Parkinson's Disease最新文献

{"title":"Quantitative Evaluation of Respiratory Dysfunction and Its Relationships With Parkinson's Disease Symptoms.","authors":"A A Pilipovich, O V Vorob'eva, S A Makarov, N N Shindryaeva","doi":"10.1155/padi/9026870","DOIUrl":"https://doi.org/10.1155/padi/9026870","url":null,"abstract":"<p><p>Respiratory disorders significantly impair functional baseline and quality of life (QoL) in Parkinson's disease (PD). This cross-sectional study aimed to evaluate spirographic lung function parameters in PD and determine their relationships with motor and nonmotor symptoms, QoL, and dopaminergic therapy. Spirometric parameters were recorded in 57 outpatients with PD and 10 healthy controls. PD patients underwent clinical assessments using UPDRS Parts II and III, Schwab and England scale, PDQ-39, and PFS-16. Spirometric analysis revealed significant decreases in VC %pred in PD patients versus controls, and in FVC %pred in PD Stage III versus PD Stage II. Decreased lung function correlated with H&Y stage (VC, FVC, FEV₁) and showed inverse correlations with UPDRS Parts II and III scores, most pronounced for axial-locomotor impairments (posturing, gait, stability, arising from chair) and bradykinesia. PFS-16 fatigue index inversely correlated with FEV₁ and PEF. Worse QoL (PDQ-39 summary index, emotional well-being, and cognition domains) was primarily coupled with decreased expiratory flow rates (FEV₁, PEF). Untreated PD patients exhibited significantly lower FVC%pred, FEV₁%pred, FEF₇₅%pred, and Tiffeneau index than those on dopaminergic therapy. This study demonstrates the presence of respiratory dysfunction in PD Stages II and III and its negative association with QoL. The results highlight the relationship between lung function decline and overall PD progression, with the strongest associations revealing the most significant contribution of postural abnormalities, bradykinesia, and pathological fatigue. Furthermore, the obtained data suggest a potential compensating role of dopaminergic therapy.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"9026870"},"PeriodicalIF":2.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Relative Fat Mass and Parkinson's Disease in American Adults: A Large Cross-Sectional Study From NHANES.","authors":"Quanhong Chu, Wenfeng Cao","doi":"10.1155/padi/2954515","DOIUrl":"10.1155/padi/2954515","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have sought to investigate the link between obesity and Parkinson's disease (PD), yielding conflicting results. Relative fat mass (RFM) is a novel obesity indicator, yet its association with PD in American adults remains unexplored. This study was designed to explore the potential relationship between RFM and PD in American adults aged 40 and older.</p><p><strong>Methods: </strong>In the present study, we ultimately included 26, 029 participants from the NHANES (1999-2018). In order to evaluate the association between RFM and PD in American adults aged 40 and older, we performed multivariate logistic regression analysis, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis. Furthermore, we conducted receiver operating characteristic (ROC) curve analysis to evaluate the predictive performance of RFM for PD.</p><p><strong>Results: </strong>Of the 26, 029 participants who were included in the study, 245 participants (0.94%) were identified as having PD. After full adjustment for confounding variables, the multivariate models demonstrated a significant positive association between RFM and PD (odds ratio [OR] = 1.40; 95% confidence interval [CI] = 1.11 - 1.77). Specifically, participants in the highest RFM quartile (Q4) had a significantly higher prevalence of PD compared with those in the lowest quartile (Q1) in model II (OR = 2.71, 95% CI: 1.48-4.96). Additionally, subgroup analyses demonstrated that the positive correlation between RFM and PD was significantly more prominent in individuals under the age of 60 (<i>p</i> for interaction < 0.05). Finally, ROC curve analysis showed that RFM yielded a higher AUC value of 0.612 in participants under the age of 60.</p><p><strong>Conclusions: </strong>This study is the first to demonstrate a positive linear association between RFM and PD among American adults aged 40 and older.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"2954515"},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Safinamide as an Adjunct to Levodopa for Motor Fluctuations in Parkinson's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ali Abdelhaleem Omar Ahmed, Omer Abdalhaleem Omer Ahmed, Afrah S Dishean, Collins Gilbert, Malaz Mohsin Anbar Sabah Elkheir, Henry A Sota, Mohamed Adil Mubarak Abdulaziz, Eman Yasir Mohamed Mahmoud, Rana Abdelhaleem Omar Ahmed","doi":"10.1155/padi/9352886","DOIUrl":"10.1155/padi/9352886","url":null,"abstract":"<p><strong>Background: </strong>Motor fluctuations often occur with long-term levodopa treatment in Parkinson's disease (PD). Safinamide is a drug that inhibits monoamine oxidase B (MAO-B) and modulates glutamate. It is used together with levodopa. A summary of the latest evidence is needed to assess its effectiveness and safety.