1
|
Culicetto L, Formica C, Lo Buono V, Latella D, Maresca G, Brigandì A, Sorbera C, Di Lorenzo G, Quartarone A, Marino S. Possible Implications of Managing Alexithymia on Quality of Life in Parkinson's Disease: A Systematic Review. PARKINSON'S DISEASE 2024; 2024:5551796. [PMID: 39228428 PMCID: PMC11371456 DOI: 10.1155/2024/5551796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/17/2024] [Accepted: 08/16/2024] [Indexed: 09/05/2024]
Abstract
Alexithymia, characterized by difficulty in recognizing and verbalizing emotions, is reported to be more prevalent in subjects with Parkinson's disease (PD) than in the general population. Although it is one of the nonmotor symptoms of PD, alexithymia is often overlooked in clinical practice. The aim of this systematic review is to investigate the prevalence of alexithymia in PD, assess its impact on quality of life, and explore the rehabilitation approaches for alexithymia. Research articles, selected from PubMed, Scopus, and Web of Science, were limited to those published in English from 2013 to 2023. The search terms combined were "Alexithymia," "Parkinson's disease,", and "Quality of life." Current literature review indicates that alexithymia is commonly assessed using the Toronto Alexithymia Scale (TAS-20), and it is associated with deficits in visuospatial and executive functions. Presently, rehabilitation interventions for alexithymia are scarce, and their effectiveness remains controversial. Future research should focus on developing comprehensive assessments and rehabilitation strategies for emotional processing, considering its significant impact on the quality of life of both patients and caregivers.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
| |
Collapse
|
2
|
Turcu-Stiolica A, Naidin MS, Halmagean S, Ionescu AM, Pirici I. The Impact of the Dietary Intake of Vitamin B12, Folic Acid, and Vitamin D3 on Homocysteine Levels and the Health-Related Quality of Life of Levodopa-Treated Patients with Parkinson's Disease-A Pilot Study in Romania. Diagnostics (Basel) 2024; 14:1609. [PMID: 39125485 PMCID: PMC11311973 DOI: 10.3390/diagnostics14151609] [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: 07/02/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies have shown that the levodopa treatment of Parkinson's disease (PD) elevates circulating homocysteine levels, which are associated with an increased risk of cardiovascular and neurological disorders, or thrombosis. The present trial aimed to examine whether the intake of vitamin B12, folic acid, and vitamin D3 supplements improved homocysteine level and quality of life (QoL). MATERIALS AND METHODS An interventional prospective trial was conducted in multiple centers across Romania. Participants with clinically established PD taking at least 300 mg/day of levodopa for more than 1 year received a daily tablet of a supplement containing 800 UI of vitamin D3, 1000 µg of folic acid, and 15 µg of vitamin B12. They were followed for 6 months and their serum homocysteine, vitamin B12, vitamin D, and QoL scores were measured at baseline and at 6 months of treatment. QoL was measured using a 15D questionnaire, which assesses mobility, vision, hearing, breathing, sleeping, eating, speech, excretion, usual activities, mental function, discomfort and symptoms, depression, distress, vitality, and sexual activity. RESULTS Twenty-four PD patients with a mean age of 71 ± 5.04 years (54.2% male and 45.8% female) finished the study. After the intervention, the mean score of speech, mental function, discomfort and symptoms, depression, and QoL significantly increased (p < 0.05 for all). Also, the serum homocysteine and vitamin D were significantly enhanced (p < 0.0001 and p = 0.025, respectively). Changes in vitamin B12 were not statistically significant at 6 months of treatment (p = 0.996). No gender differences were found among the changes that we have demonstrated for homocysteine, vitamin B12, vitamin D, and QoL levels (p < 0.05 for all). CONCLUSIONS The findings of this study showed that the dietary intake of vitamin B12, folic acid, and vitamin D3 remarkably decreased the dimensions of homocysteine and finally increased the total score of QoL in PD patients. We have successfully captured the potential benefits of the supplementation regimen over time and provided insights into the broader implications for managing PD with a focus on nutritional support.
Collapse
Affiliation(s)
- Adina Turcu-Stiolica
- Pharmaceutical Management and Marketing, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mihaela-Simona Naidin
- Pharmaceutical Management and Marketing, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | | | - Ana Maria Ionescu
- Department of Neurology, Ovidius University, 900123 Constanta, Romania;
| | - Ionica Pirici
- Department of Human Anatomy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| |
Collapse
|
3
|
Sultana OF, Bandaru M, Islam MA, Reddy PH. Unraveling the complexity of human brain: Structure, function in healthy and disease states. Ageing Res Rev 2024; 100:102414. [PMID: 39002647 DOI: 10.1016/j.arr.2024.102414] [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: 05/23/2024] [Revised: 06/29/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024]
Abstract
The human brain stands as an intricate organ, embodying a nexus of structure, function, development, and diversity. This review delves into the multifaceted landscape of the brain, spanning its anatomical intricacies, diverse functional capacities, dynamic developmental trajectories, and inherent variability across individuals. The dynamic process of brain development, from early embryonic stages to adulthood, highlights the nuanced changes that occur throughout the lifespan. The brain, a remarkably complex organ, is composed of various anatomical regions, each contributing uniquely to its overall functionality. Through an exploration of neuroanatomy, neurophysiology, and electrophysiology, this review elucidates how different brain structures interact to support a wide array of cognitive processes, sensory perception, motor control, and emotional regulation. Moreover, it addresses the impact of age, sex, and ethnic background on brain structure and function, and gender differences profoundly influence the onset, progression, and manifestation of brain disorders shaped by genetic, hormonal, environmental, and social factors. Delving into the complexities of the human brain, it investigates how variations in anatomical configuration correspond to diverse functional capacities across individuals. Furthermore, it examines the impact of neurodegenerative diseases on the structural and functional integrity of the brain. Specifically, our article explores the pathological processes underlying neurodegenerative diseases, such as Alzheimer's, Parkinson's, and Huntington's diseases, shedding light on the structural alterations and functional impairments that accompany these conditions. We will also explore the current research trends in neurodegenerative diseases and identify the existing gaps in the literature. Overall, this article deepens our understanding of the fundamental principles governing brain structure and function and paves the way for a deeper understanding of individual differences and tailored approaches in neuroscience and clinical practice-additionally, a comprehensive understanding of structural and functional changes that manifest in neurodegenerative diseases.
Collapse
Affiliation(s)
- Omme Fatema Sultana
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Madhuri Bandaru
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Md Ariful Islam
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA 5. Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
| |
Collapse
|
4
|
Pisaltu S, Ruotolo I, Sellitto G, Berardi A, Simeon R, Fabbrini G, Galeoto G. Validity and reliability of the Italian version of the short Parkinson's evaluation scale (SPES/SCOPA). Heliyon 2024; 10:e32877. [PMID: 39021984 PMCID: PMC11253227 DOI: 10.1016/j.heliyon.2024.e32877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Background In the medical and rehabilitative field, it is essential to employ tools such as evaluation scales and performance tests to assess the impact of Parkinson's disease on QoL of affected individuals. The Short Parkinson's Evaluation Scale (SPES) is a reliable and valid tool, applicable both in research and clinical practices, useful in assessing motor damage, activities of daily living, and motor complications in patients with Parkinson's disease. The aim of the study is to investigate validity and reliability of the Italian version of the SPES-SCOPA scale. Methods Translation and cultural adaptation were performed. Included patients had diagnosis of Parkinson's disease, no concurrent pathologies, MiniMental test score above 2 and signed informed consent; they were recruited at the Department of Human Neurosciences in Sapienza University of Rome, from February 2023 to November 2023. Test-retest reliability was evaluated through Intraclass Correlation Coefficient (ICC), internal consistency was assessed using Cronbach's Alpha and construct validity using Pearson's correlation between SPES-SCOPA and the gold standard PDQ-39. Results 101 patients were recruited. Inter-rater evaluation was conducted on 62 patients, while 39 underwent an intra-rater assessment. The analysis showed statistically significant data with a Cronbach's Alpha value of 0.89 for the entire scale; test-retest reliability results are statistically significant for all subscales. Correlation between PDQ-39 domains and SPES/SCOPA subscales were statistically significant for most measurements. Conclusion This research shows that the Italian version of SPES-SCOPA scale has excellent psychometric properties.
Collapse
Affiliation(s)
| | - I. Ruotolo
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - G. Sellitto
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - A. Berardi
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - R. Simeon
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
| | - G. Fabbrini
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy
| | - G. Galeoto
- Sapienza University of Rome, Department of Human Neuroscience, 00185, Rome, Italy
- IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, IS, Italy
| |
Collapse
|
5
|
Frouni I, Kwan C, Bédard D, Hamadjida A, Kang W, Belliveau S, Nuara SG, Gourdon JC, Huot P. Effect of mGluR 2 and mGluR 2/3 activators on parkinsonism in the MPTP-lesioned non-human primate. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03216-2. [PMID: 38900249 DOI: 10.1007/s00210-024-03216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
We have previously discovered that the selective activation of metabotropic glutamate type 2 receptors (mGluR2) and concurrent stimulation of metabotropic glutamate types 2 and 3 receptors (mGluR2/3) enhance the anti-parkinsonian action of L-3,4-dihydroxyphenylalanine (L-DOPA). Here, we sought to determine the effects of the mGluR2/3 orthosteric agonists LY-354,740 and LY-404,039, as well as the effects of the mGluR2 positive allosteric modulators LY-487,379 and CBiPES on the range of movement, bradykinesia, posture and alertness as adjuncts to L-DOPA. Ten 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmosets entered 4 experimental streams: L-DOPA + LY-354,740 (vehicle, 0.1, 0.3 and 1 mg/kg), L-DOPA + LY-404,039 (vehicle, 0.1, 1 and 10 mg/kg), L-DOPA + LY-487,379 (vehicle, 0.1, 1 and 10 mg/kg), L-DOPA + CBiPES (vehicle, 0.1, 1 and 10 mg/kg). For each molecule, treatments were randomised, and the range of movement, bradykinesia, posture and alertness were assessed by a blinded rater. None of the tested compounds significantly altered the global range of movement. LY-404,039 and CBiPES both reduced global bradykinesia, by up to 46% (both P < 0.05). LY-354,740, LY-404,039 and CBiPES each improved global posture by 35%, 44% and 39% (each P < 0.05), respectively. LY-404,039 and CBiPES both enhanced alertness by 54% (P < 0.05) and 79% (P < 0.01), respectively. LY-487,379 did not improve any of the parameters. Our results suggest that selective mGluR2 positive allosteric modulation and combined mGluR2/3 orthosteric stimulation might benefit bradykinesia, posture and alertness in PD when added to L-DOPA, which potentially represent novel therapeutic indications for molecules acting via these mechanisms.
