Current treatment of behavioral and cognitive symptoms of Parkinson's disease

Rektorová, Irena

doi:10.1016/j.parkreldis.2019.02.042

Cited by 28 publications

(20 citation statements)

References 177 publications

(204 reference statements)

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“…3 Recent studies suggest that the progressive disability, patient's mood, speech difficulties, and cognitive deterioration are the main factors contributing to caregiver burden and poorer caregiver's QoL. [4][5][6][7][8][9] Most PD patients are cared for in their own homes and spouses are the main informal caregivers. 10,11 During the disease progression, the caregiver of a PD patient assumes many responsibilities, including medication administration, care coordination, prompting for selfcare, surveillance of falls, provisions of emotional support.…”

Section: Introductionmentioning

confidence: 99%

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<p>Impact of Supporting People with Advanced Parkinson’s Disease on Carer’s Quality of Life and Burden</p>

Modugno¹,

Antonini²,

Tessitore³

et al. 2020

NDT

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The aim of this study was to assess the burden and the quality of life (QoL) perceived by caregivers assisting advanced Parkinson's disease (PD) patients. Patients and Methods: Consecutive advanced PD patients treated with levodopa/carbidopa intestinal gel (LCIG) or continuous subcutaneous apomorphine infusion (CSAI) or care as usual (CU) and their care partners were recruited during routine visits according to a cross-sectional design. Caregiver's distress was assessed by Zarit Burden Interview (ZBI) and a QoL survey to evaluate and understand the burden experienced by care partners during family and working activities. Results: A total of 126 patients (53 LCIG, 19 CSAI and 54 CU) and their care partners were enrolled. The ZBI score boxplot showed that LCIG and CU populations have a similar distribution (ZBI inter-quartile range [IQR] values respectively 18-42 for LCIG and 19-43 for CU group), while the CSAI group has a wider score range (IQR 16-52). Caregivers assisting patients in treatment with LCIG have more time to perform family or household duties (p=0.0022), or to engage in leisure activities (p=0.0073) compared to CU, while no difference was found when compared to CSAI group. Approximately 50% of the care partners showed mood changes in the last 6 months and LCIG and CSAI had less impact on caregiver's mood compared to CU. Patients treated with LCIG were more independent in taking a bath or shower without assistance and were more able to move and walk without assistance. Conclusion: Care partners of advanced PD patients treated with device-aided therapies have more time for their own life and a better perception of their QoL with a tendency to an improvement of mood compared with those of patients treated with CU.

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Section: Introductionmentioning

confidence: 99%

“… 3 Recent studies suggest that the progressive disability, patient’s mood, speech difficulties, and cognitive deterioration are the main factors contributing to caregiver burden and poorer caregiver’s QoL. 4 – 9 Most PD patients are cared for in their own homes and spouses are the main informal caregivers. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

<p>Impact of Supporting People with Advanced Parkinson’s Disease on Carer’s Quality of Life and Burden</p>

Modugno¹,

Antonini²,

Tessitore³

et al. 2020

NDT

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“…Os sintomas não motores da DP costumam preceder os motores em até 10 anos, sendo comum o aparecimento de anedonia, apatia, disgeusia, fadiga, dor, disfunções do comportamento no sono REM, hiposmia, disfunção autonômica, alterações visuais e depressão (SVEINBJORNSDOTTIR, 2016). As opções de tratamento atualmente disponíveis para os sintomas não motores comportamentais e cognitivos são, em geral, menos bem-sucedidas na compensação dos sintomas a longo prazo do que as opções de tratamento para os sintomas motores (REKTOROVA, 2019).…”

Section: Fundamentação Teóricaunclassified

Tradução e validação para o português de uma escala de avaliação de transtornos de controle de impulso em pacientes com doença de parkinson no Brasil

