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Parkinson Disease: HELP
Articles by Joseph H. Friedman
Based on 98 articles published since 2008

Between 2008 and 2019, J. H. Friedman wrote the following 98 articles about Parkinson Disease.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline Re: Practice parameter: assessing patients in a neurology practice for risk of falls (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. 2009

Friedman, Joseph H. · ·Neurology · Pubmed #19171841.

ABSTRACT: -- No abstract --

2 Editorial MCI in Parkinson's disease. 2018

Friedman, Joseph H. ·Dept. of Neurology, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906, USA; Dept. of Neurology, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA. Electronic address: Joseph_friedman@brown.edu. ·Parkinsonism Relat Disord · Pubmed #29413123.

ABSTRACT: -- No abstract --

3 Editorial Editorial and introduction: Behavioral aspects of Parkinson's disease. 2017

Friedman, Joseph H / Bhidayasiri, Roongroj / Truong, Daniel D. ·Butler Hospital, Department of Neurology, Alpert Medical School of Brown University, RI, USA. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Truong Neuroscience Institute, Parkinson's and Movement Disorders Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA, USA. ·J Neurol Sci · Pubmed #28087061.

ABSTRACT: -- No abstract --

4 Editorial Thoughts on fatigue in Parkinson's disease (and other disorders). 2017

Friedman, J H. ·Butler Hospital, Providence, RI, USA. · Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA. ·Eur J Neurol · Pubmed #27699949.

ABSTRACT: -- No abstract --

5 Editorial Editorial on: Pagonabarraga J, Martinez-Hora S, Fernandez de Bobadilla R et al. Minor hallucinations occur in drug-naïve Parkinson's disease patients even from the premotor phase. Movement Disorders 2015; Available from: DOI: 10.1002/mds.26432. 2016

Friedman, Joseph H. ·Movement Disorders Program, Butler Hospital, Providence, RI. · Department of Neurology, Warren Alpert School of Medicine of Brown University, Providence, RI. ·Mov Disord · Pubmed #26660462.

ABSTRACT: -- No abstract --

6 Editorial Can fall of blood pressure prevent falls in Parkinson disease? 2014

Hedera, Peter / Friedman, Joseph H. ·From the Department of Neurology (P.H.), Vanderbilt University, Nashville, TN · Movement Disorders Program (J.H.F.), Butler Hospital, Providence · and the Department of Neurology (J.H.F.), Alpert Medical School of Brown University, Providence, RI. ·Neurology · Pubmed #24682972.

ABSTRACT: -- No abstract --

7 Editorial Glad about SAD (PD). 2012

Friedman, Joseph H / Weintraub, Daniel. · ·Neurology · Pubmed #22496197.

ABSTRACT: -- No abstract --

8 Editorial Is fatigue in early Parkinson's disease a minor inconvenience or major distress? The answer is 'Yes!'. 2012

Friedman, J H. · ·Eur J Neurol · Pubmed #22340279.

ABSTRACT: -- No abstract --

9 Editorial Negative hallucinations [April Fool's]. 2010

Friedman, Joseph H. · ·Med Health R I · Pubmed #20486515.

ABSTRACT: -- No abstract --

10 Review Pharmacological interventions for psychosis in Parkinson's disease patients. 2018

Friedman, Joseph H. ·a Movement Disorders Program , Butler Hospital , Providence , RI , USA. · b Department of Neurology , Warren Alpert Medical School of Brown University , Providence , RI , USA. ·Expert Opin Pharmacother · Pubmed #29494265.

ABSTRACT: INTRODUCTION: Psychosis is a common problem for people treated for Parkinson's disease. The syndrome is quite stereotypic, with hallucinations being the most common, followed by delusions. While the hallucinations are usually not very bothersome, the delusions are typically paranoid in nature. Treatment is often, but not always, required. AREAS COVERED: This article reviews the therapeutic approaches of this syndrome focusing on drug treatments used once contributory factors have been removed. This includes a review of the evidence supporting the use of clozapine and, most recently, pimavanserin, the first drug with antipsychotic efficacy that has no effect on dopamine. Treatment with second generation antipsychotic drugs and cholinesterase inhibitors are also reviewed. EXPERT OPINION: Clozapine and pimavanserin have proven efficacy for Parkinson's disease psychosis (PDP), without impairing motor function. In clozapine's favor are its antipsychotic benefits seen within 1 week and its effectiveness in improving tremor in PD. However, this is counterbalanced by the need for blood monitoring, despite the extremely low doses used, and sedation. Pimanvanserin is well tolerated, without sedation or other significant side effects. Its onset of benefit, however takes 4-6 weeks. While quetiapine is also frequently used, its efficacy is not supported by double blinded, randomized trials.

