Navegando por Palavras-chave "levodopa"
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- ItemAcesso aberto (Open Access)Discinesias induzidas por levodopa em 176 pacientes com doença de Parkinson(Academia Brasileira de Neurologia - ABNEURO, 1995-12-01) Rocha, Maria Sheila G. [UNIFESP]; Andrade, Luiz Augusto Franco de [UNIFESP]; Ferraz, Henrique B. [UNIFESP]; Borges, Vanderci [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Dyskinesias are frequently observed in parkinsonian patients during levodopa treatment. The occurrence of these movement disorders usually makes the therapeutic management of the patients very difficult. The clinical characteristics of 176 patients with dyskinesias were retrospectively studied. Dyskinesias occurred, on average, after 6,2 years of duration of Parkinson's disease and after 4.2 years on treatment with levodopa. Patients were more likely to have dyskinesias during more advanced stages (measured by Hoehn and Yahr scale). Peak of dose and square wave were the types of dyskinesia more frequently described and were associated with choreic movements in most cases. Dystonia occurred in 40% of the cases and was predominant in end of dose and diphasic dyskinesias. Thirty-five percent of dystonia cases presented as early morning dystonia. Chorea was the most frequent involuntary movement and mostly generalized. Dystonia was most commonly described in lower limbs. Orofacial dyskinesia, when occurred alone, was more frequently seen in old rather than young patients. When dyskinesia was unilateral it was more likely to occur in the side where Parkinson's disease was more severe.
- ItemAcesso aberto (Open Access)Efeitos da Mucuna Pruriens sobre a Atividade Neuronal de Áreas do Sistema Nervoso Central(Universidade Federal de São Paulo (UNIFESP), 2018-12-12) Armenini, Breno Néglia [UNIFESP]; Céspedes, Isabel Cristina [UNIFESP]; http://lattes.cnpq.br/5014274675948150; http://lattes.cnpq.br/0249457001877013A Mucuna pruriens (Mp) é uma leguminosa, proveniente da família Fabaceae, originária da Índia. Seus principais componentes terapêuticos são a L-Dopa e a 5-hidroxi-triptamina (serotonina). Estudos demonstraram propriedades medicinais desta planta, e sua utilização tem sido proposta especialmente no tratamento da doença de Parkinson (DP). Na literatura foi demonstrada sua propriedade neuroprotetora em modelos para DP, hipoglicêmica em modelo para diabetes, entre outras. Apesar de ter efeito antidepressivo comprovado em modelo experimental, não foi descrito ainda quais os efeitos da Mp sobre os circuitos neurais envolvidos nas respostas comportamentais e emocionais; e na circuitaria dopaminérgica de áreas motoras e límbicas. Neste sentido este estudo foi elaborado a fim verificar os efeitos da Mp sobre a ativação neuronal em áreas específicas do sistema nervoso central em ratos Wistar, através da administração de seu extrato em concentração de 200mg/kg/dia, por três semanas. Assim, oito animais receberam extrato, e oito receberam solução salina. Os animais passaram por teste de Campo Aberto e Labirinto em Cruz Elevado para estudo da atividade locomotora e ansiedade patológica. Para análise dos efeitos sobre áreas do sistema nervoso central, foi utilizado o método de imunoistoquímica para proteína DeltaFosB. A partir da administração do extrato, foi possível observar a ausência de efeito sobre a massa corporal dos animais, discreto efeito comportamental ansiogênico e um efeito encefálico inibitório em amplas áreas associadas às funções cognitivas (córtex infra-límbico e cingulado), motoras (núcleos caudado e putâmen), e límbicas (área tegmentar ventral).
