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The Journal of Parkinson’s Disease is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that will expedite our fundamental understanding and improve treatment of Parkinson’s disease. The journal is international and multidisciplinary and aims to promote progress in the epidemiology, etiology, genetics, molecular correlates, pathogenesis, pharmacology, psychology, diagnosis and treatment of Parkinson’s disease.
It will publish research reports, reviews, short communications, and letters-to-the-editor and offers very rapid publication and an affordable open access option.
Authors: Gasser, Thomas
Article Type: Review Article
Abstract: An increasing proportion of the individual and population risk to develop Parkinson’s disease (PD) can be explained by genetic variants of different effect strength, forming a continuum from rare high penetrance gain or loss of function mutations to relatively common genetic risk variants that only mildly modify disease risk. In the coming years, further advances in molecular genetic technologies, in particular the increasing use of next generation sequencing, is likely to generate a wealth of new knowledge about the genetic basis of PD. Although specific treatments for PD based on the underlying genetic etiology will probably not be available in …the near future, genetic testing is therefore likely to play an increasing role, both in the counselling of individual patients and their families with respect to the expected disease course and recurrence risks, and in the stratification of patient groups in clinical trials. Thus, the usefulness of genetic testing strongly depends on question asked and needs to be considered within each particular setting. Show more
Keywords: Parkinson’s disease, genetics, mutation, risk variant
DOI: 10.3233/JPD-140507
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 209-215, 2015
Authors: Melki, Ronald
Article Type: Review Article
Abstract: Misfolded protein aggregates are the hallmark of several neurodegenerative diseases in humans. The main protein constituent of these aggregates and the regions within the brain that are affected differ from one neurodegenerative disorder to another. A plethora of reports suggest that distinct diseases have in common the ability of protein aggregates to spread and amplify within the central nervous system. This review summarizes briefly what is known about the nature of the protein aggregates that are infectious and the reason they are toxic to cells. The chameleon property of polypeptides which aggregation into distinct high-molecular weight assemblies is associated to …different diseases, in particular, that of alpha-synuclein which aggregation is the hallmark of distinct synucleinopathies, is discussed. Finally, strategies targeting the formation and propagation of structurally distinct alpha-synuclein assemblies associated to different synucleinopathies are presented and their therapeutic and diagnostic potential is discussed. Show more
Keywords: Neurodegenerative diseases, Alzheimer, Parkinson, multiple system atrophy, dementia with lewy bodies, huntington, prion, protein misfolding, ageing
DOI: 10.3233/JPD-150543
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 217-227, 2015
Authors: Allen, Natalie E. | Moloney, Niamh | van Vliet, Vanessa | Canning, Colleen G.
Article Type: Review Article
Abstract: Pain is a distressing non-motor symptom experienced by up to 85% of people with Parkinson’s disease (PD), yet it is often untreated. This pain is likely to be influenced by many factors, including the disease process, PD impairments as well as co-existing musculoskeletal and/or neuropathic pain conditions. Expert opinion recommends that exercise is included as one component of pain management programs; however, the effect of exercise on pain in this population is unclear. This review presents evidence describing the potential influence of exercise on the pain-related pathophysiological processes present in PD. Emerging evidence from both animal and human studies suggests …that exercise might contribute to neuroplasticity and neuro-restoration by increasing brain neurotrophic factors, synaptic strength and angiogenesis, as well as stimulating neurogenesis and improving metabolism and the immune response. These changes may be beneficial in improving the central processing of pain. There is also evidence that exercise can activate both the dopaminergic and non-dopaminergic pain inhibitory pathways, suggesting that exercise may help to modulate the experience of pain in PD. Whilst clinical data on the effects of exercise for pain relief in people with PD are scarce, and are urgently needed, preliminary guidelines are presented for exercise prescription for the management of central neuropathic, peripheral neuropathic and musculoskeletal pain in PD. Show more
Keywords: Parkinson disease, exercise, pain, neuronal plasticity
DOI: 10.3233/JPD-140508
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 229-239, 2015
Authors: Fasano, Alfonso | Herman, Talia | Tessitore, Alessandro | Strafella, Antonio P. | Bohnen, Nicolaas I.
