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Okunoye O, Marston L, Walters K, Schrag A. Change in the incidence of Parkinson's disease in a large UK primary care database. NPJ Parkinsons Dis 2022; 8:23. [PMID: 35292689 PMCID: PMC8924194 DOI: 10.1038/s41531-022-00284-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/21/2022] [Indexed: 11/09/2022] Open
Abstract
Parkinson's disease (PD) has the fastest rising prevalence of all neurodegenerative diseases worldwide. However, it is unclear whether its incidence has increased after accounting for age and changes in diagnostic patterns in the same population. We conducted a cohort study in individuals aged ≥50 years within a large UK primary care database between January 2006 and December 2016. To account for possible changes in diagnostic patterns, we calculated the incidence of PD using four case definitions with different stringency derived from the combination of PD diagnosis, symptoms, and treatment. Using the broadest case definition, the incidence rate (IR) per 100,000 person years at risk (PYAR) was 149 (95% CI 143.3-155.4) in 2006 and 144 (95% CI 136.9-150.7) in 2016. In conclusion, the incidence of PD in the UK remained stable between 2006 and 2016, when accounting for age and diagnostic patterns, suggesting no major change in underlying risk factors for PD during this time period in the UK.
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Affiliation(s)
- Olaitan Okunoye
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK.
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Ebrahimoghli R, Janati A, Sadeghi‐Bazargani H, Hamishehkar H, Ghaffari S, Sanaat Z, Farahbakhsh M, Farhoudi M, Khalili‐Azimi A. Epidemiology of multimorbidity in Iran: An investigation of a large pharmacy claims database. Pharmacoepidemiol Drug Saf 2019; 29:39-47. [DOI: 10.1002/pds.4925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/04/2019] [Accepted: 10/28/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Reza Ebrahimoghli
- Iranian Center of Excellence in Health Management, School of Management and Medical InformaticsTabriz University of Medical Sciences Tabriz Iran
| | - Ali Janati
- Iranian Center of Excellence in Health Management, School of Management and Medical InformaticsTabriz University of Medical Sciences Tabriz Iran
| | | | - Hadi Hamishehkar
- Drug Applied Research CenterTabriz University of Medical Sciences Tabriz Iran
| | - Samad Ghaffari
- Cardiovascular Research CenterTabriz University of Medical Sciences Tabriz Iran
| | - Zohreh Sanaat
- Hematology and Oncology Research CenterTabriz University of Medical Science Tabriz Iran
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioral SciencesTabriz University of Medical Sciences Tabriz Iran
| | - Mehdi Farhoudi
- Neurosciences Research CenterTabriz University of Medical Sciences Tabriz Iran
| | - Atefeh Khalili‐Azimi
- Iranian Center of Excellence in Health Management, School of Management and Medical InformaticsTabriz University of Medical Sciences Tabriz Iran
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Abuhasira R, Zlotnik Y, Horev A, Ifergane G. Fibromyalgia-Like Syndrome Associated with Parkinson's Disease-A Cohort Study. J Clin Med 2019; 8:jcm8081118. [PMID: 31357683 PMCID: PMC6723151 DOI: 10.3390/jcm8081118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/19/2022] Open
Abstract
Parkinson’s disease (PD) and fibromyalgia (FM) are two relatively common disorders that are considered distinct diagnoses. The aim of this study was to investigate the epidemiological characteristics of patients with both PD and FM, as well as their comorbidities and medication use. We performed a population-based retrospective cohort study in Israel from 2000 to 2015. We identified patients with PD according to a refined medication tracer algorithm and patients with FM according to their medical records. Using the algorithm, we identified 2606 patients diagnosed with PD, 60 of them (2.3%) were also diagnosed with FM. Most of the patients were females (88.3%) and the mean age of FM diagnosis was 63.95 ± 12.27 years. These patients had a higher prevalence of depression, anxiety, and dementia. Of the patients diagnosed with PD + FM, 46 (76.7%) were diagnosed with FM after the diagnosis of PD. Patients with PD + FM used analgesics of distinct kinds in higher rates, as well as more anti-PD medications. We suggest that patients with PD + FM represent a distinct subgroup with a fibromyalgia-like syndrome associated with Parkinson’s disease (FLISPAD). Their PD is more treatment resistant, and they take more medications, both analgesics and anti-PD.
