Journal of Parkinson's disease最新文献

{"title":"Associations between neuropsychological profile and regional brain FDG uptake in progressive supranuclear palsy.","authors":"Johanna Doll-Lee, Martin Klietz, Stephan Greten, Bruno Kopp, Georg Berding, Matthias Brendel, Ida Wilkens, Sabrina Katzdobler, Johannes Levin, Adrian Danek, Sophia Rogozinski, Günter Höglinger, Monika Pötter-Nerger, Carsten Buhmann, Ralph Buchert, Florian Wegner","doi":"10.1177/1877718X251343080","DOIUrl":"https://doi.org/10.1177/1877718X251343080","url":null,"abstract":"<p><p>BackgroundProgressive supranuclear palsy (PSP) is a rare neurodegenerative movement disorder clinically characterized by falls, axial rigidity, vertical supranuclear gaze palsy, bradykinesia, and cognitive decline. There is a relative lack of studies on the functional neuroimaging correlates of cognitive impairment in PSP.ObjectiveThis study investigated the relationship between regional cerebral glucose metabolism as assessed by static ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) with global scaling and the profile of cognitive performance according to the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test battery in a sample of PSP patients representative of clinical practice.Methods22 PSP patients from three tertiary movement disorder centers with CERAD testing and FDG-PET in close proximity were included retrospectively. Neuropsychological test performance was assessed for correlation with FDG uptake on a voxel-by-voxel basis with cluster-level correction for multiple testing, separately for each subtest.ResultsIn comparison to matched healthy controls, PSP patients showed reduced FDG uptake in the left inferior frontal gyrus and right angular gyrus. Reduced overall cognitive performance according to Montreal Cognitive Assessment was associated with reduced FDG uptake in the right frontal eye field. Word list learning correlated with FDG uptake in the left frontal eye field, while language fluency was linked to FDG uptake in the bilateral premotor and supplementary motor areas.ConclusionsReduction of FDG uptake in PSP primarily affects frontal brain regions and is linked to the performance in specific cognitive domains. These findings may have implications for the interpretation of FDG-PET to support the etiological diagnosis of PSP.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251343080"},"PeriodicalIF":4.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142871","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":"Incidence of antiepileptic drug use in Parkinson's disease.","authors":"Santeri Tuominen, Miia Tiihonen, Anne Paakinaho, Marjaana Koponen, Valtteri Kaasinen, Sirpa Hartikainen, Anna-Maija Tolppanen","doi":"10.1177/1877718X251343079","DOIUrl":"https://doi.org/10.1177/1877718X251343079","url":null,"abstract":"<p><p>BackgroundAntiepileptics are used to treat epilepsy but also, e.g., neuropathic pain, essential tremor and dystonia. It is not known whether they are more commonly used in persons with Parkinson's disease (PD).ObjectiveTo assess the incidence of antiepileptic use in a nationwide cohort of persons with PD before and after the diagnosis and compared the findings to a matched cohort without PD.MethodsThis register-based Finnish nationwide cohort included 18365 persons diagnosed with PD between 2001-2015. Incidence of antiepileptic initiations, from 10 years before until 10 years after the PD diagnosis, was compared to an age-, sex-, and region-matched cohort without PD.ResultsAntiepileptics were more commonly initiated for persons with PD (29.3% of PD cohort and 15.2% of comparison cohort). Gabapentinoids were the most commonly initiated antiepileptics in both cohorts. A similar pattern in initiation rates was observed for both gabapentinoids and other antiepileptics, with increased incidence in the PD cohort approximately three years before the diagnosis and a significant peak around the time of PD diagnosis (the initiation rate at the time of PD diagnosis 3/100 and 1/100 person-years, for the PD and comparison cohorts, respectively). Clonazepam initiations were more common in the PD cohort (26.7% of initiations vs. 5.8% in the comparison cohort).ConclusionsThe increase in antiepileptic initiation rates before the diagnosis of PD suggests that they might be used for prodromal motor or non-motor symptoms.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251343079"},"PeriodicalIF":4.