Journal of Parkinson's disease最新文献

{"title":"Proposed mechanisms of neuroprotection for nicotine in Parkinson's disease.","authors":"Namrata Kumari, Lauren E Cooke, Abby L Olsen","doi":"10.1177/1877718X251355112","DOIUrl":"https://doi.org/10.1177/1877718X251355112","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a neurological disorder that is characterized by the death of dopaminergic neurons in the substantia nigra. Despite extensive research, the exact cause of PD is unknown, and current treatment options are centered on symptom management rather than disease modification. Most, though not all, epidemiologic studies have demonstrated reduced risk of development of PD among smokers, generating interest in nicotine, a key component of tobacco. Many preclinical investigations have investigated nicotine's neuroprotective properties, especially through its interaction with nicotinic acetylcholine receptors in the central nervous system. Nicotine has been linked to a variety of cellular activities, including neurotransmitter release, neuronal survival, and anti-inflammatory responses. Animal studies in PD models have indicated that nicotine administration can attenuate the degeneration of dopaminergic neurons and ameliorate behavioral abnormalities. Clinical investigations evaluating nicotine as a treatment for PD have yielded mixed results in terms of efficacy. Thus, central questions remain about the effects of nicotine in patients with established PD, and neither nicotine nor smoking are recommended for treatment or prevention of PD. Further research on the multiple proposed mechanisms of nicotine is required, with particular emphasis on elucidating symptomatic versus neuroprotective effects. The aim of this scoping review is to provide a comprehensive discussion of the proposed mechanisms of neuroprotection for nicotine in Parkinson's disease.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251355112"},"PeriodicalIF":4.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation or acute unplanned cessation of oral dopaminergic medications in persons with Parkinson's disease: A practice review.","authors":"Milan Beckers, Danny Hommel, Herma Lennaerts, Clementine Stuijt, Paul Smit, Bastiaan R Bloem","doi":"10.1177/1877718X251356896","DOIUrl":"https://doi.org/10.1177/1877718X251356896","url":null,"abstract":"<p><p>Planned discontinuation or acute unplanned cessation of oral dopaminergic medications might result in a severe relapse of Parkinson's symptoms or, sporadically, in life-limiting withdrawal syndromes. Unplanned cessation may occur due to dysphagia or decreased alertness, amongst other reasons. Planned acute discontinuation occurs during surgery or a medical necessity for a 'nil per os' policy (such as hospitalizations for gastrointestinal diseases). Non-oral alternatives are available, such as transdermal rotigotine, subcutaneous apomorphine, and levodopa delivered subcutaneously or via an enteral tube. Selecting the best treatment can be difficult and should be based upon clinical considerations, patient preference and be tailored to the care setting. These considerations will differ during the course of disease. For example, more invasive treatment options can be considered in hospitalized persons with early to moderate-stage disease, whereas symptomatic palliative treatments are more appropriate towards the end of life. Here, we discuss several practical considerations for three, partially overlapping, but conceptually distinct moments at which acute discontinuation or cessation events occur: during hospitalization (including surgery), late-stage disease and end of life. We stress the need for prevention and early advance care planning and present a stepwise pharmacological approach to address unplanned acute cessation or planned discontinuation.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251356896"},"PeriodicalIF":4.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse putaminal degeneration without iron deposition in multiple system atrophy.","authors":"Shin-Ichi Ueno, Taiji Tsunemi, Daisuke Taniguchi, Nobutaka Hattori","doi":"10.1177/1877718X251355592","DOIUrl":"https://doi.org/10.1177/1877718X251355592","url":null,"abstract":"<p><p>BackgroundMultiple system atrophy (MSA) is a progressive neurodegenerative disorder characterized by parkinsonism, cerebellar ataxia, and autonomic dysfunction. Putaminal hypointensities on T2 magnetic resonance imaging (MRI) are commonly observed in the parkinsonian variant of MSA (MSA-P).ObjectiveTo report a neuropathologically confirmed case of MSA-P with an atypical MRI presentation, characterized by progressive T2 hyperintensity in the putamen, without significant iron accumulation.MethodsWe present the clinical course, imaging findings, and neuropathological results of a 57-year-old woman with MSA-P. Diagnostic