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Mai AS, Chao Y, Xiao B, Zhou Z, Yong JH, Lee ARYB, Tan EK. Risk of Suicidal Ideation and Behavior in Individuals With Parkinson Disease: A Systematic Review and Meta-Analysis. JAMA Neurol 2024; 81:10-18. [PMID: 37955917 PMCID: PMC10644251 DOI: 10.1001/jamaneurol.2023.4207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 11/14/2023]
Abstract
Importance Suicide risk may be increased in patients with Parkinson disease (PD), a common neurodegenerative condition. Mood disorders, especially depression, are prevalent in patients with PD who report suicidality. Objective To address inconsistent results from studies of suicidal ideation and behavior in patients with PD. Data Sources The study team searched MEDLINE and Embase from inception to June 14, 2023, and further screened the bibliographies of relevant studies to ensure a comprehensive search. Study Selection Original studies, published in English, discussing either suicidal ideation, behavior, or both in adults with PD were included. Accepted study designs included cross-sectional, case-control, and cohort studies. Studies that only included patients with PD after deep brain stimulation were excluded. Data Extraction and Synthesis This meta-analysis was conducted in line with the PRISMA guidelines. Two authors reviewed each study and extracted the data independently, with discrepancies referred to a third independent author. Main Outcomes and Measures Outcomes included the prevalence of suicidal ideation and behavior, measured as proportions, and the risk of suicidal behavior in patients with PD relative to controls, measured in both odds ratio (OR) and hazards ratio (HR). Results A total of 28 studies comprising 505 950 PD patients were included in the final analysis. The prevalence of suicidal ideation was evaluated in 14 studies (22.2%; 95% CI, 14.6-32.3) and suicidal behavior in 21 studies (1.25%; 95% CI, 0.64-2.41). Excluding 4 outliers, prevalence of suicidal behavior was significantly higher in prospective studies (1.75%; 95% CI, 1.03-2.95) than retrospective studies (0.50%; 95% CI, 0.24-1.01). Excluding 1 outlier, OR of suicidal behavior was pooled across 10 studies and significant (OR, 2.15; 95% CI, 1.22-3.78; P = .01). HR of suicidal behavior was assessed in 9 studies (HR, 1.73; 95% CI, 1.40-2.14; P < .001). Conclusions and Relevance This meta-analysis involving more than 500 000 patients with PD found 22.2% and 1.25% of patients with PD to have suicidal ideation and behavior, respectively. Patients with PD had 2 times the risk of suicidal behavior than controls. Early recognition and management of suicidality in PD can help reduce mortality.
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Affiliation(s)
- Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yinxia Chao
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Bin Xiao
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Zhidong Zhou
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Jung Hahn Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Eng-King Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
- Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore
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Jaramillo-Jimenez A, Bocanegra Y, Buriticá O, Pineda Salazar DA, Moreno Gómez L, Tobón Quintero CA, Aguirre-Acevedo DC, Sierra Castrillon M, Vasquez D, Velez-Hernandez JE, Borda MG, García-Cifuentes E, Aguillón DF, Madrigal-Zapata L, Aarsland D, Lopera F. Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:305-313. [PMID: 38065663 DOI: 10.1016/j.rcpeng.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/05/2021] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.
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Affiliation(s)
- Alberto Jaramillo-Jimenez
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Semillero de Investigación SINAPSIS, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Omar Buriticá
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - David Antonio Pineda Salazar
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | | | - Carlos Andrés Tobón Quintero
- Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Área de investigación e Innovación, Institución Prestadora de Servicios de Salud (IPS Universitaria), Medellín, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Melissa Sierra Castrillon
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Daniel Vasquez
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | | | - Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Elkin García-Cifuentes
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - David Fernando Aguillón
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Lucía Madrigal-Zapata
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
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Jiang JL, Chen SY, Tsai ST, Ma YC, Wang JH. Long-Term Effects of Subthalamic Stimulation on Motor Symptoms and Quality of Life in Patients with Parkinson's Disease. Healthcare (Basel) 2023; 11:healthcare11060920. [PMID: 36981577 PMCID: PMC10048478 DOI: 10.3390/healthcare11060920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/02/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting both motor functions and quality of life (QoL). This study compared motor symptoms and QoL in patients with PD before and at 1 and 5 years after subthalamic nucleus deep brain stimulation (STN-DBS) surgery in Taiwan. This study included 53 patients with PD undergoing STN-DBS. The motor symptoms improved by 39.71 ± 26.52% and 18.83 ± 37.15% in the Unified Parkinson's Disease Rating Scale (UPDRS) part II and by 36.83 ± 22.51% and 22.75 ± 36.32% in the UPDRS part III at 1 and 5 years after STN-DBS in the off-medication/on-stimulation state, respectively. The Hoehn and Yahr stage significantly improved at the 1-year follow-up but declined progressively and returned to the baseline stage 5 years post-surgery. The Schwab and England Activities of Daily Living improved and sustained for 5 years following STN-DBS. Levodopa equivalent daily dose decreased by 35.32 ± 35.87% and 15.26 ± 65.76% at 1 and 5 years post-surgery, respectively. The QoL revealed significant improvement at 1 year post-surgery; however, patients regressed to near baseline levels 5 years post-surgery. The long-term effects of STN-DBS on motor symptoms were maintained over 5 years after STN-DBS surgery. At the same time, STN-DBS had no long-lasting effect on QoL. The study findings will enable clinicians to become more aware of visible and invisible manifestations of PD.
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Affiliation(s)
- Jiin-Ling Jiang
- Department of Nursing, Tzu Chi University, Hualien 97004, Taiwan
| | - Shin-Yuan Chen
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan
| | - Sheng-Tzung Tsai
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan
| | - Yu-Chin Ma
- Department of Nursing, Tzu Chi University, Hualien 97004, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan
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Apathy-Related Symptoms Appear Early in Parkinson's Disease. Healthcare (Basel) 2022; 10:healthcare10010091. [PMID: 35052255 PMCID: PMC8775593 DOI: 10.3390/healthcare10010091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/17/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Apathy, often-unrecognized in Parkinson's Disease (PD), adversely impacts quality-of-life (QOL) and may increase with disease severity. Identifying apathy early can aid treatment and enhance prognoses. Whether feelings related to apathy (e.g., loss of pleasure) are present in mild PD and how apathy and related feelings increase with disease severity is unknown. METHODS 120 individuals (M age: 69.0 ± 8.2 y) with mild (stages 1-2, n = 71) and moderate (stages 2.5-4; n = 49) PD were assessed for apathy and apathy-related constructs including loss of pleasure, energy, interest in people or activities, and sex. Correlations were used to determine the association of apathy with apathy-related constructs. Regression models, adjusted for age, cognitive status, and transportation, compared groups for prevalence of apathy and apathy-related feelings. RESULTS Apathy-related constructs and apathy were significantly correlated. Apathy was present in one in five participants with mild PD and doubled in participants with moderate PD. Except for loss of energy, apathy-related constructs were observed in mild PD at a prevalence of 41% or greater. Strong associations were noted between all apathy-related constructs and greater disease severity. After adjustment for transportation status serving as a proxy for independence, stage of disease remained significant only for loss of pleasure and loss of energy. CONCLUSION People with mild PD showed signs of apathy and apathy-related feelings. Loss of pleasure and energy are apathy-related feelings impacted by disease severity. Clinicians should consider evaluating for feelings related to apathy to enhance early diagnosis in individuals who might otherwise not exhibit psychopathology.
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Jaramillo-Jimenez A, Bocanegra Y, Buriticá O, Pineda Salazar DA, Moreno Gómez L, Tobón Quintero CA, Aguirre-Acevedo DC, Sierra Castrillon M, Vasquez D, Velez-Hernandez JE, Borda MG, García-Cifuentes E, Aguillón DF, Madrigal-Zapata L, Aarsland D, Lopera F. Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00134-7. [PMID: 34489098 DOI: 10.1016/j.rcp.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.
