Research and Reviews in Parkinsonism最新文献

{"title":"Fear of Falling Avoidance Behavior Assessment and Intervention in Parkinson’s Disease: A Scoping Review","authors":"J. Rider, J. Longhurst, N. Lekhak, D. L. Young, M. Landers","doi":"10.2147/jprls.s350890","DOIUrl":"https://doi.org/10.2147/jprls.s350890","url":null,"abstract":": Falling and fear of falling (FOF) are significant concerns for people with Parkinson’s disease (PD). FOF can lead to activity avoidance behavior, a risk factor for increased falls and further functional decline. The significant implications of fear of falling avoidance behavior (FFAB) among PD warrant a literature review. The objective of this review was to explore existing literature on FFAB and identify what is known about this phenomenon in people with PD. This scoping review considered studies including adults 18 years and older diagnosed with PD experiencing FFAB. Using Joanna Briggs Institute methodology and the PRISMA extension for scoping reviews, we performed a scoping review searching MEDLINE, Embase, Scopus, APA PsycInfo, CINAHL, Papers First, and ProQuest Dissertations and Theses for studies examining FFAB among people with PD with no limit on publication date. A three-step search strategy was followed and data extraction was performed by two independent reviewers. A total of 9 articles met eligibility criteria. Seven studies were quantitative and two were qualitative. The results identified that FFAB has a significant impact on daily life and is associated with downstream consequences of physical and psychological decline. The symptoms and severity of PD uniquely influence FFAB. Multiple assessments were utilized, but only two measured the impact of FOF and how this fear translates into avoidance behavior. There is a paucity of literature on interventions targeting FFAB among PD. In summary, this review demonstrated that FFAB is complex, multifactorial, and significantly impacts everyday life for people with PD. Evaluation and treatment should begin in the early stages of the disease. PD adds disease-specific symptoms and progression that directly impact FFAB, possibly in a bidirectional or cyclical manner. Further research is required to explore assessment and interventions for FFAB among people with PD.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120956962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Brain Stimulation in Parkinson’s Disease: Assessing Efficacy","authors":"Fahad Somaa","doi":"10.2147/JPRLS.S306244","DOIUrl":"https://doi.org/10.2147/JPRLS.S306244","url":null,"abstract":": Parkinson’s disease (PD) has a chronic course. Currently, levodopa is the mainstay of treatment. However, long-term use of levodopa is interrupted by several side effects like dyskinesia and on–off fluctuations. Other pharmacological treatments also have adverse drug profiles and do not provide long-term relief, warranting the need for novel therapeutic approaches with a long-term efficacy profile in PD. Deep brain stimulation (DBS) is one such evolving technology with proven efficacy in advanced PD and promising results in early PD. DBS is mainly of two types, open- and closed-loop, of which open loop has been in routine use but closed loop is an innovative technology, only recently introduced for the treatment of PD. Apart from cost, DBS technology faces major challenges that hamper its integration into mainstream treatment paradigm of PD. Most of these challenges, including the cost can be overcome or considerably reduced by selecting the right DBS type, the right target for stimulation and the right patient selection. The review, therefore, assesses the efficacy of different parameters involved in selection of DBS as a treatment strategy such as patient characteristics, target characteristics, pros and cons of different DBS strategies, safety of DBS and stage of PD. The review may help clinicians to effectively use all these parameters to improve the outcomes of DBS.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127517547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment in Parkinson’s Disease: What We Know so Far","authors":"C. Painous, M. Marti","doi":"10.2147/jprls.s263041","DOIUrl":"https://doi.org/10.2147/jprls.s263041","url":null,"abstract":": One of the most impactful non-motor manifestations of Parkinson ’ s disease (PD) is cognitive impairment. Cognitive decline in PD exists as a continuum, with symptoms ranging from normal cognition to mild cognitive impairment (MCI) and fi nally dementia (PDD). MCI is clinically heterogeneous and its progression varies with cases reverting to normal cognition. On the contrary, when dementia occurs, the decline is usually rapid and stereotyped. The combination of Lewy and Alzheimer ’ s disease pathology is the most robust pathological correlate of PDD. There are no approved drugs for PD-MCI and the bene fi t from the only approved symptomatic treatment for PDD is modest. This review aims to present the aspects in which greater evidence exists and summarize the epidemiology, pathogenesis, clinical features, diagnostic approach, and treatment of cognitive dysfunction and dementia in PD.