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Clinical Criteria for the Diagnosis of Parkinson’s DiseaseReichmann, Heinz 05 March 2014 (has links) (PDF)
The diagnosis of Parkinson’s disease (PD) follows the UK Brain Bank Criteria, which demands bradykinesia and one additional symptom, i.e. rigidity, resting tremor or postural instability. The latter is not a useful sign for the early diagnosis of PD, because it does not appear before Hoehn and Yahr stage 3. Early symptoms of PD which precede the onset of motor symptoms are hyposmia, REM sleep behavioral disorder, constipation, and depression. In addition, an increasing number of patients whose PD is related to a genetic defect are being described. Thus, genetic testing may eventually develop into a tool to identify at-risk patients. The clinical diagnosis of PD can be supported by levodopa or apomorphine tests. Imaging studies such as cranial CT or MRI are helpful to distinguish idiopathic PD from atypical or secondary PD. SPECT and PET methods are valuable to distinguish PD tremor from essential tremor if this is clinically not possible. Using all of these methods, we may soon be able to make a premotor diagnosis of PD, which will raise the question whether early treatment is possible and ethically and clinically advisable. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Clinical Criteria for the Diagnosis of Parkinson’s DiseaseReichmann, Heinz January 2010 (has links)
The diagnosis of Parkinson’s disease (PD) follows the UK Brain Bank Criteria, which demands bradykinesia and one additional symptom, i.e. rigidity, resting tremor or postural instability. The latter is not a useful sign for the early diagnosis of PD, because it does not appear before Hoehn and Yahr stage 3. Early symptoms of PD which precede the onset of motor symptoms are hyposmia, REM sleep behavioral disorder, constipation, and depression. In addition, an increasing number of patients whose PD is related to a genetic defect are being described. Thus, genetic testing may eventually develop into a tool to identify at-risk patients. The clinical diagnosis of PD can be supported by levodopa or apomorphine tests. Imaging studies such as cranial CT or MRI are helpful to distinguish idiopathic PD from atypical or secondary PD. SPECT and PET methods are valuable to distinguish PD tremor from essential tremor if this is clinically not possible. Using all of these methods, we may soon be able to make a premotor diagnosis of PD, which will raise the question whether early treatment is possible and ethically and clinically advisable. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Psychiatric symptoms in idiopathic rapid-eye-movement sleep behaviour disorderTuineag, Maria 05 1900 (has links)
No description available.
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Psychiatric symptoms in idiopathic rapid-eye-movement sleep behaviour disorderTuineag, Maria 05 1900 (has links)
Le trouble comportemental en sommeil paradoxal (TCSP) idiopathique est caractérisé
par une activité motrice indésirable et souvent violente au cours du sommeil paradoxal.
Le TCSP idiopathique est considéré comme un facteur de risque de certaines maladies
neurodégénératives, particulièrement la maladie de Parkinson (MP) et la démence à
corps de Lewy (DCL). La dépression et les troubles anxieux sont fréquents dans la MP
et la DCL. L’objectif de cette étude est d’évaluer la sévérité des symptômes dépressifs
et anxieux dans le TCSP idiopathique.
Cinquante-cinq patients avec un TCSP idiopathique sans démence ni maladie
neurologique et 63 sujets contrôles ont complété la seconde édition du Beck Depression
Inventory (BDI-II) et le Beck Anxiety Inventory (BAI). Nous avons aussi utilisé le BDI
for Primary Care (BDI-PC) afin de minimiser la contribution des facteurs confondant
dans les symptômes dépressifs.
Les patients avec un TCSP idiopathique ont obtenu des scores plus élevés que les sujets
contrôles au BDI-II (9.63 ± 6.61 vs. 4.32 ± 4.58; P < 0.001), au BDI-PC (2.20 ± 2.29
vs. 0.98 ± 1.53; P = 0.001) et au BAI (8.37 ± 7.30 vs. 3.92 ± 5.26; P < 0.001). Nous
avons également trouvé une proportion plus élevée des sujets ayant des symptômes
dépressifs (4/63 ou 6% vs. 12/55 ou 22%; P = 0.03) ou anxieux (9/50 or 18% vs. 21/43
ou 49%; P = 0.003) cliniquement significatifs. La proportion des sujets ayant des
symptômes dépressifs cliniquement significatifs ne change pas en utilisant le BDI-PC
(11/55 or 20%)
Les symptômes dépressifs et anxieux sont fréquents dans le TCSP idiopathique.
L’examen de routine des patients avec un TCSP idiopathique devrait inclure un
dépistage systématique des symptômes dépressifs et anxieux afin de les prévenir ou les
traiter. / Idiopathic rapid-eye-movement sleep behaviour (iRBD) disorder can be a premotor
feature of Parkinson’s disease (PD) or dementia with Lewy bodies (DLB). Depressive
and anxiety symptoms are frequent nonmotor features in PD or DLB. We assessed the
frequency and severity of depressive and anxiety symptoms in patients with iRBD
compared to healthy control subjects. Fifty-five iRBD patients and 63 age and sexmatched
healthy subjects were studied. Participants completed the Beck Depression
Inventory – Second Edition (BDI-II) and Beck Anxiety Inventory (BAI). We assessed
the depressive and anxiety symptoms and compared the proportion of participants with
clinically significant depressive or anxiety symptoms. We also used the BDI for
Primary Care (BDI-PC) to minimize confounding factors that could overestimate
depressive symptoms. iRBD patients scored higher than controls on the BDI-II (9.63 ±
6.61 vs. 4.32 ± 4.58; P < 0.001)), BDI-PC (2.20 ± 2.29 vs. 0.98 ± 1.53; P = 0.001) and
BAI (8.37 ± 7.30 vs. 3.92 ± 5.26; P < 0.001). Compared to controls, we found a higher
proportion of patients with iRBD with either clinically significant depressive (4/63 or
6% vs. 12/55 or 22% P = 0.03) or anxiety symptoms (9/50 or 18% vs. 21/43 or 49%; P
= 0.003). The proportion of iRBD patients with clinically significant depressive
symptoms remains unchanged using the BDI-PC (11/55 or 20%). Depressive and
anxiety symptoms are frequent features in iRBD. Routine examination of patients with
iRBD disorder should include an assessment of depressive and anxiety symptoms in
order to prevent or treat them.
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