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Affiliation(s)
- Alberto Jaramillo-Jimenez
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Semillero de Investigación SINAPSIS, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Omar Buriticá
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - David Antonio Pineda Salazar
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | | | - Carlos Andrés Tobón Quintero
- Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Área de investigación e Innovación, Institución Prestadora de Servicios de Salud (IPS Universitaria), Medellín, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Melissa Sierra Castrillon
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Daniel Vasquez
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | | | - Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Elkin García-Cifuentes
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - David Fernando Aguillón
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia; Grupo Neuropsicología y Conducta, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Lucía Madrigal-Zapata
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, School of Medicine, Medellín, Colombia
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Kawaguchi M, Miyagi Y, Kishimoto J, Samura K, Tokunaga Y, Watari M, Eguchi H, Ueda S, Iihara K. Development of Quality of Life Questionnaire for Patients with Parkinson's Disease Undergoing STN-DBS. Neurol Med Chir (Tokyo) 2021; 61:475-483. [PMID: 34148942 PMCID: PMC8365237 DOI: 10.2176/nmc.oa.2020-0388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In device-aided therapy (DAT) for Parkinson’s disease (PD), factors such as device-related adverse effects, psychological and lifestyle changes, and specific disease progression can affect the quality of life (QoL) of patients with advanced PD. However, there is no existing QoL scale that includes the effects of therapeutic devices. From a semi-structured interview with patients with PD undergoing deep brain stimulation (DBS), we extracted the content of utterances that were thought to affect the QoL and created a draft questionnaire consisting of 113 items. This questionnaire was administered to 54 other patients undergoing DBS, whose data were examined for reliability and validity by factor analysis, and finally, a 24-item PD QoL questionnaire for patients on DAT (PDQ-DAT) was developed. Presently, the PDQ-DAT is the only scale that can assess the QoL of patients on DAT, including the influence treatment devices have on them. In the future, it might be used to help in shared decision-making in medicine by incorporating the patient’s sense of burden and values in the selection of treatment methods.
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Affiliation(s)
- Minako Kawaguchi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
| | - Yasushi Miyagi
- Department of Stereotactic and Functional Neurosurgery, Medical Co. LTA Fukuoka Mirai Hospital
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University
| | | | - Yutaka Tokunaga
- Department of Education and Clinical Psychology, Faculty of Humanities, Fukuoka University
| | - Mari Watari
- Department of Neurology, Medical Co. LTA Fukuoka Mirai Hospital
| | - Hiroko Eguchi
- Department of Nursing, Medical Co. LTA Fukuoka Mirai Hospital
| | - Shintaro Ueda
- Telemedicine Development Center of Asia, International Medical Department, Kyushu University Hospital
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Szturm T, Kolesar TA, Mahana B, Goertzen AL, Hobson DE, Marotta JJ, Strafella AP, Ko JH. Changes in Metabolic Activity and Gait Function by Dual-Task Cognitive Game-Based Treadmill System in Parkinson's Disease: Protocol of a Randomized Controlled Trial. Front Aging Neurosci 2021; 13:680270. [PMID: 34149399 PMCID: PMC8211751 DOI: 10.3389/fnagi.2021.680270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
Balance and gait impairments, and consequently, mobility restrictions and falls are common in Parkinson’s disease (PD). Various cognitive deficits are also common in PD and are associated with increased fall risk. These mobility and cognitive deficits are limiting factors in a person’s health, ability to perform activities of daily living, and overall quality of life. Community ambulation involves many dual-task (DT) conditions that require processing of several cognitive tasks while managing or reacting to sudden or unexpected balance challenges. DT training programs that can simultaneously target balance, gait, visuomotor, and cognitive functions are important to consider in rehabilitation and promotion of healthy active lives. In the proposed multi-center, randomized controlled trial (RCT), novel behavioral positron emission tomography (PET) brain imaging methods are used to evaluate the molecular basis and neural underpinnings of: (a) the decline of mobility function in PD, specifically, balance, gait, visuomotor, and cognitive function, and (b) the effects of an engaging, game-based DT treadmill walking program on mobility and cognitive functions. Both the interactive cognitive game tasks and treadmill walking require continuous visual attention, and share spatial processing functions, notably to minimize any balance disturbance or gait deviation/stumble. The ability to “walk and talk” normally includes activation of specific regions of the prefrontal cortex (PFC) and the basal ganglia (site of degeneration in PD). The PET imaging analysis and comparison with healthy age-matched controls will allow us to identify areas of abnormal, reduced activity levels, as well as areas of excessive activity (increased attentional resources) during DT-walking. We will then be able to identify areas of brain plasticity associated with improvements in mobility functions (balance, gait, and cognition) after intervention. We expect the gait-cognitive training effect to involve re-organization of PFC activity among other, yet to be identified brain regions. The DT mobility-training platform and behavioral PET brain imaging methods are directly applicable to other diseases that affect gait and cognition, e.g., cognitive vascular impairment, Alzheimer’s disease, as well as in aging.
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Affiliation(s)
- Tony Szturm
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tiffany A Kolesar
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB, Canada
| | - Bhuvan Mahana
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Andrew L Goertzen
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
| | - Douglas E Hobson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Antonio P Strafella
- Morton and Gloria Shulman Movement Disorder Unit, E. J. Safra Parkinson Disease Program, Neurology Division/Department of Medicine, Toronto Western Hospital, Krembil Brain Institute, University Health Network (UHN), Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, ON, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB, Canada
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Zhao N, Yang Y, Zhang L, Zhang Q, Balbuena L, Ungvari GS, Zang Y, Xiang Y. Quality of life in Parkinson's disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci Ther 2021; 27:270-279. [PMID: 33372386 PMCID: PMC7871788 DOI: 10.1111/cns.13549] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Studies regarding the impact of Parkinson's disease (PD) on quality of life (QOL) have reported conflicting results, and the underlying QOL domains require further study. In order to understand the association between PD and QOL, we conducted this meta-analysis to systematically compare QOL between PD patients and healthy controls. METHOD The PubMed, PsycINFO, EMBASE, and Web of Science databases were systematically searched. Data were analyzed using the random-effects model. RESULTS Twenty studies covering 2707 PD patients and 150,661 healthy controls were included in the study. Compared with healthy controls, PD patients had significantly poorer QOL overall and in most domains with moderate to large effects sizes. Different QOL measures varied in their association with quality of life, with the Parkinson's Disease Questionnaire-39 (PDQ-39) having the largest effect size (standard mean difference, SMD = -1.384, 95% CI: -1.607, -1.162, Z = 12.189, P < 0.001), followed by the Europe Quality of Life Questionnaire-visual analogue scale (EQ-VAS) (SMD = -1.081, 95% CI: -1.578, -0.584, Z = -4.265, P < 0.001), Europe Quality of Life Questionnaire-5D (EQ-5D) (SMD = -0.889, 95% CI: -1.181, -0.596, Z = -5.962, P < 0.001), and the Short-form Health Survey (SF) scales (physical dimension: SMD = -0.826, 95% CI: -1.529, -0.123, Z = -2.303, P = 0.021; mental dimension: SMD = -0.376, 95% CI: -0.732, -0.019, Z = -2.064, P = 0.039). CONCLUSION PD patients had lower QOL compared with healthy controls in most domains, especially in physical function and mental health. Considering the negative impact of poor QOL on daily life and functional outcomes, effective measures should be developed to improve QOL in this population.
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Affiliation(s)
- Na Zhao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Lloyd Balbuena
- Department of PsychiatryUniversity of SaskatchewanSaskatoonSKCanada
| | - Gabor S. Ungvari
- Division of PsychiatrySchool of MedicineUniversity of Western Australia/Graylands HospitalPerthWAAustralia
- The University of Notre Dame AustraliaFremantleWAAustralia
| | - Yu‐Feng Zang
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yu‐Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
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9
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Chamberlain-Carter J, Jackson J. Does resistance training reduce falls and improve quality of life in people with Parkinson’s disease using strength training exercise programmes? PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2020.1814123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Jo Jackson
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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10
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Rutten S, van den Heuvel OA, de Kruif AJTCM, Schoonmade LJ, Schumacher EIM, Vermunt K, Hagen R, van Wegen EEH, Rutten K. The Subjective Experience of Living with Parkinson's Disease: A Meta-Ethnography of Qualitative Literature. JOURNAL OF PARKINSONS DISEASE 2020; 11:139-151. [PMID: 33337388 PMCID: PMC7990446 DOI: 10.3233/jpd-202299] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: A better understanding of the subjective experience of living with Parkinson’s disease (PD) and the factors that influence this experience can be used to improve wellbeing of people with PD (PwP). Objective: To gain more insight in the subjective experience of PD from the PwP’s perspective, and the factors that contribute to this experience. Methods: In this qualitative review, we performed a systematic search of qualitative studies discussing the subjective experience of PD and extracted reported themes (first order themes). Using a meta-ethnographic approach, we categorized the first order themes into second order themes, and created a third order construct: a holistic model of the subjective experience of living with PD. Results: We included 20 studies with a total sample of 279 PwP. Data-extraction yielded 227 first order themes, which were categorized into the second order themes: 1) Awareness, 2) Disruption, 3) Adjustment, 4) The external environment, and 5) The changing self. With these themes, we developed the “model of dialectic change” which conceptualizes life with PD as a transformative journey, wherein PwP employ strategies to stabilize their changeable relationship with their external environment, while simultaneously redefining their self-concept. Conclusion: Our findings indicate that not only the symptoms of PD, but also the manner in which these cause disruptions in the PwP’s interaction with their personal environment and self-concept, determine the subjective experience of PD and quality of life. Some PwP experience problems with adjusting, resulting in psychological distress. This calls for a holistic, multidisciplinary and participatory approach of PD.
