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  1. Article: Mayo Clinic office visit. Essential tremor. An interview with J. Eric Ahlskog, M.D., Ph.D.

    Ahlskog, J Eric

    Mayo Clinic women's healthsource

    2010  Volume 14, Issue 9, Page(s) 6

    MeSH term(s) Essential Tremor/diagnosis ; Essential Tremor/therapy ; Health Knowledge, Attitudes, Practice ; Humans ; Risk Assessment ; United States ; Women's Health
    Language English
    Publishing date 2010-09
    Publishing country United States
    Document type Interview
    ZDB-ID 2192476-4
    ISSN 1091-0220
    ISSN 1091-0220
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  2. Article ; Online: Parkinson's disease progression is multifaceted: Evidence for the underlying benchmarks.

    Ahlskog, J Eric

    Parkinsonism & related disorders

    2024  Volume 121, Page(s) 106037

    Abstract: Long-term Parkinson's disease (PD) progression is not a homogeneous process and manifests in diverse ways over the lifetime. Recognition of progression benchmarks and their substrates is important for treatment and addressing the expectations of patients, ...

    Abstract Long-term Parkinson's disease (PD) progression is not a homogeneous process and manifests in diverse ways over the lifetime. Recognition of progression benchmarks and their substrates is important for treatment and addressing the expectations of patients, as well as for PD research planning.
    MeSH term(s) Humans ; Parkinson Disease ; Benchmarking ; Disease Progression ; Recognition, Psychology
    Language English
    Publishing date 2024-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2024.106037
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  3. Article ; Online: Levodopa, homocysteine and Parkinson's disease: What's the problem?

    Ahlskog, J Eric

    Parkinsonism & related disorders

    2023  Volume 109, Page(s) 105357

    Abstract: Elevated circulating homocysteine levels have been associated with cognitive impairment and cardio-cerebro-vascular events. Levodopa treatment of Parkinson's disease tends to further elevate circulating homocysteine levels due to the metabolism of ... ...

    Abstract Elevated circulating homocysteine levels have been associated with cognitive impairment and cardio-cerebro-vascular events. Levodopa treatment of Parkinson's disease tends to further elevate circulating homocysteine levels due to the metabolism of levodopa via catechol-O-methyltransferase (COMT). COMT co-factors are vitamins B12, B6 and folic acid. Accumulating deficiencies of these vitamins are presumed to be the substrate for the homocysteine elevation. B-vitamin therapy reduces homocysteine levels. This begs the question of whether Parkinson's disease patients on levodopa should be concurrently treated with ongoing B-vitamin therapy (versus long-term monitoring of B-vitamins/homocysteine). There is a substantial literature on this topic that has accumulated over the last quarter-century, and this topic is still debated. This review summarizes the relevant literature with the aim of approximating closure on this issue. Also, noteworthy is that Parkinson's disease patients with renal insufficiency may not tolerate cyanocobalamin, the standard oral B12 supplement due to facilitation of renal decline; alternatives are discussed.
    MeSH term(s) Humans ; Levodopa/adverse effects ; Parkinson Disease/drug therapy ; Catechol O-Methyltransferase ; Homocysteine ; Vitamin B Complex ; Vitamin B 12 ; Antiparkinson Agents/adverse effects
    Chemical Substances Levodopa (46627O600J) ; Catechol O-Methyltransferase (EC 2.1.1.6) ; Homocysteine (0LVT1QZ0BA) ; Vitamin B Complex (12001-76-2) ; Vitamin B 12 (P6YC3EG204) ; Antiparkinson Agents
    Language English
    Publishing date 2023-03-06
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1311489-x
    ISSN 1873-5126 ; 1353-8020
    ISSN (online) 1873-5126
    ISSN 1353-8020
    DOI 10.1016/j.parkreldis.2023.105357
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  4. Article ; Online: Considerations for trials of disease modifying treatments in Parkinson disease.

    Ahlskog, J Eric

    Neurology

    2020  Volume 94, Issue 11, Page(s) 467–468

    MeSH term(s) Biomarkers ; Disease Progression ; Humans ; Parkinson Disease
    Chemical Substances Biomarkers
    Language English
    Publishing date 2020-02-26
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000009127
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  5. Article ; Online: Common Myths and Misconceptions That Sidetrack Parkinson Disease Treatment, to the Detriment of Patients.

    Ahlskog, J Eric

    Mayo Clinic proceedings

    2020  Volume 95, Issue 10, Page(s) 2225–2234

    Abstract: Parkinson disease symptoms become apparent when there has been substantial loss of brain dopamine. That is the consequence of the slow progression of the Lewy body neurodegenerative process. Replenishment of brain dopamine with levodopa therapy dates ... ...

