Clinical Parkinsonism Related Disorders最新文献

{"title":"Do sensorimotor insoles improve gait safety in patients with Parkinson’s disease on a short scale?","authors":"Lisa K. Maurer ,&nbsp;Heiko Maurer ,&nbsp;Manuel König ,&nbsp;Marlena van Munster ,&nbsp;Saskia Haen ,&nbsp;David J. Pedrosa","doi":"10.1016/j.prdoa.2024.100290","DOIUrl":"10.1016/j.prdoa.2024.100290","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) often leads to gait abnormalities, increasing the risk of falls and affecting daily life. Sensorimotor insoles aim to enhance foot sensitivity, potentially improving gait stability.</div></div><div><h3>Methods</h3><div>This study examined whether there are short-term effects of sensorimotor insoles on neural activation (measured by EEG), kinematic gait parameters (speed, cadence, step length, and step-length variability), and subjective gait stability in PD patients. Sixteen individuals suffering from PD completed a gait task while wearing sensorimotor and placebo insoles, respectively.</div></div><div><h3>Results</h3><div>The results showed no significant changes in kinematic parameters with the sensorimotor insoles. Subjective ratings of gait stability and attentional control of gait improved on average with the sensorimotor insoles, but again did not reach statistical significance. There was no significant reduction in alpha-band activity, indicating no improvement in sensorimotor processing.</div></div><div><h3>Conclusion</h3><div>The immediate impact of sensorimotor insoles on sensorimotor processing and gait characteristics in PD patients remains inconclusive. The small sample size limited the statistical power, highlighting the need for larger studies to comprehensively assess efficacy. Further research should investigate the long-term effects and potential benefits on disability measures in PD patients.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100290"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745158","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":"Dysphagia is a risk factor of malnutrition in X-linked Dystonia-Parkinsonism","authors":"Tabitha H. Kao ,&nbsp;Perman Gochyyev ,&nbsp;Nutan Sharma ,&nbsp;Jan K. de Guzman ,&nbsp;Melanie Supnet Wells ,&nbsp;Patrick Acuna ,&nbsp;Shasha Li ,&nbsp;Hannah P. Rowe ,&nbsp;Bridget J. Perry","doi":"10.1016/j.prdoa.2024.100282","DOIUrl":"10.1016/j.prdoa.2024.100282","url":null,"abstract":"<div><h3>Introduction</h3><div>Malnutrition is a leading cause of death for persons living with X-linked dystonia-parkinsonism (XDP), a degenerative disease endemic to the Philippines. Difficulty swallowing has been linked to malnutrition in other populations; however, knowledge of this relationship is limited in XDP. As such, the purpose of this study was to determine the association between dysphagia and malnutrition in this population.</div></div><div><h3>Method(s)</h3><div>21 individuals with XDP, 26 controls, and 18 genetic carriers were included in the final data analysis. Spearman’s rank order correlation coefficient was used to determine an association between baseline EAT-10 total scores and 12-month malnutrition status, and multiple linear regression to evaluate the predictive ability of the EAT-10. A baseline EAT-10 score cut-off point predicting 12-month malnutrition status was estimated.</div></div><div><h3>Results</h3><div>For the XDP group, the baseline EAT-10 total scores had a significant negative correlation (<em>r</em> = -0.68, <em>p</em> &lt; 0.001) with and was a significant predictor (<em>p</em> = 0.001) of 12-month BMI. A baseline EAT-10 total score of ≥ 4 predicted malnutrition twelve months after administration (sensitivity = 0.93; specificity = 1; AUC = 0.95).</div></div><div><h3>Discussion</h3><div>Dysphagia, as measured using the EAT-10, was associated with BMI in the XDP population. Additionally, an EAT-10 total score ≥ 4 could predict malnutrition in twelve months after test administration. With these findings, healthcare providers could identify patients with XDP at high risk for malnutrition earlier and provide intervention sooner.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100282"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706424","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":"Comparison of MIBG uptake in the major salivary glands between Lewy body disease and progressive supranuclear palsy","authors":"Junya Ebina ,&nbsp;Sunao Mizumura ,&nbsp;Mari Shibukawa ,&nbsp;Harumi Morioka ,&nbsp;Junpei Nagasawa ,&nbsp;Masaru Yanagihashi ,&nbsp;Takehisa Hirayama ,&nbsp;Nobutomo Ishii ,&nbsp;Yukio Kobayashi ,&nbsp;Akira Inaba ,&nbsp;Satoshi Orimo ,&nbsp;Osamu Kano","doi":"10.1016/j.prdoa.2024.100287","DOIUrl":"10.1016/j.prdoa.2024.100287","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac sympathetic denervation is specific to Lewy body disease (LBD). In Parkinson’s disease (PD), sympathetic denervation in the major salivary glands (parotid glands [PG] and submandibular glands [SMG]) has been demonstrated by ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy. We compared sympathetic denervation in the MSG between PD, dementia with Lewy bodies (DLB), and progressive supranuclear palsy (PSP).