Joseph H Friedman

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..Relative weakness, and early muscle fatigue may be demonstrated on testing but frank weakness should not be apparent on routine clinical examination...

..The other atypical have been the subjects of conflicting open label reports. The effects of the atypicals in PD psychosis is reviewed...

..Treatment plans for patients with Parkinson's disease who experience sleep disorders aim to improve nighttime sleep or daytime wakefulness, and treatment options vary by sleep disorder...

..These observations confirm that rhinorrhea is a common problem and raise the questions as to whether some olfactory impairment found in PD could be confounded by rhinorrhea and also whether rhinorrhea may be a premotor symptom...

..This article reviews what is known about the symptom, putting it into the context of fatigue in other disorders, and outlines a program for developing better understanding and therapy...

..While some patients had a favorable response, aripiprazole was associated with an exacerbation of motor symptoms. In this small study on psychosis in PD, aripiprazole did not appear promising...

..In this article, the author reviews the history of these developments and raises issues that still need to be addressed by the neurologic community...

..Some patients may take their doses unevenly, with more or less for the morning dose. Patients who tend to go to bed late at night may take their doses three times daily...

..Instead, the results indicate that the neurologist’s diagnosis is influenced largely by their communication with the patients...

..This report is a compilation of vignettes describing these behavioral problems that the treating neurologist or psychiatrist attributed to the medications used for treating PD...

..EXPERT OPINION: Fatigue is a common and severe problem in Parkinson's disease. Virtually nothing is known about it aside from its epidemiology. It is an area greatly in need of investigation...

..The committee concluded that current scales are adequate for fatigue studies in PD but that studies on sensitivity and specificity of the scales are still needed...

..Only clozapine has level I evidence to support its use. Quetiapine is the only other anti-psychotic free of motor side effects, but it has failed double blind placebo controlled trials to demonstrate efficacy...

..None of the patients suffered worsened psychosis from l-Dopa or a dopamine agonist if taking antipsychotics, and motor response did not appear blunted...

..Carriers of parkin mutations, whether or not they have PD, do not perform differently on neuropsychological measures as compared to noncarriers. The cognitive functioning of parkin carriers over time warrants further study...

..To assess the frequency and clinical characteristics of carriers of previously identified mutations in 6 genes associated with early-onset Parkinson disease (PD) and provide empirical data that can be used to inform genetic counseling...

..The CGIS is suggested as a secondary outcome scale to measure change and response to treatment over time...

..GBA carriers reported more impairment, but MMSE performance did not differ among genetic groups. Detailed neuropsychological testing is required to explore the association between cognitive impairment and GBA mutations...

..6; 95% CI = 1.4-92.9). Also, patients who developed motor worsening while on quetiapine tended to be more demented (P = 0.07)...

..Suggestions are made for future research to improve the interpretability of these studies...

..This review covers the management of psychosis in three different movement disorders: Parkinson's disease, dementia with Lewy bodies and Huntington's disease...

..The lack of fear of falling but frequent falls in this small subgroup may suggest that special techniques to instill suitable caution to prevent falls are necessary, or may make training of these patients impossible...

..Men with PD had more aggressive dreams compared to females with PD. Aggressive dream content was characteristic of RBD patients and sex differences exist in the dream content of the PD population...

..While dream content appears to be more aggressive in PD patients with clinical RBD, the presence of violent dreams or clinical RBD is not associated with testosterone levels in men with PD...

..This review focuses on the management of the most common behavioral symptoms of Parkinson's disease, including depression, anxiety, psychosis, dementia, delirium, sleep disorders, fatigue, apathy, emotionalism and compulsive behaviors...

..The phenomenology, pathology, and treatment of the behavioral symptoms of Parkinson's disease will be discussed...

..Developing and tailoring exercise programs that incorporate specific preferences may result in more effective interventions for patients with PD...

..PD patients and healthy controls differed significantly on both measures. PD patients endorsed significantly more fatigue. The PFS is a reliable, valid fatigue measure...

..3% for ages > or = 60 years). In this small study, parkinsonian patients on long-term, low dose clozapine were not at increased risk for developing DM. Larger controlled prospective studies are needed to confirm this...

