Journal of Parkinson's disease最新文献

{"title":"Continuous, subcutaneous apomorphine infusion for Parkinson disease motor fluctuations: Results from the phase 3, long-term, open-label United States InfusON study.","authors":"Stuart H Isaacson, Alberto J Espay, Rajesh Pahwa, Pinky Agarwal, Holly A Shill, Jennifer Hui, Khashayar Dashtipour, Mark Lew, Peibing Qin, Andrea E Formella, Gianpiera Ceresoli-Borroni, Peter A LeWitt","doi":"10.1177/1877718X241310727","DOIUrl":"10.1177/1877718X241310727","url":null,"abstract":"<p><p>BackgroundContinuous subcutaneous apomorphine infusion (CSAI) has been used globally since the 1980s for Parkinson disease (PD) motor fluctuations but has not been available in the United States (US).ObjectiveEvaluate CSAI for motor fluctuations in the US setting.MethodsThis open-label study (NCT02339064) enrolled patients with PD experiencing ≥3 hours (h) daily OFF time despite optimized levodopa and current/prior use of at least one other adjunctive therapy. CSAI was initiated with a 1-2 mg bolus followed by 1 mg/h infusion titrated to optimal efficacy and tolerability. Following titration, patients entered a 52-week maintenance period.ResultsOf 99 patients treated, 85 completed the titration period, 69 completed maintenance week 12 and 48 completed maintenance week 52. Common treatment-related adverse events included infusion site nodules and erythema, dyskinesia, nausea, and somnolence, each of which occurred more frequently during the titration period. Reduction in OFF time began at CSAI initiation and reached a mean of 3.0 ± 3.18 h/day by maintenance week 12 (primary efficacy endpoint), with a corresponding increase in Good ON time of 3.1 ± 3.35 h/day. By maintenance week 12, 68% of patients rated themselves as much or very much improved, 62% had at least a 2-h reduction in daily OFF time, and mean concomitant oral levodopa and levodopa equivalent doses (excluding CSAI) had been reduced by 198 mg/day and 283 mg/day, respectively. Improvements were maintained through week 52.ConclusionsThis study supports the clinical utility of CSAI to reduce OFF time and increase Good ON time in patients with motor fluctuations inadequately controlled with oral therapy.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"361-373"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458480","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":"Aging, cellular senescence and Parkinson's disease.","authors":"Yue Ma, Madalynn L Erb, Darren J Moore","doi":"10.1177/1877718X251316552","DOIUrl":"10.1177/1877718X251316552","url":null,"abstract":"<p><p>Parkinson's disease (PD) is the most common neurodegenerative movement disorder, affecting 1-2% of people over age 65. The risk of developing PD dramatically increases with advanced age, indicating that aging is likely a driving factor in PD neuropathogenesis. Several age-associated biological changes are also hallmarks of PD neuropathology, including mitochondrial dysfunction, oxidative stress, and neuroinflammation. Accumulation of senescent cells is an important feature of aging that contributes to age-related diseases. How age-related cellular senescence affects brain health and whether this phenomenon contributes to neuropathogenesis in PD is not yet fully understood. In this review, we highlight hallmarks of aging, including mitochondrial dysfunction, loss of proteostasis, genomic instability and telomere attrition in relation to well established PD neuropathological pathways. We then discuss the hallmarks of cellular senescence in the context of neuroscience and review studies that directly examine cellular senescence in PD. Studying senescence in PD presents challenges and holds promise for advancing our understanding of disease mechanisms, which could contribute to the development of effective disease-modifying therapeutics. Targeting senescent cells or modulating the senescence-associated secretory phenotype (SASP) in PD requires a comprehensive understanding of the complex relationship between PD pathogenesis and cellular senescence.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"239-254"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458451","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":"The effect of polygenic risk score on PD risk and phenotype in <i>LRRK2</i> G2019S and <i>GBA1</i> carriers.","authors":"Orly Goldstein, Shachar Shani, Mali Gana-Weisz, Nadav Elkoshi, Fergal Casey, Yu H Sun, Khyati Chandratre, Jesse M Cedarbaum, Cornelis Blauwendraat, Anat Bar-Shira, Avner Thaler, Tanya Gurevich, Anat Mirelman, Nir Giladi, Avi Orr-Urtreger, Roy N Alcalay","doi":"10.1177/1877718X241310722","DOIUrl":"10.1177/1877718X241310722","url":null,"abstract":"<p><p>BackgroundWhile <i>LRRK2</i> and <i>GBA1</i> variants are associated with Parkinson's disease (PD), most carriers will not develop the disease.ObjectiveTo test if polygenic risk score (PRS) modifies disease risk and phenotypes in <i>LRRK2</i> G2019S carriers, <i>GBA1</i> carriers, and non-carriers (NC).MethodsWe genotyped 786 participants using Illumina's NeuroBooster-array (NBA) and sequenced the genome of 244, all of Ashkenazi ancestry (AJ), and calculated PRS to test its effects on clinically- and biologically-defined disease risk and phenotypes (n = 715). Among <i>LRRK2</i> G2019S PD, we tested PRS association with α-synuclein seed-amplification-assay (n = 11). We used the PPMI and AMP-PD databases as validation cohorts.ResultsIn clinically-defined PD, PRS significantly modified disease risk in <i>GBA1</i> carriers and in NC (<i>p </i>= 0.033 and <i>p </i>< 0.0001, respectively), and demonstrated a trend in <i>LRRK2</i> G2019S carriers (<i>p </i>= 0.054), with similar effect sizes (OR = 1.55, 1.62, and 1.49, respectively). PRS association with PD risk in <i>LRRK2</i> was primarily driven by the rs7938782-A risk allele, replicated in AMP-PD (268 AJs <i>LRRK2</i> G2019S carriers). PRS and age-at-onset were negatively correlated in NC (<i>p </i>< 0.0001). NBA <i>GBA1</i> genotype calls failed at <i>GBA1</i> L483P and c.115 + 1G > A mutations. False negative call rate of 10.2% was observed for the imputed <i>GBA1</i> N409S carriers.ConclusionsPRS contributes to PD risk across different genotypes. The genetic and epigenetic role of rs7938782 in <i>LRRK2</i> PD risk should be further explored. Future PRS models should be tailored to specific genotypes to better understand penetrance and phenotypes. Furthermore, models predicting PD defined biologically rather than clinically may further identify genetic risk factors for synucleinopathies.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"291-299"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458336","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":"The impact of motor, non-motor, and social aspects on the sexual health of women living with Parkinson's disease.","authors":"Kátia Cirilo Costa Nóbrega, Isaíra Almeida Pereira da Silva Nascimento, Bruno Rafael Antunes Souza, Raíssa Amorim Gonçalves, Thalyta Silva Martins, Geovanna Ferreira Santos, Bruno Eron de Almeida da Silva, André Helene Frazão, Antônio Carlos Roque, Rodolfo Savica, Maria Elisa Pimentel Piemonte","doi":"10.1177/1877718X251315375","DOIUrl":"10.1177/1877718X251315375","url":null,"abstract":"<p><p>BackgroundSexual health is influenced by a complex interplay of biological, psychological, and social factors, all of which can be impacted by Parkinson's disease (PD). Female sexual dysfunction includes reduced sexual desire and/or arousal, pain during sexual activity, or difficulty achieving orgasm. Despite its impact on quality of life, sexual health in women with PD remains poorly understood.ObjectiveTo investigate the impact of motor, non-motor, and social PD aspects on sexual health of women with PD.MethodsWe conducted a cross-sectional study with 100 women with PD (Hoehn and Yahr stages 1-3) who reported an active sex life in the last six months. Data were collected via remote interviews and included demographic and clinical features, cognitive capacity, motor and non-motor experiences, fatigue, self-esteem, sleep disorders, couple relationship quality, depressive symptoms, and sexual health assessments using the Female Sexual Function Index (FSFI) and Sexual Quotient-Female (SQ-F). Multiple regression models were used to identify predictors of FSFI and SQ-F scores.ResultsResults indicated that while several motor, non-motor, and social factors correlated with sexual health, only couple relationship quality and sleep quality significantly predicted both short-term (FSFI) and long-term (SQ-F) sexual health. No significant associations were observed with age, disease onset, postmenopausal status, or daily medication dosage.ConclusionsThe present study's evidence identifies multiple key areas, such as couple's relationship quality and sleep quality that could be targeted for intervention to improve sexual health in women with PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"421-433"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492389","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":"Narrow-based gait in people with Parkinson's disease: Its mechanisms explored.","authors":"Jamie Af Jansen, Tom Jw Buurke, Lotte van de Venis, Vivian Weerdesteyn, Noël Keijsers, Jorik Nonnekes","doi":"10.1177/1877718X241313333","DOIUrl":"10.1177/1877718X241313333","url":null,"abstract":"<p><p>BackgroundPeople with Parkinson's disease (PD) typically exhibit a narrow-based gait. We previously found that walking with reduced trunk rotation and obliquity led to narrow-based gait in healthy adults; a decrease in trunk motion coincided with a decrease in mediolateral extrapolated center of mass (XCoM) excursion, requiring a smaller step width to maintain a constant mediolateral margin of stability (MoS).ObjectiveTo assess whether reduced trunk motion in PD is related to narrow-based gait, without affecting mediolateral MoS. To explore the underlying mechanisms of narrow-based gait, we examined the effects of increasing arm swing (aiming to increase trunk motion), and widening steps on gait in PD.MethodsFifteen people with PD and narrow-based gait and 17 age-matched controls walked on a treadmill for three minutes at a fixed gait speed during three conditions: baseline, increased arm swing and widened step width. Step width, trunk rotation and obliquity were calculated using marker data, and XCoM excursion and MoS using ground reaction forces.ResultsTrunk rotation, XCoM excursion, and step width were significantly smaller in PD compared to