Parkinson's DiseasePub Date : 2022-07-11eCollection Date: 2022-01-01DOI: 10.1155/2022/9755129
Yongde Zhou, Ting Fan, Yu Ma, Jian Ding, Jianfeng Yu, Yao Chen, Cuiping Yu, Rongsong Zhou, Baoguo Wang, Chengmei Shi
{"title":"Association between Baseline Cognitive Score and Postoperative Delirium in Parkinson's Disease Patients following Deep Brain Stimulation Surgery.","authors":"Yongde Zhou, Ting Fan, Yu Ma, Jian Ding, Jianfeng Yu, Yao Chen, Cuiping Yu, Rongsong Zhou, Baoguo Wang, Chengmei Shi","doi":"10.1155/2022/9755129","DOIUrl":"https://doi.org/10.1155/2022/9755129","url":null,"abstract":"<p><strong>Background: </strong>Deep brain stimulation of the subthalamic nuclei (STN-DBS) is a standard treatment option for advanced Parkinson's disease (PD) patients. Delirium following DBS electrode implantation is common, by several studies, and cognitive impairment is a risk factor for developing postoperative delirium (POD). This prospective observational study was conducted to identify whether preoperative baseline cognitive status has an association with POD in PD patients undergoing DBS surgery.</p><p><strong>Methods: </strong>Preoperatively, neuropsychiatric and neuropsychological assessments of the patients were performed including clinical dementia rating (CDR) score, instrumental activities of daily living (IADL) score, mini-mental state exam (MMSE) score, Montreal cognitive assessment (MoCA) score, Hamilton anxiety (HAMA) and Hamilton depression (HAMD) scores, and numerical cancellation test. POD was identified by the confusion assessment method (CAM) twice per day on postoperative day 1 until discharge.</p><p><strong>Results: </strong>Twenty-seven (21.6%) of 125 patients developed POD. Among the variables screened, age, CDR score, MMSE score, and HAMA score were indicated to be independent influence factors of POD. The cutoff score, AUC, sensitivity, and specificity of age, CDR score, MMSE score, and HAMA score associated with POD was 58.5, 0.751, 92.6%, 52.0%; 0.5, 0.848, 77.8%, 91.8%; 27.5, 0.827, 88.9%, 62.2%; and 12.5, 0.706, 85.2%, 54.1%, respectively.</p><p><strong>Conclusions: </strong>We observed age, CDR score, MMSE score, and HAMA score were independent influence factors of POD in PD patients who received DBS. It is necessary to assess the cognitive status of PD patients before surgery to identify high-risk patients.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"9755129"},"PeriodicalIF":3.2,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40469484","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}
Parkinson's DiseasePub Date : 2022-07-08eCollection Date: 2022-01-01DOI: 10.1155/2022/9291077
Brady T Mannett, Braden C Capt, Krista Pearman, Lori M Buhlman, John M VandenBrooks, Gerald B Call
{"title":"Nicotine Has a Therapeutic Window of Effectiveness in a <i>Drosophila melanogaster</i> Model of Parkinson's Disease.","authors":"Brady T Mannett, Braden C Capt, Krista Pearman, Lori M Buhlman, John M VandenBrooks, Gerald B Call","doi":"10.1155/2022/9291077","DOIUrl":"https://doi.org/10.1155/2022/9291077","url":null,"abstract":"<p><p>Strong epidemiological evidence and studies in models of Parkinson's disease (PD) suggest that nicotine may be therapeutically beneficial in PD patients. However, a number of clinical trials utilizing nicotine in PD patients have had mixed results, indicating that either nicotine is not beneficial in PD patients, or an important aspect of nicotine therapy was absent. We hypothesized that nicotine must be administered early in the adult fly life in order to have beneficial effects. We show that continuous early nicotine administration improves both climbing and flight deficiencies present in homozygous <i>park</i> <sup><i>25</i></sup> mutant PD model <i>Drosophila melanogaster</i>. Using a new climbing assay, we identify several climbing deficiencies in this PD model that are improved or rescued by continuous nicotine treatment. Amongst these benefits, it appears that nicotine improves the ability of the <i>park</i> <sup><i>25</i></sup> flies to descend the climbing vial by being able to climb down more. In support of our hypothesis, we show that in order for nicotine benefits on climbing and flight to happen, nicotine administration must occur in a discrete time frame following adult fly eclosure: within one day for climbing or five days for flight. This therapeutic window of nicotine administration in this PD model fly may help to explain the lack of efficacy of nicotine in human clinical trials.