Journal of Parkinson's disease最新文献_第6页

Pointing in the right direction: Greater motor improvements with directional versus circular subthalamic nucleus deep brain stimulation for Parkinson's disease. 指向正确的方向：定向与圆形丘脑下核深部脑刺激对帕金森病的运动改善更大。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2024-12-27 DOI: 10.1177/1877718X241301071

Christopher P Hurt, Daniel J Kuhman, Alyson Moll, Barton L Guthrie, Joseph W Olson, Arie Nakhmani, Melissa Wade, Sarah A Brinkerhoff, Marshall T Holland, Harrison C Walker

{"title":"Pointing in the right direction: Greater motor improvements with directional versus circular subthalamic nucleus deep brain stimulation for Parkinson's disease.","authors":"Christopher P Hurt, Daniel J Kuhman, Alyson Moll, Barton L Guthrie, Joseph W Olson, Arie Nakhmani, Melissa Wade, Sarah A Brinkerhoff, Marshall T Holland, Harrison C Walker","doi":"10.1177/1877718X241301071","DOIUrl":"10.1177/1877718X241301071","url":null,"abstract":"BackgroundDirectional deep brain stimulation (DBS) provides more precise control of current spread than conventional ring-shaped electrodes. Whether this enhanced flexibility improves motor function is unclear.ObjectiveHere we examine whether directional and circular stimulation differentially impact motor performance in patients with Parkinson's disease.MethodsMotor behaviors were assessed in 31 patients who underwent unilateral subthalamic nucleus brain stimulation surgery (SUNDIAL, NCT03353688). Eight configurations, including 6 directional contacts and their corresponding rings), were evaluated during device activation. Objective measures of motor performance related to limb dexterity, gait, and overall mobility were evaluated in a double-blind fashion in the \"off\" medication state versus preoperative baseline, with stimulus amplitude at the center of the therapeutic window.ResultsSignificant changes in performance were observed across each of five motor tasks between the best and worst directional contacts on a given DBS row (p < 0.001 each task). Certain stimulation directions led to functional declines versus baseline, whereas the best direction yields greater improvement than ring stimulation (p = 0.005, p = 0.001, p = 0.007, p < 0.001, respectively, across tasks). Directional DBS improves therapeutic window and side effect thresholds versus ring stimulation (0.40 ± 0.94 and 0.35 ± 0.51 mA, p < 0.001, respectively), but these variables correlated only modestly with motor performance at a given stimulation site.ConclusionsOptimized directional subthalamic nucleus DBS yields better group-level motor performance than ring stimulation, in addition to its known advantages related to tolerability. Prospective studies should evaluate whether these improvements persist over longer time intervals.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"202-213"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458436","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}

引用次数: 0

Metabolic connectivity of freezing in Parkinson's disease. 帕金森病中冷冻的代谢联系。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2024-12-27 DOI: 10.1177/1877718X241305713

Céline Tard, Arnaud Delval, Luc Defebvre, Pierre Lenfant, David Devos, Caroline Moreau, Nacim Betrouni

{"title":"Metabolic connectivity of freezing in Parkinson's disease.","authors":"Céline Tard, Arnaud Delval, Luc Defebvre, Pierre Lenfant, David Devos, Caroline Moreau, Nacim Betrouni","doi":"10.1177/1877718X241305713","DOIUrl":"10.1177/1877718X241305713","url":null,"abstract":"BackgroundFreezing of gait (FoG) is among the most disabling gait disorders of Parkinson's disease. The full understanding of its mechanisms requires a network study approach. So far, FoG was mainly studied using magnetic resonance imaging, and especially using the resting state functional sequence, which does not completely reflect the brain actual modifications.ObjectiveThis study aims to investigate metabolic networks using position emission tomography (PET) imaging. Exploration after a rest or gait session combined with a delayed tracer's uptake are assumed to reflect the actual metabolism modifications.MethodsTwenty-six patients in the off-drug state underwent two PET imaging sessions using [18F]- fluorodeoxyglucose, the first after 30 min of rest (rest condition) and the second after 30 min of real gait (gait condition). Twelve patients presented real FoG during cerebral glucose uptake. Brain connectivity matrices were measured for each group and condition, and then compared.ResultsIn the rest condition, the freezing group showed globally reduced metabolic connectivity between brain regions compared to the non-freezing group. During gait, enhanced connectivity was observed in the cerebellum, cerebello-cortical loops and parieto-frontal regions, with high recruitment of the visual cortex in the freezing group. However, connectivity inside cerebellar networks remained lower in the freezing group than in the non-freezing group, while occipito-frontal connectivity was higher in the freezing group.ConclusionsStudying real freezing of gait in a vertical position emphasized the role of the visual cortex and cerebellum in gait problems.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"154-162"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458355","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}

