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Pseudobulbar affect is a common symptom in neurodegenerative diseases and can also result from lesions in cortical, subcortical and brainstem regions. In Parkinson's disease (PD), pseudobulbar affect (PBA) can occur as a wearing off phenomenon, manifested usually as crying without emotionality. In addition, subthalamic (STN) deep brain stimulation (DBS) has been reported to induce PBA in PD patients with no prior history of such episodes. We present a case of inappropriate laughter lacking mirth as a levodopa OFF phenomenon in a patient with PD, whose laughter also worsened with STN-DBS in his non-medicated state. Levodopa ameliorated his PBA both with and without stimulation. The case demonstrates pseudobulbar laughter as a levodopa OFF phenomenon that is also exacerbated by STN-DBS.
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http://dx.doi.org/10.1186/s40734-015-0023-6 | DOI Listing |
CNS Neurosci Ther
August 2025
Department of Neurology, Aerospace Center Hospital, Beijing, People's Republic of China.
Aims: This study aimed to investigate the incidence and risk factors of motor complications including wearing-off (WO) and dyskinesia during long-term levodopa (LD) therapy in Chinese patients with Parkinson's disease (PD), and develop corresponding predictive models, thereby providing a basis for personalized treatment strategies.
Methods: This cross-sectional study included 208 consecutive PD patients who were recruited. The presence of WO and dyskinesia was assessed by a 9-item wearing-off questionnaire and the Unified Parkinson's Disease Rating Scale part IV.
Clin Park Relat Disord
July 2025
Jean & Paul Amos PD & Movement Disorders Program, Department of Neurology, Emory University School of Medicine, United States.
Background: Paroxysmal abdominalgia (PxA) is an underrecognized, debilitating form of abdominal pain that manifests during wearing-off (WO) periods in Parkinson's disease (PD). Despite its profound impact, PxA remains poorly described, complicating diagnosis and management.
Methods: We conducted a retrospective case series of patients with PD and recurrent abdominal pain linked to WO episodes.
Cureus
July 2025
Department of Neurology, School of Health Sciences, Medical University of Silesia, Katowice, POL.
Drug-induced parkinsonism (DIP) is the second most common cause of parkinsonian syndromes after idiopathic Parkinson's disease (iPD), accounting for approximately 15-25% of cases in older adults. While DIP typically results from antipsychotic-induced dopamine receptor blockade and is often reversible, iPD is a progressive neurodegenerative disorder characterized by asymmetrical onset, resting tremor, and good response to levodopa. Distinguishing between these conditions is clinically important but often challenging.
View Article and Find Full Text PDFJ Neurosci
June 2025
Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109.
The nature of motor deficits in Parkinson disease (PD) and aspects of their improvements with ʟ-DOPA replacement therapy (LDRT) offer potential insights into striatal dopamine actions. The defining and most LDRT responsive feature of PD, bradykinesia, is a complex phenomenon exhibiting impairments of both simple and complex limb movements. LDRT significantly remediates the former but not the latter.
View Article and Find Full Text PDFNeurobiol Dis
August 2025
Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed Institute, Pozzilli (IS), Italy. Electronic address:
Objectives: Cogwheel rigidity in Parkinson's disease has been poorly investigated so far, thus leaving the scientific interpretation of this phenomenon substantially unsolved. A detailed clinical, biomechanical and neurophysiological investigation would clarify the pathophysiological underpinning of cogwheel rigidity.
Methods: Patients underwent robot-assisted wrist extensions at various angular velocities, when OFF and ON therapies.