Saratov JOURNAL of Medical and Scientific Research

Parkinson’s disease

Parkinson's disease in Russia: prevalence and incidence

Year: 2016, volume 12 Issue: №3 Pages: 379-384
Heading: Neurology Article type: Review
Authors: Razdorskaya V.V., Voskresenskaya O.N., Yudina G.K.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

The results of the regional studies on the frequency of Parkinson's disease (PD) and the incidence of it in Russia have been generalized, the main factors that determine the quality of the estimates of this disease epidemiological indicators have been identifyd. The article summarizes data from 19 original studies on the epidemiology of parkinsonism and Parkinson's disease in Russia published between 2005-2015. Due to the statistical heterogeneity of the primary results computational analytics was not applied to the data; however, data consolidation allowed to perform a trend analysis of epidemiological indicators. The methodological basis of the majority of studies was medical aid appealabil-ity; two of the studies used door-to-door surveys. One of the studies returned questionably low epidemiological indicators obtained from the medical records, and the rest showed the standardized prevalence of 30.0-139.9/100,000 and incidence of 7.63-21.8/100,000 per year. Contribution of Parkinson's disease to the nosological structure of parkinsonism was >61.3%. Estimate of the number of patients with PD in Russia is approximately 210,000 people. Conclusions are made regarding the prevalence of PD in Russia according to the cross-cutting research on the level of indicators in the Western countries. The prevalence of PD by appealability is 2-3 times less than the prevalence in continuous research, both national and foreign. The incidence of PD, demonstrated in half of the studies, is stable from region to region and is comparable with the universally recognized values.

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Organization of medical rehabilitation in Parkinson's disease in a specialized clinical diagnostic room

Year: 2013, volume 9 Issue: №4 Pages: 927-931
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Gubaydullina R.F.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed to create an organizational model of medical rehabilitation of patients with Parkinson's disease (PD). Material and methods. In medical institutions of Closed Administrative-Territorial Units of Russia (Seversk, Za-rechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk) in clinical and diagnostic rooms for providing care to patients with movement disorders there was created an organizational model of medical rehabilitation. Results. The organizational model of medical rehabilitation allowed to cover 100% of all PD patients. The main phases in the model were diagnosis and follow up care on the base of specialized clinical and diagnostic room, creating and performance of individual rehabilitation program with recreation therapist, educational sessions for patients and their relatives, evaluation effectiveness of rehabilitation measures, condition monitoring, assessment of antiparkinsonian therapy. Effectiveness of the rehabilitation in inpatient and outpatient settings was comparable. Conclusion. Creation and implementation of the organizational model of medical rehabilitation was possible only in specialized clinical and diagnostic rooms for diagnosis and treatment of movement disorders. There were introduction of the phasing and basic directions rehabilitation program for PD patients have been worked.

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Rehabilitation of walking disorders with a freezing in patients Parkinson disease: methods of outpatient correction

Year: 2013, volume 9 Issue: №4 Pages: 923-927
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Gubaydullina R.F., Karpova О.V., Chupina L. P.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed the effectiveness of rehabilitation approaches for patients with Parkinson disease with a freezing at an outpatient condition. Material and methods. The study included 26 patients with Parkinson disease (14 men and 12 women), average age was 54.1± 9.5 years, average disease duration — 7.8± 3.1 years, the stage of the disease by Hoehn and Yahr scale — 3, 1±0.8. The control group included 15 patients with Parkinson disease (9 men and 6 women), matched in age, duration and severity. All patients have got a stable antiparkinsonian therapy before and during the study. The experiment had been performed for 6 months. The rehabilitation program consisted of 10 sessions. In rehabilitation program there had been used a sensor treadmill and Nordic walking. Patients had been kept training the Nordic walking at home through the course of the study. The results show the effectiveness of rehabilitation for reducing the severity of a freezing, increasing the speed of walking, the increased of the length step, decreased the time for turning compared to the control group. The effect had been supported by home rehabilitation training for 3 and 6 months after the study. Besides, patients from the main group did not need the change of the antiparkinsonian therapy after the study comparing with the control group.