引用次数: 0

Estimation of and clinical consensus on the meaningful motor progression threshold on MDS-UPDRS Part III. MDS-UPDRS中有意义运动进展阈值的估计和临床共识（第三部分）。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2025-01-14 DOI: 10.1177/1877718X241302337

Dylan Trundell, Evan W Davies, Louise Barrett, Stefano Zanigni, Nima Shariati, Rebecca Rogers, Annabelle Monnet, Emma Moore, Nathalie Pross, Gennaro Pagano, Stefan Cano, Tania Nikolcheva

{"title":"Estimation of and clinical consensus on the meaningful motor progression threshold on MDS-UPDRS Part III.","authors":"Dylan Trundell, Evan W Davies, Louise Barrett, Stefano Zanigni, Nima Shariati, Rebecca Rogers, Annabelle Monnet, Emma Moore, Nathalie Pross, Gennaro Pagano, Stefan Cano, Tania Nikolcheva","doi":"10.1177/1877718X241302337","DOIUrl":"10.1177/1877718X241302337","url":null,"abstract":"BackgroundTo understand changes in the underlying progression of early Parkinson's disease, it is important to derive estimates of the threshold for meaningful motor progression on the MDS-UPDRS Part III in OFF medication state.ObjectiveTo estimate this threshold using two approaches: anchor-based analyses, and clinical consensus via a modified Delphi panel.MethodsFor the anchor-based analyses, data from a Phase II clinical trial were used. Mean and median MDS-UPDRS Part III change scores were calculated for those participants rated as 'Minimally worse' on the Clinical Global Impression of Improvement (using the first visit rated as 'Minimally worse' or worse, and at Weeks 24 and 52). Cumulative data up to Week 104 were used to assess the difference between motor progressors' and non-progressors' change scores on motor-related outcomes. For the modified Delphi panel, a panel of 13 expert clinicians received an online survey in two rounds and provided responses anonymously.ResultsFor the anchor-based analyses, estimates of meaningful change ranged from 4-6 points. Numerically worse change scores were identified on motor-related outcomes for participants who had experienced motor progression compared with those who had not. For the modified Delphi panel, consensus was reached in Round 2, with 92% agreeing that 5 points is suitable to define a clinically meaningful motor progression threshold.ConclusionsResults of the anchor-based analyses and modified Delphi panel were consistent, supporting a meaningful motor progression threshold of a worsening of 5 points on the MDS-UPDRS Part III (OFF medication state) in an early Parkinson's disease population.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"97-110"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458428","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}

引用次数: 0

Freezing of gait detection: The effect of sensor type, position, activities, datasets, and machine learning model. 步态检测的冻结：传感器类型、位置、活动、数据集和机器学习模型的影响。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2025-03-16 DOI: 10.1177/1877718X241302766

Luigi Borzì, Florenc Demrozi, Ruggero Angelo Bacchin, Cristian Turetta, Luis Sigcha, Domiziana Rinaldi, Giuliana Fazzina, Giulio Balestro, Alessandro Picelli, Graziano Pravadelli, Gabriella Olmo, Stefano Tamburin, Leonardo Lopiano, Carlo Alberto Artusi

{"title":"Freezing of gait detection: The effect of sensor type, position, activities, datasets, and machine learning model.","authors":"Luigi Borzì, Florenc Demrozi, Ruggero Angelo Bacchin, Cristian Turetta, Luis Sigcha, Domiziana Rinaldi, Giuliana Fazzina, Giulio Balestro, Alessandro Picelli, Graziano Pravadelli, Gabriella Olmo, Stefano Tamburin, Leonardo Lopiano, Carlo Alberto Artusi","doi":"10.1177/1877718X241302766","DOIUrl":"10.1177/1877718X241302766","url":null,"abstract":"BackgroundFreezing of gait (FoG) is a complex, frequent, and disabling motor symptom of Parkinson's disease (PD). Wearable technology has the potential to improve FoG assessment by providing objective, quantitative, and continuous monitoring.ObjectiveThis study aims to develop a robust FoG detection algorithm that can be embedded in a simple and unobtrusive wearable sensor system and can lead to a reliable unsupervised home assessment.MethodsTwenty-two subjects with PD and FoG were enrolled, equipped with four inertial modules on the ankles, back, and wrist, and asked to perform different tasks. Feature-driven and data-driven machine learning approaches were implemented, optimized, and evaluated. Further testing was conducted on two external datasets including a total of 545 FoG episodes.ResultsSixteen subjects experienced FoG, providing a total number of 101 FoG events. Results demonstrated that a single sensor on the ankle, with an adequate algorithm of data analysis based on machine learning, can provide a non-invasive approach for accurate FoG detection. The model proved robust on the independent datasets, with 88-95% FoG episodes correctly detected. Interestingly, while FoG can be easily discriminated from walking, static positions, and postural transitions, turning represents a significant challenge. The high number of false alarms still represents the main limitation of the FoG recognition algorithms.ConclusionsThe collected dataset includes data from different sensors at different body positions. This, together with detailed labeling of tasks, activities, FoG episodes and their severity, can be a significant contribution to research on automatic FoG detection and characterization.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"163-181"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649444","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}

