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  1. Article ; Online: A new quantitative method for evaluating freezing of gait and dual-attention task deficits in Parkinson's disease.

    Chomiak, Taylor / Pereira, Fernando Vieira / Meyer, Nicole / de Bruin, Natalie / Derwent, Lorelei / Luan, Kailie / Cihal, Alexandra / Brown, Lesley A / Hu, Bin

    Journal of neural transmission (Vienna, Austria : 1996)

    2015  Volume 122, Issue 11, Page(s) 1523–1531

    Abstract: People with Parkinson's disease (PD) can exhibit disabling gait symptoms such as freezing of gait especially when distracted by a secondary task. Quantitative measurement method of this type of cognitive-motor abnormality, however, remains poorly ... ...

    Abstract People with Parkinson's disease (PD) can exhibit disabling gait symptoms such as freezing of gait especially when distracted by a secondary task. Quantitative measurement method of this type of cognitive-motor abnormality, however, remains poorly developed. Here we examined whether stepping-in-place (SIP) with a concurrent mental task (e.g., subtraction) can be used as a simple method for evaluating cognitive-motor deficits in PD. We used a 4th generation iPod Touch sensor system to capture hip flexion data and obtain step height (SH) measurements (z axis). The accuracy of the method was compared to and validated by kinematic video analysis software. We found a general trend of reduced SH for PD subjects relative to controls under all conditions. However, the SH of PD freezers was significantly worse than PD non-freezers and controls during concurrent serial 7 subtraction and SIP tasking. During serial 7 subtraction, SH was significantly associated with whether or not a PD patient was a self-reported freezer even when controlling for disease severity. Given that this SIP-based dual-task paradigm is not limited by space requirements and can be quantified using a mobile tracking device that delivers specifically designed auditory task instructions, the method reported here may be used to standardize clinical assessment of cognitive-motor deficits under a variety of dual-task conditions in PD.
    MeSH term(s) Aged ; Attention ; Biomechanical Phenomena ; Cognition Disorders/diagnosis ; Cognition Disorders/physiopathology ; Computers, Handheld ; Diagnosis, Differential ; Female ; Gait Disorders, Neurologic/diagnosis ; Gait Disorders, Neurologic/physiopathology ; Hip ; Humans ; Male ; Middle Aged ; Mobile Applications ; Neuropsychological Tests ; Parkinson Disease/diagnosis ; Parkinson Disease/physiopathology ; Parkinson Disease/psychology ; Self Report ; Sensitivity and Specificity ; Severity of Illness Index ; Video Recording ; Wireless Technology
    Language English
    Publishing date 2015-11
    Publishing country Austria
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 184163-4
    ISSN 1435-1463 ; 0300-9564
    ISSN (online) 1435-1463
    ISSN 0300-9564
    DOI 10.1007/s00702-015-1423-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Nursing time to program and assess deep brain stimulators in movement disorder patients.

    Hunka, Karen / Suchowersky, Oksana / Wood, Susan / Derwent, Lorelei / Kiss, Zelma H T

    The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses

    2005  Volume 37, Issue 4, Page(s) 204–210

    Abstract: The use of deep brain stimulation (DBS) to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia is increasing. Although some published literature describes the methods for DBS programming, the time and nursing requirements ...

    Abstract The use of deep brain stimulation (DBS) to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia is increasing. Although some published literature describes the methods for DBS programming, the time and nursing requirements to run a DBS surgical program have not been examined previously. For this study, we prospectively recorded the time required for both assessments and programming of the DBS from the preoperative period to 1 year after surgery in a variety of patients. Results showed that the mean total time spent programming the stimulator and assessing these patients ranged from 18.0-36.2 hours per patient. It took twice as long to program the stimulator in patients with Parkinson's disease as it did in patients with essential tremor or dystonia. When setting up a program for movement disorders surgery, nursing time spent on patient assessment and programming should be considered in the workload.
    MeSH term(s) Activities of Daily Living ; Alberta ; Algorithms ; Clinical Competence ; Communication ; Decision Trees ; Deep Brain Stimulation/instrumentation ; Deep Brain Stimulation/methods ; Deep Brain Stimulation/nursing ; Equipment Design ; Humans ; Monitoring, Physiologic/nursing ; Movement Disorders/therapy ; Nurse Clinicians/education ; Nurse Clinicians/organization & administration ; Nurse's Role ; Nursing Administration Research ; Nursing Assessment/organization & administration ; Nursing Evaluation Research ; Patient Education as Topic/organization & administration ; Perioperative Care/nursing ; Perioperative Care/organization & administration ; Prospective Studies ; Time and Motion Studies ; Workload/statistics & numerical data
    Language English
    Publishing date 2005-09-15
    Publishing country United States
    Document type Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632790-4
    ISSN 0888-0395
    ISSN 0888-0395
    DOI 10.1097/01376517-200508000-00006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Effect of creatine monohydrate on clinical progression in patients with Parkinson disease: a randomized clinical trial.

