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Maas BR, Göttgens I, Tijsse Klasen HPS, Kapelle WM, Radder DLM, Bloem BR, Post B, de Vries NM, Darweesh SKL. Age and gender differences in non-motor symptoms in people with Parkinson's disease. Front Neurol 2024; 15:1339716. [PMID: 38361642 PMCID: PMC10867965 DOI: 10.3389/fneur.2024.1339716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Background Non-motor symptoms of Parkinson's disease (PD) are highly prevalent and heterogenic. Previous studies aimed to gain more insight on this heterogeneity by investigating age and gender differences in non-motor symptom severity, but findings were inconsistent. Furthermore, besides examining the single effects of age and gender, the interaction between them in relation to non-motor functioning has -as far as we know- not been investigated before. Objectives To investigate the association of age and gender identity -as well as the interaction between age and gender identity- with non-motor symptoms and their impact on quality of life. Methods We combined three large and independent studies. This approach resulted in a total number of unique participants of 1,509. We used linear regression models to assess the association of age and gender identity, and their interaction, with non-motor symptoms and their impact on quality of life. Results Older people with PD generally had worse cognitive functioning, worse autonomic functioning and worse quality of life. Women with PD generally experienced more anxiety, worse autonomic functioning and worse quality of life compared to men with PD, whereas men with PD generally had worse cognitive functioning. In interaction analyses by age and gender identity, depressive symptoms and anxiety were disproportionally worse with increasing age in women compared to men. Conclusion Our findings indicate that both age and gender -as well as their interaction- are differentially associated with non-motor symptoms of PD. Both research and clinical practice should pay more attention to demographic subgroups differences and possible different treatment approaches with respect to age and gender. We showed how combining datasets is of added value in this kind of analyses and encourage others to use similar approaches.
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Affiliation(s)
- Bart R. Maas
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Irene Göttgens
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Hermina P. S. Tijsse Klasen
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Willanka M. Kapelle
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Danique L. M. Radder
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bart Post
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nienke M. de Vries
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Sirwan K. L. Darweesh
- Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
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Janz C, Timpka J, Rosqvist K, Paul G, Storch A, Odin P. Non-Motor Symptom Management: Insights into Adherence to Treatment Guidelines in Parkinson's Disease Patients. JOURNAL OF PARKINSON'S DISEASE 2024; 14:297-312. [PMID: 38217612 PMCID: PMC10977407 DOI: 10.3233/jpd-230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/15/2024]
Abstract
Background Non-motor symptoms (NMS) reduce quality of life in Parkinson's disease (PD) patients, who experience three times more NMS than individuals without PD. While there are international and national NMS treatment guidelines, their implication in clinical practice remains unclear. Objective This study aimed to investigate the adherence to pharmacological NMS treatment guidelines in patients with mild to moderately severe PD. Methods 220 PD patients with ≥1 NMS based on the Non-Motor Symptom Questionnaire and a Hoehn and Yahr stage ≤4 were randomly selected from the Swedish Parkinson registry and screened for inclusion. NMS were evaluated using the International Parkinson and Movement Disorder Society-Non-Motor Rating Scale (MDS-NMS), Parkinson's Disease Sleep Scale 2, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale. Treatment was compared with Swedish national guidelines and international guidelines from the MDS Evidence-Based Medicine Committee. Results Among 165 included patients, the median number of NMS was 14, and in median 7 symptoms were estimated to require treatment. The most common NMS requiring treatment were pain (69%) and urinary problems (56%). Treatment of depression and constipation demonstrated the highest adherence to guidelines (79% and 77%), while dysphagia and excessive daytime sleepiness exhibited the lowest adherence (0% and 4%). On average, only 32% of NMS were treated in accordance with guidelines. Conclusions Adherence to pharmacological guidelines for NMS in patients with mild to severe PD was low. This study highlights the need for improved evaluation and treatment of NMS to enhance symptom management and quality of life among PD patients.
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Affiliation(s)
- Carin Janz
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Jonathan Timpka
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Kristina Rosqvist
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Gesine Paul
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
| | - Alexander Storch
- Department of Neurology, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
| | - Per Odin
- Department of Clinical Sciences Lund, Division of Neurology, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory and Geriatrics, Skåne University Hospital, Lund, Sweden
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Fu M, Li C, Zhao Z, Ling K, Gong Z, Li H, Li T, Li J, Cao W, Hu X, Shi L, Jin P, Guan X. Potentially inappropriate medications among older patients with Parkinson's disease: a cross-sectional analysis of a national health insurance database in China. BMC Geriatr 2023; 23:827. [PMID: 38066430 PMCID: PMC10709967 DOI: 10.1186/s12877-023-04547-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND With the rapid aging trend of China's population, the issue of drug rational use in older adults has become more and more prominent. Parkinson's disease (PD) is the one of the most common age-related neurodegenerative disorders. Pharmaceutical treatment plays a cardinal role in alleviating motor and non-motor symptoms to improve the quality of life of patients with PD. Patients with PD have complex medical needs yet little is known about the use of potentially inappropriate medications (PIM) among them in China. We quantify the prevalence of PIM use and identify its predictors among older persons with PD in China. METHODS We conducted a cross-sectional analysis using a national representative database of all medical insurance beneficiaries across China, extracting records of ambulatory visits of older adults with PD between 2015 and 2017. Beneficiaries aged 65 and above were eligible for inclusion. The prevalence of patients exposed to overall PIMs and PIMs related to motor and cognitive impairment was calculated based on Beers Criteria 2015 version. Potential predictors of PIM concerning patients' characteristics were estimated using multivariate logistic regression. RESULTS A total of 14,452 older adults with PD were included. In total, 8,356 (57.8%) patients received at least one PIM; 2,464 (17.1%) patients received at least one motor-impairing PIM and 6,201 (42.9%) patients received at least one cognition-impairing PIM. The prevalence of overall PIM use was higher in patients of older age group (54.7% [65-74] vs. 59.5% [75-84; OR, 1.22; 95% CI, 1.14-1.31] vs.65.5% [≥ 85; OR, 1.58; 95% CI, 1.38-1.80) and females (61.4% [female] vs. 55.0% [males; OR, 0.77; 95% CI, 0.72-0.82). CONCLUSIONS Prescribing PIMs for older adults with PD was common in China, especially for females and older age groups, yet younger patients were more inclined to be prescribed with motor or cognition-impaired PIMs. Our findings represent a clear target awaiting multidimensional efforts to promote the rational prescribing of medications for this vulnerable population.
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Affiliation(s)
- Mengyuan Fu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Can Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Zinan Zhao
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Kexin Ling
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Zhiwen Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Huangqianyu Li
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Ting Li
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Jianchun Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Weihang Cao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Xin Hu
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Luwen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Pengfei Jin
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China.
- National Center of Gerontology, Beijing, People's Republic of China.
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China.
| | - Xiaodong Guan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China.
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China.
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Donzuso G, Cicero CE, Vinciguerra E, Sergi R, Luca A, Mostile G, Terravecchia C, Zappia M, Nicoletti A. Gender differences in non-motor fluctuations in Parkinson's disease. J Neural Transm (Vienna) 2023; 130:1249-1257. [PMID: 37526768 PMCID: PMC10480257 DOI: 10.1007/s00702-023-02679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
Non-motor symptoms (NMS) and Non-motor fluctuations (NMF) in Parkinson's Disease (PD) are common, involving several domains and affecting quality of life. Aim of the study is to estimate the burden of NMF in PD patients and to evaluate the possible gender effect. PD patients fulfilling the MDS-PD diagnostic criteria attending the "Parkinson's Disease and Movement Disorders Centre" of the University of Catania were evaluated using the Non-Motor Fluctuations Assessment (NoMoFA) Questionnaire. NoMoFA items were also grouped into the following domains: cognitive, mood, sleep/fatigue, dysautonomia, hallucination/perception and miscellaneous domains were identified. One-hundred and twenty-one patients with PD (67 men, 55.4%; mean age 70.2 ± 8.9 years, disease duration 8.3 ± 4.6 years) were evaluated. All PD patients reported at least one NMS, whereas 87 (71.9%) also reported NMF. "Feel sluggish or had low energy levels" (47.2%) along with "Feel excessively sleepy during the day" (40.0%) were the most common NMF reported in the whole sample. The majority of PD patients reported the presence of NMF during the OFF state (79, 65.3%). At multivariate analysis, NMF were positively associated with the female gender (adjusted OR 3.13; 95%CI 1.21-8.11 p-value 0.01). Women with PD had higher NMF scores especially in depression/anxiety, sleep/fatigue and dysautonomia domains. Our study reported the presence of a gender-related pattern in the frequency of NMS and NMF in PD patients, with female gender associated with a higher risk of developing NMF, highlighting the need for personalized treatment strategies when addressing NMF.
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Affiliation(s)
- Giulia Donzuso
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Erica Vinciguerra
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Rosy Sergi
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giovanni Mostile
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Claudio Terravecchia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
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Ananthavarathan P, Patel B, Peeros S, Obrocki R, Malek N. Neurological update: non-motor symptoms in atypical parkinsonian syndromes. J Neurol 2023; 270:4558-4578. [PMID: 37316556 PMCID: PMC10421812 DOI: 10.1007/s00415-023-11807-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
Among people with Parkinson's disease (PD), non-motor symptoms (NMS) are a well-recognised cause of significant morbidity and poor quality of life. Yet, it is only more recently that NMS have been recognised to affect the lives of patients with atypical parkinsonian syndromes in a similar fashion. The aim of this article is to highlight and compare the relative prevalence of NMS among patients with atypical parkinsonian syndromes in the published literature, which largely remain underreported and unaddressed in routine clinical practice. All NMS that are recognised to occur in PD are also found to commonly occur in atypical parkinsonian syndromes. In particular, excessive daytime sleepiness is more prevalent among atypical parkinsonian syndromes (94.3%) compared to PD (33.9%) or normal controls (10.5%) (p < 0.001). Urinary dysfunction (not limited to urinary incontinence) is not only found to occur in MSA (79.7%) and PD (79.9%), but has also been reported in nearly half of the patients with PSP (49.3%), DLB (42%) and CBD (53.8%) (p < 0.001). Apathy is significantly more common among the atypical parkinsonian syndromes [PSP (56%), MSA (48%), DLB (44%), CBD (43%)] compared to PD (35%) (p = 0.029). Early recognition and addressing of NMS among atypical parkinsonian syndromes may help improve the holistic patient care provided and may encompass a range of conservative and pharmacotherapeutic treatments to address these symptoms.
