Clinical Parkinsonism Related Disorders最新文献

{"title":"Retrospective database analysis on the demographics and resource utilization of patients with Parkinson’s disease in Quebec, Canada","authors":"Véronique Baribeau ,&nbsp;Shawn Mohammed ,&nbsp;Amnah Awan ,&nbsp;Diana Parison ,&nbsp;Jean Lachaine","doi":"10.1016/j.prdoa.2025.100300","DOIUrl":"10.1016/j.prdoa.2025.100300","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) is the most prevalent neurodegenerative movement disorder. Despite its recognized significance, there remains a paucity of recent studies reporting treatment utilization and the economic impact of PD in a real-world setting, especially in Canada. This study aimed to analyze real-world treatment patterns and health care resource utilization (HCRU) of patients with PD in Quebec, Canada.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study using data between 2010–2019 from the Régie de l’assurance maladie du Québec (RAMQ) databases. Patients with PD were compared to age- and sex-matched controls. Treatment adherence and persistence were measured over 24 months. All-cause and PD-related HCRU and costs were characterized on an annual basis.</div></div><div><h3>Results</h3><div>Overall, 303 PD patients and 909 age- and sex-matched controls were selected. Adherence rates were high (≥85 %) among all drug classes, but lower with dopamine agonists. Persistence to PD treatment declined over time, with nearly 50 % discontinuation rates at 24 months in all PD drug classes, except the levodopa class (discontinuation rate: 20.4 %). PD patients had a significantly higher total costs per year than the matched control group ($17,405 vs. $6,431), mainly driven by higher inpatient costs.</div></div><div><h3>Conclusion</h3><div>Many pharmacological options exist for PD patients and, though patients are adherent while on therapy, treatment discontinuation rates are high. This suggests potential long-term challenges in PD management, especially since PD continues to place a substantial burden on the health care system. This study underscores the need for enhanced therapeutic strategies, particularly for patients inadequately controlled with standard therapies.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100300"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Memantine-induced delayed sleep phase in Huntington’s disease: A case report","authors":"Youshi Fujita ,&nbsp;Toshio Hamada ,&nbsp;Satoshi Kubota ,&nbsp;Tomomi Sakoh-Goshima ,&nbsp;Hirotaka Shirasaki","doi":"10.1016/j.prdoa.2025.100306","DOIUrl":"10.1016/j.prdoa.2025.100306","url":null,"abstract":"<div><div>Circadian rhythm sleep disorders may occur after memantine administration. We describe a 49-year-old woman with Huntington’s disease, who complained of sleep onset insomnia following the administration of memantine. Memantine reduced hyperkinetic movements but led to delayed sleep phases, that were dose-dependent and reversible, confirmed by sleep logs and actigraphy.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100306"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving to a non-dopaminergic approach for the treatment of OFF fluctuations in Parkinson’s disease","authors":"Stuart H. Isaacson ,&nbsp;Peter Jenner","doi":"10.1016/j.prdoa.2025.100303","DOIUrl":"10.1016/j.prdoa.2025.100303","url":null,"abstract":"<div><div>In levodopa treated patients with Parkinson’s disease (PD), the standard approach to managing motor fluctuations is to adjust dopaminergic therapy. However, despite the availability of a wide armamentarium of dopaminergic medications, most patients treated with levodopa will still experience significant OFF time, and it is increasingly clear that motor fluctuations have a significant non-dopaminergic component. In this narrative review, we compare and contrast the therapeutic profiles of the only two non-dopaminergic medications approved in the US for the management of OFF time, namely amantadine and istradefylline. When compared against each other the two agents exemplify two different pharmacological approaches to treatment. Whereas amantadine has a multimodal pharmacology, istradefylline has highly specific actions at A_2A receptors which are highly expressed in the indirect pathway of the basal ganglia. We discuss how both offer an important alternative approach to treatment, without increasing total dopaminergic load. Clinicians can also consider that amantadine and istradefylline each have overlapping indications with classic dopaminergic medications, but with distinct mechanisms of action that can complement each other to reduce motor complications in patients already being treated with other dopaminergic agents.