NEJM â Collection Updates for Parkinson's Disease

ORIGINAL ARTICLE: Multicenter Analysis of Glucocerebrosidase Mutations in Parkinson's Disease

Thu, 22Â OctÂ 2009 00:00:00 -05:00

Background: Recent studies indicate an increased frequency of mutations in the gene encoding glucocerebrosidase (GBA), a deficiency of which causes Gaucher's disease, among patients with Parkinson's disease. We aimed to...

ORIGINAL ARTICLE: A Double-Blind, Delayed-Start Trial of Rasagiline in Parkinson's Disease

Thu, 24Â SepÂ 2009 00:00:00 -05:00

Background: A therapy that slows disease progression is the major unmet need in Parkinson's disease.

Methods: In this double-blind trial, we examined the possibility that rasagiline has disease-modifying effects in Parkinson's...

CLINICAL THERAPEUTICS: Levodopa for the Treatment of Parkinson's Disease

Peter A. LeWitt, M.D. — Thu, 04Â DecÂ 2008 00:00:00 -05:00

A 62-year-old man presents with weakness and impaired coordination. The physical examination discloses a resting tremor of the right hand, with mild rigidity at the right wrist, and a slow,...

BOOK REVIEW:

Thu, 27Â NovÂ 2008 00:00:00 -05:00

Once, physician Thomas Graboys had it all â devoted patients, the best and brightest colleagues, a loving family, and a terrific physique. For the past decade, however, he has faced...

ORIGINAL ARTICLE: A Parkinsonian Syndrome in Methcathinone Users and the Role of Manganese

Thu, 06Â MarÂ 2008 00:00:00 -05:00

Background: A distinctive extrapyramidal syndrome has been observed in intravenous methcathinone (ephedrone) users in Eastern Europe and Russia.

Methods: We studied 23 adults in Latvia who had extrapyramidal symptoms and who...

ORIGINAL ARTICLE: Valvular Heart Disease and the Use of Dopamine Agonists for Parkinson's Disease

Thu, 04Â JanÂ 2007 00:00:00 -05:00

Background: Ergot-derived dopamine receptor agonists, often used in the treatment of Parkinson's disease, have been associated with an increased risk of valvular heart disease.

Methods: We performed an echocardiographic prevalence study...

ORIGINAL ARTICLE: Dopamine Agonists and the Risk of Cardiac-Valve Regurgitation

Thu, 04Â JanÂ 2007 00:00:00 -05:00

Background: Case reports and echocardiographic studies suggest that the ergot-derived dopamine agonists pergolide and cabergoline, used in the treatment of Parkinson's disease and the restless legs syndrome, may increase the...

ORIGINAL ARTICLE: A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease

Thu, 31Â AugÂ 2006 00:00:00 -05:00

Background: Neurostimulation of the subthalamic nucleus reduces levodopa-related motor complications in advanced Parkinson's disease. We compared this treatment plus medication with medical management.

Methods: In this randomized-pairs trial, we enrolled 156...

CLINICAL PRACTICE: Diagnosis and Initial Management of Parkinson's Disease

John G. Nutt, M.D., and G. Frederick Wooten, M.D. — Thu, 08Â SepÂ 2005 00:00:00 -05:00

A 62-year-old man presents with an intermittent tremor in his left hand and some vague discomfort in the left arm. Physical examination shows a minimal rest tremor in the left...

EDITORIAL: Parkinson's Disease Dementia â A First Step?

Daniel Z. Press, M.D. — Thu, 09Â DecÂ 2004 00:00:00 -05:00

The hallmark of Parkinson's disease is involvement of the motor system, causing tremor, rigidity, and slowness of movement. But cognitive symptoms are frequently present at the time of diagnosis,1 contribute...

ORIGINAL ARTICLE: Rivastigmine for Dementia Associated with Parkinson's Disease

Thu, 09Â DecÂ 2004 00:00:00 -05:00

Background: Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients.

Methods: Patients in whom...

ORIGINAL ARTICLE: Levodopa and the Progression of Parkinson's Disease

The Parkinson Study Group — Thu, 09Â DecÂ 2004 00:00:00 -05:00

Background: Despite the known benefit of levodopa in reducing the symptoms of Parkinson's disease, concern has been expressed that its use might hasten neurodegeneration. This study assessed the effect of...

