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Journal articles on the topic 'Hoehn Yahr scale'

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Published: 4 June 2021

Last updated: 13 February 2022

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Verheyden, Geert, Caroline S. Kampshoff, Malcolm E. Burnett, et al. "Psychometric Properties of 3 Functional Mobility Tests for People With Parkinson Disease." Physical Therapy 94, no. 2 (2014): 230–39. http://dx.doi.org/10.2522/ptj.20130141.

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BackgroundStandardized outcome measures with high clinical utility are of paramount importance for clinical practice.ObjectiveThe purpose of this study was to examine interrater and intrarater reliability, construct validity, discriminant ability, and smallest detectable differences of the sit-to-stand test (STS), Timed “Up & Go” Test (TUG), and bed mobility test for people with Parkinson disease (PD).DesignA cross-sectional, psychometric evaluation study was conducted.MethodsA group of individuals with PD (PD group) and a group of individuals who were healthy (control group) were recruited through local PD groups and assessed in a movement laboratory in their “on” phase. Measurements of time to perform one STS, TUG, and bed mobility test were collected based on video recordings of that single performance.ResultsThirty-eight individuals with PD (Hoehn and Yahr stages I–IV) and 19 age-matched control participants were recruited. Intraclass correlation coefficients for interrater and intrarater reliability for the PD group ranged from .95 to .99. Bland-Altman plots showed mean differences close to zero and narrow confidence intervals. Construct validity was established by means of moderate to good Spearman rho correlation coefficients with part III of the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr stage (range=.51–.63). Timings of all tests discriminated participants in the PD group from those in the control group and participants in the PD group in Hoehn and Yahr stages I and II from those in Hoehn and Yahr stages III and IV but did not discriminate “nonfallers” or those with single falls from repeat “fallers” or “nonfreezers” from “freezers.” Applicable smallest detectable differences were established.LimitationsThe results are not generalizable to people in the late stage of PD (Hoehn and Yahr stage IV: n=3).ConclusionsTimings of video recordings of 3 functional mobility tests with high clinical utility showed good psychometric properties for community-dwelling, ambulatory people with PD.

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Veiga, Beatriz Azevedo dos Anjos Godke, Vanderci Borges, Sonia Maria César de Azevedo Silva, Fabrício de Oliveira Goulart, Maysa Seabra Cendoroglo, and Henrique Ballalai Ferraz. "Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients." Revista Brasileira de Psiquiatria 31, no. 1 (2009): 39–42. http://dx.doi.org/10.1590/s1516-44462009000100010.

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OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

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NASSER, JOSÉ AUGUSTO, CARLOS IVAM CONFORT, ANDREI FERRAZ, and ARMANDO ALAMINOS BOUZA. "Preliminary results in surgery of Parkinson's disease." Arquivos de Neuro-Psiquiatria 56, no. 3B (1998): 533–39. http://dx.doi.org/10.1590/s0004-282x1998000400003.

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The authors present the preliminary results of 20 patients selected to be operated on between January 1996 and April 1997. These patients presented one of the present indications for stereotactic postero-ventral pallidotomy (PVP), such as: rigidity, akinesia/bradykinesia, gait dysfunction, drug induced dyskinesias and tremor. Every patient of this protocol was evaluated by: UPDRS score, Schwab and England scale, Hoehn and Yahr Staging Scale before and after surgery. The results in 3 months showed a remarkable improvement after PVP (P<0.01) in all functional assessments, except for facial expression, speech and posture. The morbidity was 5%. 5 patients (25%) who were in Hoehn and Yahr 5 underwent a bilateral simultaneous PVP. In 5 patients (25%), who had tremor, during the PVP, VIM thalamotomy was added. These preliminary results suggest that PVP is highly effective for PD symptoms

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Valderramas, Silvia, Ana Cristina Feres, and Ailton Melo. "Reliability and validity study of a Brazilian-Portuguese version of the fatigue severity scale in Parkinson's disease patients." Arquivos de Neuro-Psiquiatria 70, no. 7 (2012): 497–500. http://dx.doi.org/10.1590/s0004-282x2012000700005.

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The Fatigue Severity Scale (FSS) is one of the most frequently used self-rating scales for fatigue in Parkinson's disease (PD) and it lacks a validated Brazilian-Portuguese version. OBJECTIVE: To determine the construct validity and reproducibility of a Brazilian-Portuguese version of the FSS in patients with PD. METHODS: In a cross-sectional study, a Portuguese-language version of the FSS was applied to 30 patients with PD (62±11 years-old). The Parkinson's disease questionnaire (PDQ-39) was used as the validation criterion, while the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale (UPDRS), and the Beck Depression Inventory were employed to analyze the correlations with the FSS score. RESULTS: The test-retest intraclass correlation coefficient was 0.91 (p<0.01) for the Brazilian-Portuguese version of the FSS score, which was highly correlated with the PDQ-39 overall score (r=0.93; p<0.01) and the Beck Depression Inventory (r=0.75; p<0.01). It showed a correlation with the Hoehn and Yahr scale (r=0.40; p=0.02), and with the UPDRS as well (r=0.45, p=0.01). CONCLUSIONS: The Brazilian-Portuguese version of the FSS is valid and reproducible for using in Brazilian patients with PD.

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Martinez-Martin, Pablo, Matej Skorvanek, Jose Manuel Rojo-Abuin, Zuzana Gregova, Glenn T. Stebbins, and Christopher G. Goetz. "Validation study of the hoehn and yahr scale included in the MDS-UPDRS." Movement Disorders 33, no. 4 (2018): 651–52. http://dx.doi.org/10.1002/mds.27242.

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Shin, Sunghoon, Bee-oh Lim, Michael J. Socie, Jacob J. Sosonff, and Ki-Kwang Lee. "Fourier-Based Footfall Placement Variability in Parkinson’s Disease." BioMed Research International 2019 (April 30, 2019): 1–7. http://dx.doi.org/10.1155/2019/2689609.

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The current investigation examined whether Parkinson’s patients (PD) have greater Fourier-based footfall placement gait with the greatest mobility dysfunction variability (FPV) than the age and gender matched control group and that variability would be the greatest in the PD participants with the greatest mobility dysfunction indexed Hoehn/Yahr scale. 35 persons undergoing PD and 30 age-matched controls participated in this investigation. Participants repeated two trials’ normal walking and average and variability parameters of gait were measured using a 3.66 m electronic walkway. FPV was quantified as a change in the center of pressure during gait. Persons with PD were divided into two groups based on Hoehn/Yahr scale. Overall, persons with PD had smaller average performance indexed by mean and greater gait variability than controls as indexed by CV and Fourier-based variability (p’s<0.05). Moreover, PD with higher mobility dysfunction had not only greater variability in traditional parameters but also greater Fourier-based variability than nonfallers with MS (p<.001) with higher effect size (η2=0.37 vs.0.18-0.29). These observations highlight the fact that footfall placement variability is related to mobility dysfunction in PD. Further study is necessary to determine contributing factors to an increased FPV and whether targeted interventions such as exercise can reduce FPV.

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Nascimento, Natália Feitoza do, and Dominique Babini Lapa de Albuquerque. "Evaluation of functional changes in the evolutionary stages of Parkinson's disease: a case series." Fisioterapia em Movimento 28, no. 4 (2015): 741–49. http://dx.doi.org/10.1590/0103-5150.028.004.ao11.

