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Cover of Parkinson's Disease

Parkinson's Disease

Diagnosis and Clinical Management

Edited by Stewart A Factor, DO and William J Weiner, MD.

New York: Demos Medical Publishing; .
ISBN-10: 1-888799-50-1

This book is organized to provide a comprehensive view of PD as we move into the 21st century and takes the reader through nine sections covering clinical presentation, behavioral and psychiatric manifestations, pathology and neurochemistry, diagnosis, etiology and pathogenesis, drugs, treatment issues, surgery and subtypes of parkinsonism as the core of the book. These topics are bracketed in the beginning by a section on history that gives the reader a sense of where we have been with regard to PD starting with James Parkinson's famous essay. This, in turn, gives us an idea of how far we have come. At the end there is a section on social issues that concern PD patients now, at the turn of this century.

Contents

  • Acknowledgments
  • Contributors
  • Dedication
  • Foreword
  • Preface
  • Chapter 1. James Parkinson: The Man and the Essay
    Stewart A. Factor, D.O. and William J. Weiner, M.D.
    • Introduction
    • The Man
    • The Essay
    • Acknowledgments
    • References
  • Chapter 2. Paralysis Agitans in the Nineteenth Century
    Elan D. Louis, M.D.
    • Introduction
    • Background
    • Literature Review
    • Conclusion
    • Acknowledgments
    • References
  • Chapter 3. Charcot and Parkinson's Disease
    Christopher G. Goetz.
    • Introduction
    • Tremorous Diseases
    • References
  • Chapter 4. Twentieth Century – Timeline for PD
    William J. Weiner, M.D. and Stewart A. Factor, D.O.
  • Chapter 5. Epidemiology of Parkinsonism
    M.L. Rajput, MS and A.H. Rajput, FRCPC.
    • Selection of Location and Population
    • Diagnosis of Parkinsonism and Parkinson Syndrome Variants
    • Progression of Parkinsonism and Staging of Disease
    • Manpower Consideration for Epidemiologic Studies
    • Objectives of Epidemiologic Studies
    • Incidence of Parkinsonism
    • Life Expectancy in Parkinsonism
    • Prevalence of Parkinsonism
    • Health Services Needs
    • Race and Gender
    • Analytic and Clinical Epidemiology
    • References
  • Chapter 6. Cardinal Features of Early Parkinson's Disease
    Pramod Kr. Pal, M.D., D.M., Ali Samii, M.D., F.R.C.P.C., Donald B. Calne, D.M., F.R.C.P.C., Pramar Kr. Pal, and Ali Samii, M.D.
    • Parkinsonian Syndrome and the Definition of Parkinson's Disease
    • Aging and Parkinson's Disease
    • Clinical Features
    • Differential Diagnosis
    • Diagnosis of Early Idiopathic Parkinsonism
    • Conclusion
    • Acknowledgments
    • References
  • Chapter 7. Gait Disturbances
    Nir Giladi, MD.
    • Introduction
    • Gait Disturbances as Part of the Clinical Syndrome
    • Assessment of Gait
    • Treatment of Parkinsonian Gait
    • Functional Neurosurgery for Gait Disturbances
    • Acknowledgments
    • References
  • Chapter 8. Sensory Symptoms
    Richard M. Zweig, M.D.
    • Introduction
    • Case Report
    • Frequency, Location, and Quality of Somatosensory Symptoms
    • Pathophysiology
    • Evaluation and Treatment of Somatosensory Symptoms
    • References
  • Chapter 9. Speech, Voice, and Swallowing Disorders
    Lorraine Olson Ramig, Professor, Stefanie Countryman, Speech-Language Pathologist, Cynthia Fox, Speech-Language Pathologist, and Shimon Sapir, Ph.D., CCC-SLP.
    • Introduction
    • Speech and Voice Characteristics in Parkinson's Disease
    • Treatment
    • Conclusion
    • Acknowledgments
    • References
  • Chapter 10. Gastrointestinal Features
    Eamonn M.M. Quigley, MD, FRCP, FACP, FACG.
