101
|
Augustine EF, Pérez A, Dhall R, Umeh CC, Videnovic A, Cambi F, Wills AMA, Elm JJ, Zweig RM, Shulman LM, Nance MA, Bainbridge J, Suchowersky O. Sex Differences in Clinical Features of Early, Treated Parkinson's Disease. PLoS One 2015; 10:e0133002. [PMID: 26171861 PMCID: PMC4501841 DOI: 10.1371/journal.pone.0133002] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/22/2015] [Indexed: 11/23/2022] Open
Abstract
Introduction To improve our understanding of sex differences in the clinical characteristics of Parkinson’s Disease, we sought to examine differences in the clinical features and disease severity of men and women with early treated Parkinson’s Disease (PD) enrolled in a large-scale clinical trial. Methods Analysis was performed of baseline data from the National Institutes of Health Exploratory Trials in Parkinson’s Disease (NET-PD) Long-term Study-1, a randomized, multi-center, double-blind, placebo-controlled study of 10 grams of oral creatine/day in individuals with early, treated PD. We compared mean age at symptom onset, age at PD diagnosis, and age at randomization between men and women using t-test statistics. Sex differences in clinical features were evaluated, including: symptoms at diagnosis (motor) and symptoms at randomization (motor, non-motor, and daily functioning). Results 1,741 participants were enrolled (62.5% male). No differences were detected in mean age at PD onset, age at PD diagnosis, age at randomization, motor symptoms, or daily functioning between men and women. Differences in non-motor symptoms were observed, with women demonstrating better performance compared to men on SCOPA-COG (Z = 5.064, p<0.0001) and Symbol Digit Modality measures (Z = 5.221, p<0.0001). Conclusions Overall, men and women did not demonstrate differences in clinical motor features early in the course of PD. However, the differences observed in non-motor cognitive symptoms suggests further assessment of the influence of sex on non-motor symptoms in later stages of PD is warranted.
Collapse
Affiliation(s)
- Erika F. Augustine
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States of America
- * E-mail:
| | - Adriana Pérez
- The University of Texas School of Public Health, Austin, TX, United States of America
| | - Rohit Dhall
- Barrow Neurological Institute, Phoenix, AZ, United States of America
| | - Chizoba C. Umeh
- Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Aleksandar Videnovic
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, United States of America
| | - Franca Cambi
- Department of Neurology, University of Kentucky, Lexington, KY, United States of America
| | - Anne-Marie A. Wills
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Jordan J. Elm
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | - Richard M. Zweig
- Louisiana State University Health Sciences Center, Shreveport, LA, United States of America
| | - Lisa M. Shulman
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Martha A. Nance
- Struthers Parkinson’s Center, Minneapolis, MN, United States of America
| | - Jacquelyn Bainbridge
- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, United States of America
| | - Oksana Suchowersky
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
102
|
Kadastik-Eerme L, Rosenthal M, Paju T, Muldmaa M, Taba P. Health-related quality of life in Parkinson's disease: a cross-sectional study focusing on non-motor symptoms. Health Qual Life Outcomes 2015; 13:83. [PMID: 26088201 PMCID: PMC4474578 DOI: 10.1186/s12955-015-0281-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/06/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate factors affecting health-related quality of life (HRQoL) among Estonian persons with Parkinson's disease (PD). METHODS 268 persons with PD were evaluated using: the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS); the Hoehn and Yahr scale (HY); the Schwab and England Activities of Daily Living scale (SE-ADL); the Beck Depression Inventory (BDI); the Mini Mental State Examination (MMSE); the Parkinson's Disease Questionnaire (PDQ-39). Additional questions on clinical and socio-demographic variables were asked during a semi-structured interview. Predictors of HRQoL were tested using multiple regression analysis. RESULTS The main predictors of low HRQoL were depression and motor and non-motor aspects of daily living. 59.9 % of the variation in the PDQ-39 summary index (SI) score was explained by the predictive variables identified in this study. None of the socio-demographic variables (age, gender, urban/rural living, marital status, living alone/with others, education level) were significant predictors of HRQoL. Prevalence of non-motor Parkinson's symptoms were high (99.6 %); cognitive impairment, sleep and urinary problems were the most common. All non-motor symptoms correlated significantly with low HRQoL, except the features of impulse control disorders (ICDs). CONCLUSIONS Depression and motor and non-motor daily living experiences were found to be significant and independent factors of low HRQoL in persons with PD. Depression was the strongest determinant of low HRQoL. Our results highlight the importance of recognition and management of non-motor symptoms, as these features had more impact on patients' HRQoL than clinically assessed motor symptoms.