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Affiliation(s)
- Ran Abuhasira
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
| | - Yair Zlotnik
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
- Department of Neurology, Soroka University Medical Center, Beer Sheva, Israel
| | - Anat Horev
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
- Department of Neurology, Soroka University Medical Center, Beer Sheva, Israel
| | - Gal Ifergane
- Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.
- Department of Neurology, Soroka University Medical Center, Beer Sheva, Israel.
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van der Steen JT, Lennaerts H, Hommel D, Augustijn B, Groot M, Hasselaar J, Bloem BR, Koopmans RTCM. Dementia and Parkinson's Disease: Similar and Divergent Challenges in Providing Palliative Care. Front Neurol 2019; 10:54. [PMID: 30915012 PMCID: PMC6421983 DOI: 10.3389/fneur.2019.00054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 01/16/2019] [Indexed: 12/29/2022] Open
Abstract
Dementia and Parkinson's disease are incurable neurological conditions. Patients often experience specific, complex, and varying needs along their disease trajectory. Current management typically employs a multidisciplinary team approach. Recognition is growing that this team approach should also address palliative care issues to optimize quality of life for patient and family caregivers, but it remains unclear how palliative care is best delivered. To inspire future service development and research, we compare the trajectories and conceptualization of palliative care between dementia and Parkinson's disease. Both Parkinson's disease and dementia are characterized by a protracted course, with progressive but fairly insidious development of disability. However, patients with Parkinson's disease may experience relatively stable periods initially but with time, a wide range of debilitating symptoms develops, many of which do not respond well to treatment. Eventually, dementia develops in most Parkinson patients, while motor disability develops in many dementia patients. In both diseases, symptoms such as pain, apathy, sleeping problems, falls, and a high caregiver burden are prevalent. Advance care planning has benefits in terms of being prepared before the disease progresses into a stage with communication problems or severe cognitive impairment. However, for both conditions, the protracted disease trajectories complicate conceptualization of palliative care through different stages of the disease, with pertinent questions such as when to offer what interventions pro-actively. Given the similarities and differences, we should develop palliative approaches that are partially generic and partially disease-specific. These should be integrated seamlessly with disease-specific care. Substantial research is already being performed on dementia palliative care. This may also inform the further development of palliative care for Parkinson's disease, including an evaluation of palliative interventions and services.
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Affiliation(s)
- Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
| | - Herma Lennaerts
- Departments of Neurology and Anesthesiology, Pain and Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Danny Hommel
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, Netherlands
- Groenhuysen Organisation, Roosendaal, Netherlands
| | | | - Marieke Groot
- Department of Anesthesiology, Pain and Palliative Care/Expertise Center for Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Care/Expertise Center for Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, Netherlands
| | - Raymond T. C. M. Koopmans
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Nijmegen, Netherlands
- De Waalboog “Joachim en Anna, ” Center for Specialized Geriatric Care, Nijmegen, Netherlands
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Rudenok MM, Alieva AK, Nikolaev MA, Kolacheva AA, Ugryumov MV, Pchelina SN, Slominsky PA, Shadrina MI. Possible Involvement of Genes Related to Lysosomal Storage Disorders in the Pathogenesis of Parkinson’s Disease. Mol Biol 2019. [DOI: 10.1134/s002689331901014x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Whole-Transcriptome Analysis of Mouse Models with MPTP-Induced Early Stages of Parkinson’s Disease Reveals Stage-Specific Response of Transcriptome and a Possible Role of Myelin-Linked Genes in Neurodegeneration. Mol Neurobiol 2018; 55:7229-7241. [DOI: 10.1007/s12035-018-0907-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/11/2018] [Indexed: 01/19/2023]
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Carriere N, Verloop D, Dupont C, Fontaine V, Tir M, Krystkowiak P, Blanchard A, Defebvre MM, Defebvre L. Descriptive study of the parkinsonian population in the north of France: Epidemiological analysis and healthcare consumption. Rev Neurol (Paris) 2017; 173:396-405. [DOI: 10.1016/j.neurol.2017.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/28/2016] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
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Transcriptome Profile Changes in Mice with MPTP-Induced Early Stages of Parkinson's Disease. Mol Neurobiol 2016; 54:6775-6784. [PMID: 27757834 DOI: 10.1007/s12035-016-0190-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/30/2016] [Indexed: 01/26/2023]
