| 1. |
- Skogar, O, et al.
(författare)
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"Effects of Tactile Touch on pain, sleep and health related quality of life in Parkinsons disease with chronic pain": A randomized, controlled and prospective study
- 2013
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Ingår i: European Journal of Integrative Medicine. - : Elsevier. - 1876-3820 .- 1876-3839. ; 5:2, s. 141-152
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Parkinsons disease (PD) is often associated with chronic PD related pain. Complementary medicine are widely used but randomized, controlled and prospective studies of the effects are sparse. less thanbrgreater than less thanbrgreater thanAims of the study: To compare the effects of Tactile Touch (TT) with Rest to Music (RTM) in PD patients with chronic pain and to describe effects within groups. less thanbrgreater than less thanbrgreater thanPatients and methods: A 34 week controlled randomized and prospective trial compared the effects of TT with RTM in 45 (29 TT and 16 RTM) patients with PD and chronic pain. The whole body tactile stimulation method was performed for each individual patient by the same therapist for 10 times during the first 8 weeks. The RTM group received the same therapy except for the tactile stimulation. Pharmacotherapy was kept unchanged. Participants were assessed at pre- and post-intervention for pain, sleep patterns and health related quality of life (HRQoL). less thanbrgreater than less thanbrgreater thanResults: Differences between TT and RTM groups were few. Total PDSS significantly improved within the TT but not in the RTM-group. No significant differences between groups were seen in pain parameters, although significant improvements were seen within the TT-group after the intervention period. There were significant improvements within both groups in HRQoL and between groups in the items physical role and social functioning 4 weeks after screening. less thanbrgreater than less thanbrgreater thanConclusions: No significant differences between the TT and RTM groups were seen. Only in single aspects did patients with PD and chronic pain have more benefit more from CAM therapy with TT in combination with RTM.
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| 2. |
- Annerbo, S, et al.
(författare)
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A prospective study on the development of Alzheimer's disease with regard to thyroid-stimulating hormone and homocysteine
- 2009
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 28:3, s. 275-280
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background/Aim: </i>The combination of elevated total homocysteine (tHcy) levels and low levels of thyroid-stimulating hormone (TSH) are linked to Alzheimer’s disease (AD) in some studies, although the evidence is mixed. Our objective was to prospectively investigate the association between tHcy and TSH and the subsequent development of AD. <i>Methods:</i> A subsample of 200 nondemented subjects was taken from the Kungsholmen Project, a population-based study among people ≥75 years. Information about tHcy and TSH levels were taken from the baseline investigation of the Kungsholmen Project study. <i>Results: </i>Increased tHcy levels were related to an elevated risk of AD (n = 61) after a mean follow-up time of 6.7 years. People with high tHcy (the 3rd tertile) had more than twice as high a risk of developing AD than those with low tHcy, even after adjusting for age, sex, education, ApoE status, MMSE score and laboratory parameters. tHcy was negatively correlated with TSH (p = 0.02). There was neither an influence of TSH nor an interaction between tHcy and TSH in the development of AD. <i>Conclusions: </i>These results suggest that homocysteine, but not TSH, is involved in the development of AD. The connection between elevated tHcy and low TSH levels needs to be studied further.
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| 3. |
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| 4. |
- Annerbo, S, et al.