Article Type: Review Article
Abstract: Functional brain imaging techniques appear ideally suited to explore the pathophysiology of freezing of gait (FOG). In the last two decades, techniques based on magnetic resonance or nuclear medicine imaging have found a number of structural changes and functional disconnections between subcortical and cortical regions of the locomotor network in patients with FOG. FOG seems to be related in part to disruptions in the “executive-attention” network along with regional tissue loss including the premotor area, inferior frontal gyrus, precentral gyrus, the parietal and occipital areas involved in visuospatial functions of the right hemisphere. Several subcortical structures have been also involved …in the etiology of FOG, principally the caudate nucleus and the locomotor centers in the brainstem. Maladaptive neural compensation may present transiently in the presence of acute conflicting motor, cognitive or emotional stimulus processing, thus causing acute network overload and resulting in episodic impairment of stepping. In this review we will summarize the state of the art of neuroimaging research for FOG. We will also discuss the limitations of current approaches and delineate the next steps of neuroimaging research to unravel the pathophysiology of this mysterious motor phenomenon. Show more
Keywords: Freezing of gait, magnetic resonance imaging, Parkinson’s disease, positron emission tomography, single photon emission computed tomography
DOI: 10.3233/JPD-150536
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 241-254, 2015
Authors: Scheperjans, Filip | Pekkonen, Eero | Kaakkola, Seppo | Auvinen, Petri
Article Type: Research Article
Abstract: While the etiology and pathogenesis of Parkinson’s disease (PD) is still obscure, there is evidence for lifestyle factors influencing disease risk. Best established are the inverse associations with smoking and coffee consumption. In other contexts there is evidence that health effects of lifestyle factors may depend on gut microbiome composition. Considering the gastrointestinal involvement in PD, it was recently speculated, that the associations between smoking, coffee, and PD risk could be mediated by gut microbiota. Here we review such a possible mediatory role of gut microbiota taking into account recent findings on microbiome composition in PD and extending the scope …also to urate. Show more
Keywords: Gut-brain axis, risk factors, non-motor symptoms, gut motility, constipation, nicotine, caffeine, inflammation, gut permeability, dietary fiber
DOI: 10.3233/JPD-150557
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 255-262, 2015
Authors: Mathur, Soania | DeWitte, Steve | Robledo, Israel | Isaacs, Tom | Stamford, Jon
Article Type: Research Article
Abstract: Background: Despite an urgent need for new medications, clinical trials in Parkinson’s have a relatively low rate of success. Although many reasons have been proposed for this, the opinions of patients and scientists, the two principal stakeholders, have not been widely canvassed. Objective: The objective of the present study was to establish the main barriers to clinical trials success in Parkinson’s, as perceived by people with Parkinson’s and those engaged in conducting clinical trials in Parkinson’s. Method: Three hundred and three people (303) with a connection to Parkinson’s completed an online four-item questionnaire, directed towards discovering …the barriers that interfere with the establishment of effective clinical trials. Results: 87% of respondents were patients and their care partners and 11% were medical professionals involved with clinical research. In the survey, those involved in conducting research cited insufficient financial and administrative support as the biggest obstacles to carrying out effective clinical trials. For responders with Parkinson’s, the principal barrier to their participation in medical research was fear of potential adverse consequences and misconceptions regarding the clinical trial system as a whole, issues rooted in a perceived lack of communication of relevant information between the research and patient communities. Conclusions: Areas for future improvement as highlighted by this survey and debated at the Rallying to the Challenge meeting of people with Parkinson’s (PwP) at the Van Andel Research Institute that followed included recommendations in the areas of communication, education, funding, recruitment and compliance. Show more
Keywords: Clinical trial, patient engagement, barriers, management
DOI: 10.3233/JPD-150541
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 263-268, 2015
Authors: Lawton, Michael | Baig, Fahd | Rolinski, Michal | Ruffman, Claudio | Nithi, Kannan | May, Margaret T. | Ben-Shlomo, Yoav | Hu, Michele T.M.
