Muscular Rigidity Research Articles

Hyperreflexia in outpatients with Parkinson’s disease and coexisting cervical spinal stenosis: A retrospective cohort study

Background. Degenerative cervical myelopathy (DCM) is poorly recognized and infrequently diagnosed. Objectives. To identify symptoms and signs in the lower extremities physically and radiologically in outpatients with idiopathic Parkinson’s disease (PD) and coexisting DCM. Methods. In 2023, a retrospective cohort study was performed to review the medical records from 2016 to 2020 at the outpatient clinic of the Department of Internal Medicine. As a result, 8 women with PD were diagnosed based on the presence of cardinal features, asymmetry, and a good response to levodopa. Brain and cervical magnetic resonance imaging (MRI) was conducted in 4 patients (group A): 3 with hyperreflexia of the patellar tendon, and 1 with Babinski’s sign. Results. The motor subtype of the 8 patients aged 69 to 90 was a tremor-dominant type of PD. The Hoehn and Yahr (H&Y) stages were II (1) and III (3) in group A, and III (3) and IV (1) in those without hyperreflexia of the patellar tendon. Hyperreflexia and Babinski’s sign were predominant on the tremor-dominant side in group A. Radiologically, their anteroposterior diameters at the most stenotic level (C5-6) were 6.0, 7.1, 7.1, and 10.4 mm. They developed muscular rigidity and spasticity involving the lower extremities. The gait and balance performance were particularly affected compared with the upper extremity function. Conclusion. Hyperreflexia of the patellar tendon and imbalance of gait performance due to coexisting DCM were the important factors affecting gait in older women with tremor-dominant PD.

Impact of tango on Parkinson's disease - a narrative review

Introduction: Parkinson’s disease (PD) is a fast-growing neurodegenerative condition caused by the deficiency of dopamine (Bloem et al., 2021). Main symptoms include tremor, bradykinesia, muscular rigidity and postural instability (Ye et al., 2023). Although PD treatment primarily involves pharmacotherapy, physical activity-based treatments such as tango dance can improve the quality of life of patients. Aim of the study: This narrative review aims to assess the impact of the therapeutic benefits of tango dance therapy for people with PD. Materials and methods: A comprehensive literature search was conducted in the PubMed database up to 2024. The review included randomised controlled trials, case reports, and pilot studies focused on the impact of tango on PD. Results: Several studies have evaluated the impact of tango on patients with PD. Some of them found that tango improves dynamic balance and walking, reduces the risk of falling, improves body awareness, stability, and emotional well-being among patients with PD. Conclusions: The impact of tango on PD is not yet conclusively documented, and further research is needed.

Malignant Hyperthermia.

A narrative expert review aiming to summarize the clinical epidemiology and management of critically ill patients with malignant hyperthermia (MH). Medline searches were conducted to identify relevant articles describing the epidemiology, pathophysiology, and management of MH. Guidelines from key MH organizations were also incorporated into this review. Relevant studies regarding MH in both ICU and perioperative settings were reviewed. Data from relevant studies were summarized and qualitatively assessed. MH is a severe reaction triggered by inhalational volatile anesthetics and succinylcholine in genetically susceptible patients. The condition is characterized by an early onset (min to hr) rise in temperature, hypercarbia, and muscular rigidity following exposure to triggering medications with potential complications of coagulopathy, rhabdomyolysis, and acute kidney injury. Acute management necessitates a coordinated multidisciplinary team approach with specific management using dantrolene, active cooling, and hyperventilation. A suspected MH reaction has important implications for future anesthetic exposure for both the patient and their family. All suspected reactions should be followed up at a specialized MH testing center using muscle contracture and genetic testing. Increasing use of inhalational anesthetics in the ICU underscores the need for enhanced education on the diagnosis and management of MH to ensure optimal patient sedation care and safety.

Usp14 down-regulation corrects sleep and circadian dysfunction of a Drosophila model of Parkinson's disease.

