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Rashidi-Ranjbar N, Churchill NW, Black SE, Kumar S, Tartaglia MC, Freedman M, Lang A, Steeves TDL, Swartz RH, Saposnik G, Sahlas D, McLaughlin P, Symons S, Strother S, Pollock BG, Rajji TK, Ozzoude M, Tan B, Arnott SR, Bartha R, Borrie M, Masellis M, Pasternak SH, Frank A, Seitz D, Ismail Z, Tang-Wai DF, Casaubon LK, Mandzia J, Jog M, Scott CJM, Dowlatshahi D, Hassan A, Grimes D, Marras C, Zamyadi M, Munoz DG, Ramirez J, Berezuk C, Holmes M, Fischer CE, Schweizer TA. Neuropsychiatric symptoms and brain morphology in patients with mild cognitive impairment, cerebrovascular disease and Parkinson disease: A cross sectional and longitudinal study. Int J Geriatr Psychiatry 2024; 39:e6074. [PMID: 38491809 DOI: 10.1002/gps.6074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/11/2023] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Neuropsychiatric symptoms (NPS) increase risk of developing dementia and are linked to various neurodegenerative conditions, including mild cognitive impairment (MCI due to Alzheimer's disease [AD]), cerebrovascular disease (CVD), and Parkinson's disease (PD). We explored the structural neural correlates of NPS cross-sectionally and longitudinally across various neurodegenerative diagnoses. METHODS The study included individuals with MCI due to AD, (n = 74), CVD (n = 143), and PD (n = 137) at baseline, and at 2-years follow-up (MCI due to AD, n = 37, CVD n = 103, and PD n = 84). We assessed the severity of NPS using the Neuropsychiatric Inventory Questionnaire. For brain structure we included cortical thickness and subcortical volume of predefined regions of interest associated with corticolimbic and frontal-executive circuits. RESULTS Cross-sectional analysis revealed significant negative correlations between appetite with both circuits in the MCI and CVD groups, while apathy was associated with these circuits in both the MCI and PD groups. Longitudinally, changes in apathy scores in the MCI group were negatively linked to the changes of the frontal-executive circuit. In the CVD group, changes in agitation and nighttime behavior were negatively associated with the corticolimbic and frontal-executive circuits, respectively. In the PD group, changes in disinhibition and apathy were positively associated with the corticolimbic and frontal-executive circuits, respectively. CONCLUSIONS The observed correlations suggest that underlying pathological changes in the brain may contribute to alterations in neural activity associated with MBI. Notably, the difference between cross-sectional and longitudinal results indicates the necessity of conducting longitudinal studies for reproducible findings and drawing robust inferences.
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Affiliation(s)
- Neda Rashidi-Ranjbar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Nathan W Churchill
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandra E Black
- Division of Neurology, Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maria C Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Morris Freedman
- Division of Neurology, Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- The Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Thomas D L Steeves
- Division of Neurology, Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Richard H Swartz
- Division of Neurology, Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gustavo Saposnik
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Clinical Outcomes and Decision Neuroscience Unit, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Dametrios Sahlas
- McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Paula McLaughlin
- Nova Scotia Health, Halifax, Nova Scotia, Canada
- Departments of Medicine (Geriatrics) and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sean Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Stephen Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Stephen R Arnott
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Michael Borrie
- Nova Scotia Health, Halifax, Nova Scotia, Canada
- Departments of Medicine (Geriatrics) and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Stephen H Pasternak
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Andrew Frank
- Bruyère Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David F Tang-Wai
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario, Canada
| | - Leanne K Casaubon
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario, Canada
| | - Jennifer Mandzia
- St. Joseph's Healthcare Centre, London, Ontario, Canada
- London Health Sciences Centre, London, Ontario, Canada
| | - Mandar Jog
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christopher J M Scott
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute (TBRHRI), Northern Ontario School of Medicine University (NOSMU), Thunder Bay, Ontario, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Connie Marras
- The Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - David G Munoz
- Division of Neurosurgery, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joel Ramirez
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Courtney Berezuk
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Melissa Holmes
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Division of Neurosurgery, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Dilliott AA, Berberian SA, Sunderland KM, Binns MA, Zimmer J, Ozzoude M, Scott CJM, Gao F, Lang AE, Breen DP, Tartaglia MC, Tan B, Swartz RH, Rogaeva E, Borrie M, Finger E, Fischer CE, Frank A, Freedman M, Kumar S, Pasternak S, Pollock BG, Rajji TK, Tang-Wai DF, Abrahao A, Turnbull J, Zinman L, Casaubon L, Dowlatshahi D, Hassan A, Mandzia J, Sahlas D, Saposnik G, Grimes D, Marras C, Steeves T, Masellis M, Farhan SMK, Bartha R, Symons S, Hegele RA, Black SE, Ramirez J. Rare neurovascular genetic and imaging markers across neurodegenerative diseases. Alzheimers Dement 2023; 19:5583-5595. [PMID: 37272523 DOI: 10.1002/alz.13316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/03/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Cerebral small vessel disease (SVD) is common in patients with cognitive impairment and neurodegenerative diseases such as Alzheimer's and Parkinson's. This study investigated the burden of magnetic resonance imaging (MRI)-based markers of SVD in patients with neurodegenerative diseases as a function of rare genetic variant carrier status. METHODS The Ontario Neurodegenerative Disease Research Initiative study included 520 participants, recruited from 14 tertiary care centers, diagnosed with various neurodegenerative diseases and determined the carrier status of rare non-synonymous variants in five genes (ABCC6, COL4A1/COL4A2, NOTCH3/HTRA1). RESULTS NOTCH3/HTRA1 were found to significantly influence SVD neuroimaging outcomes; however, the mechanisms by which these variants contribute to disease progression or worsen clinical correlates are not yet understood. DISCUSSION Further studies are needed to develop genetic and imaging neurovascular markers to enhance our understanding of their potential contribution to neurodegenerative diseases.
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Affiliation(s)
- Allison A Dilliott
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Stephanie A Berberian
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Julia Zimmer
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Miracle Ozzoude
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Fuqiang Gao
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh; Anne Rowling Regenerative Neurology Clinic, University of Edinburgh; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Maria C Tartaglia
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
- Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Richard H Swartz
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Elizabeth Finger
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Baycrest Health Sciences, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephen Pasternak
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Agessandro Abrahao
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - John Turnbull
- Division of Neurology, Department of Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Lorne Zinman
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Leanne Casaubon
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Jennifer Mandzia
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Demetrios Sahlas
- Division of Neurology, Department of Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Thomas Steeves
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Sali M K Farhan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Robert Bartha
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sean Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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3
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Zebarth J, Kamal R, Perlman G, Ouk M, Xiong LY, Yu D, Lin WZ, Ramirez J, Masellis M, Goubran M, MacIntosh BJ, Black SE, Cogo-Moreira H, Scott CJM, Bartha R, Symons S, Haddad SMH, Ozzoude M, Nanayakkara N, Beaton D, Arnott S, Dowlatshahi D, Swartz RH, Saposnik G, Grimes D, Lang A, Fischer CE, Frank A, Kumar S, Pollock BG, Tang-Wai D, Finger E, Rabin JS, Swardfager W. Perivascular spaces mediate a relationship between diabetes and other cerebral small vessel disease markers in cerebrovascular and neurodegenerative diseases. J Stroke Cerebrovasc Dis 2023; 32:107273. [PMID: 37542762 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and hypertension are risk factors for cerebral small vessel disease (SVD); however, few studies have characterised their relationships with MRI-visible perivascular spaces (PVS). MRI was used to quantify deep (d) and periventricular (p) white matter hyperintensities (WMH), lacunes, PVS in the white matter (wmPVS) or basal ganglia (bgPVS), and diffusion metrics in white matter. Patients with T2DM had greater wmPVS volume and there were greater wmPVS volumes in patients with T2DM and hypertension together. Counterfactual moderated mediation models found indirect effects of T2DM on volumes of other SVD and diffusion markers that were mediated by wmPVS: pWMH, dWMH, periventricular lacunes, and deep lacunes, and progression of deep lacunes over 1 year, in patients with hypertension, but not in patients without hypertension. Studying the regulation of cortical perivascular fluid dynamics may reveal mechanisms that mediate the impact of T2DM on cerebral small vessels.
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Affiliation(s)
- Julia Zebarth
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - Radia Kamal
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - George Perlman
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - Michael Ouk
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - Lisa Y Xiong
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - Di Yu
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - William Z Lin
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada
| | - Joel Ramirez
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Mario Masellis
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Maged Goubran
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Medical Biophysics, Temerty Faculty of Medicine, University of Toronto, Princess Margret Cancer Research Tower 101 College Street Room 15-701, Toronto M5G 1L7, Canada
| | - Bradley J MacIntosh
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Medical Biophysics, Temerty Faculty of Medicine, University of Toronto, Princess Margret Cancer Research Tower 101 College Street Room 15-701, Toronto M5G 1L7, Canada
| | - Sandra E Black
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Hugo Cogo-Moreira
- Department of Education, Østfold University College, 1757 B R A Veien 4, Halden 1757, Norway
| | - Christopher J M Scott
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Western University, Medical Sciences building Room M407, London, Ontario N6A 5C1, Canada
| | - Sean Symons
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Seyyed M H Haddad
- Center for Functional and Metabolic Mapping, Robarts Research Institute, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Miracle Ozzoude
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Nuwan Nanayakkara
- Robarts Research Institute, University of Western Ontario, 100 Perth Drive, London, Ontario N6A 5K8, Canada
| | - Derek Beaton
- Data Science and Advanced Analytics (DSAA), St. Michael's Hospital, Unity Health Toronto, 36 Queen Street East, Toronto, Ontario M5B 1W8, Canada
| | - Stephen Arnott
- Rotman Research Institute, Baycrest Centre, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada
| | - Dariush Dowlatshahi
- Division of Neurology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada
| | - Richard H Swartz
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Gustavo Saposnik
- Stroke Outcomes and Decision Neuroscience Research Unit, Division of Neurology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada
| | - David Grimes
- Division of Neurology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, 725 Parkdale Ave, Ottawa, Ontario K1Y 4E9, Canada
| | - Anthony Lang
- Krembil Research Institute, University Health Network, 60 Leonard Ave, Toronto, Ontario M5T 0S8, Canada; Division of Neurology, Temerty Faculty of Medicine, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada; Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, 399 Bathurst St, Toronto, Ontario M5T 2S8, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Unity Health, 209 Victoria Street, Toronto, Ontario M5B 1T8, Canada
| | - Andrew Frank
- Bruyère Research Institute, University of Ottawa, 85 Primrose Avenue, Ottawa, Ontario K1R 6M1, Canada
| | - Sanjeev Kumar
- Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, Ontario M6J 1H4, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto M5T 1R8, Canada
| | - Bruce G Pollock
- Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health 475 Spadina Avenue, Toronto, Ontario M5S 2S1, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto M5T 1R8, Canada
| | - David Tang-Wai
- Krembil Research Institute, University Health Network, 60 Leonard Ave, Toronto, Ontario M5T 0S8, Canada; Division of Neurology, Temerty Faculty of Medicine, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada; Toronto Western Hospital, University Health Network Memory Clinic, 399 Bathurst Street, Toronto M5T 2S8, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Western University, 550 Wellington Road, London, Ontario N6C 0A7, Canada
| | - Jennifer S Rabin
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Harquail Centre for Neuromodulation, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto M4N 3M5, Canada; Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto M4N 3M5, Canada; Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Room 2109, Toronto, Ontario M5S 1A8, Canada
| | - Walter Swardfager
- Dr. Sandra Black Center for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada; Department of Pharmacology and Toxicology, University of Toronto, Medical Sciences building 1 Kings College Circle Room 4207, Toronto, Ontario M5S 1A8, Canada; Thunder Bay Regional Health Research Institute, 1040 Oliver Road, Thunder Bay, Ontario P7B 7A5, Canada.
