The objective of this study was to evaluate relationships between quantitative EEG (qEEG) changes and cognitive disturbance (mild cognitive impairment or dementia) and the motor disturbance stage in Parkinson's disease (PD). Thirty-two PD patients (age = 67.2 +/- 10.0) and 26 normal subjects (age = 68.4 +/- 4.7) were assessed using a neurological evaluation, modified Hoehn and Yahr (HY) scale for PD, a Portuguese version of the CERAD neuropsychological battery (consortium to establish a registry for Alzheimer's disease) incorporating the Mini-mental Status Examination, Clinical Dementia Rating and an EEG analysis of absolute and relative band amplitude at rest. Four groups were compared: three with PD (7 patients with dementia, 10 with mild cognitive impairment and 15 with no cognitive disturbances) and the control group. The qEEG showed no significant differences between the control group and PD patients without cognitive disturbance. Abnormalities on the qEEG were essentially associated with the occurrence of mild cognitive impairment or dementia in patients with PD. There was an increase in the absolute and relative posterior theta amplitude in the groups with mild cognitive impairment or dementia and of the posterior absolute and relative delta amplitude in the group with dementia This study suggested qEEG as a possible physiological tool in the assessment of cognitive aspects in PD.
-The objective of this research was to assess the occurrence of cognitive impairment in 32 individuals (average age: 67.2 years old) with Parkinson's disease (PD). Procedures: clinical-neurological assessment; modified Hoehn and Yahr staging scale (HYS); standard neuropsychological battery of CERAD (Consortium to Establish a Registry for Alzheimer's Disease); Pfeffer questionnaire; and Clinical Dementia Rating. A comparison was made with a control group (CG), consisting of 26 individuals with similar age and educational level but without cognitive impairment. The PD patients showed an inferior performance in the CERAD battery when compared to the CG. Three PD sub-groups were characterised according to cognition: no cognitive impairment -15 cases; mild cognitive impairment -10; dementia -7 cases. There was a significant association between motor disability (HYS) and the occurrence of dementia. Dementia and mild cognitive impairment frequently occur in PD patients and should be investigated in a routine way.KEY woRDS: Parkinson disease, dementia, cognition. Demência e transtorno cognitivo leve em pacientes com doença de ParkinsonResumo -o objetivo desta pesquisa foi avaliar a ocorrência de déficits cognitivos em 32 indivíduos (idade média: 67,2 anos) com doença de Parkinson (DP). Procedimentos: avaliação clínico-neurológica, escala de Hoehn and Yahr modificada (EHY), bateria neurospicológica do CERAD (Consortium to Establish a Registry for Alzheimer's Disease), questionário de Pfeffer e escore clínico da demência (Clinical Dementia Rating). Foi feita comparação com grupo controle (GC) de 26 indivíduos sem declínio cognitivo, com idade e nível educacional similares. os pacientes com DP tiveram desempenho inferior na bateria CERAD, quando comparados ao do GC. Foram caracterizados 3 subgrupos com PD segundo a cognição: sem déficits cognitivos -15 casos; transtorno cognitivo leve -10; demência -7 casos. Houve associação entre comprometimento motor e ocorrência de demência. Demência e transtorno cognitivo leve são freqüentes em pacientes com DP e devem ser investigados de modo rotineiro.PAlAvRAS-CHAvE: doença de Parkinson, cognição, demência.
-Pain may precede the diagnosis in Parkinson's disease (PD). The goal of this study was to assess the pain in a group of 20 females and 30 males with PD, after excluding co-morbidities as causes. It was used the following tools: Unified Parkinson's Disease Rating Scale, McGill questionnaire and Beck Depression Inventory. In 27 patients (54%), the pain was associated with PD, occurring in 22 (44%) in the off period and 5 (10%) in both on and off periods. The off period resulted in an increased frequency of pain, which was related to stiffness. There was no association between pain and tremor in off period, neither between pain and Modified Hoehn and Yahr stage, nor the Schwab and England scale. It was not observed an association between pain and depression, neither between pain and dyskinesia. It was noticed the improvement in pain in 16 patients with levodopa (59.26%). Em 27 pacientes (54%), a dor associou-se com a DP, ocorrendo em 22 (44%) no período off e em 5 (10%) nos períodos on e off. o período off resultou num aumento da freqüência da dor, o qual se relacionou com a rigidez. Não houve associação entre dor e tremor no período off, estágio Hoehn e Yahr modificado, nem a escala de Schwab e England. Não foi observado associação entre dor e depressão, nem entre dor e discinesia. Foi observada a melhora da dor em 16 pacientes com levodopa (59.26%).PAlAvRAS-CHAvE: doença de Parkinson, dor, levodopa.
Background: Increasing numbers of mutations causing monogenic forms of Parkinson's disease (PD) have been described, mostly among patients in Europe and North America. Since genetic architecture varies between different populations, studying the specific genetic profile of Brazilian patients is essential for improving genetic counseling and for selecting patients for clinical trials. Objective: We conducted a systematic review to identify genetic studies on Brazilian patients and to set a background for future studies on monogenic forms of PD in Brazil. Methods: We searched MEDLINE, EMBASE and Web of Science from inception to December 2019 using terms for "Parkinson's disease", "genetics" and "Brazil". Two independent reviewers extracted the data. For the genes LRRK2 and PRKN, the estimated prevalence was calculated for each study, and a meta-analysis was performed. Results: A total of 32 studies were included, comprising 94 Brazilian patients with PD with a causative mutation, identified from among 2,872 screened patients (3.2%). PRKN mutations were causative of PD in 48 patients out of 576 (8.3%). LRRK2 mutations were identified in 40 out of 1,556 patients (2.5%), and p.G2019S was the most common mutation (2.2%). Conclusions: PRKN is the most common autosomal recessive cause of PD, and LRRK2 is the most common autosomal dominant form. We observed that there was a lack of robust epidemiological studies on PD genetics in Brazil and, especially, that the diversity of Brazil’s population had not been considered.
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