- ItemSomente MetadadadosEffect of riluzole on dyskinesia and duration of the ON state in Parkinson disease patients - A double-blind placebo-controlled pilot study(Lippincott Williams & Wilkins, 2004-01-01) Braz, Claudia A. [UNIFESP]; Borges, Vanderci [UNIFESP]; Ferraz, Henrique B. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The objective of this study was to evaluate the effect of riluzole on dyskinesia and the duration of the ON state in patients with Parkinson disease (PD). the authors studied 16 PD patients with levodopa-induced dyskinesia. All patients initially received an apomorphine dose intended to induce the motor function benefit (ON state) generally accompanied by dyskinesia. They evaluated the patients during the OFF and ON states using the UPDRS-III, UPDRS-IV, and Larsen scales, and measured the duration of the ON state. Patients were randomly assigned to receive either riluzole (50 mg bid) or placebo for 7 consecutive days (8 patients in each group). the authors did not interrupt previously prescribed medication. Following the 7-day period, they carried out similar evaluation procedures before and after another apomorphine challenge. Mean UPDRS-IV scores were 6.1 points and 6.0 points before and after riluzole therapy respectively. for the placebo group, the scores were 6.9 points and 6.6 points for the initial and final evaluations respectively. Larsen scale had mean scores of 9.2 points and 9.9 points for the pre- and postriluzole periods, and 10.2 points and 9.6 points for pre- and post-placebo evaluations respectively. the ON state was 33.5% lengthier after 7 days of riluzole and 28.0% lengthier after placebo. They could not find any statistical differences between the 2 groups. Short-term riluzole administration in PD patients was not able to reduce apomorphine-induced dyskinesia but could extend the ON state duration, although this did not reach statistical significance.
- ItemSomente MetadadadosLevodopa effect upon functional balance of Parkinson's disease patients(Elsevier B.V., 2004-10-01) Nova, I. C.; Perracini, M. R.; Ferraz, H. B.; Universidade Federal de São Paulo (UNIFESP)Objective. the aim of this study was to evaluate functional balance in PD patients taking levodopa during their 'on' and 'off' phases.Design. We evaluated 23 PD patients who were manifesting fluctuations of levodopa effect. All patients were assessed by Hoehn-Yahr, UPDRS-III and Schwab-England rating scales and by the Berg functional balance scale during a practically defined 'off' (at least after 12 h the last levodopa intake) and 'on' (the mobile state induced by the drug) phases.Results. Mean scores obtained for all scales showed improvements during the 'on' phase of levodopa and all of the comparisons were statistically significant. Mean scores of Berg scale moved from 31.7 during the 'off' phase to 42.7 during the 'on' phase. Mean UPDRS 'off' and 'on' scores were 50.6 and 32.0, respectively.Conclusion. We conclude that Berg functional balance scale is able to detect changes in balance and that levodopa can modify the postural instability of PD patients. (C) 2004 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosLevodopa for idiopathic restless legs syndrome: Evidence based review(Wiley-Blackwell, 2007-10-15) Conti, Cristiane Fiquene; De Oliveira, Marcio Moyses; Andriolo, Regis Bruni; Saconato, Humberto; Atallah, Alvaro Nagib; Valbuza, Juliana Spelta; De Carvalho, Luciane Bizari Coin; Do Prado, Gilmar Fernandes; Universidade Federal de São Paulo (UNIFESP)Restless legs syndrome (RLS) is a sensory motor disorder characterized by a distressing urge to move the legs and sometimes also other parts of the body usually accompanied by a marked sense of discomfort or pain in the leg or other affected body part. the prevalence of RLS is estimated at 2.7 to 5% of adults and it is more common in women. the treatment of RLS with levodopa has been reported thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of levodopa for RLS. Systematic review of randomized or quasi-randomized, double blind trials on levodopa. Relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Nine eligible clinical trials were included. the subjective analyses of these studies showed contradictory results, although the objective analyses showed that treatment group had a statistically significant improvement of periodic leg movement (PLM) index, favoring the treatment group. the most commonly adverse event seen was gastrointestinal symptoms. the short-term treatment with levodopa was demonstrated effective and safety for PLM, but there was only few trials assessing long-term treatment and the augmentation phenomenon in RLS. Further long-term randomized controlled trials using standard follow-up measurements as the International RLS Study Group Rating Scale are necessary. (C) 2007 Movement Disorder Society.
