Abstract (paper published in International Journal of Neuroscience):
Int J Neurosci. 2009;119(12):2196-205.
Quetiapine improves visual hallucinations in Parkinson disease but not through normalization of sleep architecture: results from a double-blind clinical-polysomnography study.
Fernandez HH, Okun MS, Rodriguez RL, Malaty IA, Romrell J, Sun A, Wu SS, Pillarisetty S, Nyathappa A, Eisenschenk S.
Department of Neurology, College of Medicine, University of Florida, FL, USA.
Polysomnographic studies of Parkinson’s disease (PD) patients with visual hallucinations (VH) usually reveal short, fragmented rapid eye movement (REM) sleep, with lower sleep efficiency and reduced total REM sleep. Quetiapine has been demonstrated in open-label trials to be effective for the treatment of insomnia and VH in PD. To confirm quetiapine’s efficacy in improving VH, and to determine whether the mechanism was due to its effect on REM sleep architecture, we performed a pilot, double-blind, placebo-controlled study. Sixteen PD patients experiencing VH were recruited. Eight patients were randomized to quetiapine and eight patients to placebo. Patients underwent pre- and post-treatment polysomnography. The Clinical Global Impression Scale (CGIS), Brief Psychiatric Rating Scale (BPRS), and Unified Parkinson Disease Rating Scale (UPDRS) motor subscale were obtained. There were no differences in baseline characteristics between the treatment arms except that the placebo group had more sleep in stage REM (74.7 min vs. 40.1 min; p < .001). Data were imputed for all patients who prematurely discontinued (four quetiapine and one placebo) in an intention-to-treat analysis. The average quetiapine dose was 58.3 mg/day. While there was no significant difference in the change in REM duration pre- vs. post-treatment in either arm, patients randomized to quetiapine improved on the CGIS (p = .03) and the hallucination item of the BPRS (p = .02). No difference was noted in the UPDRS motor scores. Despite the small sample, this is the first double-blind trial to show quetiapine’s efficacy over placebo in controlling VH in the PD population. However, normalization of sleep architecture was not supported as the mechanism.
The American Academy of Neurology is asking you to create short films about a brain disorder that you or a loved one have. From the Neuro Film Festival site:
Make a film telling us your story, or the story of a loved one, affected by a brain disorder. Help us make the case for why more brain research is needed to find cures.
Check the rules and contribute! The deadline is February 16th, 2010.
Save the Date!
July 31st to August 7, 2010
Join us for a 7 day eastern Caribbean cruise on The Carnival Dream featuring members of the UF Movement Disorders interdisciplinary team. Ports include: Nassau, St. Thomas & St. Maarten
Presentations on dystonia and Parkinson’s disease will be offered during our days at sea. Golf and other excursions are available at the various ports. Everyone is welcome. Your 3rd and 4th guests sail for a reduced rate! To learn more about the dystonia cruise, click http://www.cecruisegroups.com/tylers_hope_cruise.html. To learn more about the Parkinson cruise, click http://www.cecruisegroups.com/parkinson_cruise_2010_carnival_dream.html.
For more information contact: Betty or Herb Tinley at 1-800-959-SHIP or herbtinley@aol.com. Reservations are required and space is limited
The Movement Disorders Society typically focuses on educating clinicians on these disorders. This year, however, they are branching out with their first patient education symposium and it was captured on video. The symposium was held at Beth Israel Deaconess Medical Center on October 2009 but is now available as a webcast. You can visit the Movement Disorders Society site where they have a new patient education section. Our own Dr. Fernandez is one of the two editors for the MDS website and is helping to broaden the educational material on it.
The UFMDC has started a Tourette Syndrome clinic dedicated to those patients. If you would like to be seen in this clinic or refer someone, please call (352) 273-5550 or use our web form.
The UF Movement Disorders Center is excited to welcome, belated though it may be, Tetsuo Ashizawa, MD and S.H. Subramony, MD to the Movement Disorders team. They bring an expertise in ataxia and in Huntington’s disease to the table and are holding special clinics for these disorders. In addition to their work with the Movement Disorders Center, Dr. Ashizawa chairs the Department of Neurology while Dr. Subramony directs the Neuromuscular division.
If you have either ataxia or Huntington’s and would like an appointment or if you would like to refer a patient with these disorders please feel free to contact us via our web form or by phone (352-273-5550).
Answer: Because the UFMDC has one of the largest interdisciplinary teams
in the world dedicated to making sure your deep brain stimulation device
is placed correctly.
You will see a fellowship trained movement disorders neurologist, a
fellowship trained movement disorders neurosurgeon, and you will receive
the best possible medical optimization. Additionally, you will have access
to a complete interdisciplinary team of experts in every area (speech,
voice, walking, balance, memory, depression/anxiety disorders, rehabilitation,
driving, occupational therapy, etc.) who specialize in the care of Parkinson's
and Movement Disorder Patients.
We will ensure you are the right candidate,
and discuss with you in detail what symptoms we think you can expect
to improve with a deep brain stimulation surgical therapy. Your case
will be discussed in detail with the interdisciplinary team prior to
any surgical intervention. In addition we will provide a top-notch operating
room experience with a neurologist, microelectrode multiple pass mapping,
and careful imaging and guidance for the proper placement of your device.
After it is implanted you will have full access to a dedicated staff
for programming and followup of your medication and DBS needs. Should
you have any problems we are always available to help you.
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