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4
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Ozzoude M, Varriano B, Beaton D, Ramirez J, Adamo S, Holmes MF, Scott CJM, Gao F, Sunderland KM, McLaughlin P, Goubran M, Kwan D, Roberts A, Bartha R, Symons S, Tan B, Swartz RH, Abrahao A, Saposnik G, Masellis M, Lang AE, Marras C, Zinman L, Shoesmith C, Borrie M, Fischer CE, Frank A, Freedman M, Montero-Odasso M, Kumar S, Pasternak S, Strother SC, Pollock BG, Rajji TK, Seitz D, Tang-Wai DF, Turnbull J, Dowlatshahi D, Hassan A, Casaubon L, Mandzia J, Sahlas D, Breen DP, Grimes D, Jog M, Steeves TDL, Arnott SR, Black SE, Finger E, Rabin J, Tartaglia MC. White matter hyperintensities and smaller cortical thickness are associated with neuropsychiatric symptoms in neurodegenerative and cerebrovascular diseases. Alzheimers Res Ther 2023; 15:114. [PMID: 37340319 PMCID: PMC10280981 DOI: 10.1186/s13195-023-01257-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 06/01/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are a core feature of most neurodegenerative and cerebrovascular diseases. White matter hyperintensities and brain atrophy have been implicated in NPS. We aimed to investigate the relative contribution of white matter hyperintensities and cortical thickness to NPS in participants across neurodegenerative and cerebrovascular diseases. METHODS Five hundred thirteen participants with one of these conditions, i.e. Alzheimer's Disease/Mild Cognitive Impairment, Amyotrophic Lateral Sclerosis, Frontotemporal Dementia, Parkinson's Disease, or Cerebrovascular Disease, were included in the study. NPS were assessed using the Neuropsychiatric Inventory - Questionnaire and grouped into hyperactivity, psychotic, affective, and apathy subsyndromes. White matter hyperintensities were quantified using a semi-automatic segmentation technique and FreeSurfer cortical thickness was used to measure regional grey matter loss. RESULTS Although NPS were frequent across the five disease groups, participants with frontotemporal dementia had the highest frequency of hyperactivity, apathy, and affective subsyndromes compared to other groups, whilst psychotic subsyndrome was high in both frontotemporal dementia and Parkinson's disease. Results from univariate and multivariate results showed that various predictors were associated with neuropsychiatric subsyndromes, especially cortical thickness in the inferior frontal, cingulate, and insula regions, sex(female), global cognition, and basal ganglia-thalamus white matter hyperintensities. CONCLUSIONS In participants with neurodegenerative and cerebrovascular diseases, our results suggest that smaller cortical thickness and white matter hyperintensity burden in several cortical-subcortical structures may contribute to the development of NPS. Further studies investigating the mechanisms that determine the progression of NPS in various neurodegenerative and cerebrovascular diseases are needed.
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Affiliation(s)
- Miracle Ozzoude
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 2S8, Canada
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | - Brenda Varriano
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 2S8, Canada
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Derek Beaton
- Data Science & Advanced Analytic, St. Michael's Hospital, Toronto, ON, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Sabrina Adamo
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, ON, Canada
| | - Melissa F Holmes
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Christopher J M Scott
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Fuqiang Gao
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | | | | | - Maged Goubran
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
- Queen's University, Kingston, ON, Canada
| | - Angela Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, ON, Canada
| | - Sean Symons
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Richard H Swartz
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Agessandro Abrahao
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Gustavo Saposnik
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Mario Masellis
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Anthony E Lang
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Connie Marras
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Lorne Zinman
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Christen Shoesmith
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Michael Borrie
- Robarts Research Institute, Western University, London, ON, Canada
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Corinne E Fischer
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Andrew Frank
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Division of Neurology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Manuel Montero-Odasso
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Lawsone Health Research Institute, London, ON, Canada
- Gait and Brain Lab, Parkwood Institute, London, ON, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Stephen Pasternak
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Stephen C Strother
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David F Tang-Wai
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - John Turnbull
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
| | - Leanne Casaubon
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- St. Joseph's Healthcare Centre, London, ON, Canada
| | - Demetrios Sahlas
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
| | - Thomas D L Steeves
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Stephen R Arnott
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jennifer Rabin
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 2S8, Canada.
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.
- Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.
- Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
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5
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Valentijn PP, Eggers C, Bloem BR, Grimes D, Goldman J, McGinley J, Gardner J, Piemonte MEP, Dahodwala N, Brennan L, Iansek R, Kovacs N, Parashos S, Hilel A, Rajan R. Validation of the Rainbow Model of Integrated Care Measurement Tool in Parkinson's Disease. Mov Disord 2023. [PMID: 37148424 DOI: 10.1002/mds.29413] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/11/2023] [Accepted: 04/04/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Integrated care is essential for improving the management and health outcomes for people with Parkinson's disease (PD); reliable and objective measures of care integration are few. OBJECTIVE The aim of this study was to test the psychometric properties of the Rainbow Model of Integrated Care Measurement Tool (RMIC-MT, provider version) for healthcare professionals involved in PD care. METHODS A cross-sectional survey was administered online to an international network representing 95 neurology centers across 41 countries and 588 healthcare providers. Exploratory factor analysis with principal axis extraction method was used to assess construct validity. Confirmatory factor analysis was used to evaluate model fit of the RMIC-MT provider version. Cronbach's alpha was used to assess the internal consistency reliability. RESULTS Overall, 371 care providers (62% response rate) participated in this study. No item had psychometric sensitivity problems. Nine factors (professional coordination, cultural competence, triple aims outcome, system coordination, clinical coordination, technical competence, community-centeredness, person-centeredness, and organizational coordination) with 42 items were determined by exploratory factor analysis. Cronbach's alpha ranged from 0.76 (clinical coordination) to 0.94 (system coordination) and showed significant correlation among all items in the scale (>0.4), indicating good internal consistency reliability. The confirmatory factor analysis model passed most goodness-of-fit tests, thereby confirming the factor structure of nine categories with a total of 40 items. CONCLUSIONS The results provide evidence for the construct validity and other psychometric properties of the provider version of the RMIC-MT to measure integrated care in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pim P Valentijn
- Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, the Netherlands
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Center for Mind, Brain and Behavior, Universities Marburg and Giessen, Marburg, Germany
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Bastiaan R Bloem
- Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - David Grimes
- Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jennifer Goldman
- Parkinson's and Movement Disorders Shirley Ryan Ability Lab and Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Departments of Physical Medicine and Rehabilitation and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer McGinley
- Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia
| | - Joan Gardner
- Struthers Parkinson's Center, HealthPartners, Minneapolis, Minnesota, USA
| | | | - Nabila Dahodwala
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Brennan
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Robert Iansek
- Clinical Research Centre for Movement Disorders and Gait, Comprehensive Parkinson Care Program, Parkinson Foundation Centre of Excellence, Kington Centre Monash Health Cheltenham, Cheltenham, Australia
| | - Norbert Kovacs
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | - Sotirios Parashos
- Struthers Parkinson's Center, HealthPartners, Minneapolis, Minnesota, USA
| | - Ariela Hilel
- Movement Disorders Center Unit, Neurology Division, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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6
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Carvalho de Abreu DC, Pieruccini-Faria F, Sarquis-Adamson Y, Black A, Fraser J, Van Ooteghem K, Cornish B, Grimes D, Jog M, Masellis M, Steeves T, Nanayakkara N, Ramirez J, Scott C, Holmes M, Ozzoude M, Berezuk C, Symons S, Mohammad Hassan Haddad S, Arnott SR, Binns M, Strother S, Beaton D, Sunderland K, Theyers A, Tan B, Zamyadi M, Levine B, Orange JB, Roberts AC, Lou W, Sujanthan S, Breen DP, Marras C, Kwan D, Adamo S, Peltsch A, Troyer AK, Black SE, McLaughlin PM, Lang AE, McIlroy W, Bartha R, Montero-Odasso M. White matter hyperintensity burden predicts cognitive but not motor decline in Parkinson's disease: results from the Ontario Neurodegenerative Diseases Research Initiative. Eur J Neurol 2023; 30:920-933. [PMID: 36692250 DOI: 10.1111/ene.15692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE The pathophysiology of Parkinson's disease (PD) negatively affects brain network connectivity, and in the presence of brain white matter hyperintensities (WMHs) cognitive and motor impairments seem to be aggravated. However, the role of WMHs in predicting accelerating symptom worsening remains controversial. The objective was to investigate whether location and segmental brain WMH burden at baseline predict cognitive and motor declines in PD after 2 years. METHODS Ninety-eight older adults followed longitudinally from Ontario Neurodegenerative Diseases Research Initiative with PD of 3-8 years in duration were included. Percentages of WMH volumes at baseline were calculated by location (deep and periventricular) and by brain region (frontal, temporal, parietal, occipital lobes and basal ganglia + thalamus). Cognitive and motor changes were assessed from baseline to 2-year follow-up. Specifically, global cognition, attention, executive function, memory, visuospatial abilities and language were assessed as were motor symptoms evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III, spatial-temporal gait variables, Freezing of Gait Questionnaire and Activities Specific Balance Confidence Scale. RESULTS Regression analysis adjusted for potential confounders showed that total and periventricular WMHs at baseline predicted decline in global cognition (p < 0.05). Also, total WMH burden predicted the decline of executive function (p < 0.05). Occipital WMH volumes also predicted decline in global cognition, visuomotor attention and visuospatial memory declines (p < 0.05). WMH volumes at baseline did not predict motor decline. CONCLUSION White matter hyperintensity burden at baseline predicted cognitive but not motor decline in early to mid-stage PD. The motor decline observed after 2 years in these older adults with PD is probably related to the primary neurodegenerative process than comorbid white matter pathology.
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Affiliation(s)
- Daniela Cristina Carvalho de Abreu
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Department of Physical Therapy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | | | - Alanna Black
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen Van Ooteghem
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - David Grimes
- Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Mandar Jog
- Division of Neurology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mario Masellis
- Cognitive and Movement Disorders Clinic, Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Steeves
- Division of Neurology, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Nuwan Nanayakkara
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Scott
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Holmes
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Courtney Berezuk
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Sean Symons
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Stephen R Arnott
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Malcolm Binns
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Stephen Strother
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Kelly Sunderland
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Athena Theyers
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
- Department of Computer Science, Western University, London, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujeevini Sujanthan
- Department of Ophthalmology and Visual Sciences, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Connie Marras
- Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Sabrina Adamo
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Alicia Peltsch
- Faculty of Engineering and Applied Science, Queen's University, Kingston, Ontario, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Anthony E Lang
- Division of Neurology, Department of Medicine, Edmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - William McIlroy
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, Western University, London, Canada
| | | | - Manuel Montero-Odasso
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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7
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Brien DC, Riek HC, Yep R, Huang J, Coe B, Areshenkoff C, Grimes D, Jog M, Lang A, Marras C, Masellis M, McLaughlin P, Peltsch A, Roberts A, Tan B, Beaton D, Lou W, Swartz R, Munoz DP. Classification and staging of Parkinson's disease using video-based eye tracking. Parkinsonism Relat Disord 2023; 110:105316. [PMID: 36822878 DOI: 10.1016/j.parkreldis.2023.105316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/11/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION 83% of those diagnosed with Parkinson's Disease (PD) eventually progress to PD with mild cognitive impairment (PD-MCI) followed by dementia (PDD) - suggesting a complex spectrum of pathology concomitant with aging. Biomarkers sensitive and specific to this spectrum are required if useful diagnostics are to be developed that may supplement current clinical testing procedures. We used video-based eye tracking and machine learning to develop a simple, non-invasive test sensitive to PD and the stages of cognitive dysfunction. METHODS From 121 PD (45 Cognitively Normal/45 MCI/20 Dementia/11 Other) and 106 healthy controls, we collected video-based eye tracking data on an interleaved pro/anti-saccade task. Features of saccade, pupil, and blink behavior were used to train a classifier to predict confidence scores for PD/PD-MCI/PDD diagnosis. RESULTS The Receiver Operator Characteristic Area Under the Curve (ROC-AUC) of the classifier was 0.88, with the cognitive-dysfunction subgroups showing progressively increased AUC, and the AUC of PDD being 0.95. The classifier reached a sensitivity of 83% and a specificity of 78%. The confidence scores predicted PD motor and cognitive performance scores. CONCLUSION Biomarkers of saccade, pupil, and blink were extracted from video-based eye tracking to create a classifier with high sensitivity to the landscape of PD cognitive and motor dysfunction. A complex landscape of PD is revealed through a quick, non-invasive eye tracking task and our model provides a framework for such a task to be used as a supplementary screening tool in the clinic.