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Affiliation(s)
- Piriyankan Ananthavarathan
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
- Department of Neuroinflammation, Institute of Neurology, University College London, 1st Floor, Russell Square House, 10-12 Russell Square, London, WC1B 5EH, UK.
| | - B Patel
- Department of Neurology, Queen's Hospital, Romford, Essex, UK
| | - S Peeros
- Department of Neurology, Queen's Hospital, Romford, Essex, UK
| | - R Obrocki
- Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Department of Neurology, Queen's Hospital, Romford, Essex, UK
| | - N Malek
- Department of Neurology, Queen's Hospital, Romford, Essex, UK
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Lee B, Edling C, Ahmad S, LeBeau FEN, Tse G, Jeevaratnam K. Clinical and Non-Clinical Cardiovascular Disease Associated Pathologies in Parkinson's Disease. Int J Mol Sci 2023; 24:12601. [PMID: 37628780 PMCID: PMC10454288 DOI: 10.3390/ijms241612601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Despite considerable breakthroughs in Parkinson's disease (PD) research, understanding of non-motor symptoms (NMS) in PD remains limited. The lack of basic level models that can properly recapitulate PD NMS either in vivo or in vitro complicates matters. Even so, recent research advances have identified cardiovascular NMS as being underestimated in PD. Considering that a cardiovascular phenotype reflects sympathetic autonomic dysregulation, cardiovascular symptoms of PD can play a pivotal role in understanding the pathogenesis of PD. In this study, we have reviewed clinical and non-clinical published papers with four key parameters: cardiovascular disease risks, electrocardiograms (ECG), neurocardiac lesions in PD, and fundamental electrophysiological studies that can be linked to the heart. We have highlighted the points and limitations that the reviewed articles have in common. ECG and pathological reports suggested that PD patients may undergo alterations in neurocardiac regulation. The pathological evidence also suggested that the hearts of PD patients were involved in alpha-synucleinopathy. Finally, there is to date little research available that addresses the electrophysiology of in vitro Parkinson's disease models. For future reference, research that can integrate cardiac electrophysiology and pathological alterations is required.
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Affiliation(s)
- Bonn Lee
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, VSM Building, Daphne Jackson Road, Guildford GU2 7YW, UK; (B.L.); (C.E.); (S.A.); (G.T.)
| | - Charlotte Edling
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, VSM Building, Daphne Jackson Road, Guildford GU2 7YW, UK; (B.L.); (C.E.); (S.A.); (G.T.)
| | - Shiraz Ahmad
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, VSM Building, Daphne Jackson Road, Guildford GU2 7YW, UK; (B.L.); (C.E.); (S.A.); (G.T.)
| | - Fiona E. N. LeBeau
- Biosciences Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK;
| | - Gary Tse
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, VSM Building, Daphne Jackson Road, Guildford GU2 7YW, UK; (B.L.); (C.E.); (S.A.); (G.T.)
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury CT2 7FS, UK
| | - Kamalan Jeevaratnam
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, VSM Building, Daphne Jackson Road, Guildford GU2 7YW, UK; (B.L.); (C.E.); (S.A.); (G.T.)
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Wu Q, Liu S, Huang X, Liu J, Wang Y, Xiang Y, Tang X, Xu Q, Yan X, Tang B, Guo J. Bidirectional Mendelian randomization study of psychiatric disorders and Parkinson’s disease. Front Aging Neurosci 2023; 15:1120615. [PMID: 36998320 PMCID: PMC10045982 DOI: 10.3389/fnagi.2023.1120615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
IntroductionAlthough the relationship between psychiatric disorders and Parkinson’s disease (PD) has attracted continuous research attention, the causal linkage between them has not reached a definite conclusion.MethodsTo identify the causal relationship between psychiatric disorders and PD, we used public summary-level data from the most recent and largest genome-wide association studies (GWASs) on psychiatric disorders and PD to conduct a bidirectional two-sample Mendelian randomization (MR). We applied stringent control steps in instrumental variable selection using the Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) method to rule out pleiotropy. The inverse-variance weighted (IVW) method was used to identify the causal relationship between psychiatric disorders and PD. Multiple MR analysis methods, including MR-Egger, weighted-median, and leave-one-out analyses, were used for sensitivity analysis, followed by heterogeneity tests. Further validation and reverse MR analyses were conducted to strengthen the results of the forward MR analysis.ResultsThe lack of sufficient estimation results could suggest a causal relationship between psychiatric disorders and PD in the forward MR analysis. However, the subsequent reverse MR analysis detected a causal relationship between PD and bipolar disorder (IVW: odds ratios [OR] =1.053, 95% confidence interval [CI] =1.02–1.09, p = 0.001). Further analysis demonstrated a causal relationship between genetically predicted PD and the risk of bipolar disorder subtype. No pleiotropy or heterogeneity was detected in the analyses.DiscussionOur study suggested that while psychiatric disorders and traits might play various roles in the risk of developing PD, PD might also be involved in the risk of developing psychiatric disorders.
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Affiliation(s)
- Qi Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
| | - Shulin Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiurong Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiabin Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yige Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yaqing Xiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuxiong Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Center for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Jifeng Guo,
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Still A, Hale L, Jayakaran P. The inter-relationship between various non-motor symptoms and with habitual physical activity in Parkinsonism: a scoping review protocol. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2133885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Amanda Still
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Leigh Hale
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Prasath Jayakaran
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Arabia G, De Martino A, Moro E. Sex and gender differences in movement disorders: Parkinson's disease, essential tremor, dystonia and chorea. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 164:101-128. [PMID: 36038202 DOI: 10.1016/bs.irn.2022.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sex and gender-based differences in epidemiology, clinical features and therapeutical responses are emerging in several movement disorders, even though they are still not widely recognized. In this chapter, we summarize the most relevant evidence concerning these differences in Parkinson's disease, essential tremor, dystonia and chorea. Indeed, both sex-related biological (hormonal levels fluctuations) and gender-related variables (socio-cultural and environmental factors) may differently impact symptoms manifestation and severity, phenotype and disease progression of movement disorders on men and women. Moreover, sex differences in treatment responses should be taken into account in any therapeutical planning. Physicians need to be aware of these major differences between men and women that will eventually have a major impact on better tailoring prevention, treatment, or even delaying progression of the most common movement disorders.
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Affiliation(s)
- Gennarina Arabia
- Magna Graecia University, Movement Disorders Center, Neurology Unit, Catanzaro, Italy.
| | - Antonio De Martino
- Magna Graecia University, Movement Disorders Center, Neurology Unit, Catanzaro, Italy
| | - Elena Moro
- Grenoble Alpes University, CHU of Grenoble, Division of Neurology, Grenoble Institute of Neurosciences, Grenoble, France
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10
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Paracha M, Herbst K, Kieburtz K, Venuto CS. Prevalence and incidence of non‐motor symptoms in individuals with and without Parkinson's disease. Mov Disord Clin Pract 2022; 9:961-966. [PMID: 36247906 PMCID: PMC9547141 DOI: 10.1002/mdc3.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background The prevalence ratio (PR) and incidence rate ratio (IRR) of nonmotor symptoms (NMS) were calculated for early Parkinson's disease (PD) versus non‐PD from 2 observational studies. Methods NMS were assessed through the self‐reported Non‐Motor Symptom Questionnaire in the online Fox Insight study and through self‐ and clinician‐rated scales in the Parkinson's Progression Marker Initiative (PPMI) study. Age‐ and sex‐adjusted/matched PR and IRR were estimated for each NMS by PD status using Poisson regression. Results Most NMS occurred more frequently in PD. Among 15,194 Fox Insight participants, sexual dysfunction had the largest adjusted PR (12.4 [95% CI, 6.9–22.2]) and dysgeusia/hyposmia had the largest adjusted IRR over a 2‐year median follow‐up (17.0 [95% CI, 7.8–37.1]). Among 607 PPMI participants, anosmia had the largest PR (16.6 [95% CI, 6.1–44.8]). During the 7‐year median follow‐up, hallucinations had the largest IRR (13.5 [95% CI, 6.3–28.8]). Conclusion Although many NMS are more common in early PD than in non‐PD, their occurrence may differ with time (hallucinations) or data collection methods (sexual dysfunction).
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Affiliation(s)
- Mariam Paracha
- Center for Health + Technology University of Rochester Rochester NY
- Department of Science and Mathematics, National Technical Institute for the Deaf Rochester Institute of Technology Rochester NY
- Department of Neurology University of Rochester Rochester NY
| | - Konnor Herbst
- Center for Health + Technology University of Rochester Rochester NY
| | - Karl Kieburtz
- Center for Health + Technology University of Rochester Rochester NY
- Department of Neurology University of Rochester Rochester NY
| | - Charles S. Venuto
- Center for Health + Technology University of Rochester Rochester NY
- Department of Neurology University of Rochester Rochester NY
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11
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Wu C, Fang Y, Zhou Y, Wu H, Huang S, Zhu S. Risk Prediction Models for Early ICU Admission in Patients With Autoimmune Encephalitis: Integrating Scale-Based Assessments of the Disease Severity. Front Immunol 2022; 13:916111. [PMID: 35757708 PMCID: PMC9226454 DOI: 10.3389/fimmu.2022.916111] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background In patients with autoimmune encephalitis (AE), the prediction of progression to a critically ill status is challenging but essential. However, there is currently no standard prediction model that comprehensively integrates the disease severity and other clinical features. The clinical assessment scale in autoimmune encephalitis (CASE) and the modified Rankin Scale (mRS) have both been applied for evaluating the severity of AE. Here, by combining the two scales and other clinical characteristics, we aimed to investigate risk factors and construct prediction models for early critical care needs of AE patients. Methods Definite and probable AE patients who were admitted to the neurology department of Tongji Hospital between 2013 and 2021 were consecutively enrolled. The CASE and mRS scores were used to evaluate the overall symptom severity at the time of hospital admission. Using logistic regression analysis, we analyzed the association between the total scores of the two scales and critical illness individually and then we evaluated this association in combination with other clinical features to predict early intensive care unit (ICU) admission. Finally, we constructed four prediction models and compared their performances. Results Of 234 patients enrolled, forty developed critical illness and were early admitted to the ICU (within 14 days of hospitalization). Four prediction models were generated; the models were named CASE, CASE-plus (CASE + prodromal symptoms + elevated fasting blood glucose + elevated cerebrospinal fluid (CSF) white blood cell (WBC) count), mRS and mRS-plus (mRS + prodromal symptoms + abnormal EEG results + elevated fasting blood glucose + elevated CSF WBC count) and had areas under the ROC curve of 0.850, 0.897, 0.695 and 0.833, respectively. All four models had good calibrations. In general, the models containing “CASE” performed better than those including “mRS”, and the CASE-plus model demonstrated the best performance. Conclusion Overall, the symptom severity at hospital admission, as defined by CASE or mRS, could predict early ICU admission, especially when assessed by CASE. Adding other clinical findings, such as prodromal symptoms, an increased fasting blood glucose level and an increased CSF WBC count, could improve the predictive efficacy.
