:: June 2009

Welcome to our Monthly Online Newsletter!

View all Treatment articles in our Treatment Report . The most recent articles are listed on top (not in alphabetical order). Click on the Topic on our home page and then the subtopic - Treatment Report. Stay updated on drugs and their side effects, and various other treatments, including exercise, nutrition, and supplements.

Highlighted Article

Parkinson's Disease Associated With Pesticide Exposure In French Farm Workers “The cause of Parkinson’s disease (PD), the second most frequent neurodegenerative disease after Alzheimer’s disease, is unknown, but in most cases it is believed to involve a combination of environmental risk factors and genetic susceptibility. Laboratory studies in rats have shown that injecting the insecticide rotenone leads to an animal model of PD and several epidemiological studies have shown an association between pesticides and PD, but most have not identified specific pesticides or studied the amount of exposure relating to the association. A new epidemiological study involving the exposure of French farm workers to pesticides found that professional exposure is associated with PD, especially for organochlorine insecticides. … Among the three main classes of pesticides (insecticides, herbicides, fungicides), researchers found the largest difference for insecticides: men who had used insecticides had a two-fold increase in the risk of PD. “Our findings support the hypothesis that environmental risk factors such as professional pesticide exposure may lead to neurodegeneration,” notes Dr. Elbaz.”

Clinical Guidelines

AHRQ - Diagnosis and Treatment of Parkinson's Disease: A Systematic Review of the Literature (2004)

New Guidelines Update Diagnosis and Treatment of Parkinson's Disease

NGC - Parkinson's disease in the long-term care setting. (2002)

NGC - Practice parameter: diagnosis and prognosis of new onset Parkinson disease (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. (2006)

NGC - Practice parameter: initiation of treatment for Parkinson?s disease: an evidence-based review. (2002)

Internet Sites

Featured site

NIH - Parkinson's Disease

NIH - Medical Encyclopedia Parkinson's disease

NIH - NINDS Parkinson's Disease Information Page

NIH - Parkinson disease

NIH - Parkinson's Disease

NIH - Parkinson's Disease Tutorial

Related Topics - Highlighted Articles

Lewy Body Dementia

Relationship between Parkinson disease with dementia and dementia with Lewy bodies. (Parkinsonism Relat Disord. 2005) "Parkinson disease (PD) and dementia with Lewy bodies (DLB) are considered Lewy body diseases (LBDs). ... Our results indicate that PDD and DLB share a common pathological substrate and that the pathological subtypes of LBD show considerable overlap in clinical manifestations."

Tremor

Olfaction testing in patients with tremor-dominant Parkinson's disease: is this a distinct condition? (Mov Disord. 2005) "There is considerable controversy regarding the relationship between essential tremor (ET) and Parkinson's disease (PD), especially when tremor is the dominant feature of PD or there is a family history of tremor. ? This finding suggests that patients with a family history of tremor may represent a different disease process even though, aside from differences in olfaction, they are clinically similar to other patients with tremor-dominant parkinsonism. It additionally suggests phenotypic overlap between PD and ET."

In this newsletter:

Diagnosis, Imaging, and Screening
General Information
Risk Factors
Risk Reduction

	Diagnosis, Imaging, and Screening

	General Information
Cognitive function in early Parkinson's disease: a population-based study. (Eur J Neurol. 2009) The Clinicians' and Nurses' Guide to Parkinson's Disease “Parkinson's disease (PD) is the second-most common neurodegenerative disorder, after Alzheimer's disease. While classically considered a movement disorder, there is a growing recognition that PD produces a wide variety of nonmotor symptoms as well. Early diagnosis of PD is important for treatment planning and maintaining the highest quality of life for the longest period of time, yet at its earliest stages, PD may often be difficult to distinguish from other causes of parkinsonism. No definitive neuroprotective treatment is yet available, but symptomatic treatments may provide significant benefit for many years for the patient with PD. The wide range of treatment options and strategies, combined with the differing needs and comorbidities of different patients, means the physician must have detailed knowledge of multiple drugs from different classes, and how each is likely to impact the individual PD patient. In addition, nonpharmacologic treatments, from physical and recreational therapy to surgery to attention to the caregiver, are also central to the optimal management of PD.”

	Risk Factors

	Risk Reduction