..These criteria require validation and may be refined, but form a starting point for studies of the epidemiology and pathophysiology of PDPsy, and are a potential indication for therapy development...

..Most clinicians perceive psychosis in dementia with Lewy bodies (DLB) as more difficult to treat than Parkinson's disease, yet there are no reports comparing the antipsychotic response between the 2 disorders...

..However, no study until this point has been published investigating whether there is any association between olfactory dysfunction and apathy in PD patients...

..Electroconvulsive treatment is generally reserved for the patient with psychotic depression who is unable to tolerate any pharmacological therapy...

..Our data are more consistent with recently published long-term outcome data suggesting an improvement in the prognosis of parkinsonian patients with psychosis with the use of atypical antipsychotic agents such as clozapine...

..This suggests that HB itself, whether from a lesion in the subthalamic nucleus or elsewhere, is not what improves motor function in PD; instead, the physiological function of the damaged structure is the determining factor...

..Freezing of Gait (FOG) can be a serious problem in Parkinson's disease (PD) and is usually refractory to medical treatment. Botulinum toxin (BTX) type A has been reported to relieve FOG in small open label studies...

..To compare the cognitive and behavioral profiles of Alzheimer's disease (AD) and cognitively impaired patients with Parkinson's disease (PD) and to determine the individual measures that best discriminate the two patient groups...

..Polysomnography was normal in 1 patient. Two of these patients had had single photon emission computed tomographic imaging of the dopamine transporter 1 year previously...

..The purpose of this study was to examine the potential effect of continuous physical cueing using robot-assisted sensorimotor gait training on reducing FOG episodes and improving gait...

..Clozapine has been shown to be effective in the treatment of Parkinson disease psychosis and tremor; however, use of clozapine has been limited because of potential adverse effects and stringent monitoring criteria...

..Tardive syndromes are a group of delayed-onset abnormal involuntary movement disorders induced by a dopamine receptor blocking agent. There are several phenomenologically distinct types of TS...

..Our results support the previous observation that RBD-like behaviors are significantly increased in SCA-3...

..We have identified increased cigarette use and longer exposure to various industrial toxins as potential explanations for the earlier onset in one twin...

..This article summarizes the clinical phenomenology, pathophysiology, epidemiology, and treatment of these disorders in elderly individuals...

..To explore current practices and opinions regarding hospital management of Parkinson disease (PD) patients in specialized PD Centers...

..We describe three cases diagnosed during life as PSP but found to have another neurologic disorder at autopsy. No explanation for the gaze palsies was found in any case...

..Impaired executive abilities and emotional functioning in MJD patients is consistent with disruption of frontal-subcortical systems...

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..Future studies involving gradual dose titration are needed to explore further olanzapine's optimum use for patients with PD with treatment-related psychosis...

..To characterize the relationships between symptoms of fatigue, physical activity, physical function, and functional capacity in patients with idiopathic PD...

..Our preliminary experience with aripiprazole is mixed but not very encouraging. Controlled studies are needed to evaluate aripiprazole in parkinsonian patients...

..Our focus in clinical care needs to be broadened beyond assessing and treating Parkinsonism, recognizing the impact of mood, cognition and function on HRQOL...

..To determine whether severity of depression and severity of anxiety were associated with particular types of sleep disturbance in patients with Parkinson's disease...

..With the development of the atypical antipsychotics, the incidence and prevalence of tardive dyskinesia have dropped remarkably, suggesting that psychosis, its treatment, and dyskinesias are not inextricably linked...

..02). Only 1 patient with drug-induced parkinsonism and 3 residents with previously diagnosed Parkinson's disease had chart notes indicating that parkinsonism had been recognized...

..An overview of sleep disorders in PD and an approach to therapy will also be outlined. The little that is known about fatigue in PD will be reviewed...

..Although patients frequently report pain, systematic evaluation of this clinical feature is lacking...

..The aim of this study was to estimate the effect of atypical and conventional antipsychotics on the risk of hospitalization for femur fracture...