PD is a complex, multifactorial neurodegenerative disease, which occurs sporadically in aged population, with some genetically linked cases. Patients develop a very obvious locomotor phenotype, with symptoms such as bradykinesia, resting tremor, muscular rigidity, and postural instability. At the cellular level, PD pathology is characterized by the presence of intracytoplasmic neurotoxic aggregates of misfolded proteins and dysfunctional organelles, resulting from failure in mechanisms of proteostasis. Nonmotor symptoms, such as constipation and olfactory deficits, are also very common in PD. They include alteration in the circadian clock, and defects in the sleep-wake cycle, which is controlled by the clock. These non-motor symptoms precede the onset of the motor symptoms by many years, offering a window of therapeutic intervention that could delay-or even prevent-the progression of the disease. The mechanistic link between aberrant circadian rhythms and neurodegeneration in PD is not fully understood, although proposed underlying mechanisms include alterations in protein homeostasis (proteostasis), which can impact protein levels of core components of the clock. Loss of proteostasis depends on the progressive pathological decline in the proteolytic activity of two major degradative systems, the ubiquitin-proteasome and the lysosome-autophagy systems, which is exacerbated in age-dependent neurodegenerative conditions like PD. Accordingly, it is known that promoting proteasome or autophagy activity increases lifespan, and rescues the pathological phenotype of animal models of neurodegeneration, presumably by enhancing the degradation of misfolded proteins and dysfunctional organelles, which are known to accumulate in these models, and to induce intracellular damage. We can enhance proteostasis by pharmacologically inhibiting or down-regulating Usp14, a proteasome-associated deubiquitinating enzyme (DUB). In a previous work, we showed that inhibition of Usp14 enhances the activity of the ubiquitin-proteasome system (UPS), autophagy and mitophagy, and abolishes motor symptoms of two well-established fly models of PD that accumulate dysfunctional mitochondria. In this work we extended the evidence on the protective effect of Usp14 down-regulation, and investigated the beneficial effect of down-regulating Usp14 in a Pink1 Drosophila model of PD that develop circadian and sleep dysfunction. We show that down-regulation of Usp14 ameliorates sleep disturbances and circadian defects that are associated to Pink1 KO flies.

High throughput LC-MS/MS method for the quantitation of baclofen in human plasma by solid phase extraction using 96 well plate format

Oral baclofen is indicated for the treatment of spasticity resulting from multiple sclerosis and is very useful for the relief of flexor spasms and concomitant pain, muscular rigidity, and clonus. It can also be used to treat patients with spinal cord injuries and other spinal cord diseases. In present work, a sensitive and high throughput LC-MS/MS method was developed and validated to estimate Baclofen in Human plasma. The developed LC-MS/MS method was sensitive enough to detect Baclofen in human plasma with a high degree of accuracy and precision, using Baclofen-d4 as an internal standard. Using BDS Hypersil C8 5µm, 100 X 4.6mm column and a mobile phase consisting of 2mM Ammonium formate with 0.02% v/v formic acid: Acetonitrile (85:15 v/v) was used to achieve best chromatographic separation. A flow rate of 1 mL/min was used to optimize the run time of 3.2 min. Plasma sample extraction was performed by Solid Phase extraction using 96 well plates. The developed bioanalytical method was validated successfully. This high throughput bioanalytical method developed and validated can be applied to routine sample analysis. this method can accommodate 80 study samples in single run excluding the CC and QC samples. Since the method uses 96 well plate formate it gives flexibility in assigning the CC, QC, and study samples in fixed well before the initiation of the process which in turn avoids the risk of sample mix up during processing. The method validation results were found to be within the acceptance range. It can be concluded that the developed high throughput LC-MS/MS method is sensitive enough to measure Baclofen up to an LOOQ 5.023 ng/mL in Human plasma and cater to high throughput analysis using 96 well plates.

Neuroleptic malignant syndrome presenting without hyperthermia: A case report of an atypical presentation

Neuroleptic malignant syndrome (NMS) is a life-threatening complication of antipsychotic medications. NMS is characterized by four key symptoms: Changes in mental status, muscular rigidity, hyperthermia, and autonomic dysfunction. Despite its key clinical symptoms, which are easily recognizable in a classic presentation, NMS occasionally does not present with all the described clinical characteristics. Atypical presentations of NMS pose a diagnostic conundrum for clinicians, leading to late recognition and treatment of a potentially treatable life-threatening condition. We present a case of NMS presenting without hyperthermia and autonomic instability but with elevated creatine kinase.