    Abstract Parkinson disease symptoms become apparent when there has been substantial loss of brain dopamine. That is the consequence of the slow progression of the Lewy body neurodegenerative process. Replenishment of brain dopamine with levodopa therapy dates back approximately a half century and continues to be the most efficacious symptomatic treatment. Understanding the fundamentals of levodopa treatment is crucial to therapeutic success. Various myths over the years have sabotaged treatment outcomes and have discouraged primary care physicians from managing patients with Parkinson disease. That is unfortunate because in some regions, neurologists, and in particular movement specialists, are in short supply. The long history of these persistent levodopa myths and the counterarguments are the focus of this article.
    MeSH term(s) Humans ; Levodopa/therapeutic use ; Parkinson Disease/drug therapy ; Therapeutic Misconception
    Chemical Substances Levodopa (46627O600J)
    Language English
    Publishing date 2020-10-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2020.02.006
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  6. Article ; Online: Aerobic Exercise: Evidence for a Direct Brain Effect to Slow Parkinson Disease Progression.

    Ahlskog, J Eric

    Mayo Clinic proceedings

    2018  Volume 93, Issue 3, Page(s) 360–372

    Abstract: No medications are proven to slow the progression of Parkinson disease (PD). Of special concern with longer-standing PD is cognitive decline, as well as motor symptoms unresponsive to dopamine replacement therapy. Not fully recognized is the substantial ... ...

    Abstract No medications are proven to slow the progression of Parkinson disease (PD). Of special concern with longer-standing PD is cognitive decline, as well as motor symptoms unresponsive to dopamine replacement therapy. Not fully recognized is the substantial accumulating evidence that long-term aerobic exercise may attenuate PD progression. Randomized controlled trial proof will not be forthcoming due to many complicating methodological factors. However, extensive and diverse avenues of scientific investigation converge to argue that aerobic exercise and cardiovascular fitness directly influence cerebral mechanisms mediating PD progression. To objectively assess the evidence for a PD exercise benefit, a comprehensive PubMed literature search was conducted, with an unbiased focus on exercise influences on parkinsonism, cognition, brain structure, and brain function. This aggregate literature provides a compelling argument for regular aerobic-type exercise and cardiovascular fitness attenuating PD progression.
    MeSH term(s) Animals ; Brain/physiopathology ; Cognition/physiology ; Disease Progression ; Exercise/physiology ; Exercise Therapy/methods ; Humans ; Parkinson Disease/physiopathology ; Parkinson Disease/therapy
    Language English
    Publishing date 2018-03-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2017.12.015
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  7. Article ; Online: My Treatment Approach to Multiple System Atrophy.

    Coon, Elizabeth A / Ahlskog, J Eric

    Mayo Clinic proceedings

    2021  Volume 96, Issue 3, Page(s) 708–719

    Abstract: Multiple system atrophy (MSA) is a neurodegenerative disorder primarily characterized by autonomic failure plus parkinsonism or cerebellar ataxia. The diagnosis may be challenging and is usually made at a tertiary care center. The long-term management ... ...

    Abstract Multiple system atrophy (MSA) is a neurodegenerative disorder primarily characterized by autonomic failure plus parkinsonism or cerebellar ataxia. The diagnosis may be challenging and is usually made at a tertiary care center. The long-term management issues are equally challenging and frequently require collaboration with the patient's local care providers. Whereas there is currently no cure for MSA, treatment focuses on the most problematic symptoms experienced by the patient. Autonomic symptoms may include severe orthostatic hypotension with syncope, urinary symptoms culminating in incontinence, constipation, anhidrosis, and erectile dysfunction. Motor symptoms include parkinsonism, cerebellar ataxia, and falls. Although certain motor symptoms may respond partially to medications, some of these medications may exacerbate autonomic problems. In this manuscript, we seek to bridge the gap between tertiary care providers and the patient's local care providers to provide multidisciplinary care to the MSA patient. Patients are often best served by management of their chronic and evolving complex problems with a team approach involving their primary care providers and subspecialists. Treatment guidelines typically list myriad therapeutic options without clarifying the most efficacious and simplest treatment strategies. Herein, we provide a guideline based on what has worked in our MSA clinic, a clinic designed to provide care throughout the disease course with subspecialty integration with the goal of empowering a partnership with the patient's home primary care providers.
    MeSH term(s) Autonomic Nervous System/physiopathology ; Disease Progression ; Humans ; Interdisciplinary Research ; Multiple System Atrophy/diagnosis ; Multiple System Atrophy/drug therapy ; Practice Guidelines as Topic ; Severity of Illness Index ; Vasodilator Agents/therapeutic use
    Chemical Substances Vasodilator Agents
    Language English
    Publishing date 2021-03-05
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2020.10.005
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  8. Article ; Online: New and Appropriate Goals for Parkinson Disease Physical Therapy.

