clinical studies and therapies in parkinsons disease

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Clinical Trials In Parkinson's Disease
Author : Santiago Perez-Lloret
Publisher : Humana
Release Date : 2020-08-19
ISBN 10 : 9781071609118
Pages : 396 pages

This volume looks at major clinical trials for motor and non-motor symptoms in Parkinson’s Disease (PD) and covers important aspects, including trial design, sample selection, and outcome selection. Chapters in this book discuss topics such as toxin-based rodent or genetic models of PD; clinical trials for motor symptoms, L-DOPA related motor complications, and gait disorders; clinical trials for mood disorders, troubled sleep, autonomic dysfunction; and clinical trials for disease modifying therapies. In the Neuromethods series style, chapters include the kind of detail and key advice from the specialists needed to get successful results in your laboratory or research center. Cutting-edge and authoritative, Clinical Trials in Parkinson’s Disease is a valuable resource for clinicians and researchers who want to enhance their interpretation of results from clinical trials and to design their own high-quality trials.

Parkinson's Disease
Author : National Collaborating Centre for Chronic Conditions (Great Britain)
Publisher : Royal College of Physicians
Release Date : 2006
ISBN 10 : 1860162835
Pages : 237 pages

Challenges in Parkinson's Disease
Author : N.A
Publisher : N.A
Release Date : 2016
ISBN 10 : 9789535172918
Pages : 329 pages

The New Parkinson's Disease Treatment Book
Author : J. Eric Ahlskog (MD, PhD.),J. Eric Ahlskog
Publisher : Oxford University Press, USA
Release Date : 2015-08-06
ISBN 10 : 0190231866
Pages : 544 pages

As many as one million Americans, including Michael J. Fox and Muhammad Ali, suffer from Parkinson's Disease. Now, a leader in the fight against Parkinson's, Dr. J. Eric Ahlskog of the Mayo Clinic, has revised and updated his definitive guide for patients and their families. Dr. Ahlskog offers a crystal-clear, nuts-and-bolts approach to the treatment of PD, distilled from more than 30 years of experience as a clinician and researcher. His goal is to educate patients so that they can better team with their doctors to do battle with the disease, streamlining the decision-making process and enhancing their treatment. To do this, Dr. Ahlskog offers a gold mine of information: How do I know if I have PD? What kinds of tests can I take? What medications slow the progress of the disease? What if medications don't help my tremor? What kinds of movement problems may develop later? How can I cope with insomnia and daytime sleepiness, dizziness and depression, memory problems, paranoia, and delusions? Indeed, the book covers virtually every topic related to Parkinson's, from sexual impotence and skin rashes, to the role of nutrition, exercise, and physical therapy. In addition, Dr. Ahlskog discusses brain surgery (though he urges that patients only consider this as a last resort) and such experimental therapies as stem cell transplantation and gene therapy. There are also lists of support and advocacy groups and Web sites that focus on Parkinson's. The ultimate guide to symptoms and treatment, this thoroughly updated Second Edition is the first place patients should turn for reliable, easy-to-grasp information on Parkinson's disease.

Recent Advances in Parkinsons Disease
Author : N.A
Publisher : Elsevier
Release Date : 2010-08-20
ISBN 10 : 0444536248
Pages : 332 pages

This first volume starts with an overview on current perspectives in genetic research and on the molecular mechanisms of neurodegeneration. This is followed by a selection of hot topics in pathophysiological research, from molecular studies to system-level investigations based on in vivo electrophysiological recordings and neurocomputational methods. Complete overview of hot topics and approaches to current PD research, from molecules, to brain circuits, to clinical and therapeutic applications. Leading authors review the state-of-the-art in their field of investigation, and provide their views and perspectives for future research. All chapters include comprehensive background information and are written in a clear form that is accessible also to the non-specialist.

