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[Restless-legs syndrome].

Restless-legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs usually accompanied or cause … of l-DOPA or codeine; the first-line treatment for moderate to severe RLS is dopaminergic agonists (pramipexole, ropinirole, rotigotine). In severe, refractory or neuropathy-associated RLS, antiepileptic (gabapentin, pregabalin) or opioid (oxycodone, tramadol) drugs can be used.

Depression in Parkinson's Disease.

Depression is very common in Parkinson's disease (PD), but its severity and particular symptoms vary. It can often be difficult to diagnose … opamine agonist from a motor standpoint and his or her depressive symptoms are mild, consider using pramipexole, which may improve mood and motivation (although this has not yet been proven in a well-controlled trial). It is a good idea to keep patients on antidepressant therapy at least 6 months; many patients require long-term treatment. If a patient is sev …

Non-Ergot Dopamine Agonists Do Not Increase the Risk of Heart Failure in Parkinson's Disease Patients: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: In recent years, some observational studies suggested that pramipexole, a non-ergot dopamine agonist (DA) used for the treatment of Parkinson's disease (PD), may increase the risk of heart failure (HF). However, the limitations inherent in observational studies made it difficult to determine whether the excess of incident HF was related to the drug or to other determinants. Thus, some concerns remained regarding the increased putative HF risk associated with non-ergot DAs as a class or individually. METHODS: In our meta-analysis, primary endpoint was the risk of incident HF in pat…

Duration of L-dopa and dopamine agonist monotherapy in Parkinson's disease.

The expected duration of initial antiparkinson monotherapy before the need for supplementation is not clearly defined for routine practice. The aim of this study was to define the length of L-dopa (L-3, 4-dihydrophenylalanine) and dopamine agonist monotherapy. The duration of monotherapy and discontinuation rates were investigated in a natural observational setting by plotting Kaplan-Meier survival curves. Out of 345 patients, 180 (52.2%) received L-dopa and 165 (47.8%) received a dopamine agonist as initial monotherapy. Half of the patients starting L-dopa received supplementary therapy with-

Effects of anodal transcranial direct current stimulation on cognitive dysfunction in patients with progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) is a tauopathy characterized by motor, neurobehavioral and disabling brainstem deficits. No disease-mod … nd the mean Hoehn & Yahr (H&Y) scale was 3.9±1 at baseline. All pharmacological treatments (L-dopa, pramipexole, rotigotine, rasagiline, amantadine) were maintained stable during the study. We aimed at evaluating along with the motor outcome (as it is reflected on a disease-specific rating scale), the post-tDCS cognitive status after the completion of the int …

[Sleep Medicine: 1965 to 2015].

The Département de psychiatrie de l'Université de Montréal houses one of the first sleep centers founded 40 years ago. This center contribut … f sleep disorders, especially the dopaminergic treatments of RLS (first with levodopa and then with pramipexole). Current research also involves the identification of prodromal markers of Parkinson disease and dementia in patients with RBD as to build a ready-to trial cohort to test the efficacy of neuroprotective agents.In summary, the CARSM is a center dedi …

Association of dopamine agonist use with impulse control disorders in Parkinson disease.

OBJECTIVE: To determine the frequency and correlates of impulse control disorders (ICDs) in Parkinson disease (PD). DESIGN: An unstructured screening interview for ICDs (compulsive gambling, buying, and sexual behavior) followed by a telephone-administered structured interview for screen-positive patients. SETTING: Two university-affiliated movement disorders centers. PARTICIPANTS: A convenience sample of 272 patients with idiopathic PD who were screened for psychiatric complications. MAIN OUTCOME MEASURES: Presence of compulsive gambling, buying, or sexual behavior as assessed by the Minn

Restless leg syndrome in patients with spinal cord injury.

BACKGROUND: The presence of restless leg syndrome (RLS) in patients with spinal cord injury (SCI) is not well established. We studied the frequency and severity of RLS in a population of patients with SCI and the effect of treatment with dopaminergic drugs when clinically indicated. METHODS: Consecutive patients with SCI admitted to an out-patient clinic of a neurorehabilitation hospital (n:195) were evaluated for the presence of RLS between February 2013 and May 2014. A diagnosis of RLS was made according to the criteria of the International RLS Study Group, and severity was assessed by the

Dopamine, T cells and multiple sclerosis (MS).

Dopamine is a key neurotransmitter that induces critical effects in the nervous system and in many peripheral organs, via 5 dopamine recepto … ized in this review). These dopaminergic drugs include: dopamine = intropin, L-DOPA, bromocriptine, pramipexole, pergolide, haloperidol, pimozide, and amantadine. Other dopaminergic drugs were not yet tested for their direct effects on T cells. Extensive evidence in multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE) show dopaminergic …

Dexpramipexole attenuates myocardial ischemia/reperfusion injury through upregulation of mitophagy.

Reperfusion causes undesirable damage to the ischemic myocardium while restoring the blood flow. In this study, we evaluated the effects of dexpramipexole (DPX) on myocardial injury induced by ischemia/reperfusion (I/R) in-vivo and the hypoxia/reoxygenation (HR) in-vitro and examined the functional mechanisms of DPX. DPX protected cells against H/R-induced mitochondrial dysfunction and prevented H/R damage. Both myocardial infarct size and tissue damage due to I/R was reduced upon DPX treatment. We discovered that DPX enhanced mitophagy in-vivo and in-vitro, which was accompanied by enhanced e…

Efficacy and tolerability of dopamine agonists in a parkinsonian population.