11 Review Dementia with Lewy Bodies and Parkinson Disease Dementia: It is the Same Disease! 2018

Friedman, Joseph H. ·Dept. of Neurology, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906, USA; Dept of Neurology, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA. Electronic address: joseph_friedman@brown.edu. ·Parkinsonism Relat Disord · Pubmed #28756177.

ABSTRACT: INTRODUCTION: The question whether DLB and PDD are distinct disorders has been debated in several forums. The two disorders, once parkinsonism is present in DLB, cannot be distinguished on clinical or pathological grounds. The conundrum exists for those DLB patients who do not yet have parkinsonism, and raises the parallel with patients who have Rapid Eye Movement Behavior Disorder but have not yet manifested parkinsonian signs. METHODS: A literature review was summarized to justify classification as a single disorder. RESULTS: Most clinical observations and trials point to these disorders, once parkinsonism is present in DLB, are identical. CONCLUSION: This article notes the advantage to clinical research and treatment by considering these two syndromes as the same so that medications approved for PDD and for PD psychosis can be extended to DLB patients and that resources for PD research and support can be also used for DLB.

12 Review Nonmotor Symptoms in Parkinson's Disease. 2017

Akbar, Umer / D'Abreu, Anelyssa / Friedman, Joseph H. ·Department of Neurology, Brown University, Providence, Rhode Island. ·Semin Neurol · Pubmed #28511256.

ABSTRACT: Nonmotor symptoms (NMSs) in Parkinson's disease (PD) have become increasingly recognized as major determinants of quality of life across cultures worldwide. Behavioral symptoms include dementia, depression, anxiety, apathy, and fatigue. Somatic symptoms include hypotension, constipation, diaphoresis, and pain. However, somatic symptoms may also be intrinsic, such as dementia, and iatrogenic, such as compulsive disorders. The authors address some of the more common disorders, yet few have been the target of clinical trials.

13 Review Misperceptions and Parkinson's disease. 2017

Friedman, Joseph H. ·Butler Hospital, Dept of Neurology, Warren Alpert Medical School of Brown University, 345 Blackstone Blvd, Providence, RI 02906, USA. Electronic address: joseph_friedman@brown.edu. ·J Neurol Sci · Pubmed #28073433.

ABSTRACT: Most of the neurobehavioral aspects of Parkinson's disease have been well established and studied, but many are not well known, and hardly studied. This article focuses on several behavioral abnormalities that are common, and frequently cause difficulty for the patient and family due to lack of recognition as part of the disease. While it is well known that L-Dopa dyskinesias are frequently not recognized or under appreciated by patients, a similar lack of recognition may affect the patient's own speech volume, where their center of gravity is located, whether they are tilted to one side, and their under-recognition of others' emotional displays. In addition, PD patients are often misperceived by others incorrect impression of their emotional and cognitive state based purely on facial expression. These changes and others are briefly reviewed.

14 Review Perioperative management of Parkinson's disease. 2017

Akbar, Umer / Kurkchubasche, Arlet G / Friedman, Joseph H. ·a Department of Neurology , Brown University, Rhode Island Hospital , Providence , RI , USA. · b Department of Surgery and Pediatrics , Brown University, Hasbro Children's Hospital , Providence , RI , USA. · c Department of Neurology , Brown University, Butler Hospital , Providence , RI , USA. ·Expert Rev Neurother · Pubmed #27677316.

ABSTRACT: INTRODUCTION: Guidelines for the management of Parkinson's disease (PD) patients in the perioperative setting are lacking. Areas covered: Here we review potential problems that may arise when PD patients are undergoing an operation. We also review the literature, where available, and provide our expert opinion and recommendations based on experience. Expert commentary: Elderly patients with PD are especially prone to complications in the perioperative setting. Extreme caution must be used to ensure appropriate medication administration, transition to non-oral agents, if indicated, and early mobilization to achieve rapid recovery after surgery.

