Journal of Parkinson's Disease - Volume 14, issue 3

Authors: Chrysou, Asterios | Heikka, Tuomas | van der Zee, Sygrid | Boertien, Jeffrey M. | Jansonius, Nomdo M. | van Laar, Teus

Article Type: Research Article

Abstract: Background: Parkinson’s disease (PD) patients experience visual symptoms and retinal degeneration. Studies using optical coherence tomography (OCT) have shown reduced thickness of the retina in PD, also a key characteristic of glaucoma. Objective: To identify the presence and pattern of retinal changes in de novo , treatment-naive PD patients compared to healthy controls (HC) and early primary open angle glaucoma (POAG) patients. Methods: Macular OCT data (10×10 mm) were collected from HC, PD, and early POAG patients, at the University Medical Center Groningen. Bayesian informative hypotheses statistical analyses were carried out comparing HC, PD-, and POAG patients, …within each retinal cell layer. Results: In total 100 HC, 121 PD, and 78 POAG patients were included. We showed significant reduced thickness of the inner plexiform layer and retinal pigment epithelium in PD compared to HC. POAG patients presented with a significantly thinner retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, outer plexiform layer, and outer photoreceptor and subretinal virtual space compared to PD. Only the outer segment layer and retinal pigment epithelium were significantly thinner in PD compared to POAG. Conclusions: De novo PD patients show reduced thickness of the retina compared to HC, especially of the inner plexiform layer, which differs significantly from POAG, showing a more extensive and widespread pattern of reduced thickness across layers. OCT is a useful tool to detect retinal changes in de novo PD, but its specificity versus other neurodegenerative disorders has to be established. Show more

Keywords: Parkinson disease, de novo, glaucoma, amacrine cells, biomarkers, inner plexiform layer Registration: ClinicalTrials.gov Identifier: NCT04180865.

DOI: 10.3233/JPD-223481

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 507-519, 2024

Authors: Śmiłowska, Katarzyna | Pietrzykowski, Tomasz | Owczarek, Aleksander J. | Dorsey, E. Ray | Bloem, Bastiaan R. | van Wamelen, Daniel J.

Article Type: Research Article

Abstract: Background: Given the growing evidence for an environmental contribution to the etiology of Parkinson’s disease (PD), searching for local and regional differences in PD prevalence in multiple areas across the world may further clarify the role of environmental toxins. Objective: To provide local and regional prevalence estimates of PD in Poland. Methods: We analyzed the prevalence of PD and its trend over the last decade (2010 to 2019) based on data from the National Health Fund in Poland. We specifically examined sex differences in PD prevalence, as well as differences across Polish regions. …Results: During the above period, the prevalence of PD in Poland increased from 226 per 100,000 to 269 per 100,000 inhabitants. Unexpectedly, we found that PD was 1.2-times more common in women than men. The increase in prevalence over the past decade was different between both sexes: an increase from 250 to 283 per 100,000 for women (13.3% increase), and from 200 to 254 per 100,000 for men (27.1% increase). In addition, we observed differences in prevalence across different Polish regions, with some regions having up to 51% lower prevalence rates than others. Conclusions: The prevalence of PD in Poland is in line with previously reported prevalence rates across Europe. However, unlike the situation in most of the world, PD was more prevalent in women than men. We discuss several possible explanations as well as potential measures that might help to reduce the growth of PD. Show more