(författare)
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The relation between homocysteine levels and development of Alzheimer's disease in mild cognitive impairment patients
- 2005
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 20:4, s. 209-214
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate over a 3-year period the connection between homocysteine (Hcy) levels and development of Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI). Hcy was analyzed in 68 men, mean age 65 years, and 68 women, mean age 64 years. Age, sex, cobalamin, folate, creatinine, and thyroid profiles as well as results of Mini-Mental State Examination at the first visit to the memory investigation unit of a geriatric department were recorded from patient journals collected between 1992 and 1999. The total numbers of persons who converted to AD within a period of 3 years from initial investigation with baseline Hcy sampling was 12 of 46 (26%) males, and 18 of 50 women (36%). The total percentage of men and women converting to AD was 31%. Thirty-three percent of men with Hcy levels >20 µmol/l converted to AD. The corresponding figure for men with Hcy levels 20–17 µmol/l was 50%, whereas none of the 18 men with Hcy levels <17 µmol/l converted to AD. These differences were statistically significant. There was also a statistically significant difference between the percentage of women with Hcy levels >16 µmol/l who converted to AD (45%) as compared to those with Hcy levels <16 µmol/l who converted (21%). These findings are inconsistent with the results of other studies showing a positive correlation with hyperhomocysteinemia and occurrence of AD. However, our findings tentatively suggest a possible protective effect of low/normal Hcy levels on dementia conversion in MCI patients.
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| 8. |
- Conradsson, D, et al.
(författare)
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The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial
- 2015
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Ingår i: Neurorehabilitation and neural repair. - : SAGE Publications. - 1552-6844 .- 1545-9683. ; 29:9, s. 827-836
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Tidskriftsartikel (refereegranskat)abstract
- Background. Highly challenging exercises have been suggested to induce neuroplasticity in individuals with Parkinson’s disease (PD); however, its effect on clinical outcomes remains largely unknown. Objective. To evaluate the short-term effects of the HiBalance program, a highly challenging balance-training regimen that incorporates both dual-tasking and PD-specific balance components, compared with usual care in elderly with mild to moderate PD. Methods. Participants with PD (n = 100) were randomized, either to the 10-week HiBalance program (n = 51) or to the control group (n = 49). Participants were evaluated before and after the intervention. The main outcomes were balance performance (Mini-BESTest), gait velocity (during normal and dual-task gait), and concerns about falling (Falls Efficacy Scale–International). Performance of a cognitive task while walking, physical activity level (average steps per day), and activities of daily living were secondary outcomes. Results. A total of 91 participants completed the study. After the intervention, the between group comparison showed significantly improved balance and gait performance in the training group. Moreover, although no significant between group difference was observed regarding gait performance during dual-tasking; the participants in the training group improved their performance of the cognitive task while walking, as compared with the control group. Regarding physical activity levels and activities of daily living, in comparison to the control group, favorable results were found for the training group. No group differences were found for concerns about falling. Conclusions. The HiBalance program significantly benefited balance and gait abilities when compared with usual care and showed promising transfer effects to everyday living. Long-term follow-up assessments will further explore these effects.
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| 9. |
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| 10. |
- Delbari, A, et al.
(författare)
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Effect of methylphenidate and/or levodopa combined with physiotherapy on mood and cognition after stroke: a randomized, double-blind, placebo-controlled trial
- 2011
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Ingår i: European neurology. - : S. Karger AG. - 1421-9913 .- 0014-3022. ; 66:1, s. 7-13
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background/Aim:</i> Stimulant medications can enhance mood and cognition in stroke rehabilitation, but human clinical trial results are inconclusive. We sought to prospectively study the effects of levodopa (LD) and/or methylphenidate (MPH) in combination with physiotherapy on mood and cognition following stroke in human subjects. <i>Methods:</i> Ischemic stroke patients were enrolled in our study 15 to 180 days after stroke onset. The patients were randomized into four medication groups (MPH, LD, MPH + LD, or placebo) and received a 15-day course of medication therapy (1 dose daily) and 45-min standard physiotherapy treatment daily. Mood and cognitive function were assessed at the study onset and 15, 90 and 180 days after study enrollment. <i>Results:</i> The strongest improvement of mood and cognition was found between baseline and the first follow-up immediately after the intervention. A significant improvement in mood was also found in the combined treatment group (MPH + LD) at 90 and 180 days, compared to the placebo group. <i>Conclusions:</i> A 15-day course of daily MPH + LD combined with physiotherapy over a 3-week period was safe and significantly improved mood status in ischemic stroke patients. Future studies are needed which determine the optimal therapeutic window for and dosage of psychostimulants as well as identify those stroke patients who might benefit the most from treatment.
