Parkinsonism & related disorders最新文献_第3页

Parkinson's disease across female reproductive stages: Clinical implications from menstruation to menopause 帕金森病在女性生殖阶段：从月经到更年期的临床意义。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-09-01 Epub Date: 2026-07-09 DOI: 10.1016/j.parkreldis.2026.108420

Dayany Leonel Boone, Vanderci Borges, Henrique Ballalai Ferraz

{"title":"Parkinson's disease across female reproductive stages: Clinical implications from menstruation to menopause","authors":"Dayany Leonel Boone, Vanderci Borges, 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}

引用次数: 0

Unmasking gastrointestinal symptoms in Parkinson's disease: A practical and discrete gut health questionnaire. 揭示帕金森病的胃肠道症状：一个实用和离散的肠道健康问卷。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-22 DOI: 10.1016/j.parkreldis.2026.108940

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

{"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}

引用次数: 0

How (We Think) Parkinson's disease begins. （我们认为）帕金森病是如何开始的。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-18 DOI: 10.1016/j.parkreldis.2026.108943

Tiago F Outeiro, Eduardo Tolosa

{"title":"How (We Think) Parkinson's disease begins.","authors":"Tiago F Outeiro, Eduardo Tolosa","doi":"10.1016/j.parkreldis.2026.108943","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2026.108943","url":null,"abstract":"<p><p>Parkinson's disease (PD) is a complex heterogeneous neurodegenerative syndrome that is clinically defined. However, how it begins at the molecular and systems level remains unresolved. In this review, we cover selected evidence from neuropathology, imaging, genetics, microbiome and immune studies to examine competing and complementary models of PD initiation. We discuss classical pathology-staging concepts alongside brain-first and periphery-first subtypes, olfactory and gut routes, and threshold and multifocal models that posit parallel central and peripheral involvement. Emerging work on microbiome dysbiosis, endotoxin exposure, environmental toxicants at the nose-brain interface, genetically defined cellular vulnerabilities, and neuroinflammation, suggest these factors may act as potential upstream drivers of alpha-synuclein (aSyn) aggregation and spread. This supports a view in which PD comprises multiple initiating biologies leading to phenotypes that converge on a shared degenerative cascade. Altogether, we posit that understanding how PD starts impacts on our ability for performing biology-based subtyping, prodromal stratification, and for devising mechanism-based early preventive strategies.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108943"},"PeriodicalIF":4.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796541","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}

引用次数: 0

Cockayne syndrome: When UV photosensitivity lights the path to diagnosis. 柯凯因综合症：当紫外线光敏性照亮诊断之路。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-10 DOI: 10.1016/j.parkreldis.2026.108918

R Calandra Cristian, Ramirez Carolina, Zolezzi Gisela, Fanessi Viviana, Brun Paloma, Damia Ana Laura, Bruque Carlos David

引用次数: 0

Episodic cerebellar ataxia mimicking stroke — diagnostic and therapeutic lessons from SCA27B 发作性小脑性共济失调模拟中风——来自SCA27B的诊断和治疗经验。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-04-02 DOI: 10.1016/j.parkreldis.2026.108303

Bruno Carvalho, Inês Margarido, Francisca Ferreira, Pedro Castro, Pedro Abreu, Carolina Soares

引用次数: 0

Distance-based WMH phenotyping in 4R-tauopathies: accounting for ventricular geometry, endpoint hierarchy, and standardized SVD profiling 4r -tau病变中基于距离的WMH表型：考虑心室几何、终点层次和标准化SVD分析。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-02-11 DOI: 10.1016/j.parkreldis.2026.108247

Jia Wu, Yongliang Xia

引用次数: 0

Expert commentary for “Episodic cerebellar ataxia mimicking stroke - diagnostic and therapeutic lessons from SCA27B” 专家评论《偶发性小脑性共济失调模拟中风——SCA27B的诊断和治疗经验》。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-04-23 DOI: 10.1016/j.parkreldis.2026.108329

Pablo Iruzubieta, Bernard Brais, David Pellerin

引用次数: 0

Is Parkinson's really a disease? Reframing it as a phenotype of aging 帕金森症真的是一种疾病吗？将其重新定义为衰老的表型。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-06-09 DOI: 10.1016/j.parkreldis.2026.108387

