Parkinsonism & related disorders最新文献

{"title":"Consensus expert recommendations for management of urinary dysfunction in Parkinson disease.","authors":"Delaram Safarpour, Camille P Vaughan, Kathleen E McKee, Alexandra L Tabakin, Pinky Agarwal, Aditya V Boddu, Frank C Lin, Hillary A Williams, Javier E Santiago, Jun Song, Ronald F Pfeiffer, Rohit Dhall","doi":"10.1016/j.parkreldis.2026.108961","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108961","url":null,"abstract":"<p><strong>Background: </strong>Urinary symptoms may occur throughout all stages of Parkinson disease (PD) and adversely affect quality of life for patients and caregivers. Lower urinary tract symptoms are multifactorial and may include urinary urgency, frequency, nocturia, incontinence, and voiding dysfunction. These symptoms may be compounded by mobility impairment disrupt sleep and contribute to falls. An updated multidisciplinary framework is needed to integrate current evidence and evolving therapeutic options into clinical practice.</p><p><strong>Objective: </strong>To develop consensus recommendations for screening, diagnosis, and management of urinary dysfunction in PD.</p><p><strong>Methods: </strong>The application of a modified virtual Delphi panel allowed for the synthesis of expert opinions into clinical statements. A multidisciplinary expert panel comprising movement disorders neurologists, urologists, urogynecologists, and a geriatrician with expertise in lower urinary tract dysfunction conducted a targeted narrative review of PubMed. Draft statements were developed across four clinical domains: evaluation, PD-specific contributors, diagnostic work-up, and interventions and rehabilitation. Statements were discussed, revised, and voted on through a modified virtual Delphi process until consensus was achieved.</p><p><strong>Results: </strong>The panel developed consensus recommendations and a unifying clinical algorithm to support screening, diagnostic evaluation, appropriate referral, and individualized multidisciplinary management.</p><p><strong>Conclusions: </strong>These consensus recommendations provide a structured approach to evaluate and manage urinary dysfunction in PD across clinical settings.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108961"},"PeriodicalIF":4.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920171","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":"Consensus practice recommendations for management of sleep dysfunction in Parkinson disease.","authors":"Carine W Maurer, Delaram Safarpour, Joyce K Lee-Iannotti, Lana M Chahine, Jeanne Feuerstein, Amy W Amara, Eleni Okeanis Vaou, Aleksandar Videnovic, Miranda M Lim, David Shprecher, Lee E Neilson","doi":"10.1016/j.parkreldis.2026.108963","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108963","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep disturbances are highly prevalent in people with Parkinson's disease (PD). Adhering to practical, evidence-informed guidelines enhances care delivery and quality of life in PD. Therefore, we sought to develop consensus statements on screening, diagnosis, and treatment of sleep dysfunction in PD.</p><p><strong>Methods: </strong>The application of a modified Delphi panel allowed for the synthesis of expert opinions into clinical statements. Consensus was predefined as a level of agreement of 100% for each item. Four virtual Delphi rounds were held. After selecting the topics for consideration, 2-3 neurologists reviewed the literature and developed draft statements. Draft statements were distributed among the panel that included 11 movement-, sleep-, or dual-trained neurologists representing all geographic areas of the contiguous United States. All members reviewed the statements and references in advance of the virtual meetings. During the virtual meetings, each statement was discussed, edited, and a vote was conducted. Statements not achieving unanimity were discussed in the text to identify potential avenues of further inquiry.</p><p><strong>Results: </strong>A total of 114 statements were developed for screening, diagnosis, and treatment of common sleep symptoms in PD and were organized by subtopic. Subtopics included insomnia, excessive daytime sleepiness, REM sleep behavior disorder and non-REM parasomnias, and other common sleep disorders (restless legs syndrome, periodic limb movements of sleep, sleep-disordered breathing, and circadian rhythm sleep wake-disorders).</p><p><strong>Conclusions: </strong>These consensus recommendations offer a practical framework for the diagnosis and treatment of sleep dysfunction in PD.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108963"},"PeriodicalIF":4.