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Mehrabani S, Khorvash F, Heidari Z, Tajabadi-Ebrahimi M, Amani R. The effects of synbiotic supplementation on oxidative stress markers, mental status, and quality of life in patients with Parkinson’s disease: A double-blind, placebo-controlled, randomized controlled trial. J Funct Foods 2023. [DOI: 10.1016/j.jff.2022.105397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Kakimoto A, Kawazoe M, Kurihara K, Mishima T, Tsuboi Y. Impact of non-motor fluctuations on QOL in patients with Parkinson's disease. Front Neurol 2023; 14:1149615. [PMID: 37139066 PMCID: PMC10149738 DOI: 10.3389/fneur.2023.1149615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Long-term levodopa treatment in patients with Parkinson's disease (PwPD) often causes motor fluctuations, which are known to affect their quality of life (QOL). These motor fluctuations may be accompanied by fluctuations in non-motor symptoms. There is no consensus on how non-motor fluctuations affect QOL. Methods This was a single-center, retrospective study and included 375 patients with Parkinson's disease (PwPD) who visited the neurology outpatient department of Fukuoka University Hospital between July 2015 and June 2018. All patients were evaluated for age, sex, disease duration, body weight, and motor symptoms by the Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III, depression scale by the Zung self-rating depression scale, apathy scale, and cognitive function by the Japanese version of The Montreal Cognitive Assessment. A nine-item wearing-off questionnaire (WOQ-9) was used to assess the motor and non-motor fluctuations. QOL in PwPD was investigated using the eight-item Parkinson's Disease Questionnaire (PDQ-8). Results In total, 375 PwPD were enrolled and classified into three groups according to the presence or absence of motor and non-motor fluctuations. The first group included 98 (26.1%) patients with non-motor fluctuations (NFL group), the second group included 128 (34.1%) patients who presented with only motor fluctuations (MFL group), and the third group included 149 (39.7%) patients without fluctuations in motor or non-motor symptoms (NoFL group). Among them, the PDQ-8 SUM and SI were significantly higher in the NFL group than in the other groups (p < 0.005), implying that the NFL group had the poorest QOL among groups. Next, multivariable analysis showed that even one non-motor fluctuation was an independent factor that worsened QOL (p < 0.001). Conclusion This study showed that PwPD with non-motor fluctuation had a lower QOL than those with no or only motor fluctuation. Moreover, the data showed that PDQ-8 scores were significantly reduced even with only one non-motor fluctuation.
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Affiliation(s)
- Asako Kakimoto
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Neurology, Konishi Daiichi Hospital, Fukuoka, Japan
| | - Miki Kawazoe
- Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan
| | - Kanako Kurihara
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takayasu Mishima
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- *Correspondence: Yoshio Tsuboi,
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Ekmekyapar Fırat Y, Turgay T, Soğan SS, Günel Karadeniz P. Effects of LSVT-BIG via telerehabilitation on non-motor and motor symptoms and quality of life in Parkinson's disease. Acta Neurol Belg 2023; 123:207-214. [PMID: 36175786 PMCID: PMC9521849 DOI: 10.1007/s13760-022-02104-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disease with motor and non-motor symptoms affecting the quality of life. This study aimed to investigate the effects of the Lee Silverman Voice Therapy (LSVT)-BIG rehabilitation program via telerehabilitation on quality of life, motor and non-motor symptoms in people with Parkinson's disease (PwPD), and their correlation with each other. METHODS Fifteen patients with mild-to-moderate PD (Hoehn and Yahr stages 1-3) were included in the LSVT-BIG exercise program with remote access for 16 sessions over four weeks. Motor and non-motor experiences before and after the program were evaluated with MDS-UPDRS parts 1, 2, and 3 and quality of life with PDQ-39. The correlation between MDS-UPDRS parts and PDQ-39 subgroups was examined. RESULTS Following the application of the LSVT-BIG rehabilitation program with remote access, MDS-UPDRS parts 1, 2, and 3 scores and PDQ-39 summary index (PDQ-39 SI) and subgroup scores (excluding social support) were improved. A moderate-strong correlation was determined between MDS-UPDRS parts 1 and 2 and the PDQ-39 parameters of the patients. CONCLUSION Both motor and non-motor symptoms may be associated with the quality of life in PD. We have concluded that LSVT-BIG treatment via telerehabilitation can improve motor and non-motor symptoms along with the quality of life in PwPD.
