Parkinson's Disease最新文献

{"title":"How Cognitive Reserve should Influence Rehabilitation Choices using Virtual Reality in Parkinson's Disease.","authors":"Letizia Pezzi,&nbsp;Andrea Di Matteo,&nbsp;Roberta Insabella,&nbsp;Sara Mastrogiacomo,&nbsp;Carlo Baldari,&nbsp;Victor Machado Reiss,&nbsp;Teresa Paolucci","doi":"10.1155/2022/7389658","DOIUrl":"https://doi.org/10.1155/2022/7389658","url":null,"abstract":"<p><p>Virtual reality (VR) is used in the rehabilitation of patients with Parkinson's disease (PD) in several studies. In VR trials, the motor, physical characteristics, and the degree of the disease are often well defined, while PD cognitive reserve is not. This systematic review was performed to define a cognitive profile for patients with PD who could best benefit from using VR to enhance functional motor aspects during rehabilitation. PubMed, Cochrane Library, Scopus, and Web of Sciences databases were analysed to identify randomized clinical trials (RCT) and randomized pilot trials that addressed the rehabilitation of motor symptoms in subjects with PD using VR. The included studies used Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA) to evaluate the cognitive aspect. Only articles written in English and with full texts were considered. The risk of bias from all included studies was assessed based on the Cochrane risk-of-bias tool and the PRISMA guideline was considered. Eighteen articles were eligible for review, including three randomized pilot trials. All studies aimed to evaluate the effect of VR on the motor aspects typically affected by PD (balance, postural control, risk of falls, walking, and reaching). The most widely adopted approach has been nonimmersive VR, except for one study that used immersive VR. Both the benefits of physical activity on the motor symptoms of patients with PD and the impact of cognitive reserve during the rehabilitation of these patients were highlighted. The analysis of the results allowed us to outline the ideal cognitive profile of patients with PD who can benefit from the effects of rehabilitation using VR.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"7389658"},"PeriodicalIF":3.2,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485605","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":"Impaired Brain Information Transmission Efficiency and Flexibility in Parkinson's Disease and Rapid Eye Movement Sleep Behavior Disorder: Evidence from Functional Connectivity and Functional Dynamics.","authors":"Jing Wei,&nbsp;Jiaqi Lyu,&nbsp;Jie Xiang,&nbsp;Yan Niu,&nbsp;Lan Yang,&nbsp;Chanjuan Fan,&nbsp;Dandan Li,&nbsp;Yanli Yang","doi":"10.1155/2022/7495371","DOIUrl":"https://doi.org/10.1155/2022/7495371","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a common neurodegenerative disorder. Rapid eye movement sleep behavior disorder (RBD) is one of the prodromal symptoms of PD. Studies have shown that brain information transmission is affected in PD patients. Consequently, we hypothesized that brain information transmission is impaired in RBD and PD. To prove our hypothesis, we performed functional connectivity (FC) and functional dynamics analysis of three aspects-based on the whole brain, within the resting-state network (RSN), and the interaction between RSNs-using normal control (NC) (<i>n</i> = 21), RBD (<i>n</i> = 24), and PD (<i>n</i> = 45) resting-state functional magnetic resonance imaging (rs-fMRI) data sets. Furthermore, we tested the explanatory power of FC and functional dynamics for the clinical features. Our results found that the global functional dynamics and FC of RBD and PD were impaired. Within RSN, the impairment concentrated in the visual network (VIS) and sensorimotor network (SMN), and the impaired degree of SMN in RBD was higher than that in PD. On the interaction between RSNs, RBD showed a widespread decrease, and PD showed a focal decrease which concentrated in SMN and VIS. Finally, we proved FC and functional dynamics were related to clinical features. These differences confirmed that brain information transmission efficiency and flexibility are impaired in RBD and PD, and these impairments are associated with the clinical features of patients.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"7495371"},"PeriodicalIF":3.2,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485606","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":"The Anti-Inflammatory Effect of Preventive Intervention with Ketogenic Diet Mediated by the Histone Acetylation of <i>mGluR5</i> Promotor Region in Rat Parkinson's Disease Model: A Dual-Tracer PET Study.","authors":"Yuankai Zhu,&nbsp;Xiangyu Tang,&nbsp;Zhaoting Cheng,&nbsp;Qingjian Dong,&nbsp;Ge Ruan","doi":"10.1155/2022/3506213","DOIUrl":"https://doi.org/10.1155/2022/3506213","url":null,"abstract":"<p><strong>Materials and methods: </strong>The neuroprotective effect of ketosis state prior to the onset of PD (preventive KD, KDp) was compared with that receiving KD after the onset (therapeutic KD, KDt) in the lipopolysaccharide- (LPS-) induced rat PD model. A total of 100 rats were randomly assigned to the following 4 groups: sham, LPS, LPS + KDp, and LPS + KDt groups.