Keywords: Parkinson’s disease, epidemiology, demography, prevalence, Poland

DOI: 10.3233/JPD-230291

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 521-532, 2024

Authors: Silva, Jacqueline D. | Jupiter, Daniel C. | Taglialatela, Giulio

Article Type: Research Article

Abstract: Background: Preclinical evidence suggests calcineurin inhibitors (CNIs) combat α-synuclein-induced neuronal dysfunction and motor impairments. However, whether CNIs prevent or treat Parkinson’s disease (PD) in humans has never been investigated. Objective: We seek to ascertain if prescription of CNIs is linked to a decreased prevalence of PD in a varied patient population and to glimpse into the mechanism(s) and target site through which CNIs might decrease PD prevalence. Methods: We analyzed electronic health records (EHRs) from patients prescribed the brain penetrant CNI tacrolimus (TAC), the peripherally restricted CNI cyclosporine (CySp), or the non-CNI sirolimus (SIR). For comparison, …EHRs from a diverse population from the same network served as a general population-like control. After propensity-score matching, prevalence, odds, and hazards of PD diagnoses among these cohorts were compared. Results: Patients prescribed CNIs have decreased odds of PD diagnosis compared to the general population-like control, while patients prescribed SIR do not. Notably, patients prescribed TAC have a decreased prevalence of PD compared to patients prescribed SIR or CySp. Conclusions: Our results suggest CNIs, especially those acting within the brain, may prevent PD. The reduced prevalence of PD in patients prescribed TAC, compared to patients prescribed SIR, suggests that mechanisms of calcineurin inhibition— other than immunosuppression, which is common to both drugs— are driving the reduction. Therefore, CNIs may provide a promising therapeutic approach for PD. Show more

Keywords: Calcineurin, tacrolimus, cyclosporine, Parkinson’s disease, α-synuclein, electronic health records, TriNetX, drug repurposing

DOI: 10.3233/JPD-230313

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 533-543, 2024

Authors: Pauly, Laure | Rauschenberger, Armin | Pauly, Claire | Schröder, Valerie E. | Van Cutsem, Gilles | Leist, Anja K. | Krüger, Rejko

Article Type: Research Article

Abstract: Background: REM-sleep behavior disorder (RBD) and other non-motor symptoms such as hyposmia were proposed by the Movement Disorder Society as research criteria for prodromal Parkinson’s disease (P-PD). Global cognitive deficit was later added. Objective: To compare non-motor symptoms, focusing on cognition, between a P-PD group and a matched control group. Methods: In this cross-sectional, case-control study, in a first set of analyses, we performed extensive cognitive testing on people with (n  = 76) and a control group without (n  = 195) probable RBD and hyposmia. Furthermore, we assessed motor and non-motor symptoms related to Parkinson’s …Disease (PD). After propensity score matching, we compared 62 P-PD with 62 age- and sex-matched controls. In addition, we performed regression analyses on the total sample (n  = 271). In a second set of analyses, we used, a.o., the CUPRO to evaluate retrograde procedural memory and visuo-constructive functions. Results: People with P-PD showed significantly poorer performances in global cognition, visuo-constructive and executive functions, mainly in mental flexibility (p  < 0.001; p  = 0.004; p  = 0.003), despite similar educational levels (p  = 0.415). We observed significantly more motor and non-motor symptoms (p  < 0.001; p  = 0.004), higher scores for depression (p  = 0.004) and apathy (p  < 0.001) as well as lower quality of life (p  < 0.001) in P-PD. CONCLUSIONS: Our findings confirm that global cognitive, executive, and visuo-constructive deficits define the P-PD group. In addition, depression, apathy, and lower quality of life were more prevalent in P-PD. If replicated in other samples, executive and visuo-constructive deficits should be considered in non-motor P-PD. Determining specific patterns will support early recognition of PD, secondary prevention of complications and the development of neuroprotective treatments. Show more

Keywords: Parkinson’s disease, cognition, population at risk, quality of life

DOI: 10.3233/JPD-230285

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 545-556, 2024

Authors: Andréasson, Mattias | Nickander, Jannike | Ståhlberg, Marcus | Fedorowski, Artur | Svenningsson, Per

Article Type: Short Communication

Abstract: Autonomic dysfunction is a prevalent feature of Parkinson’s disease (PD), mediated by disease involvement of the autonomic nervous system. Chronotropic incompetence (CI) refers to inadequate increase of heart rate in response to elevated metabolic demand, partly dependent on postganglionic sympathetic tone. In a retrospective study, PD patients with/without CI were identified. We show that PD with CI was associated with a higher levodopa equivalent daily dose and Hoehn and Yahr stage, 5±2 years after motor onset. Our data support a putative role of CI as a clinical marker of a more severe disease phenotype, possibly reflecting more widespread alpha-synuclein pathology.