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Abstract Introduction : Parkinson's disease is one of the fastest growing neurological disorders in the world and is considered to be predominantly a motor disorder, classified as neurodegenerative, chronic and extrapyramidal, characterized by tremors, muscular rigidity, postural balance deficit and bradykinesia. Objective : To analyze the functional changes presented by Parkinson's disease patients in the different evolutionary stages of the disease. Methods : The sample included 30 patients of both genders, aged between 51 and 75 years, with clinical diagnoses of Parkinson's disease in different evolutionary stages, undergoing physiotherapy in the Pernambuco Parkinson Association. The patients were evaluated through the Hoehn and Yahr Staging Scale and the Unified Parkinson's Disease Rating Scale (UPDRS). Results : The results highlighted an increase in the presence and severity of the changes presented by the Parkinson's disease patients, according to the evolution of the stages of the disease, especially considering aspects relating to motor activity and activities of daily living, including changes related to speech, swallowing, the ability to get dressed, personal hygiene, turning in bed and arising from a chair, occurrence of falls, posture, gait, postural stability and the presence of bradykinesia/hypokinesia. Conclusion : It is believed that the classification of the evolutionary stage of patients through the Hoehn and Yahr Scale and the registration of functional change through the UPDRS are useful for the development of the physiotherapy treatment plan.

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Stella, Florindo, Claudio Eduardo Muller Banzato, Elizabeth Maria Aparecida Barasnevicius Quagliato, Maura Aparecida Viana, and Gustavo Christofoletti. "Dementia and functional decline in patients with Parkinson's disease." Dementia & Neuropsychologia 2, no. 2 (2008): 96–101. http://dx.doi.org/10.1590/s1980-57642009dn20200004.

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Abstract Functional decline in Parkinson's disease (PD), characterized by reduced ability to carry out activities of daily living, usually results from typical motor impairment and may be aggravated by concomitant cognitive impairment. Objective: To compare the functional decline in Parkinson's disease between patients with dementia and cognitively preserved patients. Methods: From an original sample composed of 50 patients with a clinical diagnosis of idiopathic PD seen in a consecutive series, 33 non-depressed patients were selected comprising 13 with dementia and 20 cognitively preserved individuals. All patients enrolled in this study were drawn from a public outpatient clinic, specialized in movement disorders. The clinical stage of PD was determined by the Hoehn & Yahr scale, and the functional capacity was verified using the Unified Parkinson's Disease Rating Scale UPDRS ADL (subscale II: activities of daily living) and the Schwab & England scale. The two last scales measure the functional degree of independence in activities of daily living. The neuropsychological assessment was performed using The Cambridge Examination for Mental Disorders of the Elderly - CAMCOG, Cognitive Section and the Stroop Color Word Test. Results: As expected, in comparison with cognitively preserved patients, the group with dementia presented significantly lower scores throughout the neuropsychological evaluation. The patients with dementia were found to have a longer period of disease, a more advanced clinical staging according to the Hoehn & Yahr, and greater functional decline according both to the UPDRS ADL and Schwab & England, with statistically significant difference between the groups. Conclusion: Patients with dementia were at a more advanced clinical stage of Parkinson's disease and evidenced greater functional decline in comparison with patients without dementia.

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Gorzkowska, Agnieszka, Joanna Cholewa, Andrzej Małecki, Aleksandra Klimkowicz-Mrowiec, and Jarosław Cholewa. "What Determines Spontaneous Physical Activity in Patients with Parkinson’s Disease?" Journal of Clinical Medicine 9, no. 5 (2020): 1296. http://dx.doi.org/10.3390/jcm9051296.

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Physical activity (PA) is a factor that may have an influence on the symptoms of Parkinson’s disease (PD). The aim of this study was to identify the potential determinants of spontaneous PA in a PD patient group. A total of 134 PD patients aged 65.2 ± 9.2 years with a Hoehn–Yahr scale score ≤4 and a Mini Mental State Examination (MMSE) score ≥24 were examined. For the study’s purposes, the authors analyzed age, sex, education, history of PD, dopaminergic treatment, the severity of PD symptoms using Unified Parkinson’s Disease Rating Scale (UPDRS), and Hoehn–Yahr scale. Additionally, all participants were evaluated through a set of scales for specific neuropsychiatric symptoms including depression, anxiety, apathy, fatigue, and sleep disorders. A linear regression analysis was used with backward elimination. In the total explanatory model, for 12% of the variability in activity (R2 = 0.125; F(16.133) = 2.185; p < 0.01), the significant predictor was starting therapy with the dopamine agonist (DA) (β= 0.420; t= 4.068; p = 0.000), which was associated with a longer duration of moderate PA. In the total explanatory model, for more than 13% of the variance in time spent sitting (R2 = 0.135; F(16.130) = 2.267; p < 0.01), the significant predictors were secondary education and the results of the UPDRS. The patients with secondary and vocational education, those starting treatment with DA and those with a less severe degree of Parkinson’s symptoms (UPDRS), spent less time sitting in a day. It is possible to identify determinants of spontaneous PA. It may elucidate consequences in terms of influence on modifiable conditions of PA and the proper approach to patients with unmodifiable PA factors.

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Hsu, Tzu-Herng, Tsan-Hon Liou, Kuei-Ru Chou, et al. "Large-Scale Assessment of Function and Disability in Patients with Parkinson’s Disease Using the Functioning Disability Evaluation Scale-Adult Version." International Journal of Environmental Research and Public Health 15, no. 12 (2018): 2788. http://dx.doi.org/10.3390/ijerph15122788.

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This study assesses the functioning and disability related to Parkinson’s disease using the Functioning Disability Evaluation Scale-Adult Version (FUNDES-Adult), based on the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a large-scale database; this study describes, discusses and clarifies the predictive factor of not being in an ambulatory status. Of 7455 patients included in this study, 3561 were not ambulatory and 3894 were ambulatory or assisted ambulatory. Patients with poor walking status revealed higher FUNDES-Adult scores in all domains. Age, modified Hoehn–Yahr stage, living in an institution and the standardized score of FUNDES-Adult domains 1 and 2 were positive independent predictors of the not ambulatory status. The FUNDES-Adult could evaluate multifaceted disability and predict the walking status in patients with Parkinson’s disease.

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Kataoka, Hiroshi, and Kazuma Sugie. "Association between Fatigue and Hoehn-Yahr Staging in Parkinson’s Disease: Eight-Year Follow-Up Study." Neurology International 13, no. 2 (2021): 224–31. http://dx.doi.org/10.3390/neurolint13020023.

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The severity of Parkinson’s disease (PD) is developed by multifactorial factors. Falls can worsen disease severity. We previously found that frontal assessment battery (FAB) score was associated with a higher risk of future falls. This eight-year follow-up study aimed to verify whether factors including low FAB score can be the risk of PD progression based on the Hoehn and Yahr scale. In total, 95 patients were initially enrolled in this research and 45 were included in the final follow-up. Then, the cohort was classified into patients with and without disease progression, defined by upgrade of Hoehn-Yahr stage. Differences in clinical characteristics between patients with disease progression and those without were evaluated using the Mann–Whitney U test. Eighteen independent variables were evaluated via a univariate logistic regression analysis. Of the 45 patients enrolled, 32 had disease progression and 13 had no progression. Age (p = 0.033), BFI score (p = 0.003), Zung self-rating depression (p = 0.011), and anxiety scale (p = 0.026) were significantly increased in patients who had disease progression than those with no disease progression. On multivariate logistic regression analysis, brief fatigue inventory (BFI) score (OR = 1.048, p = 0.045, 95% CI = 1.001–1.098) was significantly related to disease progression. All BFI subscores related to general fatigue. Fatigue could predict the progression of motor dysfunction severity over a longitudinal duration in patients with PD with disease progression, having declining physical and mental fatigue.

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Tsanas, Athanasios, Max A. Little, Patrick E. McSharry, Blake K. Scanlon, and Spyridon Papapetropoulos. "Statistical analysis and mapping of the unified Parkinson’s Disease rating scale to Hoehn and Yahr staging." Parkinsonism & Related Disorders 18, no. 5 (2012): 697–99. http://dx.doi.org/10.1016/j.parkreldis.2012.01.011.