</p><p><strong>Results: </strong>Significant dopamine deficient behaviors (rotational behavior and contralateral forelimb akinesia), upregulation of proinflammatory mediators (TNF-<i>α</i>, IL-1<i>β</i>, and IL-6), loss of dopaminergic neurons, reduction of mGluR5⁺ microglia cells, increase of TSPO⁺ microglia cells, reduction of H3K9 acetylation in the <i>mGluR5</i> promoter region and mGluR5 mRNA expression, and decline in the phosphorylation levels of Akt/GSK-3<i>β</i>/CREB pathway were observed after the intervention of LPS (<i>P</i> < 0.01). TSPO and DAT PET imaging revealed the increased uptake of ¹⁸F-DPA-714 in substantia nigra and decreased uptake of ¹⁸F-FP-CIT in substantia nigra and striatum in LPS-treated rats (<i>P</i> < 0.001). These impairments were alleviated by the dietary intervention of KD, especially with the strategy of KDp (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>The anti-inflammatory effect of KD on PD was supposed to be related to the modulation of Akt/GSK-3<i>β</i>/CREB signaling pathway mediated by the histone acetylation of <i>mGluR5</i> promotor region. The KD intervention should be initiated prior to the PD onset in high-risk population to achieve a more favorable outcome.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"3506213"},"PeriodicalIF":3.2,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359267","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":"Effects of an Aquatic Physical Exercise Program on Ventilatory Parameters in People with Parkinson's Disease.","authors":"Bruna Yamaguchi,&nbsp;Dielise Debona Iucksch,&nbsp;Luis Henrique Paladini,&nbsp;Vera Lúcia Israel","doi":"10.1155/2022/2073068","DOIUrl":"https://doi.org/10.1155/2022/2073068","url":null,"abstract":"<p><p>Problems in the respiratory system are the main cause of death in Parkinson's disease (PD). Ventilatory limitations can also be part of a vicious cycle involving physical-functional limitations (e.g., walking difficulties) and the patients' perception of fatigue. The objective of this study was to analyze the effects of an aquatic physical exercise intervention program on ventilatory parameters, perception of fatigue, and gait capacity in participants with PD. This quasi-experimental study had a single group with repeated measures in four assessments, proposing an aquatic physical exercise intervention program. The inclusion criteria encompassed being in levels 1 to 4 on the Hoehn and Yahr scale and having a medical certificate for the activities. Assessments took place at 3-month intervals between them-the first period was the control, the second following the intervention, and the third period was the follow-up. The intervention had 25 biweekly sessions over 3 months. A total of 13 people (71.3 ± 5.61 years old) participated in the intervention, without significant differences in the control period. Between the intervention assessments, they had statistically significant differences in MIP, MEP, FVC, Tiffeneau index, MVV, and fatigue. The study demonstrated that the aquatic physical exercise intervention was effective for ventilatory outcomes and fatigue in people with PD.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"2073068"},"PeriodicalIF":3.2,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33460198","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":"Rasagiline as Adjunct to Levodopa for Treatment of Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Osamu Kano,&nbsp;Hiroshi Tsuda,&nbsp;Ayako Hayashi,&nbsp;Masaki Arai","doi":"10.1155/2022/4216452","DOIUrl":"https://doi.org/10.1155/2022/4216452","url":null,"abstract":"<p><strong>Background: </strong>Rasagiline is a selective, irreversible monoamine oxidase type B inhibitor used as monotherapy in early Parkinson's disease and as an adjunct therapy to levodopa in Parkinson's disease with motor fluctuations.</p><p><strong>Objectives: </strong>This meta-analysis aimed to provide updated evidence on the efficacy for motor and nonmotor symptoms and the safety of rasagiline/levodopa versus levodopa in patients with Parkinson's disease experiencing motor fluctuations.</p><p><strong>Methods: </strong>A systematic literature search was conducted (January 18-19, 2021) using PubMed, Cochrane Library, EMBASE, Web of Science, and Google Scholar to identify randomized controlled trials comparing rasagiline/levodopa versus placebo/levodopa in patients with Parkinson's disease experiencing motor fluctuations. Outcomes included change in wearing-off time, Unified Parkinson's Disease Rating Scale (UPDRS)/Movement Disorder Society-UPDRS (MDS-UPDRS) II and III scores, treatment-emergent adverse events (TEAEs), and Parkinson's Disease Questionnaire (PDQ-39) summary index score. A random effect model was used to estimate the treatment effects.