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"9291077"},"PeriodicalIF":3.2,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40512683","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":"Clinical Features of Parkinson's Disease in Patients with Early-Onset Freezing of Gait.","authors":"Hiroo Terashi, Yuki Ueta, Takeshi Taguchi, Hiroshi Mitoma, Hitoshi Aizawa","doi":"10.1155/2022/4732020","DOIUrl":"https://doi.org/10.1155/2022/4732020","url":null,"abstract":"<p><strong>Background: </strong>Freezing of gait (FOG) is an important symptom that can impair activities of daily living in patients with Parkinson's disease (PD). However, its pathogenic mechanism is largely unknown. The aim of the present study was to elucidate the clinical characteristics of newly diagnosed and levodopa-naïve patients with PD who present with FOG.</p><p><strong>Methods: </strong>A total of 53 patients with untreated PD (29 men and 24 women) within 2 years of disease onset were included in the study. Using item 3 of the Freezing of Gait Questionnaire (FOG-Q), patients were classified as \"freezers\" and \"nonfreezers\" and compared for cognitive function, depressive symptoms, apathy, olfactory function, motor severity, gait parameters, and daily physical activity. We also assessed the relationship between FOG severity (total score of items 3-6 on the FOG-Q) and various clinical parameters.</p><p><strong>Results: </strong>The FOG was reported by 8 (15%) patients with PD. The Apathy Scale score (<i>p</i>=0.018), Modified Hoehn and Yahr stage (<i>p</i> < 0.001), Unified Parkinson's Disease Rating Scale part III score (<i>p</i> < 0.001), and postural instability and gait disorder score (<i>p</i> < 0.001) were significantly higher, and the mean gait acceleration amplitude (<i>p</i>=0.006) was significantly lower in freezers compared to that in nonfreezers. However, there was no significant correlation between FOG severity and these clinical parameters. There was also no significant difference in cognitive function, depressive symptoms, and olfactory function between the two groups. Daily physical activity was significantly lower in freezers than that in nonfreezers.</p><p><strong>Conclusions: </strong>Since FOG develops soon after PD onset, the study findings suggest that the FOG might be associated with the severity of apathy, motor symptoms, and in particular, gait disturbance.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"4732020"},"PeriodicalIF":3.2,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40512682","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}
Parkinson's DiseasePub Date : 2022-07-02eCollection Date: 2022-01-01DOI: 10.1155/2022/1516807
Lena Håglin, Birgitta Törnkvist, Mona Edström, Sofia Håglin, Lennart Bäckman
{"title":"Handgrip Strength and Anthropometry in Parkinson's Disease at Diagnosis.","authors":"Lena Håglin, Birgitta Törnkvist, Mona Edström, Sofia Håglin, Lennart Bäckman","doi":"10.1155/2022/1516807","DOIUrl":"https://doi.org/10.1155/2022/1516807","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to controls. <i>Materials & Methods</i>. This cross-sectional study includes baseline data from a cohort of newly diagnosed patients with Parkinson's disease (<i>N</i> = 75; <i>M</i>/<i>F</i> = 41/34) in the New Parkinsonism in Umeå study (NYPUM). Body Impedance (BIS), handgrip strength (HGS) assessments, and evaluation of risk for malnutrition (Mini Nutritional Assessment (MNA) score) and cognitive performance (Mini-Mental State Examination (MMSE)) were performed at time of PD diagnosis.</p><p><strong>Results: </strong>Low fat-free mass index (FFMI), MNA score, and a high Unified Parkinson's Disease Rating Scale (UPDRS-total and UPDRS-III) were associated with high daytime levels of P-cortisol in total PD population but not in controls. Partial correlations reveal that high fat mass percent (FM (%)) and low FFMI were associated with older age in males with PD but not females with PD. Risk of malnutrition was associated with P-cortisol in males but not in females with PD (<i>r</i> = -0.511, <i>P</i>=0.001, and <i>n</i> = 41 and <i>r</i> = -0.055, <i>P</i>=0.759, and <i>n</i> = 34, respectively). Multiple linear regressions show that an interaction between P-cortisol and P-phosphate, older age, and high UPDRS-III score were associated with HGS in total patient population and males but not females.