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Biomedical subjects

Jose Martin Rabey

Publications and source records attributed to Jose Martin Rabey.

7 recordsLinked to original sources
PubMed2006

Excessive daytime sleepiness in patients with Parkinson's disease: a polysomnography study.

To investigate excessive daytime sleepiness (EDS) in patients with Parkinson's disease (PD), the reasons for which have not yet been clarified, polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT) were performed in 46 patients with PD, and, in addition, PSG was performed in 30 healthy controls. Assessment included Epworth Sleepiness Score (ESS), Mini-Mental State Examination (MMSE), and Hamilton Test (HT) for depression. Fifty percent of PD patients reported EDS (ESS, 10 +/- 4.5 vs. 6.9 +/- 3.7; P = 0.01). Compared with controls, PD patients as a group had lower sleep efficiency (65 +/- 22 vs. 77 +/- 14; P = 0.03), a longer Stage 2 (73 +/- 12 vs. 67 +/- 12; P = 0.03), and a shorter rapid eye movement stage (8 +/- 8 vs. 17 +/- 8; P < 0.001). Clinical data and sleep characteristics were similar in PD with/without EDS. Of interest, patients treated with clonazepam (CLNZ) had lower EDS than those without CLNZ (ESS, 7.9 +/- 4.7 vs. 11.3 +/- 4.0; P = 0.03). These patients suffered less periodic leg movement during sleep (2.1 +/- 2.7 vs. 12.4 +/- 28; P = 0.04), which might explain the finding. No correlation was found between ESS, MSLT, and all other clinical features analyzed. In PD patients, according to the data obtained, severity of EDS does not depend on any specific clinical factor and the etiology is probably multifactorial. Paradoxically, PD patients treated with CLNZ were less sleepy than patients not treated with CLNZ.

Aged↗
PubMed2006

Palpitations: could they be neurogenic? A case report.

BACKGROUND: Palpitations usually occur in patients with arrhythmias of cardiac origion, in conditions associated with increased catecholamine levels, and in psychiatric disorders. A rare etiology of palpitations is seizures with autonomic features. REVIEW SUMMARY: We report a 24-year-old man with a several-week history of episodic palpitations, weakness, dizziness, and presyncopal phenomena. Subsequent events included loss of consciousness, with postevent confusion and tonic movements. A low-grade astrocytoma was diagnosed in the right frontal lobe. CONCLUSION: This case emphasizes the importance of detailed history in the diagnosis of epilepsy.

Adult↗
PubMed2003

Anxiety in the first attack of vertigo.

BACKGROUND: Although psychiatric disturbances have been reported in chronic vestibular disorders, little is known about the psychological impact of an acute vertigo attack. METHODS: We conducted a comparative questionnaire study in 30 patients with a first attack of vestibular dysfunction and in 35 patients with a nonvestibular neurologic deficit of acute onset. RESULTS: Patients with vertigo reported more anxiety than patients with nonvestibular neurologic deficits (P = 0.002), despite the fact that premorbid anxiety was similar in both groups (P = 0.5). No difference in anxiety levels was found between vertigo patients who vomited and those who were free of vegetative symptoms (P = 0.97). Vertigo patients felt more disabled than nonvertigo patients (P = 0.06), irrespective of the objective restrictions caused by the disease. The rate of depression did not differ between the groups of patients (P = 0.09). CONCLUSION: Patients with acute vertigo experience extreme anxiety, and this contributes to their feeling of disproportionate disability. The reason for emotional disturbances in vestibular dysfunction is probably the result of physiological connections between the vestibular and limbic system and deserves further neuroanatomic investigation.

Acute Disease↗
PubMed2002

H reflex threshold in Parkinson's disease patients for different stimulus duration.

Electrical stimulus, with duration starting at 0.1 ms and gradually increased to 1.0 ms, was used for eliciting the H reflex in 14 normal subjects and 19 patients with Parkinson's disease (PD). In 71.1% of normal subjects and in 13.2% of PD patients the H reflex to M response threshold ratio (H/M TR) was <1 and the H reflex was obtained before the M response for all duration stimuli. For all stimulus durations a significant difference between the H/M TR in normal subjects and PD patients was found (t test 0.002-0.007). The duration effect was found to be highly significant-H/M TR for short stimulus duration was greater than for long stimulus durations (p<0.001). The optimal stimulus duration for evaluating H reflex behavior in PD patient was 0.2 ms. These very significant differences in behavior of the H reflex in PD patients could be used as another parameter in the assessment of extrapyramidal rigidity in PD patients.

Adult↗
PubMedDate not supplied

Activity-based diary for Parkinson's disease.

The objective of this study was to develop a Parkinson's disease diary that evaluates a patient's difficulties in performing activities as a substitute for the amount of "on"- and "off"-time and to assess its clinimetric qualities. In this study, 84 patients with Parkinson's disease kept a diary for 2 or 3 periods of 5 days. Daily, five items were recorded across 11 time periods. Patients simultaneously recorded "on-off" in the traditional way. The diary was easily understood, and median recording time was 5-10 minutes a day. Clinimetric analysis showed that the diary could be reduced successfully to 3 days, in which five items (walking, transfers, manual activities, dyskinesias, and sleep) with four response options (no, slight, moderate, and severe difficulty) were assessed seven times daily. Sumscores of the first three items accurately predicted being "on" or "off" in 93% of the cases, making separate scoring of "on" and "off" unnecessary. The diary was internally consistent and showed good reproducibility. Construct validity with external measures was adequate, and comparisons between patients grouped by disease severity and by degree of fluctuations revealed significant differences in the expected directions. Taken together, this Parkinson's disease diary has a sound clinimetric basis, provides information on the extent of perceived disability, and thereby accurately reflects the severity of "off"-periods and the variability of motor fluctuations.

Activities of Daily Living↗
PubMedDate not supplied

Comparison of the Unified Parkinson's Disease Rating Scale and the Short Parkinson's Evaluation Scale in patients with Parkinson's disease after levodopa loading.

The Short Parkinson's Evaluation Scale has been compiled and validated previously (Clinical Neuropharmacology, 1997). In the present study, we have assessed and compared the motor scoring of the Unified Parkinson's Disease Rating Scale and the Short Parkinson's Evaluation Scale in 23 patients (mean age, 61.8 years) with Parkinson's disease. Patients were 12 hours off medication at the beginning of the series. They were then given levodopa, 125 mg and 250 mg, on different days and were evaluated each 30 minutes for 2 hours. In addition, patients' motor skills (finger tapping and walking velocity) were measured at each time. Analysis of variance with repeated measures was applied. The results presented show that both scales have the same ability to measure levodopa-dose effect within time. In addition, Spearman's correlation coefficients showed a negative correlation between finger tapping and upper-limb impairment and a positive correlation between walking velocity and lower-limb impairment in both scales. In summary, the present results suggest that Short Parkinson's Evaluation Scale is a useful tool in assessing the effect of medication, having the advantage of being easier and quicker.

Aged↗