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100303"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb-Kinetic apraxia of legs in Parkinson’s disease: Prospective clinical investigation","authors":"Yacov Balash ,&nbsp;Evelin D. Mate ,&nbsp;Riyad Idries ,&nbsp;Anda Eilam ,&nbsp;Amos D. Korczyn","doi":"10.1016/j.prdoa.2025.100302","DOIUrl":"10.1016/j.prdoa.2025.100302","url":null,"abstract":"<div><h3>Background</h3><div>The study of dynamic organization of motor acts is important for investigation of motor impairment, and a possible sign of a disorder of fronto-parietal areas of the brain in Parkinson’s disease (PD). We aimed to prospectively investigate whether limb-kinetic apraxia in legs (LKA-L) is a heretofore unrecognized manifestation of PD independent of bradykinesia and rigidity.</div></div><div><h3>Methods</h3><div>Patients with PD and healthy controls (HC) performed bipedal reciprocal coordination (BRC) and monopedal reciprocal coordination (MRC) tests as a foot modification of the Oseretzky exam (originally alternate antiphase clenching and unclenching of the fists of the right and left hands). While MRC allowed for alternating movements of one leg per unit of time, BRC required synchronous movements of both legs in antiphase. Leg movement rates and their quality were measured by video recording and compared statistically between the groups of PD and HC.</div></div><div><h3>Results</h3><div>The cohort consisted of 31 PD patients (mean age 69.3 ± 7.1 years,16 males) and 12 HC (mean age 69 ± 6.2 years, 6 males). No differences between PD and HC groups were identified in MRC rate of performance, which were used as a measure of legs movement speed, although the quality of MRC movements was poorer in PD patients (<em>p</em> = 0.022). BRC rate and its performance quality were significantly flawed in PD compared to controls (<em>P</em> = 0.002 and <em>P</em> = 0.003, respectively).</div></div><div><h3>Conclusions</h3><div>Testing for dynamic organization of LKA-L revealed disorder in individuals with PD. LKA-L analyses should be considered in the diagnosis of leg movements and gait disorders in PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100302"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct sensorimotor cough features in a cohort of Progressive Supranuclear Palsy","authors":"Michela J. Mir ,&nbsp;Justin Childers ,&nbsp;Yuhan Mou ,&nbsp;Bryn Taylor ,&nbsp;Karen Wheeler-Hegland","doi":"10.1016/j.prdoa.2025.100305","DOIUrl":"10.1016/j.prdoa.2025.100305","url":null,"abstract":"<div><h3>Background</h3><div>Progressive Supranuclear Palsy (PSP) and Parkinson’s disease (PD) similarly affect many neural substrates; however, some brain regions may be more impacted by PSP vs PD, giving rise to distinct cough features that could facilitate earlier differential diagnosis and inform airway protection therapies to prevent fatal lung infections, since patients may not effectively sense and clear irritants from their airways.</div></div><div><h3>Methods</h3><div>Thirteen individuals with PSP participated and were age- and sex-matched to persons with PD and healthy, unaffected adults. Using a cross-sectional study design this study aimed to 1) compare cough function in PSP using voluntary and induced reflex cough testing, and 2) compare cough airflow and sensation metrics to PD and healthy adult groups.</div></div><div><h3>Results</h3><div>Voluntary cough function, particularly cough effectiveness during the expiratory phase, was most impaired in the PSP group (P = 0.047), while expiratory phase timing outcomes only differed between PSP and healthy controls (P = 0.03) during reflex cough. There were no significant differences between groups regarding cough sensation to a cough-inducing stimulus (capsaicin), yet there were more cough responders in PSP vs. PD group.</div></div><div><h3>Conclusions</h3><div>Degeneration of distinct neural substrates in PSP versus PD may give rise to differentiating sensorimotor cough deficits. Future directions should focus on cough interventions that maintain respiratory health.