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Affiliation(s)
- Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Heidi C Riek
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Rachel Yep
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Jeff Huang
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Brian Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Corson Areshenkoff
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - David Grimes
- Ottawa Hospital, uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada.
| | - Mandar Jog
- PF Centre of Excellence, London Movement Disorders Centre, Lawson Health Research Institute, London, ON, Canada.
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease, University Health Network and the Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Connie Marras
- Toronto Western Hospital Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, University of Toronto, Toronto, ON, Canada.
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Medicine (Neurology), Toronto, ON, Canada.
| | - Paula McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Nova Scotia Health, Halifax, NS, Canada; Department of Psychology and Neuroscience, Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada.
| | - Alicia Peltsch
- Faculty of Engineering and Applied Science, Queen's University, Kingston, ON, Canada.
| | - Angela Roberts
- School of Communication Sciences and Disorders, Department of Computer Science, University of Western Ontario, London, ON, Canada.
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.
| | - Derek Beaton
- Data Science & Advanced Analytics (DSAA), St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Richard Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre; Faculty of Medicine, Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.
| | | | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
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8
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Kapustin D, Zarei S, Wang W, Binns MA, McLaughlin PM, Abrahao A, Black SE, Borrie M, Breen D, Casaubon L, Dowlatshahi D, Finger E, Fischer CE, Frank A, Freedman M, Grimes D, Hassan A, Jog M, Kwan D, Lang A, Levine B, Mandzia J, Marras C, Masellis M, Orange JB, Pasternak S, Peltsch A, Pollock BG, Rajji TK, Roberts A, Sahlas D, Saposnik G, Seitz D, Shoesmith C, Southwell A, Steeves TDL, Sunderland K, Swartz RH, Tan B, Tang-Wai DF, Tartaglia MC, Troyer A, Turnbull J, Zinman L, Kumar S. Neuropsychiatric Symptom Burden across Neurodegenerative Disorders and its Association with Function. Can J Psychiatry 2023; 68:347-358. [PMID: 36637224 DOI: 10.1177/07067437221147443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Neuropsychiatric symptoms (NPS) are prevalent in neurodegenerative disorders, however, their frequency and impact on function across different disorders is not well understood. We compared the frequency and severity of NPS across Alzheimer's disease (AD) (either with mild cognitive impairment or dementia), Cerebrovascular disease (CVD), Parkinson's disease (PD), frontotemporal dementia (FTD), and amyotrophic lateral sclerosis (ALS), and explored the association between NPS burden and function. METHODS We obtained data from Ontario Neurodegenerative Disease Research Initiative (ONDRI) that included following cohorts: AD (N = 111), CVD (N = 148), PD (N = 136), FTD (N = 50) and ALS (N = 36). We compared the frequency and severity of individual NPS (assessed by the neuropsychiatric inventory questionnaire) across cohorts using generalized estimating equations and analysis of variance. Second, we assessed the relationship of NPS burden with instrumental (iADLs) and basic (ADLs) activities of living across cohorts using multivariate linear regression while adjusting for relevant demographic and clinical covariates. RESULTS Frequency of NPS varied across cohorts (χ2(4) = 34.4, p < .001), with post-hoc tests showing that FTD had the greatest frequency as compared to all other cohorts. The FTD cohort also had the greatest severity of NPS (H(4) = 34.5, p < .001). Further, there were differences among cohorts in terms of the association between NPS burden and ADLs (F(4,461) = 3.1, p = 0.02). Post-hoc comparisons suggested that this finding was driven by the FTD group, however, the differences did not remain significant following Bonferroni correction. There were no differences among cohorts in terms of the association between NPS burden and IADLs. CONCLUSIONS NPS frequency and severity are markedly greater in FTD as compared to other neurodegenerative diseases. Further, NPS burden appears to be associated differently with function across neurodegenerative disorders, highlighting the need for individualized clinical interventions.
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Affiliation(s)
- Daniel Kapustin
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Shadi Zarei
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Wei Wang
- 7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Malcolm A Binns
- Dalla Lana School of Public Health, 7938University of Toronto, Toronto, ON, Canada.,Rotman Research Institute at Baycrest Health Sciences, Toronto, ON, Canada
| | | | - Agessandro Abrahao
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, 71545Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, 71545Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 7938University of Toronto, Toronto, ON, Canada
| | | | - David Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Leanna Casaubon
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Corinne E Fischer
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Science, St. Michaels Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- 6363University of Ottawa, Ottawa, ON, Canada.,152971Bruyere Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute at Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Research Institute, 26627Northern Ontario School of Medicine, ON, Canada
| | - Mandar Jog
- University of Western Ontario, London, ON, Canada
| | - Donna Kwan
- 4257Queen's University, Kingston, ON, Canada
| | - Anthony Lang
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,Edmond J. Safra Program in Parkinson's Disesase and the Morton and Gloria Shulman Movement Disorders Centre, University Health Network, Toronto, ON, Canada
| | - Brian Levine
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada
| | | | - Connie Marras
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,Edmond J. Safra Program in Parkinson's Disesase and the Morton and Gloria Shulman Movement Disorders Centre, University Health Network, Toronto, ON, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, 71545Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada
| | - Joseph B Orange
- Canadian Centre for Activity and Aging, Western University, ON, Canada
| | - Stephen Pasternak
- University of Western Ontario, London, ON, Canada.,Robarts Research Institute and the Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada
| | | | - Bruce G Pollock
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Angela Roberts
- School of Communication, Northwestern University, Evanston, Illinois, USA.,School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | | | - Gustavo Saposnik
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Dallas Seitz
- Department of Psychiatry and Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christen Shoesmith
- Division of Neurology, Department of Clinical Neurological Sciences, London Health Sciences Centre, London, ON, Canada
| | | | - Thomas D L Steeves
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,6363University of Ottawa, Ottawa, ON, Canada
| | - Kelly Sunderland
- Rotman Research Institute at Baycrest Health Sciences, Toronto, ON, Canada
| | - Richard H Swartz
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,71545Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute at Baycrest Health Sciences, Toronto, ON, Canada
| | - David F Tang-Wai
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,Krembil Brain Institute, Toronto Western Hospital, Toronto, ON, Canada.,Toronto Western Hospital, University Health Network Memory Clinic, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, 7938University of Toronto, Toronto, ON, Canada
| | - Angela Troyer
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, ON, Canada
| | | | - Lorne Zinman
- Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, 71545Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), 7938University of Toronto, Toronto, ON, Canada
| | | | - Sanjeev Kumar
- 7938Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,7978Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
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9
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Abstract
Individuals living with Parkinson's disease (PD) experience interpersonal stressors that contribute to depressive risk. Interpersonal psychotherapy (IPT) emphasizes the bidirectional relationship between interpersonal stressors and mood may therefore be a suitable treatment for PD-depression. The primary aim of this study was to evaluate the feasibility of delivering 12 sessions of IPT to depressed PD patients and explore the need for modifications. A secondary aim was to obtain descriptive information about efficacy outcomes. The study used a pre-post design without a comparison group. Participants were 12 PD patients with a major depressive disorder. IPT was well accepted and tolerated by patients and required minimal modifications. Compliance with session attendance and completion of study questionnaires were excellent and treatment satisfaction was high. Depression scores declined from baseline to endpoint, with 7 patients meeting criteria for remission at endpoint. Findings are encouraging and a larger randomized controlled trial is currently underway to ascertain if IPT is an efficacious treatment for PD-depression.
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Affiliation(s)
- Diana Koszycki
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Diana Koszycki, PhD, University of Ottawa, 145 Jean-Jacques Lussier Ottawa, ON K1N 6N5, Canada.
| | - Monica Taljaard
- University of Ottawa, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Cary Kogan
- University of Ottawa, Ottawa, ON, Canada
| | - Jacques Bradwejn
- University of Ottawa, Ottawa, ON, Canada,Institut du savoir Montfort, Montfort Hospital, Ottawa, ON, Canada,Université de Montreal, QC, Canada
| | - David Grimes
- University of Ottawa, Ottawa, ON, Canada,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada,Ottawa Hospital Research Institute, Ottawa, ON, Canada
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10
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Dilliott AA, Zhang KK, Wang J, Abrahao A, Binns MA, Black SE, Borrie M, Dowlatshahi D, Finger E, Fischer CE, Frank A, Freedman M, Grimes D, Hassan A, Jog M, Kumar S, Lang AE, Mandzia J, Masellis M, Pasternak SH, Pollock BG, Rajji TK, Rogaeva E, Sahlas DJ, Saposnik G, Sato C, Seitz D, Shoesmith C, Steeves TDL, Swartz RH, Tan B, Tang-Wai DF, Tartaglia MC, Turnbull J, Zinman L, Hegele RA. Targeted copy number variant identification across the neurodegenerative disease spectrum. Mol Genet Genomic Med 2022; 10:e1986. [PMID: 35666053 PMCID: PMC9356547 DOI: 10.1002/mgg3.1986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 11/21/2021] [Revised: 03/19/2022] [Accepted: 05/03/2022] [Indexed: 11/11/2022] Open
Abstract
Background Although genetic factors are known to contribute to neurodegenerative disease susceptibility, there remains a large amount of heritability unaccounted for across the diagnoses. Copy number variants (CNVs) contribute to these phenotypes, but their presence and influence on disease state remains relatively understudied. Methods Here, we applied a depth of coverage approach to detect CNVs in 80 genes previously associated with neurodegenerative disease within participants of the Ontario Neurodegenerative Disease Research Initiative (n = 519). Results In total, we identified and validated four CNVs in the cohort, including: (1) a heterozygous deletion of exon 5 in OPTN in an Alzheimer's disease participant; (2) a duplication of exons 1–5 in PARK7 in an amyotrophic lateral sclerosis participant; (3) a duplication of >3 Mb, which encompassed ABCC6, in a cerebrovascular disease (CVD) participant; and (4) a duplication of exons 7–11 in SAMHD1 in a mild cognitive impairment participant. We also identified 43 additional CNVs that may be candidates for future replication studies. Conclusion The identification of the CNVs suggests a portion of the apparent missing heritability of the phenotypes may be due to these structural variants, and their assessment is imperative for a thorough understanding of the genetic spectrum of neurodegeneration.
