Clinical Parkinsonism Related Disorders最新文献

{"title":"The role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study","authors":"Sandro Ibrulj ,&nbsp;Dejan Georgiev ,&nbsp;Žiga Samsa ,&nbsp;Polona Mušič ,&nbsp;Mitja Benedičič ,&nbsp;Maja Trošt","doi":"10.1016/j.prdoa.2025.100299","DOIUrl":"10.1016/j.prdoa.2025.100299","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to determine (i) how often the planned (imaging based) placements of electrodes were changed due to MER and intraoperative test stimulation in Parkinson’s disease (PD), dystonia and essential tremor (ET) patients; (ii) whether the frequency of repositioning changed over time; (iii) whether patients’ age or disease duration (in PD) influenced the frequency of repositioning.</div></div><div><h3>Methods</h3><div>Data on the planned and the final placement of 141 electrodes in 72 consecutive DBS treated patients (52 PD, 11 dystonia, 9 ET) was collected over the first 8 years of DBS implementation in a single center. An association between the rate of electrode repositioning and the patients’ age, disease duration and the time/year of implementation was explored.</div></div><div><h3>Results</h3><div>Analysis of all targets showed a change in final electrode placement in 39.7 % (56/141); 39.8 % (41/103) in PD, 40.9 % (9/22) in dystonia and 37.5 % (6/16) in ET. Annual analysis showed a decrease in rate of repositioning between the centre’s first and eighth year (p = 0.013) of implementation. No correlation was found between electrode repositioning rate and patient age (p = 0.42) nor disease duration (p = 0.09) in PD.</div></div><div><h3>Conclusion</h3><div>This retrospective analysis confirms the benefit of MER and intraoperative test stimulation during DBS surgery in determining the final electrode position during the early / initial period of implementing the procedure. Our findings show a learning curve in successful preoperative planning in our centre achieved through experience.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100299"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060747","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":"Contribution of dopaminergic polymorphisms to levodopa treatment response and drug concentration in Chinese patients with Parkinson’s disease","authors":"Xiaoqin He ,&nbsp;Kai Shi ,&nbsp;Chengjun Mo ,&nbsp;Yi Zhang ,&nbsp;Qin Xiao ,&nbsp;Xiaodong Yang","doi":"10.1016/j.prdoa.2025.100333","DOIUrl":"10.1016/j.prdoa.2025.100333","url":null,"abstract":"<div><h3>Background</h3><div>Levodopa is the mainstay of treatments for Parkinson’s disease (PD), but large heterogeneity exists in patient response. Pharmacogenetic studies highlighted that genetic factors may play a relevant influence in this drug response variability.</div></div><div><h3>Objective</h3><div>To explore the relationship between dopaminergic polymorphisms, levodopa treatment response, and drug concentration in Chinese patients with PD.</div></div><div><h3>Methods</h3><div>Acute levodopa challenge test was conducted in 90 PD patients. Each patient underwent comprehensive neurological examination at baseline and after levodopa administration. Plasma levodopa concentrations were measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis. Twelve genetic polymorphisms in genes encoding dopaminergic enzymes (TH, DDC, COMT, MAOB and DBH) were genotyped.</div></div><div><h3>Results</h3><div>Patients with the TH-rs6356 TT genotype showed higher ΔMDS-UPDRS-III scores compared to those with the CC + CT genotype after adjustment for the levodopa dose in the acute challenge test (P = 0.048). Furthermore, peak plasma levodopa concentration and Δplasma levodopa concentration were significantly higher in the TH-rs6356 TT group compared to the CC + CT group after adjustment (P = 0.007). Patients with the TH-rs6356 TT genotype exhibited a longer time to peak response compared to those with the CC + CT genotype (P = 0.042). However, this difference became non-significant after adjusting for levodopa dose (P = 0.066). The impact of other dopamine-related gene polymorphisms on levodopa efficacy appeared to be minimal in our study.