{"title":"Convention vs. Innovation I: Digital technology will replace clinic-based care in Parkinson disease","authors":"","doi":"10.1016/j.parkreldis.2024.106067","DOIUrl":"10.1016/j.parkreldis.2024.106067","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"126 ","pages":"Article 106067"},"PeriodicalIF":3.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1353802024000798/pdfft?md5=7be6bc3a55ebfc1512632ff526bb8898&pid=1-s2.0-S1353802024000798-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040031","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}
Xiaoying Kang , Tong Jiao , Bowen Tan , Henrik Larsson , Karin Wirdefeldt
{"title":"Vascular disease and risk of fall-related injuries in Parkinson's disease: A nationwide cohort study in Sweden","authors":"Xiaoying Kang , Tong Jiao , Bowen Tan , Henrik Larsson , Karin Wirdefeldt","doi":"10.1016/j.parkreldis.2024.107121","DOIUrl":"10.1016/j.parkreldis.2024.107121","url":null,"abstract":"<div><h3>Introduction</h3><p>Parkinson's disease (PD) patients are prone to fall and fall-related injuries (FI). Vascular disease is common in PD and is positively associated with falls in elderly. We aimed to evaluate the association of vascular disease with FI risk in PD.</p></div><div><h3>Methods</h3><p>A nationwide cohort study of patients with primary PD diagnosis in Sweden was performed using Swedish national registers. Patients with and without vascular disease were followed from PD diagnosis until subsequent FI or 2013-12-31. The association of vascular disease with FI risk was estimated as hazard ratio (HR) and 95 % confidence interval (CI) by Cox regression using attained age as underlying timescale.</p></div><div><h3>Results</h3><p>We identified 2734 and 6979 incident FI from 8025 PD patients with and 20,543 without vascular disease, respectively. Overall, vascular disease associated positively with subsequent FI, which was mainly driven by the significant risk elevation within the first 6 months following vascular disease (HR <sub>< 0.5year</sub> [95 % CI] for PD diagnosed ≤75 years is 1.61 [1.39–1.87] and for PD diagnosed >75 years is 1.48 [1.32–1.65]). Thereafter, the association attenuated to null before it rebounded five years after exposure in PD diagnosed ≤75 years (HR <sub>> 5year</sub> = 1.26, 95 % CI: 1.10–1.45); whereas for PD diagnosed >75 years, it dropped remarkably and remained non-significant 6 months after exposure. When vascular disease was restricted to stroke, we saw a similar temporal pattern except that the short-term HRs among younger patients were stronger, lasted longer, and declined continuously without rebound.</p></div><div><h3>Conclusions</h3><p>Fall prevention is crucial to PD patients immediately after a vascular event.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"128 ","pages":"Article 107121"},"PeriodicalIF":3.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135860","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}
Yang Cheng Hu , Cynthia D.J. Kusters , Kimberly C. Paul , Aline Duarte Folle , Keren Zhang , I-Fan Shih , Adrienne M. Keener , Jeff M. Bronstein , Beate R. Ritz
{"title":"Lifetime physical activity influences Parkinson's disease progression","authors":"Yang Cheng Hu , Cynthia D.J. Kusters , Kimberly C. Paul , Aline Duarte Folle , Keren Zhang , I-Fan Shih , Adrienne M. Keener , Jeff M. Bronstein , Beate R. Ritz","doi":"10.1016/j.parkreldis.2024.107122","DOIUrl":"10.1016/j.parkreldis.2024.107122","url":null,"abstract":"<div><h3>Introduction</h3><p>Past studies suggested that Parkinson's disease (PD) patients who engage in physical activity (PA) after diagnosis have slower motor progression. Here, we examine the influence of lifetime PA prior to PD onset on motor, cognitive, and overall functional decline among PD patients.</p></div><div><h3>Methods</h3><p>For 495 participants in the Parkinson's Environment and Gene (PEG) studies, we collected PA-related measures through interviews and quantified these using metabolic equivalents (MET) scores. PD progression was defined as time to a Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) conversion to <span><math><mrow><mo>≥</mo></mrow></math></span> 35 points, Hoehn and Yahr (H&Y) <span><math><mrow><mo>≥</mo></mrow></math></span> 3, and a 4-point decline in Mini‐Mental State Examination (MMSE). We used Cox frailty models to estimate hazard ratios and inverse probability weights to account for heterogeneity by enrollment wave and censoring.