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Sökning: WFRF:(Granérus Ann Kathrine)

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1.
  • Fall, Per-Arne, et al. (författare)
  • ECT in Parkinson's disease-dopamine transporter visualised by [123I]-beta-CIT SPECT
  • 2000
  • Ingår i: Journal of Neural Transmission. - 0300-9564. ; 107:8-9, s. 997-1008
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Parkinson's disease (PD) is characterised by a loss of dopaminergic neurones in the basal ganglia. These neurones may be visualised by single photon emission computed tomography (SPECT) with the cocaine analogue 2β-carboxymethyl-3-β-(4-iodophenyl)tropane ([<sup>123</sup>I]β-CIT), which labels the dopamine reuptake sites in the nerve terminals. In order to evaluate the possibility to predict the outcome of ECT a prospective study was per-formed with six PD patients in whom the [<sup>123</sup>I]β-CIT uptake was measured before and after an electroconvulsive therapy (ECT) series. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with the most pronounced symptomathology. No significant change in uptake of the radioligand was seen after ECT. Patients with best uptake and thus with less advanced PD improved most after ECT. The possibility to use the [<sup>123</sup>I]β-CIT uptake to predict the outcome of ECT treatment has to be further evaluated.</p>
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2.
  • Fall, Per-Arne, et al. (författare)
  • ECT in Parkinson's disease - dopamine transporter visualised by [I-123]-beta-CIT SPECT
  • 2000
  • Ingår i: Journal of neural transmission. - 0300-9564 .- 1435-1463. ; 107:8-9, s. 997-1008
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Parkinson's disease (PD) is characterised by a loss of dopaminergic neurones in the basal ganglia. These neurones may be visualised by single photon emission computed tomography (SPECT) with the cocaine analogue 2 beta-carboxymethyl-3-beta-(4-iodophenyl)tropane ([(123)]beta-CIT), which labels the dopamine reuptake sites in the nerve terminals. In order to evaluate the possibility to predict the outcome of ECT a prospective study was performed with six PD patients in whom the [I-123]beta-CIT uptake was measured before and after an electroconvulsive therapy (ECT) series. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with the most pronounced symptomathology. No significant change in uptake of the radioligand was seen after ECT. Patients with best uptake and thus with less advanced PD improved most after ECT. The possibility to use the [I-123]beta-CIT uptake to predict the outcome of ECT treatment has to be further evaluated.</p>
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3.
  • Palhagen, Sven E, et al. (författare)
  • HMPAO SPECT in Parkinsons disease (PD) with major depression (MD) before and after antidepressant treatment
  • 2009
  • Ingår i: JOURNAL OF NEUROLOGY. - 0340-5354. ; 256:9, s. 1510-1518
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Previously we suggested that major depression (MD) in Parkinsons disease (PD) could be an indication of a more advanced and widespread neurodegenerative process, as PD symptoms were more severe in those with depression. We also found a different antidepressant response with SSRI medication in PD patients with depression compared to depressed patients without PD. This indicates diverse underlying pathophysiological mechanisms. Investigations using single-photon emission computed tomography (SPECT), measuring regional cerebral blood flow (rCBF), may contribute to enlighten the neurobiological substrates linked to depressive symptoms. SPECT was performed in order to compare rCBF in MD patients with and without PD. The study included 11 MD patients with PD, 14 nondepressed PD patients and 12 MD patients without PD. All patients were followed for 12 weeks with repeated evaluation of depressive as well as PD symptoms. Anti-Parkinsonian treatment remained unchanged during the study. Antidepressant treatment with SSRI (citalopram) was given to all patients with MD. SPECT was performed before and after 12 weeks of antidepressant treatment. rCBF was found to differ between PD patients with and without MD, as well as between MD patients with and without PD, both at baseline and concerning the response to treatment with SSRI (citalopram). In patients with PD the rCBF was found to be decreased in preoccipital and occipital regions, a finding more common when PD was combined with MD. In summary, larger cortical areas were found to be involved in depressed PD patients, both with hyperactivity (reciprocal to basal degeneration in PD and maybe dopaminergic treatment) and with hypoactivity (probably due to organic lesions leading to hypoperfusion). These observations support our hypothesis that PD combined with MD is an expression of a more advanced and widespread neurodegenerative disorder.</p>
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6.
