Myung Ji Kim; Su Hee Cho; Yongbo Seo; Sang-Dae Kim; Hae-Chul Park; Bum-Joon Kim
Journal of Korean Neurosurgical Society
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v.67
no.5
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pp.510-520
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2024
Objective : Parkinson's disease (PD) is one of the most prevalent neurodegenerative diseases, characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta. The treatment of PD aims to alleviate motor symptoms by replacing the reduced endogenous dopamine. Currently, there are no disease-modifying agents for the treatment of PD. Zebrafish (Danio rerio) have emerged as an effective tool for new drug discovery and screening in the age of translational research. The neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is known to cause a similar loss of dopaminergic neurons in the human midbrain, with corresponding Parkinsonian symptoms. L-type calcium channels (LTCCs) have been implicated in the generation of mitochondrial oxidative stress, which underlies the pathogenesis of PD. Therefore, we investigated the neuro-restorative effect of LTCC inhibition in an MPTP-induced zebrafish PD model and suggested a possible drug candidate that might modify the progression of PD. Methods : All experiments were conducted using a line of transgenic zebrafish, Tg(dat:EGFP), in which green fluorescent protein (GFP) is expressed in dopaminergic neurons. The experimental groups were exposed to 500 μmol MPTP from 1 to 3 days post fertilization (dpf). The drug candidates : levodopa 1 mmol, nifedipine 10 μmol, nimodipine 3.5 μmol, diethylstilbestrol 0.3 μmol, luteolin 100 μmol, and calcitriol 0.25 μmol were exposed from 3 to 5 dpf. Locomotor activity was assessed by automated tracking and dopaminergic neurons were visualized in vivo by confocal microscopy. Results : Levodopa, nimodipine, diethylstilbestrol, and calcitriol had significant positive effects on the restoration of motor behavior, which was damaged by MPTP. Nimodipine and calcitriol have significant positive effects on the restoration of dopaminergic neurons, which were reduced by MPTP. Through locomotor analysis and dopaminergic neuron quantification, we identified the neuro-restorative effects of nimodipine and calcitriol in zebrafish MPTP-induced PD model. Conclusion : The present study identified the neuro-restorative effects of nimodipine and calcitriol in an MPTP-induced zebrafish model of PD. They restored dopaminergic neurons which were damaged due to the effects of MPTP and normalized the locomotor activity. LTCCs have potential pathological roles in neurodevelopmental and neurodegenerative disorders. Zebrafish are highly amenable to high-throughput drug screening and might, therefore, be a useful tool to work towards the identification of disease-modifying treatment for PD. Further studies including zebrafish genetic models to elucidate the mechanism of action of the disease-modifying candidate by investigating Ca2+ influx and mitochondrial function in dopaminergic neurons, are needed to reveal the pathogenesis of PD and develop disease-modifying treatments for PD.
Objectives Gait disorders are incapacitating symptoms of Parkinson's disease(PD). Here, we report improvements of patients diagnosed with PD treated by Sasang Constitutional Medicine, focused on gait and balance analysis. Methods The patients diagnosed with PD were treated on the basis of Sasang Constitutional Medicine, and their stance and gait status were analyzed by zebris Medical GmbH. To evaluate other general symptoms related with PD, GAS scale, NRS scale, H&Y scale and UPDRS were used. Results Stride length, velocity, stance phase, lateral symmetry were improved in all 6 patients. Other symptoms related to Parkinson's disease were reduced, along with the improvements in GAS scale, NRS scale, H&Y scale and UPDRS score. Conclusion This case study showed Sasang Constitutional Medicine is effective in various symptoms of Parkinson's disease. Especially in regard to the stance and gait status, the improvements were assessed accurately with Gait analysis.
