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Article ; Online: Telemedicine Aids in Initial Deep Brain Stimulation Programming for Dystonia.

Prakash, Neha / Zadikoff, Cindy

Movement disorders clinical practice

2020 Volume 7, Issue 8, Page(s) 1002–1003

Keywords	covid19
Language	English
Publishing date	2020-09-17
Publishing country	United States
Document type	Journal Article
ISSN	2330-1619
ISSN (online)	2330-1619
DOI	10.1002/mdc3.13078
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Article: Telemedicine Aids in Initial Deep Brain Stimulation Programming for Dystonia

Prakash, Neha / Zadikoff, Cindy

Movement Disorders Clinical Practice

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #726308
Database	COVID19

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Article: Neurology Clerkship: Predictors of Objective Structured Clinical Examination and Shelf Performance.

Sampat, Ajay / Rouleau, Gerald / O'Brien, Celia / Zadikoff, Cindy

Journal of medical education and curricular development

2019 Volume 6, Page(s) 2382120519862782

Abstract: Background: We sought to determine whether the following factors are associated with stronger performance on the medical school neurology clerkship: (1) structure of the outpatient rotation (working with a single general neurologist or multiple ... ...

Abstract	Background: We sought to determine whether the following factors are associated with stronger performance on the medical school neurology clerkship: (1) structure of the outpatient rotation (working with a single general neurologist or multiple subspecialists), (2) dedicated shelf exam preparation, and (3) clerkships completed prior to neurology rotation. Methods: A total of 439 Feinberg medical students between 2014 and 2016 were analyzed based on the 3 variables of interest listed above. Student performance was evaluated using the National Board of Medical Examiner shelf exam and Objective Structured Clinical Examination/standardized evaluation scores. Univariate and multivariate analyses were conducted. Results: The format of the 2-week outpatient rotation did not significantly affect shelf examination ( Conclusions: Greater attending continuity did not appear to be associated with stronger performance perhaps due to a difference in types of cases observed. Students who took a practice shelf exam did better on both their shelf exam and standardized evaluation, suggesting that acquisition of knowledge translates to a better clinical performance. No individual clerkship offers an advantage, but rather it is the total number of clerkships that is correlated with stronger performance.
Language	English
Publishing date	2019-07-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2798123-X
ISSN	2382-1205
ISSN	2382-1205
DOI	10.1177/2382120519862782
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Article: Complementary & alternative management of Parkinson's disease: an evidence-based review of eastern influenced practices.

Bega, Danny / Zadikoff, Cindy

Journal of movement disorders

2014 Volume 7, Issue 2, Page(s) 57–66

Abstract: The prevalence of Parkinson's disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative ... ...

Abstract	The prevalence of Parkinson's disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM) modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.
Language	English
Publishing date	2014-10-30
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	3021788-X
ISSN	2093-4939 ; 2005-940X
ISSN (online)	2093-4939
ISSN	2005-940X
DOI	10.14802/jmd.14009
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Article: Voluntary Saccade Training Protocol in Persons With Parkinson's Disease and Healthy Adults.

Camacho, Paul B / Carbonari, Ronald / Shen, Sa / Zadikoff, Cindy / Kramer, Arthur F / López-Ortiz, Citlali

Frontiers in aging neuroscience

2019 Volume 11, Page(s) 77

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2019-04-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2558898-9
ISSN	1663-4365
ISSN	1663-4365
DOI	10.3389/fnagi.2019.00077
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Article ; Online: Neurology Clerkship

