Parkinsonism & related disorders最新文献

{"title":"Positive association between total bilirubin and early-stage Parkinson's disease","authors":"Wen Zhou,&nbsp;Qingqing Xia,&nbsp;Duan Liu,&nbsp;Jun-ying Li,&nbsp;Liang Gong","doi":"10.1016/j.parkreldis.2025.107888","DOIUrl":"10.1016/j.parkreldis.2025.107888","url":null,"abstract":"<div><h3>Background</h3><div>The correlation between total bilirubin and Parkinson's disease (PD) remains unclear currently. This study aimed to assess the association between total bilirubin and early-stage PD.</div></div><div><h3>Objective</h3><div>The ultimate goal is to gain a deeper understanding of the implications of this relationship between total bilirubin and early-stage PD.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study involving 1631 participants which collected from 2010 to 11 December 2024 in PPMI cohort. Logistic regression, smooth curve fitting, subgroup analysis, and sensitivity analyses were employed to validate the research objectives.</div></div><div><h3>Results</h3><div>The overall prevalence of PD was 81.5 % (1329/1631). Specifically, the prevalence was 78.0 % (294/377) for total bilirubin tertile 1 (T1, 3–7 μmol/L), 80.8 % (498/616) for tertile 2 (T2, 7–10 μmol/L), and 84.2 % (537/638) for tertile 3 (T3, 10–48 μmol/L), respectively (P = 0.043). Multivariate odds ratio regression adjusted for risk factors demonstrates a 5-unit increment in the total bilirubin raises the risk of early-stage PD by 1.16 times, respectively. Smooth splines analysis suggested a linear association between levels of total bilirubin and risk of early-stage PD (P nonlinearity = 0.968). Further exploratory subgroup analysis within the age, sex, BMI, and MCI groups showed that there were no significant interactions between the subgroups (all P values for interaction were &gt;0.05). Additional sensitivity analyses supported the primary findings and indicated the conclusions are robust.</div></div><div><h3>Conclusions</h3><div>The observed association between elevated total bilirubin levels and early-stage PD risk suggests that bilirubin may serve as a potential biomarker for early diagnosis and disease monitoring.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"136 ","pages":"Article 107888"},"PeriodicalIF":3.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138639","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":"Investigating the neural correlates of subjective sleep changes following subthalamic nucleus deep brain stimulation for Parkinson's disease","authors":"Luke Andrews ,&nbsp;Simon S. Keller ,&nbsp;Maneesh Bhojak ,&nbsp;Jibril Osman-Farah ,&nbsp;Antonella Macerollo","doi":"10.1016/j.parkreldis.2025.107887","DOIUrl":"10.1016/j.parkreldis.2025.107887","url":null,"abstract":"<div><h3>Introduction</h3><div>Sleep disturbances in Parkinson's disease (PD) are extremely common and significantly impact quality of life. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established therapy for motor symptoms and may also influence sleep outcomes. However, the relationship between stimulation location, structural networks, and sleep improvements remains poorly understood, particularly over longer durations.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 53 PD patients implanted with bilateral STN-DBS. Sleep outcomes were assessed using self-report measures, with subsection scores for nighttime sleep, daytime wakefulness, and total sleep disturbance analysed. Local stimulation effects were modelled using sweet spot analyses, and innervated tracts were examined through discriminative fiber filtering. Associations with motor improvements and demographic factors were analysed.</div></div><div><h3>Results</h3><div>Significant improvements were reported in both nighttime sleep and daytime wakefulness. Motor symptom improvements were significantly positively associated with cumulative sleep scores but did not fully explain sleep changes. Sweet spot analyses revealed associations between cumulative sleep score improvements and the sensorimotor STN, while fiber filtering implicated brainstem, cerebellar, and cortical motor tracts for daytime and cumulative sleep improvements. These associations remained significant after controlling for motor improvements.</div></div><div><h3>Discussion</h3><div>Our findings suggest that STN-DBS may modulate sleep via broader structural connections and beyond motor symptom improvements. The lateralised effects and involvement of widespread tracts underscore the complexity of DBS-related sleep modulation. Future studies should incorporate longitudinal designs and objective measures to disentangle motor-independent mechanisms and optimise therapeutic strategies.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"136 ","pages":"Article 107887"},"PeriodicalIF":3.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107446","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 effects of stretching in Parkinson's disease: A systematic review of randomized controlled trials","authors":"Iratxe Duñabeitia ,&nbsp;Daniel González-Devesa ,&nbsp;Nerea Blanco-Martínez ,&nbsp;Carlos Ayán-Pérez","doi":"10.1016/j.parkreldis.2025.107865","DOIUrl":"10.1016/j.parkreldis.2025.107865","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"136 ","pages":"Article 107865"},"PeriodicalIF":3.1,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070522","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":"Probabilistic mapping of gait changes after STN-DBS for Parkinson's disease","authors":"Robert C. Nickl ,&nbsp;Hazem Eldebakey ,&nbsp;J Anne Grossmann ,&nbsp;Jonas Roothans ,&nbsp;Pavel Navrátil ,&nbsp;Ioannis U. Isaias ,&nbsp;Florian Lange ,&nbsp;Patrick Fricke ,&nbsp;Philipp Capetian ,&nbsp;Cordula Matthies ,&nbsp;Jens Volkmann ,&nbsp;Martin M. Reich","doi":"10.1016/j.parkreldis.2025.107871","DOIUrl":"10.1016/j.parkreldis.2025.107871","url":null,"abstract":"<div><h3>Introduction</h3><div>Gait disturbances causing impaired mobility are common in Parkinson's disease after bilateral deep brain stimulation of the subthalamic nucleus. We describe subthalamic subregions where neurostimulation had a positive effect on gait or provoked gait disturbances.