Keywords: Parkinson’s disease, autonomic nervous system diseases, postganglionic autonomic fibers, exercise test

DOI: 10.3233/JPD-230256

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 557-563, 2024

Authors: Souza, Bruno Rafael Antunes | Nóbrega, Kátia Cirilo Costa | Silva, Bruno Eron de Almeida da | Gonçalves, Raissa Amorim | Martins, Thalyta Silva | Santos, Geovanna Ferreira | Frazão, André Helene | Roque, Antonio Carlos | Nascimento, Isaíra Almeida Pereira da Silva | Piemonte, Maria Elisa Pimentel

Article Type: Research Article

Abstract: Background: Sexual health (SH) is influenced by several biological, mental, and social factors that may be negatively impacted by Parkinson’s disease (PD). Despite its prevalence and relevance for quality of life, the factors that affect SH in men with PD (MwPD) are still poorly understood. Objectives: To investigate the impact of motor, non-motor, and social aspects on the SH in MwPD. Methods: We conducted a cross-sectional study of 80 men (mean-age 53.55±10.8) in stages 1–3 of Hoehn and Yahr classification (H&Y), who reported having an active sex life in the last six months. …The following data were collected for each person: 1) Demographic and clinical features; 2) global cognitive capacity (T-MoCA); 3) Non-Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part I); 4) Motor Aspects of Experiences of Daily Living (MDS-UPDRS, part II); 5) Fatigue (FSS); 6) Self-esteem (RSES); 7) Sleep disorder (PDSS); 8) Couple relationship quality (DAS); 9) Depressive signals (BDI); 10) Short-term sexual health by International Index of Erectile Function (IIFE); and 11) Long-term sexual health by Sexual Quotient-Male (SQ-M). Results: Our results showed that although several motor, non-motor, and social factors were correlated with SH, only motor disability levels in daily living predicted short-term SH and erectile dysfunction, while only depression predicted long-term SH in MwPD. Age, disease onset, and medication daily dosage were not correlated with SH. Conclusions: Our findings confirm that multidimensional factors can affect the SH of MwPD and emphasize that only a multi-professional team can offer proper care to improve SH in MwPD. Show more

Keywords: Parkinson’s disease, sexual health, sexual dysfunction, men

DOI: 10.3233/JPD-230212

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 565-574, 2024

Authors: Brandt, Gregor A. | Stopic, Vasilija | van der Linden, Christina | Strelow, Joshua N. | Petry-Schmelzer, Jan N. | Baldermann, Juan Carlos | Visser-Vandewalle, Veerle | Fink, Gereon R. | Barbe, Michael T. | Dembek, Till A.

Article Type: Research Article

Abstract: Background: Conventional deep brain stimulation (DBS) programming via trial-and-error warrants improvement to ensure swift achievement of optimal outcomes. The definition of a sweet spot for subthalamic DBS in Parkinson’s disease (PD-STN-DBS) may offer such advancement. Objective: This investigation examines the association of long-term motor outcomes with contact selection during monopolar review and different strategies for anatomically informed contact selection in a retrospective real-life cohort of PD-STN-DBS. Methods: We compared contact selection based on a monopolar review (MPR) to multiple anatomically informed contact selection strategies in a cohort of 28 PD patients with STN-DBS. …We employed a commercial software package for contact selection based on visual assessment of individual anatomy following two predefined strategies and two algorithmic approaches with automatic targeting of either the sensorimotor STN or our previously published sweet spot. Similarity indices between chronic stimulation and contact selection strategies were correlated to motor outcomes at 12 months follow-up. Results: Lateralized motor outcomes of chronic DBS were correlated to the similarity between chronic stimulation and visual contact selection targeting the dorsal part of the posterior STN (rho = 0.36, p  = 0.007). Similar relationships could not be established for MPR or any of the other investigated strategies. Conclusions: Our data demonstrates that a visual contact selection following a predefined strategy can be linked to beneficial long-term motor outcomes in PD-STN-DBS. Since similar correlations could not be observed for the other approaches to anatomically informed contact selection, we conclude that clear definitions and prospective validation of any approach to imaging-based DBS-programming is warranted. Show more

Keywords: Parkinson’s disease, subthalamic nucleus, deep brain stimulation, neuroimaging, retrospective analysis, clinical care, imaging guided DBS programming, anatomically informed contact selection

DOI: 10.3233/JPD-230200

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 575-587, 2024

Authors: Pedrosa, Anna J. | Feldmann, Sarah | Klippel, Jan | Volberg, Christian | Weck, Christiane | Lorenzl, Stefan | Pedrosa, David J.