Article Type: Research Article
Abstract: Background: Within Parkinson’s there is a spectrum of clinical features at presentation which may represent sub-types of the disease. However there is no widely accepted consensus of how best to group patients. Objective: Use a data-driven approach to unravel any heterogeneity in the Parkinson’s phenotype in a well-characterised, population-based incidence cohort. Methods: 769 consecutive patients, with mean disease duration of 1.3 years, were assessed using a broad range of motor, cognitive and non-motor metrics. Multiple imputation was carried out using the chained equations approach to deal with missing data. We used an exploratory and then a …confirmatory factor analysis to determine suitable domains to include within our cluster analysis. K-means cluster analysis of the factor scores and all the variables not loading into a factor was used to determine phenotypic subgroups. Results: Our factor analysis found three important factors that were characterised by: psychological well-being features; non-tremor motor features, such as posture and rigidity; and cognitive features. Our subsequent five cluster model identified groups characterised by (1) mild motor and non-motor disease (25.4%), (2) poor posture and cognition (23.3%), (3) severe tremor (20.8%), (4) poor psychological well-being, RBD and sleep (18.9%), and (5) severe motor and non-motor disease with poor psychological well-being (11.7%). Conclusion: Our approach identified several Parkinson’s phenotypic sub-groups driven by largely dopaminergic-resistant features (RBD, impaired cognition and posture, poor psychological well-being) that, in addition to dopaminergic-responsive motor features may be important for studying the aetiology, progression, and medication response of early Parkinson’s. Show more
Keywords: Parkinson’s disease, Cohort studies, cluster analysis, factor analysis
DOI: 10.3233/JPD-140523
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 269-279, 2015
Authors: Ferreira, Joaquim J. | Santos, Ana T. | Domingos, Josefa | Matthews, Helen | Isaacs, Tom | Duffen, Joy | Al-Jawad, Ahmed | Larsen, Frank | Serrano, J. Artur | Weber, Peter | Thoms, Andrea | Sollinger, Stefan | Graessner, Holm | Maetzler, Walter
Article Type: Research Article
Abstract: Background: Parkinson’s disease (PD) is a neurodegenerative disorder with fluctuating symptoms. To aid the development of a system to evaluate people with PD (PwP) at home (SENSE-PARK system) there was a need to define parameters and tools to be applied in the assessment of 6 domains: gait, bradykinesia/hypokinesia, tremor, sleep, balance and cognition. Objective: To identify relevant parameters and assessment tools of the 6 domains, from the perspective of PwP, caregivers and movement disorders specialists. Methods: A 2-round Delphi study was conducted to select a core of parameters and assessment tools to be applied. This process …included PwP, caregivers and movement disorders specialists. Results: Two hundred and thirty-three PwP, caregivers and physicians completed the first round questionnaire, and 50 the second. Results allowed the identification of parameters and assessment tools to be added to the SENSE-PARK system. The most consensual parameters were: Falls and Near Falls; Capability to Perform Activities of Daily Living; Interference with Activities of Daily Living; Capability to Process Tasks; and Capability to Recall and Retrieve Information. The most cited assessment strategies included Walkers; the Evaluation of Performance Doing Fine Motor Movements; Capability to Eat; Assessment of Sleep Quality; Identification of Circumstances and Triggers for Loose of Balance and Memory Assessment. Conclusions: An agreed set of measuring parameters, tests, tools and devices was achieved to be part of a system to evaluate PwP at home. A pattern of different perspectives was identified for each stakeholder. Show more
Keywords: Outcomes assessment, delphi technique, patient-centered outcomes research, Parkinson’s disease
DOI: 10.3233/JPD-140493
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 281-290, 2015
Authors: Ma, Joan K.-Y. | Schneider, Christine B. | Hoffmann, Rüdiger | Storch, Alexander
Article Type: Research Article