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Преимущества организации длительной когнитивной реабилитации при болезни Паркинсона в специализированном клинико-диагностическом кабинете

Year: 2013, volume 9 Issue: №4 Pages: 917-922
Heading: rehabilitative medicine Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Karpova O.V.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

The study aimed: to evaluate the advantages of the long-term of cognitive rehabilitation on the evidence of cognitive and affective disorders in Parkinson disease in a specialized clinical diagnostic room. Material and methods. The study included 37 patients with Parkinson disease (PD) — the study group, who had the long-term cognitive rehabilitation on the background of a standard drug therapy, and 28 patients in the control group, who had received only standard drug therapy. Assessment of cognitive function was carried out by neurologists, who had a course of thematic advanced training in the diagnosis and treatment of patients with extrapyramidal disorders, and who are working in a specialized clinical diagnostic room for patients with movement disorders. Results. Our results show the effectiveness of the long-term cognitive rehabilitation of Parkinson disease in specialized clinical diagnostic rooms. Whether the optimal duration and frequency of trainings, the duration of the course of the rehabilitation program remains unclear.

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Epidemiological monitoring the of Parkinson's disease morbidity

Year: 2013, volume 9 Issue: №4 Pages: 873-877
Heading: Neurology Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: the analysis of epidemiological monitoring of Parkinson's disease. Material and Methods. We conducted the full-design population study in the six closed administrative-territorial unit (Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk) with an adult's population about 450000 in the period from 2009 to 2012. For collecting information was developed the register of PD. Results. 588 patients with PD were revealed and enrolled, including 302 patients, who were revealed in the first. Primary morbidity was 11.0 per 100000 population in 2009, and in 2010 and 2011 it was 25.7 and 22.7 per 100000 population respectively. By the beginning of 2012 was so-called "dredging" of patients from population (revealing of all patients, who were not revealed earlier) and was 8.5 per 100000. Total morbidity for 4 years of observation increased: so in 2009 it was 33.1 per 100000, in 2010-92.5 per 100000, in 2011-114,2 per 100000, and in 2013-118,7 per 100000, the same like international data. The Evolution of sex and age structure according to the Register's data showed: 1) peak of morbidity at age 70-74 years, with the decay over 85 years; 2) morbidity was higher in men aged 70-74 years and older. Conclusion. Implementation of the Register of PD's patients annually allowed to monitoring of the morbidity and statistically significant show the basic epidemiological evidence and undertake federal and sampling comparative studies, it is necessary for evaluation of the changes of Parkinson's disease status, which can't be done on the basis of the state statistical dates.

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Principles of dispensary observation of patients with Parkinson's disease in a specialized clinical diagnostic room

Year: 2013, volume 9 Issue: №4 Pages: 869-873
Heading: Neurology Article type: Original article
Authors: Krivonos О.V., Smolentseva I.G., Amosova N.A., Chupina L.P.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Aim: to develop and implement of the order of the dispensary observation of Parkinson's disease patients. Material and methods, the dispensary observation of Parkinson's disease patients had been performed by neurologist and diagnostic room (CDR) based on the outpatient department of health care institutions obeyed by FMBA of Russia in six Closed Administrative-Territorial Units: Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk. Neurologist examined of patients and put data to the Register's database. Register's database had 588 Parkinson's disease examined patients, 112 of them (19,1%) had stage II of the disease by Hoehn and Yahr, 231 (39,3%) patients — stage III by Hoehn and Yahr, 187 (31,8%) patients — stage IV byHoehn and Yahr, 58 (9,9%) patients — stage V by Hoehn and Yahr. The duration of the dispensary observation of Parkinson's disease patients was 4 years (2009-2012). Results. There are and implement the order of the observed and accounting of adult's group of Parkinson's disease patients were developed, who are registered in the clinical and diagnostic rooms, including the frequency of physician's visits, the list of diagnostic and treatment activities and efficiency endpoint of the dispensary observation. Conclusion. Implementation of the order of the dispensary observation according to the Register allowed to identify the main disabling PD's symptoms (depression, dementia, motor fluctuations and dyskinesia) and timely correction of therapy.

