Clinical Parkinsonism Related Disorders最新文献

{"title":"Chorea-predominant SCA5 mimicking Huntington's disease: A case report with a novel SPTBN2 variant","authors":"Peng Lei,&nbsp;Ying Chi,&nbsp;Jie Xia,&nbsp;Tao Wang,&nbsp;Ling Zhong","doi":"10.1016/j.prdoa.2026.100501","DOIUrl":"10.1016/j.prdoa.2026.100501","url":null,"abstract":"<div><h3>Background</h3><div>Chorea has diverse etiologies, with Huntington's disease (HD) being the most common genetic cause. While spinocerebellar ataxias (SCAs) rarely present with chorea, SCA5 is typically regarded as a “pure” cerebellar syndrome. To our knowledge, chorea has not been previously reported as the predominant manifestation of SCA5.</div></div><div><h3>Case presentation</h3><div>A 51-year-old male presented with progressive dysarthria and generalized chorea. Family history suggested autosomal dominant inheritance. Cranial MRI revealed cerebellar atrophy and frontal-horn enlargement. Initially misdiagnosed with HD, he received olanzapine, achieving partial relief. Whole-exome sequencing (WES) subsequently identified a novel heterozygous missense variant in <em>SPTBN2</em>(c.2531G &gt; A, p.Arg844Gln), revising the diagnosis to SCA5. At the 9-month follow-up, chorea was significantly improved.</div></div><div><h3>Conclusion</h3><div>This case demonstrates that <em>SPTBN2</em>-related SCA5 can manifest as a chorea-predominant phenotype, easily misdiagnosed as HD. The identification of the novel c.2531G &gt; A variant expands the phenotypic and mutational spectrum of SCA5. It underscores that WES should be considered early in autosomal dominant chorea with frontal-horn enlargement, particularly when cerebellar signs are subtle, to prevent diagnostic errors.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100501"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003915","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":"Validation of the Norwegian version of the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale","authors":"Guido Alves ,&nbsp;Yvonne Stavland Sørenes ,&nbsp;Veslemøy Hamre Frantzen ,&nbsp;Michaela Dreetz Gjerstad ,&nbsp;Anders Ledaal Bjørnestad ,&nbsp;Jodi Maple-Grødem ,&nbsp;Elin Bjelland Forsaa ,&nbsp;Ylva Hivand Hiorth ,&nbsp;Karen Herlofson ,&nbsp;Espen Benjaminsen ,&nbsp;Kari Anne Bjørnarå ,&nbsp;Espen Dietrichs ,&nbsp;Roberta Balestrino ,&nbsp;Carmen Gasca-Salas ,&nbsp;Chi-Ying R. Lin ,&nbsp;Alvaro Sanchez-Ferro ,&nbsp;Michelle H.S. Tosin ,&nbsp;Tiago A. Mestre ,&nbsp;Monica M. Kurtis ,&nbsp;Pablo Martinez-Martin ,&nbsp;Christopher G. Goetz","doi":"10.1016/j.prdoa.2025.100420","DOIUrl":"10.1016/j.prdoa.2025.100420","url":null,"abstract":"<div><h3>Introduction</h3><div>The Movement Disorder Society-revised version of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) is the gold standard assessment for evaluating Parkinson’s disease (PD) symptoms and severity, but a validated Norwegian version is not yet available. We translated the original English MDS-UPDRS into Norwegian and tested the clinimetrics of the translated version following the MDS-established protocol for non-English language translations.</div></div><div><h3>Methods</h3><div>Two independent teams translated the English version of the MDS-UPDRS into Norwegian. After review of the back-translated English version, cognitive pretesting was performed in twelve PD patients at one study site. This was followed by large-scale testing completed by 351 native Norwegian-speaking PD patients at six centers across Norway. We applied confirmatory and exploratory factor analyses to determine the validity of the Norwegian version. Additional analyses were performed to test the reliability of the translated scale.</div></div><div><h3>Results</h3><div>Confirmatory factor analysis demonstrated that the factor structure of the Norwegian version was consistent with that of the English version, as indicated by comparative fit indexes of ≥0.90 for all four MDS-UPDRS parts. Exploratory factor analysis showed the same number of factors in each MDS-UPDRS part, compared to the English version, with some differences in item loadings. Cronbach’s α values were &gt;0.70 for all four MDS-UPDRS parts.</div></div><div><h3>Conclusion</h3><div>The Norwegian language MDS-UPDRS has good construct validity and internal consistency, meeting the requirements to be designated as the Official Norwegian Version of the MDS-UPDRS. We recommend using this validated version in both research and clinical practice.