Ajay Sampat / Gerald Rouleau / Celia O’Brien / Cindy Zadikoff

Journal of Medical Education and Curricular Development, Vol

Predictors of Objective Structured Clinical Examination and Shelf Performance

2019 Volume 6

Abstract	Background: We sought to determine whether the following factors are associated with stronger performance on the medical school neurology clerkship: (1) structure of the outpatient rotation (working with a single general neurologist or multiple subspecialists), (2) dedicated shelf exam preparation, and (3) clerkships completed prior to neurology rotation. Methods: A total of 439 Feinberg medical students between 2014 and 2016 were analyzed based on the 3 variables of interest listed above. Student performance was evaluated using the National Board of Medical Examiner shelf exam and Objective Structured Clinical Examination/standardized evaluation scores. Univariate and multivariate analyses were conducted. Results: The format of the 2-week outpatient rotation did not significantly affect shelf examination ( P = .59), or standardized evaluation ( P = .34) scores. Taking a shelf pre-test correlated with overall higher standardized evaluation scores ( P < .01), and higher shelf examination scores ( P < .01). No individual clerkship correlated with better performance; however, the total number of core clerkships was associated with higher shelf examination scores ( P = .007). Each additional core clerkship taken prior to neurology was associated with 0.72 points greater shelf examination score. Conclusions: Greater attending continuity did not appear to be associated with stronger performance perhaps due to a difference in types of cases observed. Students who took a practice shelf exam did better on both their shelf exam and standardized evaluation, suggesting that acquisition of knowledge translates to a better clinical performance. No individual clerkship offers an advantage, but rather it is the total number of clerkships that is correlated with stronger performance.
Keywords	Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Complementary & Alternative Management of Parkinson’s Disease

Danny Bega / Cindy Zadikoff

Journal of Movement Disorders, Vol 7, Iss 2, Pp 57-

An Evidence-Based Review of Eastern Influenced Practices

2014 Volume 66

Abstract: The prevalence of Parkinson’s disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative ... ...

Abstract	The prevalence of Parkinson’s disease (PD) appears to be lower in Asia compared to the Western world. It is unclear if this is related to the ubiquitous use of traditional medicine in Eastern healthcare, but the use of complementary and alternative medicine (CAM) modalities in countries like Korea may be as high as 76%. Among patients with PD, herbal medicines, health supplement foods, and acupuncture are interventions which are increasingly used throughout the world. Countries like Korea, China, India, and Japan have long embraced and incorporated traditional medicine into modern management of conditions such as PD, but research into various CAM modalities remains in its infancy limiting evidence-based recommendations for many treatments. We reviewed the literature on CAM treatments for PD, focusing on mind-body interventions and natural products. Based on evidence limited to randomized-controlled trials we found that mind-body interventions are generally effective forms of physical activity that are likely to foster good adherence and may reduce disability associated with PD. Based on the current data, modalities like Tai Chi and dance are safe and beneficial in PD, but better studies are needed to assess the effects of other frequently used modalities such as yoga and acupuncture. Furthermore, despite centuries of experience using medicinal herbs and plants in Eastern countries, and despite substantial preclinical data on the beneficial effects of nutritional antioxidants as neuroprotective agents in PD, there is insufficient clinical evidence that any vitamin, food additive, or supplement, can improve motor function or delay disease progression in PD.
Keywords	Parkinson’s disease ; Complementary and alternative medicine ; Korean medicine ; Herbal medicine ; Anti-oxidants ; Neutraceuticals ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610
Language	English
Publishing date	2014-10-01T00:00:00Z
Publisher	Korean Movement Disorders Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Effects of Levodopa-Carbidopa Intestinal Gel Compared with Optimized Medical Treatment on Nonmotor Symptoms in Advanced Parkinson's Disease: INSIGHTS Study.

Chung, Sun Ju / Calopa, Matilde / Ceravolo, Maria G / Tambasco, Nicola / Antonini, Angelo / Chaudhuri, K Ray / Robieson, Weining Z / Sánchez-Soliño, Olga / Zadikoff, Cindy / Jin, Man / Barbato, Luigi M

Parkinson's disease

2022 Volume 2022, Page(s) 1216975

Abstract: Background: Nonmotor symptoms (NMS) are common in advanced Parkinson's disease (APD) and reduce health-related quality of life.: Objective: The aim of the study was to evaluate levodopa-carbidopa intestinal gel (LCIG) versus optimized medical ... ...

