Parkinsonism & related disorders最新文献

{"title":"Local field potentials and motor performances modulation in response to stimulation and levodopa: a study on Parkinson's disease patients on chronic deep brain stimulation","authors":"Giulia Giannini ,&nbsp;Ilaria D'Ascanio ,&nbsp;Luca Baldelli ,&nbsp;Ilaria Cani ,&nbsp;Alfredo Conti ,&nbsp;Gaetano Leogrande ,&nbsp;Giovanna Lopane ,&nbsp;Paolo Mantovani ,&nbsp;Marianna Pegoli ,&nbsp;Pietro Cortelli ,&nbsp;Lorenzo Chiari ,&nbsp;Giovanna Calandra-Buonaura ,&nbsp;Luca Palmerini","doi":"10.1016/j.parkreldis.2025.107942","DOIUrl":"10.1016/j.parkreldis.2025.107942","url":null,"abstract":"<div><h3>Introduction</h3><div>Subthalamic (STN) local field potentials (LFP) in the beta band are considered potential biomarkers for closed-loop deep brain stimulation (DBS) in Parkinson's disease (PD). Studies focusing on chronic STN LFP modulation in response to stimulation and treatment are scant. Deepening knowledge on beta modulation during chronic stimulation could aid the development of solid computational algorithm for adaptive DBS.</div><div>This study aimed to investigate: 1) the presence of beta peaks in the first 21 patients receiving the Percept PC at our Tertiary Centre; 2) the influence of medications, stimulation, and plasma levodopa levels on beta-peaks magnitude and motor performances.</div></div><div><h3>Methods</h3><div>Twenty-one (19 males, 2 females) consecutive PD patients who underwent bilateral STN-DBS surgery were prospectively recruited. At 6 months after surgery, an extensive and systematic evaluation of raw LFP, motor performances, and plasma levodopa levels was conducted in the following four conditions: OFF-medications/ON-stimulation; OFF-medications/OFF-stimulation; ON-medications/OFF-stimulation; ON-medications/ON-stimulation.</div></div><div><h3>Results</h3><div>Analysis of STN LFP revealed that 76.2 % (16/21) of PD patients showed a beta peak. Beta peaks was identified at an average frequency of 21.0 ± 5.4 Hz, with an amplitude of 1.1 ± 0.8 μV/rtHz. A higher significant reduction of beta STN oscillations was observed following stimulation activation (p &lt; 0.001) compared to levodopa administration. LFP amplitude patterns reflected motor performance trends across the four treatment conditions.</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive and systematic evaluation of LFP behaviour in response to stimulation and medication, conducted during ongoing stimulation and in the chronic state. These findings enhance understanding of beta oscillatory changes related to therapies and stimulation.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"137 ","pages":"Article 107942"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563100","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":"Genetic testing for Parkinson's disease in Israel: Insights from the Rostock Parkinson's Disease (ROPAD) study","authors":"Saar Anis ,&nbsp;Caroline Weill ,&nbsp;Penina Ponger ,&nbsp;Maria Nassar ,&nbsp;Johnathan Reiner ,&nbsp;Odelia Chorin ,&nbsp;Sitki Cem Parlar ,&nbsp;Roy N. Alcalay ,&nbsp;Ziv Gan-Or ,&nbsp;Adi Ezra ,&nbsp;Adi Saar ,&nbsp;Avner Thaler ,&nbsp;Oren S. Cohen ,&nbsp;Yair Zlotnik ,&nbsp;Sandra Benizri ,&nbsp;Zeev Nitsan ,&nbsp;Ruth Djaldetti ,&nbsp;Gilad Yahalom ,&nbsp;Ilana Schlesinger ,&nbsp;Christine Klein ,&nbsp;Lior Greenbaum","doi":"10.1016/j.parkreldis.2025.107940","DOIUrl":"10.1016/j.parkreldis.2025.107940","url":null,"abstract":"<div><h3>Background</h3><div>We examined the yield of a large-scale genetic testing for patients with Parkinson's disease (PD) in Israel, where risk factor variants in <em>GBA1</em> and/or the pathogenic p.Gly2019Ser variant in <em>LRRK2</em> are prevalent among the Ashkenazi Jewish population.</div></div><div><h3>Methods</h3><div>This study included data from all Israeli movement disorder clinics participating in the Rostock Parkinson's Disease (ROPAD) study. Patients were tested for variants in eight PD-related genes and 37 genes with possible phenotypic overlap.