Collapse
Affiliation(s)
- Imane Frouni
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Cynthia Kwan
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Dominique Bédard
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Adjia Hamadjida
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Woojin Kang
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Sébastien Belliveau
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada
| | - Stephen G Nuara
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, Quebec, Canada
| | - Jim C Gourdon
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, Quebec, Canada
| | - Philippe Huot
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), 3801 University St, Montreal, Quebec, H3A 2B4, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
- Movement Disorder Clinic, Division of Neurology, Department of Neurosciences, McGill University Health Centre, Montreal, Quebec, Canada.
| |
Collapse
|
6
|
Kang W, Frouni I, Bédard D, Kwan C, Hamadjida A, Nuara SG, Gourdon JC, Huot P. Positive allosteric mGluR 2 modulation with BINA alleviates dyskinesia and psychosis-like behaviours in the MPTP-lesioned marmoset. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03215-3. [PMID: 38861009 DOI: 10.1007/s00210-024-03215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/03/2024] [Indexed: 06/12/2024]
Abstract
There is mounting evidence that positive allosteric modulation of metabotropic glutamate type 2 receptors (mGluR2) is an efficacious approach to reduce the severity of L-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesia, psychosis-like behaviours (PLBs), while conferring additional anti-parkinsonian benefit. However, the mGluR2 positive allosteric modulators (PAMs) tested so far, LY-487,379 and CBiPES, share a similar chemical scaffold. Here, we sought to assess whether similar benefits would be conferred by a structurally-distinct mGluR2 PAM, biphenylindanone A (BINA). Six 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmosets exhibiting dyskinesia and PLBs were administered L-DOPA with either vehicle or BINA (0.1, 1, and 10 mg/kg) in a randomised within-subject design and recorded. Behaviour was analysed by a blinded rater who scored the severity of each of parkinsonism, dyskinesia and PLBs. When added to L-DOPA, BINA 0.1 mg/kg, 1 mg/kg, and 10 mg/kg all significantly reduced the severity of global dyskinesia, by 40%, 52% and 53%, (all P < 0.001) respectively. BINA similarly attenuated the severity of global PLBs by 35%, 48%, and 50%, (all P < 0.001) respectively. Meanwhile, BINA did not alter the effect of L-DOPA on parkinsonism exhibited by the marmosets. The results of this study provide incremental evidence of positive allosteric modulation of mGluR2 as an effective therapeutic strategy for alleviating dyskinesia and PLBs, without hindering the anti-parkinsonian action of L-DOPA. Furthermore, this therapeutic benefit does not appear to be confined to a particular chemical scaffold.
Collapse
Affiliation(s)
- Woojin Kang
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Imane Frouni
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Dominique Bédard
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Cynthia Kwan
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Adjia Hamadjida
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada
| | - Stephen G Nuara
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, QC, Canada
| | - Jim C Gourdon
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, QC, Canada
| | - Philippe Huot
- Neurodegenerative Disease Group, Montreal Neurological Institute-Hospital (The Neuro), Montreal, QC, Canada.
- Comparative Medicine & Animal Resource Centre, McGill University, Montreal, QC, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
- Department of Neurosciences, McGill University Health Centre, Montreal, QC, Canada.
| |
Collapse
|
7
|
Schulte PFJ. Can clozapine be used for treatment-refractory behavioral and psychological symptoms in dementia patients? Schizophr Res 2024; 268:285-288. [PMID: 37479589 DOI: 10.1016/j.schres.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/08/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Peter F J Schulte
- Mental Health Services Noord-Holland-Noord, Alkmaar, the Netherlands.
| |
Collapse
|
8
|
Gilmour W, Mackenzie G, Feile M, Tayler-Grint L, Suveges S, Macfarlane JA, Macleod AD, Marshall V, Grunwald IQ, Steele JD, Gilbertson T. Impaired value-based decision-making in Parkinson's disease apathy. Brain 2024; 147:1362-1376. [PMID: 38305691 PMCID: PMC10994558 DOI: 10.1093/brain/awae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/07/2023] [Accepted: 01/13/2024] [Indexed: 02/03/2024] Open
Abstract
Apathy is a common and disabling complication of Parkinson's disease characterized by reduced goal-directed behaviour. Several studies have reported dysfunction within prefrontal cortical regions and projections from brainstem nuclei whose neuromodulators include dopamine, serotonin and noradrenaline. Work in animal and human neuroscience have confirmed contributions of these neuromodulators on aspects of motivated decision-making. Specifically, these neuromodulators have overlapping contributions to encoding the value of decisions, and influence whether to explore alternative courses of action or persist in an existing strategy to achieve a rewarding goal. Building upon this work, we hypothesized that apathy in Parkinson's disease should be associated with an impairment in value-based learning. Using a four-armed restless bandit reinforcement learning task, we studied decision-making in 75 volunteers; 53 patients with Parkinson's disease, with and without clinical apathy, and 22 age-matched healthy control subjects. Patients with apathy exhibited impaired ability to choose the highest value bandit. Task performance predicted an individual patient's apathy severity measured using the Lille Apathy Rating Scale (R = -0.46, P < 0.001). Computational modelling of the patient's choices confirmed the apathy group made decisions that were indifferent to the learnt value of the options, consistent with previous reports of reward insensitivity. Further analysis demonstrated a shift away from exploiting the highest value option and a reduction in perseveration, which also correlated with apathy scores (R = -0.5, P < 0.001). We went on to acquire functional MRI in 59 volunteers; a group of 19 patients with and 20 without apathy and 20 age-matched controls performing the Restless Bandit Task. Analysis of the functional MRI signal at the point of reward feedback confirmed diminished signal within ventromedial prefrontal cortex in Parkinson's disease, which was more marked in apathy, but not predictive of their individual apathy severity. Using a model-based categorization of choice type, decisions to explore lower value bandits in the apathy group activated prefrontal cortex to a similar degree to the age-matched controls. In contrast, Parkinson's patients without apathy demonstrated significantly increased activation across a distributed thalamo-cortical network. Enhanced activity in the thalamus predicted individual apathy severity across both patient groups and exhibited functional connectivity with dorsal anterior cingulate cortex and anterior insula. Given that task performance in patients without apathy was no different to the age-matched control subjects, we interpret the recruitment of this network as a possible compensatory mechanism, which compensates against symptomatic manifestation of apathy in Parkinson's disease.
Collapse
Affiliation(s)
- William Gilmour
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Department of Neurology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - Graeme Mackenzie
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Department of Neurology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| | - Mathias Feile
- Rehabilitation Psychiatry, Murray Royal Hospital, Perth PH2 7BH, UK
| | | | - Szabolcs Suveges
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Jennifer A Macfarlane
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Medical Physics, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
- SINAPSE, University of Glasgow, Imaging Centre of Excellence, Level 2, Queen Elizabeth University Hospital, Glasgow G51 4TF, Scotland, UK
| | - Angus D Macleod
- Institute of Applied Health Sciences, School of Medicine, University of Aberdeen, Foresterhill, Aberdeen AB24 2ZD, UK
- Department of Neurology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB24 2ZD, UK
| | - Vicky Marshall
- Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Iris Q Grunwald
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - J Douglas Steele
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Tom Gilbertson
- Division of Imaging Science and Technology, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
- Department of Neurology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
| |
Collapse
|
9
|
Hatano T, Oyama G, Shimo Y, Ogaki K, Nishikawa N, Nakamura R, Tsunemi T, Ogawa T, Eguchi H, Daida K, Kurita N, Ueno SI, Fukae J, Sako W, Shiina K, Nakajima S, Oji Y, Wakamori R, Saiki S, Nishioka K, Okuzumi A, Taniguchi D, Takeshige-Amano H, Fuse A, Nakajima A, Kano M, Kamo H, Yamashita Y, Shindo A, Yanagisawa N, Hattori N. Efficacy and Safety of Elobixibat in Parkinson's Disease with Chronic Constipation: CONST-PD Study. Mov Disord Clin Pract 2024; 11:352-362. [PMID: 38264844 PMCID: PMC10982595 DOI: 10.1002/mdc3.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Chronic constipation is a common digestive complication of Parkinson's disease (PD). OBJECTIVES To verify the usefulness of elobixibat, an ileal bile acid transporter inhibitor, for chronic constipation in PD. METHODS This double-blind, placebo-controlled study consisted of a 2-week observation/washout period and a 4-week treatment period. All patients received a Bowel Movement Diary at Week -2 and were allocated to elobixibat (10 mg) or placebo at Week 0. Patients visited at Weeks 2 and 4 to report daily spontaneous bowel movements (SBM), stool form, drug use, quality of life (QOL), and safety. Changes in these parameters were assessed. RESULTS The study included 38 patients in the elobixibat group and 39 in the placebo group, and 37 each completed the study. SBM frequency/week (mean ± standard deviation) increased significantly from 4.2 ± 2.6 at baseline to 5.9 ± 3.2 at Week 4 in the elobixibat group (P = 0.0079), but not in the placebo group (4.5 ± 2.7 to 5.3 ± 3.5; P = 0.0889). On analysis of covariance, the between-group difference in frequency changes at Week 4 (primary endpoint) was not significant after adjustment by baseline and sex (point estimate = 0.8; 95% confidence interval = -0.57 to 2.09, P = 0.2601), although a significant difference (P = 0.0011) was evidenced at Week 1 by a similar analysis. Stool form and scores of satisfaction and stigma were improved by elobixibat. Adverse events were as previously reported. CONCLUSIONS Elobixibat improved the SBM frequency, though the defined primary endpoint was not evidenced. QOL parameters (stool consistency and treatment satisfaction) were also improved. Elobixibat may have therapeutic benefits in PD patients suffering from chronic constipation. TRIAL REGISTRATION INFORMATION Trial Registration Number: JPRN-jRCTs031200172 (submitted: October 26, 2020; first patient enrolment: December 23, 2020; https://jrct.niph.go.jp/en-latest-detail/jRCTs031200172).
Collapse
Affiliation(s)
- Taku Hatano
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Kotaro Ogaki
- Department of Neurology, Juntendo Urayasu Hospital, Urayasu, Japan
| | - Noriko Nishikawa
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ryota Nakamura
- Department of Neurology, Juntendo Urayasu Hospital, Urayasu, Japan
| | - Taiji Tsunemi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takashi Ogawa
- Department of Neurology, Juntendo Urayasu Hospital, Urayasu, Japan
| | - Hiroto Eguchi
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Kensuke Daida
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Naohide Kurita
- Department of Neurology, Juntendo Urayasu Hospital, Urayasu, Japan
| | - Shin-Ichi Ueno
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Wataru Sako
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kenta Shiina
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Sho Nakajima
- Department of Neurology, Juntendo Urayasu Hospital, Urayasu, Japan
| | - Yutaka Oji
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ryo Wakamori
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shinji Saiki
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ayami Okuzumi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Daisuke Taniguchi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - Atsuhito Fuse
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Asuka Nakajima
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Masayoshi Kano
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Hikaru Kamo
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuri Yamashita
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsuhiko Shindo
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Naotake Yanagisawa
- Juntendo Clinical Research and Trial Center, Juntendo University Hospital, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
10
|
Summa KC, Jiang P, González-Rodríguez P, Huang X, Lin X, Vitaterna MH, Dan Y, Surmeier DJ, Turek FW. Disrupted sleep-wake regulation in the MCI-Park mouse model of Parkinson's disease. NPJ Parkinsons Dis 2024; 10:54. [PMID: 38467673 PMCID: PMC10928107 DOI: 10.1038/s41531-024-00670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
Disrupted sleep has a profound adverse impact on lives of Parkinson's disease (PD) patients and their caregivers. Sleep disturbances are exceedingly common in PD, with substantial heterogeneity in type, timing, and severity. Among the most common sleep-related symptoms reported by PD patients are insomnia, excessive daytime sleepiness, and sleep fragmentation, characterized by interruptions and decreased continuity of sleep. Alterations in brain wave activity, as measured on the electroencephalogram (EEG), also occur in PD, with changes in the pattern and relative contributions of different frequency bands of the EEG spectrum to overall EEG activity in different vigilance states consistently observed. The mechanisms underlying these PD-associated sleep-wake abnormalities are poorly understood, and they are ineffectively treated by conventional PD therapies. To help fill this gap in knowledge, a new progressive model of PD - the MCI-Park mouse - was studied. Near the transition to the parkinsonian state, these mice exhibited significantly altered sleep-wake regulation, including increased wakefulness, decreased non-rapid eye movement (NREM) sleep, increased sleep fragmentation, reduced rapid eye movement (REM) sleep, and altered EEG activity patterns. These sleep-wake abnormalities resemble those identified in PD patients. Thus, this model may help elucidate the circuit mechanisms underlying sleep disruption in PD and identify targets for novel therapeutic approaches.
