• Title/Summary/Keyword: UPDRS

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A Case-Study of Taeeumin Patient with Atypical Parkinsonian Disorders Having Dizziness and Gait Disturbance (비정형파킨슨증후군 태음인의 어지럼증과 보행장애 치험례)

  • Park, Jieun;Kim, Kukhwa;Lee, Seul;Lee, Yong-jae;Lee, Jeongyun
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.3
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    • pp.69-80
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    • 2022
  • A 52-year-old female diagnosed with Atypical Parkinsonian Disorders (APD) about one year ago suffered from dizziness and gait disturbance. The patient was identified as Taeeumin esophagus-cold lung-dry symptomatology pattern and was treated with Jowisengcheong-tang. The patient's symptoms of dizziness and night sweats were assessed using Global Assessment Scale (GAS). And, the Unified Multiple System Atrophy Rating Scale (UMSARS) and the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) were used to assess the overall function of the patient. The patient's symptoms of dizziness and night sweats were significantly improved, and UMSARS and MDS-UPDRS scores were decreased. This case showed that Sasang constitutional medicine treatment can improve APD symptoms and improve the quality of life of the patient.

Current Research Trend Analysis of Scalp Acupuncture Teatment for Parkinson's Disease Using the Search Results of China National Knowledge Infrastructure and PubMed (파킨슨병의 두침치료에 대한 최신 연구동향 분석: China National Knowledge Infrastructure, PubMed 검색을 중심으로)

  • Dong-June Lee;Byung-Cheul Shin
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.95-107
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    • 2023
  • Objectives The purpose of this study is to help find the future prospects by analyzing the trends of scalp acupuncture treatment for Parkinson's disease (PD) by searching the China National Knowledge Infrastructure (CNKI) and PubMed. Methods We searched clinical studies adopting scalp acupuncture treatment as a main intervention for PD through the searching the database of CNKI and PubMed. We analyzed the characteristics of selected studies especially according to study design, publication year, sample size, treatment period, treatment methods, outcomes criteria and adverse events. Results Twelve randomized controlled trials studies published from January 1, 2012 to July 1, 2023 were selected. In these studies, two types of scalp acupuncture treatments were performed and the most common treatment was Jiao shunfa's scalp acupuncture with fine needles. The most commonly used acupoints were "Chorea tremor control area", 風池 (GB20), 四神聰 (EX-HN1) and 百會 (GV20). The most commonly used outcome measures were effective rate, unified Parkinson disease rating scale (UPDRS) and UPDRS-III. Conclusions Through these results, we found that the Chinese review literature positively reported the effects of scalp acupuncture on PD. However, more high-quality evaluation using the well-designed studies including more objective outcomes should be required.

Clinical Study of Heart Rate Variability on Patients with Idiopathic Parkinson's Disease according to Clinical Scale(Hoehn-Yahr stage, UPDRS) (특발성 파킨슨병 환자의 임상척도에 따른 심박변이도의 변화에 대한 연구)

  • Park, Sang-min;Lee, Sang-hoon;Jung, Ji-cheol;Kim, Kun-hyung;Park, Hi-joon;Lim, Sabina;Chang, Dae-il;Lee, Yun-ho
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.137-144
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    • 2005
  • Objective : This study was designed to assess the heart rate variablitv of patients with Parkinson's disease according to Hoehn-Yahr stage. Methods : Subjects were voluntarily recruited by newspapers and internet. All the subjects are confirmed as idiopathic parkinson's disease by a neurologist. The patients were grouped by Hoehn-Yahr(H-Y) stage. Heart rate variability was measured for 5 minutes after 5 minutes' bed rest. Subjects were comprised of 3 groups which were H-Y stage I (n=14), H-Y stage H(n=9), H-Y stage III(n=7). We compared the heart rate variability of each groups by one-way ANOVA test. We also studied the relationship between UPDRS score and Heat rate variability components (SDNN, RMS-SD and TP) by pearson correlation analysis and simple linear regressin analysis Results: Age, duration was matched among groups. SDNN, RMS-SD, TP were significantly decreased as H-Y stage increased(p<0.05). Especially there was significant difference between H-Y stage I and III group(p<0.05). But other components(Heart rate, LF, HF, LF/HF ratio) were not showed significant difference. SDNN, RMS-SD and TP were significantly decreased as UPDRS scores increase(p<0.05). Conclusion : This study suggests that the function of the autonomic nervous system decreases as Parkinson`s disease progresses.

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Efficacy of Unilateral Pallidotomy for Parkinson's Diesease (파킨슨씨병 환자에서 편측 담창구파괴술의 효과)

  • Cho, Woo Jin;Lee, Kyung Jin;Ji, Cheul;Park, Sung Chan;Park, Hea Kwan;Jo, Jung Ki;Cho, Kyung Keun;Rha, Hyung Kyun;Kang, Joon Ki;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.8
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    • pp.976-980
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    • 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.