Pharmacological Assessment of Aqueous Ethanolic Extract of Thalictrum Foetidum Against Haloperidol-Induced Parkinson’s Like Symptoms in Animal Model: A Dose-Dependent Study With Mechanistic Approach

Introduction: Parkinson’s disease (PD) is characterized by dopamine deficiency in the corpus striatum due to the degeneration of dopaminergic neurons in the substantia nigra. Symptoms include bradykinesia, resting tremors, unstable posture, muscular rigidity, and a shuffled gait. Thalictrum foetidum is traditionally used for neurodegenerative disorders. Objectives: This study aimed to explore the therapeutic potential of aqueous ethanolic extract of Thalictrum foetidum (AETF) against Parkinson-like symptoms and to investigate its underlying mechanism. Methodology: Thirty-six albino mice were randomly divided into 6 groups (n = 6): normal control, disease control, standard treatment (levodopa/carbidopa, 100/25 mg/kg), and 3 treatment groups (AETF at 200, 400, and 600 mg/kg). One hour before treatment, haloperidol (1 mg/kg, i. p.) was administered to induce Parkinson’s disease in all groups except the normal control group. Results: Behavioral analysis showed significant improvement ( P < .001) in motor function, muscular coordination, and reduced muscular rigidity and tremors. AETF also reduced oxidative stress. Histological examination of the brain showed reduced Lewy bodies, neurofibrillary tangles, and plaque formation. Conclusion: AETF alleviated PD symptoms by reducing neurodegeneration, modulating oxidative stress, and inhibiting the expression of nuclear factor-κB (NF-κB) and associated inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6).

Caution for psychiatrists: malignant hyperthermia risks with the anesthetic agent succinylcholine (Suxamethonium) during electroconvulsive therapy

BackgroundMalignant hyperthermia is a potentially lethal condition triggered by specific anesthetic drugs, especially a depolarizing muscle relaxant of succinylcholine (Suxamethonium). Despite the frequent use of succinylcholine with electroconvulsive therapy (ECT), there has been no reported case of potentially lethal malignant hyperthermia following ECT. In addition, the time interval between the administration of succinylcholine and the onset of malignant hyperthermia has not been outlined in the context of ECT.Case presentationWe present the case of a 79-year-old woman suffering from severe depression, who experienced severe malignant hyperthermia due to succinylcholine administration during an ECT session. She presented with a high fever of 40.2 °C, tachycardia of 140/min, hypertension with a blood pressure exceeding 200 mmHg, significant muscle rigidity, and impaired consciousness. These symptoms emerged two hours after ECT, which occurred in a psychiatric ward rather than an operating room, and reached their peak in less than 24 h. She was given 60 mg of dantrolene, which quickly reduced the muscular rigidity. Subsequently, she received two additional doses of 20 mg and 60 mg of dantrolene, which brought her fever down to 36.2 °C and completely eased her muscle rigidity within two days after ECT.ConclusionsThis is the first reported case of potentially lethal malignant hyperthermia after ECT. In addition, it highlights the delayed onset of malignant hyperthermia following an ECT procedure, emphasizing the necessity for psychiatrists to recognize its onset even after the treatment. In the light of potentially lethal consequences of malignant hyperthermia, it is critically important for psychiatrists to closely monitor both intraoperative and postoperative patient’s vital signs and characteristic physical presentations, promptly identify any symptomatic emergence, and treat it immediately with dantrolene.

Altered hippocampal doublecortin expression in Parkinson's disease.

Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by motor and non-motor symptoms. Motor symptoms include bradykinesia, resting tremors, muscular rigidity, and postural instability, while non-motor symptoms include cognitive impairments, mood disturbances, sleep disturbances, autonomic dysfunction, and sensory abnormalities. Some of these symptoms may be influenced by the proper hippocampus functioning, including adult neurogenesis. Doublecortin (DCX) is a microtubule-associated protein that plays a pivotal role in the development and differentiation of migrating neurons. This study utilized postmortem human brain tissue of PD and age-matched control individuals to investigate DCX expression in the context of adult hippocampal neurogenesis. Our findings demonstrate a significant reduction in the number of DCX-expressing cells within the subgranular zone (SGZ), as well as a decrease in the nuclear area of these DCX-positive cells in postmortem brain tissue obtained from PD cases, suggesting an impairment in the adult hippocampal neurogenesis. Additionally, we found that the nuclear area of DCX-positive cells correlates with pH levels. In summary, we provide evidence supporting that the process of hippocampal adult neurogenesis is likely to be compromised in PD patients before cognitive dysfunction, shedding light on potential mechanisms contributing to the neuropsychiatric symptoms observed in affected individuals. Understanding these mechanisms may offer novel insights into the pathophysiology of PD and possible therapeutic avenues.