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Affiliation(s)
| | - Türkan Turgay
- Department of Physical Medicine and Rehabilitation, SANKO University School of Medicine, Gaziantep, Turkey
| | - Selver Seval Soğan
- Sani Konukoğlu Research and Practice Hospital, SANKO University, Physiotherapy and Rehabilitation Clinic, Gaziantep, Turkey
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Dakay D, Tangcalagan F, Villanueva III E, Abejero J, Saranza G. Cross-cultural validation of the Cebuano version of a screening questionnaire for Parkinson's disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1239-1245. [PMID: 36580962 PMCID: PMC9800160 DOI: 10.1055/s-0042-1758652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In the Philippines, the exact prevalence of Parkinson's disease (PD) has not yet been determined. Although cases can be extrapolated from medical registries, this method may undermine actual case rates. A reliable screening tool for PD is essential for a timely diagnosis and community-based epidemiological studies. The most widely used screening questionnaire for PD diagnosis was developed by Tanner et al., which consists of nine questions about the motor symptoms of PD. Although this questionnaire has been translated to several languages, the translated version must be validated for use in our local setting. OBJECTIVE To determine the validity of the Cebuano version of a PD screening questionnaire. METHOD The questionnaire was translated from English to Cebuano by a hired language specialist. Each item was supplied with a yes, no, or don't know answer. A total of 73 patients with PD and 244 control subjects completed the study. RESULTS The overall Cronbach alpha for internal consistency of the questionnaire was 0.9410. The item on tremor had the highest sensitivity (97.26%), while the item on problems with buttoning had the highest specificity (100.00%). A cut-off score ≥ 3 obtained the best Youden index (99.18%), with a sensitivity of 100.00% and a specificity of 99.18%. The questionnaire had an almost perfect predictive ability to diagnose PD (AUC of 0.9994). CONCLUSION The translated version of the Tanner questionnaire is a validated instrument to identify PD in a literate Cebuano population.
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Affiliation(s)
- Daryl Dakay
- Chong Hua Hospital Mandaue, Department of Internal Medicine, Cebu, Philippines.
| | - Faith Tangcalagan
- Chong Hua Hospital Mandaue, Department of Internal Medicine, Cebu, Philippines.
| | | | - Joshua Abejero
- Chong Hua Hospital, Department of Internal Medicine, Section of Neurology, Cebu, Philippines.
| | - Gerard Saranza
- Chong Hua Hospital, Department of Internal Medicine, Section of Neurology, Cebu, Philippines.,Address for correspondence Gerard Saranza
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Severity of depressive and motor symptoms impacts quality of life in Parkinson's disease patients at an academic movement clinic: A cross-sectional study. Clin Park Relat Disord 2022; 8:100180. [PMID: 36590453 PMCID: PMC9795528 DOI: 10.1016/j.prdoa.2022.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Parkinson's disease (PD) is a neurodegenerative disease with motor and non-motor manifestations that have been previously reported to affect patient quality of life (QoL). Our objective is to investigate the factors that contribute to QoL in a cohort of PD patients receiving care at a major academic institution. Methods In this cross-sectional study of 124 participants (71.77% male, mean age 65.20, mean UPDRS-III score 11.25), we analyzed if certain clinical features such as UPDRS-III, QIDS-C, and total disease duration contributed to QoL as measured by two different metrics (PDQ-39 and EQ-5D) in PD patients at a university Movement Disorders Clinic. Results Motor symptoms of PD, with the exception of tremor, as well as depression and specific depressive symptoms were significantly and positively correlated with lower QoL metrics for patients with Parkinson's, with total depressive symptom severity (QIDS-C16 Total score) contributing most to QoL scores. Of the specific depressive and motor symptoms, anhedonia and rigidity contributed the most to QoL. Disease duration was significantly correlated with lower QoL for participants with Parkinson's according to the QoL metric PDQ-39 but not ED-5D. Parkinson's patients with access to high-quality healthcare are at risk for having diminished QoL due to both depressive and motor symptoms. Conclusion While severity of motor symptoms certainly impacted QoL in our cohort, our findings suggest that depressive symptoms contribute more to impaired QoL than severe motor symptoms do. This phenomenon suggests that concomitant depression in PD as well as one's psychological adjustment to disability may have a greater impact on QoL than severe motor symptoms.
