Despite improved mobility during sleep, many Parkinsons patients report an extremely uncomfortable sleeping experience even after dopaminergic treatments. Deep brain stimulation
Once the reaction to dopaminergic drugs begins to fluctuate in Parkinsons patients, deep brain stimulation (DBS) of the subthalamic nucleus and internal globus pallidus is often used to treat hypokinesia. DBS, like dopaminergic drugs, initially provides relief, but chronic use causes worse hypokinesia and freezing of gait. Lower-frequency DBS in irregular patterns has been shown to be more effective and less detrimental in treatment. Posteroventral pallidotomy (PVP) is a specific kind of DBS that destroys a small part of the globus pallidus by scarring the neural tissue, reducing brain activity and therefore tremors and rigidity. PVP is suspected to recalibrate basal ganglia activity in the thalamocortical pathway. PVP in the dominant hemisphere has been reported to disrupt executive function verbal processing abilities, and bilateral PVP may disturb processes of focused attention.Many akinesia patients also form a linguistic akinesia in which their ability to produce verbal movements mirrors their physical akinesia symptoms, especially after unsuccessful PVP. Patients are usually able to maintain normal levels of fluency, but often stop midsentence, unable to remember or produce a desired word. According to a study of Parkinsons patients with articulatory hypokinesia, subjects with faster rates of speech experienced more problems trying to produce conversational language than those who normally spoke at slower rates. Methylphenidate
Methylphenidate, commonly used to treat ADHD, has been used in conjunction with levodopa to treat hypokinesia in the short term.
Iron(II) gluconate, or ferrous gluconate, is a black compound often used as an iron supplement. It is the iron(II) salt of gluconic acid. It is marketed under brand names such as Fergon, Ferralet and Simron. Uses
Medical
Ferrous gluconate is effectively used in the treatment of hypochromic anemia. The use of this compound compared with other iron preparations results in satisfactory reticulocyte responses, a high percentage utilization of iron, and daily increase in hemoglobin that a normal level occurs in a reasonably short time. Food additive
Ferrous gluconate is also used as a food additive when processing black olives. It is represented by the food labeling E number E579 in Europe. It imparts a uniform jet black color to the olives. Toxicity
Ferrous gluconate may be toxic in case of overdose. Children may show signs of toxicity with ingestions of 10–20 mg/kg of elemental iron. Serious toxicity may result from ingestions of more than 60 mg/kg. Iron exerts both local and systemic effects: it is corrosive to the gastrointestinal mucosa, it can have a negative impact on the heart and blood (dehydration, low blood pressure, fast and weak pulse, shock), lungs, liver, gastrointestinal system (diarrhea, nausea, vomiting blood), nervous system (chills, dizziness, coma, convulsions, headache), and skin (flushing, loss of color, bluish-colored lips and fingernails). The symptoms may disappear in a few hours, but then emerge again after 1 or more days. See also
Acceptable daily intake
Iron poisoning


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