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Sipos-Lascu, Diana, Ștefan-Cristian Vesa, and Lăcrămioara Perju-Dumbravă. "Apathy and Anhedonia: Clinical and Neurophysiological Assessment of a Romanian Cohort." Brain Sciences 11, no. 6 (2021): 729. http://dx.doi.org/10.3390/brainsci11060729.

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Background: Patients with Parkinson’s disease (PD) often have, besides the characteristic motor manifestations, a wide variety of non-motor symptoms. These include apathy and anhedonia, common issues in PD, which can be quantified with the help of evaluation scales recommended by the literature. There are sensory non-motor manifestations of PD, some of which are easy to detect through electrophysiological studies. Our aim was to investigate the possible association of apathy and anhedonia with the severity of the motor status in a sample of PD patients in Romania. We also examined the prevalence of latency changes in the P100 wave of visual evoked potentials (VEPs) and how they correlated with motor status, apathy, and anhedonia in PD patients. Methods: Thirty-four patients with PD participated in this study. All were assessed for motor status using the Unified Parkinson’s Disease Rating Scale (UPDRS) and were rated on the Hoehn and Yahr scales. The presence and severity of apathy and anhedonia were assessed using the Apathy Evaluation Scale (AES), the Dimensional Apathy Scale (DAS), the Lille Apathy Rating Scale (LARS), and the Snaith–Hamilton Pleasure Scale (SHAPS). The latency of the P100 wave of the VEP was measured in all the patients. Results: Apathy and anhedonia were common among the patients with PD (35% and 58.8%, respectively). The presence of apathy/anhedonia was correlated with the severity of motor symptoms, as assessed using the UPDRS scale (p < 0.001), and with the stage of the disease according to the Hoehn and Yahr scale (p < 0.001). A prolonged latency of the P100 wave of the VEP was observed among apathetic (p < 0.001)/anhedonic (p < 0.01) patients and those with increased disease severity (p < 0.001). Conclusion: Apathy and anhedonia are common in PD and may correlate with the severity of motor symptoms. There may be visual impairment in these patients, evidenced by a prolonged P100 latency, which correlates with the severity of disease. Significance: Scales for assessing apathy and anhedonia, as well as measuring VEP latency, could be useful in assessing the severity of disease.

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Franco, Clarissa R. C., Paula Leão, Raquel Townsend, and Carlos R. M. Rieder. "Reliability and validity of a scale for measurement of trunk mobility in Parkinson's disease: Trunk Mobility Scale." Arquivos de Neuro-Psiquiatria 69, no. 4 (2011): 636–41. http://dx.doi.org/10.1590/s0004-282x2011000500012.

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Axial rigidity is an important motor manifestation in Parkinson's disease (PD). Trunk mobility impairment can cause gait, balance and postural problems. However, only few instruments analyze the trunk mobility in PD patients. The aim of this study is to present a new Trunk Mobility Scale (TMS) and its validation in PD. The TMS constituted of dynamic tests involving trunk movements in sagittal, transversal and coronal planes. Ninety eight PD patients and 31 normal controls were analyzed. A strong correlation was found between the TMS scores and the Hoehn & Yahr staging scale (r: 0.72; p<0.01), motor Unified Parkinson's Disease Rating Scale (r: 0.84; p<0.01) and Schwab and England Activities of Daily Living (r: -0.72; p<0.01). The scale showed a satisfactory reliability rate (αCronbach: 0.85, ICC: 099). TMS is a simple and reliable instrument to evaluate trunk mobility impairment in patients with PD.

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Atum, Mahmut, and Bekir Enes Demiryürek. "Retinal morphological changes during the two years of follow-up in Parkinson’s disease." Ideggyógyászati szemle 74, no. 1-2 (2021): 57–63. http://dx.doi.org/10.18071/isz.74.0057.

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The study aims to investigate the relationship between the progression of idiopathic Parkinson’s disease (IPD) and retinal morphology. The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson’s Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

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Sobreira, Emmanuelle, Márcio A. Pena-Pereira, Alan L. Eckeli, et al. "Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised." Arquivos de Neuro-Psiquiatria 73, no. 11 (2015): 929–33. http://dx.doi.org/10.1590/0004-282x20150156.

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ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

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Baggio, Jussara Almeida Oliveira, Monica de Biagi Curtarelli, Guilherme Riccioppo Rodrigues, and Vitor Tumas. "Validation of the Brazilian version of the Clinical Gait and Balance Scale and comparison with the Berg Balance Scale." Arquivos de Neuro-Psiquiatria 71, no. 9A (2013): 621–26. http://dx.doi.org/10.1590/0004-282x20130107.

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Objective To validate the Clinical Gait and Balance Scale (GABS) for a Brazilian population of patients with Parkinson's disease (PD) and to compare it to the Berg Balance Scale (BBS). Methods One hundred and seven PD patients were evaluated by shortened UPDRS motor scale (sUPDRSm), Hoehn and Yahr (HY), Schwab and England scale (SE), Falls Efficacy Scale International (FES-I), Freezing of Gait Questionnaire (FOG-Q), BBS and GABS. Results The internal consistency of the GABS was 0.94, the intra-rater and inter-rater reliability were 0.94 and 0.98 respectively. The area under the receiver operating characteristic (ROC) curve was 0.72, with a sensitivity of 0.75 and specificity of 0.6, to discriminate patients with a history of falls in the last twelve months, for a cut-off score of 13 points. Conclusions Our study shows that the Brazilian version of the GABS is a reliable and valid instrument to assess gait and balance in PD.

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Kim, Chang-Hwan, Mi-Young Kim, Je-Heon Moon, and Bee-Oh Lim. "Effects of Hoehn-Yahr Scale on the Activation of Lower-Extremity Muscles during Walking with Parkinson's Patients." Korean Journal of Sport Biomechanics 24, no. 3 (2014): 287–93. http://dx.doi.org/10.5103/kjsb.2014.24.3.287.

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Arcolin, I., M. Giardini, M. Godi, and S. Corna. "How spatiotemporal gait variables change along the different stages of Hoehn and Yahr scale in Parkinson's disease?" Parkinsonism & Related Disorders 79 (October 2020): e49. http://dx.doi.org/10.1016/j.parkreldis.2020.06.195.

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Paek, Sun Ha, Jung Ho Han, Jee-Young Lee, Cheolyoung Kim, Beom Seok Jeon, and Dong Gyu Kim. "ELECTRODE POSITION DETERMINED BY FUSED IMAGES OF PREOPERATIVE AND POSTOPERATIVE MAGNETIC RESONANCE IMAGING AND SURGICAL OUTCOME AFTER SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION." Neurosurgery 63, no. 5 (2008): 925–37. http://dx.doi.org/10.1227/01.neu.0000334045.43940.fb.

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Abstract OBJECTIVE The electrode position is important to the surgical outcome after subthalamic nucleus (STN) deep brain stimulation (DBS). The aim of this study was to compare the surgical outcome of bilateral STN DBS with the electrode position estimated using fused magnetic resonance imaging. METHODS Bilateral STN DBS was performed in 60 patients with advanced Parkinson's disease. Patients were evaluated with the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, L-dopa equivalent dose, and Short Form-36 Health Survey before and at 3 and 6 months after surgery. Brain magnetic resonance imaging (1.5-T) was performed in 53 patients at 6 months after STN DBS. The electrode position was estimated in the fused pre- and postoperative magnetic resonance images and correlated with the surgical results. RESULTS As a group, the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr staging, Schwab and England Activities of Daily Living, and Short Form-36 Health Survey scores improved at 3 and 6 months after STN DBS. The L-dopa equivalent dose decreased by 60% at 3 and 6 months after STN DBS. The electrode position was divided into 6 types according to its relationship to the STN and the red nucleus. Most off-medication Unified Parkinson's Disease Rating Scale motor subscale scores improved regardless of the type of electrode position. The off-medication speech subscale score improved only in the patients whose electrodes were correctly positioned in the STN bilaterally. CONCLUSION The electrodes accurately positioned in the STN led to improved speech after bilateral STN DBS. An effort should be made in each patient to document the electrode position to monitor surgical performance and to improve the surgical outcome after STN DBS.