  • Wallin, Anders, et al. (författare)
  • Posterior cortical brain dysfunction in cognitively impaired patients with Parkinson´s disease - an rCBF scintigraphy study
  • 2007
  • Ingår i: Acta Neurologica Scandinavica. - 0001-6314 .- 1600-0404. ; 116:6, s. 347-354
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Objectives: </strong>The aim of the study was to visualize cortical function in Parkinson's patients with various degrees of cognitive impairment.</p> <p><strong>Materials and methods: </strong>Thirty-seven patients with Parkinson's disease and three with Parkinson plus syndromes underwent cognitive assessment and rCBF using <sup>99m</sup>TC-HMPAO-SPECT.</p> <p><strong>Results: </strong>Almost no regional reductions in cerebral blood flow were seen in patients without cognitive impairment (<em>n</em> = 16). Limited, mainly posterior, blood flow reductions were seen in patients with mild cognitive impairment (<em>n</em> = 14), whereas the reductions were extensive and bilaterally symmetric, involving both anterior and posterior brain regions in patients with dementia (<em>n</em> = 10).</p> <p><strong>Conclusions: </strong>The findings suggest a widespread cortical, mainly posterior type of dysfunction and a relationship between the degree of cognitive impairment and the magnitude of the dysfunction.</p>
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7.
  • Dizdar (Dizdar Segrell), Nil, et al. (författare)
  • L-dopa pharmacokinetics studied with microdialysis in patients with Parkinson's disease and a history of malignant melanoma
  • 1999
  • Ingår i: Acta neurologica Scandinavica. - 0001-6314. ; 100:4, s. 231-237
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>OBJECTIVES: The pharmacokinetics of free L-dopa in blood and tissue of five parkinsonian patients with malignant melanoma was studied with microdialysis. In one case the effect of L-dopa treatment on 5-S-cysteinyldopa and the melanoma was studied. Gastric emptying and its effects on free L-dopa in blood were also investigated in one of the patients.</p><p>METHODS: Five patients were given 100 mg L-dopa with 25 mg benserazide. Blood and dialysates from the circulation and fatty tissue were collected for analysis. [13C]-Octanoic breath test was used for analyzing gastric half-emptying time.</p><p>RESULTS: Four of the patients had similar pharmacokinetic patterns for L-dopa and a significant (P &lt; 0.05) increase of serum 5-S-cysteinyldopa occurring 30 min after L-dopa intake. Delayed L-dopa peaks and slow gastric half-emptying time were found in 1 patient. A dose-dependent increase of 5-S-cysteinyldopa occurred but no melanoma metastases were seen during long-term L-dopa therapy.</p><p>CONCLUSION: L-dopa therapy increases 5-S-cysteinyldopa levels but does not seem to cause progress of melanomas. Gastric emptying impacts L-dopa pharmacokinetics.</p>
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8.
  • Fall, Per-Arne, et al. (författare)
  • Age standardised incidence and prevalence of Parkinson´s disease in a Swedish community
  • 1996
  • Ingår i: Journal of Clinical Epidemiology. - 0895-4356. ; 49:6, s. 637-641
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Parkinson's disease (PD) shows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low <img src="http://www.sciencedirect.com/cache/MiamiImageURL/B6T84-3Y2MYYD-1G-2/0?wchp=dGLbVzW-zSkWz" /> -dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (age-standardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.</p>
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9.