    • Introduction and Background
    • An Overview of Gastrointestinal Motor Function
    • Gastrointestinal Dysfunction in Parkinson's Disease – Historical Background and Principal Features
    • Dysphagia in Parkinson's Disease
    • Nausea, Vomiting, Dyspepsia, and Gastric Function in Parkinson's Disease
    • Constipation, Difficult Defecation, and Colonic And Anorectal Function
    • The Pathophysiology of Gastrointestinal Dysfunction in Parkinson's Disease – Available Evidence and Future Prospects
    • Management of Gastrointestinal Complications in Parkinson's Disease
    • Conclusion
    • References
  • Chapter 11. Autonomic Nervous System Dysfunction
    Jean Pintar Hubble, M.D. and Carolyn Weeks, B.S.
    • Introduction
    • Neuropathology of Autonomic Dysfunction in Parkinson's Disease
    • Thermoregulatory Dysfunction and Skin Changes
    • Pupillary Changes
    • Gastrointestinal Dysfunction and Weight Loss
    • Cardiovascular Function
    • Urinary Bladder Dysfunction
    • Sexual Dysfunction
    • References
  • Chapter 12. Sleep Disorders
    Cynthia L. Comella, M.D., A.B.S.M.
    • Sleep Disturbances Related to Symptoms of Parkinson's Disease
    • Delayed Sleep Onset
    • Sleep Apnea
    • The Effect of Dopaminergic Therapy on Sleep in Parkinson's Disease
    • Sleep Disturbance – Hallucinations Syndrome in Parkinson's Disease Patients on Chronic Dopaminergic Therapy
    • Sleep Benefit in Parkinson's Disease
    • REM Sleep Behavior Disorder in Parkinson's Disease
    • Excessive Daytime Sleepiness in Parkinson's Disease
    • References
  • Chapter 13. Natural History
    Andrew Feigin, M.D. and David Eidelberg, M.D.
    • Introduction
    • Preclinical Period
    • Clinical Presentation
    • Rate of Progression
    • Disease Duration and Mortality
    • Conclusion
    • Acknowledgments
    • References
  • Chapter 14. Quantitative Measures and Rating Scales
    Stephen T. Gancher, M.D.
    • Introduction
    • Early Standardized Ratings
    • The Unified Parkinsons Disease Rating Scale
    • The Capit Rating Scale
    • Ratings of Dyskinesias
    • Diary Ratings
    • Administration
    • Unified Parkinson's Disease Rating Scale (UPDRS)
    • Modified Hoehn And Yahr Staging
    • Modified Schwab and England Activities of Daily Living Scale
    • Dyskinesia Rating Scale ()
    • References
  • Chapter 15. Dementia
    Karen Marder, M.D., M.P.H. and Diane M. Jacobs, Ph.D.
    • Defining Dementia in Parkinson's Disease
    • Neuropsychologic Characteristics of Dementia in Parkinson's Disease
    • Role of Dopamine in Cognitive Dysfunction
    • Progression of Cognitive Impairment in PD
    • Prevalence of Dementia
    • Incidence of Dementia
    • Risk of Dementia Compared to Age-matched Controls
    • Mortality
    • Risk Factors for Dementia in Parkinson's Disease
    • Pathology
    • Neuroimaging
    • Treatment of Cognitive Impairment
    • Depression and Dementia
    • Conclusion
    • References
  • Chapter 16. Dementia with Lewy Bodies, Alzheimer's Disease and Their Relationship to Parkinson's Disease
    Douglas Galasko, M.D.
    • Introduction
    • Neuropathologic Findings in Dementia with Lewy Bodies
    • Clinical Features of Dementia with Lewy Bodies
    • Patterns of Cognitive Impairment in Dementia with Lewy Bodies
    • Neuroimaging Studies of Dementia with Lewy Bodies
    • Management of Patients with Dementia with Lewy Bodies
    • References
  • Chapter 17. Depression
    Tiffany W. Chow, Donna L. Masterman, and Jeffrey L. Cummings, M.D.
    • Introduction
    • Risk Factors for Depression in PD
    • Cognition and Depression in PD
    • Relation of Depression to On–Off Phenomena
    • Neurobiologic Basis of Depression in PD
    • Metabolic Studies of Depression in PD
    • Treatment of Depression in PD
    • Conclusion
    • Acknowledgments
    • References
  • Chapter 18. Anxiety and Panic
    Irene Hegeman Richard, M.D. and Roger Kurlan, M.D.
    • Introduction
    • Anxiety in PD
    • Conclusion
    • References
  • Chapter 19. Apathy and Amotivation
    Lisa M. Shulman, M.D.