Article Type: Research Article

Abstract: Background: A significant proportion of people with Parkinson’s disease (PwPD) die in hospital settings. Although one could presume that most PwPD would favor being cared for and die at home, there is currently no evidence to support this assumption. Objective: We aimed at exploring PwPD’s preferences for place of end-of-life care and place of death, along with associated factors. Methods: A cross-sectional study was conducted to investigate PwPD’s end-of life wishes regarding their preferred place of care and preferred place of death. Using different approaches within a generalized linear model framework, we additionally …explored factors possibly associated with preferences for home care and home death. Results: Although most PwPD wished to be cared for and die at home, about one-third reported feeling indifferent about their place of death. Preferred home care was associated with the preference for home death. Furthermore, a preference for dying at home was more likely among PwPD’s with informal care support and spiritual/religious affiliation, but less likely if they preferred institutional care towards the end of life. Conclusions: The variation in responses regarding the preferred place of care and place of death highlights the need to distinguish between the concepts when discussing end-of-life care. However, it is worth noting that the majority of PwPD preferred care and death at home. The factors identified in relation to preferred place of care and death provide an initial understanding of PwPD decision-making, but call for further research to confirm our findings, explore causality and identify additional influencing factors. Show more

Keywords: Advance care planning, decision making, home care, hospitals, hospices, patient care planning, Parkinson’s disease, palliative care, terminal care

DOI: 10.3233/JPD-230311

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 589-599, 2024

Authors: Borm, Carlijn D.J.M. | De Graaf, Debbie | Bloem, Bastiaan R. | Theelen, Thomas | Hoyng, Carel | de Vries, Nienke | Weerdesteyn, Vivian

Article Type: Short Communication

Abstract: Gait disorders are a disabling feature of Parkinson’s disease (PD). To avoid falls, people with PD should be able to adequately adapt their gait. This requires correct response inhibition and integration of visual information. In this small pilot study, we investigated PD-related impairments in gait adaptability and the influence of ocular disorders thereon. Compared with controls, persons with PD were less able to adapt their gait in unexpected situations (U = 21.5, p  = 0.013), with only a small influence of ocular disorders on precision stepping (U = 6, p  = 0.012 in the ML-direction and in the AP-direction, (U = 20, p  = 0.456). This shows …that people with PD have more difficulty with precision stepping than healthy controls and experience more problems with adapting their gait. We found only a small impact of ocular disorders on successfully execute precision stepping. The ability to adapt gait, particularly in challenging environmental conditions or with impaired vision, may provide a useful assessment and training option for fall prevention in PD. Show more

Keywords: Parkinson’s disease, gait adaptability, ocular disorders, non-motor symptoms

DOI: 10.3233/JPD-230025

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 601-607, 2024

Authors: Corcos, Daniel M. | Lamotte, Guillaume | Luthra, Nijee S. | McKee, Kathleen E.

Article Type: Article Commentary

Abstract: There is compelling evidence that exercise must be part of main line therapy for people with Parkinson’s disease. In this viewpoint, we outline the four key components of exercise: aerobic exercise, resistance exercise, flexibility exercise, and neuromotor exercises (posture, gait, balance, and agility) that can improve both motor and non-motor symptoms of the disease and, in the case of aerobic exercise, may delay the disease. We outline guidelines on how to change and optimize the exercise prescription at different stages of the disease.

Keywords: Aerobic exercise, exercise training, Parkinson’s disease, neuroprotection

DOI: 10.3233/JPD-230277

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 609-617, 2024

Authors: Hegazi, Mohamed N. | El-Jaafary, Shaimaa | Shebl, Nourhan | El-Fawal, Hassan | Rizig, Mie | Salama, Mohamed

Article Type: Letter

DOI: 10.3233/JPD-230382

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 619-622, 2024

Article Type: Abstract

DOI: 10.3233/JPD-249002

Citation: Journal of Parkinson's Disease, vol. 14, no. 3, pp. 623-636, 2024