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| 11. |
- Delbari, A, et al.
(författare)
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Stroke epidemiology and one-month fatality among an urban population in Iran
- 2011
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 6:3, s. 195-200
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Tidskriftsartikel (refereegranskat)abstract
- Stroke is one of the most common causes of death and disability in Iran. This study evaluated stroke patient profiles with respect to rate, risk factors, and one-month fatality. Material and method A cross-sectional, hospital-based study on all stroke patients older than 45 years admitted to hospitals in the city of Qom throughout 2001. Results Four hundred and sixty patients older than 45 years were admitted as stroke. The annual stroke rate was estimated to 338/100 000 (95% confidence interval, 300–360) inhabitants older than 45 years. The annual rate of stroke was 384/100 000 (95% confidence interval, 381–386) when adjusted to the European population. Stroke subtypes were; ischaemic infarction 75%, intracranial haemorrhage 20·7%, subarachnoid haemorrhage 3%, and undetermined 1·3%. Main risk factors were hypertension in 74·6% and diabetes in 55·7%. Mortality rate was 24·6% within the first month. Conclusion Stroke incidence was higher than in Western countries. Hypertension and diabetes mellitus were considerably more frequent in our studied stroke patients than in other developing countries. Our findings need to be addressed in future health education programmes in Iran identifying patients at risk and focusing on more aggressive prevention programmes to lower stroke incidence.
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| 12. |
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| 13. |
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| 14. |
- Fereshtehnejad, SM, et al.
(författare)
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Active aging for individuals with Parkinson's disease: definitions, literature review, and models
- 2014
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2014, s. 739718-
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Tidskriftsartikel (refereegranskat)abstract
- Active aging has been emerged to optimize different aspects of health opportunities during the aging process in order to enhance quality of life. Yet, most of the efforts are on normal aging and less attention has been paid for the elderly suffering from a chronic illness such as Parkinson’s disease (PD). The aim of this review was to investigate how the concept of “active aging” fit for the elderly with PD and to propose a new model for them using the recent improvements in caring models and management approaches. For this purpose, biomedical databases have been assessed using relevant keywords to find out appropriate articles. Movement problems of PD affect physical activity, psychiatric symptoms lessen social communication, and cognitive impairment could worsen mental well-being in elderly with PD, all of which could lead to earlier retirement and poorer quality of life compared with healthy elderly. Based on the multisystematic nature of PD, a new “Active Aging Model for Parkinson’s Disease” is proposed consisting of self-care, multidisciplinary and interdisciplinary care, palliative care, patient-centered care, and personalized care. These strategies could potentially help the individuals with PD to have a better management approach for their condition towards the concept of active aging.
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| 15. |
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| 16. |
- Fereshtehnejad, SM, et al.
(författare)
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Comparison of the Psychological Symptoms and Disease-Specific Quality of Life between Early- and Typical-Onset Parkinson's Disease Patients
- 2014
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2014, s. 819260-
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Tidskriftsartikel (refereegranskat)abstract
- The impact of Parkinson’s disease (PD) on psychological status and quality of life (QoL) may vary depending on age of disease onset. The aim of this study was to compare psychological symptoms and disease-specific QoL between early onset versus the rest of the PD patients. A total number of 140 PD patients with the mean current age of 61.3(SD=10.4) yr were recruited in this study. PD patients with the onset age of ≤50 yr were defined as “early-onset” (EOPD) group(n=45), while the ones with >50 yr at the time of diagnosis were categorized as the “typical-onset” (TOPD) patients(n=95). Different questionnaires and scales were used for between-group comparisons including PDQ39, HADS (hospital anxiety and depression scale), FSS (fatigue severity scale), MNA (mininutritional assessment), and the UPDRS. Depression score was significantly higher in EOPD group (6.3(SD=4.5)versus 4.5(SD=4.2),P=0.02). Among different domains of QoL, emotion score was also significantly higher in the EOPD group (32.3(SD=21.6)versus 24.4(SD=22.7),P=0.05). Our findings showed more severe depression and more impaired emotional domain of QoL in early-onset PD patients. Depression and anxiety play an important role to worsen QoL among both EOPD and TOPD patients, while no interaction was observed in the efficacy of these two psychiatric symptoms and the onset age of PD patients.