    • Clinical Correlates of Apathy in Parkinson's Disease
    • Causes of Apathy
    • Apathy vs. Depression
    • Apathy in Medical, Neurologic, and Psychiatric Disorders
    • Recognition of Apathy and Amotivation
    • The Management of Apathy and Amotivation
    • The Effect of Motivation on Living with Chronic Illness
    • Conclusion
    • References
  • Chapter 20. Pathology
    Kevin D. Barron, M.D.
    • Historical Development
    • Histopathology
    • Dementia and PD
    • Causation
    • Other Diseases Associated with Parkinsonian Symptomatology
    • References
  • Chapter 21. Neurochemistry
    Jose Martin Rabey, M.D. and Richard Stanley Burns, M.D.
    • Anatomy of the Basal Ganglia and Related Circuits
    • Dopaminergic Systems
    • Dopamine Metabolism
    • Dopamine, Neuromelanin, and Tyrosine Hydroxylase
    • Protein Synthesis
    • Dopamine Metabolites
    • Dopamine Receptors
    • Dopamine Transporter
    • Nigrostriatal Dopamine System and Parkinsonian Symptoms
    • Other Neurotransmitters and Receptors
    • Lewy Bodies
    • Conclusion
    • References
  • Chapter 22. Basal Ganglia Anatomy and Physiology
    Thomas Wichmann, M.D., Ph.D., Yoland Smith, Ph.D., and Jerrold L. Vitek, M.D., Ph.D.
    • Introduction
    • Structure and Function of Basal Ganglia Circuits
    • Pathophysiology of Parkinson's Disease
    • Conclusions
    • References
  • Chapter 23. Dopamine Receptor Diversity
    Deborah C. Mash.
    • Introduction
    • Molecular Characterization of Dopamine Receptors
    • Neuroanatomic Localization of Dopamine Receptor Protein and mRNA
    • Pharmacologic Selectivity
    • References
  • Chapter 24. Problems in Diagnosis
    Andrew J. Lees, M.D.
    • Recent Clinicopathologic Studies
    • Helpful Clinical Pointers for the Diagnosis of Parkinson's Disease
    • The Neurologic Examination
    • Lewy Body Dementia
    • Ancillary Investigations
    • Concluding Remarks
    • References
  • Chapter 25. Single Photon Emission Tomography and Dopamine Transporter Imaging
    Kenneth Marek, M.D.
    • Diagnosis and Disease Severity
    • Parkinson's Disease Progression
    • Preclinical Parkinson's Disease
    • Future Directions
    • References
  • Chapter 26. Positron Emission Tomography
    Mark Guttman, M.D., F.R.C.P.C.
    • Introduction
    • PET Methodology
    • PET Ligands to Study Parkinson's Disease
    • Postsynaptic Dopaminergic Studies in Parkinson's Disease
    • Differential Diagnosis of PD with PET
    • PET Measurements to Assess Therapeutics in Parkinson's Disease
    • Conclusions
    • Bibliography
  • Chapter 27. Etiology: The Role of Environment and Genetics
    Caroline M. Tanner, M.D., Ph.D.
    • Introduction
    • Challenges in Investigating Parkinson's Disease
    • Parkinsonism of Known Cause
    • Clues to the Cause of Parkinson's Disease from Epidemiologic Studies
    • Risk Factors from Analytic Studies
    • Conclusion
    • References
  • Chapter 28. Pathogenesis: Oxidative Stress, Mitochondrial Dysfunction, and Excitotoxicity
    David K. Simon, M.D., Ph.D. and M. Flint Beal, M.D.
    • The Oxidative Stress Hypothesis
    • Markers of Oxidative Damage in Parkinson's Disease
    • Impaired Energy Metabolism in Parkinson's Disease
    • Other Potential Sources of Oxidative Stress
    • Excitotoxicity
    • Conclusions
    • References
  • Chapter 29. Apoptosis
    Robert E. Burke, M.D.
    • The Concept of Apoptosis
    • Apoptosis Occurs in Dopamine Neurons of the Substantia Nigra during Normal Development
    • Apoptosis in Animal Models of Parkinsonism
    • Molecular Correlates of Apoptosis in SNpc Neurons
    • Apoptosis in Parkinson's Disease: Does It Play a Role in Neuron Death?