</p></div><div><h3>Results</h3><p>For PD patients reporting the highest lifetime strenuous MET-h/wk (highest quartile), we estimated a lower HR for time-to-UPDRS-III-conversion (Q4 vs. Q1: HR = 0.56, 95 % CI = [0.36, 0.87]). Additionally, having engaged in any competitive sport also reduced the risk of reaching a UPDRS-III <span><math><mrow><mo>≥</mo></mrow></math></span> 35 points (low vs. none: HR = 0.61, 95 % CI = [0.44, 0.86]; high vs. none: HR = 0.63; 95 % CI = [0.44,0.86]); high levels of sports activities also affected progression on the H&Y scale (high vs. none: HR = 0.73; 95 % CI = [0.46,1.00]). Lifetime PA measures did not affect time-to-MMSE decline.</p></div><div><h3>Conclusion</h3><p>Our study suggests that PD patients who engaged in higher levels of lifetime strenuous PA and competitive sports prior to PD diagnosis experience slower motor and overall functional decline, suggesting that lifetime PA may contribute to a physical reserve advantageous for PD patients.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"128 ","pages":"Article 107122"},"PeriodicalIF":3.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1353802024011349/pdfft?md5=076a80b3765fe3eb7129fec0bd85f575&pid=1-s2.0-S1353802024011349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146144","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}
Alexander Choi , Nan Zhang , Charles H. Adler , Thomas G. Beach , Holly A. Shill , Erika Driver-Dunckley , Shyamal Mehta , Christine Belden , Alireza Atri , Marwan N. Sabbagh , John N. Caviness
{"title":"Resting-state EEG predicts cognitive decline in a neuropathologically diagnosed longitudinal community autopsied cohort","authors":"Alexander Choi , Nan Zhang , Charles H. Adler , Thomas G. Beach , Holly A. Shill , Erika Driver-Dunckley , Shyamal Mehta , Christine Belden , Alireza Atri , Marwan N. Sabbagh , John N. Caviness","doi":"10.1016/j.parkreldis.2024.107120","DOIUrl":"10.1016/j.parkreldis.2024.107120","url":null,"abstract":"<div><h3>Objective</h3><p>To assess correlative strengths of quantitative electroencephalography (qEEG) and visual rating scale EEG features on cognitive outcomes in only autopsied cases from the Arizona Study of Neurodegenerative Disorders (AZSAND). We hypothesized that autopsy proven Parkinson Disease will show distinct EEG features from Alzheimer's Disease prior to dementia (mild cognitive impairment).</p></div><div><h3>Background</h3><p>Cognitive decline is debilitating across neurodegenerative diseases. Resting-state EEG analysis, including spectral power across frequency bins (qEEG), has shown significant associations with neurodegenerative disease classification and cognitive status, with autopsy confirmed diagnosis relatively lacking.</p></div><div><h3>Methods</h3><p>Biannual EEG was analyzed from autopsied cases in AZSAND who had at least one rsEEG (>1 min eyes closed±eyes open). Analysis included global relative spectral power and a previously described visual rating scale (VRS). Linear mixed regression was performed for neuropsychological assessment and testing within 2 years of death (n = 236, 594 EEG exams) in a mixed linear regression model.</p></div><div><h3>Results</h3><p>The cohort included cases with final clinicopathologic diagnoses of Parkinson's disease (n = 73), Alzheimer disease (n = 65), and tauopathy not otherwise specified (n = 56). A VRS score of 3 diffuse or frequent generalized slowing) over the study duration was associated with an increase in consensus diagnosis cognitive worsening at 4.9 (3.1) years (HR 2.02, CI 1.05–3.87). Increases in global theta power% and VRS were the most consistently associated with large regression coefficients inversely with cognitive performance measures.</p></div><div><h3>Conclusion</h3><p>Resting-state EEG analysis was meaningfully related to cognitive performance measures in a community-based autopsy cohort. EEG deserves further study and use as a cognitive biomarker.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"128 ","pages":"Article 107120"},"PeriodicalIF":3.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135861","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}
Jacob Horsager , Katrine B. Andersen , Niels Okkels , Karoline Knudsen , Casper Skjærbæk , Nathalie Van Den Berge , Nicola Pavese , Hanne Gottrup , Per Borghammer