Assessment regarding the nutritional status of Parkinson's disease (PD) patients is important because their nutritional status influences the outcome of disease. The purpose of this study investigated the dietary habits, dietary quality, and quality of life for Korean PD patients according to their nutritional status. Seventy PD patients were recruited from K University Hospital (KMC IRB#0918-07) from February 2010 to October 2011. To diagnose PD, the United Kingdom Parkinson's Society Brain Bank standards were used by a neurology physician. The participants were interviewed and assessed using various tools, including a general questionnaire, anthropometrics, questionnaires for dietary habits, dietary diversity score (DVS), dietary variety score (DVS), diet quality index-international (DQI-I), beck depression inventory (BDI), the Korean version of mini mental state examination (K-MMSE), and 36-item short-form health survey (SF-36). The results of the study were as follows: 1) Most of the PD patients (69.0%) were at risk of malnutrition, and 8.5% and 22.5% of the subjects were malnourished and well-nourished, respectively. 2) Clinical symptoms (swallowing and chewing difficulties) were obvious, and the quality of diet (DDS, DVS, DQI-I) was low in the malnourished group (p < 0.01). 3) The malnourished group had significantly lower scores regarding SF-36 (quality of life) as well as that of cognitive function (p < 0.05). 4) The nutritional status of PD patients was significantly correlated with their depression (p < 0.05) and quality of life (p < 0.01). These results indicate that appropriate nutritional management will improve the nutritional status and quality of life as well as the cognitive function in Parkinson's disease patients.
Lee, Hyo Jin;Lee, Ok Sang;Jung, Sun Hoi;Park, Mi Sook;Lim, Sung Cil
Korean Journal of Clinical Pharmacy
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v.23
no.1
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pp.33-41
/
2013
Background: Prevalence of depression comorbid with neurologic disorders such as Alzheimer' disease (AD), Parkinson's disease (PD) and vascular dementia (VD) is higher than that of primary depression. Antidepressant medications, suggested by many researches for depression comorbid with neurologic disorders such as AD, PD and VD, are mainly selective serotonin reuptake inhibitors (SSRI). Objective: The primary objective of this study is the evaluation of antidepressant drug therapy for AD, PD and VD. Method: This study was a retrospective study based on medical records, carried out for 3 years and 6 months (Jan. 2007~Jul. 2010). Patients, diagnosed as comorbid depression through Beck Depression Inventory (BDI), Cornell Depression Scale (CDS), Geriatric Depression Scale (GDS) among neurologic out-patients of Chungnam National University Hospital because of AD, PD and VD, were selected. The results were evaluated by efficacy and safety of antidepressant drug therapy. Results: In result, the prescribing rates of antidepressants were 30%, 55% and 40% for each AD, PD and VD. Depression cure rates of patients receiving antidepressants vs patients not receiving antidepressants were 40% vs 39%, 33% vs 23% and 38% vs 30% for AD, PD and VD. The frequencies of prescriptoin of SSRI were 21%, 11% and 27% for each AD, PD and VD. The frequencies of prescriptoin of benzodiazepine (BZD) was 61%, 82% and 61% for each AD, PD and VD. The ratio of single BZD prescription was more than that of combination prescription of antidepressants. Tricyclic antidepressants (TCA) were rarely prescribed. The rate of patients with BZD-related side effects was 54%. The most frequent side effects of BZD were dizziness (30%), drowsiness (21%) and headache (16%). Side effects of SSRI were rare. Conclusion: In conclusion, the frequencies of prescription of antidepressants were not common for AD, PD and VD. There was little difference in depression cure rate between patient receiving antidepressants and not receiving. Even though SSRI has to be the highest priority of usage, the frequencies of prescription of SSRI were lower than those of BZD. Additional researches and efforts are required to improve antidepressant drug therapy for neurologic disorders such as AD, PD and VD.
Purpose: The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. Methods: One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were recorded in both groups. T-tests and Pearson's correlation coefficient were used to determine the birth weight odds ratio to analyze the relationship between the periodontal parameters of BOP, CAL, and PD on the one hand and an Apgar score of less than 7. An unpaired Student's t-test was used to analyze differences in means between the case and control groups using SPSS ver. 13. Results: The means of the ages, periodontal pocket depths, attachment loss, areas with BOP, Apgar score in the first 5 minutes and infant birth weight exhibited statistically significant differences between the case and control groups. The ratio of an Apgar score of <7 to periodontal disease was 3.14; the ratio of low birth weight risk in mothers with periodontal disease to that in mothers without periodontal disease was 2.74. Pearson's correlation coefficient revealed a significant correlation between the infant birth weight and BOP, CAL, and PD of the mother. In addition, there was a significant correlation between the Apgar score and BOP, CAL, and PD and also between the Apgar score and infant birth weight. Conclusions: The results of this study showed a significant relationship between periodontal disease and infant birth weight; in addition, there was a significant relationship between the periodontal indexes of BOP, CAL, and PD on the one hand and the Apgar score on the other.