</div></div><div><h3>Results</h3><div>The sample consisted of 2699 PD patients recruited in three phases (1702 [63.1 %] males, mean age at onset 59.2 ± 10.6 years, 718 [26.6 %] with a family history of PD). Positive PD-relevant genetic test (PDGT) results were obtained in 512 participants (19.0 %). Among 187 (6.9 %) patients the results were due to pathogenic variants only in <em>LRRK2</em>, in 283 (10.5 %) due to risk factor variants only in <em>GBA1,</em> and another 15 patients (0.6 %) were carriers of variants in both genes. Twenty-six subjects (1.0 %) had a positive PDGT based on findings in <em>PRKN</em> (n = 19)<em>, PINK1</em> (n = 4), <em>PARK7, SNCA,</em> or <em>VPS35</em> (one in each gene), and an additional patient had dual findings (<em>GBA1</em> and <em>SNCA</em>). The most prevalent variants were <em>LRRK2</em> p.Gly2019Ser and <em>GBA1</em> p.Asn409Ser, detected in 191 (7.1 %) and 173 (6.4 %) patients, respectively. Excluding patients harboring only <em>LRRK2</em> and/or <em>GBA1</em> variants, the yield was 27/2214 (1.2 %). Seven participants, including one with a positive PDGT, had positive testing findings in genes related to dystonia (<em>GCH1</em> and <em>TOR1A</em>) and dementia (<em>MAPT</em>).</div></div><div><h3>Conclusions</h3><div>Genetic testing for Israeli PD patients is beneficial, while the yield is primarily attributed to <em>LRRK2</em> and <em>GBA1</em> variants.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"137 ","pages":"Article 107940"},"PeriodicalIF":3.1,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556827","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":"Magnetic resonance-guided focused ultrasound for essential tremor patients with low skull density ratio: A systematic review and meta-analysis.","authors":"Júlia Dos Santos Monteiro, Rafael Reis de Oliveira, Ocílio Ribeiro Gonçalves, Beatriz Borba E Silva, Izabely Dos Reis de Paula, Maria Antonia Oliveira Machado Pereira, Davi Santos Lima, Jacy Bezerra Parmera, Rubens Gisbert Cury, João Paulo Mota Telles","doi":"10.1016/j.parkreldis.2025.107936","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107936","url":null,"abstract":"<p><strong>Introduction: </strong>Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is a non-invasive treatment option for essential tremor (ET). Its use is often limited to patients with a skull density ratio (SDR) above 0.4, despite reports of positive outcomes in those with lower SDR.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to Cochrane and PRISMA guidelines. We searched PubMed, Embase, and Cochrane Library for studies reporting clinical outcomes, sonication strategies, and adverse effects related to MRgFUS for ET according to SDR ratios. Low SDR was defined as ≤ 0.4, while high SDR was categorized as > 0.4. Data were analyzed using a random-effects model in RStudio 4.4.0, with standardized mean difference (SMD) and 95 % confidence interval (CI) used to compare tremor improvements.</p><p><strong>Results: </strong>Five studies, including a total of 505 patients, were analyzed. Tremor reduction in patients with low SDR showed a pooled mean improvement of 48.81 % (95 % CI: 40.59 %-57.03 %) at three months post-treatment. Sustained tremor improvement was observed after 12 months, with a pooled mean of 45.58 % (95 % CI: 37.96 %-53.21 %). Comparison between low SDR and high SDR groups revealed no statistically significant difference in tremor improvement (SMD = -0.02; 95 % CI: -0.46 to 0.42; p = 0.93), indicating similar treatment responses.</p><p><strong>Conclusions: </strong>These findings suggest that MRgFUS is an effective treatment for ET patients with low SDR, with sustainable tremor reduction up to one year post-treatment and comparable outcomes to those with higher SDR.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107936"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567732","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":"Regional neuromelanin reduction in the substantia nigra in different subtype of Parkinson's disease","authors":"Xiali Shao ,&nbsp;Jia Jia ,&nbsp;Hongwei Li ,&nbsp;Yuanfang Li ,&nbsp;Kai Liu ,&nbsp;Jian Wang ,&nbsp;Lirong Jin","doi":"10.1016/j.parkreldis.2025.107933","DOIUrl":"10.1016/j.parkreldis.2025.107933","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate neuromelanin-sensitive MRI (NM-MRI) characteristics in the substantia nigra pars compacta (SNc) across Parkinson's disease (PD) subtypes and their association with motor and cognitive performance.