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Abe, Kazuo, Mayako Takanashi, Takehiko Yanagihara, and Sabro Sakoda. "Pergolide Mesilate May Improve Fatigue in Patients with Parkinson’s Disease." Behavioural Neurology 13, no. 3-4 (2002): 117–21. http://dx.doi.org/10.1155/2002/473140.

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Objectives:Fatigue is a complaint frequently encountered among patients with Parkinson’s disease (PD). Considering the possible relationship between fatigue and dopaminergic dysfuncion, we investigated the effect of pergolide mesilate (a D2 and D1 dopamine receptor agonist) and bromocriptine (a D2 selective dopamine receptor) in patients with PD.Methods:We evaluated 41 patients with PD and controls. We assessed the degree of fatigue by using a fatigue scale. The severity of PD was evaluated by the Hoehn and Yahr Scale and the unified Parkinson’s disease rating scale (UPDRS).Results:After five weeks from prescription, patients taking pergolide mesilate showed significant improvement in the fatigue scale (from 5.1 ± 0.7 to 4.4 ± 0.55,p< 0.05, ) but patients taking bromocriptine did not (from 4.8 ± 0.9 to 4.7 ± 0.8).Conclusions:Our study suggested the possibility of functional correlation between fatigue and D1 receptor in patients with PD.

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Popescu, Cyprian. "Is sudoscan a reliable tool in detecting small fiber neuropathy in Parkinson’s disease patients?" Neurodegenerative Disease Management 10, no. 2 (2020): 81–93. http://dx.doi.org/10.2217/nmt-2019-0026.

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Aim: Previous studies have revealed uncertainties concerning the utility of sudoscan in identifying small fiber neuropathy in Parkinson’s disease (PD). Patients & methods: We searched for a significant reduction of electrochemical skin conductance (ESC) in 67 PD patients versus 66 controls with similar characteristics. We conducted analysis of the subgroups of PD patients without diabetes using sudoscan technology. Results: There is no discrimination between patients and controls relative to feet ESC, the modified Hoehn and Yahr Scale and/or Unified Parkinson's Disease Rating Scale. ESC in patients did not differ significantly according to the Unified Parkinson's Disease Rating Scale score. The oldest PD patients with cardiovascular risk factors have more marked small fibers dysfunction. Conclusion: The sudoscan procedure did not show advantage in the diagnosis of small fiber neuropathy. Its diagnostic value increases in some subgroups of patients with cardiovascular co-morbidity.

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Khomenko, Y. G., I. V. Miliukhina, E. V. Gracheva, et al. "Magnetic resonance spectroscopy in Parkinson’s disease." Bulletin of Siberian Medicine 18, no. 4 (2020): 150–60. http://dx.doi.org/10.20538/1682-0363-2019-4-150-160.

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Introduction. Modern neuroimaging methods allow to evaluate in vivo biochemical processes in the brain. Such methods include magnetic resonance spectroscopy (MRS) and positron emission tomography (PET). While PET is the “golden standard” in assessing the brain functional state and is widely used in neurodegenerative diseases, the diagnostic value of MRS remains undefined due to the inconsistency of the results obtained in different studies. At the same time, MRC allows obtaining information on the content of many metabolites in living tissues, including N-acetyl aspartate (NAA), which is considered to be a surrogate marker of neuronal integrity, choline (Cho), associated with membrane metabolism, Cr - energy metabolism, etc. The aim of this study is to compare MRS and PET data in patients with Parkinson’s disease (PD).Materials and methods. Twenty-six patients with PD stages I to III according to the Hoehn and Yahr Scale and age-matching control group of neurologically and cognitively intact people were examined. All patients underwent neurological examination, a multivoxel MRS of the supraventricular region, including white and gray matter, and PET with 18F-fluorodeoxyglucose (FDG) to assess cerebral metabolic rate of glucose (CMRglu).Results. Decrease of NAA/Cr and NAA/Cho in the white matter in the left hemisphere was revealed in PD group compared to control, with the NAA/Cr ratio negatively correlating with the stage of the disease of the Hoehn and Yahr Scale. The NAA content in the white matter and the cingulate cortex positively correlated with CMRglu in Brodmann fields 5–7, 8–10, 22, 23, 46. At the same time, Cho/Cr ratio negatively correlated with CMRglu in the cortical areas associated with the development of cognitive impairment in PD (Brodman areas 9, 10, 39, 47).

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Artigas, Nathalie Ribeiro, Clarissa Franco, Paula Leão, and Carlos R. M. Rieder. "Postural instability and falls are more frequent in Parkinson’s disease patients with worse trunk mobility." Arquivos de Neuro-Psiquiatria 74, no. 7 (2016): 519–23. http://dx.doi.org/10.1590/0004-282x20160074.

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ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.

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Baggio, Jussara A. Oliveira, Mônica B. Curtarelli, Guilherme R. Rodrigues, and Vitor Tumas. "Validity of the Brazilian version of the freezing of gait questionnaire." Arquivos de Neuro-Psiquiatria 70, no. 8 (2012): 599–603. http://dx.doi.org/10.1590/s0004-282x2012000800008.

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OBJECTIVE: To validate the freezing of gait questionnaire (FOG-Q) for a Brazilian population of Parkinson's disease (PD) patients. METHODS: One hundred and seven patients with a diagnosis of PD were evaluated by shortened UPDRS motor scale (sUPDRm), Hoehn and Yahr (HY), Schwab and England scale (SE), Berg balance scale (BBS), falls efficacy scale international (FES-I), gait and balance scale (GABS), and the FOG-Q Brazilian version. RESULTS: 47.7% of PD patients had FOG episodes; this group had worse scores on sUPDRSm, FOGQ, FES-I, BBS, GABS and FOG item of UPDRS when compared to the PD group without FOG. The internal consistency was 0.86, intra-rater 0.82 and inter-rater 0.78. The FOG-Q Brazilian version was significantly correlated with items related to gait and balance. The ROC curve was 0.94, the sensitivity was 0.90and specificity was 0.92. CONCLUSION: Our study suggests that the FOG-Q Brazilian version is a reliable and valid instrument for assessing FOG in PD patients.

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Camargo, Carlos Henrique Ferreira, Rafael Arthur Serpa, Thiago Matnei, Jivago Szpoganicz Sabatini, and Hélio Afonso Ghizoni Teive. "The perception of apathy by caregivers of patients with dementia in Parkinson's disease." Dementia & Neuropsychologia 10, no. 4 (2016): 339–43. http://dx.doi.org/10.1590/s1980-5764-2016dn1004014.

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ABSTRACT Background: Apathy is one of the main neuropsychiatric symptoms in patients with Parkinson's disease (PD) and is associated with Parkinson's disease dementia (PDD). Objective: To identify the characteristics of apathy in individuals with PDD according to caregiver perception. Methods: Thirty-nine patients with PD according to MDS criteria for PDD were included. The following scales were used: the Hoehn and Yahr, the Unified Parkinson's Disease Rating Scale III, Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA Cog), the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Apathy Evaluation Scale (AES). Results: A total of 97.4% of the patients showed results consistent with apathy. Analysis of question 14 of the AES revealed no correlation with the total result of all the questions [r=-1293, r²=0.0167, 95%CI (-0.4274 to 0.1940), P=0.2162], however, there was a correlation of responses to the same question with depression data on the MADRS scale [r=-0.5213, r²=0.2718, 95%CI (-0.7186 to -0.2464), P=0.00033]. Conclusion: Apathy is a disorder associated with PDD. However, the scoring scheme of the AES questions can lead to different interpretations of caregiver responses, highlighting limitations of the tool for use in studies of PDD.

