Parkinsonism & related disorders最新文献

{"title":"Susceptibility mapping of deep gray matter in Wilson’s disease: A systematic review and meta-analysis","authors":"Laís Silva Santana ,&nbsp;Guilherme José da Costa Borsatto ,&nbsp;Marianna Leite ,&nbsp;Maressa Mouty Rabello ,&nbsp;Eberval Gadelha Figueiredo ,&nbsp;João Paulo Mota Telles","doi":"10.1016/j.parkreldis.2026.108235","DOIUrl":"10.1016/j.parkreldis.2026.108235","url":null,"abstract":"<div><div>Quantitative susceptibility mapping (QSM) enables assessment of brain metal deposition. This meta-analysis evaluated QSM alterations in Wilson's disease (WD). PubMed, Embase, and Web of Science were searched up to September 2025 for studies reporting QSM measurements in neurological or hepatic WD and healthy controls (HCs). Twelve studies were included (325 WD, 254 HCs). Neurological WD showed higher susceptibility than HCs in the caudate (mean difference [MD] = 33.92, 95% CI: 18.14–49.70, p &lt; .001), putamen (MD = 48.42, 95% CI: 29.66–67.17, p &lt; .001), globus pallidus (MD = 62.24, 95% CI: 39.74–84.73, p &lt; .001), thalamus (MD = 15.15, 95% CI: 10.15–20.15, p &lt; .001), red nucleus (MD = 30.25, 95% CI: 12.57–47.93, p &lt; .001), and dentate nucleus (MD = 16.65, 95% CI: 2.52–30.78, p = .02). Compared with hepatic-onset WD, neurological presentations showed higher susceptibility in the caudate nucleus (MD = 23.45, 95% CI: 1.17–45.73, p = .04), putamen (MD = 43.20, 95% CI: 2.62–83.78, p = .04), and thalamus (MD = 11.11, 95% CI: 7.53–14.69, p &lt; .001). Hepatic-onset WD showed milder increases versus HCs in the globus pallidus (MD = 18.13, 95% CI: 4.42–31.85, p = .01), red nucleus (MD = 16.87, 95% CI: 12.11–21.63, p &lt; .001) and dentate nucleus (MD = 11.61, 95% CI: 8.28–14.95, p &lt; .001). QSM reveals marked susceptibility elevations in neurological WD and mild changes in hepatic WD.</div></div><div><h3>Trial registration</h3><div>CRD420251232999, <span><span>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251232999</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108235"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195403","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: Teaching points from A young patient with spastic paraparesis and ataxia due to P102L GSS","authors":"Jacky Ganguly ,&nbsp;Yuan Ye Beh ,&nbsp;Hrishikesh Kumar","doi":"10.1016/j.parkreldis.2026.108219","DOIUrl":"10.1016/j.parkreldis.2026.108219","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108219"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093735","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":"An information-motivation-behavioral skills model-based intervention for Parkinson's Disease Patients","authors":"Yan Jiang ,&nbsp;Yun Tao ,&nbsp;Qiuyi Yin ,&nbsp;Chuan Chen ,&nbsp;Ye Dai ,&nbsp;Yin Ying ,&nbsp;Mingwan Zhang","doi":"10.1016/j.parkreldis.2026.108231","DOIUrl":"10.1016/j.parkreldis.2026.108231","url":null,"abstract":"<div><h3>Background</h3><div>Intervention based on the information-motivation-behavioral skills (IMB) model have been applied in the self-management of patients with chronic diseases and achieved ideal results, but there were few reports on the application of this model in PD patients.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of the IMB model-based intervention in improving medication adherence, self-health management abilities, and quality of life (QoL) in PD patients.</div></div><div><h3>Methods</h3><div>A total of 70 patients were randomly divided into the control group and the intervention group. The intervention group received IMB model-based health education, while the control group received routine health education only. The effectiveness of the intervention was evaluated by measuring medication adherence, self-management ability and QoL at 3 months and 6 months after the intervention.</div></div><div><h3>Results</h3><div>For medication adherence, at 3 months, medication adherence improved in both groups but showed no significant inter-group difference (<em>P</em> &gt; 0.05). At 6 months, medication adherence in the intervention group was significantly higher than in the control group (P &lt; 0.05). Self-health management scores significantly increased over time in both groups, and the intervention group demonstrated significantly greater improvement at both 3 months and 6 months (P &lt; 0.05). While PDQ-39 scores showed no significant difference at 3 months (<em>P</em> &gt; 0.05), the intervention group exhibited significantly greater improvement in QoL at 6 months (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>IMB model-based health education takes into account patients' knowledge, motivation and behavioral skills, providing a structured and individualized intervention. It is a valuable approach for improving long-term medication adherence, enhancing self-management abilities, and ultimately boosting the QoL in PD patients.