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134138175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Opportunities in Atypical Parkinsonian Syndromes: Call to Action","authors":"M. Roach, J. W. Chou, B. Lavin, J. R. Maclean","doi":"10.2147/jprls.s228108","DOIUrl":"https://doi.org/10.2147/jprls.s228108","url":null,"abstract":": Neurodegenerative diseases are a leading cause of disability and death in the United States, and the burden of rare neurodegenerative conditions such as atypical Parkinsonian syndromes is expected to grow in the coming years as the size of the older population increases at an unprecedented rate. Atypical Parkinsonian syndromes encompass a collective of rare neurodegenerative diseases that are often misdiagnosed as Parkinson ’ s disease due to similar signs and symptoms. These syndromes include progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal degeneration (CBD), and are characterized by rapid disease progression and decreased life expectancy. In this paper, we describe the substantial burden atypical Parkinsonian syndromes pose to the healthcare system and patients attributable to challenges in diagnosis, ineffective treatment options, and rapid functional decline. Despite increased understanding and recognition of these disorders, there remains signi fi cant unmet need for patients with atypical Parkinsonian syndromes. We provide recommendations to policymakers to support access to effective disease management of atypical Parkinsonian syndromes through legislative efforts that i) prioritize development of disease-modifying treatments, ii) focus on objectively assessing disease progression in addition to symptom management, and iii) bring forth economic frameworks that capture the full value of treatments.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"3 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126041710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sialorrhea in Parkinson’s disease: prevalence, impact and management strategies","authors":"N. Miller, M. Walshe, R. Walker","doi":"10.2147/JPRLS.S177409","DOIUrl":"https://doi.org/10.2147/JPRLS.S177409","url":null,"abstract":"Nick Miller Margaret Walshe Richard W Walker 1Newcastle University Institute for Ageing, Speech and Language Sciences, Newcastle University, Newcastle-Tyne NE1 7RU, Great Britain; 2Clinical Speech and Language Studies, Trinity College Dublin, University of Dublin, Dublin 2, Ireland; 3Department of Medicine, North Tyneside General Hospital, North Shields, NE29 8NH, Great Britain Abstract: Saliva plays an important part in oral health maintenance, mastication, deglutition and the start of the digestive process. It supports clear speech. Alterations to the composition and flow of saliva through hyperor hyposecretion or anterior loss through the lips thus have potentially significant consequences. This article reviews the metrics, possible age and gender differences and diurnal variability of flow in healthy individuals. It then focuses on the ways in which this is altered in Parkinson’s disease (PD) and the possible mechanisms for why people with PD drool. It reviews procedures for clinical assessment and management. Many studies report drooling prevalence >50% of people with PD, though in the early stages the impact may not yet be great. In PD, saliva flow is normal or even decreased compared to people without PD. Motorically sialorrhea arises from an interaction between oro-facial rigidity, lingual bradykinesia and aspects of oro-pharyngeal dysphagia. Postural, cognitive, attentional and pharmacological factors may also contribute. Objective evaluation of sialorrhea looks at the rate and variability of flow (milliliters or milligrams per unit time; swallow intervals; consistency). Since objective measures seldom reflect patient-reported lived experience, assessment includes rating scales that capture subjective concerns. Because altered salivary function impacts on (peri)oral health, assessment and monitoring of this is strongly advocated. Methods in each of these assessment domains are introduced. Clinical guidelines recommend behavioral interventions in the first instance, with pharmacological treatments, including botulinum injection, as follow-up possibilities. Surgical procedures are reserved for severe or intractable cases. High-quality evidence for the efficacy of behavioral interventions is lacking. Drug therapy efficacy is also under-studied, apart from botulinum toxin management. Few studies have examined surgical interventions in PD, though principles are well established from other populations. Strands of enquiry for improving our knowledge of behavioral interventions are suggested.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125365272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice treatment in Parkinson’s disease: patient perspectives","authors":"P. Gillivan-Murphy, N. Miller, P. Carding","doi":"10.2147/JPRLS.S180183","DOIUrl":"https://doi.org/10.2147/JPRLS.S180183","url":null,"abstract":"Patricia Gillivan-Murphy Nick Miller Paul Carding 1Speech and Language Therapy Department, Mater Misericordiae University Hospital, Dublin, Ireland; 2Newcastle University Institute for Ageing, Speech and Language Sciences, Newcastle University, Newcastle-uponTyne, UK; 3Midwifery and Allied Health Research, Faculty of Health and Life Sciences, Oxford Institute of Nursing, Oxford, UK Abstract: Speech and voice changes are a central feature of the symptom complex of people with Parkinson’s disease (pwPD). Speaking is a social activity involving the pwPD, family, and the wider communicative