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Kimura, Hideki, Masayuki Kurimura, Katsurou Kurokawa, et al. "A Comprehensive Study of Repetitive Transcranial Magnetic Stimulation in Parkinson's Disease." ISRN Neurology 2011 (August 8, 2011): 1–7. http://dx.doi.org/10.5402/2011/845453.

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The clinical benefits of repetitive transcranial magnetic stimulation (rTMS) for Parkinson's disease (PD) remain controversial. We performed a comprehensive study to examine whether rTMS is a safe and effective treatment for PD. Twelve PD patients received rTMS once a week. The crossover study design consisted of 4-week sham rTMS followed by 4-week real rTMS. The Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoehn and Yahr Stage, Schwab and England ADL Scale, Actigraph, Mini-Mental State Examination, Hamilton Depression Scale, Wechsler Adult Intelligence Scale-revised, and cerebral blood flow (CBF) and cerebrospinal fluid (CSF) examinations were used to evaluate the rTMS effects. Under both drug-on and drug-off conditions, the real rTMS improved the UPDRS scores significantly, while the sham rTMS did not. There were no significant changes in the results of the neuropsychological tests, CBF and CSF. rTMS seems to be a safe and effective therapeutic option for PD patients, especially in a wearing-off state.

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Scalzo, Paula Luciana, Carolina Reis Flores, Juliana Rúbia Marques, Simone Cristina de Oliveira Robini, and Antônio Lúcio Teixeira. "Impact of changes in balance and walking capacity on the quality of life in patients with Parkinson's disease." Arquivos de Neuro-Psiquiatria 70, no. 2 (2012): 119–24. http://dx.doi.org/10.1590/s0004-282x2012000200009.

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Parkinson's disease (PD) is characterized by motor symptoms that cause the decline of functional capacity and affect the quality of life (QoL). Objective: To evaluate the impact of changes in balance and walking capacity on the PD. Methods: The instruments used were: Unified Parkinson's Disease Rating Scale (UPDRS), modified Hoehn and Yahr Scale (HY), Schwab and England scale (SE), quality of life questionnaire (PDQ-39), Berg balance Scale (BBS) and six-minute walk test (6MWT). Results: Thirty-six patients with mean disease duration of 7.3 years were assessed. Lower scores on the BBS and shorter distances walked during the 6MWT correlated with a poorer perception of QoL. This correlation occurred at the expense of the mobility and daily living activities domains. Conclusion: Our results indicated that the impairment in balance while performing functional activities and the reduction in walking capacity are important factors that negatively affect the perception of QoL in PD patients.

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Lana, Raquel de Carvalho, Lysandra Nogueira de Araujo, Francisco Cardoso, and Fátima Rodrigues-de-Paula. "Main determinants of physical activity levels in individuals with Parkinson’s disease." Arquivos de Neuro-Psiquiatria 74, no. 2 (2016): 112–16. http://dx.doi.org/10.1590/0004-282x20160009.

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ABSTRACT This study analyzed the relationship between patient characteristics, factors associated with Parkinson’s disease (PD), and physical activity level of individuals affected by the disease. Forty-six volunteers with mild-to-moderate idiopathic PD were assessed using sections II/III of the Unified Parkinson’s Disease Rating Scale and their motor functions were classified according to the modified Hoehn and Yahr (HY) scale. Data such as age, disease duration, the Human Activity Profile (HAP), the Fatigue Severity Scale were collected. Lower limb bradykinesia and clinical subtypes of PD were defined. Two models that explained 76% of the variance of the HAP were used. The first comprised age, ability to perform activities of daily living (ADL), and the HY scale; the second comprised age, ability to perform ADL, and lower limb bradykinesia. Possible modifiable factors such as the ability to perform ADL and lower limb bradykinesia were identified as predictors of physical activity level of individuals with PD.

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Barbosa, Egberto R., Luiz R. Comerlatti, Monica S. Haddad, and Milberto Scaff. "Parkinsonism secondary to ethylene oxide exposure." Arquivos de Neuro-Psiquiatria 50, no. 4 (1992): 531–33. http://dx.doi.org/10.1590/s0004-282x1992000400020.

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Ethylene oxide is a gas widely used in the production of industrial chemicals. It is also used to sterilize heat-sensitive medical supplies. Previous reports of acute and chronic exposure have described neurotoxic effects like peripheral neuropathy and cognitive impairment. We describe a pure parkinsonian syndrome following acute ethylene oxide intoxication. A 39-years-old male was referred to our Movement Disorders Clinic tor evaluation of a parkinsonian syndrome. He was acutely exposed to ethylene oxide four years before and remained comatose for three days, and gradually regained consciousness.. At that time he showed a global parkinsonian syndrome including bradykinesia, rigidity and rest tremor, with a severe motor disability; no other neurological disorders were found. The symptomatology was partially controlled with biperidene and levodopa plus carbidopa. Two years later he developed L-dopa induced dyskinesias. Four years after the intoxication he was evaluated at our clinic. General examination showed no abnormalities. Neurologic examination revealed a normal menta1 status. Motor evaluation disclosed moderate bradykinesia, rigidity and rest tremor, shuffling gait, poor facial mimic, stooped posture, and his speech was low and monotonous; deep tendon reflexes were brisk. The Hoehn-Yahr disability score was degree IV. Routine laboratory and radiological exams showed results within normal limits. The CSF examination was normal. Brain computed tomography and magnetic ressonance were normal. A trial with bromocriptine and levodopa plus carbidopa did not improve dyskinesia, and he was put on a schedule including amantadine and biperidene with improvement to grade III in Hoehn-Yahr scale. In the present case there was a clear relation between the acute exogenous intoxication and irreversible parkinsonism. No other causes for the condition were identified.

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Locke, Maren C., Samuel S. Wu, Kelly D. Foote, et al. "Weight Changes in Subthalamic Nucleus vs Globus Pallidus Internus Deep Brain Stimulation: Results From the COMPARE Parkinson Disease Deep Brain Stimulation Cohort." Neurosurgery 68, no. 5 (2011): 1233–38. http://dx.doi.org/10.1227/neu.0b013e31820b52c5.

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Abstract BACKGROUND: Parkinson's patients, on average, gain weight after deep brain stimulation (DBS). OBJECTIVE: To determine potential differences in weight gain when comparing the subthalamic nucleus and the globus pallidus internus target. METHODS: A retrospective analysis was performed on the prospective, randomized cohort of National Institutes of Health COMPARE trial DBS patients who received unilateral subthalamic nucleus or globus pallidus internus DBS. Baseline weights were recorded before DBS surgery and at 6, 12, and 18 months postoperatively. Relationships between weight change and changes in Beck Depression Inventory score, Unified Parkinson's Disease Rating Scale (UPDRS) motor score (part III) (also the dyskinesia duration and disability subscores from UPDRS IV), and Hoehn-Yahr stage were determined via Spearman's rank-order correlation coefficients. Regression analyses were performed to investigate the effects of potential factors on weight change over time. RESULTS: Patients in the COMPARE DBS cohort gained a significant amount of weight, a mean of 4.86 lb (standard deviation = 8.73) (P = .001), but there was no significant difference between subthalamic nucleus and globus pallidus internus targets (weight gain of 4.29 ± 6.79 and 5.38 ± 10.32 lb, respectively; P = .68). Weight gain did not correlate with Beck Depression Inventory score change, UPDRS motor score, dyskinesia duration, dyskinesia disability change, or the Hoehn-Yahr stage (P = .62, .21, and .31, respectively). No specific variable was associated with weight gain, and there were no differences in binge eating post-surgery in either target. CONCLUSION: There were significant changes in weight over time after DBS therapy. However, neither Beck Depression Inventory score change nor UPDRS score change or dyskinesia was correlated with weight gain. No significant factor was associated with the weight change.