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108231"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147482","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":"Phenotypic heterogeneity in P102L Gerstmann-Sträussler-Scheinker disease: A case of spastic paraparesis with ataxia","authors":"Karla Salinas-Barboza ,&nbsp;Juan Manuel Altamirano","doi":"10.1016/j.parkreldis.2025.108131","DOIUrl":"10.1016/j.parkreldis.2025.108131","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108131"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637714","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":"Deep brain stimulation beyond Motor control: A systematic review and meta-analysis of sleep outcomes in Parkinson's disease","authors":"Sivapriya Senthilkumar ,&nbsp;Mythirayee S ,&nbsp;Mohammad Faizan Rizvi ,&nbsp;Bhargavi Korlakunta ,&nbsp;Monojith Debnath ,&nbsp;Nandakumar Dalavaikodihalli Nanjaiah ,&nbsp;Ravi Yadav ,&nbsp;Rohan Mahale","doi":"10.1016/j.parkreldis.2026.108237","DOIUrl":"10.1016/j.parkreldis.2026.108237","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) has been a major advancement in treating movement disorders, yet its influence on sleep architecture remains unexplored. This systematic review evaluates the seven studies that have reported the objective polysomnography-based sleep parameters following DBS. A comprehensive literature search was made through PubMed, Cochrane, Embase, and Scopus from inception to November 30th, 2025, for studies reporting the pre- and post-DBS scores on polysomnography-based sleep outcomes. Random-effects models were utilized for the evaluation of REM, NREM, and sleep continuity/fragmentation parameters with heterogeneity assessed using the Q statistic and I². Pooled analysis revealed REM-related measures significantly improved by DBS, such as lower REM latency (95% CI: 1.669 to −0.092; p = 0.029), longer REM minutes (95% CI: 0.180 to 0.753; p = 0.001), and greater REM percentage (95% CI: 0.084 to 0.740; p = 0.014) accompanied by a diminishment of wake after sleep onset (WASO) (95% CI: 1.486 to −0.088; p = 0.027). Periodic limb movements approached statistical significance (p = 0.059) while the measures for the stages of NREM sleep and total sleep time were significantly unchanged. We interpret these results as evidence that DBS preferentially improves REM sleep measures and sleep continuity but indicates increments in sleep quality rather than the duration of sleep. Despite considerable heterogeneity, publication bias, and sensitivity to individual studies rendering these conclusions tenuous, larger multicenter studies incorporating standardized reporting and long-term follow-up are justified in order to confirm the longitudinal effects of DBS for sleep measures in PD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108237"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213741","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":"Safety and efficacy of VMAT2 inhibitors in Huntington Disease: A systematic review","authors":"Ava Baghaei ,&nbsp;Ali Zare Dehnavi ,&nbsp;Zahra Hashempour ,&nbsp;Yvette Bordelon ,&nbsp;Joohi Jimenez-Shahed ,&nbsp;Erin Furr Stimming ,&nbsp;Jessa Koch ,&nbsp;Khashayar Dashtipour","doi":"10.1016/j.parkreldis.2026.108209","DOIUrl":"10.1016/j.parkreldis.2026.108209","url":null,"abstract":"<div><h3>Background</h3><div>Chorea affects quality of life and functional independence in most adults with Huntington disease (HD). Vesicular monoamine transporter 2 (VMAT2) inhibitors, tetrabenazine, deutetrabenazine, and valbenazine, are pharmacological agents used to manage HD-related chorea. This systematic review evaluates the safety and efficacy of these agents in individuals with HD.</div></div><div><h3>Methods</h3><div>This review was conducted in accordance with PRISMA guidelines and registered with PROSPERO, CRD42024581306. A comprehensive literature search was performed for studies published up to July 3, 2025. Eligible studies included randomized controlled trials, cohort studies, and case-control studies. Two reviewers independently performed data extraction and risk-of-bias assessment.</div></div><div><h3>Results</h3><div>Three randomized trials met eligibility criteria and were included in the final analysis. All three VMAT2 inhibitors significantly reduced Unified Huntington Disease Rating Scale Total Maximal Chorea scores. Clinical Global Impression-Improvement Scale for tetrabenazine and both Patient Global Impression of Change and Clinician Global Impression of Change ratings for deutetrabenazine and valbenazine favored active treatment. Deutetrabenazine modestly improved 36-Item Short Form Health Survey physical functioning and Swallowing Disturbance Questionnaire scores. Tetrabenazine was associated with higher adverse event (AE) rates; whereas valbenazine and deutetrabenazine demonstrated better tolerability.</div></div><div><h3>Discussion</h3><div>This systematic review shows VMAT2 inhibitors significantly reduce chorea severity in HD. While tetrabenazine showed the greatest reduction in chorea scores, valbenazine and deutetrabenazine provided broader benefits on functional outcomes and improvement scales. Tetrabenazine had the highest rate of AEs, whereas deutetrabenazine demonstrated favorable tolerability, with fewer complications. Valbenazine demonstrated an intermediate safety profile. These differences should guide individualized treatment decisions in clinical practice.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"145 ","pages":"Article 108209"},"PeriodicalIF":3.