    Kieburtz, Karl / Tilley, Barbara C / Elm, Jordan J / Babcock, Debra / Hauser, Robert / Ross, G Webster / Augustine, Alicia H / Augustine, Erika U / Aminoff, Michael J / Bodis-Wollner, Ivan G / Boyd, James / Cambi, Franca / Chou, Kelvin / Christine, Chadwick W / Cines, Michelle / Dahodwala, Nabila / Derwent, Lorelei / Dewey, Richard B / Hawthorne, Katherine /
    Houghton, David J / Kamp, Cornelia / Leehey, Maureen / Lew, Mark F / Liang, Grace S Lin / Luo, Sheng T / Mari, Zoltan / Morgan, John C / Parashos, Sotirios / Pérez, Adriana / Petrovitch, Helen / Rajan, Suja / Reichwein, Sue / Roth, Jessie Tatsuno / Schneider, Jay S / Shannon, Kathleen M / Simon, David K / Simuni, Tanya / Singer, Carlos / Sudarsky, Lewis / Tanner, Caroline M / Umeh, Chizoba C / Williams, Karen / Wills, Anne-Marie

    JAMA

    2015  Volume 313, Issue 6, Page(s) 584–593

    Abstract: Importance: There are no treatments available to slow or prevent the progression of Parkinson disease, despite its global prevalence and significant health care burden. The National Institute of Neurological Disorders and Stroke Exploratory Trials in ... ...

    Abstract Importance: There are no treatments available to slow or prevent the progression of Parkinson disease, despite its global prevalence and significant health care burden. The National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease program was established to promote discovery of potential therapies.
    Objective: To determine whether creatine monohydrate was more effective than placebo in slowing long-term clinical decline in participants with Parkinson disease.
    Design, setting, and patients: The Long-term Study 1, a multicenter, double-blind, parallel-group, placebo-controlled, 1:1 randomized efficacy trial. Participants were recruited from 45 investigative sites in the United States and Canada and included 1741 men and women with early (within 5 years of diagnosis) and treated (receiving dopaminergic therapy) Parkinson disease. Participants were enrolled from March 2007 to May 2010 and followed up until September 2013.
    Interventions: Participants were randomized to placebo or creatine (10 g/d) monohydrate for a minimum of 5 years (maximum follow-up, 8 years).
    Main outcomes and measures: The primary outcome measure was a difference in clinical decline from baseline to 5-year follow-up, compared between the 2 treatment groups using a global statistical test. Clinical status was defined by 5 outcome measures: Modified Rankin Scale, Symbol Digit Modalities Test, PDQ-39 Summary Index, Schwab and England Activities of Daily Living scale, and ambulatory capacity. All outcomes were coded such that higher scores indicated worse outcomes and were analyzed by a global statistical test. Higher summed ranks (range, 5-4775) indicate worse outcomes.
    Results: The trial was terminated early for futility based on results of a planned interim analysis of participants enrolled at least 5 years prior to the date of the analysis (n = 955). The median follow-up time was 4 years. Of the 955 participants, the mean of the summed ranks for placebo was 2360 (95% CI, 2249-2470) and for creatine was 2414 (95% CI, 2304-2524). The global statistical test yielded t1865.8 = -0.75 (2-sided P = .45). There were no detectable differences (P < .01 to partially adjust for multiple comparisons) in adverse and serious adverse events by body system.
    Conclusions and relevance: Among patients with early and treated Parkinson disease, treatment with creatine monohydrate for at least 5 years, compared with placebo did not improve clinical outcomes. These findings do not support the use of creatine monohydrate in patients with Parkinson disease.
    Trial registration: clinicaltrials.gov Identifier: NCT00449865.
    MeSH term(s) Aged ; Antiparkinson Agents/adverse effects ; Antiparkinson Agents/therapeutic use ; Creatine/adverse effects ; Creatine/blood ; Creatine/therapeutic use ; Disease Progression ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Medication Adherence ; Middle Aged ; Parkinson Disease/drug therapy ; Treatment Outcome
    Chemical Substances Antiparkinson Agents ; Creatine (MU72812GK0)
    Language English
    Publishing date 2015-01-14
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2015.120
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit.