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Affiliation(s)
- Chunmei Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongkang Fang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiting Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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12
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Chen G, Du Y, Li X, Kambey PA, Wang L, Xia Y, Tang C, Shi M, Zai-li L, Zai-e X, Xiao-ling Q, Dian-shuai G. Lower GDNF Serum Level Is a Possible Risk Factor for Constipation in Patients With Parkinson Disease: A Case–Control Study. Front Neurol 2022; 12:777591. [PMID: 35095724 PMCID: PMC8792488 DOI: 10.3389/fneur.2021.777591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Constipation is a significant symptom of Parkinson's disease (PD). Glial-derived neurotrophic factor (GDNF) is important for the morphogenesis of the enteric nervous system and plays a critical role in the preservation of mucosal integrity under enteric glia surveillance. The aim of this work was to evaluate the serum levels of GDNF in patients with PD with and without constipation. Methods: This work included 128 patients with PD. The patients were classified into three groups: those with PD but no constipation (nCons-PD) (n = 49), those with prodromal stage constipation (Cons-Pro-PD) (n = 48), and those with clinical stage constipation (Cons-Clinic-PD) (n = 31). The association between serum GDNF concentration and constipation was explored using logical regression. Results: The nCons-PD group's mean GDNF levels were 528.44 pg/ml, which was higher than the Cons-Pro-PD group's 360.72 pg/ml and the Cons-Clinic-PD group's 331.36 pg/ml. The results of binary logistic regression indicated that GDNF was a protective factor in the prevention of constipation. Cons-Clinic-PD group had a higher score of MDS-UPDRS-II, MDS-UPDRS-III, MDS-UPDRS-IV, and a higher H-Y staging as compared with nCons-PD group. Relative to the nCons-PD group, Cons-Clinic-PD had higher NMSS scores, lower MoCA and PDSS scores, and were more likely to have RBD. Conclusions: GDNF serum levels are lower in patients with PD who are constipated. A low GDNF level is a potential risk factor for constipation in patients with PD.
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Affiliation(s)
- Gang Chen
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The Affiliated Shuyang Hospital of Traditional Chinese Medicine of Yangzhou Medical University, Suqian, China
| | - Yinzhen Du
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Xue Li
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Piniel Alphayo Kambey
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Li Wang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ying Xia
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Chuanxi Tang
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Mingyu Shi
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
| | - Li Zai-li
- Department of Neurology, Xuzhou Central Hospital, Xuzhou, China
| | - Xin Zai-e
- Department of Neurology, Xuzhou Central Hospital, Xuzhou, China
| | - Qin Xiao-ling
- Department of Geriatrics, Shanghai Fourth People's Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Qin Xiao-ling
| | - Gao Dian-shuai
- Department of Neurobiology, Xuzhou Key Laboratory of Neurobiology, Xuzhou Medical University, Xuzhou, China
- Gao Dian-shuai
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13
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Nonmotor Symptoms in Amyotrophic Lateral Sclerosis and Their Correlation With Disease Progression. J Clin Neuromuscul Dis 2021; 23:1-6. [PMID: 34431795 DOI: 10.1097/cnd.0000000000000343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Motor neuron disease is a progressive neurodegenerative disease involving upper and lower motor neurons. Nonmotor symptoms (NMS) are part of disease manifestation. We aim to report the prevalence and severity of NMS in patients with motor neuron disease (MND) in Lebanon. . METHODS Fifty-eight patients diagnosed with MND at the American University of Beirut Medical Center were interviewed using the NMS Scale. The prevalence of these symptoms was assessed and correlated with disease progression. RESULTS All our patients had at least 2 NMS with an average total score of 15.8. Symptoms reported in more than half of the patients were fatigue, depression, dysphagia, lack of motivation, pain, change in weight, anxiety, constipation, and lack of pleasure. A significant correlation was found between the total NMS score and Amyotrophic Lateral Sclerosis Functional Rating Scale score (P = 0.002) and between the NMS score corresponding to mental health and Amyotrophic Lateral Sclerosis Functional Rating Scale score (P = 0.012). Patients with bulbar symptoms had a significantly higher NMS score corresponding to gastrointestinal symptoms (P < 0.0001). It is important to note that NMS such as dysphagia could be related to motor neuron involvement. CONCLUSIONS NMS are commonly reported in patients with MND and seem to positively correlate with disease progression. Treating NMS is a critical aspect of the clinical care delivered to patients with MND to maintain a good quality of life.
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14
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Santos-García D, de Deus T, Cores C, Canfield H, Paz González JM, Martínez Miró C, Valdés Aymerich L, Suárez E, Jesús S, Aguilar M, Pastor P, Planellas L, Cosgaya M, García Caldentey J, Caballol N, Legarda I, Hernández-Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Catalán MJ, Nogueira V, Puente V, Dotor J, Borrué C, Solano B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo F, Martínez Castrillo JC, Sánchez Alonso P, Alonso G, López Ariztegui N, Gastón I, Kulisevsky J, Blázquez M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, de Fábregues O, Ardura J, Alonso R, Ordás C, López Díaz LM, McAfee D, Martinez-Martin P, Mir P. Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson's Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up. J Pers Med 2021; 11:626. [PMID: 34209166 PMCID: PMC8305732 DOI: 10.3390/jpm11070626] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background and Objective: Non-motor symptoms (NMS) progress in different ways between Parkinson's disease (PD) patients. The aim of the present study was to (1) analyze the change in global NMS burden in a PD cohort after a 2-year follow-up, (2) to compare the changes with a control group, and (3) to identify predictors of global NMS burden progression in the PD group. Material and Methods: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017, were followed-up with after 2 years. The Non-Motor Symptoms Scale (NMSS) was administered at baseline (V0) and at 24 months ± 1 month (V2). Linear regression models were used for determining predictive factors of global NMS burden progression (NMSS total score change from V0 to V2 as dependent variable). Results: After the 2-year follow-up, the mean NMS burden (NMSS total score) significantly increased in PD patients by 18.8% (from 45.08 ± 37.62 to 53.55 ± 42.28; p < 0.0001; N = 501; 60.2% males, mean age 62.59 ± 8.91) compared to no change observed in controls (from 14.74 ± 18.72 to 14.65 ± 21.82; p = 0.428; N = 122; 49.5% males, mean age 60.99 ± 8.32) (p < 0.0001). NMSS total score at baseline (β = -0.52), change from V0 to V2 in PDSS (Parkinson's Disease Sleep Scale) (β = -0.34), and change from V0 to V2 in NPI (Neuropsychiatric Inventory) (β = 0.25) provided the highest contributions to the model (adjusted R-squared 0.41; Durbin-Watson test = 1.865). Conclusions: Global NMS burden demonstrates short-term progression in PD patients but not in controls and identifies worsening sleep problems and neuropsychiatric symptoms as significant independent predictors of this NMS progression.
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Affiliation(s)
- Diego Santos-García
- CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain; (C.C.); (J.M.P.G.); (C.M.M.); (L.V.A.)
| | - Teresa de Deus
- CHUF, Complejo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain; (T.d.D.); (H.C.); (E.S.)
| | - Carlos Cores
- CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain; (C.C.); (J.M.P.G.); (C.M.M.); (L.V.A.)
| | - Hector Canfield
- CHUF, Complejo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain; (T.d.D.); (H.C.); (E.S.)
| | - Jose M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain; (C.C.); (J.M.P.G.); (C.M.M.); (L.V.A.)
| | - Cristina Martínez Miró
- CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain; (C.C.); (J.M.P.G.); (C.M.M.); (L.V.A.)
| | - Lorena Valdés Aymerich
- CHUAC, Complejo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain; (C.C.); (J.M.P.G.); (C.M.M.); (L.V.A.)
| | - Ester Suárez
- CHUF, Complejo Hospitalario Universitario de Ferrol, 15405 A Coruña, Spain; (T.d.D.); (H.C.); (E.S.)
| | - Silvia Jesús
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41009 Seville, Spain; (S.J.); (P.M.)
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain; (I.G.A.); (J.K.); (P.M.-M.)
| | - Miquel Aguilar
- Hospital Universitari Mutua de Terrassa, 08221 Barcelona, Spain; (M.A.); (P.P.)
| | - Pau Pastor
- Hospital Universitari Mutua de Terrassa, 08221 Barcelona, Spain; (M.A.); (P.P.)
| | - Lluis Planellas
- Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (L.P.); (M.C.)
| | - Marina Cosgaya
- Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (L.P.); (M.C.)
| | | | - Nuria Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, 08970 Barcelona, Spain;
| | - Ines Legarda
- Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain;
| | - Jorge Hernández-Vara
- Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain; (J.H.-V.); (O.d.F.)
| | - Iria Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), 36071 Pontevedra, Spain; (I.C.); (M.S.)
| | | | - Isabel González Aramburu
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain; (I.G.A.); (J.K.); (P.M.-M.)
- Hospital Universitario Marqués de Valdecilla, 39011 Santander, Spain
| | - Maria A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L’Hospitalet, 08906 Barcelona, Spain;
| | - Maria J Catalán
- Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain;
| | | | | | - Julio Dotor
- Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain;
| | | | - Berta Solano
- Institut d’Assistència Sanitària (IAS)—Institut Català de la Salut, 17190 Girona, Spain;
| | | | - Lydia Vela
- Fundación Hospital de Alcorcón, 28922 Madrid, Spain;
| | - Sonia Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC), 43500 Tarragona, Spain;
| | - Esther Cubo
- Complejo Asistencial Universitario de Burgos, 09006 Burgos, Spain;
| | - Francisco Carrillo
- Hospital Universitario de Canarias, 38320 San Cristóbal de la Laguna, Spain;
| | | | | | - Gemma Alonso
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), 36213 Vigo, Spain;
| | | | - Itziar Gastón
- Complejo Hospitalario de Navarra, 31008 Pamplona, Spain;
| | - Jaime Kulisevsky
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain; (I.G.A.); (J.K.); (P.M.-M.)