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127908","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":"Association of αS-SAA kinetics with clinical scores in the clinical spectrum of Parkinson's disease.","authors":"Giovanni Bellomo, Federico Paolini Paoletti, Lorenzo Gaetani, Andrea Toja, Yihua Ma, Carly M Farris, Luis Concha-Marambio, Lucilla Parnetti","doi":"10.1177/1877718X251342445","DOIUrl":"https://doi.org/10.1177/1877718X251342445","url":null,"abstract":"<p><p>BackgroundCerebrospinal fluid (CSF) α-synuclein seed amplification assay (αS-SAA) is a recognized biomarker of synucleinopathy. In Parkinson's disease (PD), its potential for predicting clinical outcome needs to be further assessed.ObjectiveTo evaluate the associations between clinical outcome and αS-SAA kinetic parameters in a retrospective cohort of PD patients, also investigating whether CSF total protein content influences such associations.MethodsStudy cohort included cognitively unimpaired PD (PD-CN, n = 40), PD with mild cognitive impairment (PD-MCI, n = 44), and PD with dementia (PDD, n = 10) with available clinical assessment at baseline. Among them, n = 28 PD-CN and n = 31 PD-MCI patients had 2-year follow-up, and CSF biomarkers reflecting pathophysiological pathways other than synucleinopathy.ResultsIn PD-MCI, αS-SAA time-to-threshold (TTT) is associated with longitudinal changes in Mini-Mental State Examination. The association is stronger when accounting for CSF total protein concentration.ConclusionsαS-SAA TTT may represent a prognostic factor for cognitive decline in PD-MCI.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251342445"},"PeriodicalIF":4.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127906","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":"Mortality and causes of death in patients with Parkinson's disease in Taiwan.","authors":"Shang-Jyh Chiou, Ya-Hui Hu, Yun-Chung Chen, Da-Ling Wang, Alexis Elbaz, Pei-Chen Lee","doi":"10.1177/1877718X251342490","DOIUrl":"https://doi.org/10.1177/1877718X251342490","url":null,"abstract":"<p><p>BackgroundPrevious studies that examined Parkinson's disease (PD) mortality were mostly conducted in Western countries.ObjectsWe compared mortality rates and causes of death in PD patients and persons without PD from Taiwan over 15 years of follow-up.MethodsWithin the National Health Insurance database, we followed 50,290 incident PD patients (2003-2016) and 201,153 matched non-PD participants (controls) until 31/12/2018. We used multivariable Cox proportional-hazards regression models to compare mortality rates and causes of death in PD patients and controls. Due to non-proportionality, we performed stratification by follow-up duration (≤5/>5 years). We examined interactions between PD status participants' characteristics for all-cause mortality.ResultsPD patients had higher all-cause mortality than controls (HR = 1.40, 95% CI = 1.37-1.42); the association was stronger (<i>p</i> < 0.0001) after the first 5 years of follow-up (HR = 1.49 [1.46-1.53]) than before (HR = 1.34 [1.31-1.37]). The strongest associations were observed for suicide (HR = 1.79 [1.52-2.10]), dementia (HR = 1.69 [1.47-1.93]), and pneumonia (HR = 1.57 [1.49-1.65]). The association between PD and death decreased as age increased, and was stronger in patients without comorbidities, depression, and dementia than in those with.ConclusionsTaiwanese PD patients have reduced life expectancy throughout the course of disease with a stronger association after the first 5 years of follow-up. PD had a stronger impact on mortality in younger persons and in those without comorbidities. Prevention of pneumonia and suicide, and appropriate management of dementia and comorbidities would help reduce PD-related mortality. Our findings may help health authorities allocate resources to improve the management of PD patients in order to address PD-related mortality.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251342490"},"PeriodicalIF":4.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127911","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":"Anxiety-related attentional characteristics and their relation to freezing of gait in people with Parkinson's: Cross-validation of the Adapted Gait Specific Attentional Profile (G-SAP).","authors":"Uri Rosenblum, Adam J Cocks, Meriel Norris, Elmar Kal, William R Young","doi":"10.1177/1877718X251326266","DOIUrl":"https://doi.org/10.1177/1877718X251326266","url":null,"abstract":"<p><p>BackgroundAnxiety often exacerbates freezing of gait (FOG) in people with Parkinson's (PwP). Anxiety-related attentional processes and associated processing inefficiencies, like conscious movement processing (CMP) and ruminations, can substantially impact movement control. However, their impact on FOG remains largely unexplored.ObjectiveTo validate an adapted 10-item (1-5 Likert scale) Gait-Specific Attentional Profile (G-SAP) in PwP and assess if