Collapse
Affiliation(s)
- Liis Kadastik-Eerme
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Marika Rosenthal
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Tiiu Paju
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Mari Muldmaa
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| | - Pille Taba
- Department of Neurosurgery and Neurology, Tartu University Hospital, L. Puusepa 8, Tartu, 51014, Estonia.
| |
Collapse
|
103
|
Dissanayaka NN, White E, O'Sullivan JD, Marsh R, Silburn PA, Copland DA, Mellick GD, Byrne GJ. Characteristics and Treatment of Anxiety Disorders in Parkinson's Disease. Mov Disord Clin Pract 2015; 2:155-162. [PMID: 30363816 PMCID: PMC6183244 DOI: 10.1002/mdc3.12157] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/12/2015] [Accepted: 12/14/2014] [Indexed: 01/18/2023] Open
Abstract
Background: Anxiety disorders are common in Parkinson's disease (PD) and are undertreated. The current study investigates demographic and PD-specific factors associated with Diagnostic and Statistical Manual (DSM-IV) anxiety disorders and subsyndromal anxiety in PD. It also examines the use of pharmacological and nonpharmacological treatments for anxiety in PD. Methods: Ninety nondemented PD patients completed a semistructured interview. Logistic regression models were constructed examining associations between several demographic, disease-specific, and treatment factors, as well as both current syndromal, DSM-IV anxiety disorders, and subsyndromal anxiety. Results: Associations were found between current DSM-IV anxiety disorder, as well as female gender, younger age, more severe stages of PD, and poor activities of daily living. Subsyndromal anxiety was related to a younger onset age of PD. Relationships were also found between both anxiety groups and more complications of PD therapy, as well as higher depression scores. There were no associations between anxiety and levodopa equivalent daily dosage, motor disability, and cognition. In our sample, 57% of patients with current DSM-IV anxiety disorders or subsyndromal anxiety were not currently treated with pharmacotherapy. Of those who currently received such treatment, 83% still experienced current anxiety disorders. Results suggest that anxiety is poorly recognized and treated in PD. Conclusions: Clinical trials investigating the efficacy of pharmacotherapy, tailored psychotherapy, and combination therapy primarily focusing on anxiety are much needed, with the aim of establishing novel targeted treatment protocols for the management of subtypes of anxiety disorders in PD.