</p><p><strong>Objective: </strong>To assess the effectiveness and safety of safinamide as an additional therapy to levodopa for motor fluctuations in PD.</p><p><strong>Methods: </strong>A systematic review and meta-analysis followed PRISMA guidelines. A thorough literature search was done from the beginning until January 2026 across PubMed, Scopus, the Cochrane Central Register of Controlled Trials, and Google Scholar. We included randomized controlled trials (RCTs) that compared safinamide (100 mg/day) to placebo as an addition to levodopa in adults with PD and motor fluctuations. The primary effectiveness outcomes were the change in daily OFF-time (in hours) and the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score. The main safety outcome was the occurrence of dyskinesia. We assessed the risk of bias using the Cochrane RoB 2 tool. Data were combined using random-effects models, with results shown as mean difference (MD) or risk ratio (RR) with 95% confidence intervals (CIs). We evaluated the certainty of evidence using GRADE. The protocol was registered with PROSPERO (CRD420261298124).</p><p><strong>Results: </strong>Three RCTs (<i>N</i> = 1127 participants) were included. Safinamide 100 mg significantly reduced daily OFF-time compared to placebo, with an MD of -1.21 h (95% CI: -1.60 to -0.82; <i>I</i> ² = 39%; moderate certainty). It also significantly improved motor function, as shown by the UPDRS-III MD of -3.13 points (95% CI: -4.89 to -1.37; <i>I</i> ² = 72%; low certainty). However, safinamide increased the risk of dyskinesia, with a RR of 3.01 (95% CI: 1.92 to 4.70; <i>I</i> ² = 0%; moderate certainty). In a secondary analysis of the Hattori trial's 50 mg arm (<i>n</i> = 131), safinamide 50 mg reduced OFF-time by -1.25 h (95% CI: -1.92 to -0.58) and improved the UPDRS-III by -4.06 points (95% CI: -5.54 to -2.59). This effect was smaller for OFF-time compared to the 100-mg dose, suggesting a potential dose-response relationship that warrants further investigation.</p><p><strong>Conclusion: </strong>Safinamide 100 mg per day appears to be a helpful addition to levodopa for reducing OFF-time and improving motor function in PD patients with motor fluctuations. However, this benefit comes with a higher risk of dyskinesia, so careful patient selection and monitoring are important. The 50-mg dose shows similar but less pronounced effects, supporting 100 mg as the preferred dose. Further research is needed to confirm these findings.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"9352886"},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral <i>HMGB1</i> Downregulation Is Associated With the S100-IL-17 Axis in Parkinson's Disease: An Integrated Bulk and Single-Cell Transcriptomic Analysis.","authors":"Shuning Wang, Hang Shi, Xiangjun Meng, Hui Zhu","doi":"10.1155/padi/2128634","DOIUrl":"https://doi.org/10.1155/padi/2128634","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence implicates peripheral immune dysregulation in the pathogenesis of Parkinson's disease (PD). High-mobility group box 1 (HMGB1), a key alarmin released during mitochondrial stress, has been reported to be upregulated in the peripheral blood of PD patients, yet its precise role remains unclear.</p><p><strong>Methods: </strong>We performed an integrated analysis of multiple transcriptomic datasets from peripheral blood mononuclear cells (PBMCs) of PD patients. Using a combination of methods including machine learning, cell-cell communication analysis, in silico gene perturbation, and pathway enrichment analysis, we systematically investigated the expression and regulation of <i>HMGB1</i> in peripheral immune cells in PD.</p><p><strong>Results: </strong>We found that <i>HMGB1</i> mRNA expression was significantly downregulated in PBMCs from PD patients. A machine learning model identified <i>HMGB1</i> as a potential predictive signature (AUC = 0.685). Single-cell transcriptomic analysis revealed immune cell heterogeneity and identified CD8⁺ T and CD4⁺ T cells as central hubs in the cellular communication network. In silico perturbation analysis suggested that <i>HMGB1</i> may be associated with the expression of <i>S100A8</i> and <i>S100A9</i>, which are enriched in the IL-17 signaling pathway. Drug enrichment analysis identified potential therapeutic agents, including TPEN, hydrocotarnine, and phorbol 12-myristate 13-acetate.</p><p><strong>Conclusion: </strong>Our analysis revealed a distinct downregulation of <i>HMGB1</i> within the peripheral immune compartment of PD, a change that was decoupled from the overall proinflammatory state. Observing the concomitant upregulation of the S100 gene family and activation of the IL-17 pathway, we propose a putative pathogenic axis based on computational findings: <i>HMGB1</i> downregulation is linked to S100 gene family upregulation and IL-17 pathway activation.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"2128634"},"PeriodicalIF":2.