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Affiliation(s)
- Sonja Rutten
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy & Neuroscience, Amsterdam Public Health, Amsterdam, Netherlands
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy & Neuroscience, Amsterdam Public Health, Amsterdam, Netherlands.,Amsterdam UMC, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Anja J T C M de Kruif
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Linda J Schoonmade
- Department or Research Support, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eva I M Schumacher
- Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy & Neuroscience, Amsterdam Public Health, Amsterdam, Netherlands
| | - Kees Vermunt
- Dutch Parkinson's Association, Bunnik, the Netherlands
| | - Rob Hagen
- Dutch Parkinson's Association, Bunnik, the Netherlands
| | - Erwin E H van Wegen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Koen Rutten
- Amsterdam UMC, Vrije Universiteit Amsterdam, Anatomy & Neuroscience, Amsterdam Public Health, Amsterdam, Netherlands
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11
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Jung SH, Hasegawa N, Mancini M, King LA, Carlson-Kuhta P, Smulders K, Peterson DS, Barlow N, Harker G, Morris R, Lapidus J, Nutt JG, Horak FB. Effects of the agility boot camp with cognitive challenge (ABC-C) exercise program for Parkinson’s disease. NPJ PARKINSONS DISEASE 2020; 6:31. [PMID: 33298934 PMCID: PMC7608677 DOI: 10.1038/s41531-020-00132-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
Few exercise interventions practice both gait and balance tasks with cognitive tasks to improve functional mobility in people with PD. We aimed to investigate whether the Agility Boot Camp with Cognitive Challenge (ABC-C), that simultaneously targets both mobility and cognitive function, improves dynamic balance and dual-task gait in individuals with Parkinson’s disease (PD). We used a cross-over, single-blind, randomized controlled trial to determine efficacy of the exercise intervention. Eighty-six people with idiopathic PD were randomized into either an exercise (ABC-C)-first or an active, placebo, education-first intervention and then crossed over to the other intervention. Both interventions were carried out in small groups led by a certified exercise trainer (90-min sessions, 3 times a week, for 6 weeks). Outcome measures were assessed Off levodopa at baseline and after the first and second interventions. A linear mixed-effects model tested the treatment effects on the Mini-BESTest for balance, dual-task cost on gait speed, SCOPA-COG, the UPDRS Parts II and III and the PDQ-39. Although no significant treatment effects were observed for the Mini-BESTest, SCOPA-COG or MDS-UPDRS Part III, the ABC-C intervention significantly improved the following outcomes: anticipatory postural adjustment sub-score of the Mini-BESTest (p = 0.004), dual-task cost on gait speed (p = 0.001), MDS-UPDRS Part II score (p = 0.01), PIGD sub-score of MDS-UPDRS Part III (p = 0.02), and the activities of daily living domain of the PDQ-39 (p = 0.003). Participants with more severe motor impairment or more severe cognitive dysfunction improved their total Mini-BESTest scores after exercise. The ABC-C exercise intervention can improve specific balance deficits, cognitive-gait interference, and perceived functional independence and quality of life, especially in participants with more severe PD, but a longer period of intervention may be required to improve global cognitive and motor function.
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Koutsouras GW, Levine K, Duroseau N, Ciraco C, Chan V, Pergament K, Chan T, Mancini JD, Leder AN, Krishnamachari B. Effects of depression and exercise on health-related quality of life in patients with Parkinson's disease. Chronic Illn 2020; 16:190-200. [PMID: 30185064 DOI: 10.1177/1742395318796166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES There is limited literature describing the effect exercise may have on depression and an individual's health-related quality of life (HRQoL) in Parkinson's Disease (PD). We aim to quantify this effect. METHODS A cross-sectional questionnaire was administered to 60 PD subjects. The Parkinson's Disease Questionnaire-39 (PDQ-39) summary index and the Geriatric Depression Scale-30 were used to quantify HRQoL and depression, respectively. Data were obtained on exercise habits. ANOVA and multivariate linear regression analysis were used to calculate mean differences in HRQoL. RESULTS Depression was consistently related to HRQoL (p < 0.05). Of those who exercised as an adult before PD diagnosis, 49.02% (n = 25) reported depression as compared to 88.89% (n = 8) of those who did not report adult exercise (p = 0.03). Those who exercised frequently as an adult prior to PD diagnosis had a better PDQ-39 Cognitive Index (p = 0.03). Those who were not depressed and were currently exercising had a significantly higher HRQoL than those who were depressed and did not exercise (p < 0.01). DISCUSSION Exercising and depression may interact to affect HRQoL. Thus, coordination of mental health evaluation and exercise regimens in persons with PD may improve HRQoL.
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Affiliation(s)
- George W Koutsouras
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kimberly Levine
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Nathalie Duroseau
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Christina Ciraco
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Vivian Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kathleen Pergament
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Thomas Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Jayme D Mancini
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Adena N Leder
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Bhuma Krishnamachari
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
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Interpretation of health-related quality of life outcomes in Parkinson's disease from the EARLYSTIM Study. PLoS One 2020; 15:e0237498. [PMID: 32822437 PMCID: PMC7442251 DOI: 10.1371/journal.pone.0237498] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/27/2020] [Indexed: 11/23/2022] Open
Abstract
The EARLYSTIM Study compared deep brain stimulation (DBS) with best medical treatment (BMT) over 2-years, showing a between-group difference of 8.0 from baseline in favor of DBS in health-related quality of life (HRQoL), measured with the PDQ-39 SI (summary index). This study obtained complementary information about the importance of the change in HRQoL as measured by the PDQ-39, using anchor-based (Patient Global Impression of Change, PGIC) and distribution-based techniques (magnitude of change, effect size, thresholds, distribution of benefit) applied to the EARLYSTIM study data. Anchor-based techniques showed a difference follow-up–baseline for patients who reported “minimal improvement” of -5.8 [-9.9, -1.6] (mean [95%CI]) in the DBS group vs -2.9 [-9.0, 3.1] in the BMT group. As the vast majority (80.8%) of DBS patients reported “much or very much improvement”, this difference was explored for the latter group and amounted to -8.7 for the DBS group and -6.5 in the BMT group. Distribution-based techniques that analyzed the relative change and treatment effect size showed a moderate benefit of the DBS on the HRQoL, whereas a slight worsening was observed in the BMT group. The change in the DBS group (-7.8) was higher than the MIC (Minimally Important Change) estimated value (-5.8 by the anchor; -6.3 by triangulation of thresholds), but not in the BMT (0.2 vs. -3.0 to -5.4, respectively). Almost 90% of the patients in the DBS group declared some improvement (58.3% and 56.7% beyond the estimated MIC), which was significantly different from the BMT group whose proportions were 32.0% and 30.3%, respectively. The number needed to treat to improve ≥1 MIC by DBS vs BMT was 3.8. Change in depression, disability and pain influenced the improvement of the DBS group. DBS improved HRQoL in a high proportion of patients to a significant and moderate degree, at 2 years follow-up.
