This article summarizes the current studies on the pathological mechanism of Parkinson's disease as well as the advance in studies traditional Chinese medicine (TCM) experiments in prevention and treatment of Parkinson's disease in the latest decade in terms of prevention and treatment of PD by TCM, inhibition of oxidative stress, improving mitochondrial energy metabolism, inhibition of neural immune and inflammatory responses, reduction of neural toxicity, inhibition of apoptosis and abnormal protein aggregation.
Animals ; Apoptosis ; drug effects ; Humans ; Medicine, Chinese Traditional ; Oxidative Stress ; drug effects ; Parkinson Disease ; drug therapy ; etiology ; pathology ; prevention & control

OBJECTIVE: To determine the effect of Parkinson's disease-weight bearing exercise for better balance (PD-WEBB) exercise on balance impairment and falls in people with Parkinson's disease (PD). METHODS: A single-blind, randomized controlled clinical trial was conducted. The falls efficacy scale score, unified Parkinson disease rating scale (UPDRS) score and Mini-BESTest score were measured and compared between a PD-WEBB group and a control group. RESULTS: The falls efficacy scale score, UPDRS-2 score, UPDRS-3 score and Mini-BESTest score were improved in the PD-WEBB group compared with the control group (P<0.05), with no significant change in UPDRS-1 score between the two groups. CONCLUSION PD-WEBB training can significantly improve the balance impairment and quality of life to prevent falls. PD-WEBB training is suitable for PD patients in China, and is a reasonable, effective and sustainable training of family and community assessment model.
Accidental Falls ; prevention & control ; China ; Humans ; Parkinson Disease ; therapy ; Postural Balance ; Quality of Life ; Resistance Training ; Single-Blind Method

PURPOSE: This study was done to identify the risk factors associated with falls among patients with Parkinson's Disease(PD). METHOD: A retrospective study design was used through the collection of physiological and physical health, and psychosocial functions. RESULTS: Of the 100 participants, fifty-nine(59%) reported one or more falls and seventy-one(71%) reported one or more near-falls. Anaverage 34.7 falls and 150.3 near-falls were reported in the previous year per person. Stage of PD, foot problems, balance, fear of falling, and activities of daily living were significantly associated with an increased risk of falls. CONCLUSION: The findings confirm the high risk of falling in PD patients. Also these results have implications for developing fall prevention programs for PD patients.
*Accidental Falls/prevention & control ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/*complications/physiopathology ; Postural Balance ; Risk Factors

We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery. We isolated single unit activities from the left and the right side MERs. There was no significant difference in the mean firing rate between the left side MERs (38.7+/-16.8 spikes/sec, n=78) and the right side MERs (35.5+/-17.2 spikes/sec, n=66). The bursting pattern of spikes was more frequently observed in the right STN than in the left STN. All the electrode positions were within the STNs on both sides and the off-time Unified Parkinson's Disease Rating Scale part III scores at six months after surgery decreased by 67% of the preoperative level. In this study, a continuous infusion of propofol and fentanyl did not significantly interfere with the MER signals from the STN. The results of this study suggest that propofol and fentanyl can be used for STN DBS in patients with advanced Parkinson's disease improving the overall experience of the patients.
Aged ; Anesthetics, Intravenous/*pharmacology ; *Deep Brain Stimulation ; Electrodes, Implanted ; Female ; Fentanyl/*pharmacology ; Humans ; Magnetic Resonance Imaging ; Male ; Microelectrodes ; Middle Aged ; Parkinson Disease/*prevention & control ; Propofol/*pharmacology ; Severity of Illness Index ; Subthalamic Nucleus/*drug effects/physiology ; Tomography, X-Ray Computed