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Safety and effectiveness of istradefylline as add-on therapy to levodopa in patients with Parkinson's disease: Final report of a post-marketing surveillance study in Japan. J Neurol Sci 2022; 443:120479. [PMID: 36395674 DOI: 10.1016/j.jns.2022.120479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/21/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Istradefylline is approved in Japan and the US for treatment of Parkinson's disease (PD) in adult patients who experience the wearing-off phenomenon while receiving levodopa; however, safety and efficacy data for real-world clinical use are lacking. METHODS We report the final results of a prospective, long-term, post-marketing surveillance study of istradefylline adjunct to levodopa for adults with PD experiencing the wearing-off phenomenon. Patients across 214 study sites initiating treatment with oral istradefylline once-daily 20- or 40-mg were followed-up for 1 year. We collected demographic data, disease and treatment histories, and recorded adverse events and adverse drug reactions (ADRs). The priority survey item was the occurrence of psychiatric ADRs. Effectiveness was evaluated by the physician's global and motor function assessments. RESULTS Case report forms were collected for 1320 patients, and the safety and effectiveness analysis sets included 1318 and 1284 patients, respectively. The mean age was 71.5 years and 56.2% of patients were women. A total of 274 patients (20.8%) experienced an ADR, 39 patients had a serious ADR, and 7 patients had a fatal ADR that was considered not related to istradefylline. Common ADRs included dyskinesia, hallucination, and visual hallucination. Sixty-five patients (4.9%) experienced a psychiatric ADR. Istradefylline was effective (physician-rated) in 59.8% of patients, and most patients had reduced or unchanged off-time duration, improved or unchanged off-time symptoms, and improved or unchanged motor symptoms. CONCLUSION Istradefylline safely and effectively improves motor symptoms in PD patients experiencing the wearing-off phenomenon with levodopa therapy in the real-world setting.
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Rus T, Premzl M, Križnar NZ, Kramberger MG, Rajnar R, Ocepek L, Pirtošek Z, Trošt M. Adverse effects of levodopa/carbidopa intrajejunal gel treatment: A single-center long-term follow-up study. Acta Neurol Scand 2022; 146:537-544. [PMID: 35903042 PMCID: PMC9796727 DOI: 10.1111/ane.13675] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Levodopa/carbidopa intrajejunal gel (LCIG) is an effective therapeutic strategy to overcome levodopa-induced motor complications in advanced Parkinson's disease (PD). However, it requires invasive percutaneous endoscopic gastrojejunostomy (PEG-J) and may be associated with serious adverse effects (AE). In this study, we aimed to evaluate long-term AEs related to LCIG treatment in a large homogenous cohort of advanced PD patients. METHODS One hundred three consecutive PD patients were regularly monitored for LCIG-related, PEG-J-related, and device-related AEs up to 14 years. Incidence of AEs was studied in time applying a time-to-event analysis and Cox proportional hazard model with age, disease duration, gender, and recurrent AE as covariates. Health-related quality of life (HRQoL) was estimated at each visit and compared to HRQoL before the LCIG treatment. RESULTS Among 296 AEs noted, 48.8% were LCIG-related, 32.4% PEG-J-related, and 19.6% device-related. While most of the studied AEs steadily accumulated throughout the follow-up period, 24.3% of the patients (95% CI 10.1%-36.3%) experienced PEG-J-related AE already within the first days after the PEG-J insertion. Cox model revealed that older patients had higher probability of psychosis, PEG-J- and device-related AEs (p < .05, p < .05, and p = .02) and suggested increased recurrence risk in those with early PEG-J and device-related AEs. Despite relatively high incidence of AEs, HRQoL significantly increased in the follow-up period (p < .0001). CONCLUSION AEs related to LCIG treatment are common. Therefore, careful patient selection and monitoring throughout the treatment is recommended, especially in those with early side effects. Nevertheless, LCIG significantly improves HRQoL in advanced PD patients on a long term.