</div></div><div><h3>Methods</h3><div>We recruited 81 patients with PD, 12 with DLB, 13 with PSP and 25 with control subjects. We evaluated MIBG uptake in the major salivary glands and heart using a quantitative semi-automatic method. We compared MIBG uptake between PD, DLB, and PSP patients and controls, and we evaluated disease sensitivity and specificity. We compared olfactory function with MIBG uptake between PD and PSP patients.</div></div><div><h3>Results</h3><div>MIBG uptake in the PG and SMG in the delayed phase was significantly lower in PD and DLB patients than in PSP patients and controls. Conversely, MIBG uptake in the major salivary glands and heart was comparable between PD and DLB. Between LBD and non-LBD, MIBG uptake showed 56–100 % specificity in the PG, while it had 55.6–87.5 % sensitivity in the SMG. Between PD and PSP, MIBG uptake in the PG and SMG had higher disease specificity than olfactory function, while the sensitivity of SMG MIBG uptake was comparable to olfactory function.</div></div><div><h3>Conclusion</h3><div>PD and DLB patients showed lower MIBG uptake in the major salivary glands than PSP patients, especially in the delayed phase. MIBG uptake in the major salivary glands may differentiate PD from hyposmic PSP.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100287"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706423","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 characteristics of the temporal transition to maximum tongue pressure in Parkinson’s disease: A pilot study","authors":"Sachi Hayasaka ,&nbsp;Kozo Hatori ,&nbsp;Shuko Nojiri ,&nbsp;Taku Hatano ,&nbsp;Takao Urabe ,&nbsp;Akito Hayashi ,&nbsp;Nobutaka Hattori ,&nbsp;Toshiyuki Fujiwara","doi":"10.1016/j.prdoa.2024.100244","DOIUrl":"https://doi.org/10.1016/j.prdoa.2024.100244","url":null,"abstract":"<div><h3>Introduction</h3><p>The reason why maximum tongue pressure (MTP) decreases in patients with Parkinson’s disease (PD) remains unclear. Repeated measurements of isometric force and MTP may be useful for analyzing muscle wasting and force generation. The purpose of this pilot study was to evaluate the clinical characteristics and temporal transition of MTP in PD and normal control (NC) groups.</p></div><div><h3>Methods</h3><p>There were 18 participants in this study: 10 with PD and 8 NCs. The MTP was measured 20 times at regular intervals. The area under the curve of MTP temporal transitions, time to reach MTP, and total transition time of the tongue pressure (time to return to baseline) were compared between the groups.</p></div><div><h3>Results</h3><p>MTP decreased from baseline in PD subjects. Unlike NCs, PD subjects showed diverse and inconsistent temporal transitions. The decrease in MTP and delays in time to reach MTP and time to return to baseline were significantly greater in PD subjects (p &lt; 0.05), while there was no group difference in area under the curve values. According to repeated-measures ANOVA, MTP was not different over time between PD subjects and NCs.</p></div><div><h3>Conclusion</h3><p>In this study, muscle fatigue did not affect the decrease in MTP seen in PD subjects, or the diversity and inconsistency of the temporal transition in MTP in that group. These findings indicate that the motor control needed for the repeated, identical movements associated with MTP generation may be impaired in PD patients.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"10 ","pages":"Article 100244"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590112524000136/pdfft?md5=520d02b1091a7e053aded5ef8be4bf79&pid=1-s2.0-S2590112524000136-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139985171","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":"Too little or too much nocturnal movements in Parkinson’s disease: A practical guide to managing the unseen","authors":"Jirada Sringean ,&nbsp;Ornanong Udomsirithamrong ,&nbsp;Roongroj Bhidayasiri","doi":"10.1016/j.prdoa.2024.100258","DOIUrl":"https://doi.org/10.1016/j.prdoa.2024.100258","url":null,"abstract":"<div><p>Nocturnal and sleep-related motor disorders in people with Parkinson’s disease (PD) have a wide spectrum of manifestations and present a complex clinical picture. Problems can arise due to impaired movement ability (hypokinesias), e.g. nocturnal hypokinesia or early-morning akinesia, or to excessive movement (hyperkinesias), e.g. end-of-the-day dyskinesia, parasomnias, periodic limb movement during sleep and restless legs syndrome. These disorders can have a significant negative impact on the sleep, daytime functional ability, and