Almeida¹,

Castro²,

Grippe³

2021

PIC

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A doença de Parkinson atinge cerca de 3% da população acima de 60 anos noBrasil. Além dos sintomas motores, existem diversos sintomas não motores, incluindoaspectos cardiovasculares, gastrointestinais, relacionados ao sono, psiquiátricos, entreoutros. No que concerne aos sintomas psiquiátricos, inclui-se não só ansiedade e depressão,mas também os transtornos de controle de impulso (TCIs). A prevalência de transtornos docontrole do impulso (TCIs) em portadores da doença de Parkinson é de cerca de 15 a 20%.Esse sintoma pode se apresentar como hipersexualidade, hiperfagia, compulsão por jogos oupor compras. A abordagem deve visar a identificação precoce e o ajuste do tratamento dadoença de Parkinson, a fim de prevenir consequências sociais, financeiras e legais. A escalaQUIP-RS é uma ferramenta para avaliação dos TCIs, que aborda a gravidade e a progressãodos sintomas, mas carece de validação para o Português brasileiro. OBJETIVO: Validar a QUIPRSpara o português brasileiro. METODOLOGIA: A escala QUIP-RS e sua folha de instruçõesforam previamente traduzidas, retro traduzidas e aprovadas pelo autor da versão original. Aescala foi aplicada a 20 controles e 58 pacientes portadores de doença de Parkinson. Foramanalisadas, a partir do software R, as propriedades psicométricas aceitabilidade, consistênciaexterna e interna, dimensionalidade e precisão. Foram aplicadas, também, as escalas MDSUPDRS,QUIP-CS, PDSS-BR, PDQ-8 e MoCA para melhor análise do perfil dos pacientes e paraanálise da validade divergente. RESULTADOS E DISCUSSÃO: Avaliaram-se os resultadosreferentes aos pacientes com doença de Parkinson. O alfa de Cronbach foi de 0.79,demonstrando a confiabilidade da escala. A análise gráfica exploratória e a fatorialconfirmatória comprovaram que é uma escala unidimensional. A validade convergente foidemonstrada pela relação estatisticamente significativa entre as pontuações de cadatranstorno na QUIP-RS e as questões binárias referentes a cada transtorno no QUIP-CS. Avalidade divergente foi comprovada pela falta de relação ou relação negativa com escalas queavaliam outros construtos. CONCLUSÃO: A escala QUIP-RS, conforme foi traduzida é uminstrumento útil na identificação e avaliação da gravidade e da progressão de TCIs no Brasil.

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“…In another recent review, dopamine agonists (piribedil, rotigotine and pramipexole) have been reported to improve levels of apathy in PD (Rektorova, 2019).…”

Section: Other Disordersmentioning

confidence: 99%

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

et al. 2020

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Apathy is one of the most frequent behavioral disturbances in many neurodegenerative disorders and is known to have a negative impact on the disease progression, particularly in Alzheimer's disease. Therapeutic options are currently limited and non-pharmacological approaches should constitute first line treatments. Pharmacological agents likely to reduce apathy levels are lacking. The objective of the present article is to review recent pharmacological treatments for apathy in neurodegenerative disorders. The Pubmed database was searched with a particular focus on articles published as of January 2017. Current main levels of evidence have been reported so far with cholinergic, glutamatergic and dopaminergic agents to reduce levels of apathy, despite several conflicting results. Treatment duration and samples sizes may have however decreased the validity of previous results. Ongoing studies involving more participants/treatment duration or distinct neural pathways may provide new insights in the treatment of apathy in neurodegenerative disorders.

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Current treatment of behavioral and cognitive symptoms of Parkinson's disease

Cited by 28 publications

References 177 publications

<p>Impact of Supporting People with Advanced Parkinson’s Disease on Carer’s Quality of Life and Burden</p>

<p>Impact of Supporting People with Advanced Parkinson’s Disease on Carer’s Quality of Life and Burden</p>

Tradução e validação para o português de uma escala de avaliação de transtornos de controle de impulso em pacientes com doença de parkinson no Brasil

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

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