Teaching Video NeuroImages: The underrecognized diphasic dyskinesia of Parkinson disease

Dyskinesia is a common motor complication in levodopa-treated Parkinson disease (PD), associated with higher doses, greater disease severity, and longer disease duration.1 Often assumed to be a peak-dose phenomenon, the diphasic (beginning-of-dose or end-of-dose) variant may be ignored, as exemplified by a patient with PD whose dyskinesia was initially interpreted as peak-dose (video at Neurology.org). Rapid improvement with apomorphine, a short-acting levodopa-equipotent dopamine agonist, confirmed its diphasic nature.2 Recognition of dyskinesia subtype based on the relationship with levodopa dose cycles (figure) facilitates their differing management in PD: while dopaminergic stimulation needs reduction in peak-dose dyskinesia, it should be increased in diphasic.
Source: Neurology - Category: Neurology Authors: Tags: Parkinson's disease/Parkinsonism, Chorea RESIDENT AND FELLOW SECTION Source Type: research

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AbstractParkinson ’s disease (PD) is a multisystem disorder that affects 2–3% of the population ≥ 65 years of age. The main pharmacologic agent use in the treatment of clinical symptoms of PD is levodopa (L-DOPA). However, the chronic use of L-DOPA might result in the emergence of motor complications such as motor fluctuation and dyskinesia. Previous studies have shown that the inter-individual variability and pharmacogenetic profile of PD patients seem to influence the occurrence of motor complications. For these reasons, the purpose of this study was to evaluate a possible relationship betweenD...
Source: NeuroMolecular Medicine - Category: Neurology Source Type: research
Condition:   Dyskinesias Interventions:   Drug: JM-010 A group;   Drug: JM-010 B group;   Drug: Placebos Sponsors:   Contera Pharma;   Bukwang Pharmaceutical Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
As recently as 2017, there was still more talk than action in the clinical wearables market and the majority of companies making wearable devices were pursuing health and wellness applications first, with plans to pursue a medical device indication after the consumer version of the product took off. In some cases that is still true, but a panel of experts speaking at BIOMEDevice Boston 2019 highlighted a new trend. One that might seem unexpected for those who have been following the wearables market for the past five years or longer. "I'm in the medical space, I'm used to dealing with CGMs [continuous glucose monitors...
Source: MDDI - Category: Medical Devices Authors: Tags: Digital Health Software Source Type: news
Conclusion Our study provides preliminary evidence regarding the utility of continuous EBR monitoring for the non-invasive evaluation of the motor status in patients with PD. PMID: 31092772 [PubMed - in process]
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
The response to dopaminergic treatments in Parkinson's disease depends on many clinical and genetic factors. The very common motor fluctuations and dyskinesia affect approximately half of patients after five years of treatment with levodopa. We did an evaluation of a combined effect of 16 clinical parameters and 34 single nucleotide polymorphisms to build clinical and clinical-pharmacogenetic models for prediction of time of occurrence of motor complications and to compare their predictive abilities. In total, 220 Parkinson's disease patients were included in the analysis. Their demographic, clinical, and genotype data wer...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
This study aimed to produce such a screening tool by building a classifier that models specialist identification of suitable DAT candidates. To our knowledge, this is the first objective decision tool for managing DAT referral. Subjects were randomly assigned to either a construction set (n = 112, to train, develop, cross validate, and then evaluate the classifier’s performance) or to a test set (n = 60 to test the fully specified classifier), resulting in a sensitivity and specificity of 89% and 86.6%, respectively. The classifier’s performance was then assessed in PwP who underwent deep brain stimulat...
Source: Sensors - Category: Biotechnology Authors: Tags: Article Source Type: research
Background and objectives: Studies examining the risk factors for dyskinesia in Parkinson’s disease (PD) have been inconsistent, and racial differences exist. To date, there have been no systematic studies of the characteristics of dyskinesia in the Mainland Chinese population. Methods: A total of 1974 PD patients from Mainland China were systematically investigated by univariable and multivariable analyses. PD patients with (n = 275) and without (n = 275) dyskinesia were stratified into 4 groups according to levodopa equivalent dose (LED) and analyzed by Kaplan-Meier curves and a Cox proportional hazards model. A ...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Dyskinesia-Hyperpyrexia Syndrome (DHS) is a rare hyperkinetic emergency, defined by the presence of severe, continuous, generalized, acute onset dyskinesias associated with increased creatine kinase (CK), hyperpyrexia and altered mental state, which affects patients with advanced Parkinson's disease (PD). It typically occurs in patients with long disease duration, undergoing high dopaminergic daily dose, and can be triggered by therapeutic changes, infections, hot weather, dehydration, or trauma.
Source: Parkinsonism and Related Disorders - Category: Neurology Authors: Tags: Correspondence Source Type: research
Authors: Müller T, Kuhn W, Möhr JD Abstract INTRODUCTION: Amantadine is an old, antiviral compound that moderately ameliorates impaired motor behaviour in Parkinson's disease. Its current resurgence results from the novel retarded release amantadine hydrochloride formulation, ADS5102, which has also received approval for the treatment of levodopa-related involuntary movements known as dyskinesia. Areas covered: This non-systematic, narrative drug evaluation discusses the value of ADS5102 for patients with Parkinson's disease. ADS5102 is orally applied once daily in the evening. This capsule provides highe...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
In conclusion, this work suggests that mGluR5 antagonists reduce dyskinesia by mainly affecting D1R-containing neurons and that the effect of nicotine on dyskinetic signs in aphakia mice is likely via mGluR5.
Source: Molecular Neurobiology - Category: Neurology Source Type: research
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