Collapse
Affiliation(s)
- Nadeeka N.W. Dissanayaka
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- Neurology Research CenterRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
- School of PsychologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Elizabeth White
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- School of MedicineRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
| | - John D. O'Sullivan
- Neurology Research CenterRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
- School of MedicineRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
| | - Rodney Marsh
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- School of MedicineRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- Mental Health ServiceRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
| | - Peter A. Silburn
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- Neurology Research CenterRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
- School of MedicineRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
| | - David A. Copland
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- School of Health & Rehabilitation SciencesUniversity of QueenslandSt LuciaBrisbaneQueenslandAustralia
| | - George D. Mellick
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- Neurology Research CenterRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
- Eskitis Institute for Drug DiscoveryGriffith UniversityNathanBrisbaneQueenslandAustralia
| | - Gerard J. Byrne
- UQ Center for Clinical ResearchRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- School of PsychologyThe University of QueenslandBrisbaneQueenslandAustralia
- School of MedicineRoyal Brisbane & Women's HospitalUniversity of QueenslandHerstonBrisbaneQueenslandAustralia
- Mental Health ServiceRoyal Brisbane & Women's HospitalHerstonBrisbaneQueenslandAustralia
| |
Collapse
|
104
|
Reduced plasma serotonin and 5-hydroxyindoleacetic acid levels in Parkinson's disease are associated with nonmotor symptoms. Parkinsonism Relat Disord 2015; 21:882-7. [PMID: 26028271 DOI: 10.1016/j.parkreldis.2015.05.016] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 05/03/2015] [Accepted: 05/25/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Accumulating evidence suggests that serotonergic system may be implicated in the pathophysiology of Parkinson's disease (PD), and particularly in nonmotor symptoms such as depression, fatigue, sleep disorders, sensory and autonomic dysfunction. This study aimed to evaluate plasma levels of serotonin (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) in PD patients, and investigate their associations with nonmotor symptoms. METHODS Eighty-two PD patients and sixty-four controls underwent a series of clinical assessments, including Hamilton Depression Scale, Fatigue Severity Scale, Pittsburgh Sleep Quality Index, Visual Analog Scale for Pain, and Scale for Outcomes in PD for Autonomic Symptoms. Plasma 5-HT and 5-HIAA levels were measured by HPLC-ECD. RESULTS PD patients exhibited worse performance on nonmotor symptom scales (all P-values <0.001) and presented lower plasma levels of 5-HT (P < 0.001) and 5-HIAA (P < 0.001) than control individuals. Within the PD group, decreased concentrations of plasma 5-HT and 5-HIAA were correlated with more severe depression (r = -0.447, P < 0.001; r = -0.407, P < 0.001, respectively) and pain (r = -0.485, P < 0.001; r = -0.416, P < 0.001, respectively). After performing multiple linear regression, plasma 5-HT (P = 0.01) and 5-HIAA (P = 0.006) remained significantly associated with depression. CONCLUSIONS Our results suggest that serotonergic dysfunction might exist in PD, and specifically correlated with depression and pain in PD. Plasma levels of 5-HT and 5-HIAA may be considered as peripheral markers for depression in PD.
Collapse
|
105
|
Liu R, Umbach DM, Peddada SD, Xu Z, Tröster AI, Huang X, Chen H. Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease. Neurology 2015; 84:2107-15. [PMID: 25925983 DOI: 10.1212/wnl.0000000000001609] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/06/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine potential sex differences in nonmotor symptoms (NMS) among drug-naive patients with Parkinson disease (PD), and to identify NMS that can best differentiate patients with early PD from controls. METHODS Our cross-sectional analysis included 414 newly diagnosed, untreated patients with PD (269 men and 145 women) and 188 healthy controls (121 men and 67 women) in the Parkinson's Progression Markers Initiative Study. NMS were measured using well-validated instruments covering sleep, olfactory, neurobehavioral, autonomic, and neuropsychological domains. RESULTS Male and female patients with PD were fairly comparable on motor presentations but differed on several nonmotor features. Male patients with PD had significantly more pronounced deficits in olfaction (p = 0.02) and in certain cognitive measurements (all p < 0.01) than female patients, whereas female cases experienced higher trait anxiety (p = 0.02). Multiple stepwise logistic regression analysis showed that the combination of NMS measures-University of Pennsylvania Smell Identification Test (UPSIT), Montreal Cognitive Assessment (MoCA), Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), and state anxiety from the State-Trait Anxiety Inventory-effectively differentiated patients with PD from controls with an area under the receiver operating characteristic curve (AUC) of 0.913 (95% confidence interval [CI]: 0.89-0.94). UPSIT, MoCA, and SCOPA-AUT were the most predictive NMS measurements in men (AUC = 0.919; 95% CI: 0.89-0.95) as compared to UPSIT, MoCA, and REM Sleep Behavior Disorder Screening Questionnaire in women (AUC = 0.903; 95% CI: 0.86-0.95). CONCLUSIONS Our analysis revealed notable sex differences in several nonmotor features of patients with de novo PD. Furthermore, we found a parsimonious NMS combination that could effectively differentiate de novo cases from healthy controls.
