Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

Is there a role for <i>Mycobacterium avium</i> subspecies <i>paratuberculosis</i> in Parkinson's disease?

In Parkinson's disease (PD) ZnT proteins play an important role. Zinc is a co-factor of numerous enzymes and stabilizes the tertiary structure of several proteins. Nothing is known about previous infections mediated by Mycobacterium avium subsp. paratuberculosis (MAP). We evaluated if a previous infection with MAP could induce the production of antibodies that cross-reacted with the Znt homologous antigenic peptides associated to Parkinson. The humoral response toward MAP3865c peptides, ZnT3 and ZnT10 was evaluated. The hypothesis of cross-reactivity needs to be confirmed; we have observed the presence of MAP in PD patients by PCR, positivity to MAP3865c peptides, therefore MAP infection but not cross-reaction with human homologous Znt proteins

Structure related transport properties and cellular uptake of hyperbranched polyglycerol sulfates with hydrophobic cores

A set of six hydrophobically derivatized polymers based on polyglycerol sulfates have been investigated to determine the influence of scaffold architecture on the encapsulation properties of hydrophobic guests. Each of three block and statistical copolymers has been synthesized with phenyl, naphthyl, and biphenyl substituents in a one-pot procedure. The copolymers have been functionalized with sulfate groups in order to introduce an electrostatically repulsive surface that can stabilize the aggregated carriers. In addition, sulfates provide a highly active targeting moiety for inflammation and cellular uptake. UV measurements show a supramolecular encapsulation of the investigated guest molecules in the low μM range. The transport studies with pyrene and an indocarbocyanine dye further indicated a core–shell-type architecture which provides a distinct amphiphilicity as required for supramolecular guest complexation. The combination of a host functionality with an active sulfate targeting moiety has been used to investigate the structure related cellular transport properties

Risperidone, neuroleptic malignant syndrome and probable dementia with Lewy bodies

1. 1. Conflicting reports are available regarding the sensitivity of patients with Dementia with Lewy bodies (DLB) to risperidone. 2. 2. The authors studied a rare familial case of probable DLB, who developed a documented episode of neuroleptic malignant syndrome (NMS) following the exposure to risperidone. Previously, the patient had had an episode of NMS on trifluoperazine. 3. 3. The discontinuance of risperidone, in combination with a mild increase of dopaminergic therapy, led to a complete recovery in few days. 4. 4. In patients with DLB, a continued vigilance for extrapyramidal side effects, including NMS, would be advisable during the use of risperidone

Restless legs syndrome and periodic limb movements after ischemic stroke in the right lenticulostriate region

We report the first instance of restless legs syndrome (RLS) associated with periodic limb movements (PLM) and disruption of sleep architecture occurring in a patient following ischemic infarction in the right lenticulostriate region. Recently, a role for the basal ganglia-brainstem system in the control of motor behaviors and in the regulation of awake-sleep states has been proposed. The purported roles of these structures may be relevant in explaining the occurrence of the RLS in our patient. The discrete brain localization observed in this patient may be a clue to a better understanding of the pathophysiology of RLS and PLM. (C) 2007 Elsevier Ltd. All rights reserved

Parkinson’s disease and conversion disorder: case report and literature review

Parkinson’s disease (PD) is one of the most common movement disorders and is characterized by progressive neurodegeneration of the basal ganglia, with tremor, postural instability, rigidity and Akinesia as main clinical features, but also psychiatric symptoms such as depression, anxiety and insomnia are common in PD. Conversion disorder (CD), formerly known as hysteria, is defined as a condition in which patients suffers from neurological symptoms without neurological causes, and is considered a psychiatric disorder according to the DSM-IV. Psychogenic movement disorders (PMD) are characterized by either hyperkinetic or hypokinetic movement disorders, or their combinations not fully explained by organic disease and occurring in association with underlying psychiatric or psychological factors. We present a case of a 60-year old woman with extrapyramidal signs such as tremor, postural instability, and both akinesia and dyskinesia, with acute onset after a psychological traumata. Observed in various movement disorders centers different diagnostic hypotheses were postulated including Huntington’s disease, Parkinson’s disease, distonia, corticobasal degeneration. SPECT DAT-scan evaluation showed reduced dopaminergic innervation in the striatum bilaterally predominantly on the right. No consistent response to dopaminergic replacement therapy was observed. Neuropsychological examination revealed a conversion disorder. We discuss the long diagnositic iter with many clinical evaluations and neuroradiological investigations, their economical burden and the diagnostic difficulties on behalf of literature data

