Clinical Parkinsonism Related Disorders最新文献

{"title":"The comparison of gait disorders among different motor subtypes in Parkinson’s disease patients during the early and middle stages","authors":"Jianing Mei ,&nbsp;Yu Wang ,&nbsp;Dongyu Zhu ,&nbsp;Yang Li ,&nbsp;Kan Gu ,&nbsp;Zijun Wei ,&nbsp;Xueyi Han ,&nbsp;Qianqian Li ,&nbsp;Shuyun Jiang ,&nbsp;Yunyun Zhang","doi":"10.1016/j.prdoa.2025.100309","DOIUrl":"10.1016/j.prdoa.2025.100309","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>There is a scarcity of quantitative research on gait differences among patients with different motor subtypes of Parkinson’s disease (PD), especially during the early and middle stages of the condition. The purpose of this study is to describe the gait characteristics of PD with different motor subtypes in the early and middle stages and to identify the most sensitive indicators of gait impairment.</div></div><div><h3>Methods</h3><div>General information, including age, gender, disease duration, levodopa equivalent daily dose (LEDD), and falls, was collected. Motor and non-motor symptoms of PD were assessed using multiple scales. Patients’ walking function and lower limb joint movement ability were analyzed using a 3D gait analysis system.</div></div><div><h3>Results</h3><div>The study included 64 patients with early and middle-stage PD, of whom 33 were classified as the TD subtype, 24 were classified as the PIGD subtype, and 7 were classified as the Mixed subtype. In addition, 5 healthy subjects were included in the evaluation as healthy controls. The PIGD patients have significantly higher LEDD (431.08 ± 250.90 mg vs. 302.08 ± 164.64 mg, p = 0.034) and a higher number of falls (0.29 vs. 0.00, p = 0.018) than the TD patients. The overall gait disturbances and motor and non-motor symptoms did not exhibit significant differences between TD and PIGD patients. However, the decrease in GDI (β = −0.730 vs. β = −0.235, p = 0.043) and hip flexion and extension range (β = −0.533 vs. β = −0.470, p &lt; 0.001) was more pronounced in PIGD patients compared to TD patients as the MDS-UPDRS Ⅲ score increased.</div></div><div><h3>Conclusion</h3><div>There is no significant difference in gait severity between patients with TD and PIGD subtypes during the early and middle stages of PD. However, PIGD patients exhibit a more rapid progression of gait impairment than TD, particularly affecting hip mobility.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100309"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579054","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":"Hospital utilization and telemedicine preferences in patients with late-stage Parkinson’s disease and caregivers","authors":"Seo Hyun Hong ,&nbsp;Seoyeon Kim ,&nbsp;Seungmin Lee ,&nbsp;Bora Jin ,&nbsp;Jung Hwan Shin ,&nbsp;Kyung Ah Woo ,&nbsp;Han-Joon Kim","doi":"10.1016/j.prdoa.2024.100296","DOIUrl":"10.1016/j.prdoa.2024.100296","url":null,"abstract":"<div><h3>Background</h3><div>There remains a significant gap in systematic research on healthcare utilization behaviors and the influencing factors for patients with Parkinson’s disease (PD), particularly those in late stages.</div></div><div><h3>Methods</h3><div>PD patients in late stage (Hoehn and Yahr (HY) stages 4 and 5) and their caregivers from Seoul National University Hospital Movement Disorders Clinic participated. A total of 103 respondents completed a questionnaire covering medical utilization behaviors, perceptions of face-to-face and telemedicine consultations, and additional medical service needs. Descriptive analysis was conducted based on HY stage, age, and travel time to the hospital.</div></div><div><h3>Results</h3><div>82.1% of patients in HY4 make more than 50% of in-person visits by themselves or with caregivers, compared with only 38.9% of patients in HY5. Despite proxy visits by caregivers were common, audiovisual or written materials about the patient’s condition were underused (63% answered ‘never’). Over three-quarters of patients did not receive rehabilitation therapy, mainly due to mobility issues and the lack of nearby facilities. One third of respondents were open to telemedicine, with differing preferences between age groups. 22% of HY5 patients or their caregivers were willing to pay more for telemedicine than in-person visit.</div></div><div><h3>Conclusion</h3><div>This study seeks to understand hospital use patterns and needs in late-stage PD patients and their caregivers. Current treatment framework for PD has areas that, if improved, could significantly enhance the quality of care. Telemedicine offers an opportunity to enhance PD education and assessment, introducing new methods for remotely measuring symptoms.