20th October 2014 - New research
CLINICAL
TRIAL RESULTS OF DUAL LAYER L-DOPA
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Dual layer L-dopa (IPX066), which is being developed for the treatment of
Parkinson's Disease, unusually and advantageously combines the immediate
release version of L-dopa with the controlled release version of L-dopa. An
application by Impax is with the FDA for the marketing of IPX066 as Rytary.
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Rytary�
������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� The effect of Dual Layer L-dopa on Parkinson's Disease was compared to the
effect of Sinemet plus Entacapone, which is one of the most effective
formats of L-dopa. IPX066 demonstrated improved efficacy. The average dosage
of L-dopa used in IPX066, after accounting for availability, was 22% higher
than in Sinemet and Entacapone.
IPX066 demonstrated less "off" time
(3.8 hours instead of 5.2 hours per day). IPX066 demonstrated higher "on"
time without dyskinesia (11.4 hours instead of 10 hours per day). Other
measures favoured IPX066. There were more adverse events when taking IPX066.
The most common adverse events were dyskinesia, insomnia, and confusional
state for IPX066, and falling for Sinemet and Entacapone.
Reference :
Parkinsonism Related Disorders [2014] Aug 15 [Epub ahead of print]
(F.Stocchi, A.Hsu, S.Khanna, A.Ellenbogen, A.Mahler, G.Liang, U.Dillmann,
R.Rubens, S.Kell, S. Gupta)
Complete abstract�
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13th October 2014 - New research
AIR POLLUTION AND
PARKINSON'S DISEASE
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Exposure to air pollution has been implicated as a cause of Parkinson's
Disease. The first prominent descriptions of Parkinson's Disease came at the
time of the Industrial Revolution when pollution levels escalated. Yet, no
prospective study has examined the association between particulate matter
and the risk of Parkinson's Disease.
After
adjusting for age in months, smoking, region, population density, caffeine
and ibuprofen intake, there was found to be no statistically significant
associations between exposure to air pollution and the risk of Parkinson's
Disease. The relative risk of Parkinson's Disease was 1.08 for pollution
particles that were less than 2.5 microns in diameter, 0.92 for pollution
particles that were 2.5 to 10.0 microns in diameter, and 0.99 for pollution
particles that were more than 10.0 microns in diameter. These likelihoods
are little different from what would be expected normally.
There are areas of the world where pollution is definitely a serious cause
of Parkinson's Disease. One of the world's highest prevalences of
Parkinson's Disease is in the vicinities of ferromanganese plants near
Brescia in Italy. Manganese concentrations in settled dust were found to be
significantly higher in the surroundings and downwind from the
ferromanganese plants. In high concentrations, manganese is a known cause of
Parkinson's Disease.
Reference : Environmental Health [2014] 13 (1) : 80 [Epub ahead of print]
(N.Palacios, K.C.Fitzgerald, J.E.Hart, M.G.Weisskopf, M.A.Schwarzschild,
A.Ascherio, F.Laden)
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10th October 2014 - New research
TWENTY YEARS WITH PARKINSON'S DISEASE
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Having Parkinson's Disease for more than twenty years has been found to be
associated with major milestones of disease disability, fractures, or being
confined to a wheelchair or bed. There are a very limited number of studies
on the clinical features of Parkinson's Disease twenty years after onset. So
an assessment was carried out for several years on people who had
Parkinson's Disease for more than twenty years
Those
people considered were those who had Parkinson's Disease for 20 to 22 years.
They were assessed for an average of nearly four years. Older age at onset
and longer duration of Parkinson's Disease were each associated with a
higher prevalence of major motor and non-motor milestones of disease
disability. Confinement to a wheelchair or bed had by then occurred in just
over 1 in 5 people (21%). Those factors making confinement to a wheelchair
or bed were older age, postural instability and institutionalisation.
Fractures occurred in 16% of people. Fractures were associated with postural
instability.
The most frequent outcome was death (28%). However, given the age of
diagnosis and the duration of Parkinson's Disease this might have been no
more than normal. Mortality was associated with male gender, older age,
dysphagia (difficulty in swallowing), orthostatic hypotension, postural
instability, fractures and institutionalisation.