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Saturdays-in-Motion: Education and Empowerment through an Interdisciplinary Team Approach for Parkinson's Disease in Cali-Colombia. PARKINSONS DISEASE 2020; 2020:2497386. [PMID: 32733667 PMCID: PMC7378612 DOI: 10.1155/2020/2497386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/27/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
Introduction Parkinson's disease (PD) is one of the most prevalent age-related neurodegenerative disorders. The progression of PD produces an important disease burden in patients due to functional impairment, which also has repercussions on caregivers. In addition, it has become a challenge for health systems, especially in developing countries, which have limited resources. Multidisciplinary teams with a community approach have proved effective in high-income countries; however, there is no reported literature in low- and middle-income countries about this kind of initiative. Objective This paper aims to document the experience of patients, caregivers, and experts in a community approach as an innovative model in a middle-income country. Methods A quantitative descriptive research was conducted. The selection criteria were having a PD diagnosis, attending with a caregiver to Saturdays in Motion (SIM), or being a clinical expert invited to SIM. PD patients and their caregivers answered three surveys on their points of view with respect to SIM: SIM and their quality of life (QoL) and PDQ-39 and Zarit, whereas clinical experts completed two questions related to the SIM program. Descriptive statistics were used to summarize the results of the surveys and clinical tests. Results Forty-eight, twenty-four, and twenty-one subjects answered surveys one, two, and three, respectively. In total, four clinical experts were interviewed. 87.9% of the patients consider that SIM activities improved their QoL. The most affected areas in PDQ-39 were those related to the social area. Around 66.6% of the caregivers reported a mild burden on Zarit and think that SIM enhances the PD patient's QoL. Clinical experts highlighted the sense of community and empathy. Conclusion Our preliminary experience shows a multidisciplinary model with a community approach which redefines the traditional relationship between patients, caregivers, and clinical experts. This aim of this initiative is that education and empowerment patients and caregivers reach a better perception of QoL.
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Dlamini WW, Nelson G, Nielsen SS, Racette BA. Manganese exposure, parkinsonian signs, and quality of life in South African mine workers. Am J Ind Med 2020; 63:36-43. [PMID: 31647574 DOI: 10.1002/ajim.23060] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/10/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Manganese (Mn) neurotoxicity is associated with parkinsonism; the associated motor deficits can affect individuals' quality of life (QoL). We investigated associations between Mn exposure, parkinsonian signs, and QoL in Mn mine workers. METHODS We assessed parkinsonian signs and QoL in 187 black South African Mn mine workers, using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3) and the Parkinson Disease Questionnaire (PDQ-39), respectively. We estimated cumulative Mn exposure in mg Mn/m3 -years using complete occupational histories and a job-exposure matrix. We investigated the cross-sectional association between cumulative Mn exposure and UPDRS3 score, and the UPDRS3 score and PDQ-39, adjusting for age, using linear regression. RESULTS Participants' mean age was 41.8 years (range, 21-67 years); 97.3% were male. Estimated mean cumulative Mn exposure at the time of examination was 5.4 mg Mn/m3 -years, with a mean of 14.0 years working in a Mn mine. The mean UPDRS3 score was 10.1 and 25.7% of the workers had a UPDRS3 score greater than or equal to 15. There was a U-shaped dose-response relation between cumulative Mn exposure and UPDRS3 score, with a positive association up to 15 mg Mn/m3 -years of exposure and an inverse association thereafter. Greater UPDRS3 scores were associated with poorer self-reported QoL. CONCLUSION In this cohort of employed Mn mine workers, parkinsonian signs were common and were associated with both estimated cumulative Mn exposure and poorer QoL.
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Affiliation(s)
- Wendy W Dlamini
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Gill Nelson
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Infection & Population Health, Institute for Global Health, University College London, London, UK
| | - Susan Searles Nielsen
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Brad A Racette
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
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Pitton Rissardo J, Fornari Caprara A. Parkinson’s disease rating scales: a literature review. ANNALS OF MOVEMENT DISORDERS 2020. [DOI: 10.4103/aomd.aomd_33_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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The impact of levodopa therapy-induced complications on quality of life in Parkinson's disease patients in Singapore. Sci Rep 2019; 9:9248. [PMID: 31239456 PMCID: PMC6593098 DOI: 10.1038/s41598-019-45110-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 05/31/2019] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to investigate the impact of levodopa therapy-induced complications on the quality of life (QoL) of Parkinson's disease (PD) patients in Singapore over a 1-year follow-up period. 274 PD patients were prospectively recruited, of which 78 patients completed the follow-up. Patients were evaluated on: (1) motor symptoms, (2) non-motor symptoms, (3) levodopa therapy-induced complications and (4) QoL. Levodopa-induced complications including dyskinesia and OFF symptoms occurred in 13.5% and 55.9% of the study population, respectively. In patients who completed the 1-year follow-up, there was a trend suggestive of increasing dyskinesia duration, more disabling dyskinesia as well as longer, more sudden and unpredictable OFF periods. There was a significant decline in the overall QoL at follow-up, in particular, activities of daily living, emotional well-being, cognition and communication domains were the most affected. The multivariable analysis demonstrated that worsening of UPDRS IV total score over 1-year interval was associated with worsening in PDQ-Summary Index score (d = 0.671, p = 0.014). In conclusion, levodopa-induced complications had significant adverse impacts on QoL. This study substantiates the importance for clinicians to closely monitor and promptly manage levodopa therapy-induced complications that may arise in patients.
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Cash MF, Ulanowski E, Danzl M. Development of a community-based golf and exercise program for people with Parkinson's disease. Complement Ther Clin Pract 2018; 33:149-155. [PMID: 30396614 DOI: 10.1016/j.ctcp.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 11/26/2022]
Abstract
Individuals with Parkinson's disease (PD) typically display symptoms of rigidity, bradykinesia, and postural instability that can limit participation in recreational activities. The purpose of this clinical report is to describe the development, implementation, and outcomes of a novel and innovative community-based golf and exercise program for individuals with PD. In response to community interest, the program was developed through a unique partnership that blended the expertise of physical therapists and golf professionals. The 6-week program consisted of golf instruction and task-specific exercises. Improvements were noted in seven of eight participants for golf performance (driving distance and club head speed) and quality of life (PD Questionnaire-39) outcome measures. This report describes the design and implementation of a golf and exercise program for people with PD based on community need, evidence, and clinical expertise. Considerations and recommendations for future programs are discussed, such as program length, staffing, volunteers, funding, location, and resources.
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Affiliation(s)
- Megan F Cash
- 4960 Norton Healthcare Blvd. Rehabilitation Services, Norton Healthcare, Louisville, KY, 40241, USA; 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
| | - Elizabeth Ulanowski
- 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
| | - Megan Danzl
- 2001 Newburg Road, Nolen C. Allen Hall, Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, 40205, USA.
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Scorza FA, Fiorini AC, Scorza CA, Finsterer J. Cardiac abnormalities in Parkinson's disease and Parkinsonism. J Clin Neurosci 2018; 53:1-5. [PMID: 29706419 DOI: 10.1016/j.jocn.2018.04.031] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Though there is increasing evidence for primary cardiac disease in Parkinson's disease (PD) and Parkinsonism (PS), this evidence is hardly included in the general management of these patients. METHODS Literature review. RESULTS PD is one of the most common age-related neurodegenerative disorders. Epidemiological studies have shown that PD is accompanied by high rates of premature death compared with the general population. In general, death in PD/PS is usually caused by determinant factors such as pneumonia, cerebrovascular, and cardiovascular disease. There is a significant body of literature demonstrating involvement of the heart in PD/PS. Cardiac involvement in PD/PS includes cardiac autonomic dysfunction, cardiomyopathy, coronary heart disease, arrhythmias, conduction defects, and sudden cardiac death (SCD), and sudden unexpected death in Parkinson's disease (SUDPAR). CONCLUSIONS Cardiac abnormalities found in PD/PS are manifold but the most prominent is cardiac autonomic dysfunction. The frequency of coronary heart disease in PD is a matter of debate. Only rarely reported in PD/PS are cardiomyopathies, arrhythmias, and sudden cardiac death, and SUDPAR. It is particularly recommended that PD/PS patients are more intensively investigated cardiologically as soon as the diagnosis is established. Early recognition of cardiac involvement is important for preventing SCD and SUDPAR.