In order to observe neuronal toxical effect of Levodopa and investigate if using Levodopa together with Ginkgo Bilobar Extract (EGb) would be an workable method to treat Parkinson disease, rat models of Parkinson disease (PD) were made by injecting 6-OHDA stereotaxically to right side of the mesencephic ventral tegmental area (VTA) and substantia nigra pars compacta (SNc). Rotational behavioral observation, TUNEL, immunocytochemistry, Nissl's body staining were performed to measure the difference between group treated by Levodopa (50 mg/kg every day for 3 days, 5 days, 7 days, L-dopa group) and group treated by Levodopa combined with EGb (100 mg/kg every day, E-D group). The results showed that in the L-dopa group, the numbers of apoptosis of substantial nigra, rings of rotational behavior were more than those in the E-D group (P < 0.05). The numbers of Nissl's cells in L-dopa group were fewer than in E-D group (P < 0.05). The results suggested that Levodopa had neur toxic effect and EGb may decrease the toxicity of levodopa. The combined use of EGb with Levodopa may be a workable method to treat PD and may be better than using Levodopa alone.
Animals ; Apoptosis ; drug effects ; Dihydroxyphenylalanine ; metabolism ; Drug Interactions ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ginkgo biloba ; Levodopa ; pharmacology ; therapeutic use ; toxicity ; Male ; Neurons ; drug effects ; Oxidopamine ; Parkinson Disease ; metabolism ; pathology ; prevention & control ; Random Allocation ; Rats ; Rats, Wistar ; Substantia Nigra ; pathology

OBJECTIVETo observe the effect of TCM treatment according to syndrome differentiation in en-hancing curative effect and reducing side-effect of madopa in patients with Parkinson' s disease (PD).

METHODSThe trial was conducted in 101 PD patients with a prospective stratified randomized and controlled method. They were assigned to group 1 in which the patients of rigidity were treated with Pabing Recipe 1 (PR1) plus Madopa tablets, group 2 with those of tremor given Pabing Recipe 3 (PR3) plus Madopa tablets, and group 3 given a fixed Chinese recipe plus Madopa tablets as the control. The treatment course for all the groups was 3 months. Clinical efficacy was evaluated with unified Parkinson's disease rating scale (UPDRS) and the adverse reactions observed before and after treatment.

RESULTSAfter treatment, the 4 partial scores and the total score of UPDRS decreased significantly in group 2 (P<0.01), and the former of them and the total score declined in group 1 and 3 (P<0.01), the improvement was better in group 1 and 2 than that in group 3 (P<0.01); the improvement rate in group 1 to 3 was 95.5%, 100.0% and 83.7%, respectively, which was significantly higher in group 1 and 2 than that in group 3 (P<0.05).

CONCLUSIONTCM treatment according to syndrome differentiation could improve the clinical symptoms and reduce complications in PD patients, which could enhance curative effect and reduce side-effect of madopa.

Aged ; Aged, 80 and over ; Benserazide ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Dopamine Agents ; adverse effects ; therapeutic use ; Drug Combinations ; Drug Synergism ; Drug Therapy, Combination ; Drug-Related Side Effects and Adverse Reactions ; etiology ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Levodopa ; adverse effects ; therapeutic use ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Parkinson Disease ; diagnosis ; drug therapy ; Phytotherapy ; Prospective Studies ; Syndrome ; Treatment Outcome

AIMTo investigate the role of ginsenoside Rg1 in preventing against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced apoptosis of the substantia nigra neurons in the mouse model of Parkinson's disease (PD).

METHODSC57B1 male mice were given MPTP i.p. in the PD model group. Different doses of ginsenoside Rg1 (2.5, 5.0 and 10.0 mg.kg-1) were given i.p. 3 days prior to MPTP in the pretreatment group. Nissl staining, tyrosine hydroxylase (TH) immunostaining and TdT-mediated duTP nick-end labeling (TUNEL) staining were used to observe the damage of nigral neurons. The method of immunostaining was used to detect the caspase-3 activity, expression of inducible nitric oxide synthase (iNOS) and neuronal nitric oxide synthase (nNOS).

RESULTSPretreatment with ginsenoside Rg1 was shown to prevent the loss of Nissl staining neurons and TH-positive neurons, and decrease the percent of TUNEL-positive. Simultaneously, Rg1 was found to reduce caspase-3 activity and the expression of iNOS.

CONCLUSIONGinsenoside Rg1 showed protective effect on MPTP-induced apoptosis in the mouse nigral neurons and this effect may be attributable to reducing the expression of iNOS and inhibiting the activation of caspase-3.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Apoptosis ; Caspase 3 ; Caspases ; metabolism ; Ginsenosides ; pharmacology ; therapeutic use ; Male ; Mice ; Mice, Inbred C57BL ; Neurons ; drug effects ; pathology ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Nitric Oxide Synthase ; metabolism ; Nitric Oxide Synthase Type I ; Parkinson Disease, Secondary ; chemically induced ; metabolism ; pathology ; prevention & control ; Random Allocation ; Substantia Nigra ; pathology