    Beal, M Flint / Oakes, David / Shoulson, Ira / Henchcliffe, Claire / Galpern, Wendy R / Haas, Richard / Juncos, Jorge L / Nutt, John G / Voss, Tiffini Smith / Ravina, Bernard / Shults, Clifford M / Helles, Karen / Snively, Victoria / Lew, Mark F / Griebner, Brian / Watts, Arthur / Gao, Shan / Pourcher, Emmanuelle / Bond, Louisette /
    Kompoliti, Katie / Agarwal, Pinky / Sia, Cherissa / Jog, Mandar / Cole, Linda / Sultana, Munira / Kurlan, Roger / Richard, Irene / Deeley, Cheryl / Waters, Cheryl H / Figueroa, Angel / Arkun, Ani / Brodsky, Matthew / Ondo, William G / Hunter, Christine B / Jimenez-Shahed, Joohi / Palao, Alicia / Miyasaki, Janis M / So, Julie / Tetrud, James / Reys, Liza / Smith, Katharine / Singer, Carlos / Blenke, Anita / Russell, David S / Cotto, Candace / Friedman, Joseph H / Lannon, Margaret / Zhang, Lin / Drasby, Edward / Kumar, Rajeev / Subramanian, Thyagarajan / Ford, Donna Stuppy / Grimes, David A / Cote, Diane / Conway, Jennifer / Siderowf, Andrew D / Evatt, Marian Leslie / Sommerfeld, Barbara / Lieberman, Abraham N / Okun, Michael S / Rodriguez, Ramon L / Merritt, Stacy / Swartz, Camille Louise / Martin, W R Wayne / King, Pamela / Stover, Natividad / Guthrie, Stephanie / Watts, Ray L / Ahmed, Anwar / Fernandez, Hubert H / Winters, Adrienna / Mari, Zoltan / Dawson, Ted M / Dunlop, Becky / Feigin, Andrew S / Shannon, Barbara / Nirenberg, Melissa Jill / Ogg, Mattson / Ellias, Samuel A / Thomas, Cathi-Ann / Frei, Karen / Bodis-Wollner, Ivan / Glazman, Sofya / Mayer, Thomas / Hauser, Robert A / Pahwa, Rajesh / Langhammer, April / Ranawaya, Ranjit / Derwent, Lorelei / Sethi, Kapil D / Farrow, Buff / Prakash, Rajan / Litvan, Irene / Robinson, Annette / Sahay, Alok / Gartner, Maureen / Hinson, Vanessa K / Markind, Samuel / Pelikan, Melisa / Perlmutter, Joel S / Hartlein, Johanna / Molho, Eric / Evans, Sharon / Adler, Charles H / Duffy, Amy / Lind, Marlene / Elmer, Lawrence / Davis, Kathy / Spears, Julia / Wilson, Stephanie / Leehey, Maureen A / Hermanowicz, Neal / Niswonger, Shari / Shill, Holly A / Obradov, Sanja / Rajput, Alex / Cowper, Marilyn / Lessig, Stephanie / Song, David / Fontaine, Deborah / Zadikoff, Cindy / Williams, Karen / Blindauer, Karen A / Bergholte, Jo / Propsom, Clara Schindler / Stacy, Mark A / Field, Joanne / Mihaila, Dragos / Chilton, Mark / Uc, Ergun Y / Sieren, Jeri / Simon, David K / Kraics, Lauren / Silver, Althea / Boyd, James T / Hamill, Robert W / Ingvoldstad, Christopher / Young, Jennifer / Thomas, Karen / Kostyk, Sandra K / Wojcieszek, Joanne / Pfeiffer, Ronald F / Panisset, Michel / Beland, Monica / Reich, Stephen G / Cines, Michelle / Zappala, Nancy / Rivest, Jean / Zweig, Richard / Lumina, L Pepper / Hilliard, Colette Lynn / Grill, Stephen / Kellermann, Marye / Tuite, Paul / Rolandelli, Susan / Kang, Un Jung / Young, Joan / Rao, Jayaraman / Cook, Maureen M / Severt, Lawrence / Boyar, Karyn

    JAMA neurology

    2014  Volume 71, Issue 5, Page(s) 543–552

    Abstract: Importance: Coenzyme Q10 (CoQ10), an antioxidant that supports mitochondrial function, has been shown in preclinical Parkinson disease (PD) models to reduce the loss of dopamine neurons, and was safe and well tolerated in early-phase human studies. A ... ...