</p><p><strong>Results: </strong>Six studies were included (1912 patients). Significant improvements in wearing-off time (standardized mean difference [SMD]: -0.50, 95% confidence interval [CI]: -0.92 to -0.09, <i>p</i> = 0.002), levodopa dosage (SMD: -0.18, 95% CI: -0.35 to -0.01, <i>p</i> = 0.041), UPDRS/MDS-UPDRS II (SMD: -0.39, 95% CI: -0.52 to -0.25, <i>p</i> < 0.0001), UPDRS/MDS-UPDRS III (SMD: -0.30, 95% CI: -0.44 to -0.16, <i>p</i> < 0.0001), and PDQ-39 summary index score (SMD: -0.21, 95% CI: -0.37 to -0.04, <i>p</i> = 0.013) were observed with rasagiline/levodopa versus placebo/levodopa. The incidence of TEAEs did not differ between treatments (risk ratio: 1.13, 95% CI: 0.98-1.30, <i>p</i> = 0.093).</p><p><strong>Conclusions: </strong>This meta-analysis further indicated the superiority of rasagiline/levodopa in improving motor and nonmotor symptoms of Parkinson's disease, with a similar safety profile to that of levodopa in Parkinson's disease with motor fluctuations.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"4216452"},"PeriodicalIF":3.2,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33454309","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":"Short-Term Motor Outcomes in Parkinson's Disease after Subthalamic Nucleus Deep Brain Stimulation Combined with Post-Operative Rehabilitation: A Pre-Post Comparison Study.","authors":"Kazunori Sato,&nbsp;Yoshihide Hokari,&nbsp;Eriko Kitahara,&nbsp;Nana Izawa,&nbsp;Kozo Hatori,&nbsp;Kaoru Honaga,&nbsp;Genko Oyama,&nbsp;Taku Hatano,&nbsp;Hirokazu Iwamuro,&nbsp;Atsushi Umemura,&nbsp;Yasushi Shimo,&nbsp;Nobutaka Hattori,&nbsp;Toshiyuki Fujiwara","doi":"10.1155/2022/8448638","DOIUrl":"https://doi.org/10.1155/2022/8448638","url":null,"abstract":"<p><strong>Background: </strong>The effects of subthalamic nuclear deep brain stimulation therapy (STN-DBS) and combined postoperative rehabilitation for patients with Parkinson's disease with postural instability have yet to be well reported. This study investigated the effects of short-term postoperative rehabilitation with STN-DBS on physical function in patients with Parkinson's disease.</p><p><strong>Methods: </strong>Patients diagnosed with Parkinson's disease who were admitted to our hospital for STN-DBS surgery were included in this study. Data were prospectively collected and retrospectively analyzed. Postoperative rehabilitation consisted of muscle-strengthening exercises, stretching, and balance exercises for 40-60 minutes per day for approximately 14 days. The Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test (TUG) seconds and steps, Trunk Impairment Scale (TIS), seconds for 10 times toe-tapping, lower limb extension torque using StrengthErgo240, and center of pressure sway in the quiet standing posture were evaluated preoperatively, postoperatively, and at discharge. Mini-BESTest changes were also evaluated in the two groups classified by the presence or absence of postural instability. One-way and two-way repeated measures analyses of variance were performed for each of the three periods of change, and paired <i>t</i>-tests with the Bonferroni method were performed as multiple comparison tests. A stepwise multiple regression model was used to identify factors associated with balance improvement.</p><p><strong>Results: </strong>A total of 60 patients with Parkinson's disease were included, and there were significant increases in Mini-BESTest, TIS, StrengthErgo240, and postural sway during closed-eye standing compared to pre- and postoperative conditions at discharge (<i>p</i> < 0.05), and they decreased significantly compared to the postoperative period (<i>p</i> < 0.05). On stepwise multiple regression analysis, decreased steps of TUG and improvement of TIS scores were related to improvement of the Mini-BESTest (<i>p</i> < 0.05). In addition, Mini-BESTest scores in both groups with and without postural instability were significantly increased at discharge compared to preoperative and postoperative conditions (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Postoperative rehabilitation combined with STN-DBS may provide short-term improvements in physical function compared with the preoperative medicated status. The improvements in gait step length and trunk function may be important factors for obtaining improvement of postoperative postural stability.