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Fereshtehnejad, SM, et al.
(författare)
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Evolution of Orofacial Symptoms and Disease Progression in Idiopathic Parkinson's Disease: Longitudinal Data from the Jönköping Parkinson Registry
- 2017
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2017, s. 7802819-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Orofacial symptoms are common in Parkinson’s disease (PD) both as initial manifestations and late markers of disease complications. We aimed to investigate the evolution of orofacial manifestations and their prognostic value throughout PD progression. Methods. Data was obtained from “Jönköping Parkinson Registry” database on routine care visits of 314 people with idiopathic PD in southern Sweden. Information on baseline symptomatology, orofacial features, UPDRS, and medications was recorded at baseline and during each follow-up visit within an average of 4.2 (range: 1–12) years. Results. Hypomimia, affected speech, drooling, and impaired swallowing were present in 37.3%/91.6%, 14.1%/65.5%, 11.7%/55.3%, and 10.2%/34.5% at baseline/follow-up, respectively. Male sex [OR = 2.4 (95% CI: 1.0–5.9)], UPDRS motor scores [OR = 1.2 (95% CI: 1.1–1.3)], dominant rigidity [OR = 5.2 (95% CI: 1.4–19.1)], and autonomic disturbance [OR = 3.4 (95% CI: 1.1–10.9)] were risk factors for drooling. Individuals with more severe orofacial burden at baseline had shorter median time to develop UPDRS-Part III > 28 [3rd tertile = 4.7 yr, 2nd tertile = 6.2 yr, and 1st tertile = 7.8 yr; p = 0.014]. Conclusions. Majority of people with PD manifest orofacial manifestations at either early or late stages of the disease. PD severity, symmetry of motor disturbances, and autonomic disorders correlate with orofacial symptoms. Individuals with more severe orofacial burden at baseline progressed faster to more advanced stages.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Fereshtehnejad, SM, et al.
(författare)
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Mortality in Iranian Patients with Parkinson's Disease: Cumulative Impact of Cardiovascular Comorbidities as One Major Risk Factor
- 2015
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2015, s. 834796-
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Tidskriftsartikel (refereegranskat)abstract
- Mortality rate, life expectancy, survival, and the impact of comorbidities on them in people with Parkinson’s disease (PD) need to be assessed in settings with different sociodemographic backgrounds. We investigated mortality features in Iranian PD patients focusing on the role of cardiovascular multimorbidity on their survival. Data on mortality and comorbidity profile was gathered in a cohort of 190 individuals with idiopathic PD referred to a Movement Disorders Clinic. Standardized mortality ratio (SMR) compared to the Tehran general population was 3.44 and the life expectancy at birth was 67.4 (95% CI: 59.1–75.8) yr. Patients with at least one cardiovascular comorbidity had a shorter survival time after PD onset (14.0 versus 29.2 yr,p=0.012). The hazard ratio for death increased 2.8 times (95% CI: 1.5–5.2,p=0.002) with one additional cardiovascular comorbidity. Among all comorbid conditions, stroke showed the strongest independent effect on mortality in PD patients [HR = 13.1 (95% CI: 2.4–71.7),p=0.003]. Conclusively, life expectancy was slightly lower in Iranian PD patients compared to the general population, while the SMR was high. Cardiometabolic multimorbidity substantially decreased survival in people with PD. Our study highlights the need for assessment, prevention, and treatment of cardiovascular morbidities in parkinsonian patients, given their effect on survival.