    • Relevance of Apoptosis to Other Aspects of Parkinson's Disease
    • Conclusions
    • Acknowledgments
    • References
  • Chapter 30. The Impact of MPTP on Parkinson's Disease Research: Past, Present, and Future
    J. William Langston, M.D.
    • Introduction
    • The Discovery of the Biologic Effects of MPTP
    • What Have We Learned from MPTP-induced Parkinsonism in Humans?
    • Aging and MPTP
    • Species Susceptibility
    • Intranigral Selective Vulnerability
    • Epidemiologic Investigations
    • Conclusions
    • References
  • Chapter 31. Cerebrospinal Fluid Toxicity: Clues to Pathogenesis
    Ronald E. Pfeiffer, M.D. and Ruyi Hao, M.D., Ph.D.
    • Introduction
    • Cell Culture Studies
    • Candidate Neurotoxins
    • Conclusion
    • References
  • Chapter 32. Levodopa: 30 Years of Progress
    Tanya Simuni, M.D. and Howard Hurtig, M.D.
    • Introduction
    • Historical Review
    • The Biochemistry and Metabolism of Levodopa
    • Complications of Levodopa Therapy
    • A Continuing Controversy: Is Levodopa Toxic?
    • Refinement of Levodopa Therapy: Enzyme Inhibition
    • Conclusions
    • References
  • Chapter 33. Amantadine and Anticholinergics
    Charles H. Adler, M.D., Ph.D.
    • Amantadine and Anticholinergics
    • Amantadine
    • Anticholinergics
    • References
  • Chapter 34. Monoamine Oxidase Inhibitors
    Theresa A. Zesiewicz, M.D. and Robert A. Hauser, M.D.
    • Introduction and History
    • Monoamine Oxidase: Biochemistry and Mechanism of Action
    • Monoamine Oxidase: Anatomy and Localization
    • Monoamine Oxidase Inhibitors: Reversible and Irreversible
    • Monoamine Oxidase Inhibitors: Hypertensive Crisis
    • Other MAO Inhibitors
    • Conclusion
    • Acknowledgment
    • References
  • Chapter 35. Dopamine Agonists
    Puiu F. Nisipeanu and Amos D. Korczyn.
    • Protective Effects of Dopamine Agonists
    • Adverse Effects of Dopamine Agonists
    • Drug Interactions
    • Other Dopamine Agonists
    • Nonergot Drugs
    • Comparison of Dopamine Agonists
    • Comparison Of Dopamine Agonists with Levodopa
    • Conclusions
    • References
  • Chapter 36. Catechol-O-Methyltransferase (COMT) Inhibitors
    Cheryl Waters, M.D., F.R.C.P.(C)
    • Limitations of Levodopa
    • Rationale for COMT Inhibitors
    • Clinical Studies with COMT Inhibitors
    • Safety of COMT Inhibitors
    • Differences between Tolcapone and Entacapone
    • Patient Selection Criteria
    • Comparisons of COMT Inhibitors with Other Therapies for Parkinson's Disease
    • Conclusion
    • References
  • Chapter 37. Atypical Antipsychotics
    Joseph H. Friedman, M.D. and Herbert Y. Meltzer, M.D.
    • Introduction
    • Psychosis
    • Clozapine
    • Risperidone
    • Olanzapine
    • Quetiapine
    • Other Drugs for Treating Levodopa Psychosis
    • Tremor
    • Other Motor Aspects of Parkinson's Disease
    • Conclusion
    • Addendum
    • References
  • Chapter 38. Excitatory Amino Acid Receptor Antagonists
    Fabio Blandini and J. Timothy Greenamyre.
    • Introduction
    • Excitatory Neurotransmission in the Central Nervous System
    • Glutamate-mediated Transmission in the Basal Ganglia: Relevance to PD Pathophysiology
    • The Role of Glutamate-mediated Toxicity in the Etiopathogenesis of PD
    • Prospects of Glutamate Antagonists for PD Therapy
    • Conclusion
    • References
  • Chapter 39. Other Therapies
    Eric Siemers, M.D. and Allison Brashear, M.D.
    • Introduction
    • Treatment of Dementia Associated with Parkinson's Disease
    • Treatment of Dystonia Associated with Parkinson's Disease
    • Treatment of Autonomic Failure
    • Other Treatments for Motor Symptoms and Fluctuations
    • Use of L-Threodops
    • Alternative Experimental Treatments of Parkinson's Disease
    • References
  • Chapter 40. Motor Fluctuations and Dyskinesia
    John G. Nutt, M.D.