15 Review Parkinson's disease-related fatigue: A case definition and recommendations for clinical research. 2016

Kluger, Benzi M / Herlofson, Karen / Chou, Kelvin L / Lou, Jau-Shin / Goetz, Christopher G / Lang, Anthony E / Weintraub, Daniel / Friedman, Joseph. ·Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA. · Department of Neurology, Sorlandet Hospital Arendal, Norway. · Departments of Neurology and Neurosurgery, University of Michigan Medical School, Ann Arbor, Michigan, USA. · Department of Neurology, University of North Dakota School of Medicine and Health Science, Department of Neurology, Sanford Health, Fargo, North Dakota, USA. · Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA. · Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada. · Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA. · Department of Neurology, Butler Hospital, Alpert Medical School of Brown University, Providence, Rhode Island, USA. ·Mov Disord · Pubmed #26879133.

ABSTRACT: Fatigue is one of the most common and disabling symptoms in Parkinson's disease (PD). Since fatigue was first described as a common feature of PD 20 years ago, little progress has been made in understanding its causes or treatment. Importantly, PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. In response, the Parkinson Disease Foundation and ProjectSpark assembled an international team of experts to create recommendations for clinical research to advance this field. The working group identified several areas in which shared standards would improve research quality and foster progress including terminology, diagnostic criteria, and measurement. Terminology needs to (1) clearly distinguish fatigue from related phenomena (eg, sleepiness, apathy, depression); (2) differentiate subjective fatigue complaints from objective performance fatigability; and (3) specify domains affected by fatigue and causal factors. We propose diagnostic criteria for PD-related fatigue to guide participant selection for clinical trials and add rigor to mechanistic studies. Recommendations are made for measurement of subjective fatigue complaints, performance fatigability, and neurophysiologic changes. We also suggest areas in which future research is needed to address methodological issues and validate or optimize current practices. Many limitations in current PD-related fatigue research may be addressed by improving methodological standards, many of which are already being successfully applied in clinical fatigue research in other medical conditions (eg, cancer, multiple sclerosis). © 2016 International Parkinson and Movement Disorder Society.

16 Review Recognition and treatment of neuropsychiatric disturbances in Parkinson's disease. 2015

Akbar, Umer / Friedman, Joseph H. ·a Department of Neurology, Brown University, Providence, RI, USA. ·Expert Rev Neurother · Pubmed #26289491.

ABSTRACT: The non-motor symptoms of Parkinson's disease (PD) have been attracting increasing attention due to their ubiquitous nature and their often devastating effects on the quality of life. Behavioral problems in PD include dementia, depression, apathy, fatigue, anxiety, psychosis, akathisia, personality change, sleep disorders and impulse control disorders. Some of these are intrinsic to the neuropathology while others occur as an interplay between pathology, psychology and pharmacology. While few data exist for guiding therapy, enough is known to guide therapy in a rational manner.

17 Review Apathy in Neurodegenerative Diseases: Recommendations on the Design of Clinical Trials. 2015

Cummings, Jeffrey / Friedman, Joseph H / Garibaldi, George / Jones, Martin / Macfadden, Wayne / Marsh, Laura / Robert, Philippe H. ·Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA cumminj@ccf.org. · Department of Neurology, Movement Disorders Program, Butler Hospital, Alpert Medical School of Brown University, Providence, RI, USA. · Clinical Development, Neurosciences, F. Hoffman-La Roche AG, Basel, Switzerland. · Bridge Medical Consulting Ltd, London, United Kingdom. · Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA. · CoBTeK, Research Memory Center CMRR CHU, University of Sophia Antipolis, Nice, France. ·J Geriatr Psychiatry Neurol · Pubmed #25809634.

ABSTRACT: Apathy is a common feature of neurodegenerative disorders but is difficult to study in a clinical trial setting due to practical and conceptual barriers. Principal challenges include a paucity of data regarding apathy in these disorders, an absence of established diagnostic criteria, the presence of confounding factors (eg, coexisting depression), use of concomitant medications, and an absence of a gold-standard apathy assessment scale. Based on a literature search and ongoing collaboration among the authors, we present recommendations for the design of future clinical trials of apathy, suggesting Alzheimer disease and Parkinson disease as models with relevance across a wider array of neuropsychiatric disorders. Recommendations address clarification of the targeted study population (apathy diagnosis and severity at baseline), confounding factors (mood/cognition, behavior, and treatment), outcome measures, study duration, use of comparators and considerations around environment, and the role of the caregiver and patient assent. This review contributes to the search for an optimal approach to study treatment of apathy in neuropsychiatric disorders.