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative diseases. Despite progress in the study of the molecular, genetic, and pathogenic mechanisms of PD, it is unclear which processes trigger the development of the pathology associated with PD. Models of the presymptomatic and early symptomatic stages of PD induced by MPTP have been used to analyze changes in transcriptome profile in brain tissues, to identify specific patterns and mechanisms underlying neurodegeneration in PD. The whole-transcriptome analysis in the brain tissues of the mice with MPTP-induced PD showed that striatum is involved in the pathogenesis in the earliest stages and the processes associated with vesicular transport may be altered. The expression profiles of the genes studied in the substantia nigra and peripheral blood confirm that lymphocytes from peripheral blood may reflect processes occurring in the brain. These data suggest that messenger RNA (mRNA) levels in peripheral blood may provide potential biomarkers of the neurodegeneration occurring in PD. The changes in expression at the mRNA and protein levels suggest that Snca may be involved in neurodegeneration and Drd2 may participate in the development of the compensatory mechanisms in the early stages of PD pathogenesis. Our data suggest that the brain cortex may be involved in the pathological processes in the early stages of PD, including the presymptomatic stage.
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Naldi I, Piccinni C, Mostacci B, Renzini J, Accetta G, Bisulli F, Tappatà M, Piazza A, Pagano P, Bianchi S, D'Alessandro R, Tinuper P, Poluzzi E. Prescription patterns of antiepileptic drugs in young women: development of a tool to distinguish between epilepsy and psychiatric disorders. Pharmacoepidemiol Drug Saf 2016; 25:763-9. [PMID: 26887800 DOI: 10.1002/pds.3984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 01/15/2016] [Accepted: 01/17/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Antiepileptic drugs (AEDs) are also prescribed for therapeutic indications other than epilepsy (EPI), namely, psychiatric disorders (PSY). Our aim was to develop an algorithm able to distinguish between EPI and PSY among childbearing age women based on differences in AED exposure in these patient groups. METHODS Two groups of women (18-45 years) with EPI or PSY treated with AEDs in the first semester of 2010 or 2011 were extracted from paper or electronic medical charts of specialized centers. Through the prescription database of Bologna Local Health Authority (Italy), AEDs, treatment schedule and co-treatments were collected for each patient. A prescription-based hierarchical classification system was developed. The algorithm obtained was subsequently validated on internal and external data. RESULTS Eighty-one EPI and 94 PSY subjects were recruited. AED monotherapy was the most common choice in both groups (69% EPI vs 79% PSY). Some AEDs were used only in EPI, others exclusively in PSY. Co-treatments with antipsychotics (6% vs 67%), lithium (0% vs 9%), and antidepressants (7% vs 70%) were fewer in EPI than in PSY. The hierarchical classification system identified antipsychotics, SSRIs (Selective Serotonin Reuptake Inhibitors), and number of AEDs as variables to discriminate EPI and PSY, with an overall error rate estimate of 9.7% (95%CI: 5.3% to 14.1%). CONCLUSION Among the differences between EPI and PSY, prescription data alone allowed an algorithm to be developed to diagnose each childbearing age woman receiving AEDs. This approach will be useful to stratify patients for risk estimates of AED-treated patients based on administrative databases. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ilaria Naldi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Piccinni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Barbara Mostacci
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Jessica Renzini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Gabriele Accetta
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Francesca Bisulli
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Tappatà
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Antonella Piazza
- Mental Health Department, Bologna Local Health Authority, Bologna, Italy
| | - Paola Pagano
- Pharmaceutical Department, Bologna Local Health Authority, Bologna, Italy
| | - Stefano Bianchi
- Pharmaceutical Department, University Hospital of Ferrara, Ferrara, Italy
| | | | - Paolo Tinuper
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Elisabetta Poluzzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Parkinson's Disease Prevalence and Proximity to Agricultural Cultivated Fields. PARKINSONS DISEASE 2015; 2015:576564. [PMID: 26357584 PMCID: PMC4556329 DOI: 10.1155/2015/576564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 07/13/2015] [Accepted: 07/27/2015] [Indexed: 11/17/2022]
Abstract