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956328","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":"Non-surgical treatment of essential tremor: What's in store?","authors":"Malak AlMojel, Alfonso Fasano","doi":"10.1016/j.parkreldis.2026.108967","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108967","url":null,"abstract":"<p><p>Non-surgical therapy is the mainstay of treatment for Essential Tremor (ET). Traditional pharmacological treatments were found to provide variable tremor reduction, with limited tolerability and high discontinuation rates. This narrative review analyzed studies on adults with ET, focusing on current and emerging non-surgical therapies, with priority given to efficacy and safety. While ACP-711 is a newly investigated positive allosteric modulator (PAM) of GABA-A receptors, other PAMs (SAGE-324 and PRAX-114) have been withdrawn after failure to demonstrate statistically significant effects in clinical trials. This has also extended to include highly selective Cav3 antagonists (T-type calcium channel blockers): suvecaltamide (JZP385) and NBI-827104/ACT-7099478. By contrast, ulixacaltamide (PRAX-944) has been recently found to be effective and safe in a large phase 3 trial. ES-481, a novel selective antagonist of transmembrane AMPA receptor regulatory protein (TARP)-γ8-dependent AMPA receptors, has been tested in a small trial in Canada, complicated by early participant drop-out. Non-pharmacological techniques such as transcranial neuromodulatory devices (e.g. transcranial ultrasound) have been investigated. While peripheral neuromodulatory devices (transcutaneous afferent patterned/peripheral nerve stimulation) have been FDA-cleared, other devices (e.g. orthotics) have presented promising results with improved tremor control and minimal side effects. In conclusion, emerging non-surgical treatment strategies may enhance effectiveness, tolerability, and patients' adherence. Although many compounds have failed during advanced clinical development, others remain in the pipeline. This renewed interest in the treatment of ET, along with a better understanding of its pathophysiology and clinical trial design, could ultimately lead to newer first-line agents specifically designed for ET.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108967"},"PeriodicalIF":4.3,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976771","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":"When machines see more: Digital technologies, measurement, and meaning in hyperkinetic movement disorders.","authors":"Roongroj Bhidayasiri, Chaewon Shin, Alberto Albanese","doi":"10.1016/j.parkreldis.2026.108959","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108959","url":null,"abstract":"<p><p>Hyperkinetic movement disorders force neurologists to ask: what movement are we seeing, and what does it mean? Developed from the Mark Hallett Plenary, this mini-review argues that digital technologies are best understood as tools for operationalised phenomenology: translating bedside descriptors into reproducible, clinically interpretable measures. From Charcot's visual documentation to Hallett's clinical neurophysiology, technology has long extended, rather than replaced, clinical observation. Wearables, smartphones, video/computer vision, EMG/EEG-EMG, and artificial intelligence now quantify selected features of tremor, chorea, dystonia, tics, myoclonus, dyskinesia, and functional hyperkinesia across clinic and real-world settings. We consider how these tools may clarify phenotype, capture fluctuation, guide treatment, support trials, and expose measurement pitfalls in mixed or context-dependent disorders. Their value depends on validation, interpretability, workflow integration, and patient relevance. Particular emphasis is placed on preserving clinical reasoning within the diagnostic funnel throughout care pathways. Machines may win at measurement; clinicians must ensure that measurement becomes meaning.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108959"},"PeriodicalIF":4.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897574","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":"Juvenile mitochondrial membrane protein-associated neurodegeneration with early parkinsonism and obsessive-compulsive behavior.","authors":"Juan Sebastian Sanchez Leon, Ingrid Lorena da Silva Gomes, Thomas Hugentobler Schlickmann, Bruno Samuel Fraiman de Oliveira, Sheila Trentin, Daniel Teixeira-Dos-Santos, Diego Ehlers, Leonardo Simão Medeiros, Thais Lampert Monte, Artur Francisco Schumacher Schuh","doi":"10.1016/j.parkreldis.2026.108969","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108969","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108969"},"PeriodicalIF":4.