evaluations included serial brain MRI, cerebrospinal fluid analysis, magnetic resonance spectroscopy, and post-mortem pathological examination.ResultsThe patient initially presented with L-dopa-responsive bradykinesia and right-dominant rigidity, followed by progressive motor decline, orthostatic hypotension, and urinary retention. Serial T2-weighted MRI revealed diffuse and progressively increasing hyperintensity in the putamen, accompanied by atrophy predominantly on the left side. Autopsy confirmed the diagnosis of MSA, revealing severe neuronal loss, marked gliosis, and abundant glial cytoplasmic inclusions in the putamen, with only mild iron deposition as shown by Prussian blue staining.ConclusionsThis case demonstrates that severe putaminal neurodegeneration in advanced MSA can be associated with progressive T2 hyperintensity on MRI, reflected by the absence of substantial iron deposition. These findings indicate that iron-independent mechanisms contribute to the pathophysiology of MSA-related putaminal damage in patients with MSA.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251355592"},"PeriodicalIF":4.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's disease associated with <i>LRRK2</i>-R1441C mutation: Characterization and comparison with other <i>LRRK2</i> mutations.","authors":"Rafi Hadad, Roy N Alcalay, Inna Senderova, Maria Nassar, Andjelika Milicic, Judith Aharon Peretz, Isabel Elaine Allen, Rachel Ben-Hayun, Natalia Chasnyk, Ilham Morani, Nadav Elkoshi, Victor Valcour, Ilana Schlesinger","doi":"10.1177/1877718X251354986","DOIUrl":"https://doi.org/10.1177/1877718X251354986","url":null,"abstract":"<p><p>Mutations in the leucine-rich repeat kinase 2 (<i>LRRK2</i>) gene associate with familial and sporadic Parkinson's disease (PD). While various <i>LRRK2</i> allelic variants have been studied, characteristics of R1441C carriers remain underexplored. We compared PD patients carrying the R1441C mutation (90% Israeli Arabs) to those carrying the G2019S (70% Ashkenazi Jews) and R1441G (42% Basque) variants. R1441C carriers exhibited a distinct clinical phenotype characterized by severe motor and non-motor symptoms and worse scores on the Montreal Cognitive Assessment. These findings highlight the importance of ethnic diversity and genetic stratification in PD research. These results need confirmation in larger, more diverse samples.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354986"},"PeriodicalIF":4.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis in early onset Parkinson's disease: A retrospective cohort study in southeast Minnesota.","authors":"Mohamed Derhab, Aidan F Mullan, Pierpaolo Turcano, Emanuele Camerucci, Capucine Piat, Khaled Ghoniem, Ali Zare Dehnavi, James H Bower, Rodolfo Savica","doi":"10.1177/1877718X251354978","DOIUrl":"https://doi.org/10.1177/1877718X251354978","url":null,"abstract":"<p><p>BackgroundEarly onset Parkinson's disease (EOPD), defined as Parkinson's disease (PD) diagnosed before age 50, often presents unique challenges compared to late-onset PD, particularly with regard to non-motor symptoms. Psychosis in EOPD is associated with increased functional impairment and may lead to a higher mortality risk.ObjectiveOur study is aimed to determine the prevalence of psychosis in EOPD patients and its impact on all-cause mortality, along with examining the effects of antipsychotic medications and Selective Serotonin Reuptake Inhibitors (SSRIs) on mortality in EOPD patients.MethodsOur retrospective cohort included EOPD patients diagnosed between 1990 and 2022 at Mayo Clinic, Rochester, Minnesota. Psychosis was defined using the National Institute of Neurological Disorders and Stroke/the National Institute of Mental Health (NINDS/NIMH) Work Group criteria. Cox proportional hazards models were used to analyze the association of psychosis and medications with mortality.ResultsOf 829 patients with EOPD, 158 (19.1%) developed psychosis at a median of 12.1 years after PD motor symptom onset. Psychosis was significantly associated with increased mortality in unadjusted (HR = 4.31, 95% CI: 2.59-7.18, p < 0.001) and adjusted (HR = 3.55, 95% CI: 2.10-6.01, p < 0.001) models. No significant difference in mortality risk was observed between patients treated with antipsychotics or SSRIs versus those who were not.ConclusionsPsychosis is a possible complication in EOPD and is associated with a significant increase in all-cause mortality. The use of antipsychotics and SSRIs did not significantly alter the mortality risk in these patients. Further research is needed to understand the mechanisms driving this association and to develop tailored interventions.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354978"},"PeriodicalIF":4.