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Affiliation(s)
- Fulvio A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
| | - Ana C Fiorini
- Programa de Estudos Pós-Graduado em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo (PUC-SP), Brazil; Departamento de Fonoaudiologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
| | - Carla A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
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Rocha P, Aguiar L, McClelland JA, Morris ME. Dance therapy for Parkinson's disease: A randomised feasibility trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.2.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Priscila Rocha
- Clinical research associate, College of Science Health and Engineering, La Trobe University, Melbourne, Australia
| | - Lorenna Aguiar
- Research officer, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Jodie A McClelland
- Lecturer, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Meg E Morris
- School of Allied Health, La Trobe University, Melbourne, Australia
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Parkinson disease with constipation: clinical features and relevant factors. Sci Rep 2018; 8:567. [PMID: 29330419 PMCID: PMC5766597 DOI: 10.1038/s41598-017-16790-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 11/14/2017] [Indexed: 12/14/2022] Open
Abstract
Constipation is one of the most frequent non-motor symptoms of Parkinson disease (PD) and it may be ignored by PD patients, leading to this problem not to be reported in time. The relationships between constipation and demographic variables, motor symptoms and other non-motor symptoms of PD are still unknown. PD patients were evaluated by diagnostic criteria of functional constipation in Rome III and divided into PD with constipation (PD-C) and PD with no constipation (PD-NC) groups. PD patients were assessed by rating scales of motor symptoms and other non-motor symptoms, activity of daily living and quality of life. The frequency of constipation in PD patients was 61.4%, and 24.5% of PD patients had constipation before the onset of motor symptoms. PD-C group had older age and age of onset, longer disease duration, more advanced disease stage, and more severe motor symptoms and non-motor symptoms, including worse cognition and emotion, poorer sleep quality, severer autonomic symptoms, fatigue and apathy. Binary Logistic regression analysis showed that the age, H-Y stage, depression, anxiety and autonomic dysfunction increased the risk of constipation in PD patients. Constipation exerted serious impact on the activity of daily living and quality of life in PD patients.
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Sung YH, Kim HJ, Koh SB, Kim JS, Kim SJ, Cheon SM, Cho JW, Kim YJ, Ma HI, Park MY, Baik JS, Lee PH, Chung SJ, Kim JM, Song IU, Kim HJ, Kim JY, Kwon DY, Lee JH, Lee JY, Kim JS, Yun JY, Hong JY, Kim MJ, Youn J, Kim JS, Oh ES, Yang HJ, Yoon WT, You S, Kwon KY, Park HE, Lee SY, Kim Y, Kim HT, Ahn TB. Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep. J Korean Med Sci 2018; 33:e14. [PMID: 29215823 PMCID: PMC5729655 DOI: 10.3346/jkms.2018.33.e14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/24/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. METHODS In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10-14 days. RESULTS The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. CONCLUSION The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD.
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Affiliation(s)
- Young Hee Sung
- Department of Neurology, Gachon University Gil Hospital, Incheon, Korea
| | - Hee Jin Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
| | - Seong Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Joong Seok Kim
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Neurology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Myung Cheon
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Jin Whan Cho
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Joong Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Hyeo Il Ma
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jong Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - In Uk Song
- Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Han Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Neurology, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Do Young Kwon
- Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jee Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Seon Kim
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University School of Medicine, Cheongju, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University School of Medicine and Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi Jung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Sun Kim
- Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eung Seok Oh
- Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hui Jun Yang
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sooyeoun You
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Kyum Yil Kwon
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Hyung Eun Park
- Department of Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Yun Lee
- Department of Neurology, Dong-A University College of Medicine, Busan, Korea
| | - Younsoo Kim
- Department of Neurology, Changwon Samsung Hospital, Changwon, Korea
| | - Hee Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Tae Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea.
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Jagadeesan AJ, Murugesan R, Vimala Devi S, Meera M, Madhumala G, Vishwanathan Padmaja M, Ramesh A, Banerjee A, Sushmitha S, Khokhlov AN, Marotta F, Pathak S. Current trends in etiology, prognosis and therapeutic aspects of Parkinson's disease: a review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:249-262. [PMID: 29083328 PMCID: PMC6142835 DOI: 10.23750/abm.v88i3.6063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
Parkinson's disease (PD) is a movement disorder, mainly affecting population consisting of the aged. PD occurs chiefly due to progressive loss of dopaminergic neurons in nigrostriatal pathway. Largely, PD patients suffer from non-motor symptoms, such as depression, anxiety, fatigue, and sleep disorders, that needs further investigation and addressing during PD research. Depression in PD is a predominant and complex symptom, and its pathology exists extrinsic to the nigrostriatal system. This disease can ultimately be managed by a combination of regular physiotherapy and proper medication. Taking together the present scenario of PD, including the nature of disease, characteristics, treatment, diagnosis of the patients with PD, these outcomes were reviewed to be explored along with many speech-based solutions to PD in this study. This neurodegenerative disorder needs advancement in research and development which can help patients with PD to lead a normal life.
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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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25
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Martinez-Martin P. What is quality of life and how do we measure it? Relevance to Parkinson's disease and movement disorders. Mov Disord 2016; 32:382-392. [PMID: 27911002 DOI: 10.1002/mds.26885] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/30/2016] [Accepted: 11/06/2016] [Indexed: 12/13/2022] Open
Abstract
Health-related quality of life is a patient-reported outcome that complements clinical evaluation and provides information about disease activity and effects of the treatment. The objective of this review is to present the conceptual framework, the measures, and some of their most relevant applications in the field of Parkinson's disease and movement disorders. Health-related quality of life is a subjective, individual, and multidimensional construct, and its main dimensions are physical, mental, and social, besides global perceptions of health and personal domains. Health-related quality of life measurement is carried out by means of questionnaires or scales, ideally self-applied by patients, and has a diversity of important applications for clinical practice, research, and health policy. Movement disorders and Parkinson's disease are complex conditions impacting all components of patients' health-related quality of life. The use of health-related quality of life tools provides important information on a variety of aspects that are important to patients while complementing clinical evaluations. In particular, studies using this kind of assessment can identify and monitor the most important health-related quality of life determinant factors, allowing tailored assistance and prioritized interventions. In addition, maintaining or improving the patients' health-related quality of life is an objective of care for chronic diseases and, therefore, it has to be monitored over time and as an outcome of clinical trials. Several methods are available for the interpretation of the change in scores of health-related quality of life measures, although a definitive agreement on the most appropriate method is yet to be determined. Presently, health-related quality of life assessment is an important outcome for research and management of chronic conditions such as Parkinson's disease and other movement disorders. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pablo Martinez-Martin
- National Center of Epidemiology and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Carlos III Institute of Health, Madrid, Spain
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26
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König N, Singh NB, Baumann CR, Taylor WR. Can Gait Signatures Provide Quantitative Measures for Aiding Clinical Decision-Making? A Systematic Meta-Analysis of Gait Variability Behavior in Patients with Parkinson's Disease. Front Hum Neurosci 2016; 10:319. [PMID: 27445759 PMCID: PMC4927578 DOI: 10.3389/fnhum.2016.00319] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/13/2016] [Indexed: 12/16/2022] Open
Abstract
A disturbed, inconsistent walking pattern is a common feature of patients with Parkinson's disease (PwPD). Such extreme variability in both temporal and spatial parameters of gait has been associated with unstable walking and an elevated prevalence of falls. However, despite their ability to discretise healthy from pathological function, normative variability values for key gait parameters are still missing. Furthermore, an understanding of each parameter's response to pathology, as well as the inter-parameter relationships, has received little attention. The aim of this systematic literature review and meta-analysis was therefore to define threshold levels for pathological gait variability as well as to investigate whether all gait parameters are equally perturbed in PwPD. Based on a broader systematic literature search that included 13′195 titles, 34 studies addressed Parkinson's disease, presenting 800 PwPD and 854 healthy subjects. Eight gait parameters were compared, of which six showed increased levels of variability during walking in PwPD. The most commonly reported parameter, coefficient of variation of stride time, revealed an upper threshold of 2.4% to discriminate the two groups. Variability of step width, however, was consistently lower in PwPD compared to healthy subjects, and therefore suggests an explicit sensory motor system control mechanism to prioritize balance during walking. The results provide a clear functional threshold for monitoring treatment efficacy in patients with Parkinson's disease. More importantly, however, quantification of specific functional deficits could well provide a basis for locating the source and extent of the neurological damage, and therefore aid clinical decision-making for individualizing therapies.
