Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?
Identifieur interne : 000D92 ( Main/Exploration ); précédent : 000D91; suivant : 000D93Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?
Auteurs : Jean-François Daneault [Canada] ; Benoit Carignan [Canada] ; Abbas F. Sadikot [Canada] ; Michel Panisset [Canada] ; Christian Duval [Canada]Source :
- BMC Medicine [ 1741-7015 ] ; 2013.
English descriptors
- KwdEn :
- Animals, Disease Management, Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (drug therapy), Dyskinesia, Drug-Induced (physiopathology), Humans, Levodopa (adverse effects), Motor Skills (drug effects), Motor Skills (physiology), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Recovery of Function (physiology), Signal-To-Noise Ratio.
- MESH :
- chemical , adverse effects : Levodopa.
- diagnosis : Dyskinesia, Drug-Induced, Parkinson Disease.
- drug effects : Motor Skills.
- drug therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- physiology : Motor Skills, Recovery of Function.
- physiopathology : Dyskinesia, Drug-Induced, Parkinson Disease.
- Animals, Disease Management, Humans, Signal-To-Noise Ratio.
Abstract
Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management.
The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed.
Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.
Url:
DOI: 10.1186/1741-7015-11-76
PubMed: 23514355
PubMed Central: 3751666
Affiliations:
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Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?</title><author><name sortKey="Daneault, Jean Francois" sort="Daneault, Jean Francois" uniqKey="Daneault J" first="Jean-François" last="Daneault">Jean-François Daneault</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University street, Montreal, Quebec, H3A 2B4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University street, Montreal, Quebec, H3A 2B4</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4</wicri:regionArea><wicri:noRegion>H3W 1W4</wicri:noRegion></affiliation></author><author><name sortKey="Carignan, Benoit" sort="Carignan, Benoit" uniqKey="Carignan B" first="Benoit" last="Carignan">Benoit Carignan</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4</wicri:regionArea><wicri:noRegion>H3W 1W4</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I3">Département des Sciences Biologiques, Université du Québec à Montréal, 141 Avenue Président-Kennedy, Montréal, Québec, H2X 1Y4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Département des Sciences Biologiques, Université du Québec à Montréal, 141 Avenue Président-Kennedy, Montréal, Québec, H2X 1Y4</wicri:regionArea><orgName type="university">Université du Québec à Montréal</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Sadikot, Abbas F" sort="Sadikot, Abbas F" uniqKey="Sadikot A" first="Abbas F" last="Sadikot">Abbas F. Sadikot</name><affiliation wicri:level="4"><nlm:aff id="I1">Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University street, Montreal, Quebec, H3A 2B4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University street, Montreal, Quebec, H3A 2B4</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><affiliation wicri:level="1"><nlm:aff id="I4">Unité des troubles du mouvement André-Barbeau, Centre Hospitalier de l'Université de Montréal, 1560 rue Sherbrooke Est, Montréal, Québec, H2L 4M1, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Unité des troubles du mouvement André-Barbeau, Centre Hospitalier de l'Université de Montréal, 1560 rue Sherbrooke Est, Montréal, Québec, H2L 4M1</wicri:regionArea><wicri:noRegion>H2L 4M1</wicri:noRegion></affiliation></author><author><name sortKey="Duval, Christian" sort="Duval, Christian" uniqKey="Duval C" first="Christian" last="Duval">Christian Duval</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Chemin Queen-Mary, Montréal, Québec, H3W 1W4</wicri:regionArea><wicri:noRegion>H3W 1W4</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="I5">Département de Kinanthropologie, Université du Québec à Montréal, 141 Avenue Président-Kennedy, Montréal, Québec, H2X 1Y4, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Département de Kinanthropologie, Université du Québec à Montréal, 141 Avenue Président-Kennedy, Montréal, Québec, H2X 1Y4</wicri:regionArea><orgName type="university">Université du Québec à Montréal</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author></analytic><series><title level="j">BMC Medicine</title><idno type="eISSN">1741-7015</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals</term><term>Disease Management</term><term>Dyskinesia, Drug-Induced (diagnosis)</term><term>Dyskinesia, Drug-Induced (drug therapy)</term><term>Dyskinesia, Drug-Induced (physiopathology)</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Motor Skills (drug effects)</term><term>Motor Skills (physiology)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Recovery of Function (physiology)</term><term>Signal-To-Noise Ratio</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motor Skills</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Skills</term><term>Recovery of Function</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Disease Management</term><term>Humans</term><term>Signal-To-Noise Ratio</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management.</p></sec><sec><title>Discussion</title><p>The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed.</p></sec><sec><title>Summary</title><p>Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ehringer, H" uniqKey="Ehringer H">H Ehringer</name></author><author><name sortKey="Hornykiewicz, O" uniqKey="Hornykiewicz O">O Hornykiewicz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jankovic, J" uniqKey="Jankovic J">J Jankovic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zgaljardic, Dj" uniqKey="Zgaljardic D">DJ Zgaljardic</name></author><author><name sortKey="Foldi, Ns" uniqKey="Foldi N">NS Foldi</name></author><author><name sortKey="Borod, Jc" uniqKey="Borod J">JC 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Wenzelburger</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Montréal</li></settlement><orgName><li>Université McGill</li><li>Université du Québec à Montréal</li></orgName></list><tree><country name="Canada"><region name="Québec"><name sortKey="Daneault, Jean Francois" sort="Daneault, Jean Francois" uniqKey="Daneault J" first="Jean-François" last="Daneault">Jean-François Daneault</name></region><name sortKey="Carignan, Benoit" sort="Carignan, Benoit" uniqKey="Carignan B" first="Benoit" last="Carignan">Benoit Carignan</name><name sortKey="Carignan, Benoit" sort="Carignan, Benoit" uniqKey="Carignan B" first="Benoit" last="Carignan">Benoit Carignan</name><name sortKey="Daneault, Jean Francois" sort="Daneault, Jean Francois" uniqKey="Daneault J" first="Jean-François" last="Daneault">Jean-François Daneault</name><name sortKey="Duval, Christian" sort="Duval, Christian" uniqKey="Duval C" first="Christian" last="Duval">Christian Duval</name><name sortKey="Duval, Christian" sort="Duval, Christian" uniqKey="Duval C" first="Christian" last="Duval">Christian Duval</name><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><name sortKey="Sadikot, Abbas F" sort="Sadikot, Abbas F" uniqKey="Sadikot A" first="Abbas F" last="Sadikot">Abbas F. 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