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100305"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of an active lifestyle on markers of intestinal inflammation in Parkinson’s disease: Preliminary findings","authors":"Nesrine Chtioui ,&nbsp;Christian Duval ,&nbsp;David H. St-Pierre","doi":"10.1016/j.prdoa.2025.100301","DOIUrl":"10.1016/j.prdoa.2025.100301","url":null,"abstract":"<div><div>Alterations in the gut microbiota leading to intestinal inflammation and decreased levels of Short Chain Fatty Acids (SCFA) has been observed in Parkinson’s disease (PD).</div></div><div><h3>Objective</h3><div>The aim of this study was to compare these factors between physically active and less active people with PD.</div></div><div><h3>Methods</h3><div>Stool, plasma samples and clinical data were collected from 35 people with PD (20 men and 15 women, mean age 66 years). Their level of physical activity was retrospectively assessed using the International Physical Activity Questionnaire (IPAQ). Participants were divided into two groups based on their physical activity level: Active and Inactive. Both SCFA and calprotectin, a marker of intestinal inflammation, were respectively measured by GC–MS and ELISA, according to standardized, validated protocols.</div></div><div><h3>Results</h3><div>Age, disease stage (Hoen &amp; Yahr) and Montreal Cognitive Assessments (MoCA) were similar between groups. Acetate, propionate, and butyrate levels were significantly higher in the Active group than in the Inactive group. In addition, fecal calprotectin was significantly lower in the Active group than in the Inactive group. The constipation values were significantly lower in the Active group.</div></div><div><h3>Conclusion</h3><div>Our results suggest that an active lifestyle with regular physical activity is beneficial in patients with PD, through increased production of SCFA by the gut microbiome, and reduced intestinal inflammation and constipation.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100301"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating YouTube as a source of information on hemifacial spasm","authors":"Kimberly L. Po ,&nbsp;Alfeo Julius R. Sy ,&nbsp;Roland Dominic G. Jamora","doi":"10.1016/j.prdoa.2025.100311","DOIUrl":"10.1016/j.prdoa.2025.100311","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Patients increasingly turn to YouTube for trustworthy health-related information, prompting a study to evaluate the quality and reliability of videos about hemifacial spasms (HFS) available on the platform.</div></div><div><h3>Materials and Methods</h3><div>In August 2024, a systematic search was conducted using a formal strategy to identify relevant videos. Two independent neurology resident physicians reviewed each video, scoring it with the validated modified DISCERN (mDISCERN) tool for reliability and the Global Quality Scale (GQS) for content quality. Videos were categorized based on their purpose and assessed for video/audio quality, accuracy, comprehensiveness, and procedure-specific content.</div></div><div><h3>Results</h3><div>The study included 44 videos. According to GQS, 17 (38.6 %) were rated as high quality, 14 (31.8 %) as good, 5 (17 %) as medium, and 8 (18.2 %) as poor quality. On the mDISCERN scale, 24 (54.5 %) were deemed reliable, while 9 (20.5 %) were unreliable. Videos created by physicians, academic institutions, and reputable health information websites scored higher on both mDISCERN and GQS compared to other sources. A strong positive correlation was found between mDISCERN and GQS scores (r = 0.925, p &lt; 0.001), indicating that higher reliability was linked to better content quality.</div></div><div><h3>Conclusion</h3><div>YouTube offers valuable resources for HFS patients and caregivers. Videos produced by healthcare professionals and academic institutions offered particularly accurate insights, enhancing patients’ understanding of the condition’s pathophysiology and treatment options, and serving as a useful complement to healthcare professionals’ knowledge. Healthcare professionals and academic institutions have a pivotal role in creating and promoting high-quality educational content. Future efforts should focus on increasing the availability of reliable, expert-verified videos to improve overall quality of information accessible to patients.