{"title":"Correlation between dopaminergic and metabolic asymmetry in Lewy body disease – A dual-imaging study","authors":"Jacob Horsager , Katrine B. Andersen , Niels Okkels , Karoline Knudsen , Casper Skjærbæk , Nathalie Van Den Berge , Nicola Pavese , Hanne Gottrup , Per Borghammer","doi":"10.1016/j.parkreldis.2024.107117","DOIUrl":"10.1016/j.parkreldis.2024.107117","url":null,"abstract":"<div><h3>Introduction</h3><p>The <span><math><mrow><mi>a</mi></mrow></math></span>-Synuclein Origin and Connectome (SOC) model of Lewy body diseases postulates that <span><math><mrow><mi>a</mi></mrow></math></span>-syuclein will be asymmetrically distributed in some patients with Lewy body diseases, potentially leading to asymmetric neuronal dysfunction and symptoms.</p></div><div><h3>Methods</h3><p>We included two patient groups: 19 non-demented Parkinson's disease (nPD) patients with [<sup>18</sup>F]FDG PET and motor symptoms assessed by UPDRS-III, and 65 Lewy body dementia (LBD) patients with [<sup>18</sup>F]FDG PET and dopamine radioisotope imaging. Asymmetry indices were calculated for [<sup>18</sup>F]FDG PET by including the cortex for each hemisphere, for dopamine radioisotope imaging by including the putamen and caudate separately, and for motor symptoms by using the difference between right-left UPDRS-III score. Correlations between these asymmetry indices were explored to test the predictions of the SOC model. To identify cases with a more typical LBD imaging profile, we calculated a Cingulate Island Sign (CIS) index on the [<sup>18</sup>F]FDG PET image.</p></div><div><h3>Results</h3><p>We found a significant correlation between cortical interhemispheric [<sup>18</sup>F]FDG asymmetry and motor-symptom asymmetry in nPD patients (r = 0.62, P = 0.004). In patients with LBD, we found a significant correlation between cortical interhemispheric [<sup>18</sup>F]FDG asymmetry and dopamine transporter asymmetry in the caudate (r = 0.37, P = 0.0019), but not in the putamen (r = 0.15, P = 0.22). We observed that the correlation in the caudate was stronger in LBD subjects with the highest CIS index, i.e., with more typical LBD imaging profiles.</p></div><div><h3>Conclusion</h3><p>Our study partly supports the SOC model, but further investigations are needed – ideally of <em>de novo</em>, non-demented PD patients.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"127 ","pages":"Article 107117"},"PeriodicalIF":3.1,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1353802024011295/pdfft?md5=331b8ce4f175de11f0464d0d30c8b959&pid=1-s2.0-S1353802024011295-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142097768","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":"Levodopa-carbidopa intestinal gel for advanced Parkinson's disease: Impact of LRRK2 and GBA1 mutations","authors":"Avner Thaler , Saar Anis , Penina Ponger , Tsviya Fay-Karmon , Vered Livneh , Achinoam Faust-Socher , Lior Greenbaum , Johnathan Reiner , Ariela Hilel , Hertzel Shabtai , Roy N. Alcalay , Ruth Djaldetti , Sharon Hassin-Baer , Adi Ezra , Anat Mirelman , Nir Giladi , Tanya Gurevich","doi":"10.1016/j.parkreldis.2024.107115","DOIUrl":"10.1016/j.parkreldis.2024.107115","url":null,"abstract":"<div><h3>Background</h3><p>Advanced Parkinson's disease (PD) can be treated with Levodopa-Carbidopa Intestinal Gel (LCIG).</p></div><div><h3>Objective</h3><p>To compare descriptive data of LCIG treatment in <em>GBA1-</em>PD and <em>LRRK2-</em>PD.</p></div><div><h3>Methods</h3><p>This multicenter retrospective study compared clinical data obtained from electronic medical records of PD patients treated with LCIG. Patients were grouped based on their genetic status.</p></div><div><h3>Results</h3><p>Fifty-two iPD, 15 <em>LRRK2</em>-PD and 23 <em>GBA1</em>-PD were included in this study. No difference in daily dose of LCIG or levodopa equivalent daily dose were detected. <em>GBA1</em>-PD had significantly shorter disease duration at LCIG initiation (p = 0.01) and experienced more hallucinations (p = 0.03) compared with <em>LRRK2</em>-PD and iPD. <em>LRRK2</em>-PD and iPD had significantly longer duration of LCIG treatment compared with <em>GBA1</em>-PD (p < 0.01).</p></div><div><h3>Conclusion</h3><p>Overall, LCIG treatment was well tolerated in <em>LRRK2</em>-PD and <em>GBA1</em>-PD. <em>GBA1</em>-PD required LCIG earlier in their course of their disease and had higher frequencies of hallucinations during treatment, attesting to a more severe disease course.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"127 ","pages":"Article 107115"},"PeriodicalIF":3.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087089","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}
Lenora Higginbotham , Laura M. Scorr , Sahyli Perez Parra , Barbara Sommerfeld , Hyder A. Jinnah , Stewart A. Factor