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Affiliation(s)
- Niklas König
- Department of Health Sciences and Technology, Institute for Biomechanics, Swiss Federal Institute of Technology in Zurich (ETHZ) Zürich, Switzerland
| | - Navrag B Singh
- Department of Health Sciences and Technology, Institute for Biomechanics, Swiss Federal Institute of Technology in Zurich (ETHZ) Zürich, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zürich, University of Zürich Zürich, Switzerland
| | - William R Taylor
- Department of Health Sciences and Technology, Institute for Biomechanics, Swiss Federal Institute of Technology in Zurich (ETHZ) Zürich, Switzerland
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27
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Scorza FA, Cavalheiro EA, Scorza CA, Ferraz HB. Sudden unexpected death in Parkinson's disease: Perspectives on what we have learned about sudden unexpected death in epilepsy (SUDEP). Epilepsy Behav 2016; 57:124-125. [PMID: 26949153 DOI: 10.1016/j.yebeh.2016.01.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 01/30/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Fulvio A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
| | - Esper A Cavalheiro
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Carla A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Henrique B Ferraz
- Departamento de Neurologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
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28
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Scorza FA, Scorza CA, Ferraz HB. Domperidone, Parkinson disease and sudden cardiac death: Mice and men show the way. Clinics (Sao Paulo) 2016; 71:59-61. [PMID: 26934232 PMCID: PMC4760361 DOI: 10.6061/clinics/2016(02)01] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Fulvio A Scorza
- Universidade Federal de São Paulo (EPM/UNIFESP), Escola Paulista de Medicina, Disciplina de Neurociência, São Paulo/SP, Brazil
| | - Carla A Scorza
- Universidade Federal de São Paulo (EPM/UNIFESP), Escola Paulista de Medicina, Disciplina de Neurociência, São Paulo/SP, Brazil
| | - Henrique B Ferraz
- Universidade Federal de São Paulo (EPM/UNIFESP), Escola Paulista de Medicina, Disciplina de Neurologia, São Paulo/SP, Brazil
- E-mail:
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29
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Jenkinson C, Clarke C, Gray R, Hewitson P, Ives N, Morley D, Rick C, Wheatley K, Williams A. Comparing results from long and short form versions of the Parkinson's disease questionnaire in a longitudinal study. Parkinsonism Relat Disord 2015; 21:1312-6. [DOI: 10.1016/j.parkreldis.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 08/20/2015] [Accepted: 09/01/2015] [Indexed: 11/28/2022]
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King LA, Peterson DS, Mancini M, Carlson-Kuhta P, Fling BW, Smulders K, Nutt JG, Dale M, Carter J, Winters-Stone KM, Horak FB. Do cognitive measures and brain circuitry predict outcomes of exercise in Parkinson Disease: a randomized clinical trial. BMC Neurol 2015; 15:218. [PMID: 26499867 PMCID: PMC4619336 DOI: 10.1186/s12883-015-0474-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/13/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is emerging research detailing the relationship between balance/gait/falls and cognition. Imaging studies also suggest a link between structural and functional changes in the frontal lobe (a region commonly associated with cognitive function) and mobility. People with Parkinson's disease have important changes in cognitive function that may impact rehabilitation efficacy. Our underlying hypothesis is that cognitive function and frontal lobe connections with the basal ganglia and brainstem posture/locomotor centers are responsible for postural deficits in people with Parkinson's disease and play a role in rehabilitation efficacy. The purpose of this study is to 1) determine if people with Parkinson's disease can improve mobility and/or cognition after partaking in a cognitively challenging mobility exercise program and 2) determine if cognition and brain circuitry deficits predict responsiveness to exercise rehabilitation. METHODS/DESIGN This study is a randomized cross-over controlled intervention to take place at a University Balance Disorders Laboratory. The study participants will be people with Parkinson's disease who meet inclusion criteria for the study. The intervention will be 6 weeks of group exercise (case) and 6 weeks of group education (control). The exercise is a cognitively challenging program based on the Agility Boot Camp for people with PD. The education program is a 6-week program to teach people how to better live with a chronic disease. The primary outcome measure is the MiniBESTest and the secondary outcomes are measures of mobility, cognition and neural imaging. DISCUSSION The results from this study will further our understanding of the relationship between cognition and mobility with a focus on brain circuitry as it relates to rehabilitation potential. TRIAL REGISTRATION This trial is registered at clinical trials.gov (NCT02231073).
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Affiliation(s)
- L A King
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - D S Peterson
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
- OHSU Parkinson's Center and Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland, Oregon, 97239-3098, USA.
| | - M Mancini
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - P Carlson-Kuhta
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - B W Fling
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - K Smulders
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - J G Nutt
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - M Dale
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - J Carter
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
| | - K M Winters-Stone
- Knight Cancer Institute and School of Nursing, Oregon Health & Science University, Portland, Oregon, USA.
| | - F B Horak
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA.
- OHSU Parkinson's Center and Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Rd., Portland, Oregon, 97239-3098, USA.
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31
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King LA, Wilhelm J, Chen Y, Blehm R, Nutt J, Chen Z, Serdar A, Horak FB. Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial. J Neurol Phys Ther 2015; 39:204-12. [PMID: 26308937 PMCID: PMC4772717 DOI: 10.1097/npt.0000000000000101] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. METHODS Fifty-eight people (age = 63.9 ± 8 years) with PD participated. People were randomized into (1) home exercise program, (2) individual physical therapy, or (3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test. Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included. RESULTS Only the individual group significantly improved in the Physical Performance Test. The individual exercise showed the most improvements in functional and balance measures, whereas the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. DISCUSSION AND CONCLUSIONS An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD, and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).
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Affiliation(s)
- Laurie A King
- Department of Neurology (L.A.K., R.B., J.N., F.B.H.), Department of Rehabilitation Services (J.W., A.S.), and Department of Public Health and Preventive Medicine (Y.C., Z.C.), Oregon Health & Science University, Portland, Oregon
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Kent S, Gray A, Schlackow I, Jenkinson C, McIntosh E. Mapping from the Parkinson's Disease Questionnaire PDQ-39 to the Generic EuroQol EQ-5D-3L: The Value of Mixture Models. Med Decis Making 2015; 35:902-11. [PMID: 25926283 DOI: 10.1177/0272989x15584921] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 03/17/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare a range of statistical models to enable the estimation of EQ-5D-3L utilities from responses to the Parkinson's Disease Questionnaire 39 (PDQ-39). METHODS Linear regression, beta regression, mixtures of linear regressions and beta regressions, and multinomial logistic regression were compared in terms of their ability to accurately predict EQ-5D-3L utilities from responses to the PDQ-39 using mean error (ME), mean absolute error (MAE), and mean square error (MSE), overall and by Hoehn and Yahr stage. Models were estimated using data from the PD MED trial (n = 9123) and assessed on both the estimation data as well as external data from the PD SURG trial (n = 917). RESULTS Overall, the differences in the metrics of fit between models were small in both data sets, with performance poorer for all models in PD SURG. The performance across Hoehn and Yahr stages 1 to 3 were also similar, but multinomial logistic regression was found to exhibit less bias and better individual-level predictive accuracy in PD MED for those in Hoehn and Yahr stages 4 or 5. Overall, the multinomial logistic regression reported an ME of 0.038 out of sample and MAEs of 0.128 and 0.164 and MSEs of 0.030 and 0.044 in the estimation and external data sets, respectively. Poorer levels of the mobility domain score of the PDQ-39 were associated with increased odds of reporting problems for all EQ-5D domains except anxiety/depression. CONCLUSIONS Finite mixture models with only few components can approximate the distribution of EQ-5D-3L utilities well but did not demonstrate improvements in predictive accuracy compared with multinomial logistic regression in the present data set.
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Affiliation(s)
- Seamus Kent
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (SK, AG, IS)
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (SK, AG, IS)
| | - Iryna Schlackow
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (SK, AG, IS)
| | - Crispin Jenkinson
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK (CJ)
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, Scotland, UK (EM)
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Lang Y, Gong D, Fan Y. Calcium channel blocker use and risk of Parkinson's disease: a meta-analysis. Pharmacoepidemiol Drug Saf 2015; 24:559-66. [PMID: 25845582 DOI: 10.1002/pds.3781] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/17/2015] [Accepted: 03/13/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Yakun Lang
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital; Jiangsu University; Zhenjiang 212002 Jiangsu China
| | - Dandan Gong
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital; Jiangsu University; Zhenjiang 212002 Jiangsu China
| | - Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital; Jiangsu University; Zhenjiang 212002 Jiangsu China
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34
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Butt DA, Tu K, Young J, Green D, Wang M, Ivers N, Jaakkimainen L, Lam R, Guttman M. A Validation Study of Administrative Data Algorithms to Identify Patients with Parkinsonism with Prevalence and Incidence Trends. Neuroepidemiology 2014; 43:28-37. [DOI: 10.1159/000365590] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/06/2014] [Indexed: 11/19/2022] Open
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35
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Effect of the Ai-Chi Method on Functional Activity, Quality of Life, and Posture in Patients With Parkinson Disease. TOPICS IN GERIATRIC REHABILITATION 2014. [DOI: 10.1097/tgr.0000000000000039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Quality of life related to swallowing in Parkinson's disease. Dysphagia 2014; 29:578-82. [PMID: 24952632 DOI: 10.1007/s00455-014-9548-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 05/31/2014] [Indexed: 12/16/2022]
Abstract
Swallowing difficulties in Parkinson's disease can result in decreased quality of life. The swallowing quality of life questionnaire (SWAL-QOL) is an instrument for specifically assessing quality of life with respect to swallowing, which has been little explored in patients with Parkinson's disease (PD). The goal of this study was to evaluate the quality of life with respect to swallowing in persons with PD compared to controls and at several stages of the disease using the SWAL-QOL. The experimental group was composed of 62 persons with PD at stages 1-4. Forty-one age-matched healthy subjects constituted the control group. The SWAL-QOL scores were significantly lower for the patients with PD than for the controls in all SWAL-QOL domains. Eating duration had the largest difference in score between persons with PD and the controls and the lowest mean score, followed by communication, fatigue, fear, sleep, and food selection. The scores of most domains were lower at later stages of the disease. The scores for eating duration, symptom frequency, and sleep were significantly lower at stage 4 than stages 1 and 2. In conclusion, patients with PD have significantly lower scores in all domains of the SWAL-QOL than normal controls. This means swallowing difficulties occurring in patients with PD negatively affect their QOL. Progression of the disease worsens swallowing QOL, more specifically in the domains of eating duration, symptom frequency, and sleep. This occurs mostly at later stages of the disease.