The risk for developing Parkinson's disease (PD) is a combination of multiple environmental and genetic factors. The Negev (Southern Israel) contains approximately 252.5 km2 of agricultural cultivated fields (ACF). We aimed to estimate the prevalence and incidence of PD and to examine possible geographical clustering and associations with agricultural exposures. We screened all “Clalit” Health Services members in the Negev (70% of the population) between the years 2000 and 2012. Individual demographic, clinical, and medication prescription data were available. We used a refined medication tracer algorithm to identify PD patients. We used mixed Poisson models to calculate the smoothed standardized incidence rates (SIRs) for each locality. We identified ACF and calculate the size and distance of the fields from each locality. We identified 3,792 cases of PD. SIRs were higher than expected in Jewish rural localities (median SIR [95% CI]: 1.41 [1.28; 1.53] in 2001–2004, 1.62 [1.48; 1.76] in 2005–2008, and 1.57 [1.44; 1.80] in 2009–2012). Highest SIR was observed in localities located in proximity to large ACF (SIR 1.54, 95% CI 1.32; 1.79). In conclusion, in this population based study we found that PD SIRs were higher than expected in rural localities. Furthermore, it appears that proximity to ACF and the field size contribute to PD risk.
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Horsfall L, Petersen I, Walters K, Schrag A. Time trends in incidence of Parkinson's disease diagnosis in UK primary care. J Neurol 2012; 260:1351-7. [PMID: 23263597 DOI: 10.1007/s00415-012-6804-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/10/2012] [Accepted: 12/11/2012] [Indexed: 12/30/2022]
Abstract
To examine time trends and the influence of socio-demographic and geographic factors on incidence of Parkinson's disease (PD) diagnosis in a large UK population-based cohort from The Health Improvement Network (THIN), a UK primary care database. All patients aged over 50 years and contributing data to THIN between January 1999 and December 2009 were extracted and the incidence rates of PD diagnoses were determined by age, gender, time period, social deprivation score and urban/rural status. The overall incidence of PD diagnosis for people over 50 years was 84 per 100,000 person years (95 % CI 82-85). After accounting for socio-demographic factors, the adjusted incidence rates in men were 46 % higher (95 % CI 43-48 %) than in women. Adjusted incidence rates were also 12 % higher in urban than rural areas (95 % CI 4-20 %) and slightly lower in less socially deprived areas. Over time there was a downward trend in PD diagnosis with the adjusted incidence rates declining by around 6 % every calendar year (95 % CI 5-6 %) between 1999 and 2009. Broadening the definition of PD from diagnostic codes to include symptoms and antiparkinsonian drug prescriptions increased the overall incidence to 118 per 100,000 person years (95 % CI 116-120) and showed a much weaker downward trend over time of around 1 % per calendar year (95 % CI 1-2 %). With the broader definition, the adjusted incidence rates remained significantly higher in men compared to women and in urban areas compared with rural areas but not in socially deprived areas. The PD diagnosis rates in the primary care setting were, as expected, higher in men, and slightly higher in urban areas, but not different between socio-economic groups. There was a decline in PD diagnosis in the primary care setting, which may largely represent changes in diagnosis and/or coding rather than a true decline in incidence.
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Affiliation(s)
- Laura Horsfall
- Research Department of Primary Care and Population Health, University College London, London, UK
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12
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Moisan F, Gourlet V, Mazurie JL, Dupupet JL, Houssinot J, Goldberg M, Imbernon E, Tzourio C, Elbaz A. Prediction model of Parkinson's disease based on antiparkinsonian drug claims. Am J Epidemiol 2011; 174:354-63. [PMID: 21606234 DOI: 10.1093/aje/kwr081] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Drug claims databases are increasingly available and provide opportunities to investigate epidemiologic questions. The authors used computerized drug claims databases from a social security system in 5 French districts to predict the probability that a person had Parkinson's disease (PD) based on patterns of antiparkinsonian drug (APD) use. Clinical information for a population-based sample of persons using APDs in 2007 was collected. The authors built a prediction model using demographic variables and APDs as predictors and investigated the additional predictive benefit of including information on dose and regularity of use. Among 1,114 APD users, 320 (29%) had PD and 794 (71%) had another diagnosis as determined by study neurologists. A logistic model including information on cumulative APD dose and regularity of use showed good performance (c statistic = 0.953, sensitivity = 92.5%, specificity = 86.4%). Predicted PD prevalence (among persons aged ≥18 years) was 6.66/1,000; correcting this estimate using sensitivity/specificity led to a similar figure (6.04/1,000). These data demonstrate that drug claims databases can be used to estimate the probability that a person is being treated for PD and that information on APD dose and regularity of use improves models' performances. Similar approaches could be developed for other conditions.