The protective effect of puerarin on the Parkinson disease (PD) mice with decreased estrogen level was investigated in order to develop a new potential medicine as a substitute for estrogen for preventing and treating PD. By using immunohistochemical method of avidinbiotin peroxidase complex (ABC), the distribution of the cells positive for tyrosine hydroxylase (TH) and fibres in the substantia nigra of the mouse were observed. These mice were divided into three groups randomly: group A, normal-female-mouse models; group B containing three subgroups, B1 (normal saline), B2 (estrogen), B3 (puerarin); group C containing three sub groups, C1 (normal saline), C2 (estrogen), C3 (puerarin). By using TUNEL the numbers of apoptosis cells in every visual field was counted and the difference between the experimental group and control group was compared. The results showed the numbers of the cells positive for TH were more and the numbers of apoptosis cells were less in the normal-female-mouse models group than in the group of model made after ovariosteresis and the group of model made before ovariosteresis (P < 0.05), respectively. However, there was no significant difference, between the group given estrogen/puerarin and the controls, and between the group given estrogen and given puerarin. (P > 0.05). It was suggested that puerarin may have protective effect on the nigral neurons to PD. Moreover, the protective effect might serve as a surrogate of estrogen and be associated with the apoptosis.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Apoptosis ; Estrogens ; blood ; pharmacology ; Female ; Isoflavones ; chemistry ; pharmacology ; Mice ; Mice, Inbred BALB C ; Ovariectomy ; Parkinson Disease ; blood ; prevention & control ; Phytoestrogens ; Plant Preparations ; pharmacology ; Random Allocation ; Substantia Nigra ; metabolism ; Tyrosine 3-Monooxygenase ; metabolism ; Vasodilator Agents ; chemistry ; pharmacology

OBJECTIVETo discuss the protective effect of alkaloids from Piper longum (PLA) in rat dopaminergic neuron injury of 6-OHDA-induced Parkinson's disease and its possible mechanism.

METHODThe rat PD model was established by injecting 6-OHDA into the unilateral striatum with a brain solid positioner. The PD rats were divided into the PLA group (50 mg x kg(-1) x d(-1)), the madorpa group (50 mg x kg(-1) x d(-1)) and the model group, with 15 rats in each group. All of the rats were orally given drugs once a day for 6 weeks. Meanwhile, other 15 rats were randomly selected as the sham operation group, and only injected with normal saline in the unilateral striatum. The behavioral changes were observed with the apomorphine (APO)-induced rotation and rotary rod tests. The number of tyrosine hydroxylase (TH)-positive cells in rat substantia nigra and the density of TH-positive fibers in striatum were detected by tyrosine hydroxylase immunohistochemistry. The content of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH), catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and nitric oxide synthase (NOS) in rat substantia nigra and striatum were measured by the spectrophotometric method.

RESULTAfter being induced by APO, PD rats showed obvious rotation behaviors, with decreased time stay on rotary rod and significant reduction in the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. The activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity significantly decreased, whereas the activities of NOS and the content of MDA, NO significantly increased. PLA could significantly improve the behavioral abnormality of PD rats and increase the number of TH-positive cells in sustantia nigra and the density of TH-positive fibers in striatum. It could up-regulate the activities of SOD, GSH-Px, CAT, the content of GSH and the total antioxidant capacity, and decrease the content of NOS and the content of MDA, NO.

CONCLUSIONAlkaloids from P. longum shows the protective effect in substantia nigra cells of 6-OHDA-induced PD model rats. Its mechanism may be related with their antioxidant activity.

Administration, Oral ; Alkaloids ; administration & dosage ; pharmacology ; Animals ; Apomorphine ; pharmacology ; Catalase ; metabolism ; Dopamine Agonists ; pharmacology ; Dopaminergic Neurons ; drug effects ; metabolism ; pathology ; Glutathione ; metabolism ; Glutathione Peroxidase ; metabolism ; Male ; Malondialdehyde ; metabolism ; Motor Activity ; drug effects ; Neostriatum ; drug effects ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Oxidopamine ; Parkinson Disease, Secondary ; chemically induced ; physiopathology ; prevention & control ; Piper ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Substantia Nigra ; drug effects ; metabolism ; Superoxide Dismutase ; metabolism ; Tyrosine 3-Monooxygenase ; metabolism