Abstract	Background: Nonmotor symptoms (NMS) are common in advanced Parkinson's disease (APD) and reduce health-related quality of life. Objective: The aim of the study was to evaluate levodopa-carbidopa intestinal gel (LCIG) versus optimized medical treatment (OMT) on NMS in APD. Methods: INSIGHTS was a phase 3b, open-label, randomized, multicenter study in patients with APD (LCIG or OMT, 26 weeks) (NCT02549092). Primary outcomes assessed were total NMS (NMS scale (NMSS) and PD sleep scale (PDSS-2)). Key secondary outcomes included the Unified PD Rating Scale (UPDRS) Part II, Clinical Global Impression of Change (CGI-C), and PD Questionnaire-8 (PDQ-8). Additional secondary measures of Patient Global Impression of Change (PGIC), King's PD Pain Scale (KPPS), and Parkinson Anxiety Scale (PAS) also were evaluated. Finally, safety was assessed. Results: Out of 89 patients randomized, 87 were included in the analysis (LCIG, n = 43; OMT, n = 44). There were no significant differences in NMSS or PDSS-2 total score changes (baseline to Week 26) between LCIG and OMT; within-group changes were significant for NMSS (LCIG, p < 0.001; OMT, p = 0.005) and PDSS-2 (LCIG, p < 0.001; OMT, p < 0.001). Between-group treatment differences were nominally significant for UPDRS Part II (p = 0.006) and CGI-C (p < 0.001) at Week 26 in favor of LCIG; however, statistical significance could not be claimed in light of primary efficacy outcomes. PGIC (Week 26) and KPPS (Week 12) scores were nominally significantly reduced with LCIG versus OMT (p < 0.001; p < 0.05). There were no significant differences in PDQ-8 or PAS. Adverse events (AEs) were mostly mild to moderate; common serious AEs were pneumoperitoneum (n = 2) and stoma-site infection (n = 2) (LCIG). Conclusions: There were no significant differences between LCIG versus OMT in NMSS or PDSS-2; both LCIG and OMT groups significantly improved from baseline. AEs were consistent with the known safety profile.
Language	English
Publishing date	2022-11-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573854-9
ISSN	2042-0080 ; 2090-8083
ISSN (online)	2042-0080
ISSN	2090-8083
DOI	10.1155/2022/1216975
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Article ; Online: Effects of Levodopa-Carbidopa Intestinal Gel on Dyskinesia and Non-Motor Symptoms Including Sleep: Results from a Meta-Analysis with 24-Month Follow-Up.

Chaudhuri, K Ray / Antonini, Angelo / Pahwa, Rajesh / Odin, Per / Titova, Nataliya / Thakkar, Sandeep / Snedecor, Sonya J / Hegde, Saket / Alobaidi, Ali / Parra, Juan Carlos / Zadikoff, Cindy / Bergmann, Lars / Standaert, David G

Journal of Parkinson's disease

2022 Volume 12, Issue 7, Page(s) 2071–2083

Abstract: Background: In advanced Parkinson's disease (PD), dyskinesias and non-motor symptoms such as sleep dysfunction can significantly impair quality of life, and high-quality management is an unmet need.: Objective: To analyze changes in dyskinesia and ... ...

Abstract	Background: In advanced Parkinson's disease (PD), dyskinesias and non-motor symptoms such as sleep dysfunction can significantly impair quality of life, and high-quality management is an unmet need. Objective: To analyze changes in dyskinesia and non-motor symptoms (including sleep) among studies with levodopa-carbidopa intestinal gel (LCIG) in patients with advanced PD. Methods: A comprehensive literature review identified relevant studies examining LCIG efficacy. Outcomes of interest were dyskinesia (UDysRS, UPDRS IV item 32), overall non-motor symptoms (NMSS), mentation/behavior/mood (UPDRS I), and sleep/daytime sleepiness (PDSS-2, ESS). The pooled mean (95% confidence interval) change from baseline per outcome was estimated for each 3-month interval with sufficient data (i.e., reported by≥3 studies) up to 24 months using a random-effects model. Results: Seventeen open-label studies evaluating 1243 patients with advanced PD were included. All outcomes of interest with sufficient data for meta-analysis showed statistically significant improvement within 6 months of starting LCIG. There were statistically significant improvements in dyskinesia duration as measured by UPDRS IV item 32 at 6 months (-1.10 [-1.69, -0.51] h/day) and 12 months (-1.35 [-2.07, -0.62] h/day). There were statistically and clinically significant improvements in non-motor symptoms as measured by NMSS scores at 3 months (-28.71 [-40.26, -17.15] points). Significant reduction of NMSS burden was maintained through 24 months (-17.61 [-21.52, -13.70] points). UPDRS I scores significantly improved at 3 months (-0.39 [-0.55, -0.22] points). Clinically significant improvements in PDSS-2 and ESS scores were observed at 6 and 12 months in individual studies. Conclusion: Patients with advanced PD receiving LCIG showed significant sustained improvements in the burden of dyskinesia and non-motor symptoms up to 24 months after initiation.
MeSH term(s)	Antiparkinson Agents/adverse effects ; Carbidopa/pharmacology ; Drug Combinations ; Dyskinesias ; Follow-Up Studies ; Gels ; Humans ; Levodopa/adverse effects ; Parkinson Disease/complications ; Parkinson Disease/diagnosis ; Parkinson Disease/drug therapy ; Quality of Life ; Sleep
Chemical Substances	Antiparkinson Agents ; Drug Combinations ; Gels ; Levodopa (46627O600J) ; Carbidopa (MNX7R8C5VO)
Language	English
Publishing date	2022-08-15
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2620609-2
ISSN	1877-718X ; 1877-7171
ISSN (online)	1877-718X
ISSN	1877-7171
DOI	10.3233/JPD-223295
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Article ; Online: Comparative Effectiveness of Device-Aided Therapies on Quality of Life and Off-Time in Advanced Parkinson's Disease: A Systematic Review and Bayesian Network Meta-analysis.