Collapse
Affiliation(s)
- K C Summa
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA.
| | - P Jiang
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
- Neuroscience Discovery, Informatics and Predictive Sciences, Bristol Myers Squibb, Cambridge, MA, USA
| | - P González-Rodríguez
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla and CIBERNED, Seville, Spain
| | - X Huang
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, USA
| | - X Lin
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
| | - M H Vitaterna
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
| | - Y Dan
- Department of Molecular & Cell Biology, University of California Berkeley, Berkeley, CA, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - D J Surmeier
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD, 20815, USA
| | - F W Turek
- Center for Sleep & Circadian Biology, Northwestern University, Evanston, IL, USA
- Department of Neurobiology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
- The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
11
|
Huang X, Dong K, Gan C, Xu Z, Lei D, Dong X, Liu H, Chen X. Effect of Rhythmically Cued Exercise Interventions on Functions in Patients With Parkinson Disease: A Meta-Analysis. Phys Ther 2024; 104:pzad158. [PMID: 37962936 DOI: 10.1093/ptj/pzad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 07/06/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease. METHODS PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203). RESULTS A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups. CONCLUSION Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation. IMPACT This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
Collapse
Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chu Gan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xinghua Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
12
|
Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
Collapse
Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
| | | |
Collapse
|
13
|
Balasubramanian S, Mehmood KT, Al-Baldawi S, Zúñiga Salazar G, Zúñiga D. Behind the Mask: Parkinson's Disease and Depression. Cureus 2024; 16:e52663. [PMID: 38380213 PMCID: PMC10877222 DOI: 10.7759/cureus.52663] [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] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
Parkinson's disease (PD) is a common, prevalent neurodegenerative disease. It is mainly characterized by motor symptoms such as rigidity, tremors, and bradykinesia, but it can also manifest with non-motor symptoms, of which depression is the most frequent. The latter can impair the quality of life, yet it gets overlooked and goes untreated because of the significant overlap in their clinical features, hence making the diagnosis difficult. Furthermore, there is limited data on the availability of appropriate criteria for making the diagnosis of depression in PD patients, as it can occur with varying expressions throughout the course of PD or it can also precede it. This review article has included a brief discussion on the diagnosis of depression in PD patients and their overlapped clinical manifestations. Understanding the mechanisms underlying the disease processes of PD and depression and the pathways interconnecting them gives better knowledge on devising treatment options for the patients. Only studies from Pubmed were included and all other databases were excluded. Studies from the last 50 years were included. Suitable references included in these studies were also extracted. Thus, depression in PD and PD in depression, along with their pharmacological and non-pharmacological treatment options, have been discussed.
Collapse
Affiliation(s)
| | | | | | | | - Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
| |
Collapse
|
14
|
van Wamelen DJ, Leta V, Chaudhuri KR, Jenner P. Future Directions for Developing Non-dopaminergic Strategies for the Treatment of Parkinson's Disease. Curr Neuropharmacol 2024; 22:1606-1620. [PMID: 37526188 PMCID: PMC11284721 DOI: 10.2174/1570159x21666230731110709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 08/02/2023] Open
Abstract
The symptomatic treatment of Parkinson's disease (PD) has been dominated by the use of dopaminergic medication, but significant unmet need remains, much of which is related to non-motor symptoms and the involvement of non-dopaminergic transmitter systems. As such, little has changed in the past decades that has led to milestone advances in therapy and significantly improved treatment paradigms and patient outcomes, particularly in relation to symptoms unresponsive to levodopa. This review has looked at how pharmacological approaches to treatment are likely to develop in the near and distant future and will focus on two areas: 1) novel non-dopaminergic pharmacological strategies to control motor symptoms; and 2) novel non-dopaminergic approaches for the treatment of non-motor symptoms. The overall objective of this review is to use a 'crystal ball' approach to the future of drug discovery in PD and move away from the more traditional dopamine-based treatments. Here, we discuss promising non-dopaminergic and 'dirty drugs' that have the potential to become new key players in the field of Parkinson's disease treatment.
Collapse
Affiliation(s)
- Daniel J. van Wamelen
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Valentina Leta
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - K. Ray Chaudhuri
- Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence at King’s College Hospital NHS Foundation Trust, London, United Kingdom
| | - Peter Jenner
- School of Cancer & Pharmaceutical Sciences, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| |
Collapse
|
15
|
de Andrade DC, Mylius V, Perez-Lloret S, Cury RG, Bannister K, Moisset X, Taricani Kubota G, Finnerup NB, Bouhassira D, Chaudhuri KR, Graven-Nielsen T, Treede RD. Pain in Parkinson disease: mechanistic substrates, main classification systems, and how to make sense out of them. Pain 2023; 164:2425-2434. [PMID: 37318012 DOI: 10.1097/j.pain.0000000000002968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/02/2023] [Indexed: 06/16/2023]
Abstract
ABSTRACT Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause of functional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD both in prodromal phases and during the subsequent stages of the disease, negatively affecting patient's quality of life and function. Pain in PwPD is rather heterogeneous and may occur because of different mechanisms. Targeting motor symptoms by dopamine replacement or with neuromodulatory approaches may only partially control PD-related pain. Pain in general has been classified in PwPD according to the motor signs, pain dimensions, or pain subtypes. Recently, a new classification framework focusing on chronic pain was introduced to group different types of PD pains according to mechanistic descriptors: nociceptive, neuropathic, or neither nociceptive nor neuropathic. This is also in line with the International Classification of Disease-11 , which acknowledges the possibility of chronic secondary musculoskeletal or nociceptive pain due to disease of the CNS. In this narrative review and opinion article, a group of basic and clinical scientists revise the mechanism of pain in PD and the challenges faced when classifying it as a stepping stone to discuss an integrative view of the current classification approaches and how clinical practice can be influenced by them. Knowledge gaps to be tackled by coming classification and therapeutic efforts are presented, as well as a potential framework to address them in a patient-oriented manner.
Collapse
Affiliation(s)
- Daniel Ciampi de Andrade
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Veit Mylius
- Department of Neurology, Centre for Neurorehabilitation, Valens, Switzerland
- Department of Neurology, Philipps University, Marburg, Germany
- Department of Neurology, Kantonsspital, St. Gallen, Switzerland
| | - Santiago Perez-Lloret
- Observatorio de Salud Pública, Universidad Católica Argentina, Consejo de Investigaciones Científicas y Técnicas (UCA-CONICET), Buenos Aires, Argentina
- Facultad de Medicina, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
- Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Rubens G Cury
- Movement Disorders Center, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil
| | - Kirsty Bannister
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Xavier Moisset
- Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, Clermont-Ferrand, France
| | - Gabriel Taricani Kubota
- Department of Neurology, Centre for Neurorehabilitation, Valens, Switzerland
- Pain Center, University of Sao Paulo Clinics Hospital, Sao Paulo, Brazil
- Center for Pain Treatment, Institute of Cancer of the State of Sao Paulo, University of Sao Paulo Clinics Hospital, Sao Paulo, Brazil
| | - Nanna B Finnerup
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Didier Bouhassira
- Inserm U987, APHP, UVSQ, Paris-Saclay University, Ambroise Pare Hospital, Boulogne-Billancourt, France
| | - Kallol Ray Chaudhuri
- Division of Neuroscience, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Parkinson Foundation Centre of Excellence in Care and Research, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Rolf-Detlef Treede
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences, Heidelberg University, Mannheim, Germany
| |
Collapse
|
16
|
Berthouzoz E, Lazarevic V, Zekeridou A, Castro M, Debove I, Aybek S, Schrenzel J, Burkhard PR, Fleury V. Oral and intestinal dysbiosis in Parkinson's disease. Rev Neurol (Paris) 2023; 179:937-946. [PMID: 36934020 DOI: 10.1016/j.neurol.2022.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/29/2022] [Accepted: 12/10/2022] [Indexed: 03/18/2023]
Abstract
The suspicion of an origin of Parkinson's disease (PD) at the periphery of the body and the involvement of environmental risk factors in the pathogenesis of PD have directed the attention of the scientific community towards the microbiota. The microbiota represents all the microorganisms residing both in and on a host. It plays an essential role in the physiological functioning of the host. In this article, we review the dysbiosis repeatedly demonstrated in PD and how it influences PD symptoms. Dysbiosis is associated with both motor and non-motor PD symptoms. In animal models, dysbiosis only promotes symptoms in individuals genetically susceptible to Parkinson's disease, suggesting that dysbiosis is a risk factor but not a cause of Parkinson's disease. We also review how dysbiosis contributes to the pathophysiology of PD. Dysbiosis induces numerous and complex metabolic changes, resulting in increased intestinal permeability, local and systemic inflammation, production of bacterial amyloid proteins that promote α-synuclein aggregation, as well as a decrease in short-chain fatty acid-producing bacteria that have anti-inflammatory and neuroprotective potential. In addition, we review how dysbiosis decreases the efficacy of dopaminergic treatments. We then discuss the interest of dysbiosis analysis as a biomarker of Parkinson's disease. Finally, we give an overview of how interventions modulating the gut microbiota such as dietary interventions, pro-biotics, intestinal decontamination and fecal microbiota transplantation could influence the course of PD.