</div></div><div><h3>Conclusions</h3><div>Our preliminary results from a relatively small patients’ sample, may suggest that the rs6356 polymorphism in the TH gene could act as a possible modifier of levodopa response in PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100333"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal important changes of HFS-30 and HFS-7 questionnaires for patients with hemifacial spasm","authors":"Weerawat Saengphatrachai,&nbsp;Nutchara Inthapong,&nbsp;Yuvadee Pitakpatapee,&nbsp;Natthapon Rattanathamsakul,&nbsp;Prachaya Srivanitchapoom","doi":"10.1016/j.prdoa.2024.100295","DOIUrl":"10.1016/j.prdoa.2024.100295","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemifacial spasm (HFS) significantly reduces health-related quality of life (HRQoL). Currently, the HFS-30 and HFS-7 questionnaires are used to evaluate the HRQoL in HFS patients; however, their minimal important changes (MICs) have not yet to be established. This study aimed to determine the MICs for HFS-30 and HFS-7 and patients’ characteristics associated with them.</div></div><div><h3>Methods</h3><div>Data were prospectively collected from HFS patients aged ≥18 years at a botulinum toxin clinic in a single tertiary university hospital between April 2022 and April 2023. We assessed HFS-30 and HFS-7 scores, Samsung Medical Center (SMC) grades, Patient Health Questionnaire-9 (PHQ-9) scores, and patient-reported HRQoL global rating of change scores at baseline, followed by assessments every two days for two weeks and at the one-month follow-up. MICs were determined based on the first follow-up visit when patients reported minimal improvement.</div></div><div><h3>Results</h3><div>The 112 enrolled patients had a median age of 62.8 years (IQR: 56.6–69.3) and a median disease duration of 10 years (IQR: 4–17). The MICs of the HFS-30 and HFS-7 questionnaires were −4.55 points (95 % CI: −5.49 to −3.62) and −0.96 points (95 % CI: −1.28 to −0.64), respectively. Patients with moderate-to-severe depression reported significantly greater MICs than those with milder depression (p &lt; 0.001). Patients aged less than 60 had significantly greater MICs than older patients (p = 0.045).</div></div><div><h3>Conclusions</h3><div>The MICs of the HFS-30 and HFS-7 questionnaires were −4.55 and −0.96, respectively. The MIC is substantially greater in HFS patients with moderate-to-severe depression and younger age.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100295"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176207","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":"Correlation analyses between MIBG myocardial scintigraphy and monoamine levels in dementia with Lewy bodies show potential link with the serotonergic system","authors":"Annelies Heylen ,&nbsp;Yannick Vermeiren ,&nbsp;Sebastiaan Engelborghs ,&nbsp;Frank Van Acker ,&nbsp;Peter Paul De Deyn ,&nbsp;Debby Van Dam","doi":"10.1016/j.prdoa.2025.100346","DOIUrl":"10.1016/j.prdoa.2025.100346","url":null,"abstract":"<div><h3>Setting</h3><div>Dementia with Lewy bodies (DLB) remains poorly understood and frequently misdiagnosed, complicated by co-pathology with other dementia forms. DLB patients often present with autonomic dysfunction and peripheral Lewy body pathology alongside central lesions. Monoaminergic neurotransmitter systems seem an early target for DLB pathology, especially the noradrenergic system. Noradrenaline analogue ¹²³I-metaiodobenzylguanidine (MIBG) is considered an indicative biomarker for peripheral noradrenergic sympathetic denervation.</div></div><div><h3>Objectives</h3><div>Our aim was to measure paired monoaminergic levels and MIBG scintigraphy values in DLB patients, exploring a possible link between noradrenergic neurotransmission and peripheral denervation.</div></div><div><h3>Design</h3><div>44 patients with a possible DLB diagnosis entered the study. Peripheral uptake of ¹²³I-MIBG was determined by the heart-to-mediastinum (H/M) ratio, as a measure for noradrenergic sympathetic denervation. In cerebrospinal fluid (CSF), serum and plasma samples, monoamines ((nor)adrenaline ((N)A), 5-hydroxytryptamin (5-HT, serotonin), dopamine (DA)) and respective metabolites (3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC)), were measured by means of reversed-phase ultrahigh-performance liquid chromatography with electrochemical detection.