</div></div><div><h3>Methods</h3><div>98 patients were classified according to changes in MDS-UPDRS III gait items: gait improvement (≥1-point improvement in items 3.10 and/or 3.11), gait deterioration (≥1-point worsening, confirmed by repeated clinical documentation), or no change. We performed a segregation analysis for (1) and (3) by simulating volumes of tissue activated and comparing aggregated spatial data and calculated probability maps to forecast gait performance and the parkinsonism control.</div></div><div><h3>Results</h3><div>42 patients experienced improvement of presurgical gait problems after stimulation. Seven patients showed gait deteriorations one-year post-implantation. Active contacts were more ventrally located for gait deterioration versus gait improvement. Voxel-wise probabilistic mapping of gait changes in the subthalamic area were able to forecast patient specific gait performance based on individual stimulation volume (LOOCV R² = 0.45; p &lt; 0.01) but was not associated with long-term parkinsonism control. Whereas a probabilistic map trained on MDS-UPDRS-III changes was predictive for clinical improvement in parkinsonism (R² = 0.18; p &lt; 0.01).</div></div><div><h3>Discussion</h3><div>Probabilistic mapping showed a strong correlation with therapy outcomes, especially gait improvement, and provided predictive value at the individual level. While the concept of sweet- or sourspots was insufficient to explain individual variability, the heatmap-based approach allowed symptom-specific topographies to be identified. Our findings support the use of probabilistic mapping as a valuable tool to guide individualized reprogramming strategies for improving mobility in Parkinson's disease.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"136 ","pages":"Article 107871"},"PeriodicalIF":3.1,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115583","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":"Expert commentary on \"A case report of palatal tremor in progressive supranuclear palsy\".","authors":"Shen-Yang Lim, Anthony E Lang","doi":"10.1016/j.parkreldis.2025.107873","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107873","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107873"},"PeriodicalIF":3.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161250","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":"A delphi consensus statement about French practical management of continuous apomorphine infusion in patients with Parkinson's disease and motor fluctuations.","authors":"Fabienne Ory Magne, Sophie Drapier, Ana-Raquel Marques, David Maltete, Frederique Leh, Cecile Hubsch, Frederique Fluchere, Margherita Fabbri, Angelique Gerdelat, Solene Frismand, Gwendoline Dupont, Cécile Delorme, Rene Decombe, Teodor Danaila, Jarbas Correa Lino, Olivier Colin, Cecilia Bonnet, Alexandre Bonnet, Sebastien Bailly, Emmanuel Roze","doi":"10.1016/j.parkreldis.2025.107866","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107866","url":null,"abstract":"<p><strong>Background: </strong>There are currently no consensus guidelines on how to progressively optimize treatment when initiating continuous subcutaneous apomorphine infusion (CSAI) in patients with Parkinson's disease (PwPD).</p><p><strong>Aims: </strong>To provide practical guidelines on CSAI initiation in PwPD with motor fluctuations, with a focus on the target dose of apomorphine over time and subsequent adjustment of oral treatment according to the patient's characteristics.</p><p><strong>Methods: </strong>A panel of French neurologists with extensive experience in treating patients with advanced Parkinson's disease used a modified Delphi approach to generate a knowledge synthesis on CSAI initiation according to patient characteristics.</p><p><strong>Results: </strong>We identified five profiles based on patient characteristics. The target dose of apomorphine over time and the subsequent adjustment of oral therapy were highly dependent on these profiles. The CSAI flow rate varied from a maximum of 3 mg/h for older or more sensitive patients to 6-10 mg/h for younger patients experiencing early fluctuations. In most cases, the preferred approach was to reduce both levodopa and dopamine agonists when increasing CSAI. For optimum efficacy, the total target dose of levodopa equivalent (calculated as the sum of the oral dose and the apomorphine dose) should be greater than or equal to the pre-initiation dose after initiation of CSAI, regardless of patient characteristics.</p><p><strong>Conclusion: </strong>We provide patient-tailored recommendations with precise indications for the adjustment of apomorphine, oral therapy and levodopa equivalent dose over time during CSAI initiation, based on distinct patient profiles.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107866"},"PeriodicalIF":3.