Collapse
Affiliation(s)
- E Berthouzoz
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland
| | - V Lazarevic
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Genomic Research Laboratory, Department of Infectious Diseases, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - A Zekeridou
- Division of Regenerative Dentistry and Periodontology, University Clinic of Dental Medicine, University of Geneva, 1211 Geneva 4, Switzerland
| | - M Castro
- Movement disorders Unit, Department of Neurology, University Hospital of Lausanne, 1011 Lausanne, Switzerland
| | - I Debove
- Movement disorders Unit, Department of Neurology, Inselspital, 3010 Bern, Switzerland
| | - S Aybek
- Psychosomatic Medicine Unit, Department of Neurology, Inselspital, 3010 Bern, Switzerland
| | - J Schrenzel
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Genomic Research Laboratory, Department of Infectious Diseases, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - P R Burkhard
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Movement disorders Unit, Division of Neurology, Department of Clinical Neurosciences, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - V Fleury
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Movement disorders Unit, Division of Neurology, Department of Clinical Neurosciences, University Hospital of Geneva, 1211 Geneva 14, Switzerland.
| |
Collapse
|
17
|
Stocchi F, Angelo Antonini, Barone P, Bellelli G, Fagiolini A, Ferini Strambi L, Sorbi S, Padovani A. Exploring depression in Parkinson's disease: an Italian Delphi Consensus on phenomenology, diagnosis, and management. Neurol Sci 2023; 44:3123-3131. [PMID: 37100925 PMCID: PMC10415449 DOI: 10.1007/s10072-023-06740-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/05/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Depression is a prodromic and a frequent non-motor symptom of Parkinson's disease, associated to reduced quality of life and poor outcomes. The diagnosis of depression in parkinsonian patients represents a challenge due to the overlapping of symptoms typical of the two conditions. METHODS A Delphi panel survey was performed to reach a consensus amongst different Italian specialists on four main topics: the neuropathological correlates of depression, main clinical aspects, diagnosis, and management of depression in Parkinson's disease. RESULTS AND CONCLUSION Experts have recognized that depression is an established risk factor of PD and that its anatomic substrate is related to the neuropathological abnormalities typical of the disease. Multimodal and SSRI antidepressant have been confirmed as a valid therapeutic option in the treatment of depression in PD. Tolerability, safety profile, and potential efficacy on broad spectrum of symptoms of depression including cognitive symptoms and anhedonia should be considered when selecting an antidepressant and the choice should be tailored on the patients' characteristics.
Collapse
Affiliation(s)
- Fabrizio Stocchi
- University San Raffaele Rome and IRCCS San Raffaele, Rome, Italy.
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Center for Neurodegenerative Diseases (CENSE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Paolo Barone
- Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20126, Milan, Italy
- Acute Geriatric Unit, IRCCS San Gerardo, 20900, Monza, Italy
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena, School of Medicine, Siena, Italy
| | - Luigi Ferini Strambi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Neurology-Sleep Disorders Centre, Milan, Italy
- Vita-Salute" San Raffaele University, Milan, Italy
| | - Sandro Sorbi
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| |
Collapse
|
18
|
Pereira CDS, Cruz JN, Ferreira MKM, Baia-da-Silva DC, Fontes-Junior EA, Lima RR. Global Research Trends and Hotspots Analysis of the Scientific Production of Amitriptyline: A Bibliometric Approach. Pharmaceuticals (Basel) 2023; 16:1047. [PMID: 37513958 PMCID: PMC10386017 DOI: 10.3390/ph16071047] [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: 06/28/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Amitriptyline was first introduced as a medication to treat depression. Over time, this substance has been used to treat other conditions, such as gastrointestinal disorders, fibromyalgia, neuropathic pain, and analgesia, among others. However, there are no published studies that provide a broad view of the possible motivations that have led to changes in the use of amitriptyline. In this study, we have identified the landscape of use for amitriptyline based on knowledge mapping of the 100 most-cited articles about this drug. We searched Web of Science Core Collection without time and language restrictions. We obtained 14,446 results, but we only used the 100 most-cited articles that had amitriptyline as the object of study. We collected the following information from each article: authors, country of the corresponding authors, year of publication, citation count, citation density (number of citations per year), and keywords. In addition, we seek to map in the chosen articles study design and research findings. We found that since 1980, the use of amitriptyline has expanded beyond depression, moving to off-label use to treat a variety of diseases and conditions, including post-herpetic neuralgia, neuropathic pain, primary fibrosis, fibromyalgia, and migraine, can be considered a drug with more clinical applicability than its original clinical indication.
Collapse
Affiliation(s)
- Cristian Dos Santos Pereira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University do Pará, Belém 66075-110, Brazil
| | - Jorddy Neves Cruz
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University do Pará, Belém 66075-110, Brazil
| | - Maria Karolina Martins Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University do Pará, Belém 66075-110, Brazil
| | - Daiane Claydes Baia-da-Silva
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University do Pará, Belém 66075-110, Brazil
| | - Eneas Andrade Fontes-Junior
- Laboratory of Pharmacology of Inflammation and Behavior, Federal University of Pará, Belém 66075-110, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University do Pará, Belém 66075-110, Brazil
| |
Collapse
|
19
|
Price DL, Khan A, Angers R, Cardenas A, Prato MK, Bani M, Bonhaus DW, Citron M, Biere AL. In vivo effects of the alpha-synuclein misfolding inhibitor minzasolmin supports clinical development in Parkinson's disease. NPJ Parkinsons Dis 2023; 9:114. [PMID: 37460603 PMCID: PMC10352257 DOI: 10.1038/s41531-023-00552-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
Direct targeting of alpha-synuclein (ASYN) has emerged as a disease-modifying strategy for Parkinson's disease and other synucleinopathies which is being approached using both small molecule compounds and ASYN-targeted biologics. Minzasolmin (UCB0599) is an orally bioavailable and brain-penetrant small molecule ASYN misfolding inhibitor in clinical development as a disease-modifying therapeutic for Parkinson's disease. Herein the results of preclinical evaluations of minzasolmin that formed the basis for subsequent clinical development are described. Pharmacokinetic evaluations of intraperitoneal 1 and 5 mg/kg minzasolmin in wildtype mice revealed parallel and dose-proportional exposures in brain and plasma. Three-month administration studies in the Line 61 transgenic mouse model of PD were conducted to measure ASYN pathology and other PD-relevant endpoints including markers of CNS inflammation, striatal DAT labeling and gait. Reductions in ASYN pathology were correlated with improved aspects of gait and balance, reductions in CNS inflammation marker abundance, and normalized striatal DAT levels. These findings provide support for human dose determinations and have informed the translational strategy for clinical trial design and biomarker selection for the ongoing clinical studies of minzasolmin in patients living with early-stage Parkinson's disease (ClinicalTrials.gov ID: NCT04658186; EudraCT Number 2020-003265).
Collapse
Affiliation(s)
| | - Asma Khan
- Neuropore Therapies, Inc., San Diego, CA, USA
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Jin ZH, Wang YX, Meng DT, Qin Y, Duan YN, Fang JP, Wang RD, Liu YJ, Liu C, Wang P, Yan HJ, Zhen Y, An X, Chen KK, Yu X, Lyu D, Yan XY, Fang BY. Intermittent theta-burst stimulation combined with physical therapy as an optimal rehabilitation in Parkinson's disease: study protocol for a randomised, double-blind, controlled trial. Trials 2023; 24:410. [PMID: 37328845 DOI: 10.1186/s13063-023-07425-7] [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: 11/10/2022] [Accepted: 06/02/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND First-line rehabilitative strategies to improve motor deficits are based on functional training (physical or occupational therapy), which has been demonstrated to facilitate neural reorganisation. Accumulating evidence suggests that non-invasive brain stimulation techniques, such as repetitive TMS (rTMS), may enhance neuroplasticity, thereby facilitating neural reorganisation and recovery from Parkinson's disease. Evidence also shows that intermittent theta-burst stimulation (iTBS) can improve motor function and quality of life in patients by promoting the excitability and neural remodelling of cerebral cortex. We aimed to combine iTBS stimulation with physiotherapy to improve the rehabilitation effect compared to physiotherapy alone in patients with Parkinson's disease. METHODS This randomised, double-blind clinical trial will enrol 50 Parkinson's disease patients aged 45-70 years with Hoehn and Yahr scale scores of 1-3. Patients are randomly assigned to either the iTBS + physiotherapy or sham-iTBS + physiotherapy group. The trial consists of a 2-week double-blind treatment period and a 24-week follow-up period. iTBS and sham-iTBS will be administered twice daily for 10 days based on physiotherapy. The primary outcome will be the third part of Movement Disorders-Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) from the baseline to the first 2 days following completion hospitalised intervention. The secondary outcome will be 39-item Parkinson's Disease Questionnaire (PDQ-39) at 4 weeks, 12 weeks and 24 weeks after intervention. Tertiary outcomes are clinical evaluations and mechanism study outcomes such as NMSS, 6MWD, 10MT, TUG, BBS, MRI, and EEG, the length of time between the drug needs to be adjusted when symptoms fluctuate. DISCUSSION The aim of this study is to demonstrate that iTBS can promote overall function and quality of life in Parkinson's disease patients using physiotherapy and that this efficacy may be associated with altered neuroplasticity in exercise-related brain regions. The iTBS combined with physiotherapy training model will be evaluated during a 6-month follow-up period. With significant improvement in quality of life and motor function, iTBS combined with physiotherapy can be considered as a first-line rehabilitation option for Parkinson's disease. The potential of iTBS to enhance neuroplasticity in the brain should have a more positive impact in increasing the generality and efficiency of physiotherapy, improving the quality of life and overall functional status of patients with Parkinson's disease. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200056581. Registered on 8 February 2022.
Collapse
Affiliation(s)
- Zhao-Hui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Yi-Xuan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - De-Tao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Yi Qin
- Capital Medical University, Beijing, China
| | | | - Jin-Ping Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Rui-Dan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Yan-Jun Liu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Cui Liu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Ping Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Hong-Jiao Yan
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Yi Zhen
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Xia An
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Ke-Ke Chen
- Capital Medical University, Beijing, China
| | - Xin Yu
- Capital Medical University, Beijing, China
| | - Diyang Lyu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China
| | - Xiao-Yan Yan
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Bo-Yan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Badachu, Xixiazhuang, Shijingshan District, Bejing, 100144, China.
| |
Collapse
|
21
|
Regensburger M, Ip CW, Kohl Z, Schrader C, Urban PP, Kassubek J, Jost WH. Clinical benefit of MAO-B and COMT inhibition in Parkinson's disease: practical considerations. J Neural Transm (Vienna) 2023; 130:847-861. [PMID: 36964457 PMCID: PMC10199833 DOI: 10.1007/s00702-023-02623-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 03/16/2023] [Indexed: 03/26/2023]
Abstract
Inhibitors of monoamine oxidase B (MAO-B) and catechol-O-methyltransferase (COMT) are major strategies to reduce levodopa degradation and thus to increase and prolong its effect in striatal dopaminergic neurotransmission in Parkinson's disease patients. While selegiline/rasagiline and tolcapone/entacapone have been available on the market for more than one decade, safinamide and opicapone have been approved in 2015 and 2016, respectively. Meanwhile, comprehensive data from several post-authorization studies have described the use and specific characteristics of the individual substances in clinical practice under real-life conditions. Here, we summarize current knowledge on both medication classes, with a focus on the added clinical value in Parkinson's disease. Furthermore, we outline practical considerations in the treatment of motor fluctuations and provide an outlook on ongoing studies with MAO-B and COMT inhibitors.