</p><p><strong>Conclusions: </strong>Age- and disease-associated risk factors that decrease muscle mass and HGS and increase FM (%) in patients with PD differ between males and females by an association with levels of cortisol and phosphate.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"1516807"},"PeriodicalIF":3.2,"publicationDate":"2022-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40494289","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}
Parkinson's DiseasePub Date : 2022-01-20eCollection Date: 2022-01-01DOI: 10.1155/2022/5597503
Matthias Löhle, Graziella Mangone, Wiebke Hermann, Denise Hausbrand, Martin Wolz, Julia Mende, Heinz Reichmann, Andreas Hermann, Jean-Christophe Corvol, Alexander Storch
{"title":"Functional <i>MAOB</i> Gene Intron 13 Polymorphism Predicts Dyskinesia in Parkinson's Disease.","authors":"Matthias Löhle, Graziella Mangone, Wiebke Hermann, Denise Hausbrand, Martin Wolz, Julia Mende, Heinz Reichmann, Andreas Hermann, Jean-Christophe Corvol, Alexander Storch","doi":"10.1155/2022/5597503","DOIUrl":"https://doi.org/10.1155/2022/5597503","url":null,"abstract":"<p><p>Identification of individual risk factors for motor complications in Parkinson's disease (PD) can help to guide personalised medical treatment, particularly since treatment options are still limited. To determine whether common functional gene polymorphisms in the dopamine metabolism predict the onset of motor complications in PD, we performed a retrospective, observer-blinded follow-up study of 30 PD patients who underwent genotyping of dopa-decarboxylase (<i>DDC</i>; rs921451), monoamine oxidase B (<i>MAOB</i>; rs1799836), catechol-O-methyltransferase (<i>COMT</i>; rs4680), and dopamine transporter (<i>DAT</i>; variable number tandem repeat) polymorphisms. Onset of wearing-off and dyskinesias was determined by blinded clinical assessments. Predictive values of genotypes for motor complications were evaluated using Cox proportional hazard models. During a median follow-up time of 11.6 years, 23 (77%) of 30 PD patients developed wearing-off, 16 (53%) dyskinesias, and 23 (77%) any motor complication. The <i>MAOB</i> (rs1799836) polymorphism predicted development of dyskinesias with <i>MAOB</i> <sup><i>CC/(C)/CT</i></sup> genotypes (resulting in low/intermediate brain enzyme activity) being associated with lower hazard ratios (unadjusted HR [95% CI]: 0.264 [0.089-0.787]; <i>p</i>=0.012; adjusted HR [95% CI]: 0.142 [0.039-0.520]; <i>p</i>=0.003) than <i>MAOB</i> <sup><i>TT/(T)</i></sup> genotypes (resulting in high brain enzyme activity). <i>DDC</i> (rs921451), <i>COMT</i> (rs4680), and <i>DAT</i> (VNTR) polymorphisms were not predictive of motor complications. Together, the <i>MAOB</i> (rs1799836) polymorphism predicts the development of dyskinesias in PD patients. Our results need confirmation in larger cohorts. If confirmed, individual assessment of this polymorphism might be helpful for early risk stratification and could comprise a step towards patient-tailored therapeutic strategies to prevent or delay motor complications in the course of PD.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"5597503"},"PeriodicalIF":3.2,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39962002","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}
Sun Ju Chung, Matilde Calopa, Maria G Ceravolo, Nicola Tambasco, Angelo Antonini, K Ray Chaudhuri, Weining Z Robieson, Olga Sánchez-Soliño, Cindy Zadikoff, Man Jin, Luigi M Barbato