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100296"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029659","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":"Novel NOTCH3 mutation c.1564 T > A (p.Cys522Ser) presenting with early-onset Parkinsonism and white matter lesions","authors":"Nicola Rifino ,&nbsp;Silvia Baratta ,&nbsp;Esteban Zacarias ,&nbsp;Isabella Canavero ,&nbsp;Benedetta Storti ,&nbsp;Mario Stanziano ,&nbsp;Emanuela Maderna ,&nbsp;Gianluca Marucci ,&nbsp;Franco Taroni ,&nbsp;Anna Bersano","doi":"10.1016/j.prdoa.2025.100297","DOIUrl":"10.1016/j.prdoa.2025.100297","url":null,"abstract":"<div><div>CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is a hereditary small vessel disease caused by mutations in the NOTCH3 gene, characterized by recurrent strokes, cognitive decline, and psychiatric symptoms. This report presents a novel NOTCH3 c.1564 T &gt; A (p.Cys522Ser) mutation associated with early-onset parkinsonism and significant white matter lesions. We describe a patient who presented with early-onset parkinsonism, characterized by bradykinesia and rigidity, alongside extensive white matter lesions observed through neuroimaging. Genetic testing revealed a novel c.1564 T &gt; A (p.Cys522Ser) mutation in the NOTCH3 gene, contributing to the clinical diagnosis of CADASIL. This case underscores the phenotypic variability of CADASIL and the potential for atypical presentations, including parkinsonism. Early identification of genetic mutations can facilitate appropriate management and counseling for affected individuals and their families. Further research is warranted to explore the mechanisms underlying the association between NOTCH3 mutations and parkinsonism. Our findings contribute to the understanding of CADASIL, suggesting that clinicians should consider CADASIL in differential diagnoses of early-onset parkinsonism, especially in patients with concurrent white matter lesions.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100297"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060744","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":"Associations among blood biomarkers, clinical subtypes, and prognosis in Parkinson’s disease","authors":"Hideki Oizumi ,&nbsp;Takafumi Hasegawa ,&nbsp;Ichiro Kawahata ,&nbsp;Tomoki Sekimori ,&nbsp;Tomoko Totsune ,&nbsp;Yoko Sugimura ,&nbsp;Toru Baba ,&nbsp;Kohji Fukunaga ,&nbsp;Atsushi Takeda","doi":"10.1016/j.prdoa.2025.100313","DOIUrl":"10.1016/j.prdoa.2025.100313","url":null,"abstract":"<div><h3>Background</h3><div>Early identification of the poor prognosis subtype by surrogate markers would be advantageous for selecting treatments for Parkinson’s disease (PD). The aim of the present study was to test whether plasma neurofilament light chain (NF-L), total tau (t-tau), ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), fatty acid-binding protein 3 (FABP3), and phosphorylated tau (p-tau) can be used as prognostic biomarkers in PD.</div></div><div><h3>Methods</h3><div>In the present study, both retrospective and prospective studies were performed. Plasma samples at baseline from 81 PD patients were included in the prospective study. Plasma samples at baseline from 60 patients who underwent cognitive assessment were subjected to the hierarchical cluster analysis for a retrospective study.</div></div><div><h3>Results</h3><div>On the basis of the results of the cluster analysis, patients were classified into three groups: groups (G)1, G2 and G3. Individuals in the G1 cluster, who had an older age at onset and were prone to early progression with dementia, had significantly greater plasma NF-L levels than those in the G3 cluster, who did not present with dementia at an early stage. A Cox proportional hazards regression model adjusted for age and sex revealed that high NF-L and UCH-L1 levels at baseline predicted the four future milestones (i.e., nursing care, dysphagia, wheelchair use, and repeated falls), and high plasma t-tau at baseline predicted future dysphagia.