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Affiliation(s)
- Tomaž Rus
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia
| | - Maša Premzl
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia
| | | | - Milica G. Kramberger
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia
| | - Robert Rajnar
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia
| | - Lidija Ocepek
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia
| | - Zvezdan Pirtošek
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia
| | - Maja Trošt
- Department of NeurologyUMC LjubljanaLjubljanaSlovenia,Medical FacultyUniversity of LjubljanaLjubljanaSlovenia
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Kaplan E, Altunisik E, Ekmekyapar Firat Y, Datta Barua P, Dogan S, Baygin M, Burak Demir F, Tuncer T, Palmer E, Tan RS, Yu P, Soar J, Fujita H, Rajendra Acharya U. Novel nested patch-based feature extraction model for automated Parkinson's Disease symptom classification using MRI images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 224:107030. [PMID: 35878484 DOI: 10.1016/j.cmpb.2022.107030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) is a common neurological disorder with variable clinical manifestations and magnetic resonance imaging (MRI) findings. We propose a handcrafted image classification model that can accurately (i) classify different PD stages, (ii) detect comorbid dementia, and (iii) discriminate PD-related motor symptoms. METHODS Selected image datasets from three PD studies were used to develop the classification model. Our proposed novel automated system was developed in four phases: (i) texture features are extracted from the non-fixed size patches. In the feature extraction phase, a pyramid histogram-oriented gradient (PHOG) image descriptor is used. (ii) In the feature selection phase, four feature selectors: neighborhood component analysis (NCA), Chi2, minimum redundancy maximum relevancy (mRMR), and ReliefF are used to generate four feature vectors. (iii) Two classifiers: k-nearest neighbor (kNN) and support vector machine (SVM) are used in the classification step. A ten-fold cross-validation technique is used to validate the results. (iv) Eight predicted vectors are generated using four selected feature vectors and two classifiers. Finally, iterative majority voting (IMV) is used to attain general classification results. Therefore, this model is named nested patch-PHOG-multiple feature selectors and multiple classifiers-IMV (NP-PHOG-MFSMCIMV). RESULTS Our presented NP-PHOG-MFSMCIMV model achieved 99.22, 98.70, and 99.53% accuracies for the collected PD stages, PD dementia, and PD symptoms classification datasets, respectively. SIGNIFICANCE The obtained accuracies (over 98% for all states) demonstrated the performance of developed NP-PHOG-MFSMCIMV model in automated PD state classification.