{"title":"Effects of Levodopa-Carbidopa Intestinal Gel Compared with Optimized Medical Treatment on Nonmotor Symptoms in Advanced Parkinson's Disease: INSIGHTS Study.","authors":"Sun Ju Chung, Matilde Calopa, Maria G Ceravolo, Nicola Tambasco, Angelo Antonini, K Ray Chaudhuri, Weining Z Robieson, Olga Sánchez-Soliño, Cindy Zadikoff, Man Jin, Luigi M Barbato","doi":"10.1155/2022/1216975","DOIUrl":"https://doi.org/10.1155/2022/1216975","url":null,"abstract":"<p><strong>Background: </strong>Nonmotor symptoms (NMS) are common in advanced Parkinson's disease (APD) and reduce health-related quality of life.</p><p><strong>Objective: </strong>The aim of the study was to evaluate levodopa-carbidopa intestinal gel (LCIG) versus optimized medical treatment (OMT) on NMS in APD.</p><p><strong>Methods: </strong>INSIGHTS was a phase 3b, open-label, randomized, multicenter study in patients with APD (LCIG or OMT, 26 weeks) (NCT02549092). Primary outcomes assessed were total NMS (NMS scale (NMSS) and PD sleep scale (PDSS-2)). Key secondary outcomes included the Unified PD Rating Scale (UPDRS) Part II, Clinical Global Impression of Change (CGI-C), and PD Questionnaire-8 (PDQ-8). Additional secondary measures of Patient Global Impression of Change (PGIC), King's PD Pain Scale (KPPS), and Parkinson Anxiety Scale (PAS) also were evaluated. Finally, safety was assessed.</p><p><strong>Results: </strong>Out of 89 patients randomized, 87 were included in the analysis (LCIG, <i>n</i> = 43; OMT, <i>n</i> = 44). There were no significant differences in NMSS or PDSS-2 total score changes (baseline to Week 26) between LCIG and OMT; within-group changes were significant for NMSS (LCIG, <i>p</i> < 0.001; OMT, <i>p</i> = 0.005) and PDSS-2 (LCIG, <i>p</i> < 0.001; OMT, <i>p</i> < 0.001). Between-group treatment differences were nominally significant for UPDRS Part II (<i>p</i> = 0.006) and CGI-C (<i>p</i> < 0.001) at Week 26 in favor of LCIG; however, statistical significance could not be claimed in light of primary efficacy outcomes. PGIC (Week 26) and KPPS (Week 12) scores were nominally significantly reduced with LCIG versus OMT (<i>p</i> < 0.001; <i>p</i> < 0.05). There were no significant differences in PDQ-8 or PAS. Adverse events (AEs) were mostly mild to moderate; common serious AEs were pneumoperitoneum (<i>n</i> = 2) and stoma-site infection (<i>n</i> = 2) (LCIG).</p><p><strong>Conclusions: </strong>There were no significant differences between LCIG versus OMT in NMSS or PDSS-2; both LCIG and OMT groups significantly improved from baseline. AEs were consistent with the known safety profile.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2022 ","pages":"1216975"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10412203","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}
Agnes Wilhelm, Tanja Riedl, Christian Paumann, Jessie Janssen
{"title":"Exploring a New Cueing Device in People Who Experience Freezing of Gait: Acceptance of a Study Design.","authors":"Agnes Wilhelm, Tanja Riedl, Christian Paumann, Jessie Janssen","doi":"10.1155/2022/1631169","DOIUrl":"https://doi.org/10.1155/2022/1631169","url":null,"abstract":"<p><strong>Background: </strong>Freezing of Gait (FoG) is a disabling symptom of Parkinson's Disease (PD) and is defined as a \"brief episodic absence or marked reduction of forward progression of the feet despite the intention to walk.\" Compensatory strategies such as cueing and high frequency vibrotactile stimulation can reduce FoG severity and improve gait parameters. A new Sternal high frequency Vibrotactile Stimulation Device (SVSD) with cueing function has been developed, however the clinical effects of this device are yet to be fully investigated.</p><p><strong>Objective: </strong>The aim of this study was to investigate, if the proposed study design using a SVSD and gait analysis sensor insoles was acceptable for people with PD.</p><p><strong>Methods: </strong>This feasibility study was designed as a randomized cross-over study. Thirteen participants took part in a one off 60-minute data collection session. The acceptability of the study design was assessed with a mixed methods questionnaire considering each step of the study process. Secondary outcome measures were the feasibility of using the 10 Metre Walk Test (10MWT), the Freezing of Gait Score (FoG-Score), and Patient Global Impression of Change (PGI-C) with and without the SVSD.</p><p><strong>Results: </strong>The participants scored all aspects of the study design as very satisfactory. In addition, all participants could perform the secondary outcome measures and were deemed feasible. Feedback from open ended questions provided ideas and considerations for adaptations of future clinical studies.</p><p><strong>Conclusion: </strong>The proposed study design was acceptable for people with PD. <i>Implications</i>. This study design, with small adaptations, can be used for larger studies to evaluate the effect of an SVSD on FoG in people with PD.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2022 ","pages":"1631169"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9598528","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}