Cerebellar tremor with anti-GAD antibodies

Glutamic acid decarboxylase (GAD) catalyzes the conversion of glutamic acid to gamma-aminobutyric acid (GABA). Autoantibodies directed against GAD (anti-GAD-Ab) have been described in a few patients with progressive cerebellar ataxia, however, the occurrence of a definite cerebellar tremor has not been documented

Comparison of two neural network classifiers in the differential diagnosis of essential tremor and Parkinson’s disease by ¹²³I-FP-CIT brain SPECT

Purpose : To contribute to the differentiation of Parkinson’s disease (PD) and essential tremor (ET), we compared two different artificial neural network classifiers using 123I-FP-CIT SPECT data, a probabilistic neural network (PNN) and a classification tree (ClT). Methods: 123I-FP-CIT brain SPECT with semiquantitative analysis was performed in 216 patients: 89 with ET, 64 with PD with a Hoehn and Yahr (H&amp;Y) score of ≤2 (early PD), and 63 with PD with a H&amp;Y score of ≥2.5 (advanced PD). For each of the 1,000 experiments carried out, 108 patients were randomly selected as the PNN training set, while the remaining 108 validated the trained PNN, and the percentage of the validation data correctly classified in the three groups of patients was computed. The expected performance of an “average performance PNN” was evaluated. In analogy, for ClT 1,000 classification trees with similar structures were generated. Results: For PNN, the probability of correct classification in patients with early PD was 81.9±8.1% (mean±SD), in patients with advanced PD 78.9±8.1%, and in ET patients 96.6±2.6%. For ClT, the first decision rule gave a mean value for the putamen of 5.99, which resulted in a probability of correct classification of 93.5±3.4%. This means that patients with putamen values &gt;5.99 were classified as having ET, while patients with putamen values &lt;5.99 were classified as having PD. Furthermore, if the caudate nucleus value was higher than 6.97 patients were classified as having early PD (probability 69.8±5.3%), and if the value was &lt;6.97 patients were classified as having advanced PD (probability 88.1%±8.8%). Conclusion: These results confirm that PNN achieved valid classification results. Furthermore, ClT provided reliable cut-off values able to differentiate ET and PD of different severities

Visual and auditory event related potentials in Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is classically described as an upper and lower motor neuron disease without clinical sensory disorders. Various studies have been conducted to explore and understand motor impairment but in the last years also cognitive functions have drawn attention in ALS patients investigating extra-motor involvment. Recent neuropsychological studies have been carried out to evaluate specific cognitive dysfunction also supported by MRI, PET and SPECI findings. All papers report subtle cognitive impairment especially related to the frontal lobe functions. Gil et al (1995) performed an auditory ERPs study and they found 60% of patients had P300 delayed latency. To further investigate the relationship between ALS and cognitive function, visual and auditory oddball ERPs were recorded in 10 patients by using 30 electrodes. Attention was focused on latency and amplitude of P300 and on its topographic distribution. Neuropsychological evaluation allowed to test the cognitive status of patients and psychometric tests were selected to assess intelligence, executive functions, attention, memory, word fluency, visuo-motor and visual-constructive skills. Motor disability was scored by ALS Severity Scale including bulbar and spinal score. Depression state was evaluated by using Hamilton Scale. Results of ERPs were compared to 10 healthy age-matched controls. Preliminary data show abnormalities of P300 in about 50% of patients. Correlations between visual and auditory P300 latency and amplitude, psychometric tests, disease duration, physical disability and depression will be discussed

Three sisters with very-late-onset major depression and parkinsonism

Familiar Parkinson's disease has an age of onset from the second to the sixth decade, whereas Wilson's disease (WD) usually presents in the first decade of life. We studied three sisters with a form of very-late-onset major depression and parkinsonism with probable linkage to ATP7B gene. Molecular studies demonstrated a nucleotide deletion at the 5′UTR region in a single allele of ATP7B gene. They did not have a family history of WD, or markers indicative for copper deposition in peripheral tissues. We suggest that single allele mutations of ATP7B gene may confer a susceptibility for late-onset major depression and parkinsonism