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Biomedical subjects

C G Goetz

Publications and source records attributed to C G Goetz.

At least 217 records · Page 12Linked to original sources
PubMed1986

Pain in Parkinson's disease.

We studied the prevalence and character of pain in Parkinson's disease (PD) and its association with motor fluctuations. Of 95 outpatients, 46% experienced pain they attributed to PD. Patients with pain were younger but no more disabled on objective motor scores than patients without pain. Musculoskeletal, dystonic, and joint pains were most frequent. Painful episodes, especially musculoskeletal cramps, usually occurred when parkinsonian disability was maximal.

Age Factors↗
PubMed1986

Autonomic dysfunction in Parkinson's disease.

We studied autonomic functions in 31 chronically treated patients with Parkinson's disease. They were tested twice: before a dose of medication and after medication. Before a dose of medication, when motor disability was maximal ("off"), patients had higher resting pulse rate, greater orthostatic fall in blood pressure, and decreased responses to Valsalva and cold pressor stimuli than their spouse-controls. To a heat stimulus, sweating was increased in the head and neck, and skin temperatures were cooler. After medication when function was optimal ("on"), the cardiovascular reflex abnormalities remained but were no worse. Skin temperature alterations and sweating abnormalities resolved.

Adult↗
PubMed1985

Chronic agonist therapy for Parkinson's disease: a 5-year study of bromocriptine and pergolide.

We used pergolide to treat 10 patients with idiopathic Parkinson's disease who had first responded to, and then failed, bromocriptine therapy. At the end of 5 years, patients had improved when compared with study entry. Peak efficacy, equal with both drugs, was seen at 12 months. After a mean treatment of 29 months, bromocriptine was no longer effective, but pergolide was still beneficial.

Aged↗
PubMed1985

Pergolide mesylate: lack of cardiac toxicity in patients with cardiac disease.

In a 12-month open-label trial, pergolide mesylate was administered in doses with antiparkinsonian efficacy to six patients with stable heart disease. Cardiac status did not worsen in any patient. Parkinson's disease improved in all patients. Pergolide is a safe and effective therapy for Parkinson's disease, even in patients with heart disease.

Aged↗
PubMed1985

The pathophysiology of tardive dyskinesia.

In rodent models of tardive dyskinesia, dopamine-agonist-induced stereotyped behaviors after neuroleptic administration are used to assess presumed striatal postsynaptic receptor hypersensitivity. Early studies provided evidence that neuroleptic pretreatment did alter dopaminergic receptor sensitivity and hence the threshold for amine-induced stereotyped behavior. Later studies showed a dose effect for several neuroleptics. However, no hypersensitivity was seen with thioridazine, which prevented or reversed haloperidol-induced hypersensitivity. Duration appeared to be a risk factor early in but not throughout neuroleptic administration. These findings may have implications for the understanding and prevention of tardive dyskinesia in man.

Animals↗
PubMed1984

Neuroleptic-induced dopamine hyposensitivity.

In contrast to dopaminergic hypersensitivity induced by most neuroleptic drugs including fluphenazine, thioridazine induced hyposensitivity to subsequent apomorphine stereotypy in rats. The difference between thioridazine and fluphenazine may relate in part to anticholinergic properties of thioridazine, but appears to involve additional mechanisms. Differences in dopaminergic sensitization may be important to the management and prevention of tardive dyskinesia an iatrogenic disorder associated with chronic exposure to neuroleptics.

Animals↗
PubMed1984

Fluphenazine and multifocal tic disorders.

In a five-year study, 21 patients with multiple tic disorder intolerant of haloperidol therapy were treated with fluphenazine hydrochloride. Sixteen of these patients had fewer side effects with fluphenazine and had either equivalent (five patients) or better (11 patients) tic control. Fluphenazine can be an effective treatment for multiple tics in patients with dose-limiting side effects related to haloperidol.

Adolescent↗
PubMed1984

Speech abnormalities in tardive dyskinesia.

Twelve outpatients with tardive dyskinesia underwent speech evaluation by trained listeners who analyzed oral reading and vowel production for deviation in multiple speech dimensions. In the six patients with speech abnormalities, temporal organization and voice production dimensions were the most severely deviant and were highly related to the overall intelligibility and bizarre quality of speech. Deviations in articulation were less prominent. Abnormal involuntary movement scale ratings of the trunk in these patients were significantly greater than in the patients without speech impairment, although the lingual-facial-buccal and total body scores were similar between the two groups.

Adult↗
PubMed1984

Bupropion in Parkinson's disease.

Bupropion is an antidepressant, thought to be an indirect dopaminergic agonist. No significant sympathomimetic, anti-cholinergic, or MAO inhibitor effects have been reported. We evaluated this drug in 20 patients with idiopathic Parkinson's disease. Parkinsonism lessened by at least 30% (Northwestern University Disability Scale or Modified New York University Parkinson's Disease Scale) in half the patients. Depression, present in 12 of 20, was alleviated in only 5. Bupropion is mildly efficacious in Parkinson's disease, although side effects were frequent and were dose-limiting in five patients.

Adult↗
PubMed1984

Tardive dyskinesia.

The basic pathogenesis of tardive dyskinesia appears to relate to chronic pharmacologic denervation of specific dopaminergic receptor sites in the striatum. The pathophysiology of the disorder relates to the resultant denervation hypersensitivity. The mainstay of treatment includes withdrawal of neuroleptics where feasible and the use of dopamine-depleting agents. Enhancement of the striatal cholinergic input offers potential ancillary benefit to the alleviation of abnormal movements. The benefit of manipulating other neurotransmitters remains experimental. Treatment of tardive dyskinesia with neuroleptics themselves is clearly treatment with the presumed offending agent, and should be avoided. This shortsighted therapy may temporarily abate the pathophysiology of the condition but serves to aggravate its pathogenesis.

Antipsychotic Agents↗
PubMed1983

Pergolide in Parkinson's disease.

Twenty-two patients received pergolide mesylate for Parkinson's disease for one year. Improvement was maximal at six months, but average functional scores were still better at 12 months than at pretreatment evaluation. On-off fluctuations were reduced in severity, and two of 18 patients experienced full resolution. Pergolide is an effective and safe ongoing medication for Parkinson's disease.

Aged↗