Philippe Damier, Emily J Henderson, Jesús Romero-Imbroda, Laura Galimam, Nick Kronfeld, Tobias Warnecke
{"title":"Impact of Off-Time on Quality of Life in Parkinson's Patients and Their Caregivers: Insights from Social Media.","authors":"Philippe Damier, Emily J Henderson, Jesús Romero-Imbroda, Laura Galimam, Nick Kronfeld, Tobias Warnecke","doi":"10.1155/2022/1800567","DOIUrl":"https://doi.org/10.1155/2022/1800567","url":null,"abstract":"<p><strong>Introduction: </strong>In Parkinson's disease (PD), the quality of life of both patients and caregivers is affected. While key issues relating to quality of life may not emerge in conversations with healthcare professionals (HCPs), unguarded social media conversations can provide insight into how people with Parkinson's disease (PwPD) and their caregivers are affected. We conducted a qualitative and quantitative netnographic study of PD conversations posted on social media sites over a 12-month period.</p><p><strong>Objective: </strong>To identify key themes and issues for PwPD.</p><p><strong>Methods: </strong>Using predefined and piloted search terms, we identified 392,962 social media posts (between March 31, 2020, and March 31, 2021, for the UK and France, and between September 30, 2019, and March 31, 2021, for Italy, Spain, and Germany). A random sample of these posts was then analyzed using natural language processing (NLP), and quantitative, qualitative,in-depth contextual analysis was also performed.</p><p><strong>Results: </strong>Key themes that emerged in the PD conversation related to the changing experience of symptoms over time are the physical, emotional, and cognitive impact of symptoms, the management and treatment of PD, disease awareness among the general public, and the caregiver burden. The emotional impact of motor symptoms on PwPD is significant, particularly when symptoms increase and PwPD lose their independence, which may exacerbate existing anxiety and depression. Nonmotor symptoms can also compound the difficulties with managing the physical impact of motor symptoms. The burden of nonmotor symptoms is felt by both PwPD and their caregivers, with the impact of nonmotor symptoms on cognitive processes particularly frustrating for caregivers. The experience of off-time was also featured in the online conversation. Some PwPD believe there is a lack of adequate management from healthcare professionals, who may not appreciate their concerns or take sufficient time to discuss their needs.</p><p><strong>Conclusion: </strong>This study identified key themes that PwPD and their caregivers discuss online. These findings help signpost issues of importance to PwPD and areas in which their care may be improved.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2022 ","pages":"1800567"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9741535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10342973","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}
Yu-Ting Ling, Qian-Qian Guo, Si-Min Wang, Li-Nan Zhang, Jin-Hua Chen, Yi Liu, Ruo-Heng Xuan, Bo Qu, Li-Ge Liu, Zhi-Shuang Wen, Jia-Kun Xu, Lu-Lu Jiang, Wen-Biao Xian, Bin Wu, Chang-Ming Zhang, Ling Chen, Jin-Long Liu, Nan Jiang
{"title":"Nomogram for Prediction of Postoperative Delirium after Deep Brain Stimulation of Subthalamic Nucleus in Parkinson's Disease under General Anesthesia.","authors":"Yu-Ting Ling, Qian-Qian Guo, Si-Min Wang, Li-Nan Zhang, Jin-Hua Chen, Yi Liu, Ruo-Heng Xuan, Bo Qu, Li-Ge Liu, Zhi-Shuang Wen, Jia-Kun Xu, Lu-Lu Jiang, Wen-Biao Xian, Bin Wu, Chang-Ming Zhang, Ling Chen, Jin-Long Liu, Nan Jiang","doi":"10.1155/2022/6915627","DOIUrl":"https://doi.org/10.1155/2022/6915627","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium can increase cognitive impairment and mortality in patients with Parkinson's disease. The purpose of this study was to develop and internally validate a clinical prediction model of delirium after deep brain stimulation of the subthalamic nucleus in Parkinson's disease under general anesthesia.