</div></div><div><h3>Results</h3><div>We found significant correlations between the H/M ratio and serum 5-HIAA, plasma 5-HT, plasma 5-HIAA/5-HT and plasma HVA/5-HIAA, but no further correlations with the noradrenergic system. CSF-serum MHPG, CSF-serum DOPAC, CSF-serum HVA, CSF-plasma MHPG, CSF plasma NA, CSF-plasma DOPAC, CSF-plasma MHPG/NA and CSF-plasma DOPAC/DA were significantly correlated.</div></div><div><h3>Conclusions</h3><div>These results show an association between the H/M ratio and serotonergic system, but not between peripheral noradrenergic denervation and circulating noradrenergic levels.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100346"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating tele-palliative care for atypical Parkinsonian disorders: Lessons learned from a pilot program","authors":"Mitra Afshari ,&nbsp;Kyurim Kang ,&nbsp;Ankur A. Butala ,&nbsp;Jana Guenther ,&nbsp;Rab Razzak ,&nbsp;Maya Katz ,&nbsp;Nicholas B. Galifianakis ,&nbsp;Alexander Pantelyat","doi":"10.1016/j.prdoa.2025.100352","DOIUrl":"10.1016/j.prdoa.2025.100352","url":null,"abstract":"<div><h3>Introduction</h3><div>As evidence supporting palliative care (PC) via tele-medicine for neurologic patients increases, it is important to determine the best integration methods across various healthcare settings and patient populations to optimize outcomes. Given the rising demand for PC in chronic neurodegenerative diseases like Atypical Parkinsonian Disorders (APDs), it is imperative to explore different models of PC delivery for feasibility and effectiveness.</div></div><div><h3>Methods</h3><div>Participants with APDs and their care partners at the University of California, San Francisco (UCSF) and Johns Hopkins University (JHU) received 2 virtual telemedicine PC sessions (at baseline and 6 months). Adherence and feasibility-related outcomes were assessed using a satisfaction survey developed by the investigators, using a five-point Likert scale, administered at baseline and 6 months. Additionally, participants’ quality of life (QoL), mood, functional abilities, and care partner burden were assessed at baseline and 6-month follow-up virtual visits.</div></div><div><h3>Results</h3><div>There was a 100 % attendance rate among participants and their care partners at both sites. Satisfaction levels regarding visit convenience were &gt; 78 % for both visits at UCSF and reached 100 % at JHU. No significant differences were observed between baseline and 6-month assessments at both sites in QoL, mood, or caregiver burden. However, there was a significant decrease in functional abilities during the second visit (6 months) at JHU.</div></div><div><h3>Conclusion</h3><div>These results support the integration and expansion of telemedicine PC services to address the evolving needs of individuals with APDs and their care partners, offering a viable solution to enhance access to PC in diverse healthcare settings.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100352"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of social isolation and changes in Parkinson’s disease symptoms during the COVID-19 pandemic: A longitudinal study","authors":"Anish Mehta ,&nbsp;Samuel Y.E. Ng ,&nbsp;Shermyn X.M. Neo ,&nbsp;Nicole S.Y. Chia ,&nbsp;Ehsan S. Saffari ,&nbsp;Thyagarajan Shivashanmugam ,&nbsp;Xinyi Choi ,&nbsp;Dede L. Heng ,&nbsp;Z.Y. Xu ,&nbsp;K.Y. Tay ,&nbsp;W.L. Au ,&nbsp;E.K. Tan ,&nbsp;Louis C.S. Tan","doi":"10.1016/j.prdoa.2024.100293","DOIUrl":"10.1016/j.prdoa.2024.100293","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19-related social restrictions provided an opportunity to evaluate the impact of social isolation on Parkinson’s disease.</div></div><div><h3>Objective</h3><div>This study aimed to explore changes in social isolation and their associations with PD symptoms using the Lubben Social Network Scale-Revised (LSNS-R).</div></div><div><h3>Methods</h3><div>Data from 80 participants of the Early Parkinson’s Disease Longitudinal Singapore cohort were collected from April 2019 to April 2023, covering the periods before and after the imposition of COVID-19 restrictions. Individuals with LSNS-R scores ≤ 24 were considered socially isolated. Data were stratified into strata 1 (improved LSNS-R scores) and strata 2 (worsened/unchanged scores). Linear regression was used to identify predictors of LSNS-R change, and MANCOVA was used to examine associations between LSNS-R change and motor/ non-motor symptoms.