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| 26. |
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| 27. |
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| 28. |
- Fereshtehnejad, SM, et al.
(författare)
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Orthostatic hypotension in patients with Parkinson's disease and atypical parkinsonism
- 2014
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2014, s. 475854-
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Tidskriftsartikel (refereegranskat)abstract
- Orthostatic hypotension (OH) is one of the commonly occurring nonmotor symptoms in patients with idiopathic Parkinson’s disease (IPD) and atypical parkinsonism (AP). We aimed to review current evidences on epidemiology, diagnosis, treatment, and prognosis of OH in patients with IPD and AP. Major electronic medical databases were assessed including PubMed/MEDLINE and Embase up to February 2013. English-written original or review articles with keywords such as “Parkinson’s disease,” “atypical parkinsonism,” and “orthostatic hypotension” were searched for relevant evidences. We addressed different issues such as OH definition, epidemiologic characteristics, pathophysiology, testing and diagnosis, risk factors for symptomatic OH, OH as an early sign of IPD, prognosis, and treatment options of OH in parkinsonian syndromes. Symptomatic OH is present in up to 30% of IPD, 80% of multiple system atrophy (MSA), and 27% of other AP patients. OH may herald the onset of PD before cardinal motor symptoms and our review emphasises the importance of its timely diagnosis (even as one preclinical marker) and multifactorial treatment, starting with patient education and lifestyle approach. Advancing age, male sex, disease severity, and duration and subtype of motor symptoms are predisposing factors. OH increases the risk of falls, which affects the quality of life in PD patients.
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| 29. |
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| 31. |
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| 32. |
- Fereshtehnejad, SM, et al.
(författare)
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Reliability and validity of the persian version of the fatigue severity scale in idiopathic Parkinson's disease patients
- 2013
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2013, s. 935429-
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Tidskriftsartikel (refereegranskat)abstract
- As one of the most frequent symptoms, measurement of fatigue is an issue of interest in Parkinson’s disease (PD). The fatigue severity scale (FSS) is one of the recommended questionnaires for this purpose. The aim of our study was to evaluate psychometric properties of the Persian version of the FSS (FSS-Per) to assess fatigue in PD patients. Ninety nondemented idiopathic Parkinson’s disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. In addition to the disease severity scales, the FSS-Per was used for fatigue measurement. The internal consistency coefficient was larger than 0.8 for all of the items with a total Cronbach’s alpha of 0.96 (95% CI: 0.95–0.97). The FSS-Per score correlated with the UPDRS score (, ) and the “Hoehn and Yahr” (HY) stage (, ). The total score of the FSS-Per significantly discriminated IPD patients with more severe disability (HY stage > 2) versus those with less severe disease (HY stage ) (AUC = 0.81 (95% CI: 0.72–0.90)). The FSS-Per fulfilled a high internal consistency and construct validity to measure the severity of fatigue in Iranian IPD patients. These acceptable psychometric properties were reproducible in subgroups of IPD patients regarding different levels of education, disease severity, sex and age groups.
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| 33. |
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| 37. |
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| 38. |
- Karlstedt, M, et al.
(författare)
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Determinants of Dyadic Relationship and Its Psychosocial Impact in Patients with Parkinson's Disease and Their Spouses
- 2017
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2017, s. 4697052-
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Tidskriftsartikel (refereegranskat)abstract
- The caregiver-care receiver relationship (mutuality) in Parkinson’s disease (PD) and its association with motor and non-motors symptoms, health-related quality of life (HRQoL), and caregiver burden have not fully been investigated. The aim of our study was to explore if (1) the level of mutuality perceived by PD-patients and PD-partners differs, (2) different factors are associated with perceived mutuality by PD-patients and PD-partners, and (3) mutuality is associated with PD-patients health-related quality of life (HRQoL) and caregiver burden. We collected data on motor signs (UPDRS III), non-motor manifestations (NMSQuest), PD-patients’ cognition (IQCODE), mutuality scale (MS), PD-patients’ HRQoL (PDQ8), and caregiver burden (CB) from 51 PD dyads. Predictors were identified using multivariate regression analyses. Overall, the dyads rated their own mutuality as high with no significant difference between the dyads except for the dimension of reciprocity. PD-patients’ MS score (p=.001) and NMSQuest (p≤ .001) were significant predictors of PDQ8. Strongest predictor of CB was PD-partners’ MS score (<.001) and IQCODE (p=.050). In general, it seems that non-motor symptoms contribute to a larger extent to the mutual relationship in PD-affected dyads than motor disabilities.