</div></div><div><h3>Methods</h3><div>Four groups were included: PD patients with mild motor predominant (PD-MMP, n = 37), intermediate (PD-IM, n = 41), diffuse malignant (PD-DM, n = 12), and healthy controls (HC, n = 51). Clinical evaluations and MRI scans were performed. Signal values from NM-MRI were extracted using SNc and background masks. Contrast-to-noise ratio (CNR) values for the sensorimotor, associative, and limbic territories of the SNc were compared across groups. Pearson correlations assessed the relationship between CNR values and clinical scores in PD patients.</div></div><div><h3>Results</h3><div>CNR values in the whole SNc differed significantly between groups (<em>p</em> &lt; 0.01), with PD-DM showing the greatest reduction. The associative subregion had significantly lower CNR in all PD subgroups compared to HC (<em>ps</em> &lt; 0.01). In the limbic subregion, PD-IM had lower CNR than PD-MMP (<em>p</em> = 0.04). In the sensorimotor subregion, PD-IM and PD-DM had lower CNR compared to HC (<em>p</em> &lt; 0.01). CNR values in the whole SNc weakly correlated with UPDRS motor scores (r = −0.30, <em>p</em> &lt; 0.01) and the Trail Making Test B (r = −0.27, <em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>Distinct neuromelanin alterations were observed across PD subtypes, with PD-DM showing the most significant NM loss. These findings suggest that regional NM loss is associated with motor and cognitive impairments, reflecting underlying pathological mechanisms in PD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"137 ","pages":"Article 107933"},"PeriodicalIF":3.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502159","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":"Prodromal, established, and advanced Parkinson’s disease and atypical parkinsonisms: Prevalence and healthcare service utilization in the Catalan Health Surveillance System (Catpark study)","authors":"Eva M. Melendo-Azuela ,&nbsp;Yaroslau Compta ,&nbsp;Emili Vela ,&nbsp;Sonia Mariscal ,&nbsp;Ana Cámara ,&nbsp;Berta Solano ,&nbsp;Sonia Escalante ,&nbsp;Serge Jaumà ,&nbsp;Sebastià Santaeugènia","doi":"10.1016/j.parkreldis.2025.107937","DOIUrl":"10.1016/j.parkreldis.2025.107937","url":null,"abstract":"<div><h3>Introduction</h3><div>There are several studies on epidemiology, healthcare services utilization, and associated expenditures among patients with Parkinson's disease (PD), but evidence is scanty regarding prodromal PD and atypical parkinsonisms (APs). We seek to describe all these aspects in Catalonia.</div></div><div><h3>Methods</h3><div>Retrospective cross-sectional study of patients with prodromal, established, and advanced PD and APs from the Catalan Health Surveillance System during 2021 based on PD, APs and related diagnostic codes and compared to the population without PD and APs adjusted for age, sex, and income level.</div></div><div><h3>Results</h3><div>We analyzed data from 55,751 patients with a mean age of 68.7 (SD ± 18.2) years. Established and prodromal PD were the most prevalent (2991.4 and 2539.2 cases/million, respectively), with prodromal PD exhibiting the highest incidence rate (444.2 cases/million). Conversely, APs had the lowest prevalence and incidence rates (209.4 and 46.4 cases/million). The mortality rate was 6.48 per 100 inhabitants and was higher in patients with advanced PD and in those with APs, increasing both with age and Adjusted Morbidity Groups (<em>Grups de Morbilitat Ajustats</em>, GMA) comorbidity risk. Mortality was higher in the PD population compared to the control population. Healthcare service utilization and institutionalization rates were significantly higher in the PD + APs population, particularly among patients with advanced PD and APs.</div></div><div><h3>Conclusion</h3><div>This study provides novel insights into the characteristics, epidemiology, healthcare service utilization, and associated costs of patients with PD, including potential prodromal stage cases, and APs in Catalonia, underscoring the significant burden of PD and APs and their substantial demand on healthcare resources.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"138 ","pages":"Article 107937"},"PeriodicalIF":3.