    Ahlskog, J Eric

    JAMA neurology

    2016  Volume 73, Issue 3, Page(s) 269–270

    MeSH term(s) Goals ; Humans ; Parkinson Disease/rehabilitation ; Physical Therapy Modalities
    Language English
    Publishing date 2016-03
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2015.4449
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  9. Article ; Online: Parkinson disease treatment in hospitals and nursing facilities: avoiding pitfalls.

    Ahlskog, J Eric

    Mayo Clinic proceedings

    2014  Volume 89, Issue 7, Page(s) 997–1003

    Abstract: The unique needs of patients with Parkinson disease challenge staff when such patients are admitted to hospitals or nursing facilities. Prolongation of the hospital stay, falls with injuries, fainting, or declining motor function may result from ... ...

    Abstract The unique needs of patients with Parkinson disease challenge staff when such patients are admitted to hospitals or nursing facilities. Prolongation of the hospital stay, falls with injuries, fainting, or declining motor function may result from therapeutic misadventures or failure to anticipate common problems. Staff familiarity with Parkinson disease, and especially carbidopa-levodopa dosing and dynamics, may prevent such problems and streamline hospital and nursing home care.
    MeSH term(s) Amantadine/adverse effects ; Amantadine/therapeutic use ; Antiparkinson Agents/adverse effects ; Antiparkinson Agents/therapeutic use ; Carbidopa/adverse effects ; Carbidopa/therapeutic use ; Catechols/adverse effects ; Catechols/therapeutic use ; Dopamine Agonists/adverse effects ; Dopamine Agonists/therapeutic use ; Drug Administration Schedule ; Drug Combinations ; Hospitalization ; Humans ; Levodopa/adverse effects ; Levodopa/therapeutic use ; Monoamine Oxidase Inhibitors/adverse effects ; Monoamine Oxidase Inhibitors/therapeutic use ; Nitriles/adverse effects ; Nitriles/therapeutic use ; Nursing Care ; Parkinson Disease/complications ; Parkinson Disease/drug therapy
    Chemical Substances Antiparkinson Agents ; Catechols ; Dopamine Agonists ; Drug Combinations ; Monoamine Oxidase Inhibitors ; Nitriles ; carbidopa, levodopa drug combination ; Levodopa (46627O600J) ; entacapone (4975G9NM6T) ; Amantadine (BF4C9Z1J53) ; Carbidopa (MNX7R8C5VO)
    Language English
    Publishing date 2014-07
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 124027-4
    ISSN 1942-5546 ; 0025-6196
    ISSN (online) 1942-5546
    ISSN 0025-6196
    DOI 10.1016/j.mayocp.2014.02.018
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  10. Article ; Online: Tenascin-R Autoimmunity: Isolated Tremor Reversed with Immunotherapy.

    Yang, Binxia / Brown, Andrew / McKeon, Andrew / Ahlskog, J Eric / Tipton, Philip / Guo, Yong / Lucchinetti, Claudia / Pittock, Sean J / Zekeridou, Anastasia

    Annals of neurology

    2023  Volume 94, Issue 3, Page(s) 502–507

    Abstract: Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and ... ...

    Abstract Autoimmune movement disorders are increasingly recognized, but isolated tremor is extremely rare. We describe a 70-year-old male with rapidly progressive, severe postural and intention tremor and weight loss. His cerebrospinal fluid was inflammatory and harbored a neural tissue-restricted antibody. The autoantigen was identified by immunoprecipitation and mass spectrometry and confirmed by antigen-specific assays to be specific for tenascin-R. He was investigated for cancer and diagnosed with follicular lymphoma that expressed tenascin-R suggesting a paraneoplastic origin; cancer treatment and immunotherapy led to complete recovery. With this individualized patient approach and antibody discovery, we expand the spectrum of antibodies accompanying autoimmune hyperkinetic movement disorders. ANN NEUROL 2023;94:502-507.
    MeSH term(s) Male ; Humans ; Aged ; Tremor ; Autoimmunity ; Autoimmune Diseases ; Autoantibodies ; Immunotherapy
    Chemical Substances tenascin R (147604-77-1) ; Autoantibodies
    Language English
    Publishing date 2023-07-14
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80362-5
    ISSN 1531-8249 ; 0364-5134
    ISSN (online) 1531-8249
    ISSN 0364-5134
    DOI 10.1002/ana.26730
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