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100311"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic dysfunction in progressive supranuclear Palsy: A retrospective study","authors":"Yichun Wang ,&nbsp;Manqing Xie ,&nbsp;Dan Xu ,&nbsp;Yanhong Wang ,&nbsp;Han Wang","doi":"10.1016/j.prdoa.2025.100310","DOIUrl":"10.1016/j.prdoa.2025.100310","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the characteristics of autonomic dysfunction in progressive supranuclear palsy (PSP) compared to Parkinson’s disease (PD) and multiple system atrophy-parkinsonian type (MSA-P).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 128 patients who underwent multidisciplinary team (MDT) intervention at Peking Union Medical College Hospital between March 31, 2021, and November 22, 2023. A total of 16 PSP, 27 MSA-P, and 11 PD patients were included. Autonomic dysfunction was assessed using the SCOPA-AUT scale and medical record data, analyzed with IBM SPSS Statistics 26.</div></div><div><h3>Results</h3><div>SCOPA-AUT revealed varying degrees of autonomic dysfunction across all groups. The total SCOPA-AUT score was lower in PSP (16.88 ± 6.70) than in MSA-P (23.33 ± 8.80) (p = 0.019), but not significantly different from PD (18.64 ± 9.80). All five SCOPA-AUT subscales were affected in PSP, though significant differences were found only in urinary control (p = 0.006) and urinary storage (p = 0.008) scores between PSP and MSA-P. Orthostatic hypotension was clinically identified in 7.7 % of PSP, 66.7 % of MSA-P, and 27.3 % of PD patients, with a significant difference between PSP and MSA-P (p &lt; 0.001). Residual urine volume in MSA-P (137.5 [75.5–190.25] mL) was significantly higher than in PD (34.5 [1.50–60.00] mL, p &lt; 0.001) and PSP (9.95 [1.13–56.25] mL, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings indicate that PSP presents with various forms of autonomic dysfunction, as assessed by SCOPA-AUT, with similarities to both MSA-P and PD. Objective measures, such as orthostatic blood pressure assessments and residual urine ultrasound, can provide additional insights into autonomic dysfunction in PSP.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100310"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the enigmatic: Primary progressive apraxia of speech – A case report","authors":"Mateusz Bernad ,&nbsp;Renata Kowalska-Taczanowska ,&nbsp;Karolina Duszyńska- Wąs ,&nbsp;Joanna Mączewska ,&nbsp;Piotr Alster ,&nbsp;Dariusz Koziorowski ,&nbsp;Monika Figura","doi":"10.1016/j.prdoa.2025.100304","DOIUrl":"10.1016/j.prdoa.2025.100304","url":null,"abstract":"<div><div>Primary progressive apraxia of speech (PPAOS) is a rare neurodegenerative disorder that saliently affects motor speech programming and planning. Linguistic function remains intact in the early stages of PPAOS.</div><div>Although PPAOS shares a similar symptomatology to conditions such as primary progressive aphasia (PPA) and dysarthria, it is important to remember that this disorder constitutes its own distinct clinical syndrome. PPAOS is characterized by an individually variable disease course, with a steady progression in speech deterioration. In later stages, this disorder may additionally present with symptoms such as oral apraxia, dysarthria, dysphagia, aphasia, and parkinsonian syndromes similar to either progressive supranuclear palsy (PSP) or corticobasal syndrome (CBS). 4-repeat tauopathy is the most common pathology associated with PPAOS. In this study, we present a case of a female patient suffering from PPAOS, detailing her clinical course during a 44-year long follow-up. As PPAOS is a disorder with a worldwide poorly-documented prevalence, there is limited data in literature on the subject. We thus bring this case to public discussion. We also recommend further investigating this disorder, as we would then be able to unify diagnostic and therapeutic approaches for PPAOS.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100304"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPG7 mutation – Novel phenotypic presentation mimicking idiopathic Parkinson’s disease","authors":"Karri Madhavi,&nbsp;Rukmini Mridula Kandadai,&nbsp;Sruthi Kola,&nbsp;Rupam Borgohain,&nbsp;Rajesh Alugolu,&nbsp;VVSRK Prasad","doi":"10.1016/j.prdoa.2024.100280","DOIUrl":"10.1016/j.prdoa.2024.100280","url":null,"abstract":"","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100280"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}