- ItemSomente MetadadadosLevodopa Use and Sleep in Patients with Dementia with Lewy Bodies(Wiley-Blackwell, 2009-03-15) Molloy, Sophie; Minett, Thais [UNIFESP]; O'Brien, John T.; McKeith, Ian G.; Burn, David J.; Univ Newcastle; Universidade Federal de São Paulo (UNIFESP)Sleep disturbance and excessive daytime somnolence (EDS) are features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB) that may be influenced by dopamine replacement therapy. the effect of levodopa on sleep and EDS in DLB is unknown and unclear in PD. the aim of, this study is to determine if levodopa treatment alters sleep symptoms and EDS in DLB. Dopamine naive patients with DLB (n = 15: mean mini mental state examination (MMSE) score 17.7(4.6)) and PD (n = 9; mean MMSE 25.5(2.2)) were assessed using the Epworth sleep scale. Parkinson's disease sleep scale. and the neuropsychiatric inventory prior to initiating treatment with levodopa. All measures were repeated after 3 and 6 months of levodopa therapy. the median final daily levodopa dose was 300 mg in both groups. Baseline sleep measures were comparable between groups. Levodopa treatment did not affect sleep or lead to increased EDS in DLB patients. the use of levodopa does not appear to adversely affect subjective steep measures or increase EDS in DLB patients. (C) 2009 Movement Disorder Society
- ItemAcesso aberto (Open Access)Quality of life scale in parkinson's disease PDQ-39 - (Brazilian Portuguese version) to assess patients with and without levodopa motor fluctuation(Academia Brasileira de Neurologia - ABNEURO, 2007-09-01) Souza, Renata Guzzo [UNIFESP]; Borges, Vanderci [UNIFESP]; Silva, Sonia Maria Cesar De Azevedo [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Quality of life (QoL) is an important treatment outcome indicator in Parkinson's disease (PD). The aim of this study is to assess the usefulness of the Parkinson's disease questionnaire - PDQ-39 (Brazilian Portuguese Version) in measuring QoL of PD patients with or without motor fluctuations. Fifty-six PD patients with mean disease duration of 7.4 years were assessed and 41 of them (73.3%) had motor fluctuations. The PDQ-39 has eight dimensions ranging from 0 to 100; being the higher the score, the worse the QoL. Comparing groups with and without motor fluctuations showed that the dimensions mobility, activities of daily living (ADL), communication and bodily discomfort scored higher in the fluctuating group. There was a tendency to see that the higher the Hoehn and Yahr (HY) scale stages, the higher the PDQ-39 scores. Patients suffering from the disease for more than five years had worse PDQ-39 scores only in the items ADL and communication, when compared with those with the disease for < 5 years. The PDQ-39 is an instrument that detects decrease in QoL of PD patients and the presence of motor fluctuations predicts QoL reduction.
- ItemSomente MetadadadosSíndrome das pernas inquietas: diagnóstico e tratamento. Opinião de especialistas brasileiros(Assoc Arquivos Neuro- Psiquiatria, 2007-09-01) Aloe, Flávio; Alves, Rosana S Cardoso; Andrade, Luiz Augusto Franco [UNIFESP]; Assis,Márcia; Bacelar, Andrea; Bezerra, Márcio; Cardoso, Francisco [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Fonseca, Ronaldo Guimarães; Horta, Wagner; Haddad, Mônica Santoro; Hasan, Rosa; Mattos, James Pitágoras; Prado, Gilmar Fernandes do [UNIFESP]; Rizzo, Geraldo; Rodrigues, Nonato; Silva, Ademir Batista da [UNIFESP]; Silva, Delson Jose; Teive, Helio Afonso Ghizoni; Grupo Brasileiro de Estudos em Síndrome das Pernas Inquietas (GBE-SPI); Universidade de São Paulo (USP); Hosp Israelita Albert Einstein; Pratica privada; Practica Privada; Universidade Federal de Minas Gerais (UFMG); Universidade Federal de São Paulo (UNIFESP); UFCE; Universidade Federal de Goiás (UFG)This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI) about diagnosis and management of restless legs syndrome (RLS). RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class 11 studies support the use of slow release valproic acid, clonazepan and oxycoclone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or oxycodone, and the third choice are clonazepan or slow release valproic acid.