    • Introduction
    • Prevalence of Fluctuations and Dyskinesia
    • Development of Motor Fluctuations
    • Development of Levodopa-induced Dyskinesia
    • Treatment of Fluctuations and Dyskinesia
    • Acknowledgments
    • References
  • Chapter 41. Fluctuations of Nonmotor Symptoms
    Jacob I. Sage, M.D.
    • General Principles
    • Nonmotor Phenomena Associated with the “On” State ()
    • Nonmotor Fluctuations Associated with the "Off" State
    • Treatment
    • References
  • Chapter 42. Psychosis and Related Problems
    Eric S. Molho, M.D.
    • Introduction
    • Drug-induced Psychosis: Terminology, History, and Frequency
    • Clinical Features
    • Mechanisms of Psychosis
    • Treatment of Psychosis: General Considerations
    • Treatment: Summary
    • Mania
    • Hypersexuality
    • Acknowledgment
    • References
  • Chapter 43. Status of Protective Therapies
    Andrew D. Siderowf, M.D. and Matthew B. Stern, M.D.
    • Definition of Neuroprotection and Relevance to Parkinson's Disease
    • Mechanisms of Neuronal Injury in Parkinson's Disease
    • Neuroprotective Therapy for Parkinson's Disease
    • Future Strategies
    • Conclusion
    • References
  • Chapter 44. Treatment Approaches for Early Parkinson's Disease
    J. Eric Ahlskog, Ph.D., M.D.
    • Introduction
    • General Neuroprotective Strategies
    • Strategies for Reducing Motor Complications: Dyskinesias, Fluctuations
    • Recommendations for Treatment of the Early PD Patient
    • Conclusion
    • References
  • Chapter 45. Progress in Gene Therapy
    M. Maral Mouradian, M.D.
    • Introduction
    • Methods of Gene Transfer to the Brain
    • Viral Vectors
    • Cell Vehicles for ex Vivo Gene Transfer for Parkinson's Disease
    • Candidate Therapeutic Genes for PD
    • Comparison of in Vivo and ex Vivo Gene Transfer Approaches
    • Future Considerations
    • References
  • Chapter 46. Tobacco Smoking, Nicotine, and Neuroprotection
    Peter A. LeWitt, M.D.
    • Introduction
    • Epidemiologic Studies of the Relationship between Smoking and Parkinson's Disease
    • The Magnitude of Smoking's Effects at Reducing Risk for Parkinson's Disease
    • Consistency among Studies of Reduced Risk for Parkinson's Disease in Smokers
    • Specificity of Cause-and-Effect Relationship between Smoking and Reduced Risk for Parkinson's Disease
    • The Chain of Events Underlying Smoking and the Risk for Parkinson's Disease
    • Gradation of Biologic Effect from Smoking in Lowering the Risk for Parkinson's Disease
    • The Biologic Plausibility of Smoking in Reducing the Risk for Developing Parkinson's Disease
    • Coherence of Smoking's Reduction in the Risk for Parkinson's Disease and the Natural History and Biology of the Disease
    • Experimental Evidence Exploring the Relationship between Smoking and the Risk of Developing Parkinson's Disease
    • Relevant Analogies to Other Neurodegenerative Disease
    • Conclusions
    • References
  • Chapter 47. Stereotactic Pallidotomy and Thalamotomy
    Jung Y. Park, M.D., Andres M. Lozano, M.D., and Anthony E. Lang, M.D.
    • Introduction
    • Historical Background
    • Rationale of Surgery
    • Indications and Patient Selection for Surgery
    • Surgical Techniques for Pallidotomy and Thalamotomy
    • Clinical Results
    • Conclusion
    • References
  • Chapter 48. Thalamic Stimulation
    William C. Koller, M.D., Ph.D., Kelly Lyons, Ph.D., Rajesh Pahwa, M.D., and Steven Wilkinson SF, M.D.
    • Clinical Background
    • Patient Selection for DBS
    • Surgical Procedure
    • Team Approach
    • Clinical Trials
    • Thalamotomy vs. DBS of the Thalamus
    • Mechanism of Action
    • Advantages and Disadvantages of Deep Brain Stimulation
    • Costs
    • Regulatory Status
    • Conclusion
    • References
  • Chapter 49. Pallidal and Subthalamic Stimulation
    John P. Hammerstad, M.D.