Cell Therapy for Parkinson's Disease.

Parkinson's Disease (PD) is a neurodegenerative disease characterized by the progressive loss of dopaminergic neurons of the substantia nigra pars compacta with a reduction in dopamine concentration in the striatum. It is a substantial loss of dopaminergic neurons that is responsible for the classic triad of PD symptoms, i.e., resting tremor, muscular rigidity, and bradykinesia. Several current therapies for PD may only offer symptomatic relief and do not address the underlying neurodegeneration of PD. The recent developments in cellular reprogramming have enabled the development of previously unachievable cell therapies and patient-specific modeling of PD through Induced Pluripotent Stem Cells (iPSCs). iPSCs possess the inherent capacity for pluripotency, allowing for their directed differentiation into diverse cell lineages, such as dopaminergic neurons, thus offering a promising avenue for addressing the issue of neurodegeneration within the context of PD. This narrative review provides a comprehensive overview of the effects of dopamine on PD patients, illustrates the versatility of iPSCs and their regenerative abilities, and examines the benefits of using iPSC treatment for PD as opposed to current therapeutic measures. In means of providing a treatment approach that reinforces the long-term survival of the transplanted neurons, the review covers three supplementary avenues to reinforce the potential of iPSCs.

Neuroleptic Malignant Syndrome: A potential mimic of acute encephalitis syndrome

Neuroleptic malignant syndrome (NMS) is a neurological emergency due to neuroleptic medications which is characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Here we report a case of a 74 years old female who presented with complaints of fever, altered sensorium, restlessness, self-muttering, irritation, muscular rigidity, decreased mobility and diaphoresis. She was under medication olanzapine for schizoaffective disorder. It is a diagnosis of exclusion after detailed examinations and investigations. The patient was managed with bromocriptine and supportive measures. NMS may mimic acute encephalitis syndrome. Therefore, NMS should be included in differential diagnosis with presentation as in our case.

Antiparkinsonian effects of Indian spice Amomum subulatum fruit extract by modulating the behavioural, inflammatory markers, antioxidant, and histopathology parameters in rats

Parkinson's disease (PD) is a complex neurodegenerative disorder associated with the loss of dopaminergic neurons in the substantia nigra followed by dopamine depletion in the striatum. PD usually affects people over 50; when those under 50 are involved, it is generally referred to as early-onset PD. The present study aimed to understand and explain the role of the typical Indian spice, greater cardamom, against parkinsonism and related complications. The methanolic extract of Amomum subulatum has flavonoids as the major phytoconstituent and may be a beneficial adjuvant in treating PD. Amomum subulatum fruit extract (ASFE) was given as treatment to the rats at 100 mg/kg and 200 mg/kg. Symptoms of Parkinson’s disease, such as tremors, muscular rigidity, catalepsy, locomotor activity, and grip strength, were examined by several behavioural tests. Treatment with ASFE showed a significant decrease in all the symptoms of PD. Enzyme assays revealed a reduction in the levels of antioxidant enzymes SOD, Catalase, and GSH after administering reserpine and increased levels after treating ASFE. ASFE causes dopaminergic neuron regeneration after reserpine induces injury, thus increasing dopamine levels and restoring cellular damage. The inflammatory biomarkers revealed decreased proinflammatory cytokines such as TNF-α and IL-6. In contrast, increase in the level of IL-10, which is an anti-inflammatory cytokine. The histopath studies showed reduced cell damage occurring in PD after the treatment with ASFE. The present investigation highlights the role of greater cardamom from the Indian kitchen to ethnopharmacology in progressive neurological degeneration.

Parkinson's Disease: From Genetics and Epigenetics to Treatment, a miRNA-Based Strategy.

