• 제목/요약/키워드: the Unified Parkinson disease rating scale

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

  • 권유리;엄광문;박상훈;김지원;김민직;이혜미;장지완;고성범
    • 한국정밀공학회지
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    • 제30권5호
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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.

자이로센서를 이용한 특발성 파킨슨병 환자와 정상인의 손가락 벌렸다 오므리기 동작의 측정과 비교 (Measurement and Comparison of Finger Tapping Movement in Patients with Idiopathic Parkinson's Disease and Normal Subjects using Gyrosensor)

  • 김지원;권유리;이재호;엄광문;권도영;고성범;박병규;홍정화
    • 대한의용생체공학회:의공학회지
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    • 제31권3호
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    • pp.240-244
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    • 2010
  • The purpose of this study is to compare finger tapping (FT) movement of patients with Parkinson's disease (PD) with normal subjects. A gyrosensor system was used for the measurement of FT movement, because it provides angular velocity free from the gravitational artifact and it can be used during clinical FT test listed in unified PD rating scale (UPDRS). Forty PD patients (age: 65.7 ${\pm}$ 11.1 yrs, H&Y stage:2.3 ${\pm}$ 0.5), 14 age-matched elderly subjects (65${\pm}$3.9 yrs) and 17 healthy young subjects (24${\pm}$2.1yrs) participated in this study. Angular velocity of finger tapping movement was measured in both right and left index finger. As quantitative measures, root-mean-squared (RMS) angular velocity, RMS angle, peak power and total power were used. ANOVA showed that all measures were significantly different among three groups (p<0.001) in all quantitative measures. Post-hoc test revealed that all quantitative measures except peak power in patients with PD were significantly smaller than in both healthy elderly and young subjects (p<0.01). This suggests that the measures developed in this study can distinguish patients with PD from normal subjects.

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

  • 이영은;이동혁;이지현;여서원;조승연;박정미;고창남;배형섭;박성욱
    • Korean Journal of Acupuncture
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    • 제31권1호
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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.

파킨슨병 환자에서의 우울증상 (Depressive Symptoms in Patients with Parkinson's Disease)

  • 이문숙;양창국;한홍무;김재우
    • 정신신체의학
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    • 제11권1호
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    • pp.25-35
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    • 2003
  • 연구목적: 파킨슨병 환자에서 다양한 정신증상이 동반되는 것으로 보고되고 있으며, 특히 우울증상의 동반율이 매우 높다고 보고되고 있다. 특히 파킨슨병은 완치가 어렵고, 치료의 초점이 질병의 진행 억제나 증상의 완화에 있기 때문에 파킨슨병 환자에서의 우울증상에 대한 관심과 치료는 중요하다. 본 연구는 통원치료 중인 파킨슨병 환자들을 대상으로 파킨슨병 관련 임상요인들과 우울증상 사이의 관련성을 조사하는데 목적이 있다. 연구대상 및 방법: 일 대학교병원 신경과 파킨슨병 클리닉에서 특발성 파킨슨병으로 진단 받고 치료중인 환자들 중 본 연구에 참여하기로 동의한 118명의 환자를 대상으로 하였다. 일반적인 인구통계학적 자료, 파킨슨병 관련 자료[발병연령, 치료약물 용량, 임상양상, Hoehn과 Yahr의 단계(Hoehn and Yahr stage, H&Y stage), 일상생활 평가척도(Modified Schwab and England Activities of Daily Living, ADL)], 파킨슨병 환자의 삶의 질 설문지(Parkinson's Disease quality of Life questionnaire, PDQL), 스필버그 상태/특성 불안척도, 간이정신 검사 등을 조사하였고, 우울증상의 평가는 Beck 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 결 과: 대상군의 평균 연령은 $60.4\pm7.1$세(범위:34-73세)였고, 남성이 56명(47.5%), 여성이 62명(52.5%)이었다. 대상군은 BDI 점수에 따라 비우울군 39명(33.1%), 경도 우울군 15명(12.7%), 중등도 우울군 16명(13.6%), 중증 우울군 48명(40.7%)으로 분류되었다. 파킨슨병 환자의 우울증상은 H & Y stage(r=0.34, p<0.001) 및 파킨슨병 증상의 정도(r=0.35, p<0.001), 스필버그 특성 불안 척도(TAI)(r=0.33, p<0.001)와 양의 상관관계가 있었고, 교육정도(r=-0.34, p<0.001), ADL(r=-0.37, p<0.001), PDQL(r=-0.69, p<0.001)과 음의 상관관계를 보였다. 본 연구에서 사용한 검사도구 중 우울증을 예측하는데 가장 의미있는 척도는 PDQL(p<0.005)이었다. 결 론: Beck 우울척도를 이용한 평가에 의하면 본 연구 대상 환자 118명 중 79명(67%)이 주관적인 우울증상을 호소하고 있었다. 본 연구 결과는 파킨슨병 증상이 심할수록, 그리고 H & Y stage가 높을수록 우울증상이 심각함을 보여준다. 또한 BDI 점수가 높을수록 일상생활에서의 활동에 제한이 많으며, 삶의 질이 저하되어 있음을 시사한다. 따라서 본 연구결과는 파킨슨병 환자의 신체증상에 대한 치료 이외 우울증상에 대한 정신의학적 관심과 치료가 중요함을 뒷받침한다.