Collapse
Affiliation(s)
- Martin Regensburger
- Department of Molecular Neurology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Chi Wang Ip
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Zacharias Kohl
- Department of Neurology, University of Regensburg, Regensburg, Germany
| | | | - Peter P Urban
- Abt. für Neurologie, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Jan Kassubek
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | | |
Collapse
|
22
|
Heim B, Peball M, Krismer F, Djamshidian A, Seppi K. Pimavanserin: A Truly Effective Treatment for Parkinson's Disease Psychosis? A Review of Interventions. Neuropsychiatr Dis Treat 2023; 19:1303-1312. [PMID: 37274140 PMCID: PMC10239266 DOI: 10.2147/ndt.s371641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/20/2023] [Indexed: 06/06/2023] Open
Abstract
Parkinson's disease (PD) is the second-most common neurodegenerative disorder with a long-term 60% cumulative prevalence of PD psychosis. Medical treatment is limited to few atypical antipsychotic drugs with low affinity to dopamine D2 receptors. In 2016, pimavanserin, a selective 5-HT2A inverse agonist/antagonist, was approved by the US Food and Drug Administration (FDA) as the only treatment for PD psychosis (PDP). This article provides an overview of the epidemiology, pathophysiology, and treatment options for PDP and illuminates the mode of action and therapy options with pimavanserin and the current study data.
Collapse
Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marina Peball
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
23
|
Xu Y, Geng C, Tang T, Huang J, Hou Y. How to prevent cognitive overload in the walking-arithmetic dual task among patients with Parkinson's disease. BMC Neurol 2023; 23:205. [PMID: 37231372 DOI: 10.1186/s12883-023-03231-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Participants with Parkinson's disease (PD) may experience difficulty during certain dual-task (DT) tests. Thus, it is necessary to keep the cognitive load within the limits of their ability. OBJECTIVE To identify cognitive overload and its influence on the walking and auditory addition and subtraction (AAS, all values within the range of 0-20) DT performance of patients with PD. STUDY DESIGN A cross-sectional observational study with convenience sampling. SETTING Outpatient clinic of the Department of Neurology. SUBJECTS Sixteen patients with PD and 15 sex- and age- matched people elderly healthy controls (HCs). METHODS Verbal calculation responses and gait parameters were collected from the two groups in the 2-min single arithmetic task (2-min SAT), 2-min single walking task (2-min SWT), and 2-min walking-arithmetic dual task (2-min WADT). RESULTS The group differences in the lower-limb gait parameters increased in the 2-min WADT (P < 0.01), and those in the arm, trunk, and waist parameters did not change (P > 0.05). In the 2-min SAT, the calculation speed of the PD group was significantly lower than that of the HC group (P < 0.01). In the 2-min WADT, both groups made more errors (P < 0.05), especially the PD group (P = 0.00). PD group miscalculations occurred in the first half of the 2-min SAT but were uniformly distributed in the 2-min WADT. The HC group and PD group had subtraction self-correction rates of 31.25% and 10.25%, respectively. The PD group tended to make subtraction errors when the value of the first operand was 20 or 13.46 ± 2.60 and when the value of the second and third operands were 7.75 ± 2.51 (P = 0.3657) and 8.50 ± 4.04 (P = 0.170), respectively. CONCLUSIONS Cognitive overload was observed in patients with PD. This was mainly reflected in the failure of gait control and accurate calculation, indicated by gait parameters of the lower limbs and accuracy of calculation. To impose a constant cognitive load, the amount added or subtracted, especially in subtraction with borrowing, should not be mixed during a sequential arithmetic problem in the DT, and equations with the value of the first operand equal to 20 or approximately 13, the value of the second operand approximately 7, or the value of the third operand of approximately 9 should be excluded in the AAS DT. TRIAL REGISTRATION Clinical trial registration number: ChiCTR1800020158.
Collapse
Affiliation(s)
- Ying Xu
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, No. 286 Guangji Road, Suzhou, Jiangsu, 215000, China
| | - Canru Geng
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, No. 286 Guangji Road, Suzhou, Jiangsu, 215000, China
| | - Tong Tang
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, No. 286 Guangji Road, Suzhou, Jiangsu, 215000, China
| | - Juanying Huang
- Department of Neurology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou, Jiangsu, 215000, China.
| | - Ying Hou
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, No. 286 Guangji Road, Suzhou, Jiangsu, 215000, China.
| |
Collapse
|
24
|
Deuschl G, Antonini A, Costa J, Śmiłowska K, Berg D, Corvol JC, Fabbrini G, Ferreira J, Foltynie T, Mir P, Schrag A, Seppi K, Taba P, Ruzicka E, Selikhova M, Henschke N, Villanueva G, Moro E. Confusion of evidence-based reviews and guidelines. Eur J Neurol 2023; 30:1834-1836. [PMID: 36942357 DOI: 10.1111/ene.15581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 03/23/2023]
Affiliation(s)
- Günther Deuschl
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padova, Italy
| | - Joao Costa
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Katarzyna Śmiłowska
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Jean-Christophe Corvol
- Department of Neurology, Centre d'Investigation Clinique Neurosciences, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Pitié-Salpêtrière Hospital, Paris, France
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Roma, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Joaquim Ferreira
- Faculdade de Medicina, Universidade de Lisboa, IMM Instituto de Medicina Molecular João Lobo Antunes, Lisbon, CNS Campus Neurológico, Torres Vedras, Portugal
| | - Tom Foltynie
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK
| | - Pablo Mir
- Unidad de Trastornos del Movimiento Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
- Departamento de Medicina Facultad de Medicina, Universidad de Sevilla, Seville, Spain
| | - Anette Schrag
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, UK
| | - Klaus Seppi
- Klinik f. Neurologie, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
| | - Evzen Ruzicka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Marianna Selikhova
- Department of Neurology, Pirogov Russian National Research Medical University, Moscow, Russia
| | | | | | - Elena Moro
- Division of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, INSERM U1216, Grenoble Alpes University, Grenoble, France
| |
Collapse
|
25
|
Development of Small Molecules Targeting α-Synuclein Aggregation: A Promising Strategy to Treat Parkinson’s Disease. Pharmaceutics 2023; 15:pharmaceutics15030839. [PMID: 36986700 PMCID: PMC10059018 DOI: 10.3390/pharmaceutics15030839] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Parkinson’s disease, the second most common neurodegenerative disorder worldwide, is characterized by the accumulation of protein deposits in the dopaminergic neurons. These deposits are primarily composed of aggregated forms of α-Synuclein (α-Syn). Despite the extensive research on this disease, only symptomatic treatments are currently available. However, in recent years, several compounds, mainly of an aromatic character, targeting α-Syn self-assembly and amyloid formation have been identified. These compounds, discovered by different approaches, are chemically diverse and exhibit a plethora of mechanisms of action. This work aims to provide a historical overview of the physiopathology and molecular aspects associated with Parkinson’s disease and the current trends in small compound development to target α-Syn aggregation. Although these molecules are still under development, they constitute an important step toward discovering effective anti-aggregational therapies for Parkinson’s disease.
Collapse
|
26
|
Deuschl G, Antonini A, Costa J, Śmiłowska K, Berg D, Corvol JC, Fabbrini G, Ferreira J, Foltynie T, Mir P, Schrag A, Seppi K, Taba P, Ruzicka E, Selikhova M, Henschke N, Villanueva G, Moro E. Confusion of Evidence-Based Reviews and Guidelines. Mov Disord 2023; 38:511-513. [PMID: 36942366 DOI: 10.1002/mds.29254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 03/23/2023] Open
Affiliation(s)
- Günther Deuschl
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padova, Italy
| | - Joao Costa
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Katarzyna Śmiłowska
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, UKSH-Kiel Campus, Christian-Albrechts-University, Kiel, Germany
| | - Jean-Christophe Corvol
- Department of Neurology, Centre d'Investigation Clinique Neurosciences, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Pitié-Salpêtrière Hospital, Paris, France
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Roma, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Joaquim Ferreira
- Faculdade de Medicina, Universidade de Lisboa, IMM Instituto de Medicina Molecular João Lobo Antunes, Lisbon, CNS Campus Neurológico, Torres Vedras, Portugal
| | - Tom Foltynie
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Pablo Mir
- Unidad de Trastornos del Movimiento Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
- Departamento de Medicina Facultad de Medicina, Universidad de Sevilla, Seville, Spain
| | - Anette Schrag
- Department of Clinical & Movement Neurosciences, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Klaus Seppi
- Klinik f. Neurologie, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Pille Taba
- Department of Neurology and Neurosurgery, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital, Tartu, Estonia
| | - Evzen Ruzicka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Marianna Selikhova
- Department of Neurology, Pirogov Russian National Research Medical University, Moscow, Russia
| | | | | | - Elena Moro
- Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble Institute of Neurosciences, INSERM U1216, Grenoble, France
| |
Collapse
|
27
|
Dong-Chen X, Yong C, Yang X, Chen-Yu S, Li-Hua P. Signaling pathways in Parkinson's disease: molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther 2023; 8:73. [PMID: 36810524 PMCID: PMC9944326 DOI: 10.1038/s41392-023-01353-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 01/16/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease worldwide, and its treatment remains a big challenge. The pathogenesis of PD may be related to environmental and genetic factors, and exposure to toxins and gene mutations may be the beginning of brain lesions. The identified mechanisms of PD include α-synuclein aggregation, oxidative stress, ferroptosis, mitochondrial dysfunction, neuroinflammation, and gut dysbiosis. The interactions among these molecular mechanisms complicate the pathogenesis of PD and pose great challenges to drug development. At the same time, the diagnosis and detection of PD are also one of obstacles to the treatment of PD due to its long latency and complex mechanism. Most conventional therapeutic interventions for PD possess limited effects and have serious side effects, heightening the need to develop novel treatments for this disease. In this review, we systematically summarized the pathogenesis, especially the molecular mechanisms of PD, the classical research models, clinical diagnostic criteria, and the reported drug therapy strategies, as well as the newly reported drug candidates in clinical trials. We also shed light on the components derived from medicinal plants that are newly identified for their effects in PD treatment, with the expectation to provide the summary and outlook for developing the next generation of drugs and preparations for PD therapy.
Collapse
Affiliation(s)
- Xu Dong-Chen
- College of Pharmaceutical Sciences, Zhejiang University, 310058, Hangzhou, P. R. China
| | - Chen Yong
- College of Pharmaceutical Sciences, Zhejiang University, 310058, Hangzhou, P. R. China
| | - Xu Yang
- College of Pharmaceutical Sciences, Zhejiang University, 310058, Hangzhou, P. R. China
| | - ShenTu Chen-Yu
- College of Pharmaceutical Sciences, Zhejiang University, 310058, Hangzhou, P. R. China
| | - Peng Li-Hua
- College of Pharmaceutical Sciences, Zhejiang University, 310058, Hangzhou, P. R. China. .,State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, P. R. China.
| |
Collapse
|
28
|
Sexual needs and sexual function of patients with Parkinson's disease. Neurol Sci 2023; 44:539-546. [PMID: 36287284 DOI: 10.1007/s10072-022-06467-0] [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: 09/08/2022] [Accepted: 10/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Sexual dysfunction (SD) is a frequent non-motor symptom in Parkinson's disease (PD) that is rarely addressed, and sexual counseling is sporadic. OBJECTIVES To investigate PD patients' SD and sexual counseling motivation and to propose an interventional strategy for movement disorder specialists. METHODS All consecutive PD patients who presented to a movement disorder unit between 2018 and 2019 completed anonymous questionnaires containing the Female Sexual Function Index, the International Index of Erectile Function, and a questionnaire on sexual needs and motivation to receive sexual counseling. RESULTS The age range of the 100 recruited patients (78 men) was 40-80 years, and the mean disease duration was 8.64 ± 6.84 years. SD appeared at all PD stages. The presence of SD pre-PD diagnosis significantly predicted SD post-diagnosis in men. Erectile dysfunction was the most common male SD (70%). Women reported frequent SD before PD diagnosis and currently. More than half of the responders (74% of the men and 40% of the women) were motivated to receive sexual counseling. Most of them (77.4%) were in a relationship. CONCLUSIONS The findings of this analysis revealed that most PD patients had experienced SD before being diagnosed with PD and were interested in receiving sexual counseling. We propose a six-step intervention strategy for the management of SD in PD designed for application in a movement disorder unit. We also recommend that neurologists and other healthcare providers undergo training to provide basic sexual counseling tailored to the needs of PD patients.
