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Adewusi JK, Hadjivassiliou M, Vinagre-Aragón A, O'Connor KR, Khan A, Grünewald RA, Zis P. Sensory neuropathic symptoms in idiopathic Parkinson's disease: prevalence and impact on quality of life. Acta Neurol Belg 2018; 118:445-450. [PMID: 29796943 DOI: 10.1007/s13760-018-0947-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/16/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Neuropathic symptoms are commonly reported in Parkinson's disease (PD), but robust data on the epidemiology of such symptoms are lacking. The present study sought to investigate the prevalence and determinants of peripheral sensory neuropathic symptoms (PSNS) in idiopathic PD (IPD) and ascertain the effects of such symptoms on the patients' quality of life (QoL). METHODS Patients with IPD and age-matched and gender-matched controls were screened for neuropathic symptoms using the Michigan Neuropathy Screening Instrument. The impact of neuropathic symptoms on QoL was investigated using the 36-Item Short Form Survey. RESULTS Fifty-two patients and 52 age-matched and gender-matched controls were recruited. PSNS were reported more frequently in patients with IPD than in the control subjects (57.7 versus 28.8%, p = 0.003). No significant relationships were found between PD-related clinical characteristics (i.e. disease severity and duration, duration of exposure to levodopa) and the presence of PSNS. Significant correlations were found between the number of PSNS and physical functioning (Spearman's Rho - 0.351), even after adjusting for age, gender and Hoehn and Yahr score. CONCLUSION Our results support the notion of a greater prevalence of PSNS in IPD patients as compared to the general population, which, at least in part, may be secondary to large and/or small fibre peripheral neuropathy. This warrants further investigation in larger studies that include detailed neurophysiological assessments.
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Affiliation(s)
- Joy K Adewusi
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Marios Hadjivassiliou
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK
| | - Ana Vinagre-Aragón
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK
| | - Karen Ruth O'Connor
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
| | - Aijaz Khan
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK
| | - Richard Adam Grünewald
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK
| | - Panagiotis Zis
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Sheffield, South Yorkshire, S10 2JF, UK.
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Agathos E, Tentolouris A, Eleftheriadou I, Katsaouni P, Nemtzas I, Petrou A, Papanikolaou C, Tentolouris N. Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. J Int Med Res 2018. [PMID: 29517942 PMCID: PMC5991249 DOI: 10.1177/0300060518756540] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective To examine the effect of α-lipoic acid on neuropathic symptoms in patients with diabetic neuropathy (DN). Methods Patients with painful DN were treated with 600 mg/day α-lipoic acid, orally, for 40 days. Neuropathy Symptom Score (NSS), Subjective Peripheral Neuropathy Screen Questionnaire (SPNSQ) and douleur neuropathique (DN)4 questionnaire scores were assessed at baseline and day 40. Quality-of-life treatment effects were assessed by Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and Sheehan Disability Scale (SDS). Changes in body weight, arterial blood pressure, fasting serum glucose and lipids were also assessed. Results Out of 72 patients included, significant reductions in neuropathic symptoms were shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and SDS in terms of work disability, social life disability, and family life disability scores were also significantly reduced. Moreover, 50% of patients rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline. Conclusions A-lipoic acid administration was associated with reduced neuropathic symptoms and triglycerides, and improved quality of life.
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Affiliation(s)
- Evangelos Agathos
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Anastasios Tentolouris
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Ioanna Eleftheriadou
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Panagiota Katsaouni
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Ioannis Nemtzas
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Alexandra Petrou
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Christina Papanikolaou
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
| | - Nikolaos Tentolouris
- Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, 68993 National and Kapodistrian University of Athens , Laiko General Hospital, Athens, Greece.,Part of this work was orally presented at the 5th Hellenic Congress of the Hellenic Association for the Study of the Diabetic Foot (EMEDIP) on February 5-7, 2016, Athens, Greece
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Ziegler D, Edmundson S, Gurieva I, Mankovsky B, Papanas N, Strokov I. Predictors of response to treatment with actovegin for 6 months in patients with type 2 diabetes and symptomatic polyneuropathy. J Diabetes Complications 2017; 31:1181-1187. [PMID: 28438471 DOI: 10.1016/j.jdiacomp.2017.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/07/2017] [Accepted: 03/28/2017] [Indexed: 01/15/2023]
Abstract
AIMS To evaluate two definitions of response and the predictive value of baseline covariates for response to actovegin treatment in type 2 diabetic patients with symptomatic diabetic sensorimotor polyneuropathy (DSPN). METHODS Response to 6-months treatment with actovegin or placebo was defined as a clinically meaningful decline from baseline to 6months in (1) both Neuropathy Impairment Score of Lower Limbs (NIS-LL) ≥2 points and Total Symptom Score (TSS) >50% and (2) NIS-LL ≥2 points only. Nineteen baseline covariates were evaluated using separate logistic regression models and either both NIS-LL and TSS or NIS-LL response definitions. RESULTS Intention-to-treat analysis included 567 patients. Actovegin treatment compared to placebo was associated with better odds of response (OR [95% CI] of 1.73 [1.21-2.48] for definition 1 and 1.94 [1.33-2.84] for definition 2). Significant interaction with actovegin treatment was noted only for baseline use of angiotensin receptor blockers (ARBs)/angiotensinogen converting enzyme inhibitors (ACEIs), resulting in a reduced treatment response (P=0.03). CONCLUSIONS Actovegin treatment was associated with a clinically meaningful response in neuropathic symptoms and/or impairments in patients with symptomatic DSPN. Since only one predictor of response to actovegin treatment was identified, this drug seems an appropriate therapy for the majority of patients with DSPN.
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Affiliation(s)
- Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany; Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
| | | | - Irina Gurieva
- Department of Endocrinology, Federal Bureau of Medical and Social Expertise, Moscow, Russia.
| | - Boris Mankovsky
- Department of Diabetology, National Medical Academy for Postgraduate Education, Kiev, Ukraine.
| | - Nikolaos Papanas
- Diabetes Center, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Igor Strokov
- Sechenov Moscow Medical Academy, Moscow, Russia.
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