adapted G-SAP-subscales (Physiological Arousal, CMP, Rumination, and Processing Inefficiencies) are associated with self-reported FOG frequency.MethodsWe recruited 440 PwP (M_age = 65.5 ± 8.7; 5.8 ± 5.0 years since diagnosis) across the UK. Participants completed the adapted G-SAP and questionnaires on demographics, medical background, and FOG frequency. We assessed adapted G-SAP's internal consistency, structural validity, and subscale scores associations with FOG frequency.ResultsThe adapted G-SAP showed acceptable internal consistency (α≥0.66) and acceptable/good model fit (comparative fit index = 0.976). Physiological Arousal and CMP subscale scores presented weaker correlations for PwP with FOG (PwP + FOG, r = 0.52) compared to PwP without FOG (PwP-FOG, r = 0.77; p = 0.006). Higher Rumination (OR: 1.323, 95%CI: [1.214-1.440]) and Physiological Arousal (OR: 1.195, 95%CI:[1.037-1.377]) were significantly associated with higher FOG frequency, controlling for age, time since diagnosis and balance/gait problems.ConclusionsThe adapted G-SAP is reliable and convenient to measure and identify potentially maladaptive anxiety-related attentional processes that may impact FOG. Results suggest that PwP who experience more worrisome thoughts and greater physiological arousal in daily life are likelier to freeze. Compared to PwP-FOG, for PwP + FOG high physiological arousal was associated with reduced goal-directed focus of attention. Future research will determine if this is a causal risk factor.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251326266"},"PeriodicalIF":4.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102134","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":"Mild cognitive impairment is not predictive of dementia up to 15 years after subthalamic deep brain stimulation in Parkinson's disease.","authors":"Sine Fjeldhøj, Birgitte Liang Chen Thomsen, Palle Møller Pedersen, Steen Rusborg Jensen, Anders Clausen, Merete Karlsborg, Bo Jespersen, Ove Ketil Bergdal, Annemette Løkkegaard","doi":"10.1177/1877718X251334049","DOIUrl":"https://doi.org/10.1177/1877718X251334049","url":null,"abstract":"<p><p>BackgroundCognitive impairment and dementia are common findings in patients with Parkinson's disease (PD). However, the long-term effects of subthalamic deep brain stimulation (STN-DBS) on cognition remain unclear.ObjectiveWe report short- and long-term effects of STN-DBS on cognition in PD.MethodsWe analyzed neuropsychological data before STN-DBS surgery, 3-month post-surgery, 1-year post-surgery and in a long-term follow-up (8-15 years post-surgery) to examine the effects of STN-DBS on cognition.Results81 patients with a mean disease duration of 13.0 years were examined before surgery. 50.6% were identified with mild cognitive impairment (MCI), having a mean disease duration of 14.2 years. Pre-surgical PD-MCI was not associated with clinically diagnosed dementia (PD-D) before death or before long-term follow-up (OR 0.8, 95% CI 0.3-2.2, p = 0.714), but disease duration at the time of surgery was associated with development of PD-D (OR 1.2, 95% CI 1.1-1.3, p = 0.005). Verbal fluency declined significantly 3 months after surgery, while other domains remained unaffected. In neuropsychological testing at long-term follow-up (N = 29), global cognitive impairment or dementia was found in 19 patients. The presence of depressive symptoms before surgery was associated to PD-D at long-term follow-up. Death before long-term follow-up was more common in patients with pre-surgical MCI than in patients with normal cognition.ConclusionsInfluence on cognition was described in a short- and long-term follow-up study up to 15 years after STN-DBS surgery in PD. Disease duration, but not pre-surgical MCI was associated with development of dementia. Impaired verbal fluency was observed both in a short- and long-term follow-up.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251334049"},"PeriodicalIF":4.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102143","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":"Sex-specific progression of Parkinson's disease: A longitudinal mixed-models analysis.","authors":"Anne-Marie Hanff, Christopher McCrum, Armin Rauschenberger, Gloria A Aguayo, Claire Pauly, Sonja R Jónsdóttir, Olena Tsurkalenko, Maurice P Zeegers, Anja K Leist, Rejko Krüger","doi":"10.1177/1877718X251339201","DOIUrl":"https://doi.org/10.1177/1877718X251339201","url":null,"abstract":"<p><p>BackgroundDespite its relevance, the clinical progression of motor- and non-motor symptoms associated with Parkinson's disease (PD) is poorly described and understood, particularly in relation to sex-specific differences in clinical