Collapse
|
29
|
Liu JS, Chen Y, Shi DD, Zhang BR, Pu JL. Pharmacogenomics-a New Frontier for Individualized Treatment of Parkinson's Disease. Curr Neuropharmacol 2023; 21:536-546. [PMID: 36582064 PMCID: PMC10207905 DOI: 10.2174/1570159x21666221229154830] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disease with a significant public health burden. It is characterized by the gradual degeneration of dopamine neurons in the central nervous system. Although symptomatic pharmacological management remains the primary therapeutic method for PD, clinical experience reveals significant inter-individual heterogeneity in treatment effectiveness and adverse medication responses. The mechanisms behind the observed interindividual variability may be elucidated by investigating the role of genetic variation in human-to-human variances in medication responses and adverse effects. OBJECTIVE This review aims to explore the impact of gene polymorphism on the efficacy of antiparkinsonian drugs. The identification of factors associated with treatment effectiveness variability might assist the creation of a more tailored pharmacological therapy with higher efficacy, fewer side outcomes, and cheaper costs. METHODS In this review, we conducted a thorough search in databases such as PubMed, Web of Science, and Google Scholar, and critically examined current discoveries on Parkinson's disease pharmacogenetics. The ethnicity of the individuals, research methodologies, and potential bias of these studies were thoroughly compared, with the primary focus on consistent conclusions. RESULTS This review provides a summary of the existing data on PD pharmacogenetics, identifies its limitations, and offers insights that may be beneficial for future research. Previous studies have investigated the impact of gene polymorphism on the effectiveness and adverse effects of levodopa. The trendiest genes are the COMT gene, DAT gene, and DRD2 gene. However, limited study on other anti-Parkinson's drugs has been conducted. CONCLUSION Therefore, In order to develop an individualized precision treatment for PD, it is an inevitable trend to carry out multi-center, prospective, randomized controlled clinical trials of PD pharmacogenomics covering common clinical anti-PD drugs in large, homogeneous cohorts.
Collapse
Affiliation(s)
- Jia-Si Liu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Ying Chen
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Dan-Dan Shi
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Bao-Rong Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| | - Jia-Li Pu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China
| |
Collapse
|
30
|
Wu MK, Satogami K, Liang CS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Li DJ, Lin PY, Hsu CW, Chen YW, Suen MW, Zeng BY, Takahashi S, Tseng PT, Li CT. Multiple comparison of different noninvasive brain stimulation and pharmacologic interventions in patients with methamphetamine use disorders: A network meta-analysis of randomized controlled trials. Psychiatry Clin Neurosci 2022; 76:633-643. [PMID: 35876620 DOI: 10.1111/pcn.13452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
AIM In recent decades, the prevalence of amphetamine and methamphetamine use disorders has at least doubled in some regions/countries, with accompanying high risks of drug overdose-associated mortality. Noninvasive brain stimulation (NIBS) methods may be effective treatments. However, the comparative efficacy of the NIBS protocol for amphetamine/methamphetamine use disorder (AUD/MUD) remains unknown to date. The aim of this network meta-analysis (NMA) was to compare the efficacy and acceptability of various NIBS methods/protocols for AUD/MUD management. METHODS A frequentist model-based NMA was conducted. We included randomized controlled trials (RCTs) that investigated the efficacy of NIBS and guideline-recommended pharmacologic treatments to reduce craving severity in patients with either AUD or MUD. RESULTS Twenty-two RCTs including 1888 participants met the eligibility criteria. Compared with the sham/placebo group (study = 19, subjects = 891), a combination of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex (DLPFC) and continuous TBS over the left ventromedial prefrontal cortex (study = 1, subjects = 19) was associated with the largest decreases in craving severity [standardized mean difference (SMD) = -1.50; 95% confidence intervals (95%CIs) = -2.70 to -0.31]. High-frequency repetitive transcranial magnetic stimulation over the left DLPFC was associated with the largest improvements in depression and quality of sleep (study = 3, subjects = 86) (SMD = -2.48; 95%CIs = -3.25 to -1.71 and SMD = -2.43; 95%CIs = -3.38 to -1.48, respectively). The drop-out rate of most investigated treatments did not significantly differ between groups. CONCLUSION The combined TBS protocol over the prefrontal cortex was associated with the greatest improvement in craving severity. Since few studies were available for inclusion, additional large-scale randomized controlled trials are warranted.
Collapse
Affiliation(s)
- Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kazumi Satogami
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil.,Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Gender Equality Education and Research Center, Asia University, Taichung, Taiwan.,Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Dachang Hospital, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan.,Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
31
|
Kamińska K, Lenda T, Konieczny J, Lorenc-Koci E. Behavioral and neurochemical interactions of the tricyclic antidepressant drug desipramine with L-DOPA in 6-OHDA-lesioned rats. Implications for motor and psychiatric functions in Parkinson's disease. Psychopharmacology (Berl) 2022; 239:3633-3656. [PMID: 36178508 PMCID: PMC9584871 DOI: 10.1007/s00213-022-06238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 09/12/2022] [Indexed: 11/11/2022]
Abstract
RATIONALE The pharmacological effects of antidepressants in modulating noradrenergic transmission as compared to serotonergic transmission in a rat model of Parkinson's disease under chronic L-DOPA therapy are insufficiently explored. OBJECTIVES The aim of the present study was to investigate the effect of the tricyclic antidepressant desipramine administered chronically alone or jointly with L-DOPA, on motor behavior and monoamine metabolism in selected brain structures of rats with the unilateral 6-OHDA lesion. METHODS The antiparkinsonian activities of L-DOPA and desipramine were assessed behaviorally using a rotation test and biochemically based on changes in the tissue concentrations of noradrenaline, dopamine and serotonin and their metabolites, evaluated separately for the ipsi- and contralateral motor (striatum, substantia nigra) and limbic (prefrontal cortex, hippocampus) structures of rat brain by HPLC method. RESULTS Desipramine administered alone did not induce rotational behavior, but in combination with L-DOPA, it increased the number of contralateral rotations more strongly than L-DOPA alone. Both L-DOPA and desipramine + L-DOPA significantly increased DA levels in the ipsilateral striatum, substantia nigra, prefrontal cortex and the ipsi- and contralateral hippocampus. The combined treatment also significantly increased noradrenaline content in the ipsi- and contralateral striatum, while L-DOPA alone decreased serotonin level on both sides of the hippocampus. CONCLUSIONS The performed analysis of the level of monoamines and their metabolites in the selected brain structures suggests that co-modulation of noradrenergic and dopaminergic transmission in Parkinson's disease by the combined therapy with desipramine + L-DOPA may have some positive implications for motor and psychiatric functions but further research is needed to exclude potential negative effects.
Collapse
Affiliation(s)
- Kinga Kamińska
- Department of Neuro-Psychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna street 12, 31-343, Kraków, Poland
| | - Tomasz Lenda
- Department of Neuro-Psychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna street 12, 31-343, Kraków, Poland
| | - Jolanta Konieczny
- Department of Neuro-Psychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna street 12, 31-343, Kraków, Poland
| | - Elżbieta Lorenc-Koci
- Department of Neuro-Psychopharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Smętna street 12, 31-343, Kraków, Poland.
| |
Collapse
|
32
|
Michels J, Werner CJ, Schumann-Werner B, Schulz JB, Costa AS, Reetz K. Why cognitive training is important for the health status in Parkinson's disease: preliminary evidence from a clinical three-weeks multidisciplinary intervention. Neurol Res Pract 2022; 4:47. [PMID: 36184630 PMCID: PMC9528077 DOI: 10.1186/s42466-022-00210-y] [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: 04/20/2022] [Accepted: 08/02/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Several non-motor symptoms are present in Parkinson's disease (PD), including increasing prevalence rates of cognitive impairment during disease progression. Due to its multifaceted nature, PD management involves pharmacotherapy and non-pharmacotherapies, ideally in a multidisciplinary manner. Evidence regarding the impact of multidisciplinary interventions on motor and non-motor symptoms, as well as its impact on quality of life and daily activities of living, is limited. METHODS The aim of this real-life exploratory study was to investigate the effectiveness of a three-week clinical multidisciplinary Parkinson complex therapy (Parkinson-Komplexbehandlung, PKB), which is available as standard care for PD in the German health care system. Especially, the effect of neuropsychological attention training of 40 patients with PD was analyzed concerning their impact on motor abilities (UPDRS-III ON state), cognitive profiles and reported depressive symptoms and psychosocial function. RESULTS Neuropsychological data showed an improvement in response inhibition after intervention (z = - 2.611, p = 0.009). Additionally, improvements in verbal memory (z = - 2.318, p = 0.020), motor functions (UPDRS-III-score; z = - 5.163, p < 0.001) and reduction in depression symptoms (BDI-II) (z = - 2.944, p = 0.003) were also present. CONCLUSIONS Patients with PD benefited from this multidisciplinary Parkinson complex therapy in terms of improved cognitive functioning, including attention and verbal learning, motor symptoms and emotional well-being.
Collapse
Affiliation(s)
- Jennifer Michels
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
| | - Cornelius J Werner
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
- Department of Neurology, Section "Interdisciplinary Geriatrics", Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | | | - Jörg B Schulz
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
- Department of Neurology, Section "Interdisciplinary Geriatrics", Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ana S Costa
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, 52074, Aachen, Germany.
- Department of Neurology, Section "Interdisciplinary Geriatrics", Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| |
Collapse
|
33
|
Rissardo JP, Durante Í, Sharon I, Fornari Caprara AL. Pimavanserin and Parkinson's Disease Psychosis: A Narrative Review. Brain Sci 2022; 12:1286. [PMID: 36291220 PMCID: PMC9599742 DOI: 10.3390/brainsci12101286] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 10/18/2023] Open
Abstract
Pimavanserin (PMV) is the first approved drug for treating hallucinations and delusions in Parkinson's disease (PD) psychosis. Psychosis is one of the leading causes of nursing home placement in people with PD. Furthermore, hallucinations are a more frequent cause of institutionalization than motor disability or dementia related to PD. The management of PD psychosis involves antipsychotic medications. Most of the drugs in this class directly block dopamine D2 receptors, leading to significantly worsening motor symptoms in patients with PD. The most commonly used medications for managing PD psychosis are quetiapine, clozapine, and PMV. This literature review aims to study pimavanserin's history, mechanism, clinical trials, and post-marketing experience. PMV is a potent 5-HT2A receptor antagonist/inverse agonist. Moreover, this drug can interact with 5-HT2C receptors. We calculated some physicochemical descriptors and pharmacokinetic properties of PMV. Eight clinical trials of PMV and PD psychosis are registered on ClinicalTrials.gov. Only four of them have complete results already published. Meta-analytic results showed that PMV efficacy is inferior to clozapine. However, PMV has a significantly lower number of side-effects for managing psychosis in PD. Medicare database assessment revealed 35% lower mortality with PMV compared to other atypical antipsychotics. Moreover, sensitive statistical analysis demonstrated that PMV is a protective factor for the risk of falls in individuals with PD.