Reference : Journal of Neurology, Neurosurgery and Psychiatry [2014] Oct 3
[Epub ahead of print] (R.Cilia, E.Cereda, C.Klersy, M.Canesi,
A.L.Zecchinelli, C.B.Mariani, S.Tesei, G.Sacilotto, N.Meucci, M.Zini,
C.Ruffmann, I.U.Isaias, S.Goldwurm, G.Pezzoli)
Complete abstract�
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8th October 2014 - New book
LEVODOPA-INDUCED DYSKINESIA IN PARKINSON'S DISEASE
Susan H.Fox (Editor), Jonathan M.Brotchie (Editor)
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Publisher's
description : This book aims to provide a single reference source on
levodopa-induced dyskinesias (LID) from �bench to bedside�. Initial chapters
review the clinical features and phenomenology of LID with video examples;
epidemiology and genetic risk factors for LID are covered as a background to
understanding risk factors for developing LID. The chapters cover the latest
preclinical studies aiming to understand the pathophysiology of LID at the
cellular, neurochemical, neurophysiological and circuitry level with detailed
discussion of mechanisms and future directions to take the field forward;
clinical studies from phase II to phase IV; on going RCTs in LID and
evidence-based medicine reviews of treatment options. Levodopa-Induced
Dyskinesia in Parkinson�s Disease is aimed at an international audience of
movement disorder neurologists; neuroscientists; trainees and graduate and
post-graduate students.
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5th October 2014 - New research
HANDEDNESS AND
PARKINSON'S DISEASE SYMPTOMS
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Whether somebody with Parkinson's Disease is right handed or left handed has
been found to greatly affect the side on which their Parkinson's Disease
symptoms initiate and persist.
Handedness determines a better
performance or preference for the use of one hand rather than the other.
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Handedness�
Out
of those people with Parkinson's Disease, 92% were right handed. Nearly 62%
of them had an initial onset of symptoms on the right hand side. Out of
those people with Parkinson's Disease, 8% were left handed. Around 75% of
them had an initial onset of symptoms on the left hand side. Out of those
people with Parkinson's Disease who were right handed 77% had Parkinson's
Disease symptoms that were dominant on the right hand side. Out of those
people with Parkinson's Disease who were left handed 58% of them had
Parkinson's Disease symptoms that were dominant on the left hand side.
In general, the dominant side of Parkinson's Disease symptoms was in
accordance with which handed they were. In people who were right handed,
rest tremor was the most common initial symptom. In people who were left
handed, rest tremor and rigidity and bradykinesia were the most common
initial symptoms.
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Reference : Medicina Clinica [2014] 142 (4) : 141-144 (J.Shi, J.Liu, Q.Qu)
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1st October 2014 - New research
HORMONES CAN INCREASE
THE RISK OF PARKINSON'S DISEASE
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ParkinsonismMovement Disorders [2014] Sep 25 [Epub ahead of print]
(J.I.Lundin, T.G.Ton, A.Z. LaCroix, W.T.Longstreth, G.M.Franklin,
P.D.Swanson, T.Smith-Weller, B.A.Racette, H. Checkoway)
Complete abstract
Certain types of commonly used oral contraceptives have been found to
greatly increase the risk of developing Parkinson's Disease. Oral
contraceptives, which includes estrogen and progestin, are a class of drugs
widely prescribed to women.� For more
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Oral contraceptives
Oral
contraceptive use by people with Parkinson's Disease were classified as
conjugated estrogens, esterified estrogens, or progestin. Ever having used a
hormone therapy formulation demonstrated a suggested elevated risk with
esterified estrogen use that was three times the normal. However, there was
no increase in the risk of developing Parkinson's Disease in those people
who had taken conjugated estrogen. Restricting this analysis to
prescriptions that included progestin greatly increased the risk associated
with esterified estrogen use, making Parkinson's Disease SEVEN times more
likely. Progestin also moderately increased the risk of developing
Parkinson's Disease in those people who taken conjugated estrogen.
The findings from this study suggest a great increase in Parkinson's Disease
risk associated with the use of esterified estrogen combined with progestin,
but no risk is associated with conjugated estrogen on its own.
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