The AMC Linear Disability Score in patients with newly diagnosed Parkinson disease

Objective: The aim of this study was to examine the clinimetric properties of the AMC Linear Disability Score (ALDS), a new generic disability measure based on Item Response Theory, in patients with newly diagnosed Parkinson disease (PD).\ud \ud Methods: A sample of 132 patients with PD was evaluated using the Hoehn and Yahr (H&Y), the Unified PD Rating Scale motor examination, the Schwab and England scale (S&E), the Short Form–36, the PD Quality of Life Questionnaire, and the ALDS.\ud \ud Results: The internal consistency reliability of the ALDS was good ([alpha] = 0.95) with 55 items extending the sufficient item-total correlation criterion (r > 0.20). The ALDS was correlated with other disability measures (r = 0.50 to 0.63) and decreasingly associated with measures reflecting impairments (r = 0.36 to 0.37) and mental health (r = 0.23 to -0.01). With regard to know-group validity, the ALDS indicated that patients with more severe PD (H&Y stage 3) were more disabled than patients with mild (H&Y stage 1) or moderate PD (H&Y stage 2) (p < 0.0001). The ALDS discriminated between more or less severe extrapyramidal symptoms (p = 0.001) and patients with postural instability showed lower ALDS scores compared to patients without postural instability (p = < 0.0001). Compared to the S&E (score 100% = 19%), the ALDS showed less of a ceiling effect (5%).\ud \ud Conclusion: The AMC Linear Disability Score is a flexible, feasible, and clinimetrically promising instrument to assess the level of disability in patients with newly diagnosed Parkinson disease

The bilateral origin of movement-related potentials preceding unilateral actions

It is as yet unclear why a unilateral self-paced movement in human and nonhuman primates is preceded by a bilateral Bereitschaftspotential (BP) or readiness potential (RP). The RP consists of an early symmetrical part (termed BP1 or RP), presumably of supplementary motor area (SMA) origin, and a later contralaterally dominant part (termed BP2 or NS'), to which the primary motor cortex (M1) is thought to contribute. Apart from the SMA there are other motor areas in the mesial cortex, which might provide additional sources for these slow waves. Although bilateral intracortical sources of the RP are found in the premotor cortex (Sasaki & Gemba, 1991), they play nearly any role in most discussions on the RP. Recently the very existence of the ipsilateral RP over MI has been doubted. RP recordings of two patients with an intracerebral electrode in the ventro-intermedius nucleus (Vim) of the thalamus are shown, suggesting that the ipsilateral RP is not the consequence of volume conduction or signal transmission via the corpus callosum. Rather they point to a subcortical source, from where the ipsilateral cortex is activated. Anatomical and recent RP recordings from Vim and subthalamic nucleus seem to support this interpretatio

AIDS in the Netherlands, clinical and microbiological data in 36 cases

Contains fulltext : 4450.pdf (publisher's version ) (Open Access

Cognitive profile of patients with newly diagnosed Parkinson disease

Objective: To determine the frequency and pattern of cognitive dysfunction in patients with newly diagnosed Parkinson disease (PD) and to identify its demographic and clinical correlates. Methods: A cohort of 115 consecutive patients with newly diagnosed PD and 70 healthy controls underwent a comprehensive neuropsychological assessment including tests of psychomotor speed, attention, language, memory, executive and visuospatial functions, as well as measures of affective status. Patients also received quantitative ratings of motor symptom severity and functional status. Neuropsychological performance of PD patients was compared with that of healthy controls and with available normative data. Independent demographic and clinical predictors of cognitive impairment were identified with multiple logistic regression analysis. Results: Relative to controls, PD patients performed significantly worse on most cognitive measures. However, further analysis revealed that group differences in cognitive performance could mainly be explained by measures of immediate memory and executive function. Comparison with normative data showed that impairments were most frequent on measures of executive function, memory and psychomotor speed. In all, 24% of PD patients (4% of controls) displayed defective performance on at least three neuropsychological tests and were classified as cognitively impaired. Late onset of disease was an independent predictor of cognitive dysfunction in PD. Conclusion: Cognitive impairments are common even in newly diagnosed Parkinson disease patients, with deficits being most prominent in the domains of memory and executive functions. Older age at disease onset is likely to be an important determinant of cognitive dysfunction in Parkinson diseas