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating PINK1 Parkinson's Disease: Narratives of Pacific Patients and Caregivers.","authors":"Fuafiva Fa'alau, Atefeh Kiadarbandsari, Miraneta Foroti, Richard Roxburgh, Christina M Buchanan","doi":"10.1155/padi/4024943","DOIUrl":"10.1155/padi/4024943","url":null,"abstract":"<p><p>Parkinson's disease in its common form is a sporadic disease of older age affecting men more than women, with onset after the age of 60 years. However, Parkinson's disease, caused by variants in the PINK1 gene, affects males and females equally and causes early-onset Parkinson's disease. Furthermore, although it is rare elsewhere in the world, it is relatively common among Pacific populations, where carrier rates can reach 1 in 18 for a specific variant. All these differences between PINK1 Parkinson's disease and typical Parkinson's disease would be expected to affect people differently; however, the understanding of how this form of Parkinson's disease affects Pacific peoples is limited. Exploring the lived experiences of people with PINK1 Parkinson's disease and their caregivers is essential for informing culturally responsive care. We employed a specific Pacific qualitative research approach called Talanoa, which is centred on storytelling and open dialogue sessions, to explore the experiences of Pacific people with PINK1 Parkinson's disease and their caregivers. Data were analysed thematically. We studied 16 participants (11 patients and 5 caregivers). Two main themes were identified: <i>Adaptation Struggles</i> and <i>Positive Adaptation</i>. <i>Adaptation Struggles</i> captured personal (e.g., impaired mental state and medication management), social (e.g., progressive disengagement from social and community life), cultural (e.g., stigma and the mismatch between cultural beliefs and biomedical perspectives of Parkinson's disease) and systemic challenges (e.g., limited awareness and unmet needs). <i>Positive Adaptation</i> reflected participants' efforts towards normalisation and reliance on support networks such as family, church and community. Enhancing services and awareness of PINK1 Parkinson's disease through culturally responsive care delivered by healthcare providers and health workers can facilitate early detection, improve medical management and enhance psychosocial well-being. Collaboration among researchers, clinicians and Pacific communities is vital to reducing diagnostic delays and improving long-term outcomes.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"4024943"},"PeriodicalIF":2.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of Burden Among Caregivers of Latinos Living With Parkinson's Disease.","authors":"Nicholas Renteria, Melissa N Pacheco, Alejandra Pawlak, Gwenevere Zuniga, Maria M Santos, Jacob D Jones","doi":"10.1155/padi/7714405","DOIUrl":"10.1155/padi/7714405","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease (PD) often leads to significant motor and nonmotor impairments, including immobility, dementia, and depression. These challenges can require the involvement of caregivers to manage the needs of individuals with PD. However, the demands placed on caregivers can lead to neglect of their own well-being, resulting in psychological and physical strain, also known as caregiver burden. Therefore, the present study explores the experiences of caregivers of Latinos with PD and examines the association between caregiver burden, unmet emotional needs, coping strategies, and caregiver-perceived motor experiences of daily living in the individual living with PD.</p><p><strong>Methods: </strong>Caregivers (<i>N</i> = 56) of Latinos living with PD completed validated measures, including the Zarit Burden Interview (ZBI) to measure caregiver burden, the Movement Disorder Society Unified PD Rating Scale Part II (MDS-UPDRS Part II) to measure caregiver-perceived motor experiences of daily living, the Brief Coping Orientation to Problem Experienced (Brief-COPE) to assess caregiver's coping strategies, and the Support Person's Unmet Needs Survey (SPUNS) short form to assess unmet caregiver needs. Analyses are cross-sectional and correlational.</p><p><strong>Results: </strong>Results found that greater caregiver burden was most strongly associated with more unmet emotional needs, followed by greater utilization of problem-focused coping strategies and greater caregiver-perceived functional motor impact. Caregiver burden was not correlated with care recipient's age.</p><p><strong>Conclusion: </strong>Findings suggest that caregivers of Latinos living with PD commonly experience mild-to-moderate amounts of caregiver burden, which is associated with a combination of caregiver-centric (e.g., coping strategies and unmet needs) and patient-centric (e.g., caregiver-perceived motor experiences of daily living) variables.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"7714405"},"PeriodicalIF":2.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric Analysis of Research Trends and Key Areas Related to the Relationship Between Parkinson's Disease and Exercise Therapy.","authors":"Zengkun Fang, Shuang Zeng, Dingwen Xu, Huachun Liu","doi":"10.1155/padi/2781558","DOIUrl":"10.1155/padi/2781558","url":null,"abstract":"<p><strong>Background: </strong>Exercise therapy is recognized as a crucial method that can markedly improve outcomes for individuals with Parkinson's Disease. Research on exercise therapy and Parkinson's Disease is steadily increasing; however, a bibliometric analysis in this field is currently lacking. This study applies bibliometric methods to identify trends and hotspots in research related to Parkinson's Disease and exercise therapy.