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Biomedical subjects

Lisa M Shulman

Publications and source records attributed to Lisa M Shulman.

8 recordsLinked to original sources
PubMed2006

Subjective report versus objective measurement of activities of daily living in Parkinson's disease.

We compared subjective self-reports with objective performance ratings of activities of daily living (ADLs) and instrumental ADLs (IADLs) in patients with Parkinson's disease (PD) and identified variables associated with discordance of ratings between these two methods. Seventy-six PD patients completed a modified Older Americans Resources and Services scale, assessing ADLs and IADLs. These results were compared with structured performance tests of walking, eating, dressing, money, and medicine management administered in the clinic. Patient performance was rated on a five-point Likert-type scale, ranging from 1 = no difficulty to 5 = completely unable to perform task. Significant differences were found between patients and clinicians' ratings on all tasks except walking. On the other four tasks, paired group t tests showed that patients reported better function compared with the clinician rating of medication management (1.33 vs. 2.80), eating (1.53 vs. 1.76), dressing (1.64 vs. 1.86), and managing money (1.44 vs. 2.06). A discrepancy was found between patients subjective reporting of ADL and IADL function and objective ratings. Patients overestimated their function on four of five tasks. Further study is necessary to identify whether subjective or objective performance ratings are more reflective of actual daily function.

Activities of Daily Living↗
PubMed2006

Gender disparities in Parkinson's disease.

Parkinson's disease is a chronic neurodegenerative disorder of unknown etiology. There are sparse data on gender differences in this disorder, but it is clear that there are gender discrepancies in incidence, symptoms, medication effects and treatments. There also appear to be lifecycle fluctuations in the disease course of female Parkinson's disease patients. The effect of estrogen in this disorder is multifold and its role in the development and treatment of PD will be discussed.

Estrogens↗
PubMed2003

Acupuncture in clinical neurology.

BACKGROUND: A majority of people in the United States use alternative or complementary therapy at some point in their lives, and acupuncture is among the most frequently used modalities. Many United States medical schools offer courses in alternative medicine, and a growing number of insurers offer coverage for alternative therapies. This paper critically reviews our current knowledge about the safety and efficacy of acupuncture for neurologic conditions. REVIEW SUMMARY: Acupuncture is a safe procedure when performed by trained professionals. Complications from acupuncture are rare and mainly related to negligence of sterile technique. Studies of the therapeutic value of acupuncture are fraught with challenging methodologic problems, including the choice of a placebo, a suitable control treatment, and the technique of stimulation applied. Clinical trials of the use of acupuncture for pain syndromes (headache, neck, and back pain), stroke rehabilitation, Parkinson's disease, multiple sclerosis, and substance abuse are reviewed. CONCLUSIONS: Based on the current literature, no definitive recommendation can be made regarding the efficacy of acupuncture for common pain syndromes including headache, and neck and back pain. Better quality clinical trials fail to demonstrate efficacy for the use of acupuncture as part of a rehabilitation program following stroke or as a treatment for drug addiction. Acupuncture may have a role in the treatment of sleep disturbance associated with Parkinson's disease but was not efficacious for the primary symptoms of either Parkinson's disease or multiple sclerosis. In light of increasing public interest and use of alternative therapies, this review may be helpful in promoting more discussion between patients and physicians about the use of acupuncture.

Acupuncture Therapy↗
PubMed2003

From fruit fly to bedside: translating lessons from Drosophila models of neurodegenerative disease.

PURPOSE OF REVIEW: Fly models have been developed for a variety of neurodegenerative disorders, and the field is beginning to harness the power of Drosophila genetics to dissect pathways of disease pathogenesis and identify targets for therapeutic intervention. In this review, we emphasize the most recent accomplishments and chart the potential rewards in translating lessons from Drosophila models to clinical therapeutics. RECENT FINDINGS: The conservation of human disease genes in the Drosophila genome forms the basis for several recent investigations of the normal biological functions of genes implicated in neurodegenerative disease. In addition, transgenic approaches continue to expand the list of diseases modeled in Drosophila that now includes Parkinson's disease, Alzheimer's disease, Huntington's disease, and several spinocerebellar ataxias. Studies based on these models suggest that protein folding and degradation pathways play an important role in Parkinson's disease and the polyglutamine repeat disorders, and that kinases and apoptotic pathways may modulate neurodegeneration in tauopathies. SUMMARY: Ongoing genetic studies with Drosophila neurodegenerative disease models promise to enhance our understanding of disease pathogenesis and generate target lists for future investigational research and drug development. The next challenge will be distilling a growing number of possible targets into a shortlist for fast-track drug design and clinical trials. With the advent of neurodegenerative disease models, the fruit fly is rapidly assuming a unique niche in bench to bedside research.

Amyloid beta-Protein Precursor↗
PubMed2002

Acupuncture therapy for the symptoms of Parkinson's disease.

Interest in alternative medical treatments, including acupuncture, is increasing. Alternative treatments must be subjected to the same objective standards as all medical treatments. A non-blinded pilot study of the safety, tolerability, and efficacy of acupuncture (ACUPX) for the symptoms of (PD) was performed. Twenty PD patients (mean age, 68 years; disease duration, 8.5 years; Hoehn and Yahr [H&Y] stage, 2.2; Unified Parkinson's Disease Rating Scale score [UPDRS], 38.7) each received acupuncture treatments by a licensed acupuncturist. All patients were treated with two acupuncture treatment sessions per week. The first seven patients received 10 treatments and the last 13 patients 16 treatments. Patients were evaluated before and after ACUPX with the Sickness Impact Profile (SIP); UPDRS; H & Y; Schwab and England (S & E); Beck Anxiety Inventory (BAI); Beck Depression Inventory (BDI); quantitative motor tests, including timed evaluations of arm pronation supination movements, finger dexterity, finger movements between two fixed measured points, and the stand-walk-sit test; and a patient questionnaire designed for the study. Following ACUPX, there were no significant changes in the UPDRS, H&Y, S&E, BAI, BDI, quantitative motor tests, total SIP or the two SIP Dimension scores. Analysis of the 12 SIP categories not corrected for multiple comparisons revealed a post-ACUPX improvement in the sleep and rest category only (P = 0.03). On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety. There were no adverse effects. ACUPX therapy is safe and well tolerated in PD patients. A range of PD and behavioral scales failed to show improvement following ACUPX other than sleep benefit, although patients reported other discrete symptomatic improvements. A broad battery of tests in PD patients suggested that ACUPX resulted in improvement of sleep and rest only. This finding needs to be verified using more in-depth and controlled evaluation of ACUPX for PD-related sleep disturbance.

Activities of Daily Living↗
PubMed2002

Is there a connection between estrogen and Parkinson's disease?

Increasing evidence suggests that estrogens may protect the nigrostriatal dopaminergic pathway affected in Parkinson's disease (PD). Animal studies show that estrogens influence the synthesis, release, and metabolism of dopamine and can modulate dopamine receptor expression and function. Some clinical studies suggest that PD symptoms may be exacerbated after menopause and delayed or alleviated with hormone replacement therapy, but others have failed to observe positive estrogenic effects. The conflicting findings suggest that several variables, including age, estrogen dose and formulation, and timing and length of dosing period, may determine whether benefits are seen and the nature of these benefits. Further investigation is therefore needed for the relationship between estrogens and the nigrostriatal dopaminergic system.

Estrogen Replacement Therapy↗