{"title":"Prevalence and clinical features of cervical dystonia in Parkinson's disease","authors":"Lenora Higginbotham , Laura M. Scorr , Sahyli Perez Parra , Barbara Sommerfeld , Hyder A. Jinnah , Stewart A. Factor","doi":"10.1016/j.parkreldis.2024.107114","DOIUrl":"10.1016/j.parkreldis.2024.107114","url":null,"abstract":"<div><h3>Objective</h3><p>To study the prevalence and clinical features of cervical dystonia in Parkinson's disease (CD-PD).</p></div><div><h3>Background</h3><p>PD features various forms of dystonia, including CD. Yet, the prevalence and clinical features of CD in PD patients are not well-characterized.</p></div><div><h3>Methods</h3><p>We conducted a single site, prospective study where consecutively evaluated PD patients were examined for the presence of CD to ascertain its prevalence. For each case of CD-PD, a standardized questionnaire assessing demographic and clinical features was completed. Statistical analysis was performed to compare CD-PD characteristics to those of a previously published large idiopathic CD cohort.</p></div><div><h3>Results</h3><p>Of 301 consecutive PD patients evaluated, 28 (9.3 %) had CD, far surpassing estimates of CD prevalence in the general population. This CD-PD cohort was predominantly male (71 %) with a mean age of 70.9 ± 8.1 years. The mean duration of PD was 10.4 ± 6.7 years. In most cases (<em>n</em> = 19, 68 %), CD developed after the onset of PD. Five patients reported dystonia improvements in response to levodopa, while none reported medication-induced worsening. In contrast to CD-PD, those with ICD (<em>n</em> = 209) were on average younger (59.7 ± 10.1) and mostly female (74 %, <em>p</em> < 0.001). In addition, CD-PD was overall less severe as measured by the Global Dystonia Rating Scale (GDRS) (<em>p</em> = 0.002) and featured less head tremor and pain.</p></div><div><h3>Conclusion</h3><p>Our findings indicate CD is overrepresented in PD compared to the general population and has clinical features distinct from those of ICD. These results justify larger, more comprehensive studies of CD-PD to better understand its frequency, pathophysiology, clinical characteristics, and associated risk factors.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"127 ","pages":"Article 107114"},"PeriodicalIF":3.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084134","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}
Ekhlas Assaedi, Leila Saadatpour, Hubert H. Fernandez
{"title":"Patellofemoral instability as a differential for bizarre functional gait","authors":"Ekhlas Assaedi, Leila Saadatpour, Hubert H. Fernandez","doi":"10.1016/j.parkreldis.2024.107113","DOIUrl":"10.1016/j.parkreldis.2024.107113","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"127 ","pages":"Article 107113"},"PeriodicalIF":3.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087090","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":"Temporal trends in Parkinson's disease among older adults in the United States from 1999 to 2020: Retrospective analysis from CDC WONDER database","authors":"Zoaib Habib Tharwani , F.N.U. Deepak , Muhammad Sameer Arshad , Saba Zaheer , Rakesh Kumar , Riteeka Kumari Bhimani , Maheen Jabbar , Zehra Habib , Adarsh Raja , Ramesh Shivani","doi":"10.1016/j.parkreldis.2024.107110","DOIUrl":"10.1016/j.parkreldis.2024.107110","url":null,"abstract":"<div><p>This retrospective study assessed the mortality trends related to Parkinson's Disease (PD) between 1999 and 2020. We assessed individuals aged 65 years and older and a total of 831,793 deaths were identified. Of these total number of deaths, place of death was accessible for 830,176 cases. Majority of the deaths occurred in nursing homes of long-term care facilities (367,633), followed by at home (212,886), medical facilities (165,450), other locations (44,506), and hospice (39,701). Analysis of age-adjusted mortality rates (AAMR) revealed an overall rise from 1999 to 2020, 88.9 to 119.6 per 100,000 population. AAMR showed an initial decline between 1999 and 2013, followed by a slight increase between 2013 and 2018 and then a significant rise from 2018 to 2020. Gender-based analysis showed a constantly higher AAMR for older men compared to older women. Variations in AAMR based on race and ethnicity revealed that Non-Hispanic White population had the highest AAMRs. Geographic disparities among states showed that Nebraska, Vermont, Minnesota, Utah, and Idaho had a significantly higher AAMR than Hawaii, Florida, Nevada. New York, and District of Columbia. Midwest region had a consistently higher AAMR followed by West, South, and Northeast. Additionally, nonmetropolitan areas had a higher AAMR than metropolitan areas. These findings offer valuable insights into mortality patterns related to PD among the elderly, highlighting the significance of incorporating demographic and geographic variables into public health planning and interventions.</p></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"127 ","pages":"Article 107110"},"PeriodicalIF":3.1,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049352","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}