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Gupta, Deepak K., Stanley Fahn, Curtis Tatsuoka, and Un Jung Kang. "Hoehn and Yahr stage 3 and postural stability item in the movement disorder society-unified Parkinson's disease rating scale." Movement Disorders 33, no. 7 (2018): 1188–89. http://dx.doi.org/10.1002/mds.27453.

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Bonifacio, Juan P., Matías Costa Paz, Lisandro Carbo, Carlos Yacuzzi, and Emilio Corinaldesi. "Prótesis total de rodilla en pacientes con enfermedad de Parkinson. Resultados preliminares." Revista de la Asociación Argentina de Ortopedia y Traumatología 79, no. 2 (2014): 99. http://dx.doi.org/10.15417/224.

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<div class="page" title="Page 1"><div class="layoutArea"><div class="column">Introducción: La enfermedad de Parkinson es un trastorno neurodegenerativo progresivo y crónico, con una incidencia aproximada de 31/100.000 habitantes en la Argentina. El objetivo de este estudio fue analizar un grupo de pacientes con enfermedad de Parkinson sometidos a artroplastia total de rodilla.Materiales y Métodos: Entre 2009 y 2011, se evaluó a 11 pacientes (edad promedio 68 años, rango 65-80) con enfermedad de Parkinson que fueron operados por artrosis de rodilla con prótesis cementadas estabilizadas a posteriori. Todos fueron evaluados con la escala analógica visual para el dolor, el Knee Society Scoring, el WOMAC y el grado de satisfacción subjetiva. El grado de afectación de la enfermedad de Parkinson se determinó con la escala modificada de Hoehn y Yahr. Se registraron las complicaciones.Resultados: El seguimiento promedio fue de 2 años (rango 1-3). Las evaluaciones para dolor y funcionales arrojaron los siguientes resultados: la escala analógica visual para el dolor mejoró 3 puntos promedio; KSS dolor 37/74; KSS funcional 36/51, WOMAC 67/31. El grado de satisfacción de los pacientes fue de bueno a excelente en 7 casos. La escala modificada de Hoehn y Yahr fue de 1,5 puntos en el preoperatorio y de 2,6 puntos en el posoperatorio. Hubo 6 complicaciones: dos síndromes confusionales, una trombosis venosa profunda, una luxación protésica y dos prótesis dolorosas.Conclusión: La artroplastia total de rodilla en pacientes con enfermedad de Parkinson es un procedimiento que mejora los resultados funcionales y el dolor, pero provoca mayores complicaciones que en la población general. <div class="page" title="Page 1"><div class="layoutArea"><div class="column">Total knee arthroplasty in Parkinson’s disease patients. Preliminary results Abstract Background: Parkinson’s disease is a progressive, chronic, neurodegenerative disorder with an approximate incidence of 31/100,000 persons in Argentina. The aim of this study was to assess a group of patients with Parkinson’s disease who underwent total knee arthroplasty.Methods: Between 2009 and 2011, 11 patients with Parkinson’s disease (average age 68 years, range 65-80) who underwent cemented posterior stabilized total knee arthroplasty for osteoarthritis were retrospectively reviewed. All patients were evaluated with a visual analogue scale for pain, the Knee Society Scoring, the WOMAC and the degree of subjective satisfaction. Degree of Par- kinson severity was measured with the Modified Hoehn and Yahr Scale. Complications were recorded.Results: The average follow-up was two years (range 1-3). Results for pain and function were: visual analogue scale for pain improved an average of 3 points; KSS pain 37/74; functional KSS 36/51, WOMAC 67/31. Satisfaction was good to excellent in 7 cases. The Modified Hoehn and Yahr Scale was 1.5 points preoperatively and 2.6 points postoperatively. There were 6 complications: two confusional syndromes, a deep venous thrombosis, a prosthetic dislocation and two painful prostheses.Conclusion: Total knee arthroplasty in patients with Parkinson’s disease is a procedure that improves functional outcomes and pain, but it produces more complications than in the general population. </div></div></div> </div></div></div>

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Campos, Lidiane S., Rachel P. Guimarães, Luiza G. Piovesana, Paula C. de Azevedo, Leonilda M. B. Santos, and Anelyssa D’Abreu. "Clinical predictors of cognitive impairment and psychiatric complications in Parkinson’s disease." Arquivos de Neuro-Psiquiatria 73, no. 5 (2015): 390–95. http://dx.doi.org/10.1590/0004-282x20150016.

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Objective To estimate the clinical and demographics aspects that may contribute to cognitive impairment and psychiatric symptoms in Parkinson’s disease (PD). Method All patients answered a structured standardized clinical questionnaire. Two movement disorders specialists performed the following scale: Unified Parkinson’s disease rating score (UPDRS), the modified Hoehn and Yahr staging, Schwab and England Scale, SCOPA cognition (SCOPA-COG), SCOPA-Psychiatric complications (SCOPA-PC) and Non-Motor Symptoms Scale (NMSS). We built a generalized linear model to assess predictors for the SCOPA-COG and SCOPA-PC scores. Results Almost 37% of our patients were demented as per SCOPA-COG scores. Level of education and the UPDRS-Subscale III were predictors of cognitive impairment. Higher scores in domain 3 of NMSS and male gender were associated with psychiatric complications as assessed per the SCOPA-PC. Conclusion Level of education and disease severity are predictors of dementia in PD. Psychiatric complications are more commonly observed in men.

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Katayama, Yoichi, Masahiko Kasai, Hideki Oshima, et al. "Subthalamic nucleus stimulation for Parkinson disease: benefits observed in levodopa-intolerant patients." Journal of Neurosurgery 95, no. 2 (2001): 213–21. http://dx.doi.org/10.3171/jns.2001.95.2.0213.

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Object. A blinded evaluation of the effects of subthalamic nucleus (STN) stimulation was performed in levodopaintolerant patients with Parkinson disease (PD). These patients (Group I, seven patients) were moderately or severely disabled (Hoehn and Yahr Stages III–V during the off period), but were receiving only a small dose of medication (levodopa-equivalent dose [LED] 0–400 mg/day) because they suffered unbearable side effects. The results were analyzed in comparison with those obtained in patients with advanced PD (Group II, seven patients) who were severely disabled (Hoehn and Yahr Stages IV and V during the off period), but were treated with a large dose of medication (500–990 mg/day). Methods. The patients were evaluated twice at 6 to 8 months after surgery. To determine the actual benefits afforded by STN stimulation to their overall daily activities, the patients were maintained on their medication regimen with optimal doses and schedules. Stimulation was turned off overnight for at least 12 hours. It was turned on in the morning (or remained turned off), and each patient's best and worst scores on the Unified Parkinson's Disease Rating Scale during waking daytime activity were recorded as on- and off-period scores, respectively. The order of assessment with respect to whether stimulation was occurring was determined randomly. The STN stimulation markedly improved daily activity and total motor scores in Group I patients. The percentage time of immobility (Hoehn and Yahr Stages IV and V) became 0% in patients who were intermittently immobile while not receiving stimulation. Improvements were demonstrated in tremor, rigidity, akinesia, and gait subscores. The STN stimulation produced less marked but still noticeable improvements in the daily activity and total motor scores in Group II patients. The percentage time of immobility as well as the LED was reduced in patients who displayed intermittent immobility with pronounced motor fluctuations while not receiving stimulation. Improvements were demonstrated in tremor, rigidity, and dyskinesia subscores in these patients. In contrast, STN stimulation did not improve the overall daily activities at all in patients who had become unresponsive to a tolerable dose of levodopa and were continuously immobile, even though these patients' tremor and rigidity subscores were still improved by stimulation. Conclusions. Consistent with earlier findings, the great benefit of STN stimulation in levodopa-intolerant patients is that STN stimulation can reduce the level of required levodopa medication. This suggests that STN stimulation could be a therapeutic option for patients with less-advanced PD by allowing levodopa medication to be maintained at as low a dose as possible, and to prevent adverse reactions to the continued use of large-dose levodopa.