Collapse
Affiliation(s)
- Jamir Pitton Rissardo
- Medicine Department, Federal University of Santa Maria, Santa Maria 97105-900, Brazil
| | - Ícaro Durante
- Department of Medicine, Federal University of Fronteira Sul, Passo Fundo 99010-121, Brazil
| | - Idan Sharon
- NewYork-Presbyterian Brooklyn Methodist Hospital, New York, NY 11215, USA
| | | |
Collapse
|
34
|
Yu RL, Wu RM. Mild cognitive impairment in patients with Parkinson’s disease: An updated mini-review and future outlook. Front Aging Neurosci 2022; 14:943438. [PMID: 36147702 PMCID: PMC9485585 DOI: 10.3389/fnagi.2022.943438] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Mild cognitive impairment (MCI) is one of the common non-motor symptoms in patients with Parkinson’s disease (PD). MCI is the transition stage between normal aging and full-blown dementia and is also a powerful predictor of dementia. Although the concept of MCI has been used to describe some of the PD symptoms for many years, there is a lack of consistent diagnostic criteria. Moreover, because of the diverse patterns of the cognitive functions, each cognitive impairment will have a different progression. In this review, we overviewed the diagnostic criteria for PD-MCI, primarily focused on the heterogeneity of PD-MCI patients’ cognitive function, including various types of cognitive functions and their progression rates. A review of this topic is expected to be beneficial for clinical diagnosis, early intervention, and treatment. In addition, we also discussed the unmet needs and future vision in this field.
Collapse
Affiliation(s)
- Rwei-Ling Yu
- College of Medicine, Institute of Behavioral Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ruey-Meei Wu
- Department of Neurology, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
- *Correspondence: Ruey-Meei Wu,
| |
Collapse
|
35
|
Yin C, Zong R, Song G, Zhou J, Pan L, Li X. Comparison of Motor Scores between OFF and ON States in Tremor-Dominant Parkinson's Disease after MRgFUS Treatment. J Clin Med 2022; 11:jcm11154502. [PMID: 35956119 PMCID: PMC9369361 DOI: 10.3390/jcm11154502] [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: 05/24/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: To compare the motor function improvements in ON and OFF states in tremor-dominant Parkinson’s disease (TDPD) patients within one year of follow-up after ablation of the unilateral ventral intermediate nucleus of the thalamus (Vim) by magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS). Methods: A total of nine consecutive patients confirmed with TDPD who underwent unilateral Vim ablation by MRgFUS between April 2019 and September 2019 were included. The Movement Disorder Society Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRSIII) and Clinical Rating Scale for Tremor (CRST) were performed in the ON and OFF stages to distinguish the surgical effects from drug therapy effects. The adverse events and adjustment of drug doses were also recorded. Results: The preoperative MDS-UPDRSIII score in OFF and ON states was 55.0 (48.0, 65.5) and 26.0 (17.0, 27.0), while the CRST score was 46.0 (39.5, 53.5) and 20.0 (13.0, 23.5), respectively; the Levodopa equivalent dose was 600 (456, 600) mg/d. At 1 year after operation, the total MDS-UPDRSIII score and CRST score were 40.0 (30.0, 60.5) and 16.0 (10.0, 29.5) in the OFF state, and 21.0 (17.5, 27.0) and 2.0 (1.5, 7.0) in the ON state, respectively. Compared with the preoperative levels, follow-up at the two-time points (three months and one year after operation) showed the total MDS-UPDRSIII score, as well as MDS-UPDRSIII tremor, bradykinesia, and rigidity scores of contralateral limbs all significantly improved in OFF state. However, in the ON state, only the total MDS-UPDRSIII score and tremor score of contralateral limbs significantly improved. The total CRST score and the CRST (A + B) score of contralateral limbs significantly improved at three months and one year after the operation compared with before the operation in both ON and OFF states. The Levodopa equivalent dose at one and three months were not significantly different from the preoperative dose (p > 0.05). No serious adverse responses were observed. Conclusion: Treating TDPD with unilateral Vim ablation by MRgFUS could improve the symptoms of limb tremor and the other core symptoms, such as bradykinesia and rigidity, as well as some non-motor symptoms and the symptoms of ipsilateral limbs.
Collapse
Affiliation(s)
- Chunyu Yin
- Department of Cadres’ Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China;
| | - Rui Zong
- Department of Neurosurgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; (R.Z.); (J.Z.)
| | - Ge Song
- Department of Health Care, 305 Hospital of Chinese PLA, Beijing 100017, China;
| | - Jiayou Zhou
- Department of Neurosurgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; (R.Z.); (J.Z.)
| | - Longsheng Pan
- Department of Neurosurgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; (R.Z.); (J.Z.)
- Correspondence: (L.P.); (X.L.)
| | - Xuemei Li
- Department of Cadres’ Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China;
- Correspondence: (L.P.); (X.L.)
| |
Collapse
|
36
|
Ye X, Li L, He R, Jia Y, Poon W. Rhythmic auditory stimulation promotes gait recovery in Parkinson's patients: A systematic review and meta-analysis. Front Neurol 2022; 13:940419. [PMID: 35968291 PMCID: PMC9366143 DOI: 10.3389/fneur.2022.940419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveUsing rhythmic auditory stimulation (RAS) to improve gait disturbance in Parkinson's disease (PD) is an available treatment option, yet a consensus on its effectiveness remains controversial. We summarized the effects of RAS on gait, functional activity and quality of life in PD patients through a systematic review and meta-analysis.MethodsPubMed, Embase, Web of Science, Medline, and Cochrane Library databases were initially searched to identify relevant literature up to August 2021. Next, the methodological quality of eligible comparative studies was assessed by the Physiotherapy Evidence Database Scale. The treatment effects to clinical outcome in relation to gait, motor activities, and quality of life were analyzed.ResultsA total of 18 studies consisted of 774 subjects were included in this meta-analysis. Comparing with the control group, RAS had significantly increased stride length (p < 0.001), accelerated gait speed (p < 0.001), reduced the occurrence of freezing events during walking (P = 0.009), achieved an improvement in Unified Parkinson's Disease Rating Scale (UPDRS) II (P = 0.030), UPDRS-III (P < 0.001) and Parkinson's Disease Quality of Life Questionnaire (PDQL) (p = 0.009) scores over an interval of 1–26 months.ConclusionIn this meta-analysis of 18 randomized controlled trials, we have demonstrated that RAS improves the general motor functions (UPDRS-III), particularly in gait, mobility and quality of life, in patients with Parkinson's disease.
Collapse
Affiliation(s)
- Xiaofan Ye
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Ling Li
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Rong He
- Physiotherapy Department, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yizhen Jia
- Core Laboratory, University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Waisang Poon
- Neuromedicine Center, University of Hong Kong Shenzhen Hospital, Shenzhen, China
- *Correspondence: Waisang Poon
| |
Collapse
|
37
|
Wal P, Dwivedi J, Wal A, Vig H, Singh Y. Detailed insight into the pathophysiology and the behavioral complications associated with the Parkinson's disease and its medications. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The loss of dopamine neurons in the substantia nigra, as well as other mostly catecholaminergic neurons, causes many of the motor symptoms that define Parkinson's disease. Parkinson's disease is commonly thought of as a movement disorder, the significant prevalence of psychiatric complications such as cognitive impairment, and psychosis suggests it should be considered a neuropsychiatric illness, and all behavioral complications are linked to growing disability and the medication.
Main body
Apart from the disease-induced abnormalities, there are several other side effects of the disease and also from the medication used to prevent the disease. This article focuses on the pathogenesis of Parkinson’s disease and also the behavioral abnormalities caused by the disease and its medication. The study's data were gathered by searching several review articles and research papers from a variety of sources, including Elsevier, PubMed, Research Gate, Journal of Pharmaceutical Science, etc., from the year 1985 to 2021. Parkinson's disease is a neurodegenerative disease caused by a variety of complex processes. It is responsible not just for motor symptoms, but also for a variety of behavioral symptoms that can arise as a result of the disease and/or medication.
Conclusion
Only symptomatic drugs are available; thus, finding treatments that directly address the disease mechanisms causing Parkinson’s disease is essential. To alleviate the disease's burden on patients and their families, better treatments for the neuropsychiatric repercussions of Parkinson's disease are required.
Graphical Abstract
Collapse
|
38
|
Tian J, Kang Y, Liu P, Yu H. Effect of Physical Activity on Depression in Patients with Parkinson's Disease: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116849. [PMID: 35682432 PMCID: PMC9180645 DOI: 10.3390/ijerph19116849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide, and approximately 50% of PD patients suffer from depression. We aim to determine the effects of physical activity on depression in PD patients and to provide scientific evidence-based exercise prescriptions for PD patients. A systematic review was conducted by searching PubMed, Embase, Cochrane Library, and PsycInfo until February 2022 for randomized controlled trial (RCT) studies published in English. The primary outcome was a score on a depression scale. A total of 14 RCTs involving 516 patients with PD were included in this study. The results of the meta-analysis showed that physical activity had a moderate and significant improvement in depression in PD patients (SMD = −0.60; 95% CI = −0.79 to −0.41; p < 0.00001). Subgroup analysis indicated that resistance exercise for 60−90 min more than 4 times per week for up to 12 weeks had a significant effect on PD patients who have had the disease for more than 5 years. Meta-regression showed that intervention type, intervention time, intervention frequency, intervention period, age, and disease duration were not sources of heterogeneity. Physical activity may reduce depression in PD patients. However, other larger sample sizes and high-quality studies are needed to validate these effects in the future.
Collapse
Affiliation(s)
- Jianing Tian
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Yujie Kang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
| | - Peifeng Liu
- Department of Physical Education, Central South University, Changsha 410083, China;
| | - Hongyan Yu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China; (J.T.); (Y.K.)