</p><p><strong>Methods: </strong>Data collection comprised articles relevant to Parkinson's Disease and exercise therapy, which were sourced from the Web of Science core collection for the period between January 1, 2004, and December 31, 2024. The collected literature was subsequently analyzed using a suite of bibliometric tools, including Excel, VOSviewer, and CiteSpace. Additionally, text mining was carried out via Coremine to identify significant correlations among key terms within this research domain.</p><p><strong>Results: </strong>The volume of articles on Parkinson's Disease and exercise therapy has increased yearly, with a notable surge after 2019. The top three countries contributing to this volume are the United States, Italy, and China. The leading institutions in publication output are Radboud University Nijmegen, the University of Sydney, and Northwestern University. The 10 most frequent keywords include Parkinson's Disease, exercise, rehabilitation, people, gait, balance, quality of life, physical therapy, therapy, and motor. Keywords such as telemedicine, telehealth, neurodegeneration, telerehabilitation, and wearable sensors represent current hotspots in this area of research.</p><p><strong>Conclusion: </strong>This study utilizes bibliometric techniques to perform an objective, quantitative assessment of the literature pertaining to Parkinson's Disease and exercise therapy. It outlines the current research landscape, pinpoints emerging hotspots, and addresses prevailing challenges, thereby offering valuable insights to guide and improve the focus and efficacy of subsequent studies.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"2781558"},"PeriodicalIF":2.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Loss of Balance to Understand Postural Instability Associated With Parkinson's Disease.","authors":"Ryan D Kaya, Andrew Bazyk, Colin Waltz, Eric Zimmerman, Joshua D Johnston, Benjamin L Walter, Adam Margolius, Anson B Rosenfeldt, Mandy Miller Koop, Jay L Alberts","doi":"10.1155/padi/6998888","DOIUrl":"10.1155/padi/6998888","url":null,"abstract":"<p><strong>Background/objectives: </strong>Postural instability compromises balance, contributing to annual fall rates of 45%-68% in Parkinson's disease (PD). A fundamental gap in clinical evaluation and treatment of postural instability is the use of insufficiently challenging postural control tests and reliance on subjective scoring. Traditional 3D motion capture (Traditional-MC), while precise and objective, is not feasible for clinical utilization. Markerless motion capture (MMC) is a viable candidate for quantifying postural control, feasible with embedded cameras of augmented reality (AR) headsets. This project aimed to assess MMC accuracy in quantifying postural control and to compare PD patients and healthy controls (HCs) to develop a loss-of-balance (LOB) prediction model.</p><p><strong>Methods: </strong>Video data were acquired by a clinician wearing a Microsoft HoloLens 2 AR headset as participants completed three progressively challenging postural control stances. Depth and red-green-blue camera data were analyzed with our custom-built human pose estimation software (CART-MMC). Criterion validity between Traditional-MC and CART-MMC was completed on outcomes, 95% ellipsoid sway area (Sway area) and 95% mediolateral and anteroposterior (ML and AP) ranges in 54 (HC = 28, PD = 26) participants. Group differences were assessed, and survival analysis was conducted to quantify no LOB probabilities in 31 HCs and 68 PD patients. A relaxed LASSO model was used to predict LOB in the PD group from CART-MMC data.</p><p><strong>Results: </strong>Sway area and ML range from CART-MMC were equivalent to Traditional-MC. Furthermore, ML range from CART-MMC differentiated PD patients from HCs in the stance that had the highest completion rate. As postural task difficulty increased, fewer PD patients were able to complete compared to HCs, resulting in lower survival probabilities of the PD group in Tandem-Firm-EO and FT-Foam-EC stances. In the least challenging stance, ML range predicted the occurrence of LOB in the more challenging stance (LOO-CV AUC = 0.78).</p><p><strong>Conclusions: </strong>CART-MMC is a valid method of obtaining objective postural control outcomes, which can detect latent postural control deficits and demonstrates a scalable, objective clinical and remote monitoring approach for predicting falls.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"6998888"},"PeriodicalIF":2.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the Medicine-Related Priorities for People With Parkinson's During Hospitalisation: A Systematic Review Using Meta-Ethnography.","authors":"Anna Delf, David Wright","doi":"10.1155/padi/8428752","DOIUrl":"10.1155/padi/8428752","url":null,"abstract":"<p><strong>Background: </strong>People with Parkinson's (PwP) experience disproportionately higher rates of hospitalisation, where they encounter many medication-related challenges. Although interventions have been developed to address these issues, medication-related problems persist, and the patient's voice is largely absent from their design.