Collapse
Affiliation(s)
- Rui Liu
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA.
| | - David M Umbach
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Shyamal D Peddada
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Zongli Xu
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Alexander I Tröster
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Xuemei Huang
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Honglei Chen
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| |
Collapse
|
106
|
Dissanayaka NNNW, White E, O'Sullivan JD, Marsh R, Pachana NA, Byrne GJ. The clinical spectrum of anxiety in Parkinson's disease. Mov Disord 2015; 29:967-75. [PMID: 25043800 DOI: 10.1002/mds.25937] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/11/2014] [Accepted: 05/13/2014] [Indexed: 12/24/2022] Open
Abstract
Anxiety is common in Parkinson's disease (PD), and contributes to increased disability and poorer quality of life. In spite of its significant impact, the symptomatology, chronology, and neurobiology of anxiety in PD are all poorly understood, and this hinders accurate diagnosis and development of effective treatment strategies. This review investigates and updates literature related to the clinical spectrum of anxiety in PD. The reported prevalence of anxiety in PD varies considerably, with emerging interest in the frequency of the DSM-IV residual category of "Anxiety disorder, not otherwise specified" (Anxiety disorder NOS), which is observed in up to 25% of PD patients. By design, there are no standardized diagnostic criteria for Anxiety disorder NOS, because this is the category applied to individuals who do not meet diagnostic criteria for any other current anxiety disorder. Anxiety rating scales incompletely capture anxiety symptoms that relate specifically to PD symptoms and the complications arising from PD therapy. Consequently, these scales have been deemed inappropriate for use in PD, and there remains a need for the development of a new PD-specific anxiety scale. Research establishing accurate symptom profiles of anxiety in PD is sparse, although characterizing such symptomatology would likely improve clinical diagnosis and facilitate targeted treatment strategies. Research into the neurobiological and psychological underpinnings of anxiety in PD remains inconclusive. Anxiety can precede the onset of PD motor symptoms or can develop after a diagnosis of PD. Further investigations focused on the chronology of anxiety and its relationship to PD diagnosis are required.
Collapse
Affiliation(s)
- Nadeeka N N W Dissanayaka
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia; Neurology Research Centre, Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | | | | | | | | | | |
Collapse
|
107
|
Abdel-Salam OME. Prevalence, clinical features and treatment of depression in Parkinson’s disease: An update. World J Neurol 2015; 5:17-38. [DOI: 10.5316/wjn.v5.i1.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 01/10/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023] Open
Abstract
Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases which typically affects individuals over 65 years. Although the symptomatology is predominantly motor, neuropsychiatric manifestations, e.g., depression, apathy, anxiety, and cognitive impairment occur in the course of the illness and can have a great impact on the quality of life in these patients. Parkinson’s disease is commonly comorbid with depression with prevalence rates of depression, generally higher than those reported in general population. Depression in PD is frequently underestimated and consequently undertreated, which have significant effects on the quality of life in these patients. The neurobiology of depression in PD is complex and involves alterations in dopaminergic, serotonergic, noradrenergic and possibly other neurotransmitter systems which are affected in the course of the disease. The tricyclic antidepressants and the selective serotonin reuptake inhibitors are the two classes of antidepressant drugs used for depressive symptoms in PD. Several published studies suggested that both classes are of comparable efficacy. Other serotonergic antidepressants, e.g., nefazodone and trazodone have also been of benefit. Meanwhile, there are limited data available on other drugs but these suggest a benefit from the serotonin and noradrenaline reuptake inhibitors such as mirtazapine, venlafaxine, atomoxetine and duloxetine. Some of the drugs used in symptomatic treatment of PD, e.g., the irreversible selective inhibitors of the enzyme monoamine oxidase-B, rasagiline and selegiline as well as the dopamine receptor agonist pramipexole are likely to have direct antidepressant activity independent of their motor improving action. This would make these drugs an attractive option in depressed subjects with PD. The aim of this review is to provide an updated data on the prevalence, clinical features of depression in subjects with PD. The effects of antiparkinsonian and antidepressant drugs on depressive symptoms in these patients are also discussed.