Parkinson's disease (PD) is one of the most common neurodegenerative disorders, characterized by an initial and progressive loss of dopaminergic neurons of the substantia nigra pars compacta via a potentially substantial contribution from protein aggregates, the Lewy bodies, mainly composed of α-Synuclein among other factors. Distinguishing symptoms of PD are bradykinesia, muscular rigidity, unstable posture and gait, hypokinetic movement disorder and resting tremor. Currently, there is no cure for PD, and palliative treatments, such as Levodopa administration, are directed to relieve the motor symptoms but induce severe side effects over time. Therefore, there is an urgency for discovering new drugs in order to design more effective therapeutic approaches. The evidence of epigenetic alterations, such as the dysregulation of different miRNAs that may stimulate many aspects of PD pathogenesis, opened a new scenario in the research for a successful treatment. Along this line, a promising strategy for PD treatment comes from the potential exploitation of modified exosomes, which can be loaded with bioactive molecules, such as therapeutic compounds and RNAs, and can allow their delivery to the appropriate location in the brain, overcoming the blood-brain barrier. In this regard, the transfer of miRNAs within Mesenchymal stem cell (MSC)-derived exosomes has yet to demonstrate successful results both in vitro and in vivo. This review, besides providing a systematic overview of both the genetic and epigenetic basis of the disease, aims to explore the exosomes/miRNAs network and its clinical potential for PD treatment.

Abstract #1394329: An Association Between Stiff Person Syndrome and Type 1 Diabetes

Stiff-person syndrome (SPS) is a rare neuromuscular disorder characterized by progressive muscular spasms and rigidity. Anti-glutamic acid decarboxylase (anti-GAD) antibodies are found in type 1 diabetes mellitus (T1DM). Thirty percent of patients diagnosed with SPS have T1DM. This relationship infers that SPS and T1DM share pathogenetic features. We describe a case of a 66-year-old female with a history of SPS who developed T1DM soon after the diagnosis was made. A 66-year-old female with a history of SPS, T1DM, and discoid lupus was referred to our university endocrinology clinic for diabetes management. She had ataxia, loss of balance, and muscle stiffness since 2012. The patient was diagnosed with spinal cerebellar ataxia. She was not treated with any specific agents and continued to have left-sided muscle stiffness with preserved strength. She denied weakness, pain, paresthesia, or muscle atrophy but had difficulty ambulating due to rigidity. The diagnosis of SPS was made based on positive anti-GAD antibodies (normal < 0.02) and positive N-channel antibodies in April 2016. She required hospital admission one month later and received solumedrol and IVIG. Her HbA1c was 6.5% (normal < 5.7% of total Hgb), and glucose levels were between 200-300 mg/dL, which were treated with basal and bolus insulin. She was discharged home in May 2016 with no diabetic medications. The patient developed polyuria and polydipsia with 11 Ibs unintentional weight loss 20 days after hospital discharge. She was referred to the endocrine clinic in June 2016 for further workup. Her HbA1c was 11% with C-peptide less than 0.01 (normal 0.78-5.20 ng/mL). Basal and bolus insulin were initiated, and she remains on an insulin regimen. SPS affects an estimated one person per million per year. Decreased level of gamma amino butyric acid (GABA) in the central nervous system (CNS) in SPS has been implicated, which causes a loss of neural inhibition. Glutamic acid decarboxylase (GAD) is the main enzyme required for the GABA inhibitory pathway. Anti-GAD antibodies decrease inhibitory function within the CNS and cause increased muscle activities and subsequent muscle spasms. While most patients with T1DM do not develop SPS, most with anti-GAD-positive SPS will have or develop T1DM. Either SPS or T1DM may be diagnosed first. Awareness of these associations is essential for early diagnosis and treatment of these disorders.

Challenges in Anesthetic Management of Succinylcholine-induced Masseter Muscle Rigidity in Difficult Airway Patient: A Case Report

The difficult airway is already a challenging situation for anesthesiologists, in that scenario Succinylcholine (Sch) use because of its rapid onset and short duration of action makes it a neuromuscular blockage drug of choice. Development of masseter muscular rigidity is thought to be an early indicator of the occurrence of the dreaded consequence, malignant hyperthermia. Consequently, it is essential to understand the potential side effects of this widely used drug in order to successfully treat the airway. Resulting in the use of videolaryngoscopic intubation along with propofol use and the procedure was completed successfully with no intraoperative or postoperative problems. Here we described a case report of a 33-year-old male patient with a difficult airway posted for open reduction internal fixation of bilateral Lefort’s III fracture, developed Masseter Muscle Rigidity (MMR) following administration of a standard dose of Sch.