</p><p><strong>Methods: </strong>We conducted a retrospective observational cohort study on the data of 240 patients with Parkinson's disease who underwent deep brain stimulation of the subthalamic nucleus under general anesthesia. Demographic characteristics, clinical evaluation, imaging data, laboratory data, and surgical anesthesia information were collected. Multivariate logistic regression was used to develop the prediction model for postoperative delirium.</p><p><strong>Results: </strong>A total of 159 patients were included in the cohort, of which 38 (23.90%) had postoperative delirium. Smoking (OR 4.51, 95% CI 1.56-13.02, <i>p</i> < 0.01) was the most important risk factor; other independent predictors were orthostatic hypotension (OR 3.42, 95% CI 0.90-13.06, <i>p</i>=0.07), inhibitors of type-B monoamine oxidase (OR 3.07, 95% CI 1.17-8.04, <i>p</i>=0.02), preoperative MRI with silent brain ischemia or infarction (OR 2.36, 95% CI 0.90-6.14, <i>p</i>=0.08), Hamilton anxiety scale score (OR 2.12, 95% CI 1.28-3.50, <i>p</i> < 0.01), and apolipoprotein E level in plasma (OR 1.48, 95% CI 0.95-2.29, <i>p</i>=0.08). The area under the receiver operating characteristic curve (AUC) was 0.76 (95% CI 0.66-0.86). A nomogram was established and showed good calibration and clinical predictive capacity. After bootstrap for internal verification, the AUC was 0.74 (95% CI 0.66-0.83).</p><p><strong>Conclusion: </strong>This study provides evidence for the independent inducing factors of delirium after deep brain stimulation of the subthalamic nucleus in Parkinson's disease under general anesthesia. By predicting the development of delirium, our model may identify high-risk groups that can benefit from early or preventive intervention.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2022 ","pages":"6915627"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10379776","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}
Denise Becker, Angelina Maric, Simon J Schreiner, Fabian Büchele, Christian R Baumann, Daniel Waldvogel
{"title":"Onset of Postural Instability in Parkinson's Disease Depends on Age rather than Disease Duration.","authors":"Denise Becker, Angelina Maric, Simon J Schreiner, Fabian Büchele, Christian R Baumann, Daniel Waldvogel","doi":"10.1155/2022/6233835","DOIUrl":"https://doi.org/10.1155/2022/6233835","url":null,"abstract":"<p><strong>Background: </strong>Postural instability and falls are considered a major factor of impaired quality of life in patients with advanced Parkinson's disease (PD). The knowledge of the time at which postural instability occurs will help to provide the evidence required to introduce fall-prevention strategies at the right time in PD.</p><p><strong>Objective: </strong>To investigate whether postural instability of patients with different age at disease onset is associated with age or with disease duration of PD.</p><p><strong>Methods: </strong>Patients diagnosed with sporadic PD between 1991 and 2017 and postural instability (according to the International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III, item 3.12 postural instability) were included, with strict inclusion criteria including regular follow-ups, agreement on data use, and exclusion of comorbidities affecting the free stand.</p><p><strong>Results: </strong>Applying these strict inclusion criteria, we included 106 patients. Those younger than 50 years at PD onset took significantly longer to develop postural instability (<i>n</i> = 23 patients, median: 18.4 years) compared with patients with later onset of PD (50-70 years, <i>n</i> = 66, median: 14.2 years, <i>p</i> < 0.001; and >70 years, <i>n</i> = 17, median: 5.7 years, <i>p</i> < 0.001, Kruskal-Wallis test followed by Dunn's multiple comparisons test). There was no association between total MDS-UPDRS III (as a measure of motor symptom severity) at onset of postural instability.</p><p><strong>Conclusions: </strong>In PD, postural instability is primarily associated with the age of the patient and not with disease duration.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2022 ","pages":"6233835"},"PeriodicalIF":3.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9734006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324992","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}