</div></div><div><h3>Conclusions</h3><div>Although further studies with a larger number of patients will be required, plasma NF-L may be a useful biomarker for identifying the rapidly progressive subtype of PD, and plasma NF-L and UCH-L1 may serve as biomarkers of overall PD prognosis, whereas plasma t-tau could be a biomarker for future dysphagia in PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100313"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621026","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":"Efficacy of virtual reality-based cognitive behavioral group therapy in enhancing emotional well-being and quality of life in Parkinson’s disease: A randomized controlled trial","authors":"Gooya Tayyebi ,&nbsp;Farnaz Asadiof ,&nbsp;Bahar Hashempour ,&nbsp;Mohsen Lotfi ,&nbsp;Mostafa Taheri ,&nbsp;Mahdi Naeim","doi":"10.1016/j.prdoa.2025.100316","DOIUrl":"10.1016/j.prdoa.2025.100316","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the effectiveness of virtual reality-based cognitive behavioral group therapy (VR-CBGT) in improving emotional well-being and quality of life in individuals with Parkinson’s disease.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted in 2023 at Roozbeh Hospital, Tehran, with 90 Parkinson’s patients. Participants were randomly assigned to an intervention group receiving 12 VR-CBGT sessions over three months with a control group receiving standard medical care without psychological intervention. Emotional well-being was assessed using the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured with the Parkinson’s Disease Questionnaire-39 (PDQ-39) before and after the intervention. Data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS-25.</div></div><div><h3>Results</h3><div>The intervention group demonstrated a significant improvement in emotional well-being (HADS-total score reduction of 7.2 points, P &lt; 0.001) and quality of life (PDQ-39 total score improvement of 12.5 %, P = 0.002) compared to the control group. VR-CBGT explained 18 % of the variance in emotional well-being and 26 % in quality of life.</div></div><div><h3>Conclusion</h3><div>These findings highlight VR-CBGT as an effective complementary intervention for enhancing psychological health and overall quality of life in Parkinson’s patients. The immersive nature of VR fosters engagement and facilitates cognitive and emotional processing, supporting its integration into multidisciplinary treatment approaches.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100316"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609345","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":"Dopa-responsive parkinsonism without cerebellar ataxia in spinocerebellar ataxia 6","authors":"Shun Yoshida ,&nbsp;Toshiyuki Takahashi ,&nbsp;Naoki Suzuki ,&nbsp;Muneshige Tobita","doi":"10.1016/j.prdoa.2025.100322","DOIUrl":"10.1016/j.prdoa.2025.100322","url":null,"abstract":"","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100322"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768346","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":"A four-year trajectory of Alexithymia in Parkinson’s disease patients","authors":"Lea Krey,&nbsp;Annika Heike Ritzrau,&nbsp;Theresa Schnur,&nbsp;Stephan Greten,&nbsp;Florian Wegner,&nbsp;Martin Klietz","doi":"10.1016/j.prdoa.2025.100298","DOIUrl":"10.1016/j.prdoa.2025.100298","url":null,"abstract":"<div><div>The aim of this study was to assess the presence of Alexithymia in Parkinson’s disease (PD) patients compared to their caregivers (CG) and to investigate whether Alexithymia progressed over a 4-year observational period. Alexithymia in PD is a cognitive affective disturbance resulting in difficulty to identify, distinguish and describe feelings and it is known to be strongly associated with health-related quality of life and other cognitive/ neuropsychiatric symptoms. So far, there have been no longitudinal investigations of Alexithymia in PD. We recruited 34 moderately progressed PD patients (mean disease duration of 8.9 ± 5.3 years) and their caregivers in our neurological department and did a baseline and follow-up assessment using the validated Toronto Alexithymia Scale-26 (TAS-26). Our data show that Alexithymia is more abundant in the PD cohort compared to their caregivers (p = 0.007, PD 21 %, CG 6 % at follow-up). In the 4-year observational period, Alexithymia did not increase significantly in PD patients or caregivers. However, there was a high variance in Alexithymia scores in both groups. It remains unclear when Alexithymia appears during the disease course and whether there is a dynamic in Alexithymia scores later in PD progression. This should be the objective for future studies of Alexithymia in advanced PD patients.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"12 ","pages":"Article 100298"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081274","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":"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}