18 Review Pimavanserin for the treatment of Parkinson's disease psychosis. 2013

Friedman, Joseph H. ·Movement Disorders Program, Butler Hospital , 345 Blackstone Blvd, Providence, RI 02906 , USA. ·Expert Opin Pharmacother · Pubmed #24016069.

ABSTRACT: INTRODUCTION: Parkinson's disease (PD) is a neurobehavioral disorder defined by its motor features. Its treatment is frequently complicated by the presence of psychotic symptoms, most prominently hallucinations and delusions. These cause major distress and are the primary cause for nursing home placement. Current treatment requires either a reduction in medications for mobility or the addition of atypical antipsychotics, none of which are approved in the United States, and which are associated with major potential drawbacks. AREAS COVERED: Information from extensive personal experience, a Pubmed literature search plus a direct request to Acadia Pharmaceuticals was used for this review. A brief review of the clinical problem and its current state of treatment will be followed by a discussion of pimavanserin and its potential role in treating PD psychosis (PDP). Several observations have implicated serotonin in the physiology of psychotic symptoms. Lysergic acid diethylamide, phencyclidine, and similar drugs that activate 5HT2A serotonin receptors produce psychotic syndromes, and almost all antipsychotic neuroleptics share the property of blocking the 5HT2A receptor as well as the dopamine D2 receptor. The reduced motor side effects of the second-generation antipsychotics have been ascribed to these drugs having greater 5HT2A antagonism than the first generation. Studies in animal models of psychosis have suggested benefits from drugs blocking the 5HT2A receptor alone without the motor side effects seen with D2 receptor antagonism. EXPERT OPINION: Pimavanserin, a 5HT2A inverse agonist, has no motor side effects, and a remarkable safety profile that is comparable to placebo. Its antipsychotic effects coupled with its lack of motor side effects could make it an ideal drug for treating psychotic symptoms in PD, a major unmet need. One Phase III trial in PDP has demonstrated excellent tolerability and significant benefit. The FDA agreed to the filing of a planned new drug approval (NDA) for an indication in the treatment of PDP.

19 Review Parkinson disease psychosis: Update. 2013

Friedman, J H. ·Movement Disorders Program, Butler Hospital, Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA. Tel.: +1 401 455 6669; Fax: +1 401 455 6670; E-mail: Joseph_Friedman@Brown.edu. ·Behav Neurol · Pubmed #23242358.

ABSTRACT: Psychotic symptoms are common in drug treated patients with Parkinson's disease (PD). Visual hallucinations occur in about 30% and delusions, typically paranoid in nature, occur in about 5%. These problems, particularly the delusions, cause great distress for patient and caregivers, and are among the most important precipitants for nursing home placement. Psychotic symptoms carry a poor prognosis. They often herald dementia, and are associated with increased mortality. These symptoms often abate with medication reductions, but this may not be tolerated due to worsened motor function. Only clozapine has level A evidence to support its use in PD patients with psychosis (PDP), whether demented or not. While quetiapine has been recommended by the American Academy of Neurology for "consideration," double blind placebo controlled trials have demonstrated safety but not efficacy. Other antipsychotic drugs have been reported to worsen motor function and data on the effectiveness of cholinesterase inhibitors is limited. PDP remains a serious problem with limited treatment options.

20 Review Atypical antipsychotic drugs in the treatment of Parkinson's disease. 2011

Friedman, Joseph H. ·Department of Neurology, Movement Disorders Program, Butler Hospital, Alpert Medical School of Brown University, Providence, RI 02906, USA. joseph_friedman@brown.edu ·J Pharm Pract · Pubmed #22095576.

ABSTRACT: Parkinson's disease (PD) patients often develop psychotic symptoms that severely affect quality of life and limit the use of medications to ameliorate motor symptoms. Psychotic symptoms are a major cause for nursing home placement. While these symptoms do not always require treatment, they often do but antipsychotic drugs all share the common pharmacological mechanism of blocking dopamine D2 receptors which may worsen motor problems in this very vulnerable population. Double blind, placebo controlled trials (DBPCT) have shown that clozapine is effective at controlling the psychotic symptoms at doses far below those used in schizophrenia, without worsening motor function, even improving tremor. DBPCT have demonstrated that olanzapine worsens motor function without improving psychosis. Quetiapine has been shown in DBPCT to be free of motor side effects in PD patients but not effective, whereas many open label studies have indicated that quetiapine is effective. The other atypical have been the subjects of conflicting open label reports. The effects of the atypicals in PD psychosis is reviewed.