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps in the Parkinson's disease therapeutic clinical pipeline: A focus on approaches targeting disease pathobiology.","authors":"Christos Koros, Brian Fiske, Leonidas Stefanis","doi":"10.1177/1877718X251354935","DOIUrl":"https://doi.org/10.1177/1877718X251354935","url":null,"abstract":"<p><p>The understanding of the pathobiology of Parkinson's disease (PD) is evolving, based largely on genetic discoveries. Despite a rich pipeline of potential therapies addressing aspects of the underlying biology of the disease, there is currently no available disease-modifying therapy for PD. In this short commentary, we review the status of the relevant pipeline and highlight areas where alternative or complementary approaches could also be advanced to the stage of clinical trials, with the ultimate goal of providing meaningful clinical benefit to patients and their families. The further evolution of biomarkers, cellular and animal models of the disease and delivery methods will be crucial to this end.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354935"},"PeriodicalIF":4.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the link between personality dimensions and non-motor fluctuations in Parkinson's disease.","authors":"Mathilde Boussac, Florent Faggianelli, Estelle Harroch, Alexandre Eusebio, Margherita Fabbri, Fabienne Ory-Magne, Emeline Descamps, Olivier Rascol, Chloé Laurencin, Ana-Raquel Marques, Mathieu Anheim, Bruno Giordana, Lucie Hopes, Caroline Moreau, Anne-Sophie Rolland, David Devos, David Maltête, Solène Ansquer, Elodie Hainque, Sophie Drapier, Jean-Philippe Brandel, Tiphaine Rouaud, Dominique Guehl, Bechir Jarraya, Mélissa Tir, Tatiana Witjas, Jean-Philippe Azulay, Christine Brefel-Courbon","doi":"10.1177/1877718X251354932","DOIUrl":"https://doi.org/10.1177/1877718X251354932","url":null,"abstract":"<p><p>BackgroundParkinson's disease (PD) patients on dopaminergic drugs may experience non-motor fluctuations (NMFs) which are often heterogeneous and respond variably to treatments.ObjectiveWe evaluated if personality was associated to NMFs and could modulate the NMFs responsiveness to dopaminergic medication and deep brain stimulation of the sub-thalamic nucleus (STN-DBS).MethodsFrom the PREDISTIM cohort, personality dimensions of 235 PD patients were assessed by the Temperament and Character Inventory (TCI) before STN-DBS (V0). NMFs were evaluated using the NMFs Severity Scale at V0 and one year after STN-DBS (V1). Linear regression models were performed between TCI dimensions and NMFs at V0; and logistic regression models were done between TCI dimensions and 1) groups of dopa-sensitive patients (responders to ON medication at V0) versus non-dopa-sensitive ones, and 2) responders versus non-responders to STN-DBS at V1. Odds ratios (OR) were also calculated.ResultsSignificant associations were found between two TCI personality dimensions (\"Harm Avoidance\" and \"Self-Directedness\") and severity of NMFs in OFF medication at V0: PD patients with higher Harm Avoidance and lower Self-Directedness scores having more NMFs. TCI personality dimensions were not associated with the dopa-sensitivity while Novelty Seeking was significantly associated with the STN-DBS-responder group for the psychiatric (OR = 1.09 [1.02-1.17]) and for the dysautonomic NMFs (OR = 1.11 [1.04-1.18]).ConclusionsCertain personality dimensions (Harm Avoidance and Self-Directedness) are associated with NMFs severity at baseline, and PD patients with high Novelty Seeking seem to be better candidates for NMFs improvement after STN-DBS.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354932"},"PeriodicalIF":4.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressive symptoms can negatively influence patient reported disease severity after subthalamic nucleus stimulation for Parkinson's disease.","authors":"Christine Girges, Alexis de Roquemaurel, Nirosen Vijiaratnam, Jennifer Foley, Joseph Candelario, Maricel Salazar, Catherine Milabo, John Esperida, Tim Grover, Harith Akram, Jonathan Hyam, Marie T Krüger, Ludvic Zrinzo, Patricia Limousin, Thomas Foltynie","doi":"10.1177/1877718X251354933","DOIUrl":"https://doi.org/10.1177/1877718X251354933","url":null,"abstract":"<p><p>BackgroundDepression can negatively influence an individual's perception of their disease. Although subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for Parkinson's disease (PD), some patients do not appreciate benefits despite showing objective improvements in motor function.ObjectiveWe explored the impact of depressive symptoms on self-reported outcomes of PD severity in patients who underwent STN-DBS.MethodsAssessments took place preoperatively and 2-years after surgery. Patients completed the Hospital Anxiety and Depression Scale (HADS), Unified Parkinson's Disease Rating Scale (UPDRS) Parts 2 and 4, Gait and Falls Questionnaire, Parkinson's Disease Questionnaire-39 (PDQ-39), and