overall quality of life of individuals with PD and their carers. The debilitating motor issues are often accompanied by a combination of non-motor symptoms, including pain and cramping, which add to the overall burden. Importantly, nocturnal motor disorders encompass a broader timeline than just the period of sleep, often starting in the evening, as well as occurring throughout the night and on awakening, and are not just limited to problems of insomnia or sleep fragmentation. Diagnosis can be challenging as, in many cases, the ‘gold standard’ assessment method is video polysomnography, which may not be available in all settings. Various validated questionnaires are available to support evaluation, and alternative approaches, using wearable sensors and digital technology, are now being developed to facilitate early diagnosis and monitoring. This review sets out the parameters of what can be considered normal nocturnal movement and describes the clinical manifestations, usual clinical or objective assessment methods, and evidence for optimal management strategies for the common nocturnal motor disorders that neurologists will encounter in people with PD in their clinical practice.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"10 ","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259011252400029X/pdfft?md5=ba9f73a6f4b55919183986da7b224bec&pid=1-s2.0-S259011252400029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141241713","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":"Coupling neurologic music therapy with immersive virtual reality to improve executive functions in individuals with Parkinson’s disease: A Quasi-Randomized Clinical Trial","authors":"Federica Impellizzeri ,&nbsp;Maria Grazia Maggio ,&nbsp;Paolo De Pasquale ,&nbsp;Mirjam Bonanno ,&nbsp;Lilla Bonanno ,&nbsp;Rosaria De Luca ,&nbsp;Giuseppe Paladina ,&nbsp;Angela Alibrandi ,&nbsp;Demetrio Milardi ,&nbsp;Michael Thaut ,&nbsp;Corene Hurt ,&nbsp;Angelo Quartarone ,&nbsp;Rocco Salvatore Calabrò","doi":"10.1016/j.prdoa.2024.100277","DOIUrl":"10.1016/j.prdoa.2024.100277","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) is one the most common neurodegenerative movement disorder, leading to motor and non-motor symptoms, including deficits in executive functions (EF), memory, visuospatial abilities, and psychomotor speed. Current treatments are primarily symptomatic, involving pharmacological, surgical strategies. Neurologic Music Therapy (NMT) has gained recognition for its effectiveness in neurorehabilitation of PD patients and improving motor and cognitive domains, such as EF. This study combines NMT with the virtual reality (VR) platform Computer-Assisted Rehabilitation Environment (CAREN), offering customizable environments for rhythmic cue practice to provide an innovative approach to Parkinson’s rehabilitation.</div></div><div><h3>Methods</h3><div>In our single-blind quasi-randomized controlled trial, forty patients were assigned to either an experimental group (EG = 20) or a control group (CG = 20). Both groups underwent two months of training with CAREN scenarios (three times a week for 24 sessions). The experimental group additionally received NMT applied to the selected scenarios. Participants were evaluated by a neuropsychologist at baseline and immediately after training.</div></div><div><h3>Results</h3><div>Intra-group analysis showed significant improvements in the EG for MOCA (p = 0.007), FAB (p = 0.008), Stroop Error (p = 0.003), Stroop Time (p &lt; 0.001), and Visual Search (p &lt; 0.001). The CG showed a significant difference only in Stroop Error (p = 0.02).</div></div><div><h3>Conclusions</h3><div>This pilot study is the first to combine NMT with CAREN in PD patients. Our findings suggest that NMT, within an immersive VR environment, effectively improves cognitive and EF in PD. Music structured within NMT techniques, coupled with advanced audio-visual feedback from VR, offers an innovative and potentially more effective approach for managing cognitive and executive deficits associated with PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100277"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532118","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":"Practitioner perspectives on the implementation of the Lee Silverman Voice Treatment BIG® program","authors":"Leah Botkin,&nbsp;Rachel Proffitt","doi":"10.1016/j.prdoa.2024.100268","DOIUrl":"10.1016/j.prdoa.2024.100268","url":null,"abstract":"<div><h3>Background</h3><p>The Lee Silverman Voice Treatment BIG® (LSVT BIG®) intervention, originally designed for the patients with Parkinson’s disease, is a high amplitude, high repetition therapy protocol that encourages bigger, more quality movements. The purpose of this study was to understand practitioner utilization and perspectives of the LSVT BIG® intervention as there is no published work in this area.