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The Study on the Effect of Acupuncture Treatment in Patients with Idiopathic Parkinson's Disease (특발성 파킨슨 환자에서 경혈(經穴)에 따른 침(鍼) 치료 효과의 비교 연구)

  • Park, Yeon-Cheol;Chang, Dae-Il;Lee, Yun-Ho;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.43-54
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    • 2007
  • Objectives : This study was designed to evaluate the effect of acupuncture with various scales on symptoms of Idiopathic Parkinson's disease. Methods: Subjects were voluntarily recruited through newspapers and internet advertisement. All the subjects were confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 4 weeks by oriental medical doctor at Kyung-hee University hospital. Patients were randomly assigned to three groups : sham acupuncture group, acupuncture treatment group and Sasang-Constitution acupuncture treatment group. Acupun cture points used in acupuncture treatment group were $GB_{34}$, $LR_3$, and $ST_{36}$, which were proven to be effective in rat Parkinson's disease study. Acupuncture points used in sham treatment were non-acupoints near $GB_{34}$, $LR_3$, and $ST_{36}$. In Sasang-Constitution acupuncture treatment, we classfied Sasang constitution of patients by QSCCII. Acupuncture was applied based on theory of Korean medicine. The patient's symptoms were assessed at baseline and after 4 weeks of treatment by one evaluator with Unified Kingdom Parkinson's Disease Rating Scale (UPDRS), modified Hoehn-Yahr(H-Y) stage, and Schwab & England activ ity of daily living and freezing of gait questionnaire (FOGQ). Results : The results were as follows ; 1. UPDRS IV score differences between sham group and Sasang-Constitution acupuncture treatment were statistically significant(p=0.001). 2. UPDRS total score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.041, p=0.014). 5. FOGQ score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.001, p=0.001). Conclusion : The results suggest Sasang-Constitution acupuncture treatment can be applicable to improve symptoms in patients with idiopathic Parkinson's disease.

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SPECT Imaging of Dopamine Transporter with $[^{123}I]{\beta}$-CIT: A Potential Clinical Tool in Parkinson's Disease (파킨슨병에서 $[^{123}I]{\beta}$-CIT SPECT를 이용한 도파민 운반체 영상)

  • Kim, Sang-Eun;Lee, Won-Yong;Chi, Dae-Yoon;Choe, Yearn-Seong;Lee, Kyung-Han;Choi, Yong;Oh, Seung-Jun;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.19-34
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    • 1996
  • [ $[^{123}I]{\beta}$ ]-CIT [$2{\beta}$-carbomethoxy-$3{\beta}$-(4-iodophenyl)tropane]는 도파민 운반체 (dopamine transporter)에 특이결합하며 $[^{123}I]{\beta}$-CIT의 도파민 운반체 결합정도는 파킨슨병에서 도파민 뉴우런의 변성정도를 반영하는 것으로 제안되어 왔다. 이 연구의 주요 목적은 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT SPECT를 이용하여 측정된 $[^{123}I]{\beta}$-CIT의 선조체 결합지표들이 질병의 임상적 진행정도를 반영하는지를 검토하고, 간편화된 조직방사능비가 $[^{123}I]{\beta}$-CIT의 결합정도를 나타내는 정량적 지표로 이용될 수 있는지를 검증하는 것이었다. 파킨슨병 환자 30명($59{\pm}9$세, 평균${\pm}$표준편차: Hoehn-Yahr stage 1-3)과 정상인 6명 ($58{\pm}5$세)을 대상으로 $[^{123}I]{\beta}$-CIT SPECT 영상을 얻었다. $[^{123}I]{\beta}$-CIT 선조체 결합의 정량적 지표로서 (선조체 방사능-소뇌방사능)/소뇌방사능 비(specific binding ratio, SBR)와 추적자역학모델을 이용하여 측정한 선조체 결합능(binding potential)($k_3/k_4$)을 구하였다. 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT의 선조체 결합역학은 정상인에 비하여 현저하게 느렸으며 그 결합지표들은 정상인에 비하여 뚜렷하게 낮았다. 한편, 편측파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT 결합은 증상 반대쪽 선조체 뿐만 아니라 같은 쪽 선조체에서도 정상인에 비해 유의하게 감소되어 있었다. 파킨슨병 환자에서 $[^{123}I]{\beta}$-CIT 투여 후 24시간의 선조체 SBR 및 최대 SBR, 선조체 결합능은 모두, 유병기간, Hoehn-Yahr stage, UPDRS(Unified Parkinson's Disease Rating Scale) 총점, UPDRS 운동점수, UPDRS 일상활동점수와 유의한 상관관계를 나타내었다. 24시간 선조체 SBR과 최대 SBR은 선조체 결합능과 우수한 상관관계를 보였다. 이상의 결과로부터 $[^{123}I]{\beta}$-CIT의 선조체 결합은 파킨슨병의 진행정도를 나타내는 지표로 이용될 수 있다. 또 $[^{123}I]{\beta}$-CIT 투여 후 24시간 영상으로부터 얻은 간편화된 조직방사능 비는 $[^{123}I]{\beta}$-CIT의 결합정도를 정량적으로 반영한다. $[^{123}I]{\beta}$-CIT SPECT는 파킨슨병의 조기진단 및 진행 추적에 임상적으로 유용할 것으로 판단된다.