Abstract: Background: Up to 89% of the individuals with Parkinson’s disease (PD) experience speech problem over the course of the disease. Speech prosody and intelligibility are two of the most affected areas in hypokinetic dysarthria. However, assessment of these areas could potentially be problematic as speech prosody and intelligibility could be affected by the type of speech materials employed. Objective: To comparatively explore the effects of different types of speech stimulus on speech prosody and intelligibility in PD speakers. Methods: Speech prosody and intelligibility of two groups of individuals with varying degree of dysarthria resulting from PD …was compared to that of a group of control speakers using sentence reading, passage reading and monologue. Acoustic analysis including measures on fundamental frequency (F0), intensity and speech rate was used to form a prosodic profile for each individual. Speech intelligibility was measured for the speakers with dysarthria using direct magnitude estimation. Results: Difference in F0 variability between the speakers with dysarthria and control speakers was only observed in sentence reading task. Difference in the average intensity level was observed for speakers with mild dysarthria to that of the control speakers. Additionally, there were stimulus effect on both intelligibility and prosodic profile. Conclusions: The prosodic profile of PD speakers was different from that of the control speakers in the more structured task, and lower intelligibility was found in less structured task. This highlighted the value of both structured and natural stimulus to evaluate speech production in PD speakers. Show more
Keywords: Hypokinetic dysarthria, Parkinson’s disease, prosody, intelligibility, stimulus effect
DOI: 10.3233/JPD-140451
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 291-299, 2015
Authors: Mitra, Reinika | Aronsson, Patrik | Winder, Michael | Tobin, Gunnar | Bergquist, Filip | Carlsson, Thomas
Article Type: Research Article
Abstract: Background: Urinary problems, including urinary frequency, urgency, and nocturia are some of the non-motor symptoms that correlate most with poor quality of life in Parkinson’s disease. However, the mechanism behind these symptoms is poorly understood, in particular regarding peripheral bladder pathophysiology following dopamine degeneration. Objective: In this study, we compared the contractile responsiveness of urinary bladder from the 6-OHDA unilateral rat model of Parkinson’s disease with that of normal untreated animals. Methods: The contractility of the urinary detrusor muscle was evaluated in bladder strip preparations using electrical field stimulation, and muscarinic and purinoceptor stimulations in an …vitro organ bath setup. Results: Our data show that the overall contractile response following electrical field stimulation was significantly higher (43% at maximum contraction by 20–40 Hz stimulation) in the 6-OHDA-lesioned rats as compared to control animals. This increase was associated with a significant increase in the cholinergic contractile response, where the muscarinic agonist methacholine produced a 44% (at 10 −4 M concentration) higher response in the 6-OHDA-treated rats as compared to controls with a significant left-shift of the dose response. This indicates an altered sensitivity of the muscarinic receptor system following the specific central 6-OHDA-induced dopamine depletion. In addition a 36% larger contraction of strips from the 6-OHDA animals was also observed with purinoceptor activation using the agonist ATP (5×10 −3 M) during atropine treatment. Conclusions: Our data shows that it is not only the central dopamine control of the micturition reflex that is altered in Parkinson’s disease, but also the local contractile function of the urinary bladder. The current study draws attention to a mechanism of urinary dysfunction in Parkinson’s disease that has previously not been described. Show more
Keywords: Urinary bladder pathophysiology, detrusor muscle, parasympathetic nervous system, muscarinic receptor
DOI: 10.3233/JPD-140509
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 301-311, 2015
Authors: Hassan, Anhar | Wu, Samuel S. | Schmidt, Peter | Simuni, Tanya | Giladi, Nir | Miyasaki, Janis M. | Bloem, Bastiaan R. | Malaty, Irene A. | Okun, Michael S.