21 Review Fatigue in Parkinson's disease. 2011

Friedman, Joseph H / Abrantes, Ana / Sweet, Lawrence H. ·Movement Disorders Program, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA. joseph_friedman@brown.edu ·Expert Opin Pharmacother · Pubmed #21635199.

ABSTRACT: INTRODUCTION: Non-motor symptoms of Parkinson's disease (PD) have become increasingly recognized as central to the disease. These include somatic symptoms, such as pain and autonomic dysfunction (bladder dysfunction, constipation, dipahoresis and orthostatic hypotension) and behavioral problems, such as dementia, depression, fatigue, sleep disorders and psychosis. Research on fatigue has focused on its epidemiology with only a single report of a beneficial treatment trial, which used methylphenidate. AREAS COVERED: This review was made of all articles related to fatigue in Parkinson's disease arising in PUBMED. It will cover the types of fatigue, epidemiology, pathophysiology and treatment of fatigue in PD. EXPERT OPINION: Fatigue is a common and severe problem in Parkinson's disease. Virtually nothing is known about it aside from its epidemiology. It is an area greatly in need of investigation.

22 Review Management of the hospitalized patient with Parkinson's disease: current state of the field and need for guidelines. 2011

Aminoff, Michael J / Christine, Chad W / Friedman, Joseph H / Chou, Kelvin L / Lyons, Kelly E / Pahwa, Rajesh / Bloem, Bastian R / Parashos, Sotirios A / Price, Catherine C / Malaty, Irene A / Iansek, Robert / Bodis-Wollner, Ivan / Suchowersky, Oksana / Oertel, Wolfgang H / Zamudio, Jorge / Oberdorf, Joyce / Schmidt, Peter / Okun, Michael S / Anonymous4860681. ·National Parkinson Foundation Center of Excellence, University of California San Francisco, Neurology Department, CA, USA. ·Parkinsonism Relat Disord · Pubmed #21159538.

ABSTRACT: OBJECTIVE: To review the literature and to identify practice gaps in the management of the hospitalized Parkinson's disease (PD) patient. BACKGROUND: Patients with PD are admitted to hospitals at higher rates, and frequently have longer hospital stays than the general population. Little is known about outpatient interventions that might reduce the need for hospitalization and also reduce hospital-related complications. METHODS: A literature review was performed on PubMed about hospitalization and PD between 1970 and 2010. In addition, in press peer-reviewed papers or published abstracts known to the authors were included. Information was reviewed by a National Parkinson Foundation workgroup and a narrative review article was generated. RESULTS: Motor disturbances in PD are believed to be a causal factor in the higher rates of admissions and complications. However, other conditions are commonly recorded as the primary reason for hospitalization including motor complications, reduced mobility, lack of compliance, inappropriate use of neuroleptics, falls, fractures, pneumonia, and other important medical problems. There are many relevant issues related to hospitalization in PD. Medications, dosages and specific dosage schedules are critical. Staff training regarding medications and medication management may help to avoid complications, particularly those related to reduced mobility, and aspiration pneumonia. Treatment of infections and a return to early mobility is also critical to management. CONCLUSIONS: Educational programs, recommendations, and guidelines are needed to better train interdisciplinary teams in the management of the PD patient. These initiatives have the potential for both cost savings and improved outcomes from a preventative and a hospital management standpoint.

23 Review Parkinson's disease psychosis 2010: a review article. 2010

Friedman, Joseph H. ·Dept of Neurology, Alpert Medical School of Brown University, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906, USA. Joseph_Friedman@brown.edu ·Parkinsonism Relat Disord · Pubmed #20538500.