引用次数: 0

New insights from a Malaysian real-world deep brain stimulation cohort. 来自马来西亚现实世界深部脑刺激队列的新见解。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-02-01 Epub Date: 2024-12-08 DOI: 10.1177/1877718X241297715

Alfand Marl F Dy Closas, Ai Huey Tan, Yi Wen Tay, Jia Wei Hor, Tzi Shin Toh, Jia Lun Lim, Choey Yee Lew, Chun Yoong Cham, Carolyn Chue Wai Yim, Kok Yoon Chee, Chong Guan Ng, Lei Cheng Lit, Anis Nadhirah Khairul Anuar, Lara M Lange, Zih-Hua Fang, Sara Bandres Ciga, Katja Lohmann, Christine Klein, Azlina Ahmad-Annuar, Kalai Arasu Muthusamy, Shen-Yang Lim

{"title":"New insights from a Malaysian real-world deep brain stimulation cohort.","authors":"Alfand Marl F Dy Closas, Ai Huey Tan, Yi Wen Tay, Jia Wei Hor, Tzi Shin Toh, Jia Lun Lim, Choey Yee Lew, Chun Yoong Cham, Carolyn Chue Wai Yim, Kok Yoon Chee, Chong Guan Ng, Lei Cheng Lit, Anis Nadhirah Khairul Anuar, Lara M Lange, Zih-Hua Fang, Sara Bandres Ciga, Katja Lohmann, Christine Klein, Azlina Ahmad-Annuar, Kalai Arasu Muthusamy, Shen-Yang Lim","doi":"10.1177/1877718X241297715","DOIUrl":"10.1177/1877718X241297715","url":null,"abstract":"BackgroundThe availability of deep brain stimulation (DBS), a highly efficacious treatment for several movement disorders, remains low in developing countries, with scarce data available on utilization and outcomes.ObjectiveWe characterized the DBS cohort and outcomes at a Malaysian quaternary medical center.MethodsA retrospective chart review was done on DBS-related surgery at the University of Malaya, including clinico-demographic, genetics, and outcomes data focusing on post-operative medication reduction and complications.Results149 Parkinson's disease (PD) patients underwent DBS targeting the subthalamic nucleus. Six had globus pallidus internus DBS (primarily for dystonia). Only 16.1% of patients were government-funded. Of the 133 PD patients operated in the past decade (2013-2022), 25 (18.8%) had disease duration <5 years. At 6-12 months post-DBS, median levodopa-equivalent daily dose (LEDD) reduction was 440.5 [418.9] mg/day, corresponding to a reduction of ≥50% and ≥30% in 42.2% and 69.8% of patients, respectively. LEDD reductions were larger in the early-onset and short-duration subgroups. Three patients (1.9% of 155) had symptomatic intracranial hemorrhage, resulting in stroke in two. Pathogenic monogenic or GBA1 variants were detected in 12/76 (16%) of patients tested, mostly comprising the \"severe\" GBA1 variant p.L483P (12%).ConclusionsThis is the largest report on DBS from Southeast Asia. The procedures were effective, and complication rates on par with international norms. Our study found a high frequency of GBA1-PD; and included a substantial number of patients with short-duration PD, who had good outcomes. It also highlights regional inequities in access to device-aided therapy.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"189-201"},"PeriodicalIF":4.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458334","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}

引用次数: 0

Proposed biological definitions of Parkinson's disease confuse understanding without delivering meaningful advances. 提出的帕金森病的生物学定义混淆了理解，没有带来有意义的进展。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2025-01-14 DOI: 10.1177/1877718X241308482