Collapse
|
108
|
Gao L, Nie K, Tang H, Wang L, Zhao J, Gan R, Huang J, Feng S, Zhu R, Duan Z, Zhang Y, Wang L. Sex differences in cognition among Chinese people with Parkinson’s disease. J Clin Neurosci 2015; 22:488-92. [DOI: 10.1016/j.jocn.2014.08.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/23/2014] [Accepted: 08/14/2014] [Indexed: 11/26/2022]
|
109
|
Kim SR, So HY, Choi E, Kang JH, Kim HY, Chung SJ. Influencing effect of non-motor symptom clusters on quality of life in Parkinson's disease. J Neurol Sci 2014; 347:310-5. [DOI: 10.1016/j.jns.2014.10.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 10/01/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
|
110
|
Comment on Szewczyk-Krolikowski et al.: The influence of age and gender on motor and non-motor features of early Parkinson's disease: Initial findings from the Oxford Parkinson Disease Center (OPDC) discovery cohort. Parkinsonism Relat Disord 2014; 20:1319-20. [DOI: 10.1016/j.parkreldis.2014.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 03/11/2014] [Accepted: 03/15/2014] [Indexed: 11/17/2022]
|
111
|
Correlates of quality of sexual life in male and female patients with Parkinson disease and their partners. Parkinsonism Relat Disord 2014; 20:1085-8. [DOI: 10.1016/j.parkreldis.2014.07.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 05/28/2014] [Accepted: 07/08/2014] [Indexed: 12/12/2022]
|
112
|
Picillo M, Erro R, Amboni M, Longo K, Vitale C, Moccia M, Pierro A, Scannapieco S, Santangelo G, Spina E, Orefice G, Barone P, Pellecchia MT. Gender differences in non-motor symptoms in early Parkinson's disease: A 2-years follow-up study on previously untreated patients. Parkinsonism Relat Disord 2014; 20:850-4. [DOI: 10.1016/j.parkreldis.2014.04.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/09/2014] [Accepted: 04/21/2014] [Indexed: 10/25/2022]
|
113
|
Serotonin impairment in CSF of PD patients, without an apparent clinical counterpart. PLoS One 2014; 9:e101763. [PMID: 25036938 PMCID: PMC4103775 DOI: 10.1371/journal.pone.0101763] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/11/2014] [Indexed: 11/19/2022] Open
Abstract
In Parkinson's disease (PD), several studies have detected an impaired serotonin (5-HT) pathway, likely affecting both motor and non-motor domains. However, the precise impact of 5-HT impairment is far from established. Here, we have used a HPLC chromatographic method, in a homogenous cohort (n = 35) of non fluctuating, non dyskinetic PD patients, to assess the concentration of 5-HT and its metabolite 5-HIAA in peripheral cerebrospinal fluid (CSF) obtained from lumbar puncture (LP). LP was performed following three days of therapy withdrawal, in order to vanish the effects of prolonged released dopamine agonists (DA), and in absence of any serotonergic agent. The PD patient group showed a significantly reduced CSF level of both 5-HT and 5-HIAA compared to either age-matched control subjects (n = 18), or Alzheimer's disease patients (n = 20). However, no correlation emerged between 5-HT/5-HIAA concentrations and UPDRS-III (r = −0.12), disease duration (r = −0.1), age (r = −0.27) and MMSE (r = 0.11). Intriguingly, low CSF 5-HT levels did not differ for gender or for motor phenotype (in terms of non-tremor dominant subtype and tremor dominant subtype). Further, low CSF 5-HT levels did not correlate with the presence of depression, apathy or sleep disturbance. Our findings support the contention that 5-HT impairment is a cardinal feature of stable PD, probably representing a hallmark of diffuse Lewy bodies deposition in the brainstem. However, clinical relevance remains uncertain. Given these findings, an add-on therapy with serotonergic agents seems questionable in PD patients, or should be individually tailored, unless severe depression is present.