</p></div><div><h3>Methods</h3><p>An electronic survey with optional debriefings was distributed to LSVT BIG® certified practitioners via the Facebook page run by parent company, LSVT Global Inc.</p></div><div><h3>Results</h3><p>Forty-seven practitioners engaged in this study. Practitioners were largely in the outpatient setting. Forty-seven percent reported utilizing the LSVT BIG® intervention for patient populations outside of the Parkinson’s disease diagnosis. Sixty-one percent of respondents reported using the same assessment tools and ninety-five percent reported billing insurance for their services. Twenty-three percent reported offering the LSVT BIG® intervention via telehealth. Debriefings identified barriers to implementation.</p></div><div><h3>Conclusion</h3><p>Practitioners are implementing the LSVT BIG® intervention across settings and are most likely to be in the outpatient setting, serving patients who possess a neurological diagnosis, and focus their assessment on lower extremity, gait, and balance. When billing insurance, practitioners routinely select the three CPT® codes: Neuromuscular Re-Education, Therapeutic Activity, and Therapeutic Procedure/Exercise. Practitioners identified several barriers to implementing the LSVT BIG® program, such as the high frequency of in-clinic visits. Practitioners are currently unsystematically modifying the program to meet patient and practitioner needs. Further research should continue to explore the practitioner perspectives on implementation of the LSVT BIG® intervention.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100268"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590112524000392/pdfft?md5=fa820ac7953aecc55d1946e789bb8435&pid=1-s2.0-S2590112524000392-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985079","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":"Treatment of task-specific dystonia in sports: A systematic review","authors":"B. Nijenhuis ,&nbsp;E. van Wensen ,&nbsp;M. Smit ,&nbsp;T. van Zutphen ,&nbsp;J. Zwerver ,&nbsp;M.A.J. Tijssen","doi":"10.1016/j.prdoa.2024.100245","DOIUrl":"https://doi.org/10.1016/j.prdoa.2024.100245","url":null,"abstract":"<div><h3>Introduction</h3><p>Task specific dystonia is a movement disorder only affecting a highly practiced skill and is found in a broad set of expert movements including in sports. Despite affecting many sports, there is no comprehensive review of treatment options, which is in contrast to better studied forms of task specific dystonia in musicians and writers. For this reason, studies involving an intervention to treat task specific dystonia in sports were systematically reviewed, with special attention for the quality of outcome measures.</p></div><div><h3>Methods</h3><p>The PICO systematic search strategy was employed on task-specific dystonia, and all synonyms. Inclusion criteria were peer reviewed published studies pertaining to sports, studies with a measurement and/or intervention in TSD, all in English. We excluded abstracts, expert opinions, narrative review articles, unpublished studies, dissertations and studies exclusively relating to choking. We included case reports, case studies and case-control studies.</p></div><div><h3>Results</h3><p>In April 2022 Pubmed, Embase, Web of Science, and Psychinfo were searched. Of the 7000 articles identified, 31 were included that described psychological and invasive and/or pharmacological interventions. There was a lack of formal standardized outcome measures in studies resulting in low quality evidence for the effectiveness of treatment options. A descriptive synthesis showed emotional regulation was effective, but was exclusively tried in golfers. Interventions like botulinum toxin or pharmacology had a similar effectiveness compared to studies in musicians dystonia, however there was almost no formal evidence for these treatments.</p></div><div><h3>Conclusion</h3><p>The quality of studies was low with a lack of standardized outcome measures. Future studies with larger cohorts and quantitative outcome measures are needed to improve understanding of treatments for task specific dystonia in athletes.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"10 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590112524000148/pdfft?md5=6174975c3990cd5aae605963e581058f&pid=1-s2.0-S2590112524000148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140031577","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":"Inter-rater reliability of hand motor function assessment in Parkinson’s disease: Impact of clinician training","authors":"Lorna Kenny ,&nbsp;Zahra Azizi ,&nbsp;Kevin Moore ,&nbsp;Megan Alcock ,&nbsp;Sarah Heywood ,&nbsp;Agnes Jonsson ,&nbsp;Keith McGrath ,&nbsp;Mary J. Foley ,&nbsp;Brian Sweeney ,&nbsp;Sean O’Sullivan ,&nbsp;John Barton ,&nbsp;Salvatore Tedesco ,&nbsp;Marco Sica ,&nbsp;Colum Crowe ,&nbsp;Suzanne Timmons","doi":"10.1016/j.prdoa.2024.100278","DOIUrl":"10.1016/j.prdoa.2024.100278","url":null,"abstract":"<div><div>Medication adjustments in Parkinson’s disease (PD) are driven by patient subjective report and clinicians’ rating of motor feature severity (such as bradykinesia and tremor).