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587837","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":"Supports available for apomorphine management: How best to facilitate appropriate usage of apomorphine?","authors":"Zvezdan Pirtošek","doi":"10.1016/j.parkreldis.2025.107934","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107934","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a chronic neurodegenerative disorder marked by progressive deterioration in both motor and non-motor function. In advanced stages, patients commonly experience motor fluctuations, including unpredictable \"off\" episodes that severely affect quality of life. Apomorphine, a potent dopamine receptor agonist administered subcutaneously-either as intermittent injections or continuous infusion-offers rapid and effective relief during these episodes. Despite its therapeutic value, apomorphine remains underutilized due to barriers such as limited awareness, initiation complexity, adverse effect management, and the need for specialized infrastructure. This review outlines current knowledge regarding support systems necessary for optimizing apomorphine use in PD. A structured, three-stage model-pre-initiation, initiation, and maintenance-is proposed to guide best practices. We describe the roles of key stakeholders, including multidisciplinary healthcare teams, caregivers, pharmaceutical service providers, and patient advocacy organizations. Neurologists and Parkinson's Disease Nurse Specialists (PDNS) are central to treatment coordination, while physiotherapists, occupational therapists, speech-language pathologists, and mental health professionals provide essential complementary care. When adequately informed and supported, caregivers play a critical role in promoting adherence and emotional stability. Pharmaceutical companies offer educational materials, technical assistance, home care resources, and financial support mechanisms. Patient organizations contribute through peer education and emotional reinforcement. Future directions include enhanced training models, broader telemedicine integration, and device innovation. A coordinated, patient-centered approach is needed to ensure sustained, equitable access to apomorphine for individuals living with advanced PD.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107934"},"PeriodicalIF":3.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567733","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":"Tau positron emission tomography in the Parkinson and Richardson subtypes of progressive supranuclear palsy.","authors":"Piotr Alster, Thilo van Eimeren, Natalia Madetko-Alster","doi":"10.1016/j.parkreldis.2025.107939","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107939","url":null,"abstract":"<p><p>Progressive supranuclear palsy (PSP) is an atypical form of parkinsonism affected by deficiencies regarding efficient methods of examination, thereby hindering the establishment of an early and certain diagnosis prior to post-mortem examination. Most studies are based on magnetic resonance imaging analyses; however, there is growing interest in the evaluation of radiotracers in positron emission tomography (PET). In this narrative review, we attempt to elaborate on the significance of tau radiotracers and other PET biomarkers in the context of examination of two major subtypes of PSP: Richardson's syndrome (PSP-RS) and parkinsonism predominant (PSP-P). Although the subtypes show clinical boundaries and overlaps, they may be additionally evaluated using in vivo tau imaging. The feasibility of these methods may vary depending on cell-specific accumulation. The assessment of discrepancies in cellular tau deposition, as well as the combined analysis of these features with the pathogenesis of PSP-RS and PSP-P, may provide further insights enabling the redefinition of the diagnosis and monitoring of these conditions and the formulation of efficient therapeutic strategies.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107939"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529191","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":"Prevalence and incidence of Deep Brain Stimulation and Focused Ultrasound in a cohort of elders with Essential Tremor","authors":"Diane S. Berry ,&nbsp;Tomer O. Guy ,&nbsp;Vibhash D. Sharma ,&nbsp;Elan D. Louis","doi":"10.1016/j.parkreldis.2025.107938","DOIUrl":"10.1016/j.parkreldis.2025.107938","url":null,"abstract":"<div><h3>Introduction</h3><div>Deep Brain Stimulation (DBS) and Focused Ultrasound Thalamotomy (FUS) are important surgical alternatives for managing essential tremor (ET). Studies of the prevalence (i.e., the proportion of cases reporting a surgical procedure at a given observation), the incidence (i.e., the proportion of cases reporting new occurrences of a surgical procedure at a given observation), and the surgical rate (i.e., the proportion of cases with no history of surgery who underwent a surgical procedure during a given time interval) of DBS and FUS in ET cases are few and have limitations.