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Letro, Grace Helena, Elizabeth M. A. B. Quagliato, and Maura Aparecida Viana. "Pain in Parkinson's disease." Arquivos de Neuro-Psiquiatria 67, no. 3a (2009): 591–94. http://dx.doi.org/10.1590/s0004-282x2009000400003.

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Pain may precede the diagnosis in Parkinson's disease (PD). The goal of this study was to assess the pain in a group of 20 females and 30 males with PD, after excluding co-morbidities as causes. It was used the following tools: Unified Parkinson's Disease Rating Scale, McGill questionnaire and Beck Depression Inventory. In 27 patients (54%), the pain was associated with PD, occurring in 22 (44%) in the off period and 5 (10%) in both on and off periods. The off period resulted in an increased frequency of pain, which was related to stiffness. There was no association between pain and tremor in off period, neither between pain and Modified Hoehn and Yahr stage, nor the Schwab and England scale. It was not observed an association between pain and depression, neither between pain and dyskinesia. It was noticed the improvement in pain in 16 patients with levodopa (59.26%).

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Pirscoveanu, Denisa Floriana Vasilica, Valerica Tudorica, Cornelia Zaharia, et al. "COGNITIVE DECLINE IN PATIENTS WITH PARKINSON’S DISEASE." Romanian Journal of Neurology 16, no. 4 (2017): 133–40. http://dx.doi.org/10.37897/rjn.2017.4.1.

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The goal of our study was to assess the cognitive state in patients with Parkinson′s disease (PD). We studied 62 patients (30 men and 32 women, mean age 71.1± 4.5 years and mean educational level 11.5 ± 1 years). They were admitted to the Clinic of Neurology from Craiova between January 2015 – January 2016 for Parkinson’s disease. All the patients met the diagnostic criteria for Parkinson′s disease. In this study we included only patients in stage I and II on Hoehn and Yahr scale. 35 patients were in stage I and 27 patients in stage II. The patients were treated with levo-dopa monotherapy or dopaminergic agonists monotherapy. We have also included in our study a control group composed of 70 control subjects with the same range of educational level and age. To assess the cognitive state we tested the patients using Cambridge Cognitive Examination (CAMCOG) and the revised version of the Addenbrooke′s Cognitive Examination (ACE-R) at baseline, after 6 months and one year later. For the statistical analyse, we used Student test (p<0.05 statistically considerable). At baseline the patient group showed a mean CAMCOG score 92.5 and a mean ACE-R score 89.6. The control subjects showed a mean CAMCOG score 94.3 and a mean ACE-R score 90.2. One year later the patient group showed a mean CAMCOG score 83.5 and 84.3 mean ACE-R score. The control group showed a mean CAMCOG score 90.2 and mean ACE-R score 88.3. The patients with PD showed a greater cognitive impairment than the control subjects. We observed that the patients in stage II Hoehn and Yahr had a greater cognitive impairment than patients in stage I. We have also seen in patient group a cognitive decline across every ACE-R and CAMCOG cognitive domaine.

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Silva, Paula Fernanda da Costa, Rita Pavione Rodrigues Pereira, Soraia Micaela Silva, João Carlos Ferrari Corrêa, and Fernanda Ishida Corrêa. "Correlação entre perfil clínico, qualidade de vida e incapacidade dos pacientes da Associação Brasil Parkinson." ConScientiae Saúde 10, no. 4 (2011): 650–56. http://dx.doi.org/10.5585/conssaude.v10i4.3095.

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Introdução: Portadores da Doença de Parkinson (DP) apresentam sintomas como os tremores de repouso, o freezing, a bradicinesia e a rigidez muscular que levam ao declínio funcional e dificuldades na execução das atividades de vida diária (AVD), consequentemente, comprometendo sua qualidade de vida (QV). Objetivo: Caracterizar o perfil clínico e percepção de QV de parkinsonianos assistidos na Associação Brasil Parkinson (ABP) e correlacionar com a progressão da doença e nível de incapacidade. Método: A avaliação clínico-funcional dos indivíduos foi realizada por meio da Unified Parkinson’s Disease Rate Scale (UPDRS), Escala de estágios de incapacidade de Hoehn e Yahr (HY) modificada e Questionário da doença de Parkinson (PDQ-39). Resultados: Não houve correlação significante entre progressão da doença e QV; porém, observou-se correlação moderada (r=0,5) entre incapacidade e QV, p

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Stella, Florindo, Lilian T. B. Gobbi, Sebastião Gobbi, Merlyn M. Oliani, Kátia Tanaka, and Frederico Pieruccini-Faria. "Early impairment of cognitive functions in Parkinson's disease." Arquivos de Neuro-Psiquiatria 65, no. 2b (2007): 406–10. http://dx.doi.org/10.1590/s0004-282x2007000300008.

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BACKGROUND: Impairment in non-motor functions such as disturbances of some executive functions are also common events in Parkinson's disease patients. OBJECTIVE: To verify the performance of Parkinson's disease patients in activities requiring visuoconstructive and visuospatial skills. METHOD: Thirty elderly patients with mild or moderate stages of Parkinson's disease were studied. The assessment of the clinical condition was based on the unified Parkinson's disease rating scale (56.28; SD=33.48), Hoehn and Yahr (2.2; SD=0.83), Schwab and England (78.93%), clock drawing test (7.36; SD=2.51), and mini-mental state examination (26.48; SD=10.11). Pearson's correlation and stepwise multiple regression were used for statistical analyses. RESULTS: The patients presented deterioration in visuospatial and visuoconstructive skills. CONCLUSION: The clock drawing test proved to be a useful predictive tool for identifying early cognitive impairment in thesbe individuals.

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Clael, Sacha, Filipe Dinato De Lima, Elaine Cristina da Silva Brandão, et al. "Association between functional balance and knee extensors strength in people with Parkinson’s disease." PAJAR - Pan American Journal of Aging Research 7, no. 1 (2019): 32367. http://dx.doi.org/10.15448/2357-9641.2019.1.32367.

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Aims: The aim of this study is to verify if there is a correlation between functional balance and muscular strength of knee extensors in individuals with Parkinson’s disease.Methods: The sample consisted of 28 volunteers with Parkinson’s disease (age: 65.43±8.48 years, height: 1.68±0.10 cm, weight: 71.50±13.27 kg) classified on the modified Hoehn & Yahr scale. The Four Step Square Test and the isokinetic dynamometer were used to evaluate the dynamic balance and muscular strength of knee extensors, respectively.Results: The peak torque shows a moderate, negative and significant correlation with the Four Step Square Test (right knee: r=-0.471 and p=0.012; left knee: r=-0.444 and p=0.018).Conclusions: There is a negative, moderate and significant association between muscular strength of knee extensors and dynamic balance in Parkinson’s disease individuals.

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Alieva, Anelya Kh, Maria I. Shadrina, Elena V. Filatova, et al. "Involvement of Endocytosis and Alternative Splicing in the Formation of the Pathological Process in the Early Stages of Parkinson’s Disease." BioMed Research International 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/718732.

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Parkinson’s disease (PD) is the one of most widespread neurodegenerative pathologies. Because of the impossibility of studying the endogenous processes that occur in the brain of patients with PD in the presymptomatic stage, the mechanisms that trigger the disease remain unknown. Thus, the identification of the processes that play an important role in the early stages of the disease in these patients is extremely difficult. In this context, we performed a whole-transcriptome analysis of the peripheral blood of untreated patients with stage 1 PD (Hoehn-Yahr scale). We demonstrated a significant change in the levels of transcripts included in the large groups of processes associated with the functioning of the immune system and cellular transport. Moreover, a significant change in the splicing of genes involved in cellular-transport processes was shown in our study.