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Affiliation(s)
- Allison A Dilliott
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Kristina K Zhang
- Department of Microbiology & Immunology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jian Wang
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Agessandro Abrahao
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,LCCampbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Michael Borrie
- St. Joseph's Health Care Centre, London, Ontario, Canada.,Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, Baycrest Health Sciences, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Research Institute, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,London Health Sciences Centre, London, Ontario, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mario Masellis
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Cognitive & Movement Disorders Clinic, L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain ScienceProgram, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Stephen H Pasternak
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Cognitive Neurology and Alzheimer's Disease Research Centre, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry and Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | | | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Clinical Outcomes and Decision Neuroscience Unit, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Thomas D L Steeves
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Division of Neurology, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Richard H Swartz
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,LCCampbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - David F Tang-Wai
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada.,University Health Network Memory Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Maria C Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - John Turnbull
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lorne Zinman
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | | | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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11
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Beaton D, McLaughlin PM, Orange JB, Munoz DP, Mandzia J, Abrahao A, Binns MA, Black SE, Borrie M, Dowlatshahi D, Freedman M, Fischer CE, Finger EC, Frank A, Grimes D, Hassan A, Kumar S, Lang AE, Levine B, Marras C, Masellis M, Pollock BG, Rajji TK, Ramirez J, Sahlas DJ, Saposnik G, Scott CJM, Seitz DP, Strother SC, Sunderland KM, Tan B, Tang-Wai DF, Troyer AK, Turnbull J, Zinman L, Swartz RH, Tartaglia MC, Breen DP, Kwan D, Roberts AC, The Ondri Investigators. Caregiving concerns and clinical characteristics across neurodegenerative and cerebrovascular disorders in the Ontario neurodegenerative disease research initiative. Int J Geriatr Psychiatry 2022; 37. [PMID: 35633037 DOI: 10.1002/gps.5727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Caregiving burdens are a substantial concern in the clinical care of persons with neurodegenerative disorders. In the Ontario Neurodegenerative Disease Research Initiative, we used the Zarit's Burden Interview (ZBI) to examine: (1) the types of burdens captured by the ZBI in a cross-disorder sample of neurodegenerative conditions (2) whether there are categorical or disorder-specific effects on caregiving burdens, and (3) which demographic, clinical, and cognitive measures are related to burden(s) in neurodegenerative disorders? METHODS/DESIGN N = 504 participants and their study partners (e.g., family, friends) across: Alzheimer's disease/mild cognitive impairment (AD/MCI; n = 120), Parkinson's disease (PD; n = 136), amyotrophic lateral sclerosis (ALS; n = 38), frontotemporal dementia (FTD; n = 53), and cerebrovascular disease (CVD; n = 157). Study partners provided information about themselves, and information about the clinical participants (e.g., activities of daily living (ADL)). We used Correspondence Analysis to identify types of caregiving concerns in the ZBI. We then identified relationships between those concerns and demographic and clinical measures, and a cognitive battery. RESULTS We found three components in the ZBI. The first was "overall burden" and was (1) strongly related to increased neuropsychiatric symptoms (NPI severity r = 0.586, NPI distress r = 0.587) and decreased independence in ADL (instrumental ADLs r = -0.566, basic ADLs r = -0.43), (2) moderately related to cognition (MoCA r = -0.268), and (3) showed little-to-no differences between disorders. The second and third components together showed four types of caregiving concerns: current care of the person with the neurodegenerative disease, future care of the person with the neurodegenerative disease, personal concerns of study partners, and social concerns of study partners. CONCLUSIONS Our results suggest that the experience of caregiving in neurodegenerative and cerebrovascular diseases is individualized and is not defined by diagnostic categories. Our findings highlight the importance of targeting ADL and neuropsychiatric symptoms with caregiver-personalized solutions.
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Affiliation(s)
- Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Paula M McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Medicine - Geriatrics, Dalhousie University, Halifax, NS, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Western University, London, ON, Canada.,Canadian Centre for Activity and Aging, Western University, London, ON, Canada.,Faculty of Health Sciences, Western University, London, ON, Canada
| | - Douglas P Munoz
- Department of Biomedical and Molecular Sciences, Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, London Health Sciences Center, Western University, London, ON, Canada
| | - Agessandro Abrahao
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Michael Borrie
- Department of Medicine, Division of Geriatric Medicine, Western University, Toronto, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrew Frank
- Bruyere Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Northern Ontario School of Medicine, Clinical Science Division, Depart of Internal Medicine, Thunder Bay, ON, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anthony Edward Lang
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Mario Masellis
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Demetrios J Sahlas
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Gustavo Saposnik
- Outcomes and Decision Neuroscience Research Unit, Toronto, ON, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dallas P Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Department of Medicine (Geriatric Medicine), University of Toronto, Toronto, ON, Canada.,University Hospital Network Memory Clinic, Toronto, ON, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Neuropsychology & Cognitive Health Program, Baycrest Health Sciences, Toronto, ON, Canada
| | - John Turnbull
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Lorne Zinman
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Richard H Swartz
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Krembil Neuroscience Centre Memory Clinic, Toronto, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Western University, London, ON, Canada.,Roxelyn and Richard Pepper Department of Communication Sciences and Disorders and Department of Computer Science, Northwestern University, Evanston, Illinois, USA
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12
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Ramirez J, Berberian SA, Breen DP, Gao F, Ozzoude M, Adamo S, Scott CJ, Berezuk C, Yhap V, Mestre TA, Marras C, Tartaglia MC, Grimes D, Jog M, Kwan D, Tan B, Binns MA, Arnott SR, Bartha R, Symons S, Masellis M, Black SE, Lang AE. Small and Large Magnetic Resonance Imaging–Visible Perivascular Spaces in the Basal Ganglia of Parkinson's Disease Patients. Mov Disord 2022; 37:1304-1309. [DOI: 10.1002/mds.29010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/18/2022] [Accepted: 03/16/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Stephanie A. Berberian
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - David P. Breen
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
- Anne Rowling Regenerative Neurology Clinic University of Edinburgh Edinburgh United Kingdom
- Usher Institute of Population Health Sciences and Informatics University of Edinburgh Edinburgh United Kingdom
| | - Fuqiang Gao
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Miracle Ozzoude
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
- Tanz Centre for Research in Neurodegenerative Diseases University of Toronto Toronto Ontario Canada
| | - Sabrina Adamo
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Christopher J.M. Scott
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Courtney Berezuk
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Vanessa Yhap
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
| | - Tiago A. Mestre
- Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute University of Ottawa Ottawa Ontario Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital Toronto Ontario Canada
| | - Maria C. Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases University of Toronto Toronto Ontario Canada
- Division of Neurology, Toronto Western Hospital University Health Network Toronto Ontario Canada
| | - David Grimes
- University of Ottawa Brain and Mind Research Institute Ottawa Hospital Research Institute Ottawa Ontario Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences Western University London Ontario Canada
| | - Donna Kwan
- Queen's University, Centre for Neuroscience Studies Kingston Ontario Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences Centre Toronto Ontario Canada
| | - Malcolm A. Binns
- Rotman Research Institute, Baycrest Health Sciences Centre Toronto Ontario Canada
| | - Stephen R. Arnott
- Rotman Research Institute, Baycrest Health Sciences Centre Toronto Ontario Canada
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, Department of Medical Biophysics University of Western Ontario London Ontario Canada
| | - Sean Symons
- Department of Medical Imaging University of Toronto, Sunnybrook Health Sciences Centre Toronto Ontario Canada
| | - Mario Masellis
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
- Department of Medicine (Neurology) Sunnybrook Health Sciences Centre and University of Toronto Toronto Ontario Canada
| | - Sandra E. Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute University of Toronto Toronto Ontario Canada
- Rotman Research Institute, Baycrest Health Sciences Centre Toronto Ontario Canada
- Department of Medicine (Neurology) Sunnybrook Health Sciences Centre and University of Toronto Toronto Ontario Canada
| | - Anthony E. Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital Toronto Ontario Canada
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13
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Valcic M, Black S, Freedman M, Borrie M, Frank A, Kumar S, Pasternak S, Pollock B, Rajji T, Seitz D, Tang-Wai D, Tartaglia C, Masellis M, Lang A, Breen D, Grimes D, Jog M, Marras C, Swartz R, Saposnik G, Kwan D, Tan B, Hegele R, Dilliott AA, Robinson J, Rogaeva E, Farhan S, McLaughlin P, Strother S, Binns M, Steeves T, Kostyrko P, Talib K, Fornazzari L, Churchill N, Schweizer TA, Munoz DG, Fischer CE. Determining whether Sex and Zygosity modulates the association between ApoE4 and Psychosis in Neurodegenerative Disease Cohorts using the ONDRI platform. The American Journal of Geriatric Psychiatry 2022. [DOI: 10.1016/j.jagp.2022.01.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Ozzoude M, Varriano B, Beaton D, Ramirez J, Holmes MF, Scott CJM, Gao F, Sunderland KM, McLaughlin P, Rabin J, Goubran M, Kwan D, Roberts A, Bartha R, Symons S, Tan B, Swartz RH, Abrahao A, Saposnik G, Masellis M, Lang AE, Marras C, Zinman L, Shoesmith C, Borrie M, Fischer CE, Frank A, Freedman M, Montero-Odasso M, Kumar S, Pasternak S, Strother SC, Pollock BG, Rajji TK, Seitz D, Tang-Wai DF, Turnbull J, Dowlatshahi D, Hassan A, Casaubon L, Mandzia J, Sahlas D, Breen DP, Grimes D, Jog M, Steeves TDL, Arnott SR, Black SE, Finger E, Tartaglia MC. Investigating the contribution of white matter hyperintensities and cortical thickness to empathy in neurodegenerative and cerebrovascular diseases. GeroScience 2022; 44:1575-1598. [PMID: 35294697 DOI: 10.1007/s11357-022-00539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/22/2022] [Indexed: 11/24/2022] Open
Abstract
Change in empathy is an increasingly recognised symptom of neurodegenerative diseases and contributes to caregiver burden and patient distress. Empathy impairment has been associated with brain atrophy but its relationship to white matter hyperintensities (WMH) is unknown. We aimed to investigate the relationships amongst WMH, brain atrophy, and empathy deficits in neurodegenerative and cerebrovascular diseases. Five hundred thirteen participants with Alzheimer's disease/mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia (FTD), Parkinson's disease, or cerebrovascular disease (CVD) were included. Empathy was assessed using the Interpersonal Reactivity Index. WMH were measured using a semi-automatic segmentation and FreeSurfer was used to measure cortical thickness. A heterogeneous pattern of cortical thinning was found between groups, with FTD showing thinning in frontotemporal regions and CVD in left superior parietal, left insula, and left postcentral. Results from both univariate and multivariate analyses revealed that several variables were associated with empathy, particularly cortical thickness in the fronto-insulo-temporal and cingulate regions, sex (female), global cognition, and right parietal and occipital WMH. Our results suggest that cortical atrophy and WMH may be associated with empathy deficits in neurodegenerative and cerebrovascular diseases. Future work should consider investigating the longitudinal effects of WMH and atrophy on empathy deficits in neurodegenerative and cerebrovascular diseases.