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132777","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":"Collaborative multi-agent conversational artificial intelligence for clinical support in Parkinson disease.","authors":"Adeel Mukhtar, Gul E Arzu, Waqas Tariq Toor, Usman Ali","doi":"10.1016/j.parkreldis.2026.108292","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108292","url":null,"abstract":"<p><p>Parkinson disease (PD) is a progressive neurodegenerative disorder that poses significant challenges in diagnosis, treatment planning, and long-term care, as patients and healthcare providers often lack timely and context-specific information. This study presents a collaborative multi-agent conversational artificial intelligence system designed to support clinical decision-making and personalized management of Parkinson disease. The system employs generation, critique, and synthesis agents, where generation agents utilize Qwen3-Medical-GRPO, a 4B-parameter medical language model, to produce clinically grounded responses. Critique agents assess factual correctness and clinical relevance, while a synthesis agent ensures coherence and logical consistency. A retrieval-augmented generation (RAG) framework dynamically accesses 80 curated medical resources through a vector-based search engine, integrating user profiling and knowledge graphs to deliver personalized responses. Evaluated on 50 representative clinical queries, the system achieved 95% clinical accuracy, with diagnostic suggestions scoring 4.8/5 and treatment recommendations scoring 4.6/5, and an average response time of 6.5 s. The proposed system provides explainable, scalable, and personalized conversational support, addressing existing gaps in continuity of care, personalization, and accessibility, with the potential to enhance clinical workflows and patient outcomes.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108292"},"PeriodicalIF":3.4,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593961","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":"Understanding microlesion and cognitive interactions in STN-DBS: A clinical perspective.","authors":"Halil Onder, Seyma Tazegul, Ismet Melek","doi":"10.1016/j.parkreldis.2026.108257","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108257","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108257"},"PeriodicalIF":3.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444466","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":"Imaging biomarkers for early prediction of the transition from idiopathic late-onset cerebellar ataxia to multiple system atrophy","authors":"Jun Seok Lee ,&nbsp;Junmo Kwon ,&nbsp;Jongmok Ha ,&nbsp;Ji Hye Won ,&nbsp;Jinyoung Youn ,&nbsp;Hirohisa Watanabe ,&nbsp;Hee Tae Kim ,&nbsp;Hyunjin Park ,&nbsp;Jin Whan Cho","doi":"10.1016/j.parkreldis.2026.108176","DOIUrl":"10.1016/j.parkreldis.2026.108176","url":null,"abstract":"<div><h3>Introduction</h3><div>Idiopathic late-onset cerebellar ataxia (ILOCA) is a degenerative, non-hereditary form of adult-onset cerebellar ataxia. A subset of patients with ILOCA eventually develop multiple system atrophy of the cerebellar type (MSA-C), but imaging biomarkers that predict this transition remain unidentified. This study aimed to identify imaging biomarkers that may predict phenoconversion from ILOCA to MSA-C.</div></div><div><h3>Methods</h3><div>A retrospective cohort of patients diagnosed with ILOCA who underwent baseline T1-weighted and diffusion-weighted magnetic resonance imaging (MRI) was analyzed. Patients were followed longitudinally and reclassified as ‘phenoconverters’ if they met diagnostic criteria for MSA-C, or as ‘non-phenoconverters’ otherwise. Clinical characteristics were compared between groups, and infratentorial volumetric and microstructural changes were assessed using diffusion tensor imaging (DTI).</div></div><div><h3>Results</h3><div>Over a mean follow-up of 5.7 years, 13 of 45 patients (28.9 %) transitioned to a diagnosis of MSA-C. Phenoconverters exhibited more severe baseline ataxia compared to non-phenoconverters. While cerebellar volumes were similar between groups, phenoconverters had significantly reduced volumes in the pons and superior and middle cerebellar peduncles. Additionally, they demonstrated lower mean fractional anisotropy in the middle and inferior cerebellar peduncles.</div></div><div><h3>Conclusions</h3><div>Patients with ILOCA who later develop MSA-C show early microstructural changes and volume loss in the pons and cerebellar peduncles. Combining infratentorial volumetry with DTI may offer complementary imaging biomarkers for predicting phenoconversion to MSA-C.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108176"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952638","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":"Late-onset cerebellar ataxia associated with XRCC1: Expanding the phenotypic spectrum","authors":"","doi":"10.1016/j.parkreldis.2026.108184","DOIUrl":"10.1016/j.parkreldis.2026.108184","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108184"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904016","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}