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특발성 파킨슨병의 시상밑부핵 심부뇌자극술 관련 말 평가 과제에 대한 문헌연구 (Speech Evaluation Tasks Related to Subthalamic Nucleus Deep Brain Stimulation in Idiopathic Parkinson's Disease: A Review)

  • 김선우;김향희
    • 재활복지
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    • 제18권4호
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    • pp.237-255
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    • 2014
  • 특발성 파킨슨병(idiopathic Parkinson disease, IPD)은 알 수 없는 원인으로 인해 중뇌의 흑질신경세포가 손실되는 대표적인 퇴행성 신경계 질환이다. IPD 환자는 신체 운동 이상을 주로 호소하지만 이들 중 70~90%가 운동저하형 마비말장애(hypokinetic dysarthria)를 동반하는 것으로 알려져 있다. 진행된 심도의 IPD 환자의 운동 증상 호전에 가장 효과적인 치료 방법으로 알려진 시상밑부핵 심부뇌자극술(subthalamic nucleus deep brain stimulation, STN-DBS)은 말 산출에서는 그 효과가 일관되지 않게 보고된다. 이에 본 연구에서는 STN-DBS가 말 산출에 미치는 영향을 살펴보고, 연구에서 어떠한 말 평가 과제가 사용되었는지를 조사하기 위하여 medline을 통해 2012까지 이루어진 연구 논문을 수집하였다. 총 32편 중, 연구대상자들에서 술 후 말 상태의'호전'이 관찰된 논문은 42%,'악화'는 29%,'엇갈리는 결과'는 26%,'변화 없음'은 3%로 확인되었다. 말 효과 간에는 문맥발화(contextual speech)가 연구에 사용된 비중이 높을수록 술 후 말 상태는 부정적인 결과로 보고되었으며, 말 산출 단계 중 일부 단계(예: 호흡 및 발성만, 혹은 조음만)만이 반영된 평가 과제가 연구마다 선택적으로 사용되었음을 확인하였다. 이에 본 연구는 STN-DBS를 받은 IPD 환자의 말 평가는 말 산출 하부 단계를 모두 반영하는 문맥발화 과제를 통일적으로 사용할 것을 제안한다.

3차원 보행분석기로 평가한 보행장애 및 자세불안정을 주소로 하는 파킨슨병 환자 한의 치험 2례 (Two Cases of Korean Medicine Treatment for Patients with Parkinson's Disease Evaluated Using a Three-Dimensional Gait Analysis System)

  • 이혜진;황예채;이경화;김동주;조승연;박정미;고창남;박성욱
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.774-790
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    • 2023
  • 본 증례에서는 파킨슨병으로 인한 보행장애 및 자세불안정을 호소하는 환자 2명에 대하여 한의 치료를 시행한 결과 시공간적 보행지표, 운동형상학적 보행지표, UPDRS part III 점수에서 호전이 있었으며, 향후 보행장애 및 자세불안정을 호소하는 파킨슨병 환자에 한의 치료를 활용할 수 있음을 제시하였기에 증례를 보고하는 바이다.