</div></div><div><h3>Methods</h3><div>We obtained surgical histories from 346 ET participants in a longitudinal research study that ascertained cases outside of treatment centers. 283 cases participated in follow-up evaluations at 18, 36, 54, 72 and 90 months (mean length of observation = 4.4 ± 2.5 years).</div></div><div><h3>Results</h3><div>The cumulative prevalence of DBS and FUS were 0.046 % (Confidence Interval [CI] = 0.024 to 0.068) and 0.035 % (CI = 0.016 to 0.054), respectively. The cumulative incidence (9.44 per 1000 person-years, and 9.43 per 1000 person-years, respectively) and annual surgical rates (0.009, and 0.009, respectively) observed for DBS and FUS were similar. Reported rates for DBS were lower than reported from clinic-based studies.</div></div><div><h3>Conclusion</h3><div>To date, no other studies have documented the proportion of individuals with ET who have undergone FUS, and only three studies report the proportion who underwent DBS. All of the latter ascertained cases from treatment centers, biasing estimates upwards. Our data add to the understanding of surgical rates for ET.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"137 ","pages":"Article 107938"},"PeriodicalIF":3.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548504","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":"Visual hallucinations in Parkinson's disease: The critical role of intermediate nucleus basalis of Meynert","authors":"Hiroyuki Hatsuta ,&nbsp;Masashi Mizutani ,&nbsp;Kaoru Yagita ,&nbsp;Terunori Sano ,&nbsp;Masaki Takao","doi":"10.1016/j.parkreldis.2025.107935","DOIUrl":"10.1016/j.parkreldis.2025.107935","url":null,"abstract":"<div><h3>Background and objective</h3><div>Patients with Parkinson's disease (PD) often experience visual hallucinations (VH) and delusions. PD patients with VH reportedly have a higher incidence of dementia than PD patients without VH. The nucleus basalis of Meynert (nbM) comprises acetylcholine-releasing neurons that are critical for memory, attention, and arousal. Notably, the nbM also exhibits pathological α-synuclein accumulation, which is a hallmark of Lewy body diseases, including PD. In the present study, we investigated the distribution of abnormal α-synuclein accumulation in the nbM.</div></div><div><h3>Methods</h3><div>nbM sections of PD 28 autopsy patients were prepared and analyzed via immunohistochemistry using antibodies against phosphorylated α-synuclein and Choline acetyltransferase. The analysis included quantitative assessments of Choline acetyltransferase or α-synuclein positive neurons.</div></div><div><h3>Results</h3><div>Immunohistochemical analyses of the nbM sections revealed significant cholinergic neuron loss in the intermediate nbM of patients with VH compared with those without VH (137 vs. 191, <em>p</em> = 0.04). Moreover, the ratio of α-synuclein-positive cells to choline acetyltransferase-positive cells was significantly higher in patients with VH than in those without VH (<em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>Pathological changes in nbM—particularly cholinergic deficits in the intermediate part—were therefore identified as potential contributors to VH in PD. These findings add to our understanding of the neuropathological basis of VH in PD and may inform future therapeutic strategies.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"137 ","pages":"Article 107935"},"PeriodicalIF":3.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502158","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":"Comment on \"Prevalence and clinical impact of alpha-synuclein pathology in idiopathic normal pressure hydrocephalus: Insights from RT-QuIC assay\".","authors":"Digvijay Singh Rajawat, Saketh Sainag Mandiga, Keerthi Sanapala","doi":"10.1016/j.parkreldis.2025.107926","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107926","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107926"},"PeriodicalIF":3.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507519","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}