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888349","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":"Metabolic brain imaging in genetic Parkinson's disease: from genes to network trajectories","authors":"Lisa Taruffi,&nbsp;Giacomo Argenziano,&nbsp;Annachiara Arnone,&nbsp;Alessandro Fraternali,&nbsp;Luca Codeluppi,&nbsp;Giada Coluccio,&nbsp;Giulia Di Rauso,&nbsp;Valentina Fioravanti,&nbsp;Giacomo Portaro,&nbsp;Ryan Langridge,&nbsp;Sara Montepietra,&nbsp;Silvia Paola Caminiti,&nbsp;Alessio di Fonzo,&nbsp;Ji Hyun Ko,&nbsp;Angelina Filice,&nbsp;Francesco Cavallieri","doi":"10.1016/j.parkreldis.2026.108414","DOIUrl":"10.1016/j.parkreldis.2026.108414","url":null,"abstract":"<div><div>Genetic forms of Parkinson's disease (PD) provide a unique model to investigate how distinct molecular perturbations reshape large-scale brain networks. Although most genetic variants ultimately converge on nigrostriatal dopaminergic degeneration, accumulating evidence suggests that different mutations modulate distributed motor and cognitive circuits along genotype-specific trajectories. In this narrative review, we synthesize findings from 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and cerebral perfusion single-photon emission computed tomography (SPECT) in monogenic and high-risk forms of PD, including LRRK2, GBA1, SNCA, PRKN, PINK1, DJ-1, RAB39B, and RAB32. Spatial covariance analyses have identified reproducible disease-related metabolic networks, notably the Parkinson's disease–related motor pattern (PDRP) and the Parkinson's disease cognitive pattern (PDCP), which can be quantified at the single-subject level and tracked longitudinally. Across genotypes, mutations appear to modulate the topology, resilience, and temporal evolution of shared network architectures rather than generating distinct metabolic signatures The strongest evidence concerns severe GBA1 variants, which are associated with early posterior cortical involvement and greater PDCP expression, whereas limited case-based data suggest more diffuse cortical involvement in selected SNCA multiplication carriers. In contrast, mitochondrial- and kinase-related mutations often show metabolic alterations largely confined to subcortical motor circuits. We propose a trajectory-based framework in which genetic background shapes network vulnerability and compensatory capacity rather than defining separate metabolic entities. In the era of gene-targeted therapies, imaging-defined network phenotypes may serve as functional biomarkers for risk stratification, longitudinal monitoring, and mechanistic therapeutic trials, bridging genotype and systems-level neurodegeneration.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"150 ","pages":"Article 108414"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of speed-based interventions aimed at improving bradykinesia in individuals with Parkinson's disease: a systematic review","authors":"Poliana do Amaral Yamaguchi Benfica,&nbsp;Aline Alvim Scianni,&nbsp;Jordana de Paula Magalhães,&nbsp;Sherindan Ayessa Ferreira de Brito,&nbsp;Júlia Caetano Martins,&nbsp;Christina Danielli Coelho de Morais Faria","doi":"10.1016/j.parkreldis.2026.108438","DOIUrl":"10.1016/j.parkreldis.2026.108438","url":null,"abstract":"<div><h3>Background</h3><div>Exercises that promote faster movement execution may help improve bradykinesia in individuals with Parkinson's disease (PD).</div></div><div><h3>Objectives</h3><div>To describe speed-based interventions employed to improve bradykinesia in individuals with PD, evaluate their effects, and identify gaps in the literature.</div></div><div><h3>Methods</h3><div>The review followed PRISMA guidelines. Searches were conducted in EMBASE, MEDLINE, Scielo, Lilacs, PEDro, and gray literature sources up to December 2025. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) and Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I) tools were used to assess risk of bias.</div></div><div><h3>Results</h3><div>Eight studies involving 149 participants with PD were included: six randomized controlled trials (RCTs) and two non-randomized studies. Interventions included high-cadence cycling, aerobic interval training, power training, and high-speed power yoga. All studies were rated as having high risk of bias. The findings suggest that speed-based interventions may improve upper- and lower-limb bradykinesia in individuals with PD.</div></div><div><h3>Conclusion</h3><div>This systematic review showed that speed-based interventions are effective in improving bradykinesia in both upper and lower limbs. However, these results should be interpreted with caution due to the high risk of bias presented in all included studies. Gaps were identified regarding the assessment of bradykinesia and the types of interventions applied. Further high-quality RCTs are necessary to draw definitive conclusions.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"150 ","pages":"Article 108438"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The classificatory ambiguity of task-specific tremor.","authors":"Daniele Birreci, Luca Angelini, Simone Aloisio, Anna S Grandolfo, Martina De Riggi, Alberto J Espay, Matteo Bologna","doi":"10.1016/j.parkreldis.2026.108971","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108971","url":null,"abstract":"<p><p>Task-specific tremor is a clinically heterogeneous phenotype that remains difficult to accommodate within current tremor classification. Although defined by its occurrence during a specific motor task, the boundaries with position-specific and isometric tremors remain uncertain. Additional classificatory complexity arises when a