ORIGINAL ARTICLE: Mutations in the Glucocerebrosidase Gene and Parkinson's Disease in Ashkenazi Jews

Thu, 04Â NovÂ 2004 00:00:00 -05:00

Background: A clinical association has been reported between type 1 Gaucher's disease, which is caused by a glucocerebrosidase deficiency owing to mutations in the glucocerebrosidase gene (GBA), and parkinsonism. We...

PERSPECTIVE: New Genetic Insights into Parkinson's Disease

Mel B. Feany, M.D., Ph.D. — Thu, 04Â NovÂ 2004 00:00:00 -05:00

Although Parkinson's disease was once considered a purely sporadic disease, recent advances in molecular genetics have revealed important genetic influences underlying the development of the disorder. Eight defined genetic loci...

ORIGINAL ARTICLE: Five-Year Follow-up of Bilateral Stimulation of the Subthalamic Nucleus in Advanced Parkinson's Disease

Thu, 13Â NovÂ 2003 00:00:00 -05:00

Background: Although the short-term benefits of bilateral stimulation of the subthalamic nucleus in patients with advanced Parkinson's disease have been well documented, the long-term outcomes of the procedure are unknown.

Methods:...

PERSPECTIVE: Subthalamic Stimulation for Parkinson's Disease â Living Better Electrically?

Anthony E. Lang, M.D. — Thu, 13Â NovÂ 2003 00:00:00 -05:00

One of the true miracles of modern medicine was the introduction of levodopa, the precursor of dopamine, for the treatment of Parkinson's disease. However, even in the early trials of...

REVIEW ARTICLE: Apoptosis and Caspases in Neurodegenerative Diseases

Robert M. Friedlander, M.D. — Thu, 03Â AprÂ 2003 00:00:00 -05:00

Acute and chronic neurodegenerative diseases are illnesses associated with high morbidity and mortality, and few or no effective options are available for their treatment. A characteristic of many neurodegenerative diseases...

REVIEW ARTICLE: Alzheimer's Disease and Parkinson's Disease

Robert L. Nussbaum, M.D., and Christopher E. Ellis, Ph.D. — Thu, 03Â AprÂ 2003 00:00:00 -05:00

The incidence of many common diseases is increased among the relatives of affected patients, but the pattern of inheritance rarely follows Mendel's laws. Instead, such common diseases are thought to...

ORIGINAL ARTICLE: Deep-Brain Stimulation of the Subthalamic Nucleus or the Pars Interna of the Globus Pallidus in Parkinson's Disease

The Deep-Brain Stimulation for Parkinson's Disease Study Group — Thu, 27Â SepÂ 2001 00:00:00 -05:00

Background: Increased neuronal activity in the subthalamic nucleus and the pars interna of the globus pallidus is thought to account for motor dysfunction in patients with Parkinson's disease. Although creating...

EDITORIAL: Cell Therapy for Parkinson's Disease

Thu, 08Â MarÂ 2001 00:00:00 -05:00

Parkinson's disease is characterized by the progressive loss of dopamine neurons in the substantia nigra of the midbrain. These neurons project widely throughout the cerebral hemispheres, but the motor symptoms...

ORIGINAL ARTICLE: Transplantation of Embryonic Dopamine Neurons for Severe Parkinson's Disease

Thu, 08Â MarÂ 2001 00:00:00 -05:00

Background: Transplantation of human embryonic dopamine neurons into the brains of patients with Parkinson's disease has proved beneficial in open clinical trials. However, whether this intervention would be more effective...

ORIGINAL ARTICLE: Familial Aggregation of Parkinson's Disease in Iceland

Thu, 14Â DecÂ 2000 00:00:00 -05:00

Background: The role of genetics in early-onset Parkinson's disease has been established, but whether there is a genetic contribution to the more common, late-onset form remains uncertain.

Methods: We reviewed the...

ORIGINAL ARTICLE: Long-Term Follow-up of Unilateral Pallidotomy in Advanced Parkinson's Disease

Thu, 08Â JunÂ 2000 00:00:00 -05:00

Background: Although the short-term benefits of posteroventral pallidotomy for patients with advanced Parkinson's disease have been well documented, little is known about the long-term outcome of the procedure.

Methods: We conducted...

ORIGINAL ARTICLE: Association between Early-Onset Parkinson's Disease and Mutations in the Gene

Thu, 25Â MayÂ 2000 00:00:00 -05:00

Background: Mutations in the parkin gene have recently been identified in patients with early-onset Parkinson's disease, but the frequency of the mutations and the associated phenotype have not been assessed...

