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- 주제어 : Parkinson's disease · Depressive symptoms (검색결과 4 건)
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루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례
노민영,이지현,한양희,임정태,Roh, Min-yeong,Lee, Ji-hyun,Han, Yang-hee,Leem, Jung-tae 대한한방내과학회 2021 大韓韓方內科學會誌 Vol.42 No.5
Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.
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Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson’s Disease
Bruno Terra Junho,Arthur Kummer,Francisco Cardoso,Antonio Lucio Teixeira,Natalia Pessoa Rocha 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.4
Background and Purpose Excessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson’s disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD. Methods This cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS. Results We found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD. Conclusions Nighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.
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김성렬,김지영,Hye Young Kim,Hui Young So,정선주 대한파킨슨병및이상운동질환학회 2021 Journal Of Movement Disorders Vol.14 No.2
ObjectiveaaMedication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed toidentify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson’sdisease (PD). MethodsaaWe used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinsondrugs for more than one year. ResultsaaThe subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illnessduration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, numberof medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamineoxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjectswho had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects usingamantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concernsdifferentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followedby depression and motor fluctuation. ConclusionaaSevere illness, higher levels of depression, and motor fluctuation are independent factors influencing patients’ beliefsregarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventionsfor PD patients. Key WordsaaParkinson’s
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