Electroconvulsive Therapy for Neuroleptic Malignant Syndrome: A case report

IntroductionNeuroleptic malignant syndrome (NMS) is a rare syndrome observed in around 0.2% of psychiatric patients. This syndrome consists of the presentation of muscular rigidity, tachycardia, hyperpyrexia, leukocytosis and elevated levels of CPK. Any antipsychotic drug, including atypical ones, can cause this syndrome. This being an idiosyncratic response to dopamine receptor antagonist medications.The use of ECT in patients suffering from NMS is very effective, seeing the progressive resolution of the picture in the first sessions.ObjectivesThe patient was a 43-year-old man, whose somatic history only highlights hypothyroidism, and according to his psychiatric history, he was diagnosed of mental retardation and paranoid schizophrenia. He was a resident of a group home. And he was recently admitted to a mid-stay psychiatric unit. During this admission, the responsible doctor added haloperidol to his medication regimen. His other medications at the time were; valproic acid, risperidone and trazodone. A few days later, the patient began to present a dysthermic sensation (presenting a temperature of 39ºC) and drowsiness. A laboratory tests and a chest X-ray was performed, highlighting: leukocytosis and an increase in elevated creatine phosphokinase (CPK).Due to his recent exposure to 2 different antipsychotics, with fever, rigidity, and elevated CPK, we considered NMS. Antipsychotics were withdrawn and supportive measures were started. Within the next 2 days, his CPK level began to decline and the fever and leukocytosis resolved. But without resolving muscle rigidity. At the same time, he began to exhibit staring, negativism and prejudice delusions. Therefore, electroconvulsive therapy sessions were started.Methods.ResultsAfter the third session, his catatonic symptoms increased to better; he became more verbal, with less negativism and the psychotic symptomatology ceased. After the fifth session of ECT, he returned to his initial level and was able to walk to the bathroom without assistance and perform other activities of daily living.ConclusionsIt is extremely important that professionals specialized in psychiatry become familiar with ECT and consider this technique as treatment in cases of neuroleptic malignant syndrome.Disclosure of InterestNone Declared

Characteristics of behavioral reactions and the profile of brain isatin-binding proteins of rats with the rotenone-induced experimental parkinsonism

The neurotoxins rotenone and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (МPTP) are used for modeling Parkinson's disease in animals (PD). They induce the mitochondrial respiratory chain dysfunction, which leads to the dopaminergic (DA) neuron degeneration. The advantage of the rotenone model consists in ability of rotenone to cause neurodegeneration showing symptoms and molecular biological characteristics similar to those of PD. Isatin (indoldione-2,3) is an endogenous regulator found in tissues and biological fluids of humans and animals. It exhibits a broad range of biological activity mediated by numerous isatin-binding proteins. In this work we have investigated behavioral reactions and profiles of brain isatin-binding proteins of rats with Parkinson's syndrome (PS) in comparison with the corresponding parameters of MPTP-induced Parkinsonism in mice. Systemic injection of rotenone caused severe PS comparable with the effect of MPTP injection. It was accompanied by significant body weight loss, death, oligokinesia, muscular rigidity, and postural instability of animals. In spite of the same pathogenic basis of PS caused by rotenone and MPTP, the molecular mechanisms of their action differ. In the case of rotenone-induced PS, the pool of isatin-binding proteins common of the control rats and the rats with PS (146) significantly exceeded the pool of the common proteins of control mice and mice with PS induced by MPTP, whether right after neurotoxin injection (27), or (all the more) in a week after the MPTP injection (14). The comparison of isatin-binding proteins specific of the animals with MPTP-induced PS and with the rotenone-induced PS (as compared with the control animals) revealed total absence of proteins common of these two models of PD. It is to be noted that both neurotoxins particularly affected the proteins participating in the signal transmission and enzyme activity regulation. The changes of the profile of isatin-binding proteins in response to the injection of rotenone suggest that the neuroprotector isatin could also influence positively in the case of the rotenone model of PD.

Effects of Yoga therapy in teaching oral hygiene practice and tooth brushing skills in patients with Parkinson's disease: A qualitative study.