controls, while the MoS did not differ. Increased arm swing did not substantially increase trunk motions in PD, though people with PD were able to widen their step width.ConclusionsWe provide further evidence for a relation between trunk motion and step width. In PD, reduced trunk motion may contribute to narrow-based gait, without affecting mediolateral MoS; future work is needed to confirm a causal relationship between reduced trunk motion and narrow-based gait in PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"329-337"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458489","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":"<i>Lactobacillaceae</i> and Parkinson's disease: An apparent paradox.","authors":"Marieke Me van der Maden, Marcel M Verbeek, Milan Beckers","doi":"10.1177/1877718X241312401","DOIUrl":"10.1177/1877718X241312401","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a neurodegenerative disorder predominantly known for its motor symptoms such as bradykinesia, rigidity and tremor, but the disorder is also increasingly recognized for its association with impaired gastrointestinal function. The composition of the gut microbiome is known to be different in PD compared with healthy individuals. One of the bacterial families with increased abundance in people with PD is <i>Lactobacillaceae</i>. Interestingly, opposite effects have been ascribed to <i>Lactobacillaceae</i> in PD. A number of studies have linked <i>Lactobacillaceae</i> spp. in the gut to worse motor function, and to premature degradation of levodopa. However, other studies have linked administration of <i>Lactobacillaceae</i>-containing probiotics to improved motor function and reduced gastrointestinal problems. In this narrative review, we investigate this apparent paradox. The key to its understanding appears to lie in the specific species of <i>Lactobacillaceae</i>. The species <i>L. plantarum</i> in particular seemed to show a correlation with improved motor symptoms, as well as a reduction in intestinal inflammation, whereas <i>L. brevis, L. curvatus</i> and <i>L. fermentum</i> have properties that might be detrimental to people with PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"269-281"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458444","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":"Saccade, pupil, and blink abnormalities in prodromal and manifest alpha-synucleinopathies.","authors":"Maha Habibi, Brian C Coe, Donald C Brien, Jeff Huang, Heidi C Riek, Frank Bremmer, Lars Timmermann, Annette Janzen, Wolfgang H Oertel, Douglas P Munoz","doi":"10.1177/1877718X241308193","DOIUrl":"10.1177/1877718X241308193","url":null,"abstract":"<p><p>BackgroundSaccade, pupil, and blink control are impaired in patients with α-synucleinopathies (αSYN): Parkinson's disease (PD) and multiple system atrophy (MSA). Isolated REM (rapid eye movement) Sleep Behavior Disorder (iRBD) is a prodromal stage of PD and MSA and a prime candidate for investigating early oculo-pupillo-motor abnormalities that may precede or predict conversion to clinically manifest αSYN.ObjectiveDetermine whether saccade, pupil, and blink responses in iRBD are normal or similar to those identified in PD and MSA.MethodsVideo-based eye-tracking was conducted with 68 patients with iRBD, 49 with PD, 17 with MSA, and 95 healthy controls (CTRL) performing an interleaved pro-/anti-saccade task that probed sensory, motor, and cognitive processes involved in eye movement control.ResultsHorizontal saccade and blink behavior was intact in iRBD, but abnormal in PD and MSA. iRBD patients, however, demonstrated reduced pupil dilation size, which closely resembled the changes found in PD and MSA. In the iRBD group, the extent of these pupillary changes appeared to correlate with the degree of hyposmia and reduction in dopamine transporter imaging signal.ConclusionsPupil abnormalities were present in iRBD, but blink and horizontal saccade responses were intact. Future longitudinal studies are required to determine which prodromal pupil abnormalities predict conversion from iRBD to PD or MSA and to identify the time window, in relation to conversion, when horizontal saccade responses become abnormal.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"300-310"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458356","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 6 months of endurance exercise on motor function, exercise capacity, and autonomic function based on presence of autonomic dysfunction in individuals with early Parkinson's disease.","authors":"Garett J Griffith, Niyati Mehta, Guillaume Lamotte, Kathleen E McKee, Erin Suttman, Jacob M Haus, Elizabeth Joslin, Katherine Balfany, Wendy M Kohrt, Cory L Christiansen, Edward L Melanson, Lana M Chahine, Demetra D Christou, Charity G Patterson, Daniel M Corcos","doi":"10.1177/1877718X241308813","DOIUrl":"10.1177/1877718X241308813","url":null,"abstract":"<p><p>BackgroundEndurance exercise improves aerobic capacity (VO_2peak) and motor symptoms in people with early Parkinson's disease (PD). Some people with PD exhibit signs of chronotropic incompetence (CI), which may impact exercise-induced benefits.ObjectiveWe investigated whether CI in people with early PD influences the