Background
As the 2nd most common neurodegenerative disorder, Parkinson's disease (PD) affects over 1 million Americans. Treatment is complex and may include pharmacotherapy, rehabilitative measures, and surgical intervention. A comprehensive understanding of the patient's perceptions about PD is a vital step towards improving health literacy and clinical outcomes.
Methods
KnowPD is a web-based survey with Likert responses for a cross-sectional, nonrandomized study to assess patients' knowledge of PD symptoms, medications, deep brain stimulation (DBS), rehabilitation, and other factors relevant to disease management.
Results
Of the 98 subjects surveyed, 90% agreed they had sufficient knowledge of PD. However, in this cohort, 82% incorrectly believed levodopa stops working as the disease progresses, 77% erroneously thought DBS improves balance and reduces falls, and, <50% could answer specific questions regarding the dosing of levodopa despite over 75% reporting managing their own medications. A majority of patients (84%) believed it was possible to live well with PD, correlating with their self-reported knowledge of the disease. Finally, patients selected electronic video (13.7%) and reading (20.0%) material, yearly symposia (20.0%), and lunch lectures (28.4%) as their preferred method of information delivery.
Conclusion
Misconceptions are prevalent among PD patients, and these appear to be unrelated to gender, provider type, or education level. Identification and characterization of this knowledge gap is vital towards allocating patient education resources, and the findings described herein will form the basis for effective educational interventions.
Deep brain stimulation (DBS) has improved the quality of life for many patients with select movement disorders. Since its first approval in the United States for thalamic stimulation as a potential treatment for essential and parkinsonian tremors in 1997, advances in neurostimulation technology have helped propel an expansion of research into other indications for DBS, including dystonia, obsessive compulsive disorder, epilepsy, and Tourette syndrome. The evolving approach to programming is based on optimizing symptomatic benefits while minimizing stimulation-induced side effects, neurotoxicity, and energy inefficiency. A solid foundation in the basics of programming is critical to approaching the now more complex neurostimulation systems. Advances such as segmented leads, multiple independent current sources, and pulse shaping are quickly changing the landscape of programming options. This chapter provides an overview of common DBS programming strategies.
Clinically defined by consensus in 2007, Parkinson's disease psychosis (PDP) encompasses psychiatric symptoms of illusions, hallucinations, and delusions associated with Parkinson's disease. Since that time, an increase in research has yielded new insights into clinical features of PDP, how these symptoms evolve over time, and novel therapeutic targets. This article reviews the literature surrounding PDP, highlighting the spectrum of clinical manifestations, the pathophysiology, and treatment options. The article concludes with a treatment strategy incorporating the reviewed evidence.
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Psychiatr Ann
. 2020;50(3):113–120.]
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