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Affiliation(s)
- Miracle Ozzoude
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada.,L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brenda Varriano
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada
| | - Derek Beaton
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Melissa F Holmes
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Christopher J M Scott
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Fuqiang Gao
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | | | - Paula McLaughlin
- Nova Scotia Health and Dalhousie University, Halifax, NS, Canada
| | - Jennifer Rabin
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Maged Goubran
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Queen's University, Kingston, ON, Canada
| | - Angela Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.,School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, ON, Canada
| | - Sean Symons
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Agessandro Abrahao
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Connie Marras
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program for Parkinson Disease, Movement Disorder Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Lorne Zinman
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christen Shoesmith
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,St. Joseph's Healthcare Centre, London, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Andrew Frank
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Lawson Health Research Institute, London, ON, Canada.,Gait and Brain Lab, Parkwood Institute, London, ON, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Stephen Pasternak
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Stephen C Strother
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David F Tang-Wai
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - John Turnbull
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
| | - Leanne Casaubon
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Demetrios Sahlas
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,London Health Sciences Centre, London, ON, Canada
| | - Thomas D L Steeves
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Stephen R Arnott
- Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Heart & Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 0S8, Canada. .,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada. .,Memory Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
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15
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Dash D, Cote D, Conway J, Grimes D, Mestre TA. Evaluation of the Impact of Integrated Care and Self-Management After Deep Brain Stimulation in Parkinson's Disease. J Parkinsons Dis 2022; 12:JPD212911. [PMID: 35253775 DOI: 10.3233/jpd-212911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive neurodegenerative disorder with a myriad of motor and non-motor symptoms. Although deep brain stimulation (DBS) has a dramatic impact in the lives of people with PD, care delivery remains complex. There is a lack of evidence on the implementation and role of integrated care and self-management support in people with PD with chronic DBS. OBJECTIVE To evaluate care needs, implementation and impact of a pragmatic network for PD care, the Integrated Parkinson Care Network (IPCN). METHODS This is a subgroup analyses of a 6-month, pre-post design, single-centre, phase 2 study to assess a patient-centred care model based on integrated care, self-management support (IPCN) in PD, focusing on those participants with chronic DBS. RESULTS We included 22 people with PD and chronic DBS (median time since DBS - 30 months). The mean age was 63.9 (7.6) years and mean disease duration was 15.2 (6.9) years. The top three care priorities were speech (54.5%), mobility (40.9%) and mood (31.8%). After the IPCN program, there was a positive change in the perception of support for chronic care (Patient Assessment of Chronic Illness Case: 0.85; 95% CI: 1.2 to -0.4) and self-management (5As: 0.77; 95% CI: 0.39 -1.15), along with quality of life (PDQ8 : 7.1, 95% CI:1.8 -12.4). CONCLUSION The IPCN is a care delivery model that addresses specific care needs of people with PD and chronic DBS. The current study showed its feasibility and warrants further evaluation.
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Affiliation(s)
- Deepa Dash
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, The Ottawa Hospital and the University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
| | - Diane Cote
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jennifer Conway
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David Grimes
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, The Ottawa Hospital and the University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
| | - Tiago A Mestre
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, The Ottawa Hospital and the University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
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16
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Grosjean S, Ciocca JL, Gauthier-Beaupré A, Poitras E, Grimes D, Mestre T. Co-designing a digital companion with people living with Parkinson's to support self-care in a personalized way: The eCARE-PD Study. Digit Health 2022; 8:20552076221081695. [PMID: 35251682 PMCID: PMC8891888 DOI: 10.1177/20552076221081695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 08/24/2021] [Accepted: 01/30/2022] [Indexed: 12/24/2022] Open
Abstract
eHealth technologies play a role in the development of integrated care models for people living with Parkinson disease by improving communication with their health care teams and support self-care practices in a personalized way. This article presents a co-design approach to designing an eHealth technology, the eCARE-PD platform, that addresses the needs and expectations of people living with Parkinson disease, generates tailored care tips, and recommends actions for managing care priorities at home. We use a co-design approach involving four main iterative phases: (1) preparation, (2) mapping, (3) testing and using, and (4) co-producing solutions and requirements. This approach uses several methods to engage people directly to design this technology. The study allowed us to identify design principles to be integrated in the development of the eCARE-PD platform. These principles incorporate the expectations of future users, which were expressed during the iterative phases of the co-design process: (a) six key design features based on users’ needs and expectations, (b) six main issues users raised during a test at home and key features for improving the design of the eCARE-PD platform, and (c) collective solutions to design an interactive, meaningful, tailored, empathic, and socially acceptable technology. The results of the successive phases of the co-design process allow us to underline the progressive constitution of a technology defined over successive iterations as a digital companion supporting the self-care process at home and having the capacity to generate tailored digital health communication.
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Affiliation(s)
| | | | | | - Emely Poitras
- Department of Communication, University of Ottawa, Canada
| | - David Grimes
- Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
| | - Tiago Mestre
- Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Canada
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17
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Yaxley WJ, McBean R, Wong D, Grimes D, Vasey P, Frydenberg M, Yaxley JW. Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer? Investig Clin Urol 2021; 62:650-657. [PMID: 34729965 PMCID: PMC8566790 DOI: 10.4111/icu.20210097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 02/28/2021] [Revised: 05/16/2021] [Accepted: 07/08/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Lutetium labelled prostate-specific membrane antigen radioligand therapy (Lu-PSMA RLT) has shown pleasing early results in management of high-volume metastatic castration resistant prostate cancer (mCRPC), but its role in the early treatment of men with only lymph node metastasis (LNM) is unknown. The aim was to assess the outcome of Lu-PSMA RLT earlier in the treatment of men with only LNM. MATERIALS AND METHODS Single institution retrospective review of men with only LNM on staging Ga-PSMA PET PSMA who proceeded with Lu-PSMA RLT. RESULTS There were 17 men with only LNM, including 13 with mCRPC and 3 who were both hormone and chemotherapy naïve. The median PSA was 3.7 (0.46-120 ng/mL). A PSA decline of ≥50% occurred in 10/17 (58.8%), decreasing to <0.2 ng/mL in 35.3% (6/17). The PSA continues to decline or remain stable in 10/17 (58.8%) with a median follow-up of 13 months, and 8/17 (47.1%) have not reached their pre-treatment levels. There were no significant side effects. There was a better PSA response in men without prior chemotherapy (p=0.05). The prostate cancer specific and overall survival is 82.4% (14/17). CONCLUSIONS Our results identify improved PSA response to Lu-PSMA RLT in men with only LNM, especially in the chemotherapy naïve cohort, compared to previous series with more advanced mCRPC. These findings provide important proof of principle to aid with planning of future prospective randomized trials evaluating the role of Lu-PSMA RLT earlier in the management of node metastatic prostate cancer, including men naïve of ADT and chemotherapy.
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Affiliation(s)
- William John Yaxley
- Department of Urology, QEII Jubilee Hospital, Brisbane, Australia.,The University of Queensland, School of Medicine, Brisbane, Australia
| | - Rhiannon McBean
- I-MED Radiology Network, Wesley Hospital, Brisbane, Australia
| | - David Wong
- The University of Queensland, School of Medicine, Brisbane, Australia.,I-MED Radiology Network, Wesley Hospital, Brisbane, Australia
| | - David Grimes
- Icon Cancer Centre, Wesley Hospital, Brisbane, Australia
| | - Paul Vasey
- Icon Cancer Centre, Wesley Hospital, Brisbane, Australia
| | - Mark Frydenberg
- Department of Surgery, Monash University, Melbourne, Australia
| | - John William Yaxley
- The University of Queensland, School of Medicine, Brisbane, Australia.,Wesley Urology Clinic, Wesley Hospital, Brisbane, Australia.,Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia.
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18
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Dilliott AA, Abdelhady A, Sunderland KM, Farhan SMK, Abrahao A, Binns MA, Black SE, Borrie M, Casaubon LK, Dowlatshahi D, Finger E, Fischer CE, Frank A, Freedman M, Grimes D, Hassan A, Jog M, Kumar S, Kwan D, Lang AE, Mandzia J, Masellis M, McIntyre AD, Pasternak SH, Pollock BG, Rajji TK, Rogaeva E, Sahlas DJ, Saposnik G, Sato C, Seitz D, Shoesmith C, Steeves TDL, Swartz RH, Tan B, Tang-Wai DF, Tartaglia MC, Turnbull J, Zinman L, Hegele RA. Contribution of rare variant associations to neurodegenerative disease presentation. NPJ Genom Med 2021; 6:80. [PMID: 34584092 PMCID: PMC8478934 DOI: 10.1038/s41525-021-00243-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/27/2021] [Indexed: 12/25/2022] Open
Abstract
Genetic factors contribute to neurodegenerative diseases, with high heritability estimates across diagnoses; however, a large portion of the genetic influence remains poorly understood. Many previous studies have attempted to fill the gaps by performing linkage analyses and association studies in individual disease cohorts, but have failed to consider the clinical and pathological overlap observed across neurodegenerative diseases and the potential for genetic overlap between the phenotypes. Here, we leveraged rare variant association analyses (RVAAs) to elucidate the genetic overlap among multiple neurodegenerative diagnoses, including Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia (FTD), mild cognitive impairment, and Parkinson's disease (PD), as well as cerebrovascular disease, using the data generated with a custom-designed neurodegenerative disease gene panel in the Ontario Neurodegenerative Disease Research Initiative (ONDRI). As expected, only ~3% of ONDRI participants harboured a monogenic variant likely driving their disease presentation. Yet, when genes were binned based on previous disease associations, we observed an enrichment of putative loss of function variants in PD genes across all ONDRI cohorts. Further, individual gene-based RVAA identified significant enrichment of rare, nonsynonymous variants in PARK2 in the FTD cohort, and in NOTCH3 in the PD cohort. The results indicate that there may be greater heterogeneity in the genetic factors contributing to neurodegeneration than previously appreciated. Although the mechanisms by which these genes contribute to disease presentation must be further explored, we hypothesize they may be a result of rare variants of moderate phenotypic effect contributing to overlapping pathology and clinical features observed across neurodegenerative diagnoses.
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Affiliation(s)
- Allison A Dilliott
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Abdalla Abdelhady
- Department of Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Sali M K Farhan
- Departments of Neurology and Neurosurgery, and Human Genetics, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Agessandro Abrahao
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
- LCCampbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Michael Borrie
- St. Joseph's Health Care Centre, London, ON, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Leanne K Casaubon
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- University Health Network Stroke Program, Toronto Western Hospital, Toronto, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Andrew Frank
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, Baycrest Health Sciences, Mt. Sinai Hospital and University of Toronto, Toronto, ON, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Thunder Bay Regional Research Institute and Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Anthony E Lang
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Mario Masellis
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Cognitive & Movement Disorders Clinic and L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Science Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Adam D McIntyre
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Stephen H Pasternak
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Cognitive Neurology and Alzheimer's Disease Research Centre, Parkwood Institute, St. Joseph's Health Care, London, ON, Canada
| | - Bruce G Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | | | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Clinical Outcomes and Decision Neuroscience Unit, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Christine Sato
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Thomas D L Steeves
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Division of Neurology, St. Michael's Hospital, Toronto, ON, Canada
| | - Richard H Swartz
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
- LCCampbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program Sunnybrook Health Sciences Research Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada
- Krembil Research Institute, Toronto Western Hospital, Toronto, ON, Canada
- University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Maria C Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada
| | - John Turnbull
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Lorne Zinman
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
- Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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19
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Scott JR, Drife J, Grimes D, Gabbe S, Branch DW, Smith R, Kochenour N. On published research: a BOGSAT perspective. BJOG 2021; 128:1750-1751. [PMID: 34355848 DOI: 10.1111/1471-0528.16854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- James R Scott
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - James Drife
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - David Grimes
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Steven Gabbe
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - David Ware Branch
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Roger Smith
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Neil Kochenour
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Kumar S, Shen J, Grimes D, Mestre T, Thavorn K. Return on Investment Analysis for the Integrated Parkinson's Care Network: Lesson Learned from a Pilot Study. J Parkinsons Dis 2021; 11:2085-2091. [PMID: 34366368 DOI: 10.3233/jpd-212578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a complex and debilitating condition that requires care from a multispecialty team. The Integrated Parkinson Care Network (IPCN) is an innovative pragmatic care model that focuses on integrated care, self-management support and technology-enabled care. OBJECTIVE This study aims to estimate the costs of the IPCN and assess whether benefits gained from the intervention offset its costs based on a single center experience. METHODS We conducted a return on investment (ROI) analysis of the IPCN from a societal perspective. The ROI for the IPCN was estimated as a ratio of the net savings and the intervention cost. The intervention cost was calculated as a sum of set-up and implementation costs. Cost savings was measured as the absolute reduction in the societal costs realized by PD patients. A positive ROI indicated that savings generated from the intervention offset its cost. RESULTS The total cost of the IPCN for 100 PD patients was C$135,669, or C$226 per patient per month. IPCN was associated with the reduction in societal cost of C$915 per patient per month (95%CI: -2,782, 951). The ROI per PD patient per month for the IPCN was 3.08 (95%CI: -0.60, 22.93), suggesting that for every C$1 invested in the IPCN, C$4.08 is gained through reduction in societal costs. The returns were greater among advanced PD patients. CONCLUSION The IPCN has the potential to offer a good return on investment for PD patients, and its value for money is higher among advanced PD patients.