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| 39. |
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| 40. |
- Karlstedt, M, et al.
(författare)
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Mediating Effect of Mutuality on Health-Related Quality of Life in Patients with Parkinson's Disease
- 2018
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Ingår i: Parkinson's disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2018, s. 9548681-
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Tidskriftsartikel (refereegranskat)abstract
- The relationship quality, mutuality, has been identified as a protective factor in family care situations, but its role in mediating health-related quality of life (HRQoL) in patients having Parkinson’s disease (PD) is not known. Data on patients’ and partners’ mutuality (MS), motor signs (UPDRS III), non-motor symptoms (NMSQuest), impaired cognition (IQCODE), dependency in activities of daily life (ADL), and HRQoL (PDQ8) were collected from 51 dyads. Structural equation model with manifest variables was applied to explore if the MS score mediated the effect of UPDRS III, NMSQuest, IQCODE, and dependency in ADL on PDQ8. The results suggest that increasing severity of motor and non-motor symptoms decreases patients’ mutuality which leads to worse HRQoL. Partners’ mutuality mediated the effect of impaired cognition which in turn decreased patients’ mutuality. The findings enhance our understanding of how various symptoms may influence PD patients’ HRQoL. This may help clinicians to personalize interventions to provide more effective interventions to improve the lives of patients with PD.
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| 41. |
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| 45. |
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| 46. |
- Lokk, J
(författare)
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Dipyridamole-associated headache in stroke patients--interindividual differences?
- 2009
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Ingår i: European neurology. - : S. Karger AG. - 1421-9913 .- 0014-3022. ; 62:2, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Secondary pharmacological prevention of ischemic stroke or transient ischemic attack (TIA) is often provided with acetylsalicylic acid (ASA), dipyridamole (DP) or a combination of the two. A problem with DP is the occurrence of headache, sometimes leading to medication cessation. By using a titration regime of DP the incidence of headache gets lower. However, there are no studies on interindividual differences in the incidence of headache with regard to age, gender, localization of stroke and the number of days since stroke onset. <i>Method:</i> 20 stroke units in Sweden recruited newly diagnosed stroke and TIA patients in need for thrombocyte antiaggregating therapy. They were offered a titration regime of the combination ASA 25 mg + DP 200 mg once daily for 5 days followed by twice daily. Baseline characteristics of the patients were recorded and headache symptoms were filled in by each patient in a diary for 10 consecutive days. Rescue medication with paracetamol was optional. <i>Results:</i> 174 ischemic stroke patients with a mean age of 70.3 years, 63% men and 37% women, were recruited. Headache of any kind was reported in 70 patients (40.2%) and 37 (21.3%) assessed the headache as moderate/severe. Six patients stopped medication due to headache. A subsiding character of the headache was found with a mean of 3.1 days. Patients with TIA had a significantly higher risk of getting headache compared to manifest stroke, regardless of localization. There was a trend towards higher risk in younger age groups and females. No effect was seen on the number of days since stroke onset. <i>Conclusion:</i> DP is often associated with subsiding headache, however, with only few patients stopping medication due to headache. Being a younger female with a TIA seems to increase the risk of getting headache when having DP medication. Careful and adequate information about the possibly occurring headache should be given to patients prescribed a DP medication in order to increase compliance and optimize the pharmacological secondary stroke prevention.
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