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Pinzon-Morales RD, Garces-Arboleda M, Orozco-Gutierrez AA. Automatic identification of various nuclei in the basal ganglia for Parkinson's disease neurosurgery. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2010; 2009:3473-6. [PMID: 19964989 DOI: 10.1109/iembs.2009.5334611] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Stereotactic neurosurgery for Parkinson's disease (PD) is one of the most used treatments for relief symptoms of this degenerative disorder. Current methods include ablation and deep brain stimulation (DBS) that can be applied to the various nuclei in the basal ganglia (BG), for instance to the Subthalamic nucleus (STN) or the Ventral medial nucleus (Vim). Identification of thus regions must be rigorous and within a minimum position error. Usually, skilled specialist identifies the brain area by comparing and listening to the rhythm created by the temporal and spatial aggregation of action potentials presented in microelectrode recordings (MER). We present a novel system for automatic identification of the various nuclei in the BG which addresses the limitations of the subjectivity and the non-stationary nature of MER signals. This system incorporates the time-frequency analysis using the Hilbert-Huang Transform (HHT), which is a recent tool for processing nonlinear and non-stationary data, with a dynamic classifier based on Hidden Markov Models (HMM). Classification accuracy in two different databases is compared to validate the performance of the proposed method. Results show that system can recognize selected nuclei with a mean accuracy of 90%.
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Yacoubian TA, Howard G, Kissela B, Sands CD, Standaert DG. Racial differences in Parkinson's disease medication use in the reasons for geographic and racial differences in stroke cohort: a cross-sectional study. Neuroepidemiology 2009; 33:329-34. [PMID: 19887838 DOI: 10.1159/000254568] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 06/29/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies have suggested that African-American populations have a lower prevalence of Parkinson's disease (PD); however, because African-Americans are underrepresented in many cohorts, this relationship is poorly understood. We evaluated data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study to describe potential racial differences in PD prevalence. METHODS We identified subjects using PD medications from the REGARDS study, a national longitudinal cohort study of 30,000 persons over age 45 with approximately equal representation of African-Americans and Whites. RESULTS The prevalence of PD medication use across the cohort was 0.78% and was less among African-Americans (0.51%) than among Whites (0.97%; OR 1.90; 95% CI 1.31-2.74). There was an association of gender and PD medication use, with a prevalence of 0.61% in females and 0.97% in males (OR 1.57; 95% CI 1.13-2.18). There was no association with income, education level or geographic region of residence. CONCLUSIONS The lower rate of PD medication use among African-Americans supports the suspected lower prevalence of PD among African-Americans suggested by other studies. While racial differences in PD diagnosis and treatment may contribute to the differences we observed, comparable disparities have not been observed in the REGARDS cohort for other diagnoses. Further studies of the REGARDS cohort may lead to important insights into potential biological differences in PD among African-Americans and Whites.
