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Volumn 15, Issue 9, 2014, Pages

A review of lower urinary tract symptoms in patients with Parkinson's disease

Author keywords

Bladder outlet obstruction; BPH; Lower urinary tract symptoms; Overactive bladder; Parkinson's disease; Urinary symptoms

Indexed keywords

CHOLINERGIC RECEPTOR BLOCKING AGENT; DOPAMINE; DOPAMINE RECEPTOR STIMULATING AGENT; LEVODOPA;

EID: 84903664236     PISSN: 15272737     EISSN: 15346285     Source Type: Journal    
DOI: 10.1007/s11934-014-0435-0     Document Type: Review
Times cited : (22)

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    • .• Phé V, Caremel R, Bart S, Castel-Lacanal E, de Sèze M, Duchêne F, et al. le Comité de neuro-urologie de l'Association française d'urologie. "Lower urinary tract dysfunctions in parkinsonian syndromes: a review by the Neuro-Urology Comittee of the French Association of Urology. " [Article in French]. Prog Urol. 2013;23(5):296-308. -A review of LUTS in parkinsonian syndromes completed by the French Association of Urology. -The review discussed the efficacy of Posterior Tibial Nerve Stimulation very well.
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    • -This paper suggests that "DBS has a major potential to contribute towards the holistic care of PD patients." This is in light of an increase in the ability to more objectively assess the effect of DBS on the nonmotor burden in PD pts. -Nonmotor Symptoms Screening Questionnaire (NMSQuest) is a 30-item validated questionnaire to assess nonmotor burden in 545 pts with PD pre/post DBS. -Suggest that DBS shows no worsening of symptomatology. -Adverse effects include: transient psychiatric and mood disturbance (depression, hypomania, delirium), apathy, impaired verbal fluency, and impulse control disorders. Mechanism unclear, but may involve lesioning effect of frontostriatal circuits along the trajectory of the electrode, suboptimal positioning of the electrodes, current spread to adjacent structures, or non-judicial post-surgical medication adjustment
    • •• Ashkan K, Samuel M, Reddy P, Ray CK. The impact of deep brain stimulation on the nonmotor symptoms of Parkinson's disease. J Neural Transm. 2013;120(4):639-42. -This paper suggests that "DBS has a major potential to contribute towards the holistic care of PD patients." This is in light of an increase in the ability to more objectively assess the effect of DBS on the nonmotor burden in PD pts. -Nonmotor Symptoms Screening Questionnaire (NMSQuest) is a 30-item validated questionnaire to assess nonmotor burden in 545 pts with PD pre/post DBS. -Suggest that DBS shows no worsening of symptomatology. -Adverse effects include: transient psychiatric and mood disturbance (depression, hypomania, delirium), apathy, impaired verbal fluency, and impulse control disorders. Mechanism unclear, but may involve lesioning effect of frontostriatal circuits along the trajectory of the electrode, suboptimal positioning of the electrodes, current spread to adjacent structures, or non-judicial post-surgical medication adjustment.
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    • Bladder dysfunction in advanced Parkinson's disease
    • - Aim: To assess severity of bladder dysfunction in.
    • •• Winge K, Nielsen KK. Bladder dysfunction in advanced Parkinson's disease. Neurourol Urodyn. 2012;31(8):1279-83. - Aim: To assess severity of bladder dysfunction in PD as stratified by symptomatic treatment, specifically DBS and Apomorphine vs medical treatment. - Used two validated questionnaires: DanPSS and IPSS. Used these to assess symptomatology and impact on quality of life. - The analysis found that in the conventional group, the severity of bladder dysfunction (DanPSS ≥ 10) correlated with a greater PD stage (based on the modified Hoehn and Yahr PD staging from 0 to 5). This did not hold for the nonconventional group, however, which included those treated with DBS or apomorphine and also did not hold when given the IPSS validated questionnaire. - They completed a further analysis based on specific symptoms and found that DBS patients had significantly less nocturia (as defined by > 2 episodes of voiding per night) and were less bothered by it. - Drawbacks: ○ Definition of nocturia in the DanPSS isn't rigorous as the established ICS definition of nocturia (minimum one episode of waking to void that is preceded and followed by sleep) ○ Low N in general (N=107), but specifically in Apomorphine group (n=9). Unable to draw substantial conclusions from such a low sample size. ○ Only looked into questionnaire-based evaluation. Lacks the objectivity of other studies, as it doesn't include urodynamic testing, etc.
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    • Winge, K.1    Nielsen, K.K.2


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