- Hospital de Sant Pau, 08041 Barcelona, Spain
| | - Marta Blázquez
- Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Manuel Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), 36071 Pontevedra, Spain; (I.C.); (M.S.)
| | | | | | | | - Oriol de Fábregues
- Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain; (J.H.-V.); (O.d.F.)
| | | | - Ruben Alonso
- Hospital Universitario Lucus Augusti (HULA), 27002 Lugo, Spain;
| | | | - Luis M López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO), 32005 Orense, Spain;
| | - Darrian McAfee
- Laboratory for Cognition and Neural Stimulation, Univeristy of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Pablo Martinez-Martin
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain; (I.G.A.); (J.K.); (P.M.-M.)
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41009 Seville, Spain; (S.J.); (P.M.)
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), 28031 Madrid, Spain; (I.G.A.); (J.K.); (P.M.-M.)
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15
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van Wamelen DJ, Sauerbier A, Leta V, Rodriguez-Blazquez C, Falup-Pecurariu C, Rodriguez-Violante M, Rizos A, Tsuboi Y, Metta V, Bhidayasiri R, Bhattacharya K, Borgohain R, Prashanth LK, Rosales R, Lewis S, Fung V, Behari M, Goyal V, Kishore A, Lloret SP, Martinez-Martin P, Chaudhuri KR. Cross-sectional analysis of the Parkinson's disease Non-motor International Longitudinal Study baseline non-motor characteristics, geographical distribution and impact on quality of life. Sci Rep 2021; 11:9611. [PMID: 33953218 PMCID: PMC8100281 DOI: 10.1038/s41598-021-88651-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/12/2021] [Indexed: 01/20/2023] Open
Abstract
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naïve and non-drug-naïve treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 ± 10.8 years, mean disease duration 6.3 ± 5.6 years, median Hoehn and Yahr stage was 2 (2–3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 ± 37.2. Differences in non-motor burden and patterns differed significantly between drug-naïve participants, those with a disease duration of less than five years, and those with a duration of five years or over (p ≤ 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 ± 36.3; Americas: 55.3 ± 42.8; Asia: 26.6 ± 25.1; p < 0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p ≤ 0.020). The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.
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Affiliation(s)
- Daniel J van Wamelen
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK. .,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands. .,Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Anna Sauerbier
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Neurology, Faculty of Medicine University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Valentina Leta
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Carmen Rodriguez-Blazquez
- National Center of Epidemiology, Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Cristian Falup-Pecurariu
- Department of Neurology, Faculty of Medicine, County Emergency Clinic Hospital, Transilvania University, Braşov, Romania
| | | | - Alexandra Rizos
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | - Y Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Vinod Metta
- Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
| | | | - Kalyan Bhattacharya
- Formerly RG Kar Medical College and Institute of Neuroscience, Kolkata, India
| | | | - L K Prashanth
- Center for Parkinson's Disease and Movement Disorders Clinic, Vikram Hospitals, Bangalore, India.,Parkinson's Disease and Movement Disorders Clinic, Bangalore, India
| | | | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Victor Fung
- Movement Disorders Unit, Neurology Department, Westmead Hospital, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Madhuri Behari
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Asha Kishore
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Santiago Perez Lloret
- Biomedical Research Center, Interamerican Open University (CAECIHS-UAI), National Research Council (CONICET), Buenos Aires, Argentina.,Department of Physiology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Parkinson's Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK
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Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, Cores Bartolomé C, Feal Panceiras MJ, Paz González JM, Valdés Aymerich L, García Moreno JM, Blázquez Estrada M, Jesús S, Mir P, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Cabo López I, López Manzanares L, Ávila Rivera MA, Catalán MJ, López Díaz LM, Borrué C, Álvarez Sauco M, Vela L, Cubo E, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Pascual-Sedano B, Seijo M, Ruíz Martínez J, Valero C, Kurtis M, González Ardura J, Prieto Jurczynska C, Martinez-Martin P. Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression. J Neurol Sci 2020; 418:117109. [PMID: 32927370 DOI: 10.1016/j.jns.2020.117109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. MATERIAL AND METHODS PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. RESULTS The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. CONCLUSIONS SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.
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Affiliation(s)
- D Santos-García
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Valdés Aymerich
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L M López Díaz
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B Pascual-Sedano
- Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | | | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; CIBERNED, Instituto de Salud Carlos III, Madrid. COPPADIS Study Group, Spain
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Aubignat M, Tir M, Krystkowiak P. [Non-motor symptoms of Parkinson's disease from pathophysiology to early diagnosis]. Rev Med Interne 2020; 42:251-257. [PMID: 32680717 DOI: 10.1016/j.revmed.2020.06.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/30/2020] [Accepted: 06/21/2020] [Indexed: 12/22/2022]
Abstract
Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease. The pathophysiology of Parkinson's disease is complex and imperfectly known. Primum movens is abnormal intra-neuronal accumulation of the protein α-synuclein, leading to metabolic disturbances and neurodegeneration. This abnormal accumulation of α-synuclein is also found in dementia with Lewy bodies and multiple system atrophy, which together with Parkinson's disease form the group of α-synucleinopathies. Well known by its motor signs (bradykinesia, rest tremor, cogwheel rigidity and gait disturbance), Parkinson's disease is above all a systemic disease composed of a myriad of non-motor symptoms (constipation, sense of smell disorders, rapid eye movement sleep behaviour disorders, genitourinary disorders…). These non-motor symptoms caused by accumulation and migration of α-synuclein deposits from the gut and the olfactory bulb to the central nervous system may precede motor signs by ten years and therefore be of interest for early diagnosis. Furthermore, non-motor symptoms have a poorer impact on quality of life than motor signs themselves. Therefore, understanding, recognition and management of non-motor symptoms are crucial in management of parkinsonian patient. In this paper, we offer an update on the main non-motor symptoms of Parkinson's disease, from their pathophysiology to their screening, ending with their management.
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Affiliation(s)
- M Aubignat
- Service de neurologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France; Centre Expert Parkinson, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France.
| | - M Tir
- Service de neurologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France; Centre Expert Parkinson, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France
| | - P Krystkowiak
- Service de neurologie, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France; Centre Expert Parkinson, CHU Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France
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Bogosian A, Rixon L, Hurt CS. Prioritising target non-pharmacological interventions for research in Parkinson's disease: achieving consensus from key stakeholders. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:35. [PMID: 32595982 PMCID: PMC7315468 DOI: 10.1186/s40900-020-00212-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In 2014 Parkinson's UK conducted a research prioritisation exercise with stakeholders highlighting important clinical research questions. The exercise highlighted the need for effective interventions to be developed and tested to tackle a range of non-motor symptoms including: sleep quality, stress and anxiety, mild cognitive impairment, dementia and urinary problems. The present work set out to build on this exercise by prioritising types of non-pharmacological interventions to be tested to treat the identified non-motor symptoms. METHODS A Patient and Public Involvement exercise was used to reach consensus on intervention priorities for the treatment of non-motor symptoms. A Delphi structure was used to support the feedback collected. A first-round prioritisation survey was conducted followed by a panel discussion. Nineteen panellists completed the first-round survey (9 people with Parkinson's and 10 professionals working in Parkinson's) and 16 participated in the panel discussion (8 people with Parkinson's and 8 professionals working in Parkinson's). A second-round prioritization survey was conducted after the panel discussion with 13 people with Parkinson's. RESULTS Physical activity, third wave cognitive therapies and cognitive training were rated as priority interventions for the treatment of a range of non-motor symptoms. There was broad agreement on intervention priorities between health care professionals and people with Parkinson's. A consensus was reached that research should focus on therapies which could be used to treat several different non-motor symptoms. In the context of increasing digitisation, the need for human interaction as an intervention component was highlighted. CONCLUSION Bringing together Parkinson's professionals and people with Parkinson's resulted in a final treatment priority list which should be both feasible to carry out in routine clinical practice and acceptable to both professionals and people with Parkinson's. The workshop further specified research priorities in Parkinson's disease based on the current evidence base, stakeholder preferences, and feasibility. Research should focus on developing and testing non-pharmacological treatments which could be effective across a range of symptoms but specifically focusing on tailored physical activity interventions, cognitive therapies and cognitive training.
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Affiliation(s)
- Angeliki Bogosian
- Division of Health Services Research and Management, City, University of London, London, UK
| | - Lorna Rixon
- Division of Health Services Research and Management, City, University of London, London, UK
| | - Catherine S. Hurt
- Division of Health Services Research and Management, City, University of London, London, UK
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Wang L, Wang G, Duan Y, Wang F, Lin S, Zhang F, Li H, Li A, Li H. A Comparative Study of the Diagnostic Potential of Plasma and Erythrocytic α-Synuclein in Parkinson's Disease. NEURODEGENER DIS 2020; 19:204-210. [PMID: 32485710 DOI: 10.1159/000506480] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 02/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disease characterized by intracellular α-synuclein (α-Syn) deposition. Alternation of the α-Syn expression level in plasma or erythrocytes may be used as a potential PD biomarker. However, no studies have compared their prognostic value directly with the same cohort. METHODS The levels of α-Syn in plasma and erythrocytes, obtained from 45 PD patients and 45 control subjects, were measured with enzyme-linked immunosorbent assay. Then, correlation and receiver operating characteristic curve (ROC) analysis were performed to characterize the predictive power of erythrocytic and plasma α-Syn. RESULTS Our results showed that α-Syn expression levels in both plasma and erythrocytes were significantly higher in PD patients than in control subjects (823.14 ± 257.79 vs. 297.10 ± 192.82 pg/mL, p < 0.0001 in plasma; 3,104.14 ± 143.03 vs. 2,944.82 ± 200.41 pg/mL, p < 0.001 in erythrocytes, respectively). The results of the ROC analysis suggested that plasma α-Syn exhibited better predictive power than erythrocytic α-Syn with a sensitivity of 80.0%, specificity of 97.7%, and a positive predictive value of 77.8%. The expression level of plasma α-Syn correlated well with the age of patients, H-Y stage, MoCA scale, and UPDRS motor scale. On the contrary, there was no correlation between erythrocytic α-Syn level and clinical parameters in this study. CONCLUSION Our results suggest that plasma α-Syn could be a specific and sensitive potential diagnostic biomarker for PD.