Collapse
|
114
|
Gender differences on motor and non-motor symptoms of de novo patients with early Parkinson's disease. Neurol Sci 2014; 35:1991-6. [PMID: 25012756 DOI: 10.1007/s10072-014-1879-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
The affect of gender differences on clinical presentation of Parkinson's disease (PD) remains controversial. De novo PD subjects were recruited from a trial-based multicenter cohort in clinical sites of Chinese Parkinson Study Group. Demographic information, motor and non-motor symptom measurements were performed by face-to-face interview using specific scales. Scores and frequencies of symptoms were compared between male and female patients, and regression models were used to control the effects of age and disease duration. Totally 428 PD patients were enrolled in this study, and 60.3 % of them were male. Total UPDRS scores were not significantly different between male and female (25.02 ± 12.84 vs. 25.24 ± 13.22, adjusted p = 0.984). No significant gender differences were found on scores for four cardinal motor signs, neither on motor subtypes (PIGD 19.0 vs. 15.9 %, adjusted p = 0.303). Female patients more likely had depressive symptoms (38.8 vs. 27.5 %, adjusted p = 0.023; CES-D score 13.78 ± 10.91 vs. 11.23 ± 9.42, adjusted p = 0.015). Male patients had significantly higher scores for MMSE (28.26 ± 2.21 vs. 27.00 ± 3.38, adjusted p = 0.0001), and lower scores for identification (1.39 ± 1.63 vs. 2.01 ± 2.63, adjusted p = 0.002) in ADAS-cog. No significant differences were found for other non-motor symptoms including motivation problems (male 29.8 % vs. female 30.6 %, adjusted p = 0.760), fatigue (62.6 vs. 70.5 %, adjusted p = 0.140), constipation (37.2 vs. 30.1 %, adjusted p = 0.243), and sleep quality (57.6 vs. 61.3 %, adjusted p = 0.357; PSQI score: 5.62 ± 3.31 vs. 6.10 ± 3.53, adjusted p = 0.133). Female might be more depressed and have worse performance on cognition in early untreated PD patients, but gender differences are not apparent on motor and other non-motor symptoms.
Collapse
|
115
|
Mahajan A, Rosenthal LS, Gamaldo C, Salas RE, Pontone GM, McCoy A, Umeh C, Mari Z. REM Sleep Behavior and Motor Findings in Parkinson's Disease: A Cross-sectional Analysis. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2014; 4:245. [PMID: 25009765 PMCID: PMC4070091 DOI: 10.7916/d84b2zdf] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 05/20/2014] [Indexed: 01/14/2023]
Abstract
Background Parkinson's disease (PD) represents a major public health challenge that will only grow in our aging population. Understanding the connection between PD and associated prodromal conditions, such as rapid eye movement sleep behavioral disorder (RBD), is critical to identifying prevention strategies. However, the relationship between RBD and severity of motor findings in early PD is unknown. This study aims to examine this relationship. Methods The study population consisted of 418 PD patients who completed the Movement Disorders Society-United Parkinson's Disease Rating Scale (MDS-UPDRS) and rapid eye movement sleep (REM) disorder questionnaires at the baseline visit of the Michael J. Fox's Parkinson's Progression Markers Initiative (PPMI). Cross-sectional analysis was carried out to assess the association between REM Sleep Behavior Screening Questionnaire score and MDS UPDRS-3 (motor) score categories. Correlation with a higher score category was described as “worse motor findings”. A score of 5 on the REM disorder questionnaire was defined as predictive of RBD. Results Out of the 418 PD patients, 113 (27.0%) had RBD. With univariate logistic regression analysis, individuals with scores predictive of RBD were 1.66 times more likely to have worse motor findings (p = 0.028). Even with age, gender, and Geriatric Depression Scale scores taken into account, individuals with scores predictive of RBD were 1.69 times more likely to have worse motor findings (p = 0.025). Discussion PD patients with RBD symptoms had worse motor findings than those unlikely to have RBD. This association provides further evidence for the relationship between RBD and PD.