    • A Brief Historical Account
    • Techniques
    • Results of Treatment Trials: GPi Stimulation
    • Results of Treatment Trials: Stimulation of the Subthalamic Nucleus
    • Adverse Effects of Deep Brain Stimulation
    • Outcomes Remaining to Be Answered
    • References
  • Chapter 50. Neural Transplantation
    J. Stephen Fink, M.D., Ph.D.
    • Introduction
    • Human Fetal Transplants in Parkinson's Disease
    • Other Cell Sources for Parkinson's Disease
    • Transplantation for Other Neurodegenerative Diseases
    • Summary: Prospects for New Cell Sources
    • References
  • Chapter 51. Juvenile and Young-Onset Parkinsonism
    Oscar S. Gershanik, M.D.
    • Introduction
    • Historical Background
    • Clinical Features
    • Diagnostic Challenges
    • Pathology
    • Epidemiology and Genetics
    • Response to Medications, Therapeutic Strategies
    • Special Situations and Needs of the Young Patient
    • References
  • Chapter 52. Is There a Familial Form of Parkinson's Disease?
    Lawrence I. Golbe, M.D.
    • How Familial Is Parkinson's Disease?
    • Are Familial Clusters Genetic in Origin?
    • Clinically Inapparent PD
    • Fluorodopa PET and Clinical Genetics
    • Known Parkinson's Disease Genes or Loci
    • Conclusions
    • References
  • Chapter 53. Parkinson's Plus Syndromes
    David Riley, M.D.
    • Introduction
    • Progressive Supranuclear Palsy
    • Multiple System Atrophy
    • Cortical-Basal Ganglionic Degeneration
    • Frontotemporal Dementia with Parkinsonism
    • Conclusion
    • References
  • Chapter 54. Symptomatic Parkinsonism
    William T. Garrett, M.D. and Kapil D. Sethi, M.D., F.R.C.P (U.K.)
    • Introduction
    • Infection
    • Drug-induced Parkinsonism
    • Toxin-induced Parkinsonism
    • MPTP
    • Structural Lesions
    • Miscellaneous Causes of Secondary Parkinsonism
    • References
  • Chapter 55. Quality of Life: Issues and Measurement
    Mickie Welsh, R.N. DNSc.
    • Historical Perspective
    • What Is Quality of Life?
    • Quality of Life in Parkinson's Disease
    • Applying Quality of Life Concepts
    • Assessing Quality of Life in the Clinical Setting
    • Quantifying Quality of Life in Parkinson's Disease
    • Methodological Considerations
    • Integrating Quality-of-Life Research into Practice
    • Future Applications
    • References
  • Chapter 56. Family Caregiving
    Julie H. Carter, M.N. ANP, Patricia G. Archbold, R.N, D.N.Sc, F.A.A.N., and Barbara J. Stewart, Ph.D.
    • Family Caregiving in Parkinson's Disease
    • Demographic Trends in Family Caregiving for the Twenty-First Century
    • Important Role of Family Caregiving in Chronic Illness
    • The Risks Associated with Family Caregiving
    • Predictors of Caregiver Strain
    • Caregiver Role Strain
    • Caregiver Characteristics
    • The Caregiving Situation
    • Assessment
    • Interventions
    • Conclusion
    • References
  • Chapter 57. Economic Impact of Parkinson's Disease: Implications for Interventions
    Andrew Siderowf, M.D. and Robert G. Holloway, M.D.
    • Introduction
    • Economic Burden of Parkinson's Disease
    • Direct and Indirect Cost of Parkinson's Disease
    • Influence of Clinical Features on Resource Use
    • Cost of Medications and Surgery for Parkinson's Disease
    • Cost Effectiveness Research for Parkinson's Disease
    • Cost-Effectiveness of PD-related Medications
    • Surgery for Parkinson's Disease
    • Implications of Cost-Effectiveness Research
    • Summary
    • References
  • Chapter 58. Driving
    Stewart A. Factor, D.O. and William J. Weiner, M.D.
    • Introduction
    • Driving and the Elderly
    • Driving in Parkinson's Disease
    • Conclusion
    • Acknowledgments
    • References

By agreement with the publisher, this book is accessible by the search feature, but cannot be browsed.

Copyright © 2002, Demos Medical Publishing, Inc.
Bookshelf ID: NBK10147

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