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Affiliation(s)
- Ela Kaplan
- Department of Radiology, Adıyaman Training and Research Hospital, Turkey
| | - Erman Altunisik
- Department of Neurology, Adiyaman University Medicine Faculty, Adiyaman, Turkey
| | | | - Prabal Datta Barua
- School of Business (Information Systems), University of Southern Queensland, Toowoomba, QLD 4350, Australia; Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Sengul Dogan
- Department of Digital Forensics Engineering, College of Technology, Firat University, Elazig, Turkey
| | - Mehmet Baygin
- Department of Computer Engineering, College of Engineering, Ardahan University, Ardahan, Turkey
| | - Fahrettin Burak Demir
- Department of Software Engineering, Faculty of Engineering and Natural Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Turker Tuncer
- Department of Digital Forensics Engineering, College of Technology, Firat University, Elazig, Turkey
| | - Elizabeth Palmer
- Centre of Clinical Genetics, Sydney Children's Hospitals Network, Randwick 2031, Australia; Discipline of Paediatrics and Child Health, School of Clinical Medicine Randwick, Faculty of Medicine and Health, UNSW, Randwick, NSW 2031, Australia
| | - Ru-San Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - Ping Yu
- School of Computing and Information Technology, University of Wollongong, Wollongong NSW 2522, Australia
| | - Jeffrey Soar
- School of Business (Information Systems), University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Hamido Fujita
- Faculty of Information Technology, HUTECH University of Technology, Ho Chi Minh City, Viet Nam; Andalusian Research Institute in Data Science and Computational Intelligence, University of Granada, Granada, Spain; Regional Research Center, Iwate Prefectural University, Iwate, Japan
| | - U Rajendra Acharya
- School of Business (Information Systems), University of Southern Queensland, Toowoomba, QLD 4350, Australia; Ngee Ann Polytechnic, Department of Electronics and Computer Engineering, 599489, Singapore; Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore; Department of Biomedical Informatics and Medical Engineering, Asia University, Taichung, Taiwan; International Research Organization for Advanced Science and Technology (IROAST), Kumamoto University, Kumamoto, Japan.
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Li T, Zou S, Zhang Z, Liu M, Liang Z. Efficacy of pramipexole on quality of life in patients with Parkinson's disease: a systematic review and meta-analysis. BMC Neurol 2022; 22:320. [PMID: 36008796 PMCID: PMC9404654 DOI: 10.1186/s12883-022-02830-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quality of life (QoL) in patients with Parkinson's disease (PD) is increasingly used as an efficacy outcome in clinical studies of PD to evaluate the impact of treatment from the patient's perspective. Studies demonstrating the treatment effect of pramipexole on QoL remain inconclusive. This study aims to evaluate the effect of pramipexole on QoL in patients with PD by conducting a systematic review and meta-analysis of existing clinical trials. METHODS A systematic literature search of PubMed, Embase and the Cochrane Library was performed from inception to 30 April 2022 to identify randomised, placebo-controlled trials of patients with idiopathic PD receiving pramipexole, who reported a change from baseline in their QoL as measured by the 39-item Parkinson's Disease Questionnaire (PDQ-39). Risk of bias was independently assessed by two reviewers using the Cochrane Collaboration's tool for bias assessment. RESULTS Of 80 eligible articles screened, six trials consisting of at least 2000 patients with early or advanced PD were included. From the synthesis of all six selected trials, a significant mean change from baseline in the PDQ-39 total score of -2.49 (95% CI, -3.43 to -1.54; p < 0.0001) was observed with pramipexole compared with placebo. A trend toward improvement in QoL was consistently observed among patients who received optimal doses of pramipexole (≥ 80% of the study population on 1.5 mg dosage), regardless of disease severity (advanced versus early) or baseline QoL levels. CONCLUSION This meta-analysis provides evidence for the potential treatment benefit of pramipexole in improving QoL in patients with PD.