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Affiliation(s)
- Srishti Kumar
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Julia Shen
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - David Grimes
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Tiago Mestre
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,ICES, Toronto, Ontario, Canada
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21
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van Munster M, Stümpel J, Thieken F, J. Pedrosa D, Antonini A, Côté D, Fabbri M, Ferreira JJ, Růžička E, Grimes D, Mestre TA. Moving towards Integrated and Personalized Care in Parkinson's Disease: A Framework Proposal for Training Parkinson Nurses. J Pers Med 2021; 11:623. [PMID: 34209024 PMCID: PMC8304750 DOI: 10.3390/jpm11070623] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/28/2022] Open
Abstract
Delivering healthcare to people living with Parkinson's disease (PD) may be challenging in face of differentiated care needs during a PD journey and a growing complexity. In this regard, integrative care models may foster flexible solutions on patients' care needs whereas Parkinson Nurses (PN) may be pivotal facilitators. However, at present hardly any training opportunities tailored to the care priorities of PD-patients are to be found for nurses. Following a conceptual approach, this article aims at setting a framework for training PN by reviewing existing literature on care priorities for PD. As a result, six prerequisites were formulated concerning a framework for training PN. The proposed training framework consist of three modules covering topics of PD: (i) comprehensive care, (ii) self-management support and (iii) health coaching. A fourth module on telemedicine may be added if applicable. The framework streamlines important theoretical concepts of professional PD management and may enable the development of novel, personalized care approaches.
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Affiliation(s)
- Marlena van Munster
- Department of Neurology, University Hospital Marburg, 35033 Marburg, Germany; (F.T.); (D.J.P.)
| | - Johanne Stümpel
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES), University of Cologne, 50931 Cologne, Germany;
- Research Unit Ethics, University Hospital Cologne, 50931 Cologne, Germany
| | - Franziska Thieken
- Department of Neurology, University Hospital Marburg, 35033 Marburg, Germany; (F.T.); (D.J.P.)
| | - David J. Pedrosa
- Department of Neurology, University Hospital Marburg, 35033 Marburg, Germany; (F.T.); (D.J.P.)
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, University of Padua, 35122 Padua, Italy;
| | - Diane Côté
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada;
| | - Margherita Fabbri
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, TOULOUSE University Hospital, INSERM, University of Toulouse 3, 31062 Toulouse, France;
| | - Joaquim J. Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CNS—Campus Neurológico Sénior Torres Vedras, 2560-280 Torres Vedras, Portugal
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University, General University Hospital in Prague, CZ-121 08 Prague, Czech Republic;
| | - David Grimes
- Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON K1Y 4E9, Canada; (D.G.); (T.A.M.)
| | - Tiago A. Mestre
- Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, ON K1Y 4E9, Canada; (D.G.); (T.A.M.)
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22
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Fishman KN, Roberts AC, Orange JB, Sunderland KM, Marras C, Tan B, Steeves T, Kwan D, Lang AE, Grimes D, Levine B, Masellis M, Binns MA, Jog M, Strother SC, Investigators O, McLaughlin PM, Troyer AK. Bilingualism in Parkinson's disease: Relationship to cognition and quality of life. J Clin Exp Neuropsychol 2021; 43:199-212. [PMID: 33827353 DOI: 10.1080/13803395.2021.1902946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Some studies have found that bilingualism promotes cognitive reserve. OBJECTIVE We aimed to determine whether bilingualism, defined as regularly (i.e. daily) using at least two languages at least since early adulthood, is associated with cognitive advantages in Parkinson's disease (PD) or whether the possible benefits of bilingualism are lost in the context of PD, possibly affecting quality of life (QoL) and independence. METHOD Participants with idiopathic PD (n = 140, mean age = 67.9 [SD = 6.4], 78% men) completed standard neuropsychological tasks evaluating attention/working memory, language, executive function, memory, and visuospatial ability, as well as measures of wellbeing and functional independence. RESULTS Bilinguals with PD (n = 21) performed worse than monolinguals with PD (n = 92) on attention/working memory and language measures. The between-group differences in attention/working memory were restricted to verbally-based measures. When measured along a continuum, a higher degree of bilingualism was correlated with lower scores on measures of attention/working memory and language. There were no group differences in self- or informant-reported cognitive decline, PD health-related QoL, or functional independence. CONCLUSIONS Bilingualism in PD was not associated with better cognitive performance. Lower scores on language-based measures may reflect a distributed fund of linguistic information across more than one language, lower language proficiency in English, and/or other cultural artifacts. Furthermore, using normative data specific to the dominant language spoken or conducting neuropsychological testing in participants' self-reported most proficient language may enhance additional studies addressing this topic. Future research may also examine the roles of bilingualism over time and across other neurodegenerative diseases with and without EF impairment to illuminate further the impact of bilingualism on cognition and QoL, and shape culturally and linguistically diverse research and clinical care.
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Affiliation(s)
- Keera N Fishman
- University of Ottawa, Ottawa, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Angela C Roberts
- Northwestern University, Evanston, Illinois, USA.,, Western University, London, Ontario, Canada
| | - J B Orange
- , Western University, London, Ontario, Canada
| | | | - Connie Marras
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian Tan
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | - Donna Kwan
- Queen's University, Toronto, Ontario, Canada
| | - Anthony E Lang
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Brian Levine
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mandar Jog
- , Western University, London, Ontario, Canada
| | - Stephen C Strother
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | | | - Paula M McLaughlin
- Queen's University, Toronto, Ontario, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Angela K Troyer
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
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23
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Kessler D, Hatch S, Alexander L, Grimes D, Côté D, Liddy C, Mestre T. The Integrated Parkinson's disease Care Network (IPCN): Qualitative evaluation of a new approach to care for Parkinson's disease. Patient Educ Couns 2021; 104:136-142. [PMID: 32660740 DOI: 10.1016/j.pec.2020.07.002] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 05/21/2023]
Abstract
OBJECTIVES To evaluate the acceptability of the Integrated Parkinson's disease Care Network (IPCN) from the perspectives of persons with Parkinson's disease (PD), their care partners and healthcare providers, including identification of important components and areas for improvement. METHODS We used a descriptive qualitative approach with interviews (n = 15) and focus groups (n = 31) with persons with PD who were newly diagnosed and those with advanced PD, care partners and healthcare providers. Questions were designed to gather feedback on each component of the IPCN. RESULTS Four overarching categories emerged: CCI support, New knowledge, Goal identification and achievement, and Readiness for self-management. These represent important aspects of participants' experiences of the IPCN. CONCLUSION Most participants experienced the IPCN as helpful for managing living with PD and accessing resources. The relationship with the CCI was a critical component; the CCI was perceived to be knowledgeable, accessible, and responsive. PRACTICE IMPLICATIONS The IPCN is a model to promote coordinated care and self-management. This study supports the key components of the IPCN as important for supporting patients in managing their lives with PD. Incorporation of other strategies to support self-management may enhance the model. Availability of and access to community resources was identified as an ongoing challenge.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère Street, Annex E, Ottawa, ON, K1N 5C8, Canada.