ORIGINAL ARTICLE: A Five-Year Study of the Incidence of Dyskinesia in Patients with Early Parkinson's Disease Who Were Treated with Ropinirole or Levodopa

Thu, 18Â MayÂ 2000 00:00:00 -05:00

Background: There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist.

Methods: In this prospective, randomized, double-blind study, we compared the...

EDITORIAL: New Treatment Options for Tremors

Thu, 17Â FebÂ 2000 00:00:00 -05:00

The revival and refinement of stereotactic neurosurgery represent the most important therapeutic advance in the treatment of movement disorders in the past 30 years. The majority of patients who undergo...

ORIGINAL ARTICLE: A Comparison of Continuous Thalamic Stimulation and Thalamotomy for Suppression of Severe Tremor

Thu, 17Â FebÂ 2000 00:00:00 -05:00

Background: Deep-brain stimulation through an electrode implanted in the thalamus was developed as an alternative to thalamotomy for the treatment of drug-resistant tremor. Stimulation is thought to be as effective...

IMAGES IN CLINICAL MEDICINE: Tremor as a Cause of PseudoâVentricular Tachycardia

Rafael Llinas, M.D. and Galen V. Henderson, M.D. — Thu, 21Â OctÂ 1999 00:00:00 -05:00

Figure 1. An 84-year-old woman with a history of falling was found on the ground unable to get up. On admission to the hospital for evaluation of syncope, she had...

SOUNDING BOARD: Use of Placebo Surgery in Controlled Trials of a Cellular-Based Therapy for Parkinson's Disease

Thu, 23Â SepÂ 1999 00:00:00 -05:00

Surgical procedures are frequently introduced into general practice on the basis of uncontrolled studies that are less rigorous than those required for the approval of medical interventions.1 The standard for...

EDITORIAL: Parkinson's Disease, Depression, and Electrical Stimulation of the Brain

Thu, 13Â MayÂ 1999 00:00:00 -05:00

On November 6, 1780, the Italian anatomist Luigi Galvani made an entry in his diary that recorded his observation of electrically stimulated muscle contractions in the legs of a freshly...

ORIGINAL ARTICLE: Transient Acute Depression Induced by High-Frequency Deep-Brain Stimulation

Thu, 13Â MayÂ 1999 00:00:00 -05:00

Continuous high-frequency stimulation of the basal ganglia was recently introduced for the treatment of patients with advanced Parkinson's disease.1 This treatment seems to be most effective when the electrodes are...

EDITORIAL: Managing Psychosis in Patients with Parkinson's Disease

Thu, 11Â MarÂ 1999 00:00:00 -05:00

Managing psychosis is one of the most difficult challenges in the care of patients with Parkinson's disease. This complication occurs in 10 to 15 percent of such patients and consists...

ORIGINAL ARTICLE: Low-Dose Clozapine for the Treatment of Drug-Induced Psychosis in Parkinson's Disease

The Parkinson Study Group — Thu, 11Â MarÂ 1999 00:00:00 -05:00

Background: Drug-induced psychosis is a difficult problem to manage in patients with Parkinson's disease. Multiple open-label studies have reported that treatment with clozapine at low doses ameliorates psychosis without worsening...

ORIGINAL ARTICLE: Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson's Disease

Thu, 15Â OctÂ 1998 00:00:00 -05:00

Background: In many patients with idiopathic Parkinson's disease, treatment with levodopa is complicated by fluctuations between an âoffâ period (also referred to as âoff medicationâ), when the medication is not...

REVIEW ARTICLE: Parkinson's Disease â First of Two Parts

Anthony E. Lang, M.D., and Andres M. Lozano, M.D. — Thu, 08Â OctÂ 1998 00:00:00 -05:00

More than 180 years ago, James Parkinson first described the disorder that bears his name, and 30 years ago levodopa, still the most effective therapy, was introduced. Parkinson's disease is...

ORIGINAL ARTICLE: Prevalence of Parkinsonian Signs and Associated Mortality in a Community Population of Older People

Thu, 11Â JanÂ 1996 00:00:00 -05:00

Background: Older people frequently have signs of parkinsonism, but information about the prevalence of parkinsonism and mortality among those with the condition in the community is limited.

Methods: A stratified random...

EDITORIAL: Living with Parkinson's Disease