Article Type: Research Article
Abstract: Background: Parkinson’s disease (PD) patients with 20 years or more survival (PD-20) are not well characterized. Objective: To evaluate PD-20 patient characteristics and identify areas for improvement of their health care. Methods: The international, multicenter National Parkinson’s Foundation Quality Improvement Initiative (NPF-QII) study database was queried to identify PD-20 subjects. Demographic and clinical data were analyzed. Results: We identified 187 PD-20 subjects (55% men) representing 4% (187/4,619) of all NPF-QII participants. Subjects were mean age 69.5 years; mean age at PD onset was 44.0 years. The majority (75%) had 20-25 years of PD duration, …the longest duration being 49 years. They were median Hoehn and Yahr stage 3, and 75% had motor fluctuations. Half (54%) reported exercising. The majority (89%) were living at home and required a caregiver (88%). They were mildly cognitively impaired for age (Montreal Cognitive Assessment estimate 22.6±3.7), with most deficits in verbal fluency and delayed recall. Quality of life (Parkinson’s Disease Quality of Life Questionnaire index 36±15%) was mild to moderately impaired, with most impairment in mobility and activities of daily living. Caregiver strain measured by the Multidimensional Caregiver Strain Index (27±16%), recorded highest subscores in social constraint. PD-20 subjects aged <70 years versus ≥70 only differed significantly by worse cognition (P < 0.0001). Conclusions: PD-20 subjects reflect an elite group of PD survivors with early-onset disease and relatively mild cognitive disability despite long disease duration. Interventions for caregivers, mobility, and activities of daily living are areas that could improve caregiver burden and patient quality of life. Show more
Keywords: Advanced, complications, Parkinson’s disease, quality-of-life
DOI: 10.3233/JPD-140515
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 313-319, 2015
Authors: Williams, Isobel Anne | Wilkinson, Leonora | Limousin, Patricia | Jahanshahi, Marjan
Article Type: Research Article
Abstract: Background: Deep brain stimulation of the subthalamic nucleus (STN DBS) ameliorates the motor symptoms of Parkinson’s disease (PD). However, some aspects of executive control are impaired with STN DBS. Objective: We tested the prediction that (i) STN DBS interferes with switching from automatic to controlled processing during fast-paced random number generation (RNG) (ii) STN DBS-induced cognitive control changes are load-dependent. Methods: Fifteen PD patients with bilateral STN DBS performed paced-RNG, under three levels of cognitive load synchronised with a pacing stimulus presented at 1, 0.5 and 0.33 Hz (faster rates require greater cognitive control), with DBS …on or off. Measures of output randomness were calculated. Countscore 1 (CS1) indicates habitual counting in steps of one (CS1). Countscore 2 (CS2) indicates a more controlled strategy of counting in twos. Results: The fastest rate was associated with an increased CS1 score with STN DBS on compared to off. At the slowest rate, patients had higher CS2 scores with DBS off than on, such that the differences between CS1 and CS2 scores disappeared. Conclusions: We provide evidence for a load-dependent effect of STN DBS on paced RNG in PD. Patients could switch to more controlled RNG strategies during conditions of low cognitive load at slower rates only when the STN stimulators were off, but when STN stimulation was on, they engaged in more automatic habitual counting under increased cognitive load. These findings are consistent with the proposal that the STN implements a switch signal from the medial frontal cortex which enables a shift from automatic to controlled processing. Show more
Keywords: Subthalamic nucleus, deep brain stimulation, Parkinson’s disease, controlled processing, automatic, impulse control disorders
DOI: 10.3233/JPD-140355
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 321-331, 2015
Authors: Rahimi, Jasmin | Milenkovic, Ivan | Kovacs, Gabor G.