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Affiliation(s)
- Luxuan Wang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.,Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
| | - Guowei Wang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.,Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
| | - Yangyang Duan
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.,Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
| | - Feng Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
| | - Shaoqing Lin
- Department of Neurology, Brain Center of Sunshine Union Hospital, Sunshine Union Hospital, Weifang, China
| | - Fengting Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.,Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
| | - Hui Li
- Department of Computer Science, Jiangsu Ocean University, Lianyungang, China
| | - Andy Li
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute Biotechnology Enterprise (BRITE), North Carolina Central University, Durham, North Carolina, USA,
| | - Haining Li
- Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China
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20
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Toyama M, Okuma Y, Yamamoto M, Kashihara K, Yoshida K, Saiki H, Maeda T, Tsuboi Y, Takahashi Y, Nakayama T. Non-motor symptoms depending on motor severity in Japanese patients with Parkinson's disease: A multicenter cross-sectional study. J Neurol Sci 2020; 412:116641. [PMID: 32151836 DOI: 10.1016/j.jns.2019.116641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/03/2019] [Accepted: 12/18/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although non-motor symptoms (NMS) in patients with Parkinson's disease (PD) often worsen as the severity of motor symptoms (MS) increases, few studies have assessed the associated factors of non-motor symptoms. OBJECTIVE This study aims to determine whether the presence of NMS in PD patients is associated with or independent from the severity of MS considering confounders. METHODS The registry of PD patients from seven facilities in Japan was used. Multiple logistic regression was performed with each domain and item of the Non-motor Symptoms Scale (NMSS) as objective variables. Severity of motor symptoms was assessed by Hoehn & Yahr stage (HY stage) as an explanatory variable. The analysis was adjusted for sex, age, disease duration, presence/absence of wearing off and dyskinesia, clinical phenotypes and Levodopa equivalent daily dose. RESULTS A total of 1037 patients were analyzed. Analysis by NMSS domain showed higher odds ratios (ORs) in patients with higher HY stages compared with patients with lower HY stages for domains D1 (cardiovascular), D2 (sleep/fatigue), D3 (mood/apathy), D4 (perceptual problems/hallucinations), D5 (attention/memory), and D6 (gastrointestinal) (ORs: 1.54-2.72, P < .05). However, only domains D7 (urinary) and D8 (sexual dysfunction) were not associated with HY stage. Item 2 (fainting) and Item 14 (delusions) showed higher ORs in the HY stage 4-5 (ORs: 9.95 and 5.92, P < .05). CONCLUSIONS Most NMS worsened with exacerbation of MS in PD patients, however some NMS domains were also affected with other factors. These findings contribute to the understanding of the clinical picture of PD and may improve personalized medicine and research in PD.
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Affiliation(s)
- Mayumi Toyama
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan.
| | | | - Mitsutoshi Yamamoto
- Department of Neurology, Kagawa Prefectural Central Hospital (current affiliation: Takamatsu Neurology Clinic, Takamatsu Institute for Parkinson Disease), Japan
| | | | | | - Hidemoto Saiki
- Department of Neurology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Japan
| | | | - Yoshimitsu Takahashi
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan
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Nonmotor symptoms of 820 Taiwanese patients with Parkinson's disease: an exploratory-comparative study. J Neurol 2020; 267:1499-1507. [PMID: 32025799 DOI: 10.1007/s00415-020-09708-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Nonmotor symptoms (NMSs) severely affect the daily quality of life of patients with Parkinson's disease (PD). Although many studies have documented the clinical characteristics of NMSs in PD patients, some issues remain unaddressed. The severity and gender distribution of NMSs in Asian and the Western patients differ. The correlations between clinical characteristics and NMS manifestations remain unclear. We studied these relationships in a large cohort of Taiwanese PD patients. METHODS Patients with PD were recruited from the outpatient clinic of a tertiary medical center and evaluated with standardized assessment protocols, including the NonMotor Symptoms Scale (NMSS), Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) scale, Mini-Mental Status Examination, and Montreal Cognitive Assessment. RESULTS Among 820 patients enrolled, 41.8% were female. The prevalence of the NMSs was 96.5%, with attention/memory (79.51%) being the most frequently involved domain. The mean severity score on the NMSS was 36.48 ± 34.30. Male patients reported higher NMS prevalence and severity than female patients, mostly in the gastrointestinal tract and urinary domains. We found that the severity of NMSs was correlated with disease duration, UPDRS Part III score, and H&Y stage. CONCLUSION Although they exhibited similar NMS prevalence, Taiwanese PD patients reported less intense NMSs compared with those reported by Western patients. Furthermore, the NMS items our patients emphasized and gender discrepancies were distinct from those in Western studies.
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Sánchez-Martínez CM, Choreño-Parra JA, Placencia-Álvarez N, Nuñez-Orozco L, Guadarrama-Ortiz P. Frequency and Dynamics of Non-motor Symptoms Presentation in Hispanic Patients With Parkinson Disease. Front Neurol 2019; 10:1197. [PMID: 31798522 PMCID: PMC6868116 DOI: 10.3389/fneur.2019.01197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/28/2019] [Indexed: 12/26/2022] Open
Abstract
The clinical phenotype of Parkinson's disease (PD) encompasses a wide range of non-motor symptoms (NMS) compromising the quality of life of affected patients. Currently, information about NMS in PD is scarce among Hispanic populations. Furthermore, few studies have reported the temporal pattern of NMS presentation. We conducted a cross-sectional study aimed to describe the frequency and time of NMS occurrence in Hispanic patients with PD using the self-completed NMS questionnaire (NMSQuest). Participants were interrogated about the time of each NMS presentation respect to the onset of motor symptoms. The frequency of NMS was described according to gender, age at disease onset, disease duration and Hoehn and Yahr (H&Y) stage. We enrolled 120 patients, 73.33% males and 26.66% females, with a mean age of 63.33 ± 8.60 years. All the participants presented at least 1 NMS. The median number of NMS per patient was 12. The most frequent NMS domains were miscellaneous, urinary tract, sleep/fatigue, and gastrointestinal tract symptoms, with no significant gender differences. The most frequent individual NMS were nocturia, urinary urgency, feeling sadness, and constipation. Any patient reported NMS before the onset of motor manifestations. The pattern of occurrence of NMS domains in our population was as follows: attention/memory, cardiovascular, gastrointestinal tract, perceptual problems/hallucinations, mood/cognition, urinary, miscellaneous, sleep/fatigue, and sexual function. Nausea/vomiting was the earliest symptom observed in all patients, whereas sexual dysfunction and changes in interest for sex were the last symptoms to occur. We found no differences in the total number and frequency of NMS between participants grouped according to their age at disease onset. Conversely, patients with a duration of disease >10 years reported a higher frequency of NMS compared to participants with a duration of disease < 10 years. The total number of NMS per patient increased as the HY stage progressed. The proportion of patients presenting symptoms of the gastrointestinal tract, urinary tract, mood/cognition, cardiovascular, and sexual function domains was higher in the HY 4–5 group. Our study provides relevant data to improve our understanding of NMS in PD, which may contribute to anticipate and plan diagnostic and therapeutic strategies among Hispanic PD patients.
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Affiliation(s)
| | - José Alberto Choreño-Parra
- Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, Mexico.,Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Noel Placencia-Álvarez
- Department of Neurology, Centro Médico Nacional 20 de Noviembre, ISSSTE, Mexico City, Mexico
| | - Lilia Nuñez-Orozco
- Department of Neurology, Centro Médico Nacional 20 de Noviembre, ISSSTE, Mexico City, Mexico
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Sleep disturbances and gastrointestinal dysfunction are associated with thalamic atrophy in Parkinson's disease. BMC Neurosci 2019; 20:55. [PMID: 31640554 PMCID: PMC6805461 DOI: 10.1186/s12868-019-0537-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 10/12/2019] [Indexed: 01/18/2023] Open
Abstract
Background Non-motor symptoms are common aspects of Parkinson’s disease (PD) occurring even at the prodromal stage of the disease and greatly affecting the quality of life. Here, we investigated whether non-motor symptoms burden was associated with cortical thickness and subcortical nuclei volume in PD patients. Methods We studied 41 non-demented PD patients. Non-motor symptoms burden was assessed using the Non-Motor Symptoms Scale grading (NMSS). Cortical thickness and subcortical nuclei volume analyses were carried out using Free-Surfer. PD patients were divided into two groups according to the NMSS grading: mild to moderate (NMSS: 0–40) and severe (NMSS: ≥ 41) non-motor symptoms. Results Thalamic atrophy was associated with higher NMSQ and NMSS total scores. The non-motor symptoms that drove this correlation were sleep/fatigue and gastrointestinal tract dysfunction. We also found that PD patients with severe non-motor symptoms had significant thalamic atrophy compared to the group with mild to moderate non-motor symptoms. Conclusions Our findings show that greater non-motor symptom burden is associated with thalamic atrophy in PD. Thalamus plays an important role in processing sensory information including visceral afferent from the gastrointestinal tract and in regulating states of sleep and wakefulness.
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Decreased Striatal Vesicular Monoamine Transporter Type 2 Correlates With the Nonmotor Symptoms in Parkinson Disease. Clin Nucl Med 2019; 44:707-713. [PMID: 31205154 DOI: 10.1097/rlu.0000000000002664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Nonmotor symptoms (NMS) are critical players in the patients' quality of life in Parkinson disease (PD). Vesicular monoamine transporter type 2 (VMAT2) has been reported owing to a role in affecting dopamine neurons in the striatum. Therefore, this study set out to characterize the relationship between VMAT2 distribution in the striatum in relation to the NMS in PD. METHODS Totally, 21 age-matched normal controls and 37 patients with PD in the moderate stages were included, followed by examination using F-DTBZ (F-AV133) PET/CT. The specific uptake ratio (SUR) of each striatal subregion was then determined with the occipital cortex as the reference background region. The overall NMSs of each individual patient were evaluated. Finally, the role of the striatal SURs in the clinical symptom scores were evaluated through the application of a Spearman correlation analysis as well as a multivariable stepwise regression analysis. RESULTS Patients with PD, particularly those at a more advanced stage, exhibited a more pronounced reduction in SURs in the bilateral putamen and caudate nucleus (P < 0.05, vs healthy controls). Meanwhile, patients at more advanced PD stages were found to have significantly worse scores in NMS except cognitive function. The Spearman correlation analysis demonstrated that NMS scores, with the exception of cognition scores, were correlated with striatal SURs (P < 0.05). CONCLUSION The key findings of the study identified a correlation between decreased striatal VMAT2 with a broad spectrum of NMS in patients with PD, highlighting the association between diminished dopamine supply and the development of NMS in PD.