ABSTRACT: Psychotic symptoms are common in Parkinson's disease (PD), generally associated with the medications used to treat the motor symptoms. On rare occasion they occur in patients not taking medication for PD. Psychotic symptoms are usually hallucinations, typically visual, less commonly auditory, and rarely in other domains. Hallucinations are generally stereotyped and without emotional content. Initially patients usually have insight so that the hallucinations are benign in terms of their immediate impact but have poor prognostic implications, with increased risk of dementia, worsened psychotic symptoms and mortality. Delusions occur in about 5-10% of drug treated patients and are considerably more disruptive, being paranoid in nature, often of spousal infidelity or abandonment by family. Treatment of Parkinson's disease psychosis (PDP) focuses on reducing the psychiatric symptom load while balancing the competing problem of mobility. Contributors to the psychotic symptoms should be searched for, such as systemic illness and other psycho-active medications. If none are identified or can be eliminated then the PD medications should be reduced to the lowest levels that allow tolerable motor function. Once this level has been reached there are two schools of thought on treatment, using either acetylcholinesterase inhibitors or atypical anti-psychotics. Only clozapine has level I evidence to support its use. Quetiapine is the only other anti-psychotic free of motor side effects, but it has failed double blind placebo controlled trials to demonstrate efficacy.

24 Review Fatigue rating scales critique and recommendations by the Movement Disorders Society task force on rating scales for Parkinson's disease. 2010

Friedman, Joseph H / Alves, Guido / Hagell, Peter / Marinus, Johan / Marsh, Laura / Martinez-Martin, Pablo / Goetz, Christopher G / Poewe, Werner / Rascol, Olivier / Sampaio, Cristina / Stebbins, Glenn / Schrag, Anette. ·NeuroHealth, Parkinson's Disease and Movement Disorders Center, Warwick, Rhode Island 02886, USA. joseph_friedman@brown.edu ·Mov Disord · Pubmed #20461797.

ABSTRACT: Fatigue has been shown to be a consistent and common problem in Parkinson's disease (PD) in multiple countries and cultures. It is one of the most disabling of all symptoms, including motor dysfunction, and appears early, often predating the onset of motor symptoms. Several studies of the epidemiology of fatigue have been published, often using different scales, but few on treatment. The Movement Disorder Society (MDS) commissioned a task force to assess available clinical rating scales, critique their psychometric properties, summarize their clinical properties, and evaluate the evidence in support of their use in clinical studies in PD. Six clinical researchers reviewed all studies published in peer reviewed journals of fatigue in PD, evaluated the scales' previous use, performance parameters, and quality of validation data, if available. Scales were rated according to criteria provided by the MDS. A scale was "recommended" if it has been used in clinical studies beyond the group that developed it, has been used in PD and psychometric studies have established that it is a valid, reliable and sensitive to change in people with PD. Requiring a scale to have demonstrated sensitivity to change in PD specifically rather than in other areas in order to attain a rating of "recommended" differs from the use of this term in previous MDS task force scale reviews. "Suggested" scales failed to meet all the criteria of a "recommended" scale, usually the criterion of sensitivity to change in a study of PD. Scales were "listed" if they had been used in PD studies but had little or no psychometric data to assess. Some scales could be used both to screen for fatigue as well as to assess fatigue severity, but some were only used to assess severity. The Fatigue Severity Scale was "recommended" for both screening and severity rating. The Fatigue Assessment Inventory, an expanded version of the Fatigue severity Scale, is "suggested" for both screening and severity. The Functional Assessment of Chronic Illness Therapy-Fatigue was "recommended" for screening and "suggested" for severity. The Multidimensional Fatigue Inventory was "suggested" for screening and "recommended" for severity. The Parkinson Fatigue Scale was "recommended" for screening and "suggested" for severity rating. The Fatigue Severity Inventory was "listed" for both screening and severity. The Fatigue Impact Scale for Daily Use, an adaptation of the Fatigue Impact Scale was "listed" for screening and "suggested" for severity. Visual Analogue and Global Impression Scales are both "listed" for screening and severity. The committee concluded that current scales are adequate for fatigue studies in PD but that studies on sensitivity and specificity of the scales are still needed.

25 Review Sleep disturbances and Parkinson's disease. 2008

Friedman, Joseph H / Millman, Richard P. ·Neuro Health Parkinson's Disease and Movement Disorders, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. joseph_friedman@Brown.edu ·CNS Spectr · Pubmed #18323762.

ABSTRACT: Although Parkinson's disease is defined by its motor symptoms, the symptoms that are most devastating to patients and caregivers are dementia and psychosis. In addition, sleep has a tremendous impact on patient well being and quality of life. Eighty percent to 90% of Parkinson's disease patients have a sleep disorder affecting their ability to fall asleep, ability to stay asleep, dreams, motor activity during sleep, post-sleep behavior, or daytime somnolence. Treatment plans for patients with Parkinson's disease who experience sleep disorders aim to improve nighttime sleep or daytime wakefulness, and treatment options vary by sleep disorder.