context. Sensory-motor, cognitive-linguistic, and affective changes in Parkinson’s disease (PD) combine to alter communication, impacting on psychosocial quality-of-life, leading to risks of social withdrawal and increased depression and anxiety. The underlying pathophysiology of speech, voice, and communication difficulties in pwPD is multi-factorial and complex. Sensory-motor changes in the respiratory, phonatory, and articulatory subsystems, underscaling of effort, and central processing problems are further affected by broader cognitive-linguistic difficulties, and non-speech motor deficits. Many studies show that, when pwPD are asked to rate their own voice and how it functions in everyday situations, they show increased voice-related disability and negative impact relative to healthy controls. Voice treatment is integral to improving communication in pwPD. Studies show positive benefits from the perspective of pwPD and carers. Treatment approaches vary from one-to-one to group interventions, a singular focus on increasing loudness to more general voice exercises, and choral singing. The nature and underlying pathophysiology of speech, voice, and communication changes in pwPD are reviewed before exploring the effects of voice treatment programs and pwPD and carer perceptions of their effect. Larger scale, better powered, controlled trials of intervention for voice and speech that measure clinically and socially relevant outcomes are finally underway. Future research should also focus on issues of treatment compliance, practicality (for service delivery and use), and long-term follow-up outcomes. The role of carers in longer-term maintenance represents a further important area of exploration.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"156 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122614975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson’s disease-associated dysarthria: prevalence, impact and management strategies","authors":"Gemma Moya-Galé, Erika S. Levy","doi":"10.2147/JPRLS.S168090","DOIUrl":"https://doi.org/10.2147/JPRLS.S168090","url":null,"abstract":"Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/AX620v98FnI Abstract: Dysarthria is a motor speech disorder of neurological origin and is characterized by deficits in the execution of movement for speech. Close to 90% of individuals with Parkinson’s disease (PD) present with hypokinetic dysarthria, as evidenced by reduced vocal loudness, monotone, reduced fundamental frequency range, consonant and vowel imprecision, breathiness and irregular pauses. The presence of these speech deficits negatively impacts intelligibility, functional communication and, ultimately, social participation. The aims of this review are to 1) describe the nature of this motor speech disorder and its impact on the ability to communicate effectively, 2) provide an overview of medical approaches to dysarthria management and 3) review research on behavioral treatment techniques aimed at improving the intelligibility and quality of life of individuals with dysarthria secondary to PD. The delivery of speech treatment through telepractice is also examined, as this is a modality particularly well-suited to individuals with the mobility difficulties characteristic of PD. Finally, dysarthria management across languages is considered, representing a relevant new and under-researched area in motor speech disorders.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126762887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication gaps about OFF periods between physicians and patients with Parkinson’s disease: a patient–physician dialogue analysis","authors":"A. V. Levit, Cheryl Zebendon, Lauren Walter, P. O'Donnell, C. Marras","doi":"10.2147/JPRLS.S188923","DOIUrl":"https://doi.org/10.2147/JPRLS.S188923","url":null,"abstract":"Anna V Levit Cheryl Zebendon Lauren Walter Patricia O’Donnell Connie Marras 1Acorda Therapeutics, Inc., Ardsley, NY, USA; 2Verilogue, Inc., Horsham, PA, USA; 3The Edmond J Safra Program in Parkinson’s Research, University Health Network, Toronto Western Hospital, Toronto, ON, Canada Background: As Parkinson’s disease (PD) progresses, patients may experience the return of PD symptoms (OFF periods) despite treatment. Recognizing and treating OFF periods requires effective communication between physicians and patients. Methods: A linguistic analysis investigated communication gaps between patients and physicians using a database containing dialogues recorded during regular office visits. Follow-up interviews were conducted with selected physicians, patients, and caregivers. Results: Four areas were identified showing communication gaps between patients and physicians: differences in language; patient knowledge about OFF periods; differences in approach to describing OFF periods; and attitude toward management of OFF periods. Conclusion: Closing communication gaps may improve overall PD management.","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134023091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and Reviews in Parkinsonism relaunch","authors":"P. Hedera","doi":"10.2147/JPRLS.S202262","DOIUrl":"https://doi.org/10.2147/JPRLS.S202262","url":null,"abstract":"","PeriodicalId":103935,"journal":{"name":"Research and Reviews in Parkinsonism","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131781896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}