Collapse
Affiliation(s)
- Abhimanyu Mahajan
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Liana S Rosenthal
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Charlene Gamaldo
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Rachel E Salas
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University, Baltimore, MD, USA
| | - Arita McCoy
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Chizoba Umeh
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| | - Zoltan Mari
- Department of Neurology Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
116
|
Sex differences in Parkinson's disease. J Clin Neurosci 2014; 21:1503-6. [PMID: 24767694 DOI: 10.1016/j.jocn.2013.12.016] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 12/05/2013] [Accepted: 12/15/2013] [Indexed: 11/24/2022]
Abstract
Sex-related differences in Parkinson's disease (PD) have been recognised, but remain poorly understood. We aimed to further clarify real-life differences in disease experience according to sex, by evaluating quality of life (QoL), demographic and clinical characteristics of PD patients. A cross-sectional survey was conducted on 210 PD patients (129 men, 81 women) attending specialist neurological clinics across three centres. Outcome measures included the motor examination of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and QoL as measured by the 39-item Parkinson's Disease Questionnaire (PDQ-39). A male to female ratio of 1.6:1 was observed. Men reported a greater disease burden than women as noted by higher UPDRS-III scores (27 ± 13 versus 23 ± 13, p=0.032), daily levodopa equivalent doses (898.1 ± 481.3mg versus 750.7 ± 427.2mg, p=0.037) and caregiver reliance (44% versus 29.5%, p=0.039). The UPDRS-III score was significantly associated with sex after controlling for age and disease duration, with men more severely affected (β=-0.165, r(2)=0.101, p=0.028). The PDQ-39 showed men reported lower QoL in activities of daily living (ADL), cognition and communication sub-scales (p<0.05). An association was identified in men between PDQ-39 ADL and cognition sub-scales (r=0.660, p<0.001). Men with an appointed caregiver had a higher PDQ-39 Summary Index (t=3.222, degrees of freedom=122, p=0.002). PD was found to have greater overall impact on the health and well-being of male patients in sub-specialty clinical practice. Our study further supports the need for increased sex-delineated clinical assessment and consideration of potential differences required in the management of PD.
Collapse
|
117
|
Mehanna R, Moore S, Hou JG, Sarwar AI, Lai EC. Comparing clinical features of young onset, middle onset and late onset Parkinson's disease. Parkinsonism Relat Disord 2014; 20:530-4. [PMID: 24631501 DOI: 10.1016/j.parkreldis.2014.02.013] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 02/04/2014] [Accepted: 02/12/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parkinson's disease (PD) affects 1-2% of the population over 65 years. There is evidence that the clinical features differ with age at symptom onset, but published information is scarce. METHODS We reviewed the charts of 593 PD patients and divided them into young onset (≤49 years), middle onset (50-69 years) and late onset (≥70 years) groups. Data collected included age at symptom onset, year of onset, family history of Parkinson's disease in first and second degree relatives, predominant first symptom, first anti parkinsonian medication prescribed, frequency of levodopa-induced dyskinesia, therapy related dystonia, therapy related gastrointestinal side effects, hallucination, dementia, depression and apathy. RESULTS The middle onset was the largest group (51%), followed by the late onset (39%) and the young onset (10%) groups. Young onset patients had a more frequent family history of Parkinson's disease and a longer survival. Symptoms other than tremor were more frequent as the initial symptom of the young onset group, and the frequency of tremor as the first symptom increased with advancing age at onset. Depression was more frequent in the young onset group. The frequency of treatment related dyskinesia or dystonia decreased with advancing age at onset. CONCLUSION We have identified specific clinical differences in Parkinson's disease related to the patient's age at onset and added to the existing knowledge of the variability of disease presentation. We suggest an age of onset of 49 years or less for the definition of young onset PD.