Parkinson's disease is a chronic neurodegenerative disorder associated with heterogeneous symptoms. Though it is characterized by means of four distinct motor symptoms such as resting tremors, muscular rigidity, bradykinesia, and postural instability. These patients also have deficits in fine motor skills while performing simple tasks such as brushing their own teeth, taking bath, remembering small details, and writing skills. The study aimed to qualitatively evaluate the effectiveness of Yoga therapy in teaching oral hygiene practice and subsequently, on tooth brushing skills in patients who were diagnosed with Parkinson's disease. This qualitative study was conducted on 100 patients diagnosed with Parkinson's disease. Institutional ethical committee permission was obtained prior to commencing the study. Written informed consent was obtained from patients or their caregivers before conducting this study. Detailed clinical history was recorded and gender characteristics were noted down. In the present study, there were 67 female and 33 male participants. Yoga exercises were taught to Parkinson's patients by a qualified yoga instructor. Improvements in toothbrushing skills were noted down by a single operator and oral hygiene status was analyzed using gingival index and plaque index on follow-up durations at 1, 2, 3, and 6 months. Yoga exercises comprised of warming up, stretching, yoga breathing exercises or pranayama, and/or relaxation process. Statistical analysis was performed by use of IBM SPSS Version 20.0. (IBM Corp., Armonk, NY) software designed for Windows. Intra-group comparison between categorical variables was done by statistical test-paired student 't-test'. On comparing plaque indices, the mean ± SD plaque index at 1st, 2nd, 3rd, and 6th months were 1.89 ± 0.02, 1.72 ± 0.01, 1.42 ± 0.12, and 0.56 ± 0.02, respectively. Mean ± SD gingival index scores at 1st month, 2nd month, 3rd month, and 6th-month durations, scores were 1.76 ± 0.06, 1.57 ± 0.12, 1.23 ± 0.02, and 0.76 ± 0.01, respectively. Statistical significance difference was noted on comparing the indices scores. Yoga practice has been shown to improve toothbrushing skills and oral hygiene in Parkinson's disease patients.

Salival biomarkers in inflamatory oro-cranio-cervical inflamatory alterations

During the COVID 19 pandemic, the general population suffered from high degrees of stress, the consequence of which was an increase in myofascial pain syndrome. This inflammatory ailment which affects soft tissues causes pain, muscular rigidity, and modifies posture due to hyperactivity. A state of muscular ischemia leads to structural and chemical changes, and to variations in saliva’s electrical conductivity. The objective of this research was to measure the changes in pH and electrical conductivity of saliva samples, and to use these as biomarkers during therapeutical Maxillary Functional Orthopedics (Planas’ Simple Indirect Tracks and Simões Network 20). All the subjects that took part in the study evidenced changes in the beforementioned biomarkers, as well as clinical improvement of their symptoms.

Fisetin Ameliorates Levodopa-Induced Dyskinesia in Experimental Model Parkinson's Disease: Role of Mitochondrial Activities and Monoamines Turnover

Background: Levodopa (or l-DOPA) is the current standard of care for the management of Parkinson's disease (PD), but its chronic administration has been associated with the development of LID (l-DOPA-induced dyskinesia). Fisetin is a dietary flavonoid known for its neuroprotective efficacy. Aim: To determine the neuroprotective potential of fisetin in 6-hydroxydopamine (6-OHDA)-lesioned LID animals. Methods: 6-OHDA (12 µg and L-ascorbic acid [10 µL]) was injected in a substantial nigra of Sprague-Dawley rat to develop PD followed by l-DOPA (20 mg/kg and benserazide HCl [5 mg/kg], 42 days) to induce LID. Rats were concomitantly administered with vehicle or amantadine (40 mg/kg), or fisetin (5, 10, and 25 mg/kg, p.o.) for 42 days with l-DOPA. Results: Chronic l-DOPA administration resulted in progressive abnormal involuntary movements (AIMs viz. axial, forelimb, and orolingual), akinesia (forelimb adjusting steps, FAS), muscular rigidity (catalepsy bar test), muscular coordination, and neurological impairments. Fisetin at doses of 10 and 25 mg/kg effectively reduced ( P &lt; .05) these LID-induced AIMs and behavioral changes. Furthermore, fisetin treatment markedly ( P &lt; .05) attenuated LID-induced diminished striatal mitochondrial complex activities, striatal monoamines (serotonin [5-HT] and dopamine [DA]), elevated monoamines turnover (DA: DOPAC and 5-HT: 5-HIAA). In addition, fisetin treatment effectively ( P &lt; .05) reversed the upregulated expressions of striatal cFOS, FosB, Homer, Nurr-77, Parkin, and Pdyn. Conclusion: Our study demonstrated that fisetin offered neuroprotection via amelioration of striatum mitochondrial dysfunction and monoamine (5-HT and DA) turnover to halt further development of abnormal involuntary movement and dyskinesia.