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Affiliation(s)
- Tao Li
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Shuang Zou
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.,Present Address: Information Centre, The Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Zijuan Zhang
- Boehringer Ingelheim (China) Investment Co. Ltd, Shanghai, People's Republic of China.,Present Address: Medical Affairs, Biogen Biotechnology (Shanghai) Co. Ltd, Shanghai, People's Republic of China
| | - Meiruo Liu
- Boehringer Ingelheim (China) Investment Co. Ltd, Shanghai, People's Republic of China
| | - Zhanhua Liang
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
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Zhong Z, He X, Ge J, Zhu J, Yao C, Cai H, Ye XY, Xie T, Bai R. Discovery of small-molecule compounds and natural products against Parkinson's disease: Pathological mechanism and structural modification. Eur J Med Chem 2022; 237:114378. [DOI: 10.1016/j.ejmech.2022.114378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/08/2021] [Accepted: 04/09/2022] [Indexed: 11/24/2022]
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Feital AMBDF, Gonçalves BM, de Souza TR, Christo PP, Scalzo PL. Pilates method for low back pain in individuals with Parkinson’s disease: A feasibility study. J Bodyw Mov Ther 2022; 32:19-28. [DOI: 10.1016/j.jbmt.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
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Zipprich HM, Mendorf S, Schönenberg A, Prell T. The impact of poor medication knowledge on health-related quality of life in people with Parkinson's disease: a mediation analysis. Qual Life Res 2022; 31:1473-1482. [PMID: 34797508 PMCID: PMC9023397 DOI: 10.1007/s11136-021-03024-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to determine how limited medication knowledge as one aspect of health literacy contributes to poorer health-related quality of life (HRQoL) in people with Parkinson's disease (PD). METHODS Demographical data, PD-specific data (MDS-Unified Parkinson's Disease-Rating Scale, Nonmotor symptom scale), and data about depressive symptoms (Beck's depression inventory), cognition (Montreal cognitive assessment), HRQoL (Short-Form Health Questionnaire-36, SF-36), and medication knowledge (names, time of taking, indication, dosage) were assessed in 193 patients with PD. Multivariate analysis of variance (MANOVA), multivariate analysis of covariance, and mediation analyses were used to study the relationship between medication knowledge and HRQoL in combination with different mediators and covariates. RESULTS Overall, 43.5% patients showed deficits in at least one of the 4 knowledge items, which was associated with higher age, number of medications per day and depression level, and poorer cognitive function, motor function, and lower education level. Using one-way MANOVA, we identified that medication knowledge significantly impacts physical functioning, social functioning, role limitations due to physical problems, and role limitations due to emotional problems. Mediation models using age, education level, and gender as covariates showed that the relationship between knowledge and SF-36 domains was fully mediated by Beck's Depression Inventory but not by Montreal Cognitive Assessment. CONCLUSIONS Patients who expressed unawareness of their medication did not necessarily have cognitive deficits; however, depressive symptoms may instead be present. This concomitant depressive symptomatology is crucial in explaining the contribution of nonadherence and decreased medication knowledge to poor quality of life.
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Affiliation(s)
- Hannah M Zipprich
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Sarah Mendorf
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Aline Schönenberg
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany
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Redenšek S, Kristanc T, Blagus T, Trošt M, Dolžan V. Genetic Variability of the Vitamin D Receptor Affects Susceptibility to Parkinson’s Disease and Dopaminergic Treatment Adverse Events. Front Aging Neurosci 2022; 14:853277. [PMID: 35517045 PMCID: PMC9063754 DOI: 10.3389/fnagi.2022.853277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Vitamin D is a lipid-soluble molecule and an important transcriptional regulator in many tissues and organs, including the brain. Its role has been demonstrated also in Parkinson’s disease (PD) pathogenesis. Vitamin D receptor (VDR) is responsible for the initiation of vitamin D signaling cascade. The aim of this study was to assess the associations of VDR genetic variability with PD risk and different PD-related phenotypes. We genotyped 231 well characterized PD patients and 161 healthy blood donors for six VDR single nucleotide polymorphisms, namely rs739837, rs4516035, rs11568820, rs731236, rs2228570, and rs1544410. We observed that VDR rs2228570 is associated with PD risk (p < 0.001). Additionally, we observed associations of specific VDR genotypes with adverse events of dopaminergic treatment. VDR rs1544410 (GG vs. GA + AA: p = 0.005; GG vs. GA: p = 0.009) was associated with the occurrence of visual hallucinations and VDR rs739837 (TT vs. GG: p = 0.036), rs731236 (TT vs. TC + CC: p = 0.011; TT vs. TC: p = 0.028; TT vs. CC: p = 0.035), and rs1544410 (GG vs. GA: p = 0.014) with the occurrence of orthostatic hypotension. We believe that the reported study may support personalized approach to PD treatment, especially in terms of monitoring vitamin D level and vitamin D supplementation in patients with high risk VDR genotypes.