</div></div><div><h3>Objective</h3><div>As patients may be seen by different clinicians at different visits, this study aims to determine the inter-rater reliability of upper limb motor function assessment among clinicians treating people with PD (PwPD).</div></div><div><h3>Methods</h3><div>PwPD performed six standardised hand movements from the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), while two cameras simultaneously recorded. Eight clinicians independently rated tremor and bradykinesia severity using a visual analogue scale. We compared intraclass correlation coefficient (ICC) before and after a training/calibration session where high-variance participant videos were reviewed and MDS-UPDRS instructions discussed.</div></div><div><h3>Results</h3><div>In the first round, poor agreement was observed for most hand movements, with best agreement for resting tremor (ICC 0.66 bilaterally; right hand 95 % CI 0.50–0.82; left hand: 0.50–0.81). Postural tremor (left hand) had poor agreement (ICC 0.14; 95 % CI 0.04–0.33), as did wrist pronation-supination (right hand ICC 0.34; 95 % CI 0.19–0.56). In post-training rating exercises, agreements improved, especially for the right hand. Best agreement was observed for hand open-close ratings in the left hand (ICC 0.82, 95 % CI 0.64–0.94) and resting tremor in the right hand (ICC 0.92, 95 % CI 0.83–0.98). Discrimination between right and left hand features by raters also improved, except in resting tremor (disimprovement) and wrist pronation-supination (no change).</div></div><div><h3>Conclusions</h3><div>Clinicians vary in rating video-recorded PD upper limb motor features, especially bradykinesia, but this can be improved somewhat with training.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100278"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572472","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":"Orthostatic hypotension and subjective symptomatic orthostasis in Parkinson’s disease: Associations and correlations","authors":"Jillian M. Heisler ,&nbsp;Jon Toledo-Atucha ,&nbsp;Chih-Chun Lin ,&nbsp;Harsh N. Patel ,&nbsp;William G. Ondo","doi":"10.1016/j.prdoa.2024.100262","DOIUrl":"https://doi.org/10.1016/j.prdoa.2024.100262","url":null,"abstract":"<div><h3>Background</h3><p>Both measured orthostatic hypotension and symptomatic orthostasis are common in PD but their relationship is unclear.</p></div><div><h3>Objective</h3><p>We aim to determine clinical predictors of both measured orthostatic hypotension and reported symptomatic orthostasis in PD, including the impact of “on”/“off” status and seasons, and to determine the correlation between measured OH and subjective orthostasis.</p></div><div><h3>Methods</h3><p>We analyzed BP readings, demographic and disease state predictors for both 1. Measured blood pressure OH criteria and 2. The subjective report of orthostatic symptoms, using logistic regression analyses from an initial “on” motor state clinical visit in all PD patient visits. We then correlated subjective orthostasis symptoms with BP measurements. We also compared intra-subject BP measures in PD patients seen in both “on” and “off” states, and when seen “on” in both summer and winter.</p></div><div><h3>Results</h3><p>723 consecutive visits over 2 years identified 250 unique PD individuals. Subjective orthostasis was reported by 44 % and “on” measured OH (&gt;20 drop in SBP or 10 DBP upon standing) was seen in 30 %. Measured OH did not significantly correlate with any assessed clinical feature or specific medicine. Subjective orthostasis correlated most with older age, dementia, and L-dopa use. Subjective orthostasis correlated equally with absolute lower measured standing SBP and the drop in SBP from sitting to standing. Compared to the “off” state, “on” state showed lower sitting and standing SBP, more than DBP, but no significant change in BP drop upon standing. Seasons did not impact measured BP.</p></div><div><h3>Conclusions</h3><p>Both OH and symptomatic orthostasis are common. Dopaminergic medications did not cause traditionally defined OH but lowered all SBP (sitting and standing) and thus reduced pulse pressure, possibly by increasing arteriole compliance simply by reducing motor tone, as this BP-lowering effect may be specific to Parkinsonism.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100262"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590112524000331/pdfft?md5=42edf063500ffdb6a0c88fae7251bed3&pid=1-s2.0-S2590112524000331-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605780","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}