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Motor Features (motor + feature)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Population-based case,control study of morale in Parkinson's disease

EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2009
J. Benito-León
Background:, Parkinson's disease (PD) is associated with cognitive, psychiatric, and motor features. Each could contribute to a poor sense of well-being and low morale. A systematic study of morale in community-dwelling PD cases has not been performed. Methods:, A total of 52 PD cases and 260 matched controls from three Spanish communities were assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0[low morale],17). The PGCMS includes three dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging. Results:, The PGCMS score was lower in PD cases than controls (8.71 ± 3.64 vs. 11.03 ± 2.77, P < 0.001), as were the agitation subscore (3.36 ± 1.91 vs. 4.07 ± 1.59, P < 0.05), lonely dissatisfaction subscore (3.48 ± 1.36 vs. 4.11 ± 1.12, P < 0.01), and attitude toward own aging subscore (1.86 ± 1.37 vs. 2.85 ± 1.13, P < 0.001). In a linear regression analysis that adjusted for depressive symptoms and other covariates, PD cases had a lower PGCMS score than controls (P < 0.001). Conclusions:, Morale was significantly lower in community-dwelling PD cases than matched controls. The detection and possible treatment of this problem may improve the psychological well-being of patients with this disease. [source]

Functional correlates of lower cognitive test scores in essential tremor,

MOVEMENT DISORDERS, Issue 4 2010
Elan D. Louis MD
Abstract Although motor features have been the defining element of essential tremor (ET), lower neurocognitive test scores are increasingly being recognized. However, the clinical correlates, if any, of these lower test scores remain largely unexplored. The aim of this study was to determine whether cognitive test scores in ET have any functional correlates. The Modified Mini Mental Status Examination (MMSE), Katz Activities of Daily Living (ADL) scale and Lawton Instrumental (I) ADL scale were administered to 95 cases. The Katz ADL score (rho = 0.26, P = 0.01) and Lawton IADL score (rho = 0.32, P = 0.001) were correlated with MMSE scores, such that poorer cognitive performance indicated greater dysfunction. Furthermore, cognitive test scores were a better predictor of functional disability than was tremor severity. Poorer cognitive performance in ET was associated with greater functional deficit. Cognition should enter the clinical dialog with ET patients as an issue of clinical significance. © 2010 Movement Disorder Society [source]

Clinical measures of progression in Parkinson's disease,

MOVEMENT DISORDERS, Issue S2 2009
Werner Poewe MD
Abstract Despite all recent advances in symptomatic therapy Parkinson's disease (PD) continues to be a relentlessly progressive neurodegenerative disorder. Therefore therapies that will slow or hold disease progression are a major medical unmet need in PD. Clinical measures of disease progression that have been used in disease modification trials so far have focused on indices of progression of cardinal motor features like bradykinesia, rigidity, and tremor as captured by the UPDRS and the emerging need for effective dopaminergic symptomatic therapy. Progression of global disability in PD, however, is driven by additional factors beyond progressive nigrostriatal denervation leading to increasing severity of cardinal motor features. Progressive pathology in extranigral sites in the brain or peripheral autonomic nervous system contribute to poorly levodopa responsive motor symptoms like postural instability, freezing and falls or nonmotor symptoms. In addition treatment-induced motor complications also impact on PD disability. Although it is widely accepted that clinical progression of PD is multidimensional and in addition includes effects of aging, there is no consensus how to best implement more clinically meaningful endpoints for disease progression trials that would reflect these complex interactions impacting on the evolution of global disability in PD. There is an urgent need for biomarkers for disease progression that would faithfully reflect advancing neurodegeneration and resulted clinical disability in PD and that could be used in shorter term clinical trials testing putative disease modifying agents. © 2009 Movement Disorder Society [source]

Replacement of dopaminergic medication with subthalamic nucleus stimulation in Parkinson's disease: Long-term observation,

MOVEMENT DISORDERS, Issue 4 2009
Luigi M. Romito MD
Abstract Stimulation of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson's disease (PD), but the medication requirements after implant are poorly known. We performed a long-term prospective evaluation of 20 patients maintained at stable dopaminergic therapy for 5 years after bilateral STN implants, who were evaluated 6 months, 1 year, 3 years, and 5 years after surgery. We measured, during the entire observation period, the effect of deep brain stimulation on motor and functional outcome measures, the levodopa equivalent daily dose and the total electrical energy delivered. At 5 years, the UPDRS motor score had improved by 54.2% and levodopa equivalent dose was reduced by 61.9%, compared with preimplant. Dopaminergic medication remained stable during the observation period, but energy was progressively increased over time. Rest tremor, rigidity, gait, lower and upper limb akinesia, and total axial score were improved in decreasing order. Postural stability and speech improved transiently, whereas on-period freezing of gait, motor fluctuations and dyskinesias recovered durably. Functional measures did not show improvement in autonomy and daily living activities after STN implant. Chronic STN stimulation allows to replace for dopaminergic medications in the long-term at the expense of an increase of the total energy delivered. This is associated with marked improvement of motor features without a matching benefit in functional measures. © 2008 Movement Disorder Society [source]

A novel RAB7 mutation associated with ulcero-mutilating neuropathy

ANNALS OF NEUROLOGY, Issue 4 2004
Henry Houlden PhD, MRCP
There are two known autosomal dominant genes for the hereditary ulcero-mutilating neuropathies: SPTLC1 (hereditary sensory neuropathy type 1) and RAB7 (Charcot,Marie,Tooth disease type 2B). We report a family with autosomal dominant ulcero-mutilating neuropathy, developing in the teens and characterized by ulcers, amputations, sensory involvement in the feet but no motor features. Sequencing the RAB7 gene showed a novel heterozygous A to C mutation, changing asparagine to threonine at codon 161. The mutation is situated adjacent to a previously identified valine to methionine mutation at codon 162, implying a hotspot for mutations in the highly conserved C terminus of RAB7. Ann Neurol 2004;56:586,590 [source]