the Non-motor Symptoms Scale. The UPDRS Part 3 (motor examination) was also performed. Patients were dichotomized into two groups (normal or high) based on their postoperative follow-up HADS depression score.ResultsEighteen patients (33.3%) were assigned to the high group (hHADS-D), and 36 patients (66.7%) were assigned to the normal group (nHADS-D). The UPDRS Part 3 OFF-medication score improved to a similar extent in both groups, and participants experienced a similar reduction in their levodopa equivalent daily dose following STN-DBS. Unlike the nHADS-D group, however, hHADS-D patients did not self-report improvements on any clinical outcome measure at follow-up from baseline, and instead indicated a significant worsening on the UPDRS Part 2 ON-medication and PDQ-39 cognition domain. This was not explicable by their preoperative non-motor symptom burden, nor changes in dopaminergic medications. There were no differences between groups in terms of proportion using anti-depressants, surgical complications or postoperative side effects.ConclusionsDepressive symptoms may play a significant role in subjective self-reporting, and should be carefully considered when evaluating STN-DBS effectiveness and managing patients postoperatively.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354933"},"PeriodicalIF":4.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and utilization of compensation strategies for Parkinson's disease in Dutch long-term care facilities: A survey among 130 healthcare professionals.","authors":"Ties J Gaveel, Anouk Tosserams, Maarten J Nijkrake, Jorik Nonnekes","doi":"10.1177/1877718X251354928","DOIUrl":"https://doi.org/10.1177/1877718X251354928","url":null,"abstract":"<p><p>BackgroundCompensation strategies have been shown to improve functional mobility in people with Parkinson's disease (PD) who live independently. However, knowledge on its utilization in in long-term care (LTC) settings is unknown.ObjectiveThis study aimed to establish the knowledge and utilization of compensation strategies for functional mobility for individuals with PD among healthcare professionals working in LTC facilities in the Netherlands. Secondary aims included assessing subgroup differences among healthcare professionals and exploring perceived barriers to utilizing these strategies in LTC.MethodsA cross-sectional online survey design was conducted with (allied) healthcare professionals working in LTC facilities across the Netherlands.ResultsOverall knowledge and utilization of compensation strategies among 130 healthcare professionals was high, with a median of 5 out of 7 known categories, 4 out of 7 used for gait, and 3 out of 5 for transfers. Variations among professions existed, with physiotherapists and occupational therapists demonstrating higher scores than nurses and personal care assistants. Professionals specifically trained in PD care and those working in specialized PD departments demonstrated a higher level of knowledge. Main identified barriers for utilization were limited knowledge and time of the healthcare professionals, and concerns regarding limited feasibility in patients with severe cognitive impairments.ConclusionsWhile knowledge and utilization of compensation strategies for PD in LTC facilities was widespread, the findings highlight a need for tailored training programs for healthcare professionals to improve patient care. Future research should evaluate the feasibility and usefulness of such training programs.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251354928"},"PeriodicalIF":4.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding barriers and facilitators to participation in Parkinson's research in Black communities in the UK.","authors":"Ivelina Dobreva, Sabrina Kalam, Moïse Roche, Ece Bayram, Rimona S Weil, Angeliki Zarkali","doi":"10.1177/1877718X251351990","DOIUrl":"10.1177/1877718X251351990","url":null,"abstract":"<p><p>People from Black backgrounds are underrepresented in Parkinson's research, despite evidence of higher disease burden and risk of dementia. Greater understanding of the factors influencing participation in Parkinson's research can improve recruitment, quality and generalizability of both observational research studies and clinical trials. Through focus groups with 17 people with Parkinson's and carers from Black communities, we identified distrust in the research process, stigma of Parkinson's diagnosis, and accessibility as key barriers to research participation. Participants made recommendations including: raising awareness of Parkinson's and related research, involving community ambassadors, improving communication throughout the research process, and providing practical support.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251351990"},"PeriodicalIF":4.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}