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Affiliation(s)
- Talene A Yacoubian
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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15
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Brefel-Courbon C, Grolleau S, Thalamas C, Bourrel R, Allaria-Lapierre V, Loï R, Micallef-Roll J, Lapeyre-Mestre M. Comparison of chronic analgesic drugs prevalence in Parkinson's disease, other chronic diseases and the general population. Pain 2008; 141:14-8. [PMID: 19062167 DOI: 10.1016/j.pain.2008.04.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 04/07/2008] [Accepted: 04/25/2008] [Indexed: 12/11/2022]
Abstract
Patients with Parkinson's disease (PD) frequently experienced pain. Nevertheless, there are no epidemiological data about frequency of pain in PD. We compare pain prevalence using analgesic prescription in PD patients, in the general population and in two samples of painful patients: diabetics and osteoarthritis patients in France. Data were obtained from the French System of Health Insurance for the year 2005. Medications (antiparkinsonian, antidiabetics drugs and osteoarthritis drugs) were used for identification of PD, diabetic and osteoarthritis patients. We estimated the prevalence of analgesic drugs prescription (at least one analgesic drug) and the prevalence of chronic analgesic drugs prescription (more than 90 DDD of analgesic drug). The study included 11,466 PD patients. PD patients significantly received more prescription of analgesics than the general population (82% versus 77%,) and fewer than patients with osteoarthritis (82% versus 90%). No significant difference was found between PD and diabetic patients. The chronic prescription of analgesic drugs was more prevalent in PD patients (33%) than in the general population (20%) and in diabetic patients (26%) and similar to that in osteoarthritis patients. PD patients were more exposed than the general population and diabetics to opiates, acetaminophen, and adjuvant analgesics chronic use.
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Naughton C, Bennett K, Feely J. Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age Ageing 2006; 35:633-6. [PMID: 17047009 DOI: 10.1093/ageing/afl106] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Corina Naughton
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin 8, Dublin, Ireland.
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Wettermark B, Hammar N, Fored CM, MichaelFored C, Leimanis A, Otterblad Olausson P, Bergman U, Persson I, Sundström A, Westerholm B, Rosén M. The new Swedish Prescribed Drug Register--opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf 2006; 16:726-35. [PMID: 16897791 DOI: 10.1002/pds.1294] [Citation(s) in RCA: 1270] [Impact Index Per Article: 70.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
PURPOSE To describe the content and potentials of the new Swedish national register on prescribed and dispensed medicines. METHODS The Swedish Prescribed Drug Register contains information about age, sex and unique identifier of the patient as well as the prescriber's profession and practice. Information regarding drug utilization and expenditures for prescribed drugs in the entire Swedish population was extracted from the first six months July-December 2005 and compared with total drug sales in the country including OTC and hospital use. RESULTS The total quantity of drugs sold in Sweden was 2666 million DDDs, corresponding to 1608 DDD/1000 inhabitants daily. The total expenditures were 1.6 billion Euro. The prescribed drugs, included in the register, accounted for 84% of the total utilization and 77% of the total expenditures. About half of all men and two-thirds of all women in the country purchased drugs. The proportion increased by age. The most common drugs for chronic treatment were diuretics among women (8.8% of the population) and antithrombotic agents among men (7.6%). Psychotropic drugs, corticosteroids and analgesics were more common among women, while men used antithrombotic agents, antidiabetic drugs, lipid lowering agents and ACE inhibitors to a greater extent. CONCLUSIONS The new register provides valuable data on exposure to drugs and is useful to study patterns of drug utilization. The possibilities for record linkage to other health registers gives from an international perspective good opportunities to explore drug and disease associations and the risks, benefits, effectiveness and health economical effects of drug use.
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Affiliation(s)
- Björn Wettermark
- Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Karolinska Institutet, Stockholm, Sweden.
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Desboeuf K, Grau M, Riche F, Fradin M, Bez J, Montastruc JL, Senard JM. Prevalence and Costs of Parkinsonian Syndromes Associated with Orthostatic Hypotension. Therapie 2006; 61:93-9. [PMID: 16886700 DOI: 10.2515/therapie:2006020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To measure the frequency of and direct costs related to parkinsonian syndromes associated with orthostatic hypotension (OH). PATIENTS/METHODS Patients over 45 years using at least one antiparkinsonian drug (excluding piribedil or anticholinergics prescribed alone) were identified from the Haute-Garonne Social Security prescription database and separated in two groups according to simultaneous prescription (OH group) or not (control group) of drugs for orthostatic hypotension. Direct medical costs were analysed retrospectively, over a 6-month period, from the health care payer's perspective. RESULTS Eighty-eight patients (9.1%) out of 971 parkinsonian also received antihypotensive drugs. Direct medical costs were significantly higher in OH than in control group (4.425 vs. 3.074 Euro/patient/6 months, p < 0.05). Beside hospitalisation and ancillary cares, drugs accounted for highest expenses (989 vs. 781 Euro/patient/6 months in control group) since use of controlled-release levodopa formulations or dopamine agonists was higher in OH group. CONCLUSION Occurrence of OH is associated with higher medical expenditure in parkinsonian syndromes.