</div></div><div><h3>Results</h3><div>Mean LSNS-R scores decreased (p = 0.014), and proportions of social isolation increased (p &lt; 0. 001) during COVID-19 restrictions. However, 35 % showed improved LSNS-R scores, while 65 % had worsened/unchanged scores. The regression model was significant in strata 1 (R2 = 0.806, p = 0.001), with age, marital status, and social isolation status being significantly associated with change in LSNS-R scores. LSNS-R. Results of MANCOVA indicated that LSNS-R improvements in LSNS-R were significantly associated with outcomes (Roy’s Largest Root statistic = 126.638, p &lt; 0.001), particularly for changes in PDQ8, HADS-Anxiety, and HADS-Depression scores. The regression model was not significant in strata 2 (R2 = 0. 279, p = 0.206), wherein motor and non-motor symptoms worsened.</div></div><div><h3>Conclusion</h3><div>While worsening LSNS-R scores were associated with poorer outcomes, improvements in social networks were associated with improved non-motor symptoms and quality of life. These findings underscore the complexity of social isolation in PD and the need for targeted interventions.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100293"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932879","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":"GBA genotype-Parkinson’s phenotype correlation in a cohort of 252 Italian patients from the Tuscany region","authors":"Rodolfo Tonin ,&nbsp;Silvia Ramat ,&nbsp;Marina Rinaldi ,&nbsp;Silvia Falliano ,&nbsp;Federica Feo ,&nbsp;Francesca Cardona ,&nbsp;Camilla Matassini ,&nbsp;Guido Mannaioni ,&nbsp;Giulia Grigioni ,&nbsp;Luca Caremani ,&nbsp;Alessandra Govoni ,&nbsp;Maria Luisa Della Bona ,&nbsp;Giancarlo la Marca ,&nbsp;Renzo Guerrini ,&nbsp;Amelia Morrone","doi":"10.1016/j.prdoa.2025.100326","DOIUrl":"10.1016/j.prdoa.2025.100326","url":null,"abstract":"<div><h3>Introduction</h3><div>heterozygous mutations in the glucocerebrosidase gene (<em>GBA1</em>), encoding the lysosomal enzyme β-glucocerebrosidase (GCase) are the most common genetic risk factor for Parkinson’s disease (PD). To assess the frequency of <em>GBA1</em> variants related to PD in a cohort of Tuscany patients and to determine the link between <em>GBA1</em> variants and motor and non-motor clinical features in PD.</div></div><div><h3>Methods</h3><div>We screened GCase enzyme activity on Dried Blood Spot using tandem mass spectrometry (LC-MS/MS) and performed sequencing analysis on entire cohort of PD patients by Next Generation Sequencing (NGS) technology. Variants were confirmed with Sanger method.</div></div><div><h3>Results</h3><div>among the 252 PD patients, we detected reduced GCase activity (≤5 μmol/h/L) in 78 (31%). NGS analysis identified 22 carriers of <em>GBA1</em> variants (8.7%) in whom 14 carried common <em>GBA1</em> variants currently known to be related to PD (Leu444Pro, Asn370Ser, Glu326Lys, Thr369Met and Asp409His). PD patients who were heterozygous<!--> <!-->carriers<!--> <!-->of pathogenic<!--> <em>GBA1</em> <!-->variants presented with earlier onset of PD, faster disease progression and a more frequent non-motor symptoms compared to the remaining PD patients without <em>GBA1</em> mutations.</div></div><div><h3>Conclusions</h3><div>8.7% of the 252 PD patients carried <em>GBA1</em> variants at a heterozygous level, and their clinical presentation and progression were more severe compared to other patients within our cohort.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100326"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of inverted U-shaped curve association between serum potassium and prodromal Parkinson’s disease","authors":"Wen Zhou,&nbsp;Qingqing Xia,&nbsp;Duan Liu,&nbsp;Jun-ying Li,&nbsp;Liang Gong","doi":"10.1016/j.prdoa.2025.100323","DOIUrl":"10.1016/j.prdoa.2025.100323","url":null,"abstract":"<div><h3>Background</h3><div>The association between serum potassium and prodromal Parkinson’s disease (PPD) remains unclear currently.</div></div><div><h3>Objective</h3><div>The ultimate goal is to gain a deeper understanding of the implications of this association between serum potassium and PPD.