task-specific tremor phenotype is accompanied by neurological signs that remain subtle, questionable, or uncertain, such as possible dystonic posturing, rest tremor, mild bradykinesia, or response to alleviating maneuvers, and do not clearly support classification as a combined tremor syndrome, but raise the question of whether additional descriptive categories are needed. However, as in other movement disorders, caution is warranted against using additive labels to formalize uncertainty (the \"plus\" suffix) without biological, prognostic, or therapeutic validation. Available data suggest that the same task-specific tremor phenotype may reflect different underlying pathophysiological processes, with variable overlap with essential tremor, dystonia, and Parkinson's disease. This article addresses three unresolved issues in task-specific tremor: the interpretation of subtle neurological signs without prematurely introducing a \"task-specific tremor-plus\" category; the blurred boundary between task-specific, position-specific, and isometric tremors; and the relationship between heterogeneous clinical phenotypes and the available pathophysiological evidence. Rather than introducing new descriptive labels, we propose that these phenotypes should be approached through precise phenomenological description, quantitative characterization, and longitudinal follow-up, with the aim of determining whether they represent stable clinical variants, evolving combined tremor syndromes, or different expressions within a broader tremor spectrum.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108971"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913042","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":"Parkinson's disease across female reproductive stages: Clinical implications from menstruation to menopause","authors":"Dayany Leonel Boone,&nbsp;Vanderci Borges,&nbsp;Henrique Ballalai Ferraz","doi":"10.1016/j.parkreldis.2026.108420","DOIUrl":"10.1016/j.parkreldis.2026.108420","url":null,"abstract":"<div><div>Parkinson's disease (PD) is a neurodegenerative disorder that differs between women and men in epidemiology, clinical manifestations, treatment response, adverse effects, and disease progression. The central hypothesis that sex hormones may modulate dopaminergic and neuroinflammatory/oxidative stress circuits could explain the observed clinical and epidemiological differences. These factors may influence motor and non-motor symptoms, pharmacological management, reproductive counseling, sexual health, and decisions regarding advanced therapies. In this narrative review, we synthesize current evidence and highlight key knowledge gaps on PD across the menstrual cycle, pregnancy, and menopause. We also discuss the potential role of estrogen exposure, menopausal hormone therapy, pregnancy-related medication considerations, deep brain stimulation (DBS) during pregnancy, and clinically relevant knowledge gaps. Available evidence remains limited, heterogeneous, and largely based on observational studies, case series, and expert opinion. Recognizing reproductive-stage influences may improve individualized care for women with PD and should be prioritized in future prospective research.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"150 ","pages":"Article 108420"},"PeriodicalIF":4.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking gastrointestinal symptoms in Parkinson's disease: A practical and discrete gut health questionnaire.","authors":"Indu Subramanian, Eamonn Quigley, Carley Rusch, John Dean, Shafaq Ali, Henry P Parkman, Amanda Bryant, Carine W Maurer, Leslie Cloud, Fariha Jamal, Ronald F Pfeiffer, Delaram Safarpour","doi":"10.1016/j.parkreldis.2026.108940","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108940","url":null,"abstract":"<p><p>Gastrointestinal dysfunction represents a pervasive and disabling group of non-motor symptoms that often go unrecognized and untreated in Parkinson's Disease(PD). These symptoms can affect levodopa responsiveness, quality of life, and nutritional status. Because gastrointestinal symptoms may be highly stigmatizing or embarrassing, some patients-particularly those from certain cultural backgrounds and genders-may feel uncomfortable raising these concerns or answering sensitive questions in the presence of family members or caregivers during clinic visits. To address this gap, a brief, discrete questionnaire was developed to facilitate proactive and practical screening andto operationalize the consensus recommendations for the management of GI dysfunction in PD established by the Parkinson Study Group. The questionnaire can be completed by patients before their visit or administered privately by nursing staff or physicians, thereby promoting recognition of GI symptoms and improving the quality of care for individuals with PD.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108940"},"PeriodicalIF":4.3,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875725","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}