A clinical retrospective study was carried out in a population of 366 Parkinson's disease (PD) outpatients, to analyse the efficacy and tolerability of nonergoline and ergoline dopamine agonist (DA), in monotherapy or in combination with L-dopa. Safety was comparable in both groups except for higher occurrence of gastrointestinal symptoms in ergoline group and somnolence in nonergoline group. No significant difference concerning efficacy and tolerability was found during DA monotherapy. Mean age at PD onset was slightly higher in patients withdrawing DA monotherapy for adverse events comparing

Parkinson's Disease Medication Alters Small Intestinal Motility and Microbiota Composition in Healthy Rats.

Parkinson's disease (PD) is known to be associated with altered gastrointestinal function and microbiota composition. To date, the effect of PD medication on the gastrointestinal function and microbiota, at the site of drug absorption, the small intestine, has not been studied, although it may represent an important confounder in reported microbiota alterations observed in PD patients. To this end, healthy (non-PD) wild-type Groningen rats were employed and treated with dopamine, pramipexole (in combination with levodopa-carbidopa), or ropinirole (in combination with levodopa-carbidopa) for 14…

[Rhabdomyolysis as a complication of Parkinson's disease].

BACKGROUND: Rhabdomyolysis is known as one of the possible causes of acute renal failure and can be triggered by different situations. In recent years, Parkinson's disease emerged as a condition that can be complicated by the development of rhabdomyolysis and consequently, in some cases, of acute renal failure. We report two cases of rhabdomyolysis, one of which complicated by an oligo-anuric renal failure, which occurred in patients affected by Parkinson's disease and admitted to our Division. METHODS AND RESULTS: The first case occurred in a 90-year-old Parkinsonian woman, under treatment w

Restless Legs Syndrome: A Review.

IMPORTANCE: Restless legs syndrome (RLS) is a sleep-related movement disorder that affects approximately 3% of US adults to a clinically sig … roved RLS symptoms vs approximately 40% with placebo (P < .001). Dopamine agonists (eg, ropinirole, pramipexole, rotigotine) are no longer recommended as first-line medications due to the risk of augmentation, an iatrogenic worsening of RLS symptoms, which has an annual incidence of 7% to 10% with these medications. Patients who do not improve with first-line …

Treatment strategies for motor fluctuations in Parkinson's disease: a systematic review of efficacy, functionality, and drug accessibility with a focus on Latin America.

BACKGROUND: Motor fluctuations represent a major therapeutic challenge in Parkinson's disease, particularly among individuals on long-term l … ia. High-certainty evidence supports the efficacy of extended-release levodopa (IPX066), opicapone, pramipexole, rotigotine, and safinamide in reducing OFF-time, although improvements in functional disability and quality of life were modest or inconsistent. Moderate-certainty evidence supports device-aided therapies, including levodopa-carbidopa intestinal ge …

Chronic Pain Treatment Strategies in Parkinson's Disease.

Neurological disorders, including Parkinson's disease (PD), have increased in prevalence and are expected to further increase in the coming … t is converted to dopamine by the action of a naturally occurring enzyme called DOPA decarboxylase. Pramipexole, a D2 dopamine agonist, and apomorphine, a dopamine agonist, and Rotigotine, a dopamine receptor agonist, have showed efficacy on PD-associated pain. Other treatments that have shown efficacy in treating pain of diverse etiologies are acetaminophen, …

Scoping Review of Treatment Strategies for Holmes Tremor: Pharmacological and Surgical Interventions.

BACKGROUND: Holmes tremor is a rare neurological condition, first described in 1904, characterized by a low-frequency tremor that manifests at rest, posture, and action. Despite its recognition for over a century, effective treatment strategies for Holmes tremor remain elusive due to its rarity and challenges in conducting robust studies. METHODS: Given that the existent medical literature on Holmes tremor is based on reports and case series, we conducted a survey using the keywords "Holmes tremor" and "Rubral tremor" to analyze the therapeutic approaches utilized, as well as their success ra

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… The daily doses of pramipexole ranged between 1.08 and 2.8 mg, while those of piribedil ranged between 120 and 300 mg [ 27 , 29 , 32 , 33 , 45 , 47 , 99 ]. … Some reports show positive outcomes even in the absence of response to levodopa [ 21 , 25 , 32 ], and one report described a successful treatment with ropinirole in an absent response to pramipexole [ 21 ]. …

Management of REM sleep behavior disorder: an American Academy of Sleep Medicine clinical practice guideline.

INTRODUCTION: This guideline establishes clinical practice recommendations for the management of rapid eye movement sleep behavior disorder … t of isolated RBD in adults. (CONDITIONAL). UNLABELLED: 3. * The AASM suggests that clinicians use pramipexole (vs no treatment) for the treatment of isolated RBD in adults. (CONDITIONAL). UNLABELLED: 4. The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of isolated RBD in adults with mild cognitive impairment …

The Movement Disorder Society Evidence-Based Medicine Review Update: Treatments for the non-motor symptoms of Parkinson's disease.

The Movement Disorder Society (MDS) Task Force on Evidence-Based Medicine (EBM) Review of Treatments for Parkinson's Disease (PD) was first … atments that are efficacious for the management of the different non-motor symptoms are as follows: pramipexole for the treatment of depressive symptoms, clozapine for the treatment of psychosis, rivastigmine for the treatment of dementia, and botulinum toxin A (BTX-A) and BTX-B as well as glycopyrrolate for the treatment of sialorrhea. The practical implicat …

[Sleep disorders in patients with a neurocognitive disorder].

INTRODUCTION: Sleep disorders are prevalent in patients with a neurocognitive disorder, and diagnosis and treatment in these patients remain … strategies such as exercise and leg massages may be beneficial. Low-dose dopamine agonists (such as pramipexole 0.125mg two hours before bedtime) can be used to treat the condition, but a prolonged treatment may paradoxically worsen the symptoms. Alpha-2-delta calcium channel ligands can also be used while monitoring for the risk of falls. CONCLUSION: Multip …