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25
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Santos García D, de Deus Fonticoba T, Suárez Castro E, Borrué C, Mata M, Solano Vila B, Cots Foraster A, Álvarez Sauco M, Rodríguez Pérez AB, Vela L, Macías Y, Escalante S, Esteve P, Reverté Villarroya S, Cubo E, Casas E, Arnaiz S, Carrillo Padilla F, Pueyo Morlans M, Mir P, Martinez-Martin P. Non-motor symptoms burden, mood, and gait problems are the most significant factors contributing to a poor quality of life in non-demented Parkinson's disease patients: Results from the COPPADIS Study Cohort. Parkinsonism Relat Disord 2019; 66:151-157. [PMID: 31409572 DOI: 10.1016/j.parkreldis.2019.07.031] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/18/2019] [Accepted: 07/27/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group. METHODS The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures. RESULTS QoL was worse in PD patients (n = 692; 62.6 ± 8.9 years old, 60.3% males) than controls (n = 206; 61 ± 8.3 years old, 49.5% males): PDQ-39, 17.1 ± 13.5 vs 4.4 ± 6.3 (p < 0.0001); PQ-10, 7.3 ± 1.6 vs 8.1 ± 1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ± 0.6 vs 4.2 ± 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (β = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, β = -0.46 and -0.21, respectively; EUROHIS-QOL8, β = -0.44 and -0.23, respectively). CONCLUSIONS QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.
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Affiliation(s)
- D Santos García
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain; Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | - M Mata
- Hospital Infanta Sofía, Madrid, Spain
| | - B Solano Vila
- Institut d'Assistència Sanitària (IAS) - Institut Cátala de la Salud, Girona, Spain
| | - A Cots Foraster
- Institut d'Assistència Sanitària (IAS) - Institut Cátala de la Salud, Girona, Spain
| | | | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain; CINAC (Centro Integral de Neurociencias A. C.), Hospital HM Puerta del Sur, Móstoles, Madrid, Spain
| | - Y Macías
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - S Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, Tarragona, Spain
| | - P Esteve
- Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, Tarragona, Spain
| | | | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - E Casas
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - S Arnaiz
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - F Carrillo Padilla
- Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - M Pueyo Morlans
- Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - P Martinez-Martin
- Centro Nacional de Epidemiología y CIBERNED, Instituto de Salud Carlos III, Madrid, Spain
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Santos García D, Jesús S, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Catalán MJ, López Díaz L, Puente V, García Moreno JM, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Menéndez González M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, Fábregues‐Boixar O, González Ardura J, Prieto Jurczynska C, Martinez‐Martin P, Mir P, Adarmes Astrid D, Almeria M, Alonso Cánovas A, Alonso Frech F, Aneiros Díaz A, Arnáiz S, Arribas S, Ascunce Vidondo A, Bernardo Lambrich N, Bejr‐Kasem H, Blázquez Estrada M, Botí M, Cabello González C, Cámara Lorenzo A, Carrillo F, Casas E, Clavero P, Cortina Fernández A, Cots Foraster A, Crespo Cuevas A, de Deus Fonticoba T, Díez‐Fairen M, Erro E, Estelrich Peyret E, Fernández Guillán N, Gámez P, Gallego M, García Campos C, Gómez Garre MP, González Aloy J, González García B, González Palmás MJ, González Toledo GR, Golpe Díaz A, Grau Solá M, Guardia G, Horta‐Barba A, Infante J, Labandeira C, Labrador MA, Lacruz F, Lage Castro M, López Seoane B, Macías Y, Mata M, Martí Andres G, Martí MJ, McAfee D, Meitín MT, Méndez del Barrio C, Miranda Santiago J, Morales Casado MI, Moreno Diéguez A, Nogueira V, Novo Amado A, Novo Ponte S, Ordás C, Pagonabarraga J, Pareés I, Pascual‐Sedano B, Pastor P, Pérez Fuertes A, Pérez Noguera R, Prats MA, Pueyo Morlans M, Redondo Rafales N, Rodríguez Méndez L, Rodríguez Pérez AB, Roldán F, Ruíz De Arcos M, Sánchez‐Carpintero M, Sánchez Díez G, Sánchez Rodríguez A, Santacruz P, Segundo Rodríguez JC, Serarols A, Sierra Peña M, Suárez Castro E, Tartari JP, Vargas L, Vázquez Gómez R, Villanueva C, Vives B, Villar MD. COPPADIS
‐2015 (
CO
hort of Patients with PArkinson's
DI
sease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol 2019; 26:1399-1407. [DOI: 10.1111/ene.14008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Santos García
- CHUAC, Complejo Hospitalario Universitario de A Coruña A CoruñaSpain
| | - S. Jesús
- Hospital Universitario Virgen del Rocío SevillaSpain
| | - M. Aguilar
- Hospital Universitari Mutua de Terrassa Terrassa Barcelona Spain
| | | | | | - N. Caballol
- Consorci Sanitari Integral Hospital Moisés Broggi Sant Joan Despí Barcelona Spain
| | - I. Legarda
- Hospital Universitario Son Espases Palma de MallorcaSpain
| | | | - I. Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | | | - M. A. Ávila Rivera
- Consorci Sanitari Integral Hospital General de L'Hospitalet, L'Hospitalet de Llobregat Barcelona Spain
| | - M. J. Catalán
- Hospital Universitario Clínico San Carlos Madrid Spain
| | - L. López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO) Orense Spain
| | | | | | | | - B. Solano Vila
- Institut d'Assistència Sanitària (IAS) – Institut Català de la Salut Girona Spain
| | | | - L. Vela
- Fundación Hospital de Alcorcón MadridSpain
| | - S. Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC) Tortosa Tarragona Spain
| | - E. Cubo
- Complejo Asistencial Universitario de Burgos Burgos Spain
| | - F. Carrillo Padilla
- Hospital Universitario de Canarias San Cristóbal de la LagunaSanta Cruz de Tenerife Spain
| | | | | | - M. G. Alonso Losada
- Hospital Álvaro Cunqueiro Complejo Hospitalario Universitario de Vigo (CHUVI) Vigo Spain
| | | | - I. Gastón
- Complejo Hospitalario de Navarra Pamplona Spain
| | | | | | - M. Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | - C. Valero
- Hospital Arnau de Vilanova Valencia Spain
| | - M. Kurtis
- Hospital Ruber Internacional Madrid Spain
| | | | | | | | - P. Martinez‐Martin
- Centro Nacional de Epidemiología y CIBERNED Instituto de Salud Carlos III Madrid Spain
| | - P. Mir
- Hospital Universitario Virgen del Rocío SevillaSpain
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Chacko J, George S, Cyriac S, Chakrapani B. A tale of two patients: Levodopa and creative awakening in parkinson's disease - A qualitative report. Asian J Psychiatr 2019; 43:179-181. [PMID: 31212166 DOI: 10.1016/j.ajp.2019.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/15/2019] [Accepted: 06/07/2019] [Indexed: 11/17/2022]
Abstract
Artistic creativity can emerge in patients with Parkinson's disease. Here we describe two patients who had creative awakening while on levodopa treatment for Parkinson's disease and discuss its implications.
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Affiliation(s)
- Jacob Chacko
- Consultant neurologist, Rajagiri Hospital, (Aluva,) Kerala
| | - Sanju George
- Professor of psychiatry and psychology, Rajagiri College of Social Sciences, Kalamassery, Kochi, Kerala, India.
| | - Sheetal Cyriac
- Rajagiri College of Social Sciences, Kalamassery, Kochi, Kerala, India
| | - Baby Chakrapani
- Centre for Neuroscience, Department of Biotechnology, Cochin University of Science and Technology (CUSAT); Inter University Centre for Nanomaterials and Devices (IUCND), Cochin University of Science and Technology (CUSAT)
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Shetty K, Krishnan S, Thulaseedharan JV, Mohan M, Kishore A. Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson's Disease. J Mov Disord 2019; 12:84-90. [PMID: 30944288 PMCID: PMC6547043 DOI: 10.14802/jmd.18048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/20/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Recent reports of hearing impairment in Parkinson's disease (PD) have suggested that auditory dysfunction could be a non-motor manifestation of PD. These reports were based on observations of elderly patients for whom presbycusis may, to some extent, have contributed to hearing dysfunction. Therefore, we aimed to explore the auditory functions in younger patients with PD. METHODS We conducted a case-control study in a relatively younger (< 55 years of age at study time) population of PD patients and healthy volunteers to test whether auditory dysfunction is a significant non-motor dysfunction in PD. Pure tone audiometry (PTA) and brainstem evoked response audiometry (BERA) were performed in all participants. RESULTS None of the patients or controls reported hearing deficits. Fifty-one patients with PD and 50 healthy volunteers who were age- and gender-matched to the patients participated. PTA-detected hearing impairment was found in 64.7% of patients and 28% of controls (p < 0.001) for both low-mid and/or high frequencies. Hearing impairment was more frequent in the younger subgroups of patients than age-matched controls, while the frequency of hearing impairment was similar in older groups of subjects. BERA was not different between patients and controls. CONCLUSION Asymptomatic auditory dysfunction is a common non-motor manifestation of early-onset PD and more frequent in younger patients, indicating that it may be independent of aging. The mechanism underlying this dysfunction appears to be peripheral, although a central dysfunction cannot be ruled out based on the findings of this study.
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Affiliation(s)
- Kuldeep Shetty
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Syam Krishnan
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Jissa Vinoda Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Manju Mohan
- Department of Audiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Asha Kishore
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
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Garuda B, Pappala K, Seepana G, Thalabaktula S, Uppaturi A. Non-motor symptoms of Parkinson’s disease: its prevalence across various stages and its correlation with the severity of the disease and quality of life. ANNALS OF MOVEMENT DISORDERS 2019. [DOI: 10.4103/aomd.aomd_9_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kandadai R, Bethala A, Sirineni D, Turaga S, Jabeen S, Kanikannan M, Borgohain R. Change in non-motor symptoms after deep brain stimulation of bilateral subthalamic nuclei in patients with Parkinson’s disease. ANNALS OF MOVEMENT DISORDERS 2019. [DOI: 10.4103/aomd.aomd_4_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Deeb W, Nozile-Firth K, Okun MS. Parkinson's disease: Diagnosis and appreciation of comorbidities. HANDBOOK OF CLINICAL NEUROLOGY 2019; 167:257-277. [PMID: 31753136 DOI: 10.1016/b978-0-12-804766-8.00014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Parkinson's disease (PD) is a complex neuropsychiatric disorder that manifests with a variety of motor and nonmotor symptoms. Its incidence increases with age. It is important for clinicians to be able to distinguish symptoms of aging and other comorbidities from those of PD. The diagnosis of PD has traditionally been rendered using strict criteria that mainly rely on the cardinal motor symptoms of rest tremor, rigidity, and bradykinesia. However, newer diagnostic criteria proposed by the Movement Disorders Society for diagnosis of PD collectively reflect a greater appreciation for the nonmotor symptoms. The treatment of PD remains symptomatic and the most noticeable improvements have been documented in the motor symptoms. Levodopa remains the gold standard for therapy, however there are now many other potential medical and surgical treatment strategies. Nonmotor symptoms have been shown to affect quality of life more than the motor symptoms. There is ongoing research into symptomatic and disease modifying treatments. Given the multisystem involvement in PD, an interdisciplinary patient-centered approach is recommended by most experts. This chapter addresses first the diagnostic approach and the many geriatric considerations. This is followed by a review of the nonmotor symptoms. Finally, a summary of current treatment strategies in PD is presented along with potential treatment complications.