progression.ObjectiveIdentification of differential aspects in disease progression in men and women with PD.MethodsLinear mixed-model analyses of 802 people with typical PD from the Luxembourg Parkinson's study's prospective cohort (median time of follow-up = three years). We estimated the effect of time and its moderation by sex (alpha ≤ 0.05), including confidence intervals, for the following outcomes: MDS-UPDRS I-IV, Starkstein Apathy Scale, Beck Depression Inventory, Montreal Cognitive Assessment (MoCA), Sniffin' sticks, bodily discomfort, rapid eye movement sleep behavior disorder questionnaire, PD Sleep Scale (PDSS), Munich Dysphagia Test-PD, Functional Mobility Composite Score, and the MDS-based tremor and postural instability and gait disturbances scale. In addition, the marginal means illustrated the symptoms' trajectories in men and women. Men and women had similar age.ResultsOverall, we observed a slower progression (interaction effect) in women compared to men, especially for MoCA (-0.159, 95%CI [-0.272, -0.046], p = 0.006), PDSS (-0.716, 95%CI [-1.229, -0.203], p = 0.006), PIGD (0.133, 95%CI [0.025 0.241], p = 0.016), and MDS-UPDRS II (0.346, 95%CI [0.120, 0.572], p = 0.003). The finding for MDS-UPDRS II was significant (FWER of 5%) after adjustment for multiple comparisons (Bonferroni-Holm).ConclusionsNext to the further exploration of sex-specific progression, interventions, proactive monitoring and communication strategies tailored to the symptoms progression and needs of men and women need to be developed.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251339201"},"PeriodicalIF":4.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102188","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":"Effects of theta burst stimulation on the Parkinsonian gait disorder and cortical gait-network activity.","authors":"Janina Dutke, Jonas Gehlenborg, Miriam Heise, Wolfgang Hamel, Christian Gerloff, Götz Thomalla, Tim Magnus, Andreas K Engel, Christian Ke Moll, Alessandro Gulberti, Monika Pötter-Nerger","doi":"10.1177/1877718X251320941","DOIUrl":"https://doi.org/10.1177/1877718X251320941","url":null,"abstract":"<p><p>BackgroundThe Parkinsonian gait disorder and freezing of gait (FoG) are challenging symptoms of Parkinson's disease (PD).ObjectiveTo assess the effect of subthalamic theta burst deep brain stimulation (TBS-DBS) on the Parkinsonian gait performance in real-world conditions and cortical activity indexed by mobile EEG.MethodsIn this monocentric, randomised, double-blind, short-term study, 12 age-matched controls (11 male, age 59 ± 8 years) and 15 PD participants (14 male, age 62 ± 9 years, disease duration 15 ± 6 years) with subthalamic stimulation (76 ± 39 months) were assessed with clinical scores (FoG-Course, MDS-UPDRS) and a standardized gait course simulating everyday life situations. Three DBS algorithms were applied in a randomized order with intertrial waiting periods of 30 min: (1) OFF-DBS; (2) cDBS; (3) TBS-DBS (interburst frequency 5 Hz, intraburst frequency 200 Hz) with regular medication. During the standardized gait course a mobile, 24-channel EEG system and 6 wearable axial kinematic sensors were used.ResultsThe primary outcome, the relative change of FoG-Course by DBS, was not superior with TBS-DBS compared to cDBS in the entire sample. Seven of fifteen PD participants rated subjectively TBS-DBS equal or better than cDBS (\"TBS-preference group\"). EEG recordings revealed movement-induced alpha and beta suppression in premotor and motor cortex in both cDBS and TBS-DBS conditions in PD with slightly different patterns between the DBS modes.ConclusionsIn this pilot trial, TBS-DBS showed benefits in the subjective perception of gait in a subgroup of PD patients accompanied by specific cortical network changes. TBS-DBS merits further investigation in future larger cohort studies with longer observation periods.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251320941"},"PeriodicalIF":4.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094047","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":"Intestinal biomarkers, microbiota composition, and genetic predisposition to inflammatory bowel disease as predictors of Parkinson's disease manifestation.","authors":"Zhi Chai, Yuxia Ouyang, Anketse Debebe, Mellissa Picker, Won-Jun Lee, Seth Fenton, Anouck Becker-Dorison, Kerstin Augustin-Emmerichs, Andreas Schwiertz, Susanne N Weber, Frank Lammert, Jianzhong Hu, Gang Fang, Marcus M Unger, Inga Peter","doi":"10.1177/1877718X251328567","DOIUrl":"https://doi.org/10.1177/1877718X251328567","url":null,"abstract":"<p><p>BackgroundParkinson's disease (PD) is often accompanied by gastrointestinal