• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2012년도 춘계학술대회 논문집
• /
• pp.755-756
• /
• 2012

• 대한의용생체공학회:의공학회지
• /
• 제33권1호
• /
• pp.47-52
• /
• 2012

The purpose of this study is to investigate whether medication and deep brain stimulation (DBS) have differential effects on the speed and amplitude of bradykinesia in patients with Parkinson's disease (PD). Five PD patients with implanted DBS electrodes (age: $60.6{\pm}7.4yrs$, H&Y stage: $3.1{\pm}0.2$) participated in this study. FT (finger tapping) movement was measured using a gyrosensor system in four treatment conditions: Med (Medication)-off/DBS-off, Med-off/DBS-on, Med-on/DBS-off and Med-on/DBS-on. Quantitative measures representing average speed and amplitude of FT movement included root-mean-squared (RMS) angular velocity and RMS angle. One-way repeated measures ANOVA showed that RMS angular velocity of Med-on/DBS-on was significantly greater than those of Med-off/DBS-off and Med-off/DBS-on (p < 0.01) whereas RMS angle was not different among conditions (p = 0.06). Two way repeated measures ANOVA showed that only medication improved RMS angular velocity (p < 0.01), whereas both medication and DBS had no significant effect on RMS angle (p > 0.02). Effect size of RMS angular velocity was greater than that of RMS angle in both medication and DBS. This suggests that medication and DBS have differential effects on FT bradykinesia and velocity and amplitude impairments may be associated with different functional aspects in PD.

• 정신신체의학
• /
• 제23권1호
• /
• pp.66-69
• /
• 2015

정상뇌압수두증은 보행장애, 요실금 및 치매 등의 전형적인 세 가지 증상 외에도 추체외로 증상과 다양한 신경심리 증상이 동반될 수 있다. 이 사례는 불안과 정동증상으로 치료 중 보행장애와 요실금 증상을 보였던 46세 여자 환자에서 항파킨슨 약물의 사용과 기존 정신과 치료 약물의 중단에도 불구하고 증상의 호전이 없었으나, 뇌 컴퓨터 단층 촬영상 뇌실의 확장 소견이 보였고 시험적 뇌척수액 배액에 의해서 수일 내에 증상들이 극적으로 호전되어 정상뇌압수두증을 감별해야 했던 경우이다. 뚜렷한 대뇌 실질의 위축 소견이 없으나 뇌실이 확장되어 있을 경우 추체외로 증상과 신경심리 증상이 있을 경우 정상뇌압수두증의 전형적 세 가지 증상을 보이지 않는다 하더라도 정상뇌압수두증의 가능성을 고려해서 시험적 뇌척수액 배액 등의 시술이 진단과 치료에 도움이 될 수 있음을 보여주는 사례라고 생각된다.

• Journal of Korean Neurosurgical Society
• /
• 제30권8호
• /
• pp.976-980
• /
• 2001

Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.

• Annals of Clinical Neurophysiology
• /
• 제8권2호
• /
• pp.107-124
• /
• 2006

The basal ganglia are a group of nuclei located in the deep portion of the brain. Along with the cerebellum, the basal ganglia have a major role in controlling human voluntary movements, and their dysfunction is apparently responsible for various involuntary movements. Although the exact mechanism of how the basal ganglia control movements has yet to be clarified, the model of focused selection (through the direct pathway) and tonic inhibition (via the indirect pathway) is proposed to be a principal functional model of the basal ganglia. Parkinson's disease (PD) is classically characterized by bradykinesia, rigidity and tremor-at-rest. All features seem to be associated with dopamine depletion resulting from the degeneration of the nigrostriatal pathway, which produces reduced activity of the direct pathway and a concurrent enhancement of excitatory output from STN. This change may result in increased tonic background inhibition and reduced focused selection via the direct pathway, causing difficulties in performing voluntary movements selectively. However, it has not been possible to define a single underlying pathophysiologic mechanism that explains all parkinsonian symptoms. Here the data that give separate understanding to each of the three classic features are discussed.

• 대한한방내과학회지
• /
• 제38권5호
• /
• pp.600-609
• /
• 2017

Drug-induced Parkinsonism is the most frequently observed type among the cases of secondary Parkinsonism. Besides typical parkinsonian symptoms, such as tremor, rigidity and bradykinesia, drug-induced Parkinsonism manifests with additional simultaneous symptoms like orobuccolingual dyskinesia, mixed type of tremor (resting, action), and symmetry of expressions. We present a case of drug-induced Parkinsonism, affected by taking the antiulcer drug cimetidine. Jodeung-san extract (Choto-san, Tsumura Co. 10) was administered for 7 days and acupuncture (electronic, auricular, pharmacopuncture) was conducted 3 times. The clinical outcomes were then evaluated through the patient's global impression of change, visual analogue scale, and Hoehn and Yahr stage. After the treatment, the clinical features, such as tremor and orobuccolingual dyskinesia, disappeared. The combination of Jodeung-san and electro-acupuncture at GB34 could therefore be a remedy for the patients with drug-induced Parkinsonism.