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study involving 1035 participants in PPMI cohort. Age, sex, education years, race, body mass index (BMI), calcium, alanine aminotransferase, aspartate aminotransferase, lymphocytes, neutrophils, serum uric acid, serum sodium, serum potassium, creatinine, serum glucose were obtained from all participants. Logistic regression, and smooth curve fitting were utilized to substantiate the research objectives.</div></div><div><h3>Results</h3><div>The overall PPD was 83.4 % (863/1035). Multivariate odds ratio regression adjusted for risk factors demonstrates a 1-unit increment in the serum potassium raises the risk of PPD by 1.82 times, respectively. Smooth splines analysis suggested an inverted U-shaped association between serum potassium and PPD (P nonlinearity &lt; 0.05), with the zenith of risk at 4.479 mmol/L. Further subgroup analysis and sensitivity analyses supported the primary findings and indicated the conclusions are robust.</div></div><div><h3>Conclusions</h3><div>This study highlights the association between serum potassium levels and the risk of incident PPD, independent of confounders. The association between serum potassium and PPD is inverted U-shaped, the threshold value is 4.479 mmol/l.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100323"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Movement disorders accompanying lithium intoxication – An evolving clinical presentation and SILENT syndrome","authors":"Artur Bystrzyński ,&nbsp;Magdalena Kwaśniak-Butowska ,&nbsp;Jarosław Sławek","doi":"10.1016/j.prdoa.2025.100347","DOIUrl":"10.1016/j.prdoa.2025.100347","url":null,"abstract":"<div><div>Lithium carbonate is a known medication for bipolar disorder and requires monitoring due to the central nervous system toxicity. Symptoms mainly include cerebellar dysfunction, although may fluctuate and change over time. We present an evolving clinical picture of a patient with a complex symptoms and prolonged effect of intoxication.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100347"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences between patient- and therapist-rated working alliance and their relationships with physical rehabilitation outcomes in individuals with Parkinson’s disease","authors":"Keita Sue ,&nbsp;Kazumi Sakurai ,&nbsp;Daiki Usuda ,&nbsp;Katsuyuki Kobayashi ,&nbsp;Keiko Nakamura ,&nbsp;Tomomi Kinoshita ,&nbsp;Kimito Momose","doi":"10.1016/j.prdoa.2025.100349","DOIUrl":"10.1016/j.prdoa.2025.100349","url":null,"abstract":"<div><h3>Introduction</h3><div>Working Alliance (WA) significantly influences therapeutic success in psychotherapy or rehabilitation for musculoskeletal problems. The perception of WA often differs between patients and therapists. However, little is known about WA in patients with Parkinson’s disease (PD) and its relationship with clinical outcomes following physical rehabilitation. This study aimed to examine the differences in WA between patients and physical therapists in the early phase of a<!--> <!-->physical rehabilitation program and explore their relationships with improvements in gait-related assessments.</div></div><div><h3>Methods</h3><div>Twenty-one patients with PD who participated in the Lee Silverman Voice Treatment BIG program were included. Gait-related assessments, which included gait speed at 10-meter walking test (10-MWT) and timed up &amp; go, were conducted before and after the program. WA was assessed using Working Alliance Inventory (WAI) for both patients and therapists after the completion of the fifth session. The difference between patient- and therapist-rated WAI was analyzed using an unpaired <em>t</em>-test. Correlational analyses between both patient- and therapist-rated WAI scores and improvement rates in gait-related assessments were also performed.</div></div><div><h3>Results</h3><div>Patients rated WAI scores significantly higher than therapists. Only patient-rated WAI scores were correlated with improvement rates in gait speed on 10-MWT, while therapist-rated WAI showed no significant correlation.</div></div><div><h3>Conclusion</h3><div>The results suggest patients with PD perceived WA higher than therapists in the early phase of rehabilitation, and patients’ perceptions may influence functional improvements in rehabilitation.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100349"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}