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Parkinson's disease in the elderly patient: an objective assessment of night-time movement and daytime bradykinesia

Leeman, Annette Louise; (1991) Parkinson's disease in the elderly patient: an objective assessment of night-time movement and daytime bradykinesia. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

The disability caused by Parkinson's disease in old age is difficult to quantify and the response to medication may be small. Consequently, emphasis has been placed on objective methods of assessment of night-time and daytime mobility in the following work. The size and frequency of movement during sleep were recorded using a bed movement monitor. Mean move size was reduced in those with either Parkinson's disease or a low cognitive function score. When both these factors coexisted the resultant reduction in mobility was associated with a higher prevalence of pressure sores. Furthermore, frequency of movement was inversely proportional to cognitive function score. A double-blind, placebo-controlled, cross-over study of nocturnal dosing with Sinemet-Plus in patients with Parkinson's disease was carried out. Following active treatment, there was an improvement in sleep both as assessed subjectively and by measurement of night-time mobility. Despite the long interval between dosing and morning assessment, walking time was also faster. In a further double-blind, placebo-controlled, cross-over study, a pedobarograph and a gait assessment trolley were used in a novel way to measure the effect of Sinemet-Plus on daytime bradykinesia. After active treatment, the nature of foot strike improved and the double support time was reduced. Serial plasma concentrations of levodopa and 3-0-methyldopa were measured using high-performance liquid chromatography. As duration of levodopa therapy increased there was a decrease in the area under the levodopa plasma concentration/time curve and an increase in the mean 3-0-methyldopa plasma concentration. However, no relationship was found between parameters of gait and plasma concentrations of levodopa and 3-0 methyldopa, or measurements of mean arterial blood pressure.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Parkinson's disease in the elderly patient: an objective assessment of night-time movement and daytime bradykinesia
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Biological sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10122095
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