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Dauwerse L, Hendrikx A, Schipper K, Struiksma C, Abma TA. Quality-of-life of patients with Parkinson’s disease. Brain Inj 2014; 28:1342-52. [DOI: 10.3109/02699052.2014.916417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Strouwen C, Molenaar EALM, Keus SHJ, Münks L, Munneke M, Vandenberghe W, Bloem BR, Nieuwboer A. Protocol for a randomized comparison of integrated versus consecutive dual task practice in Parkinson's disease: the DUALITY trial. BMC Neurol 2014; 14:61. [PMID: 24674594 PMCID: PMC3974198 DOI: 10.1186/1471-2377-14-61] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/24/2014] [Indexed: 02/02/2023] Open
Abstract
Background Multiple tasking is an integral part of daily mobility. Patients with Parkinson’s disease have dual tasking difficulties due to their combined motor and cognitive deficits. Two contrasting physiotherapy interventions have been proposed to alleviate dual tasking difficulties: either to discourage simultaneous execution of dual tasks (consecutive training); or to practice their concurrent use (integrated training). It is currently unclear which of these training methods should be adopted to achieve safe and consolidated dual task performance in daily life. Therefore, the proposed randomized controlled trial will compare the effects of integrated versus consecutive training of dual tasking (tested by combining walking with cognitive exercises). Methods and design Hundred and twenty patients with Parkinson’s disease will be recruited to participate in this multi-centered, single blind, randomized controlled trial. Patients in Hoehn & Yahr stage II-III, with or without freezing of gait, and who report dual task difficulties will be included. All patients will undergo a six-week control period without intervention after which they will be randomized to integrated or consecutive task practice. Training will consist of standardized walking and cognitive exercises delivered at home four times a week during six weeks. Treatment is guided by a physiotherapist twice a week and consists of two sessions of self-practice using an MP3 player. Blinded testers will assess patients before and after the control period, after the intervention period and after a 12-week follow-up period. The primary outcome measure is dual task gait velocity, i.e. walking combined with a novel untrained cognitive task to evaluate the consolidation of learning. Secondary outcomes include several single and dual task gait and cognitive measures, functional outcomes and a quality of life scale. Falling will be recorded as a possible adverse event using a weekly phone call for the entire study period. Discussion This randomized study will evaluate the effectiveness and safety of integrated versus consecutive task training in patients with Parkinson’s disease. The study will also highlight whether dual task gait training leads to robust motor learning effects, and whether these can be retained and carried-over to untrained dual tasks and functional mobility. Trial registration Clinicaltrials.gov NCT01375413.
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Affiliation(s)
| | | | | | | | | | | | | | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Faculty of Kinesiology and Rehabilitation, Tervuursevest 101 bus 1501, Leuven 3001, Belgium.
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Jiang JL, Lo SF, Tsai ST, Chen SY. A systematic review of the impact of subthalamic nucleus stimulation on the quality of life of patients with Parkinson's disease. Tzu Chi Med J 2014. [DOI: 10.1016/j.tcmj.2013.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Xu J, Gong D, Man C, Fan Y. Parkinson's disease and risk of mortality: meta-analysis and systematic review. Acta Neurol Scand 2014; 129:71-9. [PMID: 24256347 DOI: 10.1111/ane.12201] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2013] [Indexed: 01/02/2023]
Abstract
To evaluate the existing prospective observational studies on the morality risk among Parkinson's disease (PD) patients and determine the overall risk ratio (RR) of mortality by conducting a meta-analysis and systematic review. Original articles published in English were searched in PubMed and Embase databases prior to March 2013. Only prospective observational studies providing adjusted risk estimates related to PD and future mortality were considered eligible. Pooled adjusted RR and 95% confidence interval (CI) were computed either by fixed-effects models or by random-effects models. Eight studies with 72,833 participants were identified and analysed. In the pooled analyses, patients with PD had a greater risk of all-cause mortality (RR = 2.22; 95% CI: 1.78-2.77). Subgroup analyses based on the design, gender, follow-up duration and sample size showed that a consistent positive association between PD and the mortality risk in each subgroup. However, no statistical significance was found for the baseline age <65 years (RR = 1.42; 95% CI: 0.72-2.77). PD patients with dementia had particularly high mortality risks (RR = 3.78; 95% CI: 2.06-6.92). This meta-analysis indicated that among patients with PD, the all-cause mortality increased by 2.22-fold compared with the general population. PD patients with dementia particularly had higher risks of mortality.
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Affiliation(s)
- J. Xu
- Institute of Molecular Biology & Translational Medicine; Affiliated People's Hospital; Jiangsu University; Zhenjiang Jiangsu China
| | - D.D. Gong
- Institute of Molecular Biology & Translational Medicine; Affiliated People's Hospital; Jiangsu University; Zhenjiang Jiangsu China
| | - C.F. Man
- Institute of Molecular Biology & Translational Medicine; Affiliated People's Hospital; Jiangsu University; Zhenjiang Jiangsu China
| | - Y. Fan
- Institute of Molecular Biology & Translational Medicine; Affiliated People's Hospital; Jiangsu University; Zhenjiang Jiangsu China
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Lukins TR, Tisch S, Jonker B. The latest evidence on target selection in deep brain stimulation for Parkinson’s disease. J Clin Neurosci 2014; 21:22-7. [PMID: 24210797 DOI: 10.1016/j.jocn.2013.05.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/31/2013] [Indexed: 10/26/2022]
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Martinez-Martin P. Nonmotor symptoms and health-related quality of life in early Parkinson's disease. Mov Disord 2013; 29:166-8. [DOI: 10.1002/mds.25799] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/13/2013] [Accepted: 12/09/2013] [Indexed: 12/24/2022] Open
Affiliation(s)
- Pablo Martinez-Martin
- Research Unit, Alzheimer Center Reina Sofía Foundation; Section of Neuroepidemiology; National Center for Epidemiology; and Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health; Madrid Spain
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Singh NB, König N, Arampatzis A, Taylor WR. Age-related modifications to the magnitude and periodicity of neuromuscular noise. PLoS One 2013; 8:e82791. [PMID: 24349362 PMCID: PMC3861468 DOI: 10.1371/journal.pone.0082791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/29/2013] [Indexed: 11/24/2022] Open
Abstract
Background Evaluation of task related outcomes within geriatric and fall-prone populations is essential not only for identification of neuromuscular deficits, but also for effective implementation of fall prevention strategies. As most tasks and activities of daily living are performed at submaximal force levels, restoration of muscle strength often does not produce the expected benefit in functional capacity. However, it is known that muscular control plays a key role in the performance of functional tasks, but it remains unclear to what degree muscular control and the associated neuromuscular noise (NmN) is age-related, particularly in the lower-extremities. Objectives The aim of this study was to determine the effects of age and fall-pathology on the magnitude as well as the frequency of NmN during lower extremity force production. Methods Sixteen young healthy adults, as well as seventy elderly women (36 healthy, 34 elderly fallers), performed force production tests at moderate levels (15% of maximum voluntary isometric contractions). Results Elderly fallers exhibited the highest magnitude of NmN, while the highest frequency components of NmN tended to occur in the healthy elderly. Young subjects exhibited significantly more power in the low frequency ranges than either of the elderly groups, and had the lowest levels of NmN. Conclusion These data suggest increased degeneration of muscular control through greater NmN in elderly fallers compared to healthy elderly or young subjects. This could possibly be associated with muscle atrophy and lower levels of motor unit synchronisation.