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Affiliation(s)
- Wissam Deeb
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States.
| | - Kamilia Nozile-Firth
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States
| | - Michael S Okun
- Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States
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Baumeister TR, Kim JL, Zhu M, McKeown MJ. White matter myelin profiles linked to clinical subtypes of Parkinson's disease. J Magn Reson Imaging 2018; 50:164-174. [DOI: 10.1002/jmri.26543] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Jowon L. Kim
- Medical Undergraduate ProgramUniversity of British Columbia Vancouver Canada
| | - Maria Zhu
- Graduate Program in NeuroscienceUniversity of British Columbia Vancouver Canada
| | - Martin J. McKeown
- Division of NeurologyUniversity of British Columbia Vancouver Canada
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Rabelo MB, Lopes MDS, Corona AP, Araújo RPCD, Nóbrega AC. Hearing handicap perception and hearing alterations in individuals with Parkinson's disease. REVISTA CEFAC 2018. [DOI: 10.1590/1982-0216201820213117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to investigate the relationship between the perception of self-reported hearing impairment and the handicap with peripheral and central hearing alterations, in individuals with Parkinson's disease. Methods: individuals with Parkinson's disease were seen and evaluated at a reference outpatient clinic for the treatment of movement disorders, between April and August 2015. All of them underwent basic audiological evaluation and hearing processing tests. The hearing handicap assessment was performed using the Hearing Handicap Inventory for the Elderly. As for the analysis of the relationship between hearing handicap perception and audiological, clinical and demographic variables, individuals were considered with or without perception, according to their score. Results: thirty-three individuals, mostly males, with a mean age of 63.7 years, took part in the study. There was a high frequency (n = 31) of peripheral or central hearing alterations in the study population. However, only 14 reported some difficulty in hearing, eight not presenting hearing handicap perception, two having mild-moderate perception and four showing a significant perception. Conclusion: the perceptions of hearing difficulties and the handicap are not related to audiological alterations in individuals presented with Parkinson's disease.
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Sauerbier A, Jitkritsadakul O, Titova N, Klingelhoefer L, Tsuboi Y, Carr H, Kumar H, Banerjee R, Erro R, Bhidayasiri R, Schrag A, Zis P, Lim SY, Al-Hashel J, Kamel WA, Martinez-Martin P, Ray Chaudhuri K. Non-Motor Symptoms Assessed by Non-Motor Symptoms Questionnaire and Non-Motor Symptoms Scale in Parkinson's Disease in Selected Asian Populations. Neuroepidemiology 2017; 49:1-17. [DOI: 10.1159/000478702] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 06/06/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Ethnic variations have been described in medical conditions, such as hypertension, diabetes, and multiple sclerosis. Whether ethnicity plays a role in Parkinson's disease (PD), particularly with regard to non-motor symptoms (NMS), remains unclear. Existing literature is diverse, controversial, and inadequately documented. This review aims to analyse and report the currently available literature on NMS, specifically in Asian PD patients. Summary: We conducted a literature review using PubMed, searching for articles and currently available publications that reference and assess NMS in PD patients living in Asia using the validated NMS Questionnaire (NMS Quest) and NMS Scale (NMSS). In total, 24 articles were included: 12 using the NMS Quest and 12 using the NMSS. Symptoms of constipation, memory impairment, and nocturia were the most frequently self-reported symptoms (NMS Quest) in selected Asian populations, while symptoms within the domains sleep/fatigue, attention/memory, and mood/apathy were most prevalent when applying the health-professional completed NMSS. Key Messages: NMS are generally prevalent and highly burdensome within selected Asian PD populations living in countries included in this review. Our review suggests that NMS-driven phenotypic heterogeneity is present in Asian patients, and compared to Western PD populations there might be variations in assessed NMS.
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Biundo R, Fiorenzato E, Antonini A. Nonmotor Symptoms and Natural History of Parkinson's Disease: Evidence From Cognitive Dysfunction and Role of Noninvasive Interventions. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:389-415. [PMID: 28802926 DOI: 10.1016/bs.irn.2017.05.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder, characterized by motor and nonmotor symptoms (NMS). Several subsequent studies substantiate the great functional burden related to NMS, their progression, and negative effect on quality of life in PD. Additional evidence indicates interesting relationships between striatal dopaminergic function and NMS. The basal ganglia are implicated in the modulation and integration of sensory information and pain, bladder function is under control of both inhibitory (D1) and facilitatory (D2) dopaminergic inputs, finally reduced dopaminergic activity in the mesocortical and mesolimbic pathways is involved in the development of several NMS including mood, motivational, and cognitive alterations. Some NMS fluctuate in response to dopaminergic treatment and are relieved by dopamine replacement therapy, other are insensitive to current therapeutic strategies. The relation among the overall disease complications, perhaps the most important for PD patients and family members' well-being and functionality is dementia that affects most PD patients over the course of disease. Specific pharmacological treatment is lacking, and alternative approaches have been implemented to improve everyday functionality and quality of life. The state of the art suggests that cognitive rehabilitation in PD is possible and may either increase performance or preserve cognitive level over the time. However, it is also evident that cognitive abnormalities in PD are heterogeneous and we still do not have biomarkers to detect early patients at risk for dementia. Cognitive dysfunction is one the most prevalent NMS and is a clinically and functionally important disease milestone. Given the available clinical and imaging evidence it is possible to use cognition to model NMS progression and design nonpharmacological interventions. In this chapter we will address the use of cognitive rehabilitation and noninvasive brain stimulation techniques to modulate cognitive performance and rescue connectivity in affected brain circuitry.
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Affiliation(s)
- Roberta Biundo
- Parkinson's Disease and Movement Disorders Unit, San Camillo Hospital IRCCS, Venice-Lido, Italy
| | - Eleonora Fiorenzato
- Parkinson's Disease and Movement Disorders Unit, San Camillo Hospital IRCCS, Venice-Lido, Italy; University of Padua, Padua, Italy
| | - Angelo Antonini
- Parkinson's Disease and Movement Disorders Unit, San Camillo Hospital IRCCS, Venice-Lido, Italy; University of Padua, Padua, Italy.
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Katunina E, Titova N. The Epidemiology of Nonmotor Symptoms in Parkinson's Disease (Cohort and Other Studies). INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:91-110. [PMID: 28802941 DOI: 10.1016/bs.irn.2017.05.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nonmotor symptoms (NMS) of Parkinson's disease (PD) were recognized by James Parkinson himself and are now considered to be an integral part of PD. While clinical assessment had focused on prevalence and severity of individual NMS such as dementia and depression, work in the last decade has concentrated on global or holistic assessment of NMS using validated tools such as the NMS questionnaire and NMS scale. These studies from cohorts of varying sizes have allowed comparison of NMS across different disease stages, duration, age, and ethnicity in PD. The data also allow exploration of the concept of the nonlinear relationship of NMS to disease duration of PD and motor stages as well as nonmotor subtypes of PD. In this chapter, these aspects of epidemiological studies of NMS in PD cohorts are described.
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Affiliation(s)
- Elena Katunina
- Federal State Budgetary Educational Institution of Higher Education, "N.I. Pirogov Russian National Research Medical University" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Nataliya Titova
- Federal State Budgetary Educational Institution of Higher Education, "N.I. Pirogov Russian National Research Medical University" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
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Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ, Kurtis MM, Skorvanek M. Measurement of Nonmotor Symptoms in Clinical Practice. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:291-345. [PMID: 28802923 DOI: 10.1016/bs.irn.2017.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nonmotor symptoms constitute a prominent part of Parkinson's disease manifestations. They are present since the first phases of the disease, increase their number and severity with disease progression, and importantly impact on patients' health and quality of life, caregivers' burden, and social resources. Research on Parkinson's disease has traditionally focused on the motor aspects of the disease, but an increasing interest in the nonmotor manifestations has risen in the past decade. The availability of assessment instruments for detecting and measuring these symptoms has allowed understanding of their importance and course over time, as well as estimation of therapeutic effects on them. In this chapter, a review of the basic characteristics of nonmotor symptom assessments used in clinical practice and research are presented.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and CIBERNED, Institute of Health Carlos III, Madrid, Spain.
| | | | - Maria João Forjaz
- National School of Public Health and REDISSEC, Institute of Health Carlos III, Madrid, Spain
| | - Monica M Kurtis
- Movement Disorders Unit, Hospital Ruber Internacional, Madrid, Spain
| | - Matej Skorvanek
- P.J. Safarik University, Kosice, Slovakia; University Hospital of L. Pasteur, Kosice, Slovakia
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Maeda T, Shimo Y, Chiu SW, Yamaguchi T, Kashihara K, Tsuboi Y, Nomoto M, Hattori N, Watanabe H, Saiki H. Clinical manifestations of nonmotor symptoms in 1021 Japanese Parkinson's disease patients from 35 medical centers. Parkinsonism Relat Disord 2017; 38:54-60. [DOI: 10.1016/j.parkreldis.2017.02.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/27/2016] [Accepted: 02/19/2017] [Indexed: 11/17/2022]
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Bago Rožanković P, Rožanković M, Vučak Novosel L, Stojić M. Nonmotor symptoms in de novo Parkinson disease comparing to normal aging. Clin Neurol Neurosurg 2017; 155:7-11. [DOI: 10.1016/j.clineuro.2017.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/01/2017] [Accepted: 02/05/2017] [Indexed: 10/20/2022]
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Mendonça MD, Lampreia T, Miguel R, Caetano A, Barbosa R, Bugalho P. Motor and non-motor symptoms in old-age onset Parkinson's disease patients. J Neural Transm (Vienna) 2017; 124:863-867. [PMID: 28314948 DOI: 10.1007/s00702-017-1711-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/14/2017] [Indexed: 11/28/2022]
Abstract
Advancing age is a well-known risk factor for Parkinson's disease (PD). With population ageing it is expected that the total number of patients with PD onset at oldage increases. Information on the motor but particularly on non-motor phenotype of this late-onset population is lacking. We recruited 24 patients with PD onset at or over 75 years. Each patient was matched with 1 control patient with PD onset between the ages of 40 and 65 and matched for disease duration. Both groups were assessed with the UPDRS, the Non-motor symptoms scale (NMSS) and other scales to assess non-motor symptoms. Groups were compared with conditional logistic regression analysis. Old-age onset PD was, on average, 80 years at the time of PD onset while middle-age onset were 59. Disease duration was approximately 5 years in both groups. While no difference was observed in the total UPDRS-III scores, old-age onset PD was associated with higher axial symptoms (7.42 vs. 4.63, p = 0.011) and a higher frequency of dementia (7/24 vs. 0/24, p = 0.009). While no difference in the total number of non-motor symptoms was observed (6.79 vs. 6.22, p = 0.310), old-age onset patients had a higher prevalence of gastrointestinal symptoms (20/24 vs. 12/24, p = 0.037). For the same disease duration, older age onset is associated with worse axial motor dysfunction and dementia in PD patients. Beside gastrointestinal symptoms, non-motor symptoms are not associated with age.