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100420"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927700","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":"CSF tap test parameters and Short-Term outcomes in operated and non-operated patients with idiopathic normal pressure Hydrocephalus: A cohort study","authors":"Sagar Poudel ,&nbsp;Deepa Dash ,&nbsp;Aparna Wagle Shukla ,&nbsp;Ajay Garg ,&nbsp;Ashish Dutt Upadhyay ,&nbsp;Naveet Wig ,&nbsp;Roopa Rajan ,&nbsp;Animesh Das ,&nbsp;Divya MR ,&nbsp;Manjari Tripathi ,&nbsp;Achal K. Srivastava ,&nbsp;SS Kale ,&nbsp;Poodipedi Sarat Chandra ,&nbsp;Ashish Suri ,&nbsp;Pramod K Pal ,&nbsp;Hrishikesh Kumar ,&nbsp;Sakoon Saggu ,&nbsp;Deepti Vibha ,&nbsp;Rajesh Kumar Singh ,&nbsp;Jasmine Parihar ,&nbsp;Arunmozhimaran Elavarasi","doi":"10.1016/j.prdoa.2026.100425","DOIUrl":"10.1016/j.prdoa.2026.100425","url":null,"abstract":"<div><h3>Background</h3><div>Normal Pressure hydrocephalus (NPH) is treated by ventriculoperitoneal shunting. The cerebrospinal fluid tap test (CSF-TT) is widely used to identify candidates for shunt surgery in idiopathic NPH (iNPH). This study aimed to compare the CSF tap test responses and 24-week functional outcomes between patients with probable iNPH who underwent surgery and those who did not.</div></div><div><h3>Methods</h3><div>This Ambispective cohort study included 40 patients with probable iNPH, as defined by the 2019 Japanese guidelines, from 2019 to 2024. All patients underwent a large-volume CSF-TT, and they were offered surgery based on the clinico-radiologic profile.</div></div><div><h3>Results</h3><div>Twenty-four patients underwent ventriculoperitoneal shunt surgery, and 16 did not for various reasons. No significant differences were found in the baseline or 24-hour post-CSF tap test parameters between the groups. However, at 24 weeks, 62.5% of the operated patients showed at least a 1-point improvement in mRS. In contrast, only 14.3% in the non-operated group did, indicating the beneficial role of VP shunting in NPH. Those who were operated had a 10 times higher odds (95% CI 1.6–105) of achieving at least one point improvement in mRS at 24 weeks. Interestingly, 46.7% of patients whose mRS did not improve after CSF-TT but who underwent surgery still benefited from shunting.</div></div><div><h3>Conclusion</h3><div>Shunt surgery leads to a favorable short-term functional outcome in patients with probable iNPH. However, the CSF-TT alone lacks sufficient discriminatory power to guide surgical decisions in a cohort of patients with clinico-radiological probable iNPH. A negative tap test should not preclude surgery in patients with supportive clinical and imaging features.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100425"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078203","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":"Differentiating effects of levodopa and subthalamic nucleus deep brain stimulation on motor features in Parkinson disease","authors":"Tiffanie A. Lee ,&nbsp;Deepa Ramesh ,&nbsp;Mwiza Ushe ,&nbsp;Scott A. Norris ,&nbsp;Samer D. Tabbal ,&nbsp;Joel S. Perlmutter ,&nbsp;John R. Younce","doi":"10.1016/j.prdoa.2025.100417","DOIUrl":"10.1016/j.prdoa.2025.100417","url":null,"abstract":"<div><h3>Introduction</h3><div>While deep brain stimulation of the subthalamic nucleus (STN DBS) is traditionally used to treat motor fluctuations in Parkinson disease (PD), recent progress in levodopa delivery systems may offer non-invasive alternatives to surgical options. To gain insight into symptoms more likely to be treated effectively by STN DBS or levodopa, we systematically compared the differential effects of levodopa and STN-DBS on specific parkinsonian motor components.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 395 PD patients who received bilateral STN-DBS at Washington University (1999–2020). UPDRS-III was obtained in three conditions: preoperative OFF-medication, preoperative ON-medication, and postoperative ON-DBS/OFF-medication. Exploratory factor analysis identified a consensus structure across conditions. Treatment responses by factor were compared using Wilcoxon rank-sum tests and correlations were assessed with Kendall’s tau.</div></div><div><h3>Results</h3><div>Both treatments significantly improved all motor features. STN-DBS showed slightly superior efficacy for upper body tremor (mean change: −3.84 vs −3.43, p &lt; 0.001), while levodopa demonstrated much greater effectiveness for axial symptoms (−5.41 vs −2.65, p &lt; 0.001), and slightly greater effectiveness for lower body tremor (−1.25 vs −1.06, p &lt; 0.001), and lower body bradykinesia (−1.18 vs −0.91, p = 0.005). Correlations between treatment responses were weak but statistically significant for rigidity (τ = 0.158), bradykinesia (hand: τ = 0.118; leg: τ = 0.179), and axial symptoms (τ = 0.207).