Francisco Cardoso, Peter Schmidt

引用次数: 0

SynNeurGe: The road ahead for a biological definition of Parkinson's disease. SynNeurGe：帕金森病生物学定义的未来之路。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2024-12-08 DOI: 10.1177/1877718X241298194

Günter U Höglinger, Anthony E Lang

{"title":"SynNeurGe: The road ahead for a biological definition of Parkinson's disease.","authors":"Günter U Höglinger, Anthony E Lang","doi":"10.1177/1877718X241298194","DOIUrl":"https://doi.org/10.1177/1877718X241298194","url":null,"abstract":"While significant progress has been made in treating Parkinson's disease (PD) symptoms, disease-modifying therapies (DMTs) have consistently failed. To address the underlying molecular mechanisms of PD, two biology-based criteria have been proposed: the \"Synucleinopathy-Neurodegeneration-Genetics\" (SynNeurGe) and \"neuronal α-synuclein disease\" (NSD) frameworks. Both frameworks emphasize the importance of biological markers over clinical symptoms. They recognize α-synuclein aggregation and genetic mutations (such as SNCA) as key diagnostic elements, with α-synuclein seed amplification assays (SAA) in cerebrospinal fluid (CSF) used to detect early disease stages. Dopaminergic neurodegeneration, measured by DAT imaging, is also central to both frameworks. These shared features aim to improve early diagnosis and precision medicine for PD. However, SynNeurGe provides a broader, more flexible framework that integrates α-synuclein pathology (S), neurodegeneration (N), and genetics (G), linked to clinical features (C). It aims to accommodate the complexity of PD and related Lewy body diseases, facilitating research on targeted DMTs. In contrast, NSD focuses specifically on PD and Lewy body dementia, introducing a staging system (NSD-ISS) based on biological markers and clinical impairment, helping track disease progression from preclinical to symptomatic stages. Despite their differences, both approaches highlight the need for more specific biomarkers and prospective studies to improve early intervention and personalized treatment. Harmonizing SynNeurGe and NSD concepts will be key in creating a universally accepted framework for precise PD diagnosis and therapy development.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X241298194"},"PeriodicalIF":4.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458439","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}

引用次数: 0

Neurotrophic factors for Parkinson's disease: Current status, progress, and remaining questions. Conclusions from a 2023 workshop. 帕金森病的神经营养因子：现状、进展和遗留问题来自2023年研讨会的结论。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2024-11-01 Epub Date: 2024-12-27 DOI: 10.1177/1877718X241301041

Roger A Barker, Mart Saarma, Clive N Svendsen, Catherine Morgan, Alan Whone, Massimo S Fiandaca, Matthias Luz, Krystof S Bankiewicz, Brian Fiske, Lyndsey Isaacs, Arthur Roach, Thomas Phipps, Jeffrey H Kordower, Emma L Lane, Henri J Huttunen, Aideen Sullivan, Gerard O'Keeffe, Valeria Yartseva, Howard Federoff

{"title":"Neurotrophic factors for Parkinson's disease: Current status, progress, and remaining questions. Conclusions from a 2023 workshop.","authors":"Roger A Barker, Mart Saarma, Clive N Svendsen, Catherine Morgan, Alan Whone, Massimo S Fiandaca, Matthias Luz, Krystof S Bankiewicz, Brian Fiske, Lyndsey Isaacs, Arthur Roach, Thomas Phipps, Jeffrey H Kordower, Emma L Lane, Henri J Huttunen, Aideen Sullivan, Gerard O'Keeffe, Valeria Yartseva, Howard Federoff","doi":"10.1177/1877718X241301041","DOIUrl":"https://doi.org/10.1177/1877718X241301041","url":null,"abstract":"In 2023, a workshop was organized by the UK charity Cure Parkinson's with The Michael J Fox Foundation for Parkinson's Research and Parkinson's UK to review the field of growth factors (GFs) for Parkinson's disease (PD). This was a follow up to a previous meeting held in 2019.1 This 2023 workshop reviewed new relevant data that has emerged in the intervening 4 years around the development of new GFs and better models for studying them including the merit of combining treatments as well as therapies that can be modulated. We also discussed new insights into GF delivery and trial design that have emerged from the analyses of completed GDNF trials, including the patient voice, as well as the recently completed CDNF trial.2 We then concluded with our recommendations on how GF studies in PD should develop going forward.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":"14 8","pages":"1659-1676"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432460","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}