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Affiliation(s)
- Navrag B. Singh
- Institute for Biomechanics, Department of Health Science and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
| | - Niklas König
- Institute for Biomechanics, Department of Health Science and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
| | - Adamantios Arampatzis
- Department of Training & Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - William R. Taylor
- Institute for Biomechanics, Department of Health Science and Technology, Eidgenössische Technische Hochschule Zürich, Zürich, Switzerland
- * E-mail:
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Choe C, Lucioni A. Assessing Patient-Reported Outcomes for Patients with Neurogenic Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2013. [DOI: 10.1007/s11884-013-0198-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Exploring outcome measures for exercise intervention in people with Parkinson's disease. PARKINSONS DISEASE 2013; 2013:572134. [PMID: 23738230 PMCID: PMC3657411 DOI: 10.1155/2013/572134] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/28/2013] [Indexed: 12/19/2022]
Abstract
Background. It is widely believed that exercise improves mobility in people with Parkinson's disease (PD). However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC) or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF). To determine the responsiveness to exercise, we calculated the standardized response means. t-tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration (P = 0.03), stride velocity (P = 0.001), peak arm speed (P = 0.001), and horizontal trunk ROM during gait (P = 0.02). Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F = 4.95; P = 0.03). Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.
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Arankalle DV, Nair PMK. Effect of electroacupuncture on function and quality of life in Parkinson's disease: a case report. Acupunct Med 2013; 31:235-8. [PMID: 23470639 DOI: 10.1136/acupmed-2012-010285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 56-year-old man diagnosed in 2003 as having Hoehn & Yahr stage III Parkinson's disease (PD) came to our clinic in 2012 with slurred speech, right-sided bradykinesia, erectile dysfunction, rigidity, emotional instability and depression. His PD showed progressive signs with postural instability, moderate bilateral signs, and he rated 80% on the Schwab & England Activities of Daily Living Scale. A modified protocol of electroacupuncture was administered for a period of 5 weeks, six times per week, with each session lasting for 30 min. Assessments were based on the Berg Balance Scale (BBS) and Parkinson's Disease Questionnaire-39 (PDQ-39) items, a disease-specific measure of subjective health status. He showed improvement on the BBS, suggesting improved functional status. His quality of life showed improvement particularly on the 'activities of daily living', 'cognition' and 'communication' dimensions of the PDQ-39. Acupuncture treatments in animal experiments have generated valuable mechanistic insights that could be relevant to PD, for example, demonstrating its neuroprotective potential from stimulation of various neuroprotective agents. The literature also suggests acupuncture may play a role in the improvement of motor function and quality of life in PD. Acupuncture is tolerated well by individuals with PD and should be considered as an integrative approach for their symptomatic management.
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Affiliation(s)
- Dhananjay Vijay Arankalle
- Office of Research and Development, National Institute of Naturopathy (Department of AYUSH, Ministry of Health and Family Welfare, Government of India), Pune, India.
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Ray Chaudhuri K, Rojo JM, Schapira AHV, Brooks DJ, Stocchi F, Odin P, Antonini A, Brown RJ, Martinez-Martin P. A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need. PLoS One 2013; 8:e57221. [PMID: 23468940 PMCID: PMC3584126 DOI: 10.1371/journal.pone.0057221] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 01/18/2013] [Indexed: 01/25/2023] Open
Abstract
Background Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores to determine levels of NMS burden (NMSB) and to complete PD patient classification. Methods This was an observational, cross-sectional international study of 935 consecutive patients. Using a distribution of NMSS scores by quartiles, a classification based on levels from 0 (no NMSB at all) to 4 (very severe NMSB) was obtained and its relation with Hoehn and Yahr (HY) staging, motor and health-related quality of life scales was analyzed. Concordance between NMSB levels and grouping based on clinician's global impression of severity, using categorical regression, was determined. Disability and HRQoL predictors were identified by multiple regression models. Results The distribution of motor and QoL scales scores by HY and NMSB levels was significantly discriminative. The difference in the classification of cases for both methods, HY and NMSB, was significant (gamma = 0.45; ASE = 0.032). Concordance between NMSB and global severity-based levels from categorical regression was 91.8%, (kappaw = 0.97). NMS score was predictor of disability and QoL. Conclusions Current clinical practice does not address a need for inclusion of non-motor scores in routine assessment of PD in spite of the overwhelming influence of NMS on disability and quality of life. Our data overcome the problems of “pure motor assessment” and we propose a combined approach with addition of NMSB levels to standard motor assessments.
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Affiliation(s)
- Kallol Ray Chaudhuri
- National Parkinson Foundation Centre of Excellence, Kings College Hospital and Kings College, and University Hospital Lewisham, London, United Kingdom
| | - Jose Manuel Rojo
- Department of Statistics, Centre of Human and Social Sciences, Spanish Council for Scientific Research, Madrid, Spain
| | | | - David J. Brooks
- Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Per Odin
- Department of Neurology, Lund University Hospital, Lund, Sweden
| | - Angelo Antonini
- Department for Parkinson's Disease, IRCCS San Camillo, Venice, Italy
| | - Richard J. Brown
- Department of Psychology, Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Pablo Martinez-Martin
- Alzheimer Disease Research Unit and CIBERNED, CIEN Foundation, Carlos III Institute of Health, Alzheimer Centre Reina Sofia Foundation, Madrid, Spain
- * E-mail:
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Covassin N, Neikrug AB, Liu L, Maglione J, Natarajan L, Corey-Bloom J, Loredo JS, Palmer BW, Redwine LS, Ancoli-Israel S. Relationships between clinical characteristics and nocturnal cardiac autonomic activity in Parkinson's disease. Auton Neurosci 2012; 171:85-8. [PMID: 23141523 DOI: 10.1016/j.autneu.2012.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 10/11/2012] [Accepted: 10/14/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The aim of the present study was to explore the association between Parkinson's disease (PD) clinical characteristics and cardiac autonomic control across sleep stages. METHODS Frequency-domain heart rate variability (HRV) measures were estimated in 18 PD patients undergoing a night of polysomnography. RESULTS Significant relationships were found between PD severity and nocturnal HRV indices. The associations were restricted to rapid eye movement (R) sleep. CONCLUSIONS The progressive nocturnal cardiac autonomic impairment occurring with more severe PD can be subclinical emerging only during conditions requiring active modulation of physiological functions such as R-sleep.
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Affiliation(s)
- Naima Covassin
- Department of General Psychology, University of Padova, Italy
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Dubayova T, Krokavcova M, Nagyova I, Rosenberger J, Gdovinova Z, Middel B, Groothoff JW, van Dijk JP. Type D, anxiety and depression in association with quality of life in patients with Parkinson’s disease and patients with multiple sclerosis. Qual Life Res 2012; 22:1353-60. [DOI: 10.1007/s11136-012-0257-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2012] [Indexed: 11/30/2022]
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Efficacy of tailored computer-based neurorehabilitation for improvement of movement initiation in Parkinson's disease. Brain Res 2012; 1452:151-64. [PMID: 22459048 DOI: 10.1016/j.brainres.2012.02.073] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 02/02/2012] [Accepted: 02/29/2012] [Indexed: 12/31/2022]
Abstract
While Parkinson's disease (PD) is considered a motor disorder, motor signs of PD can be exacerbated by cognitive dysfunction. We evaluated the efficacy of a computer-based cognitive rehabilitation training program designed to improve motor-related executive function. Thirty people with PD and 21 controls participated in the 10-day training. Training consisted of a two-phase button press task. First, subjects produced an externally cued (EC) digit sequence, typing numbers displayed on the computer screen. Second, subjects were prompted to generate the same sequence in the absence of the number display (internally represented sequence, IR). Sequence length was automatically adjusted to maintain 87% correct performance. Participants were evaluated before and after training using a fixed version of the training task, and generalization of training was assessed using measures involving IR motor sequencing, switching and activities of daily living. PD participants were divided into two groups, those who showed impairment in IR motor sequence production prior to training (N=14) and those whose performance was similar to controls (N=16). Following training the impaired PD group showed significantly greater reduction in sequence initiation and completion time and in error rate for IR conditions compared to the unimpaired PD and control groups. All groups improved on Trails B-A, and pre-training Trails B was identified as a predictor of training-based improvement in IR sequence completion time and error rate. Our findings highlight the importance of neurorehabilitation tailored to the specific cognitive deficits of the PD patient.
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