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The regional model of organization of medical care to patients with Parkinson disease in modern socio-economic conditions

Summary:

There is the evidence-based organizational and functional model of health care for people with Parkinson disease at the regional level, showing the role and importance of new organizational technology embodied in the closed administrative-territorial formations.

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Parkinson's disease: the reliability of morbidity and mortality statistics in the Russian Federation

Summary:

The aim of the research was to study the significance of morbidity of Parkinson's disease (PD) and mortality in Russian Federation in international comparisons. Material and Methods: In accordance with the purpose of the study the morbidity and mortality were analyzed in the Russian Federation on the basis of volumes "Morbidity in Russia" of the Ministry of Health of the Russian Federation in 2009-2012, "Human resources for health care institutions" of the Ministry of Health of the Russian Federation in 2012, tables С 51 about the mortality of subjects of the Russian Federation in 2012, data of mortality from Parkinson's disease in different countries in 2011, published by WHO. Results. The analysis of data on the morbidity patterns showed that in the Russian Federation in 2009-2012 there was an increase in general morbidity of adult patients with PD from 75.1 to 87.7 per thousand of populations. The data of primary morbidity in the adult population of the Russian Federation from PD also tend to increase from 8.0 to 8.5 per thousand of populations. The sharp fluctuations of mortality's data were revealed in subject of Russian Federation that was related of unreliable data. Mortality from PD in Russian Federation in 2012 was 0.31 per thousand of populations. Conclusion. The values in the study of general and primary PD's morbidity in the Russian Federation were lower than performance in international comparisons. PD's mortality in Russia was also lower than in other developed countries. Abidance by rules of selecting the primary cause of death (PCOD), confirmed by an automated system, where one of the causes is PD will make mortality statistics of PD reliable and internationally comparable.

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Non-motor symptoms in parkinson’s disease

Year: 2012, volume 8 Issue: №2 Pages: 535-538
Heading: Neurology Article type: Original article
Authors: Torgan T.I., Baidina T.V.
Organization: Perm State University of Medicine n.a. academician E.A. Vagner
Summary:

The goal of the research was to investigate some non-motor disorders at patients with Parkinson disease (PD) and to determine their relations to the main manifestations of the disease. 68 patients with PD without dementia were studied. Duration of disease was 4 (2-6) years. The following scales were used: Modifed Fatigue Impact Scale (MFIS), Unifed Parkinson Disease Rating Scale (UPDRS, part 3), Hospital Anxiety and Depression Scale (HADS), A. M. Veyn Questionnaire for autonomic disturbances and the Epworth Sleepiness Scale (ESS). The results of this study have revealed the presence of emotional disorders, fatigue, autonomic dysfunction and dyssomnia at patients with PD. Non-motor symptom severity does not depend on age and sex of the patients, as well as the main motor symptoms of the disease. The relationships of the examined non-motor symptoms were revealed.

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The diagnostic reliability of outpatient neurological care to patients with Parkinson’s disease

Year: 2012, volume 8 Issue: №2 Pages: 513-517
Heading: Neurology Article type: Original article
Authors: Razdorskaya V.V., Voskresenskaya O.N., Yudina G.K.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Goal: discussion of the revealing aspects of Parkinson’s disease (PD) by ambulatory neurologists. Techniques: a longitudinal epidemiological survey on applications to a specialized clinic. Results. 603 patients with Parkinsonism suspicions were examined for a four-year period. The syndromal diagnosis of Parkinsonism/extra pyramidal syndrome was correctly recognized by ambulatory neurologists in ca. ¾ of the whole contingent of patients. Hypodiagnostics of PD was the most frequent mistake (71 of 146 corrected diagnoses). Hyperdiagnostics of PD followed by frequency (57 of 146 corrected diagnoses). Every ffth patient applied for consultation caused diffculties in the ambulatory chain. Conclusion. The diagnostic mistakes, no provisional diagnosis for every tenth PD patient cause justifed anxiety in the patients regarding the quality of guaranteed medical aid and force them to apply for specialized consulting reception individually.

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