Association of serum carotenoid, retinol, and tocopherol concentrations with the progression of Parkinson's Disease

  • Kim, Ji Hyun;Hwang, Jinah;Shim, Eugene;Chung, Eun-Jung;Jang, Sung Hee;Koh, Seong-Beom
    • Nutrition Research and Practice
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    • 제11권2호
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    • pp.114-120
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    • 2017
  • BACKGROUND/OBJECTIVES: A pivotal role of oxidative stress has been emphasized in the pathogenesis as well as in the disease progression of Parkinson's disease (PD). We aimed at investigating serum levels of antioxidant vitamins and elucidating whether they could be associated with the pathogenesis and progression of PD. MATERIALS/METHODS: Serum levels of retinol, ${\alpha}$- and ${\gamma}$-tocopherols, ${\alpha}$- and ${\beta}$-carotenes, lutein, lycopene, zeaxanthin and ${\beta}$-cryptoxanthin were measured and compared between 104 patients with idiopathic PD and 52 healthy controls matched for age and gender. In order to examine the relationship between antioxidant vitamins and the disease progression, multiple group comparisons were performed among the early PD (Hoehn and Yahr stage I and II, N = 47), advanced PD (stage III and IV, N = 57) and control groups. Separate correlation analyses were performed between the measured antioxidant vitamins and clinical variables, such as Hoehn and Yahr stage and Unified Parkinson's Disease Rating Scale (UPDRS) motor score. RESULTS: Compared to controls, PD patients had lower levels of ${\alpha}$- and ${\beta}$-carotenes and lycopene. ${\alpha}$-carotene, ${\beta}$-carotene and lycopene levels were significantly reduced in advanced PD patients relative to early PD patients and were negatively correlated with Hoehn and Yahr stage and UPDRS motor score in PD patients. No significant differences were found in serum levels of retinol, ${\alpha}$- and ${\gamma}$-tocopherols, and other carotenoids between PD patients and controls. No significant correlations were found between these vitamin levels and clinical variables in PD patients. CONCLUSTIONS: We found that serum levels of some carotenoids, ${\alpha}$-carotene, ${\beta}$-carotene and lycopene, were lower in PD patients, and that these carotenoids inversely correlated with clinical variables representing disease progression. Our findings suggest that decreases in serum ${\alpha}$-carotene, ${\beta}$-carotene and lycopene may be associated with the pathogenesis as well as progression of PD.

번조(煩躁)를 동반한 턱떨림 환자 2례에 대한 증례 보고 (Jaw Tremors with Agitation : Two Cases Report)

  • 한인식;선승호;오현석;이득수;이용현;정종진;이원철
    • 동의생리병리학회지
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    • 제27권1호
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    • pp.142-147
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    • 2013
  • The purpose of this study was to report the effect of Korean medicine and acupuncture in jaw tremor with Agitation. We studied two inpatients who had jaw tremor with agitation in the OO University Korean medicine hospital. They was treated with acupuncture (LU8, LR4, HT3, LR2) and herbal medicine. The effect of treatment was evaluated by Visual Analog Scale(VAS) and motor examination of Unified Parkinson's Disease Rating Scale(UPDRSIII). Both VAS of jaw tremor symptom and agitation and UPDRSIII score of tremor were decreased. The result suggest the combination treatment of herbal medicine and acupuncture might be effective for the jaw tremor with agitation.

심화상염(心火上炎)으로 변증된 손떨림 환자에 청심연자탕가미방 및 침치료 치험 2례 (Hand Tremors Diagnosed as Heart Fire Flaming Upward Syndrome and Treated with Chengsimyeonjatang-gamibang and acupuncture : Two Cases Report)

  • 한인식;이선주;오현석;이득수;이원철;선승호
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.134-141
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    • 2012
  • Object : This clinical study is to report the effects of Chengsimyeonjatang-gamibang on tremors. Methods : Two patients was treated with Chengsimyeonjatang-gamibang and acupuncture that was applied at LU8, LR4, HT3, LR2, GV20, GB20. The effect of treatment was evaluated by Visual Analog Scale(VAS) and Motor examination of Unified Parkinson's Disease Rating Scale(UPDRSIII). Results : After Korean medicine treatment, the patients' VAS and UPDRSIII scores were decreased and conditions were improved. Conclusions : The Korean medicine treatment of Chengsimyeonjatang-gamibang and acupuncture might be effective for the tremors.

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STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol

  • Lee, Ji-Yeoun;Han, Jung-Ho;Kim, Han-Joon;Jeon, Beom-Seok;Kim, Dong-Gyu;Paek, Sun-Ha
    • Journal of Korean Neurosurgical Society
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    • 제44권1호
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    • pp.26-35
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    • 2008
  • Objective : In the evaluation of patients with Parkinson's disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol. Methods : Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery. Results : All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer's guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations. Conclusion : Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients' comfort and improve the clinical symptoms in harmony with STN stimulation.