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Affiliation(s)
- Karine Desboeuf
- Laboratoire de Pharmacologie Médicale et Clinique, INSERM U586, Faculté de Médecine, Toulouse, France
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Lindgren P, von Campenhausen S, Spottke E, Siebert U, Dodel R. Cost of Parkinson's disease in Europe. Eur J Neurol 2005; 12 Suppl 1:68-73. [PMID: 15877783 DOI: 10.1111/j.1468-1331.2005.01197.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- P Lindgren
- Stockholm Health Economics, Stockholm, Sweden and Department of Cardiovascular Epidemiology, Karolinska Institutet, Stockholm, Sweden
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Abstract
Dysphagia is a common problem in older patients and is becoming a larger health care problem as the populations of the United States and other developed countries rapidly age. Changes in physiology with aging are seen in the upper esophageal sphincter and pharyngeal region in both symptomatic and asymptomatic older individuals. Age related changes in the esophageal body and lower esophageal sphincter are more difficult to identify, while esophageal sensation certainly is blunted with age. Stroke, Parkinson's disease, amyotrophic lateral sclerosis, Zenker's diverticula, and several other motility and structural disorders may cause oropharyngeal dysphagia in an older patient. Esophageal dysphagia can also be caused by both disorders of motility (achalasia, diffuse esophageal spasm, scleroderma and others) and structure (malignancy, strictures, rings, external compression, and others). Many of these disorders have an increased prevalence in older patients and should be sought with an appropriate diagnostic evaluation in older patients. The treatment of dysphagia in older patients is similar to that in younger patients, but more invasive therapies such as surgery may not be possible in some older patients making less aggressive medical and endoscopic therapy more attractive.
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Affiliation(s)
- Sami R Achem
- Department of Medicine, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA
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Gony M, Lapeyre-Mestre M, Montastruc JL. Risk of serious extrapyramidal symptoms in patients with Parkinson's disease receiving antidepressant drugs: a pharmacoepidemiologic study comparing serotonin reuptake inhibitors and other antidepressant drugs. Clin Neuropharmacol 2003; 26:142-5. [PMID: 12782916 DOI: 10.1097/00002826-200305000-00007] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To compare the risk of occurrence of "serious" extrapyramidal symptoms (EPS) between selective serotonin reuptake inhibitors and other antidepressant drugs in patients with Parkinson's disease (PD), the authors performed a retrospective study using the French Pharmacovigilance Database (i.e., the database recording all serious adverse drug reactions reported in France by physicians to the National French Pharmacovigilance Network). Patients with PD were identified from the case reports including at least one antiparkinsonian drug (except anticholinergics). The authors studied patients with PD exposed to at least one antidepressant (classified as imipraminics, selective serotonin reuptake inhibitors, or "other") drug. EPS were defined as aggravation of the parkinsonian symptoms. Of the76,640 case reports registered in the database between January 1, 1995, and December 31, 2000, 916 were identified as patients treated with at least one antiparkinsonian drug, including 199 treated with antidepressant drugs. Among them the authors found nine case reports of EPS (i.e., 4.5% of the patients with PD treated with at least one antidepressant). The odds ratio for EPS was 2.18 (0.47-11.35) for selective serotonin reuptake inhibitors, 1.17 (0.22-5.50) for imipraminics, and 0.74 (0.10-4.06) for other antidepressants. This study failed to find any significant difference in the occurrence of serious EPS according to the different classes of antidepressant drugs in patients with PD treated with dopaminergic antiparkinsonian drugs.
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Affiliation(s)
- Mireille Gony
- Service de Pharmacologie Clinique, Unité de Pharmacoépidémilogie and Centre Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémilogie et d'Informations sur le Médicament du Centre Hospitalier Universitaire, Faculté de Médecine de Toulouse, France
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Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2002; 11:421-36. [PMID: 12271887 DOI: 10.1002/pds.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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