</div></div><div><h3>Conclusion</h3><div>Levodopa and STN-DBS demonstrate similar but distinct therapeutic profiles across parkinsonian motor domains. However, weak correlations between treatment modalities for all motor features challenge the utility of levodopa responsiveness for DBS candidacy and support individualization of treatment selection based on symptom profile.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100417"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792270","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 genes associated with smell dysfunction in Parkinson’s disease","authors":"Md Zainul Ali ,&nbsp;Manjari Kiran ,&nbsp;Pankaj Singh Dholaniya","doi":"10.1016/j.prdoa.2026.100453","DOIUrl":"10.1016/j.prdoa.2026.100453","url":null,"abstract":"<div><div>Parkinson’s disease (PD) predominantly affects individuals above the age of 50 and currently lacks curative treatments. Although motor symptoms classically define PD, non-motor symptoms (NMS) frequently manifest earlier. In this study, we first investigated the potential of NMS to distinguish PD patients from healthy controls (HC). Machine learning-based feature ranking applied to clinical data identified olfactory dysfunction, quantified using the University of Pennsylvania Smell Identification Test (UPSIT), as the most informative predictor distinguishing PD patients from HC. To further elucidate the biological basis of olfactory impairment, we analyzed peripheral blood transcriptomic data from the Parkinson’s Progression Markers Initiative (PPMI). Weighted Gene Co-expression Network Analysis (WGCNA) identified disease and olfaction-associated gene modules, from which 32 key genes were prioritized. DNA methylation analysis identified CpG loci associated with these genes, indicating coordinated transcriptional and epigenetic regulation. Independent single-cell RNA sequencing datasets demonstrated consistent expression trends across immune cell subsets, strengthening the robustness of these findings. This integrative clinical and transcriptomic analysis highlights smell loss as both the most discriminative clinical marker and a biologically grounded feature of PD, providing systems-level insight into molecular mechanisms underlying olfactory dysfunction in PD pathogenesis.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100453"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148178438","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":"Gait and balance deterioration following deep brain stimulation in Parkinson’s disease: a counterfactual review","authors":"Nana Tchantchaleishvili ,&nbsp;Andrii Netliukh ,&nbsp;Mario Ganau","doi":"10.1016/j.prdoa.2026.100444","DOIUrl":"10.1016/j.prdoa.2026.100444","url":null,"abstract":"<div><h3>Background</h3><div>Deep brain stimulation (DBS) is an established treatment for motor complications in Parkinson’s disease. While appendicular motor symptoms often improve, gait and balance frequently deteriorate over time, contributing substantially to disability and falls. The mechanisms underlying this deterioration remain debated and include stimulation-related effects, interactions with dopaminergic therapy, and disease progression.</div></div><div><h3>Objective</h3><div>To re-examine gait and balance deterioration after DBS in Parkinson’s disease using a counterfactual interpretive approach that distinguishes stimulation-related effects from medication interactions and time-dependent progression.</div></div><div><h3>Methods</h3><div>A structured narrative review was conducted following PRISMA reporting principles. Studies evaluating gait and balance outcomes after DBS were synthesized using clinically relevant counterfactual contrasts, including stimulation ON versus OFF, medication ON versus OFF, and early versus late postoperative time points. Eligibility criteria were expanded to specify inclusion of original observational, experimental, and programming studies that reported gait or balance outcomes under interpretable stimulation, medication, or temporal conditions.