Antonini, Angelo / Pahwa, Rajesh / Odin, Per / Isaacson, Stuart H / Merola, Aristide / Wang, Lin / Kandukuri, Prasanna L / Alobaidi, Ali / Yan, Connie H / Bao, Yanjun / Zadikoff, Cindy / Parra, Juan Carlos / Bergmann, Lars / Chaudhuri, K Ray

CNS drugs

2022 Volume 36, Issue 12, Page(s) 1269–1283

Abstract: Introduction: Research comparing levodopa/carbidopa intestinal gel (LCIG), deep brain stimulation (DBS), and continuous subcutaneous apomorphine infusion (CSAI) for advanced Parkinson's disease (PD) is lacking. This network meta-analysis (NMA) assessed ... ...

Abstract	Introduction: Research comparing levodopa/carbidopa intestinal gel (LCIG), deep brain stimulation (DBS), and continuous subcutaneous apomorphine infusion (CSAI) for advanced Parkinson's disease (PD) is lacking. This network meta-analysis (NMA) assessed the comparative effectiveness of LCIG, DBS, CSAI and best medical therapy (BMT) in reducing off-time and improving quality of life (QoL) in patients with advanced PD. Methods: A systematic literature review was conducted for randomized controlled trials (RCTs), observational and interventional studies from January 2003 to September 2019. Data extracted at baseline and 6 months were off-time, as reported by diary or Unified Parkinson's Disease Rating Scale Part IV item 39, and QoL, as reported by Parkinson's Disease Questionnaire (PDQ-39/PDQ-8). Bayesian NMA was performed to estimate pooled treatment effect sizes and to rank treatments in order of effectiveness. Results: A total of 22 studies fulfilled the inclusion criteria (n = 2063 patients): four RCTs, and 16 single-armed, one 2-armed and one 3-armed prospective studies. Baseline mean age was between 55.5-70.9 years, duration of PD was 9.1-15.3 years, off-time ranged from 5.4 to 8.7 h/day in 9 studies, and PDQ scores ranged from 28.8 to 67.0 in 19 studies. Levodopa/carbidopa intestinal gel and DBS demonstrated significantly greater improvement in off-time and QoL at 6 months compared with CSAI and BMT (p < 0.05). There was no significant difference in the effects of LCIG and DBS, but DBS was ranked first for reduction in off-time, and LCIG was ranked first for improvement in QoL. Conclusions: This NMA found that LCIG and DBS were associated with superior improvement in off-time and PD-related QoL compared with CSAI and BMT at 6 months after treatment initiation. This comparative effectiveness research may assist providers, patients, and caregivers in the selection of the optimal device-aided therapy.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Carbidopa/therapeutic use ; Levodopa/therapeutic use ; Quality of Life ; Network Meta-Analysis ; Parkinson Disease/drug therapy ; Apomorphine/therapeutic use
Chemical Substances	Carbidopa (MNX7R8C5VO) ; Levodopa (46627O600J) ; Apomorphine (N21FAR7B4S)
Language	English
Publishing date	2022-11-21
Publishing country	New Zealand
Document type	Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1203800-3
ISSN	1179-1934 ; 1172-7047
ISSN (online)	1179-1934
ISSN	1172-7047
DOI	10.1007/s40263-022-00963-9
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