Deep Brain Stimulation for Parkinson's Disease
Author : Gordon H. Baltuch,Matthew B. Stern
Publisher : CRC Press
Release Date : 2007-03-19
ISBN 10 : 9781420019759
Pages : 372 pages

Considered the largest breakthrough in the treatment of Parkinson's disease in the past 40 years, Deep Brain Stimulation (DBS) is a pioneering procedure of neurology and functional neurosurgery, forging enormous change and growth within the field. The first comprehensive text devoted to this surgical therapy, Deep Brain Stimulation for Parkinson's

Leucine-Rich Repeat Kinase 2 (LRRK2)
Author : Hardy J. Rideout
Publisher : Springer
Release Date : 2017-03-28
ISBN 10 : 3319499696
Pages : 271 pages

This is the first book to assemble the leading researchers in the field of LRRK2 biology and neurology and provide a snapshot of the current state of knowledge, encompassing all major aspects of its function and dysfunction. The contributors are experts in cell biology and physiology, neurobiology, and medicinal chemistry, bringing a multidisciplinary perspective on the gene and its role in disease. The book covers the identification of LRRK2 as a major contributor to the pathogenesis of Parkinson's Disease. It also discusses the current state of the field after a decade of research, putative normal physiological roles of LRRK2, and the various pathways that have been identified in the search for the mechanism(s) of its induction of neurodegeneration.

Treatment of Parkinsonism
Author : Melvin David Yahr
Publisher : Raven Press (ID)
Release Date : 1973
ISBN 10 :
Pages : 303 pages

An Essay on the Shaking Palsy
Author : James Parkinson
Publisher : N.A
Release Date : 1817
ISBN 10 :
Pages : 66 pages

Diagnosis and Treatment of Parkinson's Disease
Author : Cindy Levine
Publisher : Department of Health and Human Services Pu Ncy for Healthcare Res
Release Date : 2003-01-01
ISBN 10 : 9781587630880
Pages : 306 pages

Levodopa pharmacokinetics -from stomach to brain
Author : Maria Nord
Publisher : Linköping University Electronic Press
Release Date : 2019-01-07
ISBN 10 : 9176855570
Pages : 72 pages

