 vs. 2.8; UPDRS total: 75.7 vs. 65.3; S&E: 53.5% vs. 65.8% and PD duration: 114.4 months vs. 125.8 months. Depressed patients showed more advanced staging (H&Y), a more severe global clinical condition (UPDRS) and also a greater decrease in their functional capacity (S&E). These data reinforce the hypothesis that depression is associated to poorer functioning in patients with PD. (C) 2008 Elsevier B.V All rights reserved

Psychopathological features in patients with Parkinson's disease and related caregivers' burden

Background Along with classical motor disorders in Parkinson's disease (PD), psychopathological features frequently co-occur, which may increase the caregiver's burden.Aims To identify the profile of psychopathological symptoms inpatients with PD and the impact imposed by this condition on the caregiver's burden.Subjects Fifty patients with idiopathic PD seen consecutively at the Movement Disorder Outpatient Clinic at the Hospital of State University of Campinas, Brazil, and their 50 respective caregivers were studied.Methods The 50 patients with PD were divided into three groups according to the respective psychiatric diagnosis received (depression: N = 17, dementia: N = 13 and non-depressed and non-demented: N = 20). We divided the caregivers into three groups according to the mental condition of their patients. To assess the mental condition of patients and the caregiver's burden, and to correlate those psychopathological features found with clinical features of PD, we applied the Neuropsychiatric Inventory (NPI).Results Patients with dementia presented the highest NPI scores of psychopathological symptoms (26.4), followed by patients with depression (24.9). Non-depressed and non-demented patients revealed fewer symptoms (7.2). Caregivers, burden was found to be proportional to the degree of patients' symptomatology.Conclusion Patients with dementia presented more severe motor impairment and lower functionality, followed by patients with depression and those non-demented, non-depressed. Psychotic symptoms, agitation, aberrant motor behaviours and sleep disturbances were higher in dementia group. Neuropsychiatric disturbances correlated with caregiver's burden, which was highest in patients with dementia. Copyright (C) 2009 John Wiley & Sons, Ltd.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Gait Analysis Comparing Parkinson's Disease With Healthy Elderly Subjects.

There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD) patients with healthy elder (HE) subjects, and when there is such research, it is not correlated to clinical measures. To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL), and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.6881-