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Three Case Reports of Postural Instability and Gait Difficulty in Parkinson's Disease Patients Treated with Korean and Western Medicine (파킨슨병 환자의 자세 불안정과 보행장애에 대한 한양방 복합치료 3예)

  • Lee, Young-Eun;Lee, Dong-Hyuk;Lee, Ji-Hyun;Lu, Hsu-Yuan;Cho, Seung-Yeon;Park, Jung-Mi;Ko, Chang-Nam;Bae, Hyung-Sup;Park, Seong-Uk
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.40-47
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    • 2014
  • Objectives : Postural instability and gait difficulty(PIGD) can develop in all Parkinson's disease patients, especially late in the disease course, but does not respond well to conventional dopamine treatment. This study aimed to report three cases of PIGD in Parkinson's disease patients treated with Korean and Western medicine treatment. Methods : We used acupuncture, bee venom acupuncture, herbal medicine and moxibustion to treat patients during hospitalization. They continued Western medication and received rehabilitation treatment. We observed the changes of PIGD using the Unified Parkinson's Disease Rating Scale(UPDRS). Results : After treatment, PIGD symptoms improved and UPDRS scores were decreased. Especially, scores of falling, walking, gait and postural stability subsections related with PIGD were decreased. In addition, general conditions of patients were improved. Conclusions : This study suggests that Korean medicine treatment could be effective in the treatment of PIGD in Parkinson's disease patients.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

A Literature Review of Parkinson's Disease Rating, Balance, Fall and Gait Scales (파킨슨 환자들의 질환등급, 균형, 낙상 및 보행능력 평가척도 고찰)

  • Kim, Chang-Hwan;Kim, Mi-Young;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.25 no.4
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    • pp.441-451
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    • 2015
  • Objective : The purpose of the study was to investigate and compare the differences between Parkinson's disease rating, balance, fall and gait scales. Results : Parkinson's disease rating scales include the Hoehn-Yahr Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). The Hoehn-Yahr Scale can measure disease rates easily; however it is not sensitive enough to evaluate the disease's process and management. UPDRS's advantage is in it's higher inter-reliability score; however it is more complicated to use. Parkinson's balance scales are comprised of the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence Scale (ABC). BBS has the advantage in that it is cheaper to measure and simple in use. ABC's advantage is especially in it's ability to measure higher functional levels; however it is more difficult measure responses due to scores appearing in both extremes. The Fall Efficacy Scale (FES) and The Survey of Activities and Fear of Falling in the Elderly (SAFE) are Parkinson's fall scales. FES's leverage over SAFE is that it is simpler to measure; however it does not coincide with responses which proves disadvantageous in measuring balance loss in high-level Parkinson's patients. SAFE's advantage is in it's simpler use and ability to be utilized without encountering the fear of fall; however it's at a disadvantage in regards to its use with multilateral aspects providing insufficient inspection. Lastly, the Dynamic Gait Index (DGI) and the Functional Gait Assessment (FGA) are Parkinson's gait scales. DGI is advantageous in its ability to test gait ability when exposed to a variety of external environments; however it is disadvantageous in that it registers higher scores with activities. FGA's advantage is in it's dynamic balance test; however it at a disadvantage with those unable to walk. Conclusion : A researcher of Parkinson's patients must choose each scale while considering their positive and negative characteristics.

Quantification of the Effect of Medication and Deep Brain Stimulation on Parkinsonian Rigidity (파킨슨병 환자의 경직에 대한 약물과 DBS 의 효과의 정량화)

  • Kwon, Yu-Ri;Eom, Gwang-Moon;Park, Sang-Hun;Kim, Ji-Won;Kim, Min-Jik;Lee, Hye-Mi;Jang, Ji-Wan;Koh, Seong-Beom
    • Journal of the Korean Society for Precision Engineering
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    • v.30 no.5
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    • pp.559-563
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    • 2013
  • This study aims to quantify the effects of medication (Med) and deep brain stimulation (DBS) on resting rigidity in patients with Parkinson's disease. We tested 10 limbs of five patients under each of four treatment conditions: 1) baseline, 2) DBS, 3) Med, 4) DBS + Med. Rigidity at the wrist joint was assessed using the Unified Parkinson's Disease Rating Scale (UPDRS). The examiner randomly imposed flexion and extension movement on patient's wrist joint. Resistance to passive movement was quantified by viscoelastic properties. Not only rigidity score but also damping constant showed improvements in rigidity by DBS and Med treatments (p<0.05). This indicates that the viscosity can represent the change in rigidity due to DBS as well as Med, which was manifested by UPDRS score.