| | - Stacey Hatch
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Libby Alexander
- School of Rehabilitation Therapy, 31 George Street, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - David Grimes
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada; University of Ottawa Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1J 8M5, Canada
| | - Diane Côté
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Clare Liddy
- Department of Family Medicine, University of Ottawa, 600 Peter Morand Cres. Suite 201, Ottawa, ON, K1G 5Z3, Canada; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 43 Bruyère Street, Annex E, Ottawa, ON, K1N 5C8, Canada
| | - Tiago Mestre
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada; University of Ottawa Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, K1J 8M5, Canada
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24
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Mestre TA, Kessler D, Côté D, Liddy C, Thavorn K, Taljaard M, Grimes D. Pilot Evaluation of a Pragmatic Network for Integrated Care and Self-Management in Parkinson's Disease. Mov Disord 2020; 36:398-406. [PMID: 33280165 DOI: 10.1002/mds.28332] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a chronic neurodegenerative disorder that challenges care provision. A multidisciplinary care model needs to be impactful, feasible, and viable economically for widespread utilization. Supportive evidence is lacking. OBJECTIVE The objective of this study was to evaluate the implementation and impact of a pragmatic network for PD care, the Integrated Parkinson Care Network (IPCN). METHODS A 6-month, pre-post design, single-center, phase 2 study for complex interventions for patients with newly diagnosed (<1 year) and advanced (diagnosis >8 years) PD was used to assess a patient-centered care model based on integrated care, self-management support, and technology-enabled care. We comprehensively assessed the implementation of care paths, change in selected health and care quality outcomes after the Integrated Parkinson Care Network program, and costs analyses. RESULTS We recruited 100 participants in 6 months. Overall, the top care priorities were speech and communication (33.7%), anxiety and depression (31.6%), and mobility, balance, and falls (29.6%), and the most commonly (>45%) used resources were speech-language pathology, community seniors services, and physiotherapy. Care priorities were met successfully in 90.6% of the cases, and there was a positive change in the Parkinson's Disease Questionnaire-8 (2.7; 95% confidence interval, 0.4-5.0; statistically significant in the advanced group), the perception of support for chronic care (Patient Assessment of Chronic Illness Case score, 1.1; 95% confidence interval, 0.9-1.4), and self-management (5As score, 1.2; 95% confidence interval, 1.0-1.4). The total cost of the Integrated Parkinson Care Network was C$1367 per patient. CONCLUSIONS A pragmatic development of a care delivery network based on integrated care and self-management support is promising for its feasibility, impact, and a sustainable cost. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago A Mestre
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Diane Côté
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,The Ottawa Method's Center, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,The Ottawa Method's Center, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - David Grimes
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada
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25
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Mestre TA, Freitas E, Basndwah A, Lopez MR, de Oliveira LM, Al-Shorafat DM, Zhang T, Lui JP, Grimes D, Fox SH. Glycopyrrolate Improves Disability From Sialorrhea in Parkinson's Disease: A 12-Week Controlled Trial. Mov Disord 2020; 35:2319-2323. [PMID: 32657457 DOI: 10.1002/mds.28196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the 12-week efficacy and safety of oral glycopyrrolate for moderate-to-severe sialorrhea in Parkinson's disease (PD). BACKGROUND Chronic moderate-to-severe sialorrhea has a negative impact on quality of life in PD. There is no robust evidence for oral treatments for sialorrhea longer than 1 week. METHODS This was a 12-week, double-blinded, placebo-controlled, parallel phase II study in patients with PD and Movement Disorder Society-Unified Parkinson's Disease Rating Scale item 2.2 > 2. The intervention was glycopyrrolate up to 4.5 mg/d; the primary outcome was sialorrhea related-disability (Radboud Oral Motor Inventory for Parkinson's Disease-Saliva). We used an intention-to-treat analysis. A P < 0.05 was deemed significant. RESULTS We recruited 28 patients (age, 71.1 ± 6.9 years; PD duration, 11.4 ± 7.2 years; Radboud Oral Motor Inventory for Parkinson's Disease-Saliva, 22.4 ± 5.7). Glycopyrrolate was superior to placebo at 12 weeks in the Radboud Oral Motor Inventory for Parkinson's Disease-Saliva (between-group difference, 5.3; 95% confidence interval, 1.0-9.6). Dry mouth was the most common adverse event (glycopyrrolate, n = 6; placebo, n = 2). CONCLUSIONS The results support the efficacy of glycopyrrolate to treat sialorrhea-related disability up to 12 weeks and contribute to addressing unmet nonmotor care needs in PD. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago A Mestre
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Canada
| | - Eliza Freitas
- Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Ahmed Basndwah
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Canada
| | - Marta Ruiz Lopez
- Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,University Hospital Fundación Jimenez Diaz, Madrid, Spain
| | - Lais Machado de Oliveira
- Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Duha Mohammed Al-Shorafat
- Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Tinghua Zhang
- Ottawa Methods Center, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jane P Lui
- Department of Pharmacy, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Parkinson Disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Canada
| | - Susan H Fox
- Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.,Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada
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Fabbri M, Caldas AC, Ramos JB, Sanchez-Ferro Á, Antonini A, Růžička E, Lynch T, Rascol O, Grimes D, Eggers C, Mestre TA, Ferreira JJ. Moving towards home-based community-centred integrated care in Parkinson's disease. Parkinsonism Relat Disord 2020; 78:21-26. [PMID: 32674024 DOI: 10.1016/j.parkreldis.2020.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/16/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
People living with Parkinson's disease (PwP) experience a wide range of motor and non-motor symptoms associated with increasing complexity of care delivery. A multispecialty approach has been presented as an intuitive solution for tailored and comprehensive care delivery. Nevertheless, past trials of both multidisciplinary or interdisciplinary care models in PD suggested no measurable change to a small benefit in quality of life (QoL) and failed to show economic sustainability. We propose a home-based community-centred integrated care (iCARE-PD) for PwP as a pragmatic solution to harness the potential of existing care resources using an integrated care strategy, enable self-management support and implement technology-enabled care. The iCARE-PD model is based on Freeman's concept of continuity of care and the expanded Chronic Care Model for organization of care strategies. A home-based community-centred integrated care has immediate implications for clinical practice, with potential benefits in rural areas or lower-income countries, by enhancing access to care with optimized costs. There is a need to establish which and how interventions may be used as an instrument of care in each local deployment of the iCARE-PD model. We put forward a multidisciplinary framework to generate the evidence supportive of its implementation as the standard of care in the future and delineate the core strategies to secure the implementation of this care approach across different health care systems to ensure feasibility and economic sustainability. We envision this model becoming a paradigm of personalized care transferable to people with atypical forms of neurodegenerative parkinsonism.
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Affiliation(s)
- Margherita Fabbri
- Instituto de Medicina Molecular, Facultade de Medicina, University of Lisbon, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Facultade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, TOULOUSE University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Ana Castro Caldas
- Laboratory of Clinical Pharmacology and Therapeutics, Facultade de Medicina, Universidade de Lisboa, Lisbon, Portugal; CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Joana B Ramos
- Serviço de Anestesiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Álvaro Sanchez-Ferro
- HM CINAC, Hospital Universitario HM Puerta Del Sur, Universidad CEU-San Pablo, Madrid, Spain
| | - Angelo Antonini
- Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Timothy Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Oliver Rascol
- Services de Neurologie et de Pharmacologie Clinique, Centre de Reference AMS, Centre D'Investigation Clinique, Réseau NS-Park/FCRIN et Centre of Excellence for Neurodegenerative Disorders (COEN) de Toulouse, CHU de Toulouse, Toulouse 3 University, Toulouse, France
| | - David Grimes
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Marburg, Germany
| | - Tiago A Mestre
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Facultade de Medicina, University of Lisbon, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Facultade de Medicina, Universidade de Lisboa, Lisbon, Portugal; CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.
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Ramirez J, Dilliott AA, Binns MA, Breen DP, Evans EC, Beaton D, McLaughlin PM, Kwan D, Holmes MF, Ozzoude M, Scott CJM, Strother SC, Symons S, Swartz RH, Grimes D, Jog M, Masellis M, Black SE, Joutel A, Marras C, Rogaeva E, Hegele RA, Lang AE. Parkinson's Disease, NOTCH3 Genetic Variants, and White Matter Hyperintensities. Mov Disord 2020; 35:2090-2095. [PMID: 32573853 DOI: 10.1002/mds.28171] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/01/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND White matter hyperintensities (WMH) on magnetic resonance imaging may influence clinical presentation in patients with Parkinson's disease (PD), although their significance and pathophysiological origins remain unresolved. Studies examining WMH have identified pathogenic variants in NOTCH3 as an underlying cause of inherited forms of cerebral small vessel disease. METHODS We examined NOTCH3 variants, WMH volumes, and clinical correlates in 139 PD patients in the Ontario Neurodegenerative Disease Research Initiative cohort. RESULTS We identified 13 PD patients (~9%) with rare (<1% of general population), nonsynonymous NOTCH3 variants. Bayesian linear modeling demonstrated a doubling of WMH between variant negative and positive patients (3.1 vs. 6.9 mL), with large effect sizes for periventricular WMH (d = 0.8) and lacunes (d = 1.2). Negative correlations were observed between WMH and global cognition (r = -0.2). CONCLUSION The NOTCH3 rare variants in PD may significantly contribute to increased WMH burden, which in turn may negatively influence cognition. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Allison A Dilliott
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily C Evans
- Mississauga Academy of Medicine, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Paula M McLaughlin
- Queen's University, Centre for Neuroscience Studies, Kingston, Ontario.,Nova Scotia Health Authority, Dalhousie University, Department of Medicine-Geriatrics, Halifax, Nova Scotia, Canada
| | - Donna Kwan
- Queen's University, Centre for Neuroscience Studies, Kingston, Ontario
| | - Melissa F Holmes
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Sean Symons
- Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa Brain and Mind Research Institute, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - Anne Joutel
- Institute of Psychiatry and Neuroscience of Paris- Institut national de la santé et de la recherche médicale (INSERM), Paris Descartes University, Paris, France
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Ontario, Canada
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
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28
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Grimes D, Fitzpatrick M, Gordon J, Miyasaki J, Fon EA, Schlossmacher M, Suchowersky O, Rajput A, Lafontaine AL, Mestre T, Appel-Cresswell S, Kalia SK, Schoffer K, Zurowski M, Postuma RB, Udow S, Fox S, Barbeau P, Hutton B. Canadian guideline for Parkinson disease. CMAJ 2020; 191:E989-E1004. [PMID: 31501181 DOI: 10.1503/cmaj.181504] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- David Grimes
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont.
| | - Megan Fitzpatrick
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Joyce Gordon
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Janis Miyasaki
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Edward A Fon
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Michael Schlossmacher
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Oksana Suchowersky
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Alexander Rajput
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Anne Louise Lafontaine
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Tiago Mestre
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Silke Appel-Cresswell
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Suneil K Kalia
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Kerrie Schoffer
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Mateusz Zurowski
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Ronald B Postuma
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Sean Udow
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Susan Fox
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Pauline Barbeau
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
| | - Brian Hutton
- The Ottawa Hospital, University of Ottawa Brain and Mind Research Institute (Grimes, Fitzpatrick, Schlossmacher, Mestre), Ottawa, Ont.; Parkinson Canada (Gordon), Toronto, Ont.; University of Alberta Hospital (Miyasaki), Edmonton, Alta.; Montreal Neurological Institute (Fon), McGill University, Montréal, Que.; University of Alberta (Suchowersky), Edmonton, Alta.; Royal University Hospital (Rajput), University of Saskatchewan, Saskatoon, Sask.; Montreal General Hospital (Lafontaine, Postuma), McGill University, Montréal, Que.; Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health (Appel-Cresswell), University of British Columbia, Vancouver, BC; Toronto Western Hospital (Kalia, Zurowski, Fox), University of Toronto, Toronto, Ont.; Dalhousie University (Schoffer), Halifax, NS; University of Manitoba Rady Faculty of Health Sciences (Udow), Winnipeg, Man.; Knowledge Synthesis Group (Barbeau, Hutton), Ottawa Hospital Research Institute, Ottawa, Ont
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Mestre TA, Eberly S, Tanner C, Grimes D, Lang AE, Oakes D, Marras C. Reply to "Studying reproducibility of data-driven Parkinson's disease subtypes". Parkinsonism Relat Disord 2019; 66:245-246. [PMID: 30655161 DOI: 10.1016/j.parkreldis.2018.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/26/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Tiago A Mestre
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, ON, Canada.
| | - Shirley Eberly
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Caroline Tanner
- Parkinson's Disease Research, Education and Clinical Center, Neurology, San Francisco Veterans Affairs Medical Center & Department of Neurology, University of California - San Francisco, San Francisco, CA, USA
| | - David Grimes
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, ON, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Center and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, ON, Canada
| | - David Oakes
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Center and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, ON, Canada
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Kessler D, Hauteclocque J, Grimes D, Mestre T, Côtéd D, Liddy C. Development of the Integrated Parkinson’s Care Network (IPCN): using co-design to plan collaborative care for people with Parkinson’s disease. Qual Life Res 2019; 28:1355-1364. [DOI: 10.1007/s11136-018-2092-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
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Abdullakutty A, Grimes D, Sivarajah S, Ramakrishnan Y, Srinivasan D. Trans-nasal endoscopic assisted enucleation of recurrent Keratocystic Odontogenic tumour (KCOT) of the Pterygoid plates- a joint Maxillofacial- ENT approach. Br J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.bjoms.2018.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- Gillian Prue
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
- HPV Action, Rugby, UK
| | - David Grimes
- School of Mathematics and Physics, Queen’s University Belfast, Belfast, UK
| | | | - Mark Lawler
- HPV Action, Rugby, UK
- European Cancer Concord and Centre for Cancer Research & Cell Biology, Queen’s University Belfast, Belfast, UK
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Marshall A, Tuley M, Dosik J, Damstra M, Grimes D, Anderson J. 403 Methodology to evaluate the photosensitivity potential of a systemically administered investigational product in healthy volunteer subjects. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Postuma RB, Anang J, Pelletier A, Joseph L, Moscovich M, Grimes D, Furtado S, Munhoz RP, Appel-Cresswell S, Moro A, Borys A, Hobson D, Lang AE. Caffeine as symptomatic treatment for Parkinson disease (Café-PD): A randomized trial. Neurology 2017; 89:1795-1803. [PMID: 28954882 DOI: 10.1212/wnl.0000000000004568] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/02/2017] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To assess effects of caffeine on Parkinson disease (PD). METHODS In this multicenter parallel-group controlled trial, patients with PD with 1-8 years disease duration, Hoehn & Yahr stages I-III, on stable symptomatic therapy were randomized to caffeine 200 mg BID vs matching placebo capsules for 6-18 months. The primary research question was whether objective motor scores would differ at 6 months (Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale [MDS-UPDRS]-III, Class I evidence). Secondary outcomes included safety and tolerability, motor symptoms (MDS-UPDRS-II), motor fluctuations, sleep, nonmotor symptoms (MDS-UPDRS-I), cognition (Montreal Cognitive Assessment), and quality of life. RESULTS Sixty patients received caffeine and 61 placebo. Caffeine was well-tolerated with similar prevalence of side effects as placebo. There was no improvement in motor parkinsonism (the primary outcome) with caffeine treatment compared to placebo (difference between groups -0.48 [95% confidence interval -3.21 to 2.25] points on MDS-UPDRS-III). Similarly, on secondary outcomes, there was no change in motor signs or motor symptoms (MDS-UPDRS-II) at any time point, and no difference on quality of life. There was a slight improvement in somnolence over the first 6 months, which attenuated over time. There was a slight increase in dyskinesia with caffeine (MDS-UPDRS-4.1+4.2 = 0.25 points higher), and caffeine was associated with worse cognitive testing scores (average Montreal Cognitive Assessment = 0.66 [0.01, 1.32] worse than placebo). CONCLUSION Caffeine did not provide clinically important improvement of motor manifestations of PD (Class I evidence). Epidemiologic links between caffeine and lower PD risk do not appear to be explained by symptomatic effects. CLINICALTRIALSGOV IDENTIFIER NCT01738178. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that for patients with PD, caffeine does not significantly improve motor manifestations.
