28.11.2012 Views

Mechanisms of aluminium neurotoxicity in oxidative stress-induced ...

Mechanisms of aluminium neurotoxicity in oxidative stress-induced ...

Mechanisms of aluminium neurotoxicity in oxidative stress-induced ...

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

INTRODUCTION<br />

Table 3: National Institute <strong>of</strong> Neurological Disorders (NINDS) diagnostic<br />

criteria for PD (Jankovic 2008)<br />

Group A features (characteristic <strong>of</strong> PD)<br />

Rest<strong>in</strong>g tremor<br />

Bradyk<strong>in</strong>esia<br />

Rigidity<br />

Asymmetric onset<br />

Group B features (suggestive <strong>of</strong> alternative diagnoses)<br />

Features unusual early <strong>in</strong> the cl<strong>in</strong>ical course<br />

Prom<strong>in</strong>ent postural <strong>in</strong>stability <strong>in</strong> the first 3 years after symptom onset<br />

Freez<strong>in</strong>g phenomenon <strong>in</strong> the first 3 years<br />

Halluc<strong>in</strong>ations unrelated to medications <strong>in</strong> the first 3 years<br />

Dementia preced<strong>in</strong>g motor symptoms or <strong>in</strong> the first year<br />

Supranuclear gaze palsy (other than restriction <strong>of</strong> upward gaze) or slow<strong>in</strong>g <strong>of</strong> vertical<br />

saccades<br />

Severe, symptomatic dysautonomia unrelated to medications<br />

Documentation <strong>of</strong> condition known to produce park<strong>in</strong>sonism and plausibly connected<br />

to the patient’s symptoms (such as suitably located focal bra<strong>in</strong> lesions or neuroleptic<br />

use with<strong>in</strong> the past 6 months)<br />

Criteria for def<strong>in</strong>ite PD<br />

All criteria for probable Park<strong>in</strong>son’s are met and<br />

Histopathological confirmation <strong>of</strong> the diagnosis is obta<strong>in</strong>ed at autopsy<br />

Criteria for probable PD<br />

At least three <strong>of</strong> the four features <strong>in</strong> group A are present and<br />

None <strong>of</strong> the features <strong>in</strong> group B is present (note: symptom duration >3 years is<br />

necessary to meet this requirement) and<br />

Substantial and susta<strong>in</strong>ed response to levodopa or a dopam<strong>in</strong>e agonist has been<br />

documented<br />

Criteria for possible PD<br />

At least two <strong>of</strong> the four features <strong>in</strong> group A are present; at least one <strong>of</strong> these is tremor<br />

or bradyk<strong>in</strong>esia and<br />

Either none <strong>of</strong> the features <strong>in</strong> group B is present or symptoms have been present (3<br />

years and none <strong>of</strong> the features <strong>in</strong> group B is present and<br />

Either substantial and susta<strong>in</strong>ed response to levodopa or a dopam<strong>in</strong>e agonist has<br />

been documented or the patient has not had an adequate trial <strong>of</strong> levodopa or a<br />

dopam<strong>in</strong>e agonist<br />

11

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!