change in motor signs, VO_2peak, and peak heart rate (HR) following 6 months of endurance exercise.MethodsWe performed secondary analyses of the Study in Parkinson's Disease of Exercise (SPARX), which randomized people with early PD into a high-intensity endurance exercise [80-85% of peak HR], moderate-intensity endurance exercise [60-65% of peak HR], or usual care group. MDS-UDPRS Part 3 score, VO_2peak, and heart rate (HR) response to maximal cardiopulmonary exercise testing (CPET) were analyzed at baseline and following 6 months of exercise. Participants were divided into three groups: 1) normal chronotropic response at baseline, 2) CI at baseline, and 3) taking medications with a known negative chronotropic effect regardless of CI status.ResultsData from 119 individuals (64.0 ± 9.0 years, 57.1% male, 0.3 years since diagnosis [median]) were analyzed. There were no differences among the groups in change in MDS-UPDRS motor score (<i>p </i>= 0.953), VO_2peak (<i>p </i>= 0.965), or peak HR (<i>p </i>= 0.388). People randomized into the high-intensity group improved VO_2peak compared to usual care (<i>p </i>< 0.001_adj) regardless of CI status.ConclusionsBaseline CI did not alter responses to endurance exercise in those with early PD, suggesting that the beneficial effects of endurance exercise on disease progression and VO_2peak in people with early PD apply equally to people with CI.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"387-396"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458486","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":"Two-year feasibility and safety of open-label autologous peripheral nerve tissue implantation during deep brain stimulation in patients with Parkinson's disease.","authors":"Jorge E Quintero, Monica J Chau, John T Slevin, Lisa Koehl, Julie A Gurwell, Elizabeth Wallace, Richard J Kryscio, Riham El Khouli, Amelia J Anderson-Mooney, Frederick A Schmitt, Greg A Gerhardt, Craig G van Horne","doi":"10.1177/1877718X241312409","DOIUrl":"10.1177/1877718X241312409","url":null,"abstract":"<p><p>BackgroundMotor dysfunction in Parkinson's disease (PD) is characterized by a loss of functioning neurons in the substantia nigra. Two options exist when encountering damaged neurons: replace or support. We implemented a strategy of using autologous peripheral nerve tissue, in a reparative state, to provide a collection of neurorestorative support to unhealthy neurons with the goal of modifying the motor progression of PD.ObjectiveReport on two-year compliance feasibility, safety, and clinical experience of combining this delivery at the time of deep brain stimulation (DBS) surgery.MethodsParticipants with PD undergoing open-label peripheral nerve tissue implantation to the substantia nigra at the time of DBS surgery were followed from pre-surgery to two years after surgery through clinical evaluations.ResultsSeventeen of 18 participants who underwent the procedure completed the 2-year study visits. No study-related serious adverse events occurred.ConclusionsThe trial met its primary endpoints of feasibility and safety. We were able to practicably and safely implant participants and have participants comply with 2-year visits and exams. Adverse events related to study participation were deemed manageable by participants.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"397-408"},"PeriodicalIF":4.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501848","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":"A perspective of persons with Parkinson's disease on the contribution of alpha-synuclein seed amplification assay biomarker to the diagnosis of Parkinson's disease.","authors":"Susanne Bowen, David Blacker, Richard Prettyman","doi":"10.1177/1877718X251315651","DOIUrl":"https://doi.org/10.1177/1877718X251315651","url":null,"abstract":"<p><p>Alpha-synuclein is a normal protein, but misfolded forms in the cerebrospinal fluid can be detected using the alpha-synuclein seed amplification assay (αSyn-SAA), a potential biomarker for Parkinson's disease (PD). Some experts consider this assay a 'game changer' for redefining and reclassifying PD. In this article, we, three individuals with PD, share our perspective on the suitability of αSyn-SAA as the basis for a new classification and staging system for PD. We also discuss other biomarkers and their relevance to those with PD, drawing on our research and the scientific background of two authors. We aim to clarify complex media reports and study findings for the PD community. We argue that while αSyn-SAA can identify the presence of pathology, it cannot explain the underlying cause for such pathology or predict the progression of PD. Given the varied biological pathways leading to PD, using αSyn-SAA as a unified biological definition for a new classification system is premature. Further research is needed before it can serve as the foundation for defining and staging Parkinson's disease. Although αSyn-SAA has its place, like the DAT scan, it should be seen as a tool for confirming diagnoses rather than defining them.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251315651"},"PeriodicalIF":4.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458445","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}