Parkinson’s disease (PD) is one of the most common neurodegenerative disorders and it is caused by a loss of dopamine (DA) producing neurons in the basal ganglia in the brain. The PD patient suffers from motor symptoms such as tremor, bradykinesia and rigidity and treatment with levodopa (LD), the precursor of DA, has positive effects on these symptoms. Several factors affect the availability of orally given LD. Gastric emptying (GE) is one factor and it has been shown to be delayed in PD patients resulting in impaired levodopa uptake. Different enzymes metabolize LD on its way from the gut to the brain resulting in less LD available in the brain and more side effects from the metabolites. By adding dopa decarboxylase inhibitors (carbidopa or benserazide) or COMT-inhibitors (e.g. entacapone) the bioavailability of LD increases significantly and more LD can pass the blood-brain-barrier and be converted to DA in the brain. It has been considered of importance to avoid high levodopa peaks in the brain because this seems to induce changes in postsynaptic dopaminergic neurons causing disabling motor complications in PD patients. More continuously given LD, e.g. duodenal or intravenous (IV) infusions, has been shown to improve these motor complications. Deep brain stimulation of the subthalamic nucleus (STN DBS) has also been proven to improve motor complications and to make it possible to reduce the LD dosage in PD patients. In this doctoral thesis the main purpose is to study the pharmacokinetics of LD in patients with PD and motor complications; in blood and subcutaneous tissue and study the effect of GE and PD stage on LD uptake and the effect of continuously given LD (CDS) on LD uptake and GE; in blood and cerebrospinal fluid (CSF) when adding the peripheral enzyme inhibitors entacapone and carbidopa to LD infusion IV; in brain during STN DBSand during oral or IV LD treatment. To conclude, LD uptake is more favorable in PD patients with less severe disease and GE is delayed in PD patients. No obvious relation between LD uptake and GE or between GE and PD stage is seen and CDS decreases the LD levels. Entacapone increases the maximal concentration of LD in blood and CSF. This is more evident with additional carbidopa and important to consider in avoiding high LD peaks in brain during PD treatment. LD in brain increases during both oral and IV LD treatment and the DA levels follows LD well indicating that PD patients still have capacity to metabolize LD to DA despite probable pronounced nigral degeneration. STN DBS seems to increase putaminal DA levels and together with IV LD treatment also increases LD in brain possibly explaining why it is possible to decrease LD medication after STN DBS surgery. Parkinsons sjukdom (PS) är en av de vanligaste s.k. neurodegenerativasjukdomarna och orsakas av förlust av dopamin(DA)producerande nervceller i hjärnan. Detta orsakar motoriska symptom såsom skakningar, stelhet och förlångsammade rörelser. Levodopa (LD) är ett ämne, som kan omvandlas till DA i hjärnan och ge symptomlindring och det är oftast förstahandsval vid behandling av patienter med PS. Flera faktorer påverkar tillgängligheten av LD, bl.a. den hastighet som magsäcken tömmer sig med och denna verkar förlångsammad hos personer med PS vilket ger sämre tillgänglighet av LD i blodet och därmed i hjärnan. LD bryts även ner i hög grad av olika enzym ute i kroppen vilket leder till mindre mängd LD som hamnar i hjärnan och till fler nedbrytningsprodukter som orsakar biverkningar. Tillägg av enzymhämmare leder till ökad mängd LD som kan nå hjärnan och omvandlas till DA. Det anses viktigt att undvika höga toppar av LD i hjärnan då dessa verkar bidra till utvecklandet av besvärliga motoriska komplikationer hos patienter med PS. Om LD ges mer kontinuerligt, exempelvis som en kontinuerlig infusion in i tarmen eller i blodet, så minskar dessa motoriska komplikationer. Inopererande av stimulatorer i vissa delar av hjärnan (DBS) har också visat sig minska dessa motoriska komplikationer och även resultera i att man kan minska LD-dosen. Huvudsyftet med den här avhandlingen är att studera LD hos patienter med PS; i blod och fettvävnad då LD ges i tablettform och se om det finns något samband med LD-upptag och hastigheten på magsäckstömningen (MT) och om kontinuerligt given LD påverkar LD-upptaget eller MT; i blod och i ryggmärgsvätska då enzymhämmarna entakapon och karbidopa tillsätts LD; i hjärna vid behandling med DBS och då LD ges både som tablett och som infusion i blodet. Sammanfattningsvis kan vi se att LD-upptaget är mer gynnsamt hos patienter med PS i tidigare skede av sjukdomens komplikationsfas. MT är förlångsammad hos patienter med PS och det är inget tydligt samband mellan LD-upptag och MT eller mellan MT och sjukdomsgrad. Kontinuerligt given LD minskar LDnivåerna. Enzymhämmaren entakapon ökar den maximala koncentrationen av LD i blod och ryggmärgsvätska och effekten är mer tydlig vid tillägg av karbidopa vilket är viktigt att ta i beaktande vid behandling av PS för att undvika höga toppar av LD i hjärnan. LD ökar i hjärnan då man behandlar med LD i tablettform och som infusion i blodet och DA-nivåerna i hjärnan följer LD väl vilket visar på att patienter med PS fortfarande kan omvandla LD till DA trots trolig uttalad brist av de DA-producerande nervcellerna i hjärnan. DBS verkar öka DA i vissa områden i hjärnan och tillsammans med LD-infusion i blodet verkar det även öka LD i hjärnan och det kan förklara varför man kan sänka LDdosen efter DBS-operation.

Therapy of Parkinson's Disease
Author : Rajesh Pahwa,Kelly E. Lyons,William Koller
Publisher : CRC Press
Release Date : 2004-04-19
ISBN 10 : 1135533695
Pages : 592 pages

A comprehensive review of current tactics in the therapeutic management of Parkinson's disease, this volume offers summaries of salient research findings as well as contemporary attitudes and practical advice from field specialists. The well-timed Third Edition is expanded and topically reorganized to register trends and progress in anti-parkinsoni