Purpose: This study was done to identify the risk factors associated with falls among patients with Parkinson's Disease(PD). Method: A retrospective study design was used through the collection of physiological and physical health, and psychosocial functions. Results: Of the 100 participants, fifty-nine(59%) reported one or more falls and seventy-one(71%) reported one or more near-falls. Anaverage 34.7 falls and 150.3 near-falls were reported in the previous year per person. Stage of PD, foot problems, balance, fear of falling, and activities of daily living were significantly associated with an increased risk of falls. Conclusion: The findings confirm the high risk of falling in PD patients. Also these results have implications for developing fall prevention programs for PD patients.
Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life - and the need for institutionalization - is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management.
Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects millions of people worldwide. The conventional treatment model for PD have harmful side effects, such as dyskinesia, hallucinations, nausea, and fatigue, and are expensive. As a result, natural products derived from medicinal herbs, fruits, and vegetables have emerged as potential therapeutic strategies for PD. These natural products have been traditionally used to treat various diseases and have been shown to possess anti-oxidative and anti-inflammatory properties, as well as inhibitory roles in protein misfolding, mitochondrial homeostasis, neuroinflammation and other neuroprotective processes. In addition, they have fewer side effects and are generally less expensive than conventional drugs. It also discusses the limitations of current treatments and the potential of natural remedies derived from plants to treat PD in new ways or as supplements to existing treatments. The multifunctional mechanisms of medicinal plants that may be utilized to treat PD are also discussed, including the modulation of neurotransmitter systems, the enhancement of neurotrophic factors, and the inhibition of apoptosis. While more research is needed to fully understand their mechanisms of action and efficacy, natural products have the potential to provide safer and more effective treatment options for patients with PD.
Kim, Keum-Soon;Kim, Bog-Ja;Kim, Kyung-Hee;Choe, Myoung-Ae;Yi, Myung-Sun;Hah, Yang-Sook;Chung, Sun-Ju;Kwon, So-Hi
Journal of Korean Academy of Nursing
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v.37
no.2
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pp.242-248
/
2007
Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.
Parkinson's disease (PD) is the second-most prevalent neurodegenerative disease and is characterized by dopaminergic neuronal death in the midbrain. Recently, the association between alterations in PD pathology and the gut microbiota has been explored. Microbiota-targeted interventions have been suggested as a novel therapeutic approach for PD. Agathobaculum butyriciproducens SR79T (SR79) is an anaerobic bacterium. Previously, we showed that SR79 treatment induced cognitive improvement and reduced Alzheimer's disease pathologies in a mouse model. In this study, we hypothesized that SR79 treatment may have beneficial effects on PD pathology. To investigate the therapeutic effects of SR79 on PD, 6-hydroxydopamine (6-OHDA)-induced mouse models were used. D-Amphetamine sulfate (d-AMPH)-induced behavioral rotations and dopaminergic cell death were analyzed in unilateral 6-OHDA-lesioned mice. Treatment with SR79 significantly decreased ipsilateral rotations induced by d-AMPH. Moreover, SR79 treatment markedly activated the AKT/GSK3β signaling pathway in the striatum. In addition, SR79 treatment affected the Nrf2/ARE signaling pathway and its downstream target genes in the striatum of 6-OHDA-lesioned mice. Our findings suggest a protective role of SR79 in 6-OHDA-induced toxicity by regulating the AKT/Nrf2/ARE signaling pathway and astrocyte activation. Thus, SR79 may be a potential microbe-based intervention and therapeutic strategy for PD.
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