Collapse
Affiliation(s)
- Raja Mehanna
- University of Texas Health Science center, 6410 Fannin Street, Suite 1014, Houston, TX, USA.
| | - Suzanne Moore
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - J Gabriel Hou
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Aliya I Sarwar
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Eugene C Lai
- Houston Methodist Neurological Institute, Houston, TX, USA
| |
Collapse
|
118
|
Heller J, Dogan I, Schulz JB, Reetz K. Evidence for gender differences in cognition, emotion and quality of life in Parkinson's disease? Aging Dis 2014; 5:63-75. [PMID: 24490118 PMCID: PMC3901615 DOI: 10.14366/ad.2014.050063] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/11/2013] [Accepted: 10/16/2013] [Indexed: 11/03/2022] Open
Abstract
A number of gender differences have been documented in the incidence and symptomatology of the second most common age-related neurodegenerative disorder, idiopathic Parkinson's disease (PD). Overall, previous reports suggest a less frequent incidence and a more benign phenotype in women mainly in Western populations, which is thought to be mediated by estrogens in particular in early stages of the disease. Not only motor symptoms seem to underlie gender effects, but also non-motor symptoms such as psychiatric and cognitive impairments, which can often precede motor manifestation. However, reliable results for gender differences in PD in particular of cognitive function and emotion processing, having a major impact on quality of life, are lacking. Moreover, studies investigating gender effects in PD in these areas have revealed highly heterogeneous results. The present review summarizes findings of currently available studies on gender effects on neuropsychological tests covering major cognitive domains, emotion processing as well as quality of life in patients with PD. Overall, the occurrence of cognitive impairment in PD seems to be associated with male gender, though inconsistent results were shown in cognitive screening tests. Regarding emotion recognition, men with PD were found to be less accurate than women with PD at identifying fearful expressions, whereas vice versa results appeared in healthy subjects. Lower quality of life and greater disability were reported by women compared to men with PD, which corresponds with the results in healthy subjects. Several disease-specific mediators as well as the question of a general gender and age-related effect as observed in healthy individuals are discussed. Increased knowledge on possible gender effects in PD would provide an enhanced insight in underlying pathological mechanisms, and has potential implications for the diagnosis and treatment of PD.
Collapse
Affiliation(s)
- Julia Heller
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany
- JARA – Translational Brain Medicine, Jülich and Aachen, Germany
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany
- JARA – Translational Brain Medicine, Jülich and Aachen, Germany
- Institute of Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, Wilhelm-Johnen-Straße, Jülich, Germany
| | - Jörg B. Schulz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany
- JARA – Translational Brain Medicine, Jülich and Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Pauwelsstraße 30, Aachen, Germany
- JARA – Translational Brain Medicine, Jülich and Aachen, Germany
- Institute of Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, Wilhelm-Johnen-Straße, Jülich, Germany
| |
Collapse
|
119
|
The influence of age and gender on motor and non-motor features of early Parkinson's disease: Initial findings from the Oxford Parkinson Disease Center (OPDC) discovery cohort. Parkinsonism Relat Disord 2014; 20:99-105. [DOI: 10.1016/j.parkreldis.2013.09.025] [Citation(s) in RCA: 150] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
|
120
|
Solla P, Cannas A, Mulas CS, Perra S, Corona A, Bassareo PP, Marrosu F. Association between fatigue and other motor and non-motor symptoms in Parkinson’s disease patients. J Neurol 2013; 261:382-91. [DOI: 10.1007/s00415-013-7207-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/15/2013] [Accepted: 12/03/2013] [Indexed: 01/26/2023]
|
121
|
Body Weight-Supported High-Intensity Locomotor Training and Adapted Physical Activity Program in Patients With Parkinson's Disease: A Complementary Approach? Arch Phys Med Rehabil 2013; 94:2032-3. [DOI: 10.1016/j.apmr.2013.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 02/17/2013] [Indexed: 11/20/2022]
|
122
|
Gender differences in non-motor symptoms in early, drug naïve Parkinson’s disease. J Neurol 2013; 260:2849-55. [DOI: 10.1007/s00415-013-7085-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/08/2013] [Accepted: 08/18/2013] [Indexed: 11/30/2022]
|