</div></div><div><h3>Results</h3><div>Gait and balance deterioration after DBS reflects multiple, non-exclusive mechanisms. Acute or early postoperative worsening may occur in association with stimulation activation or electrode implantation and can be partially reversible with stimulation adjustment. Several studies demonstrate non-additive and sometimes opposing effects of DBS and dopaminergic medication on gait and balance. In contrast, longitudinal studies consistently show progressive gait and balance decline over extended follow-up despite sustained improvement in appendicular motor symptoms, supporting a prominent role for time-dependent disease progression. Balance outcomes, particularly dynamic postural control, appear more consistently affected than gait measures.</div></div><div><h3>Conclusions</h3><div>Gait and balance deterioration after DBS in Parkinson’s disease cannot be attributed to a single mechanism. Interpreting outcomes through counterfactual contrasts clarifies the relative contributions of stimulation effects, medication interactions, and disease progression, and provides a clinically grounded framework for understanding postoperative deterioration. This framework supports more precise clinical attribution of postoperative gait decline and may inform individualized programming, medication adjustment, and patient counseling.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100444"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147740086","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":"Stigma and social symptoms in Parkinson’s disease: A scoping review","authors":"Francesca Gaiera ,&nbsp;Emma O’Shea ,&nbsp;Gerard W. O’Keeffe ,&nbsp;Mary Doherty ,&nbsp;Suzanne Timmons","doi":"10.1016/j.prdoa.2026.100446","DOIUrl":"10.1016/j.prdoa.2026.100446","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of Parkinson’s disease (PD) is increasing more rapidly than any other neurodegenerative disorder. Motor and non-motor symptoms, and deficits in cognition and communication, negatively impact people with PD’s social functioning and can result in enacted and felt stigma. The aim of this scoping review is to explore the determinants and effects of stigma in PD.</div></div><div><h3>Methods</h3><div>This scoping review followed the Joanna Briggs Institute methodology for scoping reviews. Quantitative and qualitative studies from January 2000 to April 2026 focusing on stigma in PD were considered for inclusion. Databases included Medline via OVID, PsychInfo and Scopus.</div></div><div><h3>Results</h3><div>From 334 screened articles, 25 papers were finally included. Most papers found depression to be a determinant of enacted and felt stigma. Some papers found motor symptoms, younger age, difficulty with activities of daily living, and severe PD to be predictive of stigma. Facial masking, abnormal bodily movement, and speech impairment were linked to felt stigma and to stigmatising attitudes from the general public and clinical practitioners alike.</div></div><div><h3>Discussion</h3><div>Stigmatising views have damaging consequences for people with PD. Negative outcomes of stigma include greater difficulties in the social and emotional spheres, and social avoidance and isolation. More awareness and education for the public, but also healthcare providers, are needed to address negative attitudes and bias towards people with PD. There needs to be more research into interventions to reduce felt stigma, such as psychological training or peer support.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100446"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951145","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":"Treatment-resistant Parkinson's disease psychosis responding to xanomeline-trospium: A case report","authors":"Andrew Farah,&nbsp;Karen Timbrook-Dillow,&nbsp;Heather Garrison","doi":"10.1016/j.prdoa.2026.100497","DOIUrl":"10.1016/j.prdoa.2026.100497","url":null,"abstract":"<div><div>We report the case of an 83-year-old male with Parkinsonism and severe psychosis characterized by persistent daytime and nighttime hallucinations associated with marked fear and distress. His psychosis failed to respond to therapeutic trials of quetiapine, brexpiprazole, and pimavanserin. He was referred specifically for a trial of clozapine therapy, which the patient and caregiver declined due to its risk profile. Treatment with xanomeline–trospium was initiated at 50/20 mg twice daily and resulted in substantial improvement, including resolution of nighttime hallucinations within two weeks. He further achieved a near complete resolution of psychotic symptoms within three weeks of a dose escalation to 100/20 mg twice daily. To