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Affiliation(s)
- Ronald B Postuma
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada.
| | - Julius Anang
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Amelie Pelletier
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Lawrence Joseph
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Mariana Moscovich
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - David Grimes
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Sarah Furtado
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Renato P Munhoz
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Silke Appel-Cresswell
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Adriana Moro
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Andrew Borys
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Douglas Hobson
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
| | - Anthony E Lang
- From the Department of Neurology, Montreal General Hospital (R.B.P., A.P.), and Department of Epidemiology and Biostatistics (L.J.), McGill University, Montreal; Department of Neurology (J.A., A.B., D.H.), University of Manitoba, Winnipeg, Canada; Pontifical Catholic University of Parana (M.M., A.M.), Curitiba, Brazil; Department of Neurology (D.G.), Ottawa Hospital, University of Ottawa Brain and Mind Research Institute; Department of Neurology (S.F.), University of Calgary; Division of Neurology (R.P.M., A.E.L.), Toronto Western Hospital; and Department of Medicine, Division of Neurology, Djavad Mowafaghian Centre for Brain Health, and Pacific Parkinson's Research Centre (S.A.-C.), University of British Columbia, Vancouver, Canada
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Ip J, Vigar M, Grimes D, Xie Y, Gandhi D. P2674Surveillance of AF Recurrence post Surgical AF Ablation using implantable cardiac monitor: 30 months follow up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maidment RI, Grimes D, Black E, Tarnavsky E, Young M, Greatrex H, Allan RP, Stein T, Nkonde E, Senkunda S, Alcántara EMU. Erratum: A new, long-term daily satellite-based rainfall dataset for operational monitoring in Africa. Sci Data 2017; 4:170082. [PMID: 28696421 PMCID: PMC5505116 DOI: 10.1038/sdata.2017.82] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Maidment RI, Grimes D, Black E, Tarnavsky E, Young M, Greatrex H, Allan RP, Stein T, Nkonde E, Senkunda S, Alcántara EMU. Erratum: A new, long-term daily satellite-based rainfall dataset for operational monitoring in Africa. Sci Data 2017. [PMID: 28696421 DOI: 10.1038/sdata.2017.82 10.1038/sdata.2017.63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This corrects the article DOI: 10.1038/sdata.2017.63.
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Ip J, Vigar M, Grimes D, Xie Y, Gandhi D, Cheng J. 1360Surveillance of AF recurrence post AF ablation using implantable cardiac monitor: 3 year follow up. Europace 2017. [DOI: 10.1093/ehjci/eux157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Maidment RI, Grimes D, Black E, Tarnavsky E, Young M, Greatrex H, Allan RP, Stein T, Nkonde E, Senkunda S, Alcántara EMU. A new, long-term daily satellite-based rainfall dataset for operational monitoring in Africa. Sci Data 2017; 4:170063. [PMID: 28534868 PMCID: PMC5441289 DOI: 10.1038/sdata.2017.63] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 04/05/2017] [Indexed: 11/15/2022] Open
Abstract
Rainfall information is essential for many applications in developing countries, and yet, continually updated information at fine temporal and spatial scales is lacking. In Africa, rainfall monitoring is particularly important given the close relationship between climate and livelihoods. To address this information gap, this paper describes two versions (v2.0 and v3.0) of the TAMSAT daily rainfall dataset based on high-resolution thermal-infrared observations, available from 1983 to the present. The datasets are based on the disaggregation of 10-day (v2.0) and 5-day (v3.0) total TAMSAT rainfall estimates to a daily time-step using daily cold cloud duration. This approach provides temporally consistent historic and near-real time daily rainfall information for all of Africa. The estimates have been evaluated using ground-based observations from five countries with contrasting rainfall climates (Mozambique, Niger, Nigeria, Uganda, and Zambia) and compared to other satellite-based rainfall estimates. The results indicate that both versions of the TAMSAT daily estimates reliably detects rainy days, but have less skill in capturing rainfall amount—results that are comparable to the other datasets.
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Affiliation(s)
- Ross I Maidment
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - David Grimes
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - Emily Black
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - Elena Tarnavsky
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - Matthew Young
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - Helen Greatrex
- International Research Institute for Climate and Society (IRI), Columbia University, New York, NY 10964-1000, USA
| | - Richard P Allan
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK.,National Centre for Earth Observation (NCEO), Reading RG6 6BB, UK
| | - Thorwald Stein
- Department of Meteorology, University of Reading, Reading RG6 6BB, UK
| | - Edson Nkonde
- Zambian Meteorological Department, P.O. Box 30200, Lusaka, Zambia
| | - Samuel Senkunda
- Uganda National Meteorological Authority, P.O. Box 7025, Kampala, Uganda
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Patel J, Grimes D, Avery C. Do new NICE oral cancer referral guidelines (NG12) risk delay in cancer diagnosis? An audit comparing outcomes of the new guidelines against old guidelines. Br J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.bjoms.2016.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Grimes D, Patel J, Avery C. New NICE referral guidance for oral cancer: does it risk delay in diagnosis? Br J Oral Maxillofac Surg 2016; 55:404-406. [PMID: 27823849 DOI: 10.1016/j.bjoms.2016.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
Abstract
Changes to guidance about the two-week wait referrals for suspected cancer of the head and neck have created a new recommendation for a general medical practitioner to refer any patients to a dentist under certain criteria. The potential effect of this was assessed based on 91 referrals to an oral and maxillofacial unit. A total of 33 met the criteria for initial referral to a dentist; of these, one was later diagnosed with cancer. We outline the potential deleterious effects the new guidance might have on the rapid diagnosis of oral lesions.
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Affiliation(s)
- D Grimes
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW.
| | - J Patel
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW.
| | - C Avery
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW.
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Grimes D, Aulakh GS, Hayter J. Spontaneous resolution of a central giant cell lesion: case report. Br J Oral Maxillofac Surg 2016; 55:220-221. [PMID: 27478035 DOI: 10.1016/j.bjoms.2016.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022]
Affiliation(s)
- D Grimes
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW.
| | - G S Aulakh
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW
| | - J Hayter
- Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW
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Grimes D, MacLeod I, Taylor T, O'Connor M, Sidebottom A. Computed tomography as an aid to planning intubation in the difficult airway. Br J Oral Maxillofac Surg 2015; 54:80-2. [PMID: 26530731 DOI: 10.1016/j.bjoms.2015.09.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 03/18/2015] [Accepted: 09/26/2015] [Indexed: 11/19/2022]
Abstract
Patients having oral and maxillofacial operations often require nasal intubation, but limited mouth opening and unfavourable nasal anatomy can make it difficult. We aimed to find out whether there is an association between the prediction of difficult nasal intubation on computed tomography (CT) and actual problems. We retrospectively reviewed the imaging and anaesthetic records of 77 patients who had replacement of the temporomandibular joint (TMJ) as these patients often have limited mouth opening and have had a preoperative CT. There was a positive correlation between a radiographically-assessed difficult nostril and difficulty of intubation (p<0.001). The positive predictive value was 71.4%. As a consequence, our radiologists now routinely report on the nasal cavity in these patients, and their report and the scan are then reviewed by the anaesthetist before intubation. Our results suggest that review of the CT before planned nasal intubation should be part of routine practice.
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Affiliation(s)
- David Grimes
- Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH.
| | - Iain MacLeod
- Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH.
| | - Timothy Taylor
- Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH.
| | - Mary O'Connor
- Queen's Medical Centre, Derby Road, Nottingham, UK, NG7 2UH. Mary.O'
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Leordean D, Grimes D, Keynton J, Maier J, Harfe B, Benson M, Gray A, Bhattacharya S, Norris D. FOXA2 controls Pkd1l1 expression in the mouse node during left-right determination. Cilia 2015. [PMCID: PMC4519122 DOI: 10.1186/2046-2530-4-s1-p37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Grimes D, Thomas M, Sah S, Srinivasan D, Richmond A, Watson J. Orbital volume measurement using 3D CT models. Br J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.bjoms.2014.07.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smith MR, Sharma R, Grimes D. Reducing infant mortality in Arkansas: a grassroots initiative utilizing African-American sororities. J Ark Med Soc 2014; 110:204-205. [PMID: 24720005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Hadj Tahar A, Chuang R, Steeves T, Jog M, Lang A, Grimes D. Efficacy and safety of T2000 in older patients with essential tremor. Parkinsonism Relat Disord 2012; 19:485-6. [PMID: 23254160 DOI: 10.1016/j.parkreldis.2012.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/08/2012] [Accepted: 11/12/2012] [Indexed: 11/30/2022]
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Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov (N Y) 2012; 2:tre-02-85-417-1. [PMID: 23440162 PMCID: PMC3570036 DOI: 10.7916/d88w3c1m] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Accepted: 06/03/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND It is generally agreed that diffusion of botulinum toxin occurs, but the extent of the spread and its clinical importance are disputed. Many factors have been suggested to play a role but which have the most clinical relevance is a subject of much discussion. METHODS This review discusses the variables affecting diffusion, including protein composition and molecular size as well as injection factors (e.g., volume, dose, injection method). It also discusses data on diffusion from comparative studies in animal models and human clinical trials that illustrate differences between the available botulinum toxin products (onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, and rimabotulinumtoxinB). RESULTS Neither molecular weight nor the presence of complexing proteins appears to affect diffusion; however, injection volume, concentration, and dose all play roles and are modifiable. Both animal and human studies show that botulinum toxin products are not interchangeable, and that some products are associated with greater diffusion and higher rates of diffusion-related adverse events than others. DISCUSSION Each of the botulinum toxins is a unique pharmacologic entity. A working knowledge of the different serotypes is essential to avoid unwanted diffusion-related adverse events. In addition, clinicians should be aware that the factors influencing diffusion may range from properties intrinsic to the drug to accurate muscle selection as well as dilution, volume, and dose injected.
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Affiliation(s)
- Matthew A. Brodsky
- Oregon Health & Science University, Portland, Oregon, United States of America
| | - David M. Swope
- Loma Linda University, Loma Linda, California, United States of America
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