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Affiliation(s)
- Marcelo D Mendonça
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal. .,CEDOC-Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Tania Lampreia
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Rita Miguel
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - André Caetano
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Raquel Barbosa
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Paulo Bugalho
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,CEDOC-Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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Gender effect on non-motor symptoms in Parkinson's disease: are men more at risk? Parkinsonism Relat Disord 2017; 35:69-74. [DOI: 10.1016/j.parkreldis.2016.12.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/03/2016] [Accepted: 12/12/2016] [Indexed: 11/19/2022]
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Nonmotor Fluctuations in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:947-971. [DOI: 10.1016/bs.irn.2017.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Nonmotor Symptoms in Parkinson's Disease: Gender and Ethnic Differences. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:417-446. [DOI: 10.1016/bs.irn.2017.05.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Gastrointestinal Dysfunctions in Parkinson's Disease: Symptoms and Treatments. PARKINSONS DISEASE 2016; 2016:6762528. [PMID: 28050310 PMCID: PMC5168460 DOI: 10.1155/2016/6762528] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/16/2016] [Indexed: 12/21/2022]
Abstract
A diagnosis of Parkinson's disease is classically established after the manifestation of motor symptoms such as rigidity, bradykinesia, and tremor. However, a growing body of evidence supports the hypothesis that nonmotor symptoms, especially gastrointestinal dysfunctions, could be considered as early biomarkers since they are ubiquitously found among confirmed patients and occur much earlier than their motor manifestations. According to Braak's hypothesis, the disease is postulated to originate in the intestine and then spread to the brain via the vagus nerve, a phenomenon that would involve other neuronal types than the well-established dopaminergic population. It has therefore been proposed that peripheral nondopaminergic impairments might precede the alteration of dopaminergic neurons in the central nervous system and, ultimately, the emergence of motor symptoms. Considering the growing interest in the gut-brain axis in Parkinson's disease, this review aims at providing a comprehensive picture of the multiple gastrointestinal features of the disease, along with the therapeutic approaches used to reduce their burden. Moreover, we highlight the importance of gastrointestinal symptoms with respect to the patients' responses towards medical treatments and discuss the various possible adverse interactions that can potentially occur, which are still poorly understood.
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Colosimo C, Bhidayasiri R. Nonmotor symptoms in Parkinson's disease: are we still waiting for the honeymoon? Eur J Neurol 2016; 23:1595-1596. [DOI: 10.1111/ene.13123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. Colosimo
- Department of Neurology; Santa Maria University Hospital; Terni Italy
| | - R. Bhidayasiri
- Department of Medicine; Faculty of Medicine; Chulalongkorn Center of Excellence for Parkinson's Disease and Related Disorders; Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society; Bangkok Thailand
- Department of Rehabilitation Medicine; Juntendo University; Tokyo Japan
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Abstract
Parkinson disease (PD) is a common progressive neurodegenerative condition, causing both motor and non motor symptoms. Motor symptoms include stiffness, slowness, rest tremor and poor postural reflexes, whereas nonmotor symptoms include abnormalities of mood, cognition, sleep and autonomic function. Affected patients show cell loss in the substantia nigra pars compacta, and accumulation of aggregated alpha-synuclein into intracellular structures called Lewy bodies, within specific brain regions. The main known non modifiable risk factor is age. The neuroepidemiology of PD is complex with susceptibility genes and a number of modifiable risk factors that can increase and others that can mitigate risk and outcome.
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Affiliation(s)
- Andrea Lee
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA
| | - Rebecca M Gilbert
- Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY 10016, USA; The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, New York University Langone Medical Center, 240 East 38th Street, 20th Floor, New York, NY 10016, USA.
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Impact of Sex on the Nonmotor Symptoms and the Health-Related Quality of Life in Parkinson's Disease. PARKINSONS DISEASE 2016; 2016:7951840. [PMID: 27293959 PMCID: PMC4884810 DOI: 10.1155/2016/7951840] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/27/2016] [Accepted: 04/12/2016] [Indexed: 12/30/2022]
Abstract
Background. Female Parkinson's disease (PD) patients seem to experience not only more severe motor complications and postural instability but also more pronounced depression, anxiety, pain, and sleep disturbances. Objective. The aim of the present study was to evaluate the role of sex as a possible independent predictor of HRQoL in PD. Methods. In this cross-sectional study, 621 consecutive patients treated at the University of Pécs were enrolled. Severity of PD symptoms was assessed by MDS-UPDRS, UDysRS, Non-Motor Symptoms Scale, PDSS-2, Hamilton Anxiety Scale, Montgomery-Asberg Depression Rating Scale, Lille Apathy Rating Scale, and Addenbrooke Cognitive Examination. HRQoL was assessed by PDQ-39 and EQ-5D. Multiple regression analysis was performed to estimate the PDQ-39 and EQ-5D index values based on various clinical factors. Results. Although females received significantly lower dosage of levodopa, they had significantly more disabling dyskinesia and worse postural instability. Anxiety, pain, sleep disturbances, and orthostatic symptoms were more frequent among females while sexual dysfunction, apathy, and daytime sleepiness were more severe among males. Women had worse HRQoL than men (EQ-5D index value: 0.620 ± 0.240 versus 0.663 ± 0.229, p = 0.025, and PDQ-39 SI: 27.1 ± 17.0 versus 23.5 ± 15.9, p = 0.010). Based on multiple regression analysis, sex was an independent predictor for HRQoL in PD. Conclusions. Based on our results, female sex is an independent predictor for having worse HRQoL in PD.
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Nonmotor Features in Parkinson's Disease: What Are the Most Important Associated Factors? PARKINSONS DISEASE 2016; 2016:4370674. [PMID: 27195172 PMCID: PMC4853954 DOI: 10.1155/2016/4370674] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/30/2016] [Indexed: 11/24/2022]
Abstract
Introduction. The purpose of this study was to demonstrate the frequency and severity of nonmotor symptoms and their correlations with a wide range of demographic and clinical factors in a large cohort of patients with Parkinson's disease (PD). Methods. 268 PD patients were assessed using the validated Movement Disorders Society's Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Beck Depression Inventory (BDI), Parkinson's Disease Questionnaire (PDQ-39), the Hoehn and Yahr scale (HY), the Schwab and England Activities of Daily Living (SE-ADL) Scale, and the Minimental State Examination (MMSE). Results. Nonmotor symptoms had a strong positive relationship with depression and lower quality of life. Also, age, duration and severity of PD, cognitive impairment, daily dose, and duration of levodopa treatment correlated with the burden of nonmotor symptoms. Patients with postural instability and gait disorder (PIGD) dominance or with the presence of motor complications had higher MDS-UPDRS Part I scores expressing the load of nonmotor features, compared to participants with other disease subtypes or without motor complications. Conclusions. Though the severity of individual nonmotor symptoms was generally rated by PD patients as “mild” or less, we found a significant cumulative effect of nonmotor symptoms on patients' mood, daily activities, and quality of life.
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Surathi P, Jhunjhunwala K, Yadav R, Pal PK. Research in Parkinson's disease in India: A review. Ann Indian Acad Neurol 2016; 19:9-20. [PMID: 27011622 PMCID: PMC4782561 DOI: 10.4103/0972-2327.167713] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder affecting patients in large numbers throughout the world. In this article, we review all the published data on PD based on studies in Indian population. We have tried to consolidate the contribution of Indian studies in PD research. We found 95 articles, of which 92 were original research papers. This is a relatively less number, but in the last decade, there has been an increase in research on PD from this country. But most of them seem to be restricted to only a few research institutes. The nonmotor symptoms and genetics are the most commonly studied aspects. The systematic review of the articles reveals that the epidemiology in India may be different with relatively lesser incidence here. Most of the genetic mutations found to cause PD in other population are not found in India, revealing that other genetic factors may be involved. Further research needs to be encouraged to understand the disease in Indian patients better, as all the results cannot be extrapolated from the Western literature to this heterogeneous Indian population. There need to be more studies on therapeutic aspects of the disease.
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Affiliation(s)
- Pratibha Surathi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
| | - Ketan Jhunjhunwala
- Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, Karnataka, India
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Progression of non-motor symptoms in Parkinson's disease among different age populations: A two-year follow-up study. J Neurol Sci 2015; 360:72-7. [PMID: 26723977 DOI: 10.1016/j.jns.2015.11.047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/08/2015] [Accepted: 11/26/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Non-motor symptoms (NMS) are gaining increasing relevance in the management of Parkinson's disease (PD), but little is known about their progression, especially among patients with different ages. METHODS A total of 117 PD patients who were divided into four age groups (<50, 50-60, 60-70, and >70years old) were included to assess NMS at baseline and follow-up visit (21.6±5.6months). The frequency and severity of NMS were assessed using the Non-Motor Symptom Scale (NMSS). RESULTS After adjusting for confounding factors, patients at the last visit had significantly higher frequency of "Difficulty falling asleep" item (p=0.034) and "Urinary" domain (p=0.017), and higher total NMSS score (p=0.011) as well as scores for "Sleep/fatigue" (p=0.013) and "Sexual dysfunction" (p=0.014) domains and scores for "Fatigue" (p=0.004), "Lack of motivation" (p=0.033), "Interest in sex" (p=0.014) and "Problems having sex" (p=0.031) items than patients at baseline. The frequency changes of each NMS among four age groups exhibited an anfractuous result, while the annual severity changes of each NMS were not significant different among four age groups. Multinomial logistic regression model indicated that age had no correlation with the changes of NMS frequency and severity. CONCLUSIONS The severity of NMS in PD tends to become progressively worse with the course of the disease. Age is not related to the progression of NMS in PD.
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