Clinical Parkinsonism Related Disorders最新文献

{"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":"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}

{"title":"Apomorphine titration with and without anti-emetic pretreatment in patients with Parkinson’s disease experiencing OFF episodes: A modified Delphi panel","authors":"Stuart H. Isaacson ,&nbsp;Richard Dewey ,&nbsp;Robert A. Hauser ,&nbsp;Daniel Kremens ,&nbsp;Rajeev Kumar ,&nbsp;Mark Lew ,&nbsp;William Ondo ,&nbsp;Fernando Pagan ,&nbsp;Kelly E. Lyons ,&nbsp;Rajesh Pahwa","doi":"10.1016/j.prdoa.2024.100264","DOIUrl":"10.1016/j.prdoa.2024.100264","url":null,"abstract":"<div><h3>Introduction</h3><p>In the United States (US), prophylactic treatment with the antiemetic trimethobenzamide has been used before initiating apomorphine therapy. However, US trimethobenzamide stores have been depleted, leaving uncertainty regarding whether antiemetic pretreatment is needed.</p></div><div><h3>Methods</h3><p>This modified Delphi panel aimed to inform circumstances when apomorphine is initiated without antiemetic pretreatment. During Round 1, a panel of 9 US movement disorder specialists rated the appropriateness of prescribing apomorphine therapy with and without antiemetic pretreatment across 192 patient scenarios and were able to review their scores in relation to other scores. During the Round 2, consensus was defined for each scenario as either strong (&gt;75 % agreement) or moderate (66 % agreement).</p></div><div><h3>Results</h3><p>There was strong consensus on 118 of 192 scenario’s (97 as appropriate and 21 as inappropriate), moderate consensus on 29 scenarios, some agreement on 32 scenarios, and lack of agreement on 13 scenarios. In the absence of an antiemetic, there was strong consensus that titration schedules should be flexible and based on dose response. However, the group only reached moderate consensus on the speed of titration, highlighting the need for more systematic information on this area. In the presence of an antiemetic, panelists considered usual initial dosing and flexible titration to be appropriate in most scenarios except for when the patient is already experiencing dopaminergic adverse events.</p></div><div><h3>Conclusions</h3><p>Experts generally reached consensus that apomorphine can usually be prescribed without antiemetic pretreatment. Recommendations described here reflect the areas of greatest agreement among a panel of experts based on current available evidence.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100264"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590112524000355/pdfft?md5=6ba220423b62c813059f60b2494d160c&pid=1-s2.0-S2590112524000355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716095","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":"Characteristics of Creutzfeldt-Jakob disease at Siriraj Hospital, Thailand: Case series and literature review","authors":"Chaisak Dumrikarnlert ,&nbsp;Nuttapong Kanokkawinwong ,&nbsp;Chatchawan Rattanabannakit ,&nbsp;Vorapun Senanarong","doi":"10.1016/j.prdoa.2024.100281","DOIUrl":"10.1016/j.prdoa.2024.100281","url":null,"abstract":"<div><h3>Introduction</h3><div>Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, fatal, neurodegenerative disease classified as prion diseases. There are many subtypes of this disease, but information about clinical presentation and investigation findings in Thailand is scarce.</div></div><div><h3>Objective</h3><div>To describe the clinical presentation, radiological and electroencephalographic characteristics of CJD encountered at Siriraj hospital in the past 10 years (between January 1, 2006 and December 31, 2015).</div></div><div><h3>Materials and Methods</h3><div>This was descriptive epidemiological data (retrospective, observational study). Patients with rapidly progressive dementia who met the diagnostic criteria for sporadic CJD (sCJD) and variant CJD (vCJD) were included. All were investigated in detail to find any other possible treatable cause including brain magnetic resonance imaging (MRI), electroencephalography (EEG), and cerebrospinal fluid (CSF) analysis.</div></div><div><h3>Results</h3><div>Of the 18 cases, they were classified as sCJD 15 cases and possible vCJD 3 cases. The mean age of the patients was 60.72 years (range: 24‐77) and 10 patients were male. The main clinical manifestations were cognitive disturbance (100 %) and myoclonus (14 out of 18 cases, 77 %). Brain imaging abnormalities were observed in 17 patients: Hyperintensities in diffusion weight imaging (DWI) in the cortical regions (temporal, parietal, and occipital) were observed in 94 % of the patients. Classical EEG of periodic epileptiform discharges were observed in 83.33 % of patients.</div></div><div><h3>Conclusions</h3><div>CJD is a rare but fatal disease that needs to be considered in the patient with cognitive, neuropsychiatric, and movement disorders. Findings of specific abnormalities on brain imaging and/or EEG can support the diagnosis in suspicious cases.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"11 ","pages":"Article 100281"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883201","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":"Meaning in life and Parkinson’s disease in the UK Biobank","authors":"Angelina R. Sutin ,&nbsp;Martina Luchetti ,&nbsp;Yannick Stephan ,&nbsp;Antonio Terracciano","doi":"10.1016/j.prdoa.2023.100231","DOIUrl":"https://doi.org/10.1016/j.prdoa.2023.100231","url":null,"abstract":"<div><h3>Introduction</h3><p>Meaning in life is an aspect of eudaimonic well-being associated with lower dementia risk. This research examines whether this protective association extends to Parkinson’s disease (PD).</p></div><div><h3>Methods</h3><p>Participants (<em>N</em> = 153,569) from the UK Biobank reported on their meaning in life. Cases of PD were identified through health records.</p></div><div><h3>Results</h3><p>Meaning in life was associated with a 50 % lower likelihood of prevalent PD (OR = 0.68, 95 % CI = 0.59–0.78). Over the 5-year follow-up, meaning was associated with a 35 % lower risk of incident PD (HR = 0.74, 95 % CI = 0.65–0.83), an association robust to sociodemographic characteristics, depression, history of seeking mental health care, smoking, physical activity, and genetic risk and not moderated by age, sex, education, deprivation, or genetic risk.</p></div><div><h3>Conclusions</h3><p>Meaning in life is associated with lower risk of incident PD, an association independent of other major risk factors and generalizable across sociodemographic groups. Meaning is a promising target of intervention for common neurodegenerative diseases.</p></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"10 ","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259011252300049X/pdfft?md5=13f5541a2e83d4991c76267b5ffb5daa&pid=1-s2.0-S259011252300049X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100978","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}