    Abstract Importance: Coenzyme Q10 (CoQ10), an antioxidant that supports mitochondrial function, has been shown in preclinical Parkinson disease (PD) models to reduce the loss of dopamine neurons, and was safe and well tolerated in early-phase human studies. A previous phase II study suggested possible clinical benefit.
    Objective: To examine whether CoQ10 could slow disease progression in early PD.
    Design, setting, and participants: A phase III randomized, placebo-controlled, double-blind clinical trial at 67 North American sites consisting of participants 30 years of age or older who received a diagnosis of PD within 5 years and who had the following inclusion criteria: the presence of a rest tremor, bradykinesia, and rigidity; a modified Hoehn and Yahr stage of 2.5 or less; and no anticipated need for dopaminergic therapy within 3 months. Exclusion criteria included the use of any PD medication within 60 days, the use of any symptomatic PD medication for more than 90 days, atypical or drug-induced parkinsonism, a Unified Parkinson's Disease Rating Scale (UPDRS) rest tremor score of 3 or greater for any limb, a Mini-Mental State Examination score of 25 or less, a history of stroke, the use of certain supplements, and substantial recent exposure to CoQ10. Of 696 participants screened, 78 were found to be ineligible, and 18 declined participation.
    Interventions: The remaining 600 participants were randomly assigned to receive placebo, 1200 mg/d of CoQ10, or 2400 mg/d of CoQ10; all participants received 1200 IU/d of vitamin E.
    Main outcomes and measures: Participants were observed for 16 months or until a disability requiring dopaminergic treatment. The prospectively defined primary outcome measure was the change in total UPDRS score (Parts I-III) from baseline to final visit. The study was powered to detect a 3-point difference between an active treatment and placebo.
    Results: The baseline characteristics of the participants were well balanced, the mean age was 62.5 years, 66% of participants were male, and the mean baseline total UPDRS score was 22.7. A total of 267 participants required treatment (94 received placebo, 87 received 1200 mg/d of CoQ10, and 86 received 2400 mg/d of CoQ10), and 65 participants (29 who received placebo, 19 who received 1200 mg/d of CoQ10, and 17 who received 2400 mg/d of CoQ10) withdrew prematurely. Treatments were well tolerated with no safety concerns. The study was terminated after a prespecified futility criterion was reached. At study termination, both active treatment groups showed slight adverse trends relative to placebo. Adjusted mean changes (worsening) in total UPDRS scores from baseline to final visit were 6.9 points (placebo), 7.5 points (1200 mg/d of CoQ10; P = .49 relative to placebo), and 8.0 points (2400 mg/d of CoQ10; P = .21 relative to placebo).
    Conclusions and relevance: Coenzyme Q10 was safe and well tolerated in this population, but showed no evidence of clinical benefit.
    Trial registration: clinicaltrials.gov Identifier: NCT00740714.
    MeSH term(s) Aged ; Antioxidants/administration & dosage ; Antioxidants/metabolism ; Dose-Response Relationship, Drug ; Double-Blind Method ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/diagnosis ; Parkinson Disease/drug therapy ; Parkinson Disease/enzymology ; Prospective Studies ; Treatment Outcome ; Ubiquinone/administration & dosage ; Ubiquinone/analogs & derivatives ; Ubiquinone/blood
    Chemical Substances Antioxidants ; Ubiquinone (1339-63-5) ; coenzyme Q10 (EJ27X76M46)
    Language English
    Publishing date 2014-03-24
    Publishing country United States
    Document type Clinical Trial, Phase III ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2702023-X
    ISSN 2168-6157 ; 2168-6149
    ISSN (online) 2168-6157
    ISSN 2168-6149
    DOI 10.1001/jamaneurol.2014.131
    Database MEDical Literature Analysis and Retrieval System OnLINE

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