Article Type: Research Article
Abstract: Background: Spreading of misfolded proteins has been suggested for neurodegenerative diseases. The hierarchical distribution of protein deposits in Alzheimer‘s (AD) and Parkinson’s disease (PD) supports this concept. Objectives: To evaluate α-synuclein and tau-deposition in the optic pathway as an excellent anatomical model, which follows a strict trajectory including a cortico-geniculate feedback connection. Methods: We immunostained the optic nerve, lateral geniculate nucleus (LGN), and occipital cortex for AT8 (phosphorylated tau), α-synuclein, and disease-associated prion protein (PrP) in 47 cases with tau pathology (AD type, argyrophilic grain disease, or progressive supranuclear palsy), 16 PD, and 5 Creutzfeldt-Jakob disease …(CJD) cases, respectively. Results: We detected immunoreactivity for all proteins along the optic pathway. The optic nerve showed immunopositivity only in cases with tau (6/8, 75%) or α-synuclein (5/7, 71%) pathology. The LGN was involved also frequently (tau: 22/47, 46.8% ; α-synuclein: 15/16, 93.7% ; PrP 5/5, 100%). The occipital cortex was variably affected by tau or α-synuclein pathology, but always showed PrP immunoreactivity in the CJD cases. Tau pathology in the LGN correlated with tau immunoreactivity in the occipital cortex and Braak stages of neurofibrillary degeneration. In tauopathies, which do not involve the occipital cortex, like argyrophilic grain disease or progressive supranuclear palsy, tau pathology was more frequently astrocytic in the LGN. Conclusions: Our results have implications 1) for the understanding of disease spreading along neural pathways and 2) for the diagnostic evaluation of the visual system in neurodegenerative proteinopathies as a potential biomarker to evaluate disease progression or subgrouping of cases. Show more
Keywords: Lateral geniculate body, neurodegeneration, prion-like spreading, prion protein, α-synuclein, tau; visual system
DOI: 10.3233/JPD-140485
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 333-340, 2015
Authors: Jonasson, Stina B. | Ullén, Susann | Iwarsson, Susanne | Lexell, Jan | Nilsson, Maria H.
Article Type: Research Article
Abstract: Background: Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related self-efficacy. It is common in people with Parkinson’s disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors. Objective: To identify explanatory factors of concerns about falling in people with PD by focusing on personal and environmental factors as well as PD-related disabilities. Methods: Data …were collected from 241 persons with PD (39% women, median age 70 years, PD duration 8 years). Concerns about falling (assessed with the Falls Efficacy Scale-International, FES-I; categorized into low, moderate, or high concerns) were used as the dependent variable in a multivariate ordinal regression analysis. Personal factors, environmental factors and PD-related disabilities constituted independent variables. Results: Low, moderate and high concerns about falling were reported by 29% , 24% and 47% of the participants, respectively. Walking difficulties, orthostatism, motor symptoms, age, and fatigue (presented in order of importance) were significant (p < 0.05) explanatory factors of concerns about falling. Conclusions: Several factors significantly explained concerns about falling in people with PD. Walking difficulties was by far the strongest explanatory factor. This suggests that minimizing walking difficulties should be a primary target when aiming at reducing concerns about falling in people with PD. Show more
Keywords: Accidental falls, fear, multivariate analysis, Parkinson disease, regression analysis, self efficacy
DOI: 10.3233/JPD-140524
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 341-349, 2015
Authors: Cohen, Matthew L. | Aita, Stephen | Mari, Zoltan | Brandt, Jason
Article Type: Research Article
Abstract: Background: Apathy and depression are associated with poor cognition in patients with Parkinson’s disease (PD). However, the cognitive signature of each syndrome is not well understood. The cognitive consequences of having apathy or depression, versus apathy and depression, are also unclear. Objective: This study investigated the unique and combined effects of apathy and depression on cognition in PD patients. Methods: PD patients were identified from a clinical research database as having self-reported apathy (n = 21), depression (n = 11), or both (n = 43). PD patients without apathy or depression served as the Control group (n = 49). The …groups were of similar age, education, disease severity, age of symptom onset, and medication status. A multivariate analysis of variance (MANOVA) compared the groups on 17 neuropsychological test scores in the domains of attention, motor and psychomotor speed, construction, language, episodic memory, and executive functioning. Results: There was a significant overall effect of group: F (18,276) = 2.12, p = 0.006, η p 2 = 0.12 . Univariate analyses and planned contrasts revealed medium-sized effects distinguishing only the control group and the group with both apathy and depression (η p 2 = 0.06 – 0.12 ) on measures of verbal fluency and manual, processing, and psychomotor speed. Conclusions: PD patients with apathy alone or depression alone did not perform worse than PD controls on neuropsychological tests. Patients with apathy and depression performed worse than controls, but only on speed-based measures. This suggests that apathy and depression are associated with the same or similar circuits as those of cognitive and motor speed. Show more