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Piovezan, Mauro R., Helio A. G. Teive, Elcio J. Piovesan, Maria J. Mader, and Lineu Cesar Werneck. "Cognitive function assessment in idiopathic Parkinson's disease." Arquivos de Neuro-Psiquiatria 65, no. 4a (2007): 942–46. http://dx.doi.org/10.1590/s0004-282x2007000600003.

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Idiopathic Parkinson’s disease (PD) is characterized by reduced nigrostriatal and cortical dopaminergic influence, with changes in movement and, subsequently, behavioral and cognitive disturbances. We studied cognitive impairment in Parkinson’s disease by assessing a group of 30 idiopathic Parkinson’s disease patients with an average age of 64.23 years (PG group) and compared our findings with those for a control group of 30 patients (CG group). All the patients were submitted to the following assessments: motor function, using the UPDRS; staging, using the Hoehn-Yahr scales (PG group only); depression, using the Montgomery-Asberg scale; attention impairment; verbal fluency (FAR and animals); cognitive function, using the Mini Mental State Examination; visuospatial and executive functions; and clock drawing. In addition to altered motor function in PD patients, we found statistically significant differences between PD patients and controls in terms of cognitive function, verbal, executive and visuospatial functions, and attention deficits. Depression was more prevalent in the PG group.

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Prell, Tino, Denise Schaller, Caroline Perner, Otto W. Witte, and Julian Grosskreutz. "Sicca Symptoms in Parkinson’s Disease: Association with Other Nonmotor Symptoms and Health-Related Quality of Life." Parkinson's Disease 2020 (February 12, 2020): 1–7. http://dx.doi.org/10.1155/2020/2958635.

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Background. Frequently used nonmotor scales do not cover all aspects of dysautonomia in Parkinson’s disease (PD). This study explores the association between autonomic symptoms and sicca symptoms with other nonmotor symptoms and health-related quality of life (QoL) in PD. Methods. Autonomic symptoms (Survey of Autonomic Symptoms, SASs), motor function (Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale III, MDS-UPDRS III), nonmotor symptoms (nonmotor symptoms questionnaire, NMS-Quest), and QoL (PD Questionnaire-39, PDQ-39) were analysed in 93 PD patients without dementia. Multivariable and multivariate analyses were performed to study the association between clinical parameters and PDQ-39 domains. Results. Among the autonomic symptoms, sicca symptoms (xerostomia and dry eyes) were the most commonly reported (69%), followed by sexual dysfunction in men, leaking of urine, vasomotor dysfunction, constipation, sudomotor dysfunction, and orthostatic symptoms. The autonomic symptom burden (SAS total) correlated with the NMS-Quest and Hoehn and Yahr stage, but not with age, levodopa equivalent daily dose, disease duration, and the MDS-UPDRS III. The SAS total score was an independent predictor of the PDQ-39 summary index and mainly affected the PDQ-39 cognition and emotional well-being domains. Sicca symptoms were not associated with age, MDS-UPDRS III, disease duration, Hoehn and Yahr stage, and levodopa equivalent daily dose but aggravated the PDQ-39 domains: cognition, emotional well-being, bodily discomfort, and mobility. Sicca symptoms frequently occur together with other nonmotor symptoms, namely, urine urgency, orthostatic problems, and concentration problems. Overall, 75% of the subjects took at least one drug that can cause sicca symptoms (anti-PD medication, antidepressant drugs, antihypertensive drugs, antipsychotic drugs, antimuscarinic drugs, and analgesic drugs). Conclusion. Sicca symptoms are common in PD and negatively influence QoL. The observed association between sicca symptoms and other nonmotor symptoms provides further preliminary evidence for the growing recognition of different nonmotor clusters in PD.

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Sani, A. F., and M. Hamdan. "1.174 Correlation between severity of Parkinson's disease (according to Hoehn–Yahr) and depression in Parkinson's disease (Hamilton Depression Rating Scale)." Parkinsonism & Related Disorders 13 (January 2007): S53. http://dx.doi.org/10.1016/s1353-8020(08)70446-2.

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Skorvanek, Matej, Pablo Martinez-Martin, Glenn T. Stebbins, and Christopher G. Goetz. "Reply: Hoehn and Yahr stage 3 and Postural stability item in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale." Movement Disorders 33, no. 7 (2018): 1189–90. http://dx.doi.org/10.1002/mds.27452.

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Giardini, M., I. Arcolin, M. Godi, A. Nardone, and S. Corna. "Evaluation of Parkinson's disease progression: changes in spatio-temporal gait variables along the different stages of Hoehn and Yahr scale." Gait & Posture 74 (September 2019): 19. http://dx.doi.org/10.1016/j.gaitpost.2019.07.470.

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Horváth, Krisztina, Zsuzsanna Aschermann, Péter Ács, et al. "Minimal Clinically Important Difference on Parkinson’s Disease Sleep Scale 2nd Version." Parkinson's Disease 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/970534.

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Background and Aims. The aim of the present study was to determine the estimates of minimal clinically important difference for Parkinson’s Disease Sleep Scale 2nd version (PDSS-2) total score and dimensions.Methods. The subject population consisted of 413 PD patients. At baseline, MDS-UPDRS, Hoehn-Yahr Scale, Mattis Dementia Rating Scale, and PDSS-2 were assessed. Nine months later the PDSS-2 was reevaluated with the Patient-Reported Global Impression Improvement Scale. Both anchor-based techniques (within patients’ score change method and sensitivity- and specificity-based method by receiver operating characteristic analysis) and distribution-based approaches (effect size calculations) were utilized to determine the magnitude of minimal clinically important difference.Results. According to our results, any improvements larger than −3.44 points or worsening larger than 2.07 points can represent clinically important changes for the patients. These thresholds have the effect size of 0.21 and −0.21, respectively.Conclusions. Minimal clinically important differences are the smallest change of scores that are subjectively meaningful to patients. Studies using the PDSS-2 as outcome measure should utilize the threshold of −3.44 points for detecting improvement or the threshold of 2.07 points for observing worsening.

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Campos-Sousa, Raimundo Nonato, Elizabeth Maria Aparecida Barasnevicius Quagliato, Kelson James Almeida, Inacio Augusto Dias de Castro, and Viriato Campelo. "Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance." Arquivos de Neuro-Psiquiatria 71, no. 9A (2013): 591–95. http://dx.doi.org/10.1590/0004-282x20130101.

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Introduction Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time - groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.

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Dias, Alice Estevo, Maira Tonidandel Barbosa, João Carlos Papaterra Limongi, and Egberto Reis Barbosa. "Speech disorders did not correlate with age at onset of Parkinson’s disease." Arquivos de Neuro-Psiquiatria 74, no. 2 (2016): 117–21. http://dx.doi.org/10.1590/0004-282x20160008.

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ABSTRACT Speech disorders are common manifestations of Parkinson´s disease. Objective To compare speech articulation in patients according to age at onset of the disease. Methods Fifty patients was divided into two groups: Group I consisted of 30 patients with age at onset between 40 and 55 years; Group II consisted of 20 patients with age at onset after 65 years. All patients were evaluated based on the Unified Parkinson’s Disease Rating Scale scores, Hoehn and Yahr scale and speech evaluation by perceptual and acoustical analysis. Results There was no statistically significant difference between the two groups regarding neurological involvement and speech characteristics. Correlation analysis indicated differences in speech articulation in relation to staging and axial scores of rigidity and bradykinesia for middle and late-onset. Conclusions Impairment of speech articulation did not correlate with age at onset of disease, but was positively related with disease duration and higher scores in both groups.

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Tsai, Ting Ta, Yu Wei Hu, and Chin Man Wang. "Poster 156: Correlation Between the M.D. Anderson Dysphagia Inventory Scale and the UPDRS and Hoehn & Yahr Disability Scale in Early Stage Parkinson's Disease." PM&R 9 (September 2017): S182. http://dx.doi.org/10.1016/j.pmrj.2017.08.098.

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