Khashayar Dashtipour

{"title":"Is Parkinson's really a disease? Reframing it as a phenotype of aging","authors":"Khashayar Dashtipour","doi":"10.1016/j.parkreldis.2026.108387","DOIUrl":"10.1016/j.parkreldis.2026.108387","url":null,"abstract":"<div><div>The boundary between aging and neurodegenerative disorders remains unresolved, and emerging evidence challenges this dichotomy. Parkinson's disease (PD) has traditionally been defined as a neurodegenerative disease with motor and non-motor manifestations. It was not until two decades ago that clinical and research studies shed light on PD heterogeneity at the clinical, pathological, cellular, and genetic levels. In parallel, our understanding of aging mechanisms advanced, revealing shared mechanisms between aging and neurodegeneration, with numerous features overlapping with processes commonly associated with PD. These observations lead us to a fundamental question of whether we should consider PD and other neurodegenerative disorders as a distinct disease or if they are just a phenotypic manifestation of individuals during aging as a result of their genetic makeup and environmental factors over time. The heterogeneity of PD across clinical, pathological, cellular, pathogenic, and genetic levels mirrors the changes we observe during aging, seemingly driven by a shared mechanism.</div><div>This viewpoint conceptualizes PD not as a distinct condition set apart from normality, but as a phenotype that evolves over time and is shaped by an individual's genetic makeup, much as each person ages along a unique trajectory. Considering PD from this angle may prompt a rethinking of how we classify neurodegenerative disorders, design clinical trials, and focus on patient-centered care. However, this viewpoint doesn't argue against PD as a clinically meaningful entity and doesn't overlook the suffering that our patients face during the course of the disease and the substantial burden experienced by them.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"149 ","pages":"Article 108387"},"PeriodicalIF":4.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227318","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}

引用次数: 0

Quality of “on”: a novel therapeutic objective in advanced Parkinson's disease “on”的质量：治疗晚期帕金森病的新目标。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-06-17 DOI: 10.1016/j.parkreldis.2026.108391

Eric Freire-Álvarez, Diego Santos-García, Francisco Escamilla-Sevilla, Matilde Calopa, Fátima Carrillo, Rocío García-Ramos, Inés Legarda, Irene Martínez-Torres, Juan Carlos Martínez-Castrillo, Juan Carlos Gómez-Esteban

{"title":"Quality of “on”: a novel therapeutic objective in advanced Parkinson's disease","authors":"Eric Freire-Álvarez, Diego Santos-García, Francisco Escamilla-Sevilla, Matilde Calopa, Fátima Carrillo, Rocío García-Ramos, Inés Legarda, Irene Martínez-Torres, Juan Carlos Martínez-Castrillo, Juan Carlos Gómez-Esteban","doi":"10.1016/j.parkreldis.2026.108391","DOIUrl":"10.1016/j.parkreldis.2026.108391","url":null,"abstract":"<div><div>Parkinson's disease (PD) is typically managed by dopaminergic supplementation. As the disease progresses, most patients receiving levodopa treatment develop motor and non-motor symptoms that may be managed with therapy modifications. However, in time, they become refractory to conventional medical treatment and require device-aided therapies (DATs). The characterization of “on-off” periods and therapeutic efficacy variables in DATs have received ample attention in the literature, but only limited information is available on variables that affect the well-being of patients during “on” periods unrelated to their duration. In this Point of View article, therefore, we reflected on the concept of the quality of “on” periods — that is to say, the motor and non-motor fluctuating symptoms experienced during “on” time by patients with advanced PD (APD) treated with DATs that must be addressed and defined by acknowledging those issues raised by the patients as essential to their well-being. To explore this definition, a panel of experts in movement disorders met to discuss and subsequently conducted an exhaustive literature search. By this approach, we offer an analysis of symptoms that impact the <em>quality</em> of “on” periods in patients undergoing DATs which may be modifiable with therapy and propose a definition and initial approach to consider the <em>quality</em> of “on” as a therapeutic goal in treating persons with APD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"149 ","pages":"Article 108391"},"PeriodicalIF":4.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295955","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}

引用次数: 0

Collaborative multi-agent conversational artificial intelligence for clinical support in Parkinson disease 协同多主体对话人工智能在帕金森病临床支持中的应用。

IF 4.3 3区医学

Parkinsonism & related disorders Pub Date : 2026-08-01 Epub Date: 2026-03-28 DOI: 10.1016/j.parkreldis.2026.108292

Adeel Mukhtar, Gul E Arzu, Waqas Tariq Toor, Usman Ali

{"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":"10.1016/j.parkreldis.2026.108292","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"149 ","pages":"Article 108292"},"PeriodicalIF":4.3,"publicationDate":"2026-08-01","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}

引用次数: 0