symptoms. While elevated inflammatory biomarkers have been reported in PD patients compared to controls, the role of intestinal dysmotility and inflammation in disease manifestation is not fully understood.ObjectiveThis study sought to determine if fecal biomarkers and genetic predisposition to intestinal inflammation could help identify PD subtypes for future targeted therapies.MethodsThe association of disease activity, assessed through United Parkinson's disease Rating Scale (UPDRS) and Non-Motor Symptoms Questionnaire (NMSQ), with constipation severity, fecal calprotectin and six short-chain fatty acid (SCFA) levels, polygenic risk scores (PRS) for inflammatory bowel disease (IBD) and PD, and microbiota diversity were investigated in 95 participants with established PD using regression analyses. Unsupervised k-means clustering was applied to stratify PD patients based on inflammatory biomarkers.ResultsHaving constipation was linked to worse mentation (UPDRSI, adj.<i>p</i> = 0.03) and more limited daily living activities (UPDRSII, adj.<i>p</i> = 0.03), with symptom severity linearly associated with higher disease activity (UPDRSI, adj.<i>p</i> = 0.002; NMSQ-total, adj.<i>p</i> = 0.02). Fecal calprotectin was elevated in those with constipation (<i>p</i> = 0.02) and associated with longer disease duration irrespective of the age (adj.<i>p</i> = 0.02). Cluster analysis demonstrated that PD patients with a higher non-motor symptom UPDRSII score were more likely to have more severe constipation, lower fecal SCFA levels, lower bacterial diversity, and higher PRS-CD and PRS-IBD.ConclusionsGut dysmotility, along with pro-inflammatory intestinal profiles, and greater genetic predisposition to IBD were observed in PD patients with worse non-motor symptoms. Monitoring intestinal biomarkers may help identify PD patients for targeted interventions.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251328567"},"PeriodicalIF":4.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999007","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":"Early thinking palliative care for people with Parkinson's disease: A thematic synthesis based on a systematic mixed-methods review.","authors":"Michela Garon, Christiane Weck, Valentina Leta, Bauke W Dijkstra, Catharina Muente, Giovanni Gentile, Dhaval Trivedi, Marieke M Groot, Stefan Lorenzl, Per Odin, Spyridon Konitsiotis, David J Pedrosa, Dimitrios I Fotiadis, Marjan J Meinders, Bastiaan R Bloem, Anette E Schrag, Laura Grover, Pille Taba, K Ray Chaudhuri, Angelo Antonini, Piret Paal","doi":"10.1177/1877718X251321110","DOIUrl":"https://doi.org/10.1177/1877718X251321110","url":null,"abstract":"<p><p>BackgroundParkinson's disease is a progressive neurodegenerative disorder. Awareness and the evidence supporting the merits of palliative care (PC) approaches to people with Parkinson's disease (PwP) are increasing.ObjectiveThis review aimed to address four key questions related to PC for PwPs and their caregivers: i) What are the indicators for timely access to PC? ii) When should PC be introduced? iii) What are the current care models for providing PC? iv) What are the barriers and facilitators at the organizational level?MethodsA systematic literature search was conducted in PubMed, CINAHL, Cochrane, EMBASE, and MEDLINE (2006-2024). Six reviewers independently screened abstracts and full texts, and thematic synthesis was applied to develop analytical themes. Reporting followed PRISMA guidelines.ResultsOut of 894 studies, 70 were included. PwPs were infrequently referred to PC services, and while several referral criteria were identified, no consensus emerged. Barriers to accessing PC included insufficient information, inadequate education, difficulties determining referral timing, limited home-based care options, inconsistent provider support, and disparities linked to socioeconomic and cultural factors. Facilitators included improved care coordination and education for PwPs, caregivers, and healthcare providers. Effective PC models were identified, including home-based, hospital-based, and community-based approaches, which improved quality of life and reduced healthcare costs.ConclusionsEstablishing consensus on referral timing and criteria is essential for integrating PC into Parkinson's disease care. Overcoming barriers requires enhanced education, better care coordination, and targeted interventions to address disparities, ensuring comprehensive, patient-centred care for PwPs and their caregivers.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251321110"},"PeriodicalIF":4.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022918","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}