  • Fall, Per-Arne, 1943- (författare)
  • Aspects of Parkinson's disease. Epidemiology, risk factors and ECT in advanced disease
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • <p>The purpose was to investigate some aspects of epidemiology, risk factors and treatment with ECT in advanced Parkinson’s disease (PD).</p><p>In study I, we performed a descriptive epidemiologic population-based survey in the Central Health Care District in Östergötland in south-east Sweden, with a population of almost 150,000 inhabitants 1989. The case finding was accomplished in three ways: 1. Collection of all prescriptions for Parkinson’s disease. 2. Search in medical files. 3. Checking with all nursing homes in the area. The crude prevalence was found to be 115 per 100,000 inhabitants. When we used the European Standard Population as a tool for easy comparisons of PD prevalence between different areas and time periods 76 PD-cases per 100,000 inhabitants were found. The corresponding incidences were 11.0 (crude) and 7.9 (age standardised) per 100,000 person-years. Mean age at onset was 65.6. A low prevalence and a high age at onset suggested that e.g. environmental factors could influence the occurrence of PD, and the results implies that only few such factors were present in the investigated area.</p><p>The findings led to study II, a case-control study which investigated the possible impact of nutritional and environmental risk factors for idiopathic Parkinson’s disease (IP), including 113 cases and 263 control subjects. Dietary, drinking, and smoking habits, as well as previous occupation, were requested in a structured questionnaire. No increased risk was found for any of the nutrients. A reduced risk was found for coffee, wine, and spirits but also for broiled meat, smoked ham or meat, eggs, French loaf or white bread, and tomatoes. These findings could indicate an antioxidant effect. Frequency of preceding and present smoking was reduced in IP patients. Possible mechanisms are discussed. Various occupational groups and exposures were analysed and increased risks of IP in men were found for agricultural work, pesticide exposure, male carpenters, and in female cleaners.</p><p>In advanced PD there is a need for further therapeutic improvements, and electroconvulsive therapy (ECT) is one insufficiently explored and evaluated method. In study III ECT 16 non-depressed, nondemented PD patients with advanced disease were treated with ECT. In all patients an antiparkinsonian effect of ECT was seen, lasting between a few days and 18 months. Five patients, all with signs of blood brain barrier damage, developed transitory mental confusion after ECT. The results indicated that ECT could cause increased dopaminergic activity, which led us to study IV. Single photon emission computed tomography (SPECT) with the cocaine analogue [123I]-β-CIT was used in order to visualise dopaminergic neurones in the brain. Six patients with PD were examined before and after a series of ECT, and in three cases SPECT was also repeated after one year. The side-to-side difference in the radiotracer uptake was found to be significantly lower in striatum located contralaterally to the part of the body with most pronounced symptomatology. No significant change in uptake of [123I]-β-CIT was seen after ECT, although all patients improved and the most pronounced improvement was seen in patients with less advanced PD.</p><p>Study V points at two new positive observations with maintenance ECT (MECT). i.e. repeated ECT treatment of PD. One patient had either severe mental side effects on higher L-dopa doses or intolerable parkinsonian symptoms on lower doses. MECT implied marked improvement in parkinsonian symptoms without mental side effects. Another PD patient, who also had a mental depression, showed slight improvement of motor symptoms on a series of ECT. When treated with MECT further antiparkinsonian effects were seen.</p>
10.
  • Fall, Per-Arne, et al. (författare)
  • ECT in Parkinson's disease : Changes in motor symptoms, monoamine metabolites and neuropeptides
  • 1995
  • Ingår i: Journal of Neural Transmission. Parkinson's disease and dementia section.. - 0936-3076. ; 10:2-3, s. 129-140
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Electroconvulsive therapy (ECT) was given to 16 non-depressed, non-demented patients with advanced Parkinson's disease (PD). In all the patients an antiparkinsonian effect was seen, lasting for 18 months in one patient, 3-5 months in seven patients, and a few days to four weeks in eight patients. After ECT the levels of homovanillic acid and neuropeptide Y in cerebrospinal fluid (CSF) were significantly increased. The eight patients with long lasting motor improvement after ECT had significantly lower CSF-3-methoxy-4-hydroxyphenylglycol compared to the group with short lasting improvement. Five patients developed transitory mental confusion after ECT. In these patients, and in no others, a high albumin-ratio was found already before ECT was given - an indication of blood CSF barrier damage. Our results suggest that ECT is valuable in patients with drug refractory PD or PD with intolerance to antiparkinsonian drugs.</p>
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