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142976","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":"Gait initiation deficits in Parkinson's disease with freezing of gait: A large-scale force platform study of anticipatory postural adjustments","authors":"Luana dos Santos de Oliveira ,&nbsp;Carla Silva-Batista ,&nbsp;Andrea Cristina de Lima-Pardini ,&nbsp;Fay B. Horak ,&nbsp;Daniel Boari Coelho","doi":"10.1016/j.parkreldis.2025.107882","DOIUrl":"10.1016/j.parkreldis.2025.107882","url":null,"abstract":"<div><h3>Introduction</h3><div>Freezing of gait (FoG) is a debilitating motor symptom in Parkinson's disease (PD), often occurring during step initiation due to impaired anticipatory postural adjustments (APAs). Previous studies show inconsistent findings regarding APA alterations in people with PD with FoG (PwPD + FoG) and without FoG (PwPD-FoG). This study aimed to investigate APA characteristics using a force platform to assess postural control deficits associated with FoG.</div></div><div><h3>Methods</h3><div>We analyzed baseline data from 130 PwPD (70 with FoG) and 41 healthy controls. A force platform during self-initiated stepping measured APA duration, amplitude, and step amplitude. All participants with PD were tested in the ON medication. One-way ANOVA and ANCOVA (controlling for UPDRS-III and medication) were conducted to compare groups.</div></div><div><h3>Results</h3><div>APA duration was significantly shorter in Healthy compared to PwPD + FoG and PwPD-FoG, with no difference between PD groups. Step amplitude was significantly lower in PwPD + FoG compared to Healthy and PwPD-FoG, but this difference was insignificant after covariate. APA mediolateral amplitude followed PD + FoG &lt; PD-FoG &lt; Healthy; ANCOVA confirmed lower values in PwPD + FoG compared to PwPD-FoG. APA anteroposterior amplitude was also reduced in PwPD + FoG relative to PwPD-FoG and Healthy, with ANCOVA confirming significantly lower values in PwPD + FoG versus PwPD-FoG. NFOG-Q scores were negatively correlated with mediolateral and anteroposterior APA amplitudes.</div></div><div><h3>Conclusion</h3><div>FoG in PD is associated with reduced APA amplitude (mediolateral and anteroposterior), suggesting postural control deficits persist despite dopaminergic medication. These findings highlight the importance of interventions targeting APA improvements to mitigate gait initiation failures in PwPD + FoG.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"136 ","pages":"Article 107882"},"PeriodicalIF":3.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083720","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":"Alpha-synuclein in Parkinson's disease: Embracing debate, exercising skepticism.","authors":"Alberto J Espay, Andrew J Lees, Francisco Cardoso, Steven J Frucht, Daniel Erskine, Andrea Sturchio, Alberto Imarisio, Christian Hoffmann, Kora T Montemagno, Samuel Naudi-Fabra, Dragomir Milovanovic, Glenda M Halliday, Fredric P Manfredsson","doi":"10.1016/j.parkreldis.2025.107874","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107874","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107874"},"PeriodicalIF":3.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132786","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":"A genetic perspective on retinal thinning in Parkinson's disease: Direct damage or comorbid glaucoma?","authors":"Meng-Yue Xu, Meng-Qi Qin","doi":"10.1016/j.parkreldis.2025.107870","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107870","url":null,"abstract":"<p><p>This study used Mendelian randomization to reveal a causal link between Parkinson's disease (PD) and retinal nerve fiber layer thinning. Moreover, the tremor-dominant (TD) PD subtype was genetically associated with increased glaucoma risk, suggesting PD, especially TD subtype, may contribute to retinal neurodegeneration via both direct and glaucoma-related pathways.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107870"},"PeriodicalIF":3.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143025","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":"Apomorphine: past, present and future in Parkinson's disease and beyond.","authors":"Manon Auffret","doi":"10.1016/j.parkreldis.2025.107872","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107872","url":null,"abstract":"<p><p>The year 2025 marks the 180th anniversary of the first documented synthesis of apomorphine, and the first U.S. Food and Drug Administration (FDA) approval of a subcutaneous apomorphine infusion device for advanced Parkinson's disease (SPN-830). This narrative review therefore aims to examine apomorphine clinical journey, celebrating its turbulent yet founding past, analyzing its current challenges in the treatment of Parkinson's disease (PD) and envisioning its promising future, both in neurological disorders and beyond. Enduring misconceptions and the lack of class 1 evidence for supporting the use of continuous subcutaneous apomorphine infusion (CSAI) in PD have long been thought to have prevented its generalized use. The TOLEDO study, which robustly demonstrated a clinically meaningful reduction in off time (as expected based on decades of clinical experience) has now removed this barrier. Challenges to be addressed moving forward include (1) redefining the place of apomorphine in the PD treatment paradigm (from early use to terminal care), (2) reducing access disparities (availability, cost), (3) improving delivery systems and apomorphine formulations, and (4) expanding clinical use both in and outside of neurological disorders, with already tangible results for atypical Parkinsonian syndromes and disorders of consciousness, and promising perspectives in Alzheimer's disease.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107872"},"PeriodicalIF":3.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111664","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}