引用次数: 0

Chronic urinary tract infections cause persistent microglial changes in a humanized ɑ-synuclein mouse model. 慢性尿路感染在人源化的小鼠模型中引起持续的小胶质细胞改变。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2024-11-01 Epub Date: 2024-12-27 DOI: 10.1177/1877718X241289046

Gabriela Mercado, Ann-Céline Clabout, Vanessa Howland, Ehsan Arkin, Anna Barber Janer, Dieter Plessers, Jennifer A Steiner, Wanli W Smith, Tom Hannan, Patrik Brundin, Wouter Peelaerts

{"title":"Chronic urinary tract infections cause persistent microglial changes in a humanized ɑ-synuclein mouse model.","authors":"Gabriela Mercado, Ann-Céline Clabout, Vanessa Howland, Ehsan Arkin, Anna Barber Janer, Dieter Plessers, Jennifer A Steiner, Wanli W Smith, Tom Hannan, Patrik Brundin, Wouter Peelaerts","doi":"10.1177/1877718X241289046","DOIUrl":"https://doi.org/10.1177/1877718X241289046","url":null,"abstract":"Background: Urinary tract infections (UTIs) have recently been linked to the onset of multiple synucleinopathies including Parkinson's disease (PD) and multiple system atrophy (MSA). UTIs are more common in people with PD or MSA, than in the general population and within these patient groups the incidence of UTIs is evenly distributed between men and women. UTIs are especially common during disease, but also in the years before clinical diagnosis.Objective: The mechanisms by which UTIs may contribute to the development and progression of PD or MSA are not well understood. In this work, we evaluate the neuroinflammatory effects of recurrent UTIs on the brain.Methods: In a humanized mouse model of ɑ-synuclein, we find that repeated administration of uropathogenic E. coli result in sustained UTIs, or a non-resolving chronic UTI phenotype with persistent bacteriuria. Using this model, we investigate the effects of repeated chronic UTIs on neuroinflammation and synucleinopathy in the brain.Results: Recurrent UTIs lead to behavioral motor changes and are accompanied by persistent neuroinflammatory changes in multiple brain areas. Affected regions with microglial changes involve multiple lower brainstem areas responsible for sickness behavior, including the dorsal vagal complex, and the cingulate cortex.Conclusions: These results suggests that recurrent UTIs can have lasting impact on the brain, and it warrants further investigation of the potential role of UTIs in the disease progression of synucleinopathies and related neurological disorders.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":"14 8","pages":"1559-1574"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433488","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}

引用次数: 0

Increasing trends in utilization of physical and occupational therapy services in early Parkinson's disease. 在早期帕金森病中使用物理和职业治疗服务的趋势日益增加。

IF 4 3区医学

Journal of Parkinson's disease Pub Date : 2024-11-01 Epub Date: 2024-10-24 DOI: 10.1177/1877718X241291991

Jason K Longhurst, Timothy Chrusciel, Syed O Ahmad

{"title":"Increasing trends in utilization of physical and occupational therapy services in early Parkinson's disease.","authors":"Jason K Longhurst, Timothy Chrusciel, Syed O Ahmad","doi":"10.1177/1877718X241291991","DOIUrl":"https://doi.org/10.1177/1877718X241291991","url":null,"abstract":"Background: Best practice guidelines in Parkinson's disease (PD) calls for the immediate initiation of rehabilitation therapies (inclusive of physical (PT) and occupational therapy (OT)) to prevent or ameliorate the loss of function and quality of life associated with disease progression.Objective: The purpose of this study was to determine the utilization of PT and OT services within the first 2 years following PD diagnosis and to observe longitudinal trends in PT and OT utilization early following PD diagnosis.Methods: This retrospective cohort study accessed 12 years (2011 to 2023) of data from electronic health records at a midwestern US healthy system. Patients with new PD diagnoses and two-years of visit history were included. The primary outcome was utilization of PT or OT services within two-years of PD diagnosis. Data extracted included demographics and PD therapies. Records of 9720 patients were included in the analyses.Results: Overall, 36.9% of the cohort (n = 3586) received either physical or occupational therapy within two years of receipt of PD diagnosis. Increasing age, higher comorbidity index, female gender, use of dopamine replacement therapies, and African American race were all positively associated with receipt of PT or OT services (ps < 0.007). The longitudinal trend revealed an average year over year increase in PT/OT utilization of 1.4% between 2013 and 2021 (p < 0.001).Conclusions: This study shows a promising increase in utilization of PT and OT services over previous reports and longitudinally, however it continues to convey how far clinical practice continues to lag behind best practice and scientific recommendation.","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":"14 8","pages":"1594-1601"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433507","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}

引用次数: 0