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"8448638"},"PeriodicalIF":3.2,"publicationDate":"2022-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40715455","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":"Collective Expert Perspectives on the Use of Safinamide as Adjunctive Therapy for Parkinson's Disease: Online-Based Delphi Survey.","authors":"Atsushi Takeda,&nbsp;Yoshio Tsuboi,&nbsp;Masahiro Nomoto,&nbsp;Hideki Mochizuki,&nbsp;Nobutaka Hattori","doi":"10.1155/2022/3203212","DOIUrl":"https://doi.org/10.1155/2022/3203212","url":null,"abstract":"<p><strong>Background: </strong>Safinamide is a selective, reversible monoamine oxidase-B inhibitor with a sodium channel inhibitory effect. Published clinical evidence supports safinamide as an effective therapy for Parkinson's disease (PD) with wearing-off. However, to date, no consensus recommendations have been available to guide physicians in Asia on the optimal use of safinamide in clinical practice. To summarize opinions on the optimal patient profile and methods of using safinamide in common clinical scenarios, Japanese movement disorder specialists with expertise in PD investigated the perspectives of neurologists and neurosurgeons.</p><p><strong>Methods: </strong>The Delphi panel approach was used to summarize the opinions of panelists. The panel comprised doctors from Japan with extensive clinical practice experience in the use of safinamide (<i>n</i> = 46 at the final round). The consensus was defined as 80% or more agreement between panelists for each scenario at the final round.</p><p><strong>Results: </strong>There was a high level of agreement that patients with the following symptoms are suitable for safinamide treatment such as bradykinesia (100%), rigidity (95.7%), and/or gait disorder (89.1%) based on motor symptoms and PD-related pain (97.8%) and/or depression or apathy (93.5%) based on non-motor symptoms. Morning-off (95.7%), but not dyskinesia (71.7%), also reached consensus. The use of high-dose safinamide (100 mg/day) was recommended when the improvement in PD symptoms is insufficient and increasing the doses of other anti-PD medications is difficult (97.8%) or when the abovementioned non-motor symptoms adversely affect daily life (93.5%).</p><p><strong>Conclusions: </strong>This report provides expert perspectives on the use of safinamide for a wide range of clinical scenarios in Japan.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"3203212"},"PeriodicalIF":3.2,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40644208","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":"Intestinal Transit in Early Moderate Parkinson's Disease Correlates with Probable RBD: Subclinical Esophageal Dysmotility Does Not Correlate.","authors":"Casper Skjærbæk,&nbsp;Karoline Knudsen,&nbsp;Martin Kinnerup,&nbsp;Kim Vang Hansen,&nbsp;Per Borghammer","doi":"10.1155/2022/4108401","DOIUrl":"https://doi.org/10.1155/2022/4108401","url":null,"abstract":"<p><strong>Background: </strong>Nonmotor symptoms, including constipation and dysphagia, are very common in Parkinson's disease (PD) and Lewy pathology is widespread in the gastrointestinal tract, particularly in the lower esophagus. Constipation and REM sleep behavior disorder (RBD) may present prior to clinical diagnosis. Yet, little is known about esophageal dysfunction and its connection to constipation in early PD.</p><p><strong>Objective: </strong>This study aimed to investigate esophageal and colonic transit in early moderate PD and to study correlations between symptoms and objective measures.</p><p><strong>Methods: </strong>Thirty early moderate PD patients and 28 healthy controls (HC) were included in this cross-sectional study. Esophageal transit times were determined by esophageal scintigraphy and colonic transit times by CT after radio-opaque marker ingestion. Olfaction tests, clinical evaluation, and nonmotor questionnaires were also performed.</p><p><strong>Results: </strong>Distal esophageal transit times and colonic transit times were both significantly prolonged in the PD group compared to HC (<i>p</i> < 0.05 and<i>p</i> < 0.01, respectively) and a moderate-strong positive correlation was found between colonic transit time (CTT) and RBDSQ score (<i>r</i> = 0.61,<i>p</i> < 0.001). Significant correlations were also found between CTT and SCOPA-AUT scores as well as between CTT and ROME III functional constipation scores.</p><p><strong>Conclusion: </strong>Colonic transit correlates with probable RBD and is more severely prolonged in early moderate PD than is the distal esophageal transit time.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"4108401"},"PeriodicalIF":3.2,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40644209","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":"Occupational Therapy for People with Early Parkinson's Disease: A Retrospective Program Evaluation.","authors":"Alan Sadural,&nbsp;Jillian MacDonald,&nbsp;Joelle Johnson,&nbsp;Kavita Gohil,&nbsp;Miriam Rafferty","doi":"10.1155/2022/1931468","DOIUrl":"https://doi.org/10.1155/2022/1931468","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical practice guidelines establish that occupational therapy (OT) services are indicated for people with early Parkinson's disease (PD). However, OT is uncommon compared to other rehabilitation services. This study describes the development and evaluation of a proactive, consultative OT program for people with early PD as a part of an integrated care approach.