</p><p><strong>Objectives: </strong>To explore medication-related priorities during hospitalisation from the perspective of PwP to inform the development of future patient-led interventions.</p><p><strong>Methods: </strong>A systematic review using meta-ethnography was conducted and registered with PROSPERO. A SPICE-informed search (Setting, Perspective, Intervention, Comparison, Evaluation) was undertaken across MEDLINE, PsycINFO, CINAHL, Embase and Google Scholar in June 2025. Eligible qualitative and mixed-method studies explored the perspectives of PwP regarding inpatient medication-related care. Two reviewers independently screened studies using Covidence. First- and second-order constructs were synthesised into third-order constructs representing medication-related priorities. Reporting followed Enhancing Meta-Ethnography Reporting Guidance (eMERGe), and methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist.</p><p><strong>Results: </strong>Four studies met the inclusion criteria. Four overarching themes reflected the core medication-related priorities of PwP during hospitalisation: timely and accurate medication administration, autonomy, access to skilled and knowledgeable staff, and advocacy to support patient needs. These priorities informed the development of an interpretive conceptual framework illustrating the interaction between PwP medication-related priorities and hospital systems.</p><p><strong>Conclusions: </strong>Findings suggest the need to strengthen systems supporting timely medication administration, enable self-administration where appropriate, promote flexibility and person-centred care, and implement Parkinson's clinical champions to advocate for and support PwP throughout hospitalisation.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"8428752"},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's Disease: Immunometabolic Control Points Across Neural, Vascular, and Peripheral Systems.","authors":"Y Narvaez Irizarry Felix, M Bermudez Adorno Alondra, Ermolinsky Boris, Kucheryavykh Lilia, Inyushin Mikhail","doi":"10.1155/padi/5349481","DOIUrl":"10.1155/padi/5349481","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a progressive neurodegenerative disorder most associated with degeneration of dopaminergic neurons in the substantia nigra pars compacta. Increasing clinical and experimental evidence, however, indicates that PD is a multisystem disease in which immune, metabolic, vascular, and peripheral nervous system dysfunction precede and shape motor circuit failure. Nonmotor manifestations, including olfactory impairment, sleep and autonomic disturbances, gastrointestinal dysfunction, and cognitive decline, often arise years before motor diagnosis, highlighting pathogenic mechanisms beyond dopamine deficiency alone. In this review, we synthesize evidence supporting the view that PD represents a disorder of chronic immunometabolic dysregulation rather than isolated neuronal loss. We focus on underestimated but high-impact immunological control points that integrate central and peripheral disease mechanisms, including environmental and microbial immune priming, gut-brain axis interactions, platelet-mediated inflammatory signaling, amyloid-β (Aβ) as an innate immune peptide, immune checkpoint regulation via the PD-1/PD-L1 axis, and nicotinamide adenine dinucleotide (NAD⁺) homeostasis governed by nicotinamide phosphoribosyltransferase (NAMPT). Recent pharmacological evidence further supports this framework, as metabolic interventions that improve systemic energy balance and reduce inflammation have also demonstrated neuroprotective effects in experimental models, reinforcing the concept that immunometabolic pathways are therapeutically actionable. Motor impairment in PD arises from basal ganglia network dysfunction, accompanied by pathological beta-band synchronization, which is increasingly linked to neuroinflammation and metabolic stress. In parallel, platelet activation during inflammation and vascular injury releases amyloid precursor protein and Aβ, linking systemic immune activation to neurovascular signaling. Clinical observations from immune checkpoint inhibitor therapy demonstrate that disruption of PD-1/PD-L1 signaling can lead to Parkinsonism and neuroinflammatory syndromes, underscoring the importance of immune restraint in neural homeostasis. Finally, we highlight NAMPT-dependent NAD⁺ salvage as an important immunometabolic hub integrating energy metabolism, inflammation, and neuronal survival. Together, these findings support a unifying framework in which PD reflects failure of immunometabolic control across neural and peripheral systems, suggesting new avenues for disease-modifying therapeutic strategies beyond symptomatic dopamine replacement.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2026 ","pages":"5349481"},"PeriodicalIF":2.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}