Keywords: Parkinson’s disease, cognition, apathy, depression
DOI: 10.3233/JPD-140484
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 351-359, 2015
Authors: Deli, Gabriella | Aschermann, Zsuzsanna | Ács, Péter | Bosnyák, Edit | Janszky, József | Faludi, Béla | Makkos, Attila | Kovács, Márton | Komoly, Sámuel | Balás, István | Dóczi, Tamás | Kovács, Norbert
Article Type: Research Article
Abstract: Background: Sleep problems are among the most common non-motor symptoms of Parkinson’s disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2. Objective: To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD. Methods: In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were …examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2. Results: Total score of MDS-UPDRS improved from 81 (median, interquartile-range: 63-103) to 55 points (median, IQR: 46-75, p < 0.001). Health-related quality of life, measured by PDQ-39, also improved from 29 (IQR: 18-40) to 15 (IQR: 9-28) points (p = 0.002). Most domains of NMSS also improved. At baseline 13 patients reported sleep problems, but 1 year after DBS implantation only 3 did (p = 0.012). Although only 6 out of 15 items showed a significant decrease after DBS implantation, the total score of PDSS-2 decreased from 24 (IQR: 17-32) to 10 (IQR: 7-18) points (P < 0.001). Conclusions: Based on our results, PDSS-2 can detect improvements in sleep quality reliably after DBS implantation. Show more
Keywords: Sleep, non-motor symptoms, subthalamic deep brain stimulation, restless legs syndrome
DOI: 10.3233/JPD-150540
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 361-368, 2015
Authors: Zhao, Yan | Heida, Tjitske | van Wegen, Erwin E.H. | Bloem, Bastiaan R. | van Wezel, Richard J.A.
Article Type: Research Article
Abstract: Recent advances in smart glasses, wearable computers in the form of glasses, bring new therapeutic and monitoring possibilities for people with Parkinson’s disease (PD). For example, it can provide visual and auditory cues during activities of daily living that have long been used to improve gait disturbances. Furthermore, smart glasses can personalize therapies based on the state of the user and/or the user environment in real-time using object recognition and motion tracking. To provide guidelines for developers in creating new PD applications for smart glasses, a self-reported questionnaire was designed to survey the requirements, constraints, and attitudes of people with …PD with respect to this new technology. The survey was advertised online over an 11 month period on the website of the Parkinson Vereninging. The results were derived from 62 participants (54.8% men and 45.2% women, average age of 65.7 ± 9.1), representing a response rate of 79.5% . The participants were overall very enthusiastic about smart glasses as an assistive technology to facilitate daily living activities, especially its potential to self-manage motor problems and provide navigational guidance, thereby restoring their confidence and independence. The reported level of usage of mobile technologies like tablets and smartphones suggests that smart glasses could be adopted relatively easily, especially by younger people with PD. However, the respondents were concerned about the cost, appearance, efficacy, and potential side effects of smart glasses. To accommodate a wide range of symptoms, personal preferences, and comfort level with technology, smart glasses should be designed to allow simple operation and personalization. Show more
Keywords: Health care technology, medical informatics, mobile applications, self-management, cues, virtual reality exposure therapy
DOI: 10.3233/JPD-150568
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 369-378, 2015
Authors: Tard, Céline | Delval, Arnaud | Duhamel, Alain | Moreau, Caroline | Devos, David | Defebvre, Luc | Dujardin, Kathy
Article Type: Research Article