</p><p><strong>Materials and methods: </strong>The program was developed by an occupational therapist adapting practice guidelines for people with early PD. Retrospective program evaluation occurred at an outpatient rehabilitation clinic. The consultative OT program for early PD includes a 90-minute evaluation with instruction in self-management techniques, individually tailored exercises, and follow-up recommendations. The program was evaluated with the RE-AIM framework. Postprogram semistructured interviews provided patient-reported program effectiveness and satisfaction.</p><p><strong>Results: </strong>In 2018, 23 individuals used OT out of 77 people with early PD who attended the proactive rehabilitation program. Most individuals (<i>n</i> = 16, 69.6%) were within Hoehn and Yahr stages 1-2 and were seen within 3 years of PD diagnosis. Participants presented with deficits in hand strength (60.0 ± 23.4 pounds) and dexterity (right hand 30.0 ± 8.0 seconds) and reported complaints about basic and/or instrumental activities of daily living (<i>n</i> = 15, 65.2%). Semistructured interviews (<i>n</i> = 16) revealed that most individuals (75%) reported high satisfaction. Of the 10 who recalled a home exercise program, 60% reported continued adherence. Consultative OT was delivered with fidelity in 22/23 individuals (96%). After one year, only two occupational therapists at one clinic had adopted the program, and the program is maintained in the organization.</p><p><strong>Conclusion: </strong>Occupational therapists reached people in the early stages of PD when a specific program was tailored to evaluate and target their specific needs. Motor activity deficits noted in individuals with early PD support future scaling and sustainability efforts of OT within this population. Quality improvement suggestions are discussed for future implementation and clinical trials.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"1931468"},"PeriodicalIF":3.2,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9300278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40644210","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":"Central Aortic Pressure and Arterial Stiffness in Parkinson's Disease: A Comparative Study.","authors":"Mehmet Balal,&nbsp;Meltem Demirkiran,&nbsp;Saime Paydas","doi":"10.1155/2022/6723950","DOIUrl":"https://doi.org/10.1155/2022/6723950","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular autonomic dysfunction, which leads to hemodynamic disorders, is commonly observed in patients with Parkinson's disease (PD). Central aortic pressure (CAP) is the systolic blood pressure (SBP) at the root of the aorta. In young people, CAP is lower than peripheral arterial blood pressure. In older people, the difference between CAP and peripheral arterial blood pressure decreases depending on the extent of arterial stiffness (AS). In patients with AS, CAP increases. CAP is thus regarded as an indicator of AS.</p><p><strong>Objective: </strong>To compare CAP and other hemodynamic parameters for AS between patients with Parkinson's disease and control group. We also aimed to evaluate changes in these hemodynamic parameters after the levodopa (LD) intake.</p><p><strong>Methods: </strong>We included 82 patients with PD and 76 healthy controls. Age, sex, disease duration, disease subtype, Hoehn-Yahr stage (H&Y), and nonmotor symptoms (NMS) were documented. TensioMed Software v.3.0.0.1 was used to measure CAP, peripheral arterial blood pressure, pulse pressure (PP), heart rate (HR), mean arterial pressure (MAP), augmentation index (AI), pulse wave velocity, and ejection time. All patients were being treated with LD, and measurements were performed 1 h before and 1 h after LD intake.</p><p><strong>Results: </strong>Baseline peripheral arterial blood pressure and CAP values were significantly higher in the PD group than in the control group (<i>p</i> < 0.001 and <i>p</i>=0.02, respectively). Most cardiac hemodynamic parameters, including peripheral arterial blood pressure and CAP, decreased significantly (<i>p</i> < 0.02 and <i>p</i> < 0.001, respectively) after LD intake in the PD group. Disease subtype, duration, and severity did not affect any of the hemodynamic parameters. When NMS were evaluated, patients with psychosis and dementia showed higher baseline parameters.</p><p><strong>Conclusion: </strong>Loss of postganglionic noradrenergic innervation is well-known with PD. Several cardiac hemodynamic parameters were affected, suggesting cardiac autonomic dysfunction in these patients. The data obtained were independent of disease severity, duration, and subtype. After LD intake, most of these parameters decreased, which might have a positive effect on the vascular burden.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":" ","pages":"6723950"},"PeriodicalIF":3.2,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40636897","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}