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Affiliation(s)
- Sara Redenšek
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tilen Kristanc
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Blagus
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maja Trošt
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- *Correspondence: Vita Dolžan,
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Schönenberg A, Prell T. Measuring quality of life with the Parkinson’s Disease Questionnaire-39 in people with cognitive impairment. PLoS One 2022; 17:e0266140. [PMID: 35363801 PMCID: PMC8975160 DOI: 10.1371/journal.pone.0266140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Quality of life (QoL) is a key outcome in healthcare. However, whether cognitively impaired people with Parkinson’s disease (PD) can reliably self-report QoL is unclear, and patients are often excluded from studies based on cognition test scores. The aim of this analysis was to assess the validity of the Parkinson’s Disease Questionnaire-39 (PDQ-39) in PD patients with and without cognitive impairment. Methods In this study, 221 individuals with PD completed the PDQ-39, Montreal Cognitive Assessment (MOCA), and Beck’s Depression Inventory (BDI-II). The PDQ-39’s internal consistency, convergent validity with BDI-II, and floor and ceiling effects were analyzed for patients with and without cognitive impairment. Results Ninety-four patients showed cognitive impairment (MOCA <21), whereas 127 patients had mild/no impairment. Both MOCA groups differed significantly with regards to PD severity. The PDQ-39’s internal consistency was adequate for most subdomains in both MOCA groups, but floor effects were present for the subdomains Stigmatization, Social Support and Communication, regardless of impairment. For some subdomains, the PDQ-39’s convergent validity with the BDI receded in the low MOCA group but remained significant for most PDQ-39 domains, especially for the PDQ total score (r = .386, p < .001) and for the subdomain emotional well-being (r = .446, p < .001). Conclusion The PDQ-39 can be used to measure QoL in cognitively impaired PD patients, thus test scores indicating cognitive impairment alone should not lead to exclusion of PD patients from clinical studies. Although the correlation between BDI-II and PDQ-39 shrinks for some subdomains in cognitively impairment patients, this finding may be explained by the difference in PD severity, as factors influencing QoL may shift with increasing age and PD symptoms.
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Affiliation(s)
- Aline Schönenberg
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- * E-mail:
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany
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Stathis P, Papadopoulos G. Evaluation and validation of a patient-reported quality-of-life questionnaire for Parkinson's disease. J Patient Rep Outcomes 2022; 6:17. [PMID: 35235090 PMCID: PMC8891413 DOI: 10.1186/s41687-022-00427-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background Parkinson’s disease (PD) is a chronic, progressive illness with a profound impact on the health-related quality of life (HRQoL). Disease-specific patient-reported HRQoL measures, such as PDQ-39 and its short version PDQ-8, are increasingly used in clinical practice to address the consequences of PD on everyday life. Due to limitations in the content, especially in non-motor symptoms and sleep disturbances of PDQ-8, PDQoL7, a 7-item, short-term, self-reported, PD-specific HRQoL questionnaire was developed. Methods A representative sample of 60 adults with idiopathic PD completed the PDQoL7 questionnaire and the existing validated PDQ-8 and EQ-5D-5L questionnaires (all in Greek). Results PDQoL7 summary index strongly correlated with PDQ-8 (rs = 0.833, P < 0.001) and EQ-5D-5L (rs = − 0.852, P < 0.001). The correlation between PDQoL7 and EQ-5D-5L was statistically significantly stronger compared to PDQ-8 and EQ-5D-5L (rs = − 0.852 vs rs = − 0.789 respectively, P < 0.001). The internal consistency of PDQoL7 was not affected by item deletion (positive item to total correlations: 0.29–0.63). No redundant items (with inter-item correlation coefficients greater than 0.80) were identified. Cronbach’s α for PDQoL7 was comparable to PDQ-8 (0.804 versus 0.799 respectively). As PDQoL7 had three-dimensional structure, omega coefficient analysis confirmed its reliability (omega total: 0.88; omega hierarchical: 0.58). Conclusions PDQoL7 is an acceptable, easy to use, valid and reliable tool for the determination of HRQoL in PD patients that is potentially more comprehensive than PDQ-8 based on the available evidence. PDQoL7 could allow for a more thorough evaluation of the impact of PD and contribute to guiding healthcare decisions. This will be confirmed in subsequent analysis on larger patient cohorts. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00427-0.