our knowledge, this is the first published case of Parkinson's disease psychosis successfully treated with xanomeline–trospium, a novel M1/M4 muscarinic receptor agonist-based therapy. The patient's psychosis proved refractory to three pharmacologically distinct therapies—quetiapine, a low-affinity, rapidly dissociating dopamine D2 receptor antagonist; brexpiprazole, a dopamine D2 partial agonist; and pimavanserin, a selective 5-HT2A receptor inverse agonist—before improving with xanomeline–trospium, whose antipsychotic effects are mediated through central M1/M4 muscarinic receptor agonism. This case supports the further investigation of muscarinic receptor agonism as a therapeutic strategy for Parkinson's disease psychosis.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100497"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neutrophil-to-lymphocyte ratio in Parkinson's disease: a systematic review and meta-analysis of its association with differential diagnosis, severity, and prognosis","authors":"Miguel Cabanillas-Lazo,&nbsp;Alvaro Montes-Baldarrago,&nbsp;Sandra Uriol-Alvino,&nbsp;Hans Baltazar-Ñahui,&nbsp;Natalia B. Pereda-Leon,&nbsp;Harold Jimenez-Alvarez,&nbsp;Frank Mayta-Tovalino","doi":"10.1016/j.prdoa.2026.100494","DOIUrl":"10.1016/j.prdoa.2026.100494","url":null,"abstract":"<div><h3>Background and aim</h3><div>This study aimed to systematically review and meta-analyze the evidence on the association of the neutrophil-to-lymphocyte ratio (NLR) with clinical parameters in Parkinson's disease (PD), specifically its role in group differentiation (from healthy controls and other neurodegenerative diseases), disease severity, and prognosis.</div></div><div><h3>Methods</h3><div>In this study, a systematic review and meta-analysis were performed according to the PRISMA guidelines. A search conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to June 2024 was undertaken, providing observational studies that reported NLR in PD. The random-effects models pooled the mean differences of PD versus controls and PD versus multiple system atrophy (MSA), and pooled for UPDRS subscale correlation coefficients, total UPDRS, and Hoehn &amp; Yahr (H&amp;Y) stage. Constipation, depressive symptomatology, and mild cognitive impairment (MCI) markers were also analyzed.</div></div><div><h3>Results</h3><div>Twenty-eight studies were included. The NLR was significantly higher in patients with PD than in healthy controls (MD, 0.38; 95% CI 0.22–0.53; I² = 90%; moderate certainty). No significant difference was observed between PD and MSA. NLR showed moderate positive correlations with UPDRS I (<em>r</em> = 0.42), UPDRS II (<em>r</em> = 0.34), UPDRS III (<em>r</em> = 0.27), total UPDRS (<em>r</em> = 0.67), and H&amp;Y stage (<em>r</em> = 0.33). Associations were significant for depressive symptoms (high certainty) but not for constipation. For MCI, the NLR was lower rather than higher in patients who developed impairment, with modest discriminatory performance (moderate certainty).</div></div><div><h3>Conclusion</h3><div>NLR is higher in PD and correlates with clinical severity and depressive symptoms, but it does not discriminate PD from MSA or between motor subtypes, and it was not associated with incident mild cognitive impairment in the expected direction.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100494"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148843613","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":"Functional speech disorder in a patient with X-linked adrenomyeloneuropathy: a diagnostic challenge","authors":"Juan Sebastián Sánchez León,&nbsp;Ingrid Lorena da Silva Gomes,&nbsp;Artur Francisco Schumacher Schuh,&nbsp;Daniel Teixeira-dos-Santos,&nbsp;Lucia Tesolin,&nbsp;Maira Rozenfeld Olchik","doi":"10.1016/j.prdoa.2026.100479","DOIUrl":"10.1016/j.prdoa.2026.100479","url":null,"abstract":"<div><div>We describe a 54-year-old female carrier of X-linked adrenomyeloneuropathy presenting with episodic stuttering triggered by mild exertion. Despite pre-existing neurological disease, normal neuroimaging, clinical inconsistency, distractibility, and rapid response to respiratory-based therapy supported a functional speech disorder. This case emphasizes the importance of recognizing functional speech disorders in patients with other comorbid neurological conditions.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100479"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498118","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}