Abstract: Background: Due to its high prevalence in dual-task paradigms, freezing of gait in Parkinson’s disease is thought to be associated with dysexecutive syndrome and attentional disorders. However, the role of specific attentional disorders in patients with freezing of gait is still unclear. Objective: Here, we sought to specifically determine which basic attentional modalities are impaired in patients with freezing of gait. Methods: Seventy-eight parkinsonian patients performed a computer-controlled reaction-time paradigm designed to measure the different attentional subcomponents, controlled for visuospatial processing and motor participation. Results: The freezer (n = 42) and non-freezer (n = 36) groups …were matched for age, educational level, MMSE and Mattis Dementia Rating Scale. There were no intergroup differences in simple reaction times, whereas choice reaction times were higher in the freezer group than in the non-freezer group for divided attention (p = 0.023). Conclusions: At equivalent levels of overall cognitive efficiency, freezer patients showed a greater slowdown than non-freezer patients with a specific impairment in divided attention. Show more
Keywords: Focusing, dual-task, Parkinsonism, attention, divided attention
DOI: 10.3233/JPD-140498
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 379-387, 2015
Authors: Jiao, Yun | Dou, Yuchen | Lockwood, Georgina | Pani, Amar | Smeyne, Richard Jay
Article Type: Research Article
Abstract: Background: MPTP and paraquat are two compounds that have been used to model Parkinson’s disease in mice. Previous studies in two non-traditional strains of mice have shown that a single dose of MPTP can induce changes in body temperature, while the effects of paraquat have not been examined. Examination of body temperature is important since small fluctuations in an animal’s core temperature can significantly affect drug metabolism, and if significant enough can even culminate in an animal’s death. Objective: To determine how external heating can alter the survival of C57BL/6J mice following MPTP administration. Methods: In …this study, we examine the effects of MPTP (4×20 mg/kg, 2 hours apart) and paraquat (2×10 mg/kg/week for 3 weeks) on core temperature of C57BL/6J mice. Correlations of purine and catecholamine levels were also done in mice treated with MPTP. Results: We find that MPTP induces a significant hypothermia in C57BL/6J mice that reduces their core temperature below the limit of fatal hypothermia. Unlike MPTP, paraquat did not induce a significant hypothermia. Placement of animals on heating pads significantly abrogates the loss of core temperature. In both heated and non-heated conditions, mice treated with MPTP showed a significant depletion of ATP within 2 hours of administration in both striatum and SN that started to recover 2 hours after MPTP administration was complete. Striatal DA and DOPAC are significantly reduced starting 4–6 hours after MPTP. Conclusions: The fatal hypothermic effects of MPTP can be abrogated through use of external heating. Show more
Keywords: Mouse strain, MPTP, paraquat, temperature, fatal hypothermic temperature
DOI: 10.3233/JPD-140424
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 389-401, 2015
Authors: Ellis, Charles | Crosson, Bruce | Gonzalez Rothi, Leslie J. | Okun, Michael S. | Rosenbek, John C.
Article Type: Research Article
Abstract: Background: Models of basal ganglia (BG) function suggest that expressive language deficits will likely and consistently present in BG disease. Disparities currently exist between the predictions of models of BG function in expressive language and data from studies of BG disease. Traditional expressive language assessment methodologies that emphasize measures of language form (word and sentence productivity) while not carefully considering how language is used, may only partially account for these disparities. Objective: To use measures of cohesion to examine the use of cohesive markers in narrative discourse. Methods: Twelve individuals with idiopathic Parkinson’s disease (PD) were …compared to 12 matched neurologically intact controls on measures of discourse performance. Three discourse samples (typical day, memorable vacation and family) were analyzed for measures of narrative productivity, number of cohesive ties and cohesive adequacy. Mixed model analyses were completed for group comparisons. Results: Group differences were not observed on measures of language form as measured by narrative productivity, communication units, and number of cohesive ties produced. In contrast, group differences were observed in cohesive adequacy as individuals with PD produced a higher percentage of incomplete and erroneous cohesive ties relative the control subjects across narratives. Conclusions: These results support the conclusion that the BG in PD may have an executive role in expressive language use that can be disrupted without impacting language form. Show more
Keywords: Basal ganglia, Parkinson’s disease, language, discourse, cohesion
DOI: 10.3233/JPD-140476
Citation: Journal of Parkinson's Disease, vol. 5, no. 2, pp. 403-411, 2015
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