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Affiliation(s)
- Pantelis Stathis
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece.
| | - George Papadopoulos
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece
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Zhao N, Yang Y, Zhang L, Zhang Q, Balbuena L, Ungvari GS, Zang Y, Xiang Y. Quality of life in Parkinson's disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci Ther 2021; 27:270-279. [PMID: 33372386 PMCID: PMC7871788 DOI: 10.1111/cns.13549] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Studies regarding the impact of Parkinson's disease (PD) on quality of life (QOL) have reported conflicting results, and the underlying QOL domains require further study. In order to understand the association between PD and QOL, we conducted this meta-analysis to systematically compare QOL between PD patients and healthy controls. METHOD The PubMed, PsycINFO, EMBASE, and Web of Science databases were systematically searched. Data were analyzed using the random-effects model. RESULTS Twenty studies covering 2707 PD patients and 150,661 healthy controls were included in the study. Compared with healthy controls, PD patients had significantly poorer QOL overall and in most domains with moderate to large effects sizes. Different QOL measures varied in their association with quality of life, with the Parkinson's Disease Questionnaire-39 (PDQ-39) having the largest effect size (standard mean difference, SMD = -1.384, 95% CI: -1.607, -1.162, Z = 12.189, P < 0.001), followed by the Europe Quality of Life Questionnaire-visual analogue scale (EQ-VAS) (SMD = -1.081, 95% CI: -1.578, -0.584, Z = -4.265, P < 0.001), Europe Quality of Life Questionnaire-5D (EQ-5D) (SMD = -0.889, 95% CI: -1.181, -0.596, Z = -5.962, P < 0.001), and the Short-form Health Survey (SF) scales (physical dimension: SMD = -0.826, 95% CI: -1.529, -0.123, Z = -2.303, P = 0.021; mental dimension: SMD = -0.376, 95% CI: -0.732, -0.019, Z = -2.064, P = 0.039). CONCLUSION PD patients had lower QOL compared with healthy controls in most domains, especially in physical function and mental health. Considering the negative impact of poor QOL on daily life and functional outcomes, effective measures should be developed to improve QOL in this population.
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Affiliation(s)
- Na Zhao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & The Advanced Innovation Center for Human Brain ProtectionSchool of Mental HealthCapital Medical UniversityBeijingChina
| | - Lloyd Balbuena
- Department of PsychiatryUniversity of SaskatchewanSaskatoonSKCanada
| | - Gabor S. Ungvari
- Division of PsychiatrySchool of MedicineUniversity of Western Australia/Graylands HospitalPerthWAAustralia
- The University of Notre Dame AustraliaFremantleWAAustralia
| | - Yu‐Feng Zang
- Center for Cognition and Brain DisordersInstitutes of Psychological SciencesHangzhou Normal UniversityHangzhouChina
| | - Yu‐Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health SciencesUniversity of MacauMacao SARChina
- Center for Cognition and Brain SciencesUniversity of MacauMacao SARChina
- Institute of Advanced Studies in Humanities and Social SciencesUniversity of MacauMacao SARChina
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