- Correspondence:
| |
Collapse
|
39
|
Prange S, Klinger H, Laurencin C, Danaila T, Thobois S. Depression in Patients with Parkinson's Disease: Current Understanding of its Neurobiology and Implications for Treatment. Drugs Aging 2022; 39:417-439. [PMID: 35705848 PMCID: PMC9200562 DOI: 10.1007/s40266-022-00942-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 12/11/2022]
Abstract
Depression is one of the most frequent and burdensome non-motor symptoms in Parkinson’s disease (PD), across all stages. Even when its severity is mild, PD depression has a great impact on quality of life for these patients and their caregivers. Accordingly, accurate diagnosis, supported by validated scales, identification of risk factors, and recognition of motor and non-motor symptoms comorbid to depression are critical to understanding the neurobiology of depression, which in turn determines the effectiveness of dopaminergic drugs, antidepressants and non-pharmacological interventions. Recent advances using in vivo functional and structural imaging demonstrate that PD depression is underpinned by dysfunction of limbic networks and monoaminergic systems, depending on the stage of PD and its associated symptoms, including apathy, anxiety, rapid eye movement sleep behavior disorder (RBD), cognitive impairment and dementia. In particular, the evolution of serotonergic, noradrenergic, and dopaminergic dysfunction and abnormalities of limbic circuits across time, involving the anterior cingulate and orbitofrontal cortices, amygdala, thalamus and ventral striatum, help to delineate the variable expression of depression in patients with prodromal, early and advanced PD. Evidence is accumulating to support the use of dual serotonin and noradrenaline reuptake inhibitors (desipramine, nortriptyline, venlafaxine) in patients with PD and moderate to severe depression, while selective serotonin reuptake inhibitors, repetitive transcranial magnetic stimulation and cognitive behavioral therapy may also be considered. In all patients, recent findings advocate that optimization of dopamine replacement therapy and evaluation of deep brain stimulation of the subthalamic nucleus to improve motor symptoms represents an important first step, in addition to physical activity. Overall, this review indicates that increasing understanding of neurobiological changes help to implement a roadmap of tailored interventions for patients with PD and depression, depending on the stage and comorbid symptoms underlying PD subtypes and their prognosis.
Collapse
Affiliation(s)
- Stéphane Prange
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France
| | - Chloé Laurencin
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Teodor Danaila
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France.,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France
| | - Stéphane Thobois
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, NS-PARK/FCRIN Network, 59 Boulevard Pinel, 69500, Bron, France. .,Physiopathology of the Basal Ganglia Team, Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, 67 Boulevard Pinel, 69675, Bron, France. .,Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Univ Lyon, Université Claude Bernard Lyon 1, Oullins, France.
| |
Collapse
|
40
|
MacDonald S, Shah AS, Tousi B. Current Therapies and Drug Development Pipeline in Lewy Body Dementia: An Update. Drugs Aging 2022; 39:505-522. [PMID: 35619045 DOI: 10.1007/s40266-022-00939-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/25/2022]
Abstract
The term Lewy body dementia refers to either of two related diagnoses: dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Clinical management of Lewy body dementia is challenging. The current treatment options focus on relieving symptoms; no disease-modifying therapies are available. There are currently no US Food and Drug Administration (FDA) approved drugs for the treatment of DLB, and there are only a few for PDD. Cholinesterase inhibitors are shown to be beneficial in improving cognitive symptoms in Lewy body dementia. Rivastigmine was approved by the FDA to treat PDD. Donepezil was approved in Japan as a treatment for DLB. Levodopa may provide modest benefit in treating motor symptoms and zonisamide in adjunct to low-dose levodopa helps with parkinsonism. Treatment of autonomic symptoms are based on symptomatic treatment with off-label agents. Our main objective in this article is to present an overview of the current pharmacological options available to treat the clinical features of DLB and PDD. When evaluating the existing management options for Lewy body dementia, it is difficult to fully separate PDD from DLB. However, we have attempted to identify whether the cited studies include patients with PDD and/or DLB. Moreover, we have provided an overview of the current drug pipeline in Lewy body dementia. All currently active trials are in phase I or II and most are focused on disease modification rather than symptomatic treatment. Phase II trial results for neflamapimod show promising results. Due to heterogeneity of symptoms and underlying pathophysiology, there is a need for new biomarker strategies and improved definitions of outcome measures for Lewy body dementia drug trials.
Collapse
Affiliation(s)
- Steve MacDonald
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA
| | | | - Babak Tousi
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA.
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| |
Collapse
|
41
|
Symptomatic Care in Multiple System Atrophy: State of the Art. CEREBELLUM (LONDON, ENGLAND) 2022; 22:433-446. [PMID: 35581488 PMCID: PMC10125958 DOI: 10.1007/s12311-022-01411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/23/2022] [Indexed: 12/14/2022]
Abstract
Without any disease-modifying treatment strategy for multiple system atrophy (MSA), the therapeutic management of MSA patients focuses on a multidisciplinary strategy of symptom control. In the present review, we will focus on state of the art treatment in MSA and additionally give a short overview about ongoing randomized controlled trials in this field.
Collapse
|
42
|
Levodopa-Carbidopa Intestinal Gel Improves Symptoms of Orthostatic Hypotension in Patients with Parkinson’s Disease—Prospective Pilot Interventional Study. J Pers Med 2022; 12:jpm12050718. [PMID: 35629141 PMCID: PMC9146778 DOI: 10.3390/jpm12050718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Parkinson’s disease (PD) is currently considered progressive neurodegeneration of both the central and peripheral nervous systems. Widespread neuropathological changes lead to a complex clinical presentation with typical motor (hypokinesia, tremor, and rigidity) and various nonmotor symptoms. Orthostatic hypotension is one of the most disabling nonmotor features contributing to increased morbidity and mortality and decreased quality of life (QoL). Our study aimed to disclose the effect of a continuous infusion of levodopa-carbidopa intestinal gel (LCIG) on symptoms of orthostatic hypotension. Nine patients indicated for LCIG and eight matched patients on optimized medical treatment (OMT) were examined with scales for orthostatic symptoms (SCOPA-AUT), nonmotor symptoms and motor fluctuations (MDS-UPDRS), and QoL (PDQ39) at both baseline and after six months. The scores of “light-headedness after standing” and “fainting” decreased in the LCIG group compared to the OMT group. Treatment with LCIG was associated with a significantly higher decrease in the score of “light-headedness after standing”. Change in the PDQ39 correlated positively with fluctuation improvement and with change in the scores of both “light-headedness” and “fainting”. LCIG treatment improved symptoms of orthostatic hypotension in patients with PD mainly by a reduction in motor complications. Decreased severity in both motor and nonmotor fluctuations was connected also with improved QoL. Continuous treatment with LCIG should be considered not only in the case of severe motor fluctuation but also in patients with nonmotor fluctuations responsive to dopaminergic treatment.
Collapse
|
43
|
Evaluation of Inhibitory Activities of Sophora flavescens and Angelica gigas Nakai Root Extracts against Monoamine Oxidases, Cholinesterases, and β-Secretase. Processes (Basel) 2022. [DOI: 10.3390/pr10050880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In this study, Sophora flavescens (SF) from Yeongcheon (YSF) and Mt. Jiri (JiSF), and Angelica gias (AG) from Yeongcheon (YAG), Mt. Jiri (JiAG), and Jecheon (JeAG) were extracted using three concentrations of ethanol, 95% (95Et), 70% (70Et), and 50% (50Et), and hot water (DW) to evaluate the inhibitions of monoamine oxidases (MAOs; MAO-A and B), cholinesterases (ChEs; AChE and BChE) and β-secretase (BACE1) for targeting depression and neurodegenerative diseases. There were no significant differences in constituent compounds depending on herbal origins, except that YSF-95Et and JiSF-95Et showed a distinct non-polar spot upper maackiain position, and JiAG and JeAG showed a higher amount of decursin than YAG. Ethanolic YAG and JeAG extracts showed the highest MAO-A inhibition, and YSF-95Et mostly inhibited MAO-B. JiSF-95Et showed the highest AChE inhibition and YSF-70Et, JiSF-95Et, and -70Et showed the highest BChE inhibition. Interestingly, ethanolic AG extracts showed extremely potent BACE1 inhibition, especially for JiAG-95Et and JeAG-50Et, whereas there have been no reports about BACE1 inhibition of decursin, the major compound, or AG extracts in other studies. All extracts were nontoxic to MDCK and SH-SY5Y with a low toxicity to HL-60. The results showed a different pattern of inhibitory activities of the extracts toward target enzymes depending on the origins, and multi-target abilities, especially for MAO-B and BChE by YSF-95Et, for AChE and BChE by JiSF-95Et, and for MAO-B and BACE1 by JiAG-95Et. It is suggested that those extracts are potential candidates for finding novel compounds with multi-target inhibitory activities, and herbal origin is an important factor to be considered in selection of the plants.
Collapse
|
44
|
Zhang Y, Xu X. Chinese Herbal Medicine in the Treatment of Depression in Parkinson’s Disease: From Molecules to Systems. Front Pharmacol 2022; 13:879459. [PMID: 35496318 PMCID: PMC9043316 DOI: 10.3389/fphar.2022.879459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Depression is one of the most common non-motor symptoms in patients with Parkinson’s disease (PD). Depression in PD (DPD) increases the disability rate and reduces the quality of life of PD patients and increases the caregiver burden. Although previous studies have explained the relationship between depression and PD through a variety of pathological mechanisms, whether depression is a precursor or an independent risk factor for PD remains unclear. Additionally, increasing evidence shows that conventional anti-PD drug therapy is not ideal for DPD. Chinese Herbal Medicine (CHM) prescriptions exhibit the characteristics of multi-target, multi-pathway, and multi-level treatment of DPD and may simultaneously improve the motor symptoms of PD patients through multiple mechanisms. However, the specific pharmacological mechanisms of these CHM prescriptions remain unelucidated. Here, we investigated the mechanisms of action of the active ingredients of single herbs predominantly used in CHM prescriptions for depression as well as the therapeutic effect of CHM prescriptions on DPD. This review may facilitate the design of new selective and effective treatment strategies for DPD.
Collapse
Affiliation(s)
- Yi Zhang
- Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoman Xu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiaoman Xu,
| |
Collapse
|
45
|
Self-reported periodontitis and C-reactive protein in Parkinson's disease: a cross-sectional study of two American cohorts. NPJ Parkinsons Dis 2022; 8:40. [PMID: 35418117 PMCID: PMC9008053 DOI: 10.1038/s41531-022-00302-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Periodontitis triggers systemic repercussions, such as elevated levels of high-sensitive C-reactive protein (hs-CRP). This has never been studied within Parkinson's Disease (PD). The aim of this study is to compare hs-CRP levels of self-reported periodontitis cases versus cases without periodontitis in PD patients. Data from the National Health and Nutrition Examination Survey (2015-2016 and 2017-2018 waves) were analyzed. PD cases were identified through medication regimens and periodontitis cases through a validated self-report questionnaire. 51 participants were included (24 females, 27 males, with mean age of 62.96 (14.71)). While the self-reported periodontitis group presented elevated levels of circulating hs-CRP (5.36 vs. 1.99 mg/L, p = 0.031), the self-reported without periodontitis group presented higher lymphocyte levels (29.35 vs. 28.03%, p = 0.007). Blood levels of hs-CRP were significantly higher in PD cases with self-reported periodontitis. Apart from the lymphocyte levels, there were no other significant differences according to the self-reported periodontal status. Future studies shall explore this association using clinical measures.
Collapse
|
46
|
Bock MA, Brown EG, Zhang L, Tanner C. Association of Motor and Nonmotor Symptoms With Health-Related Quality of Life in a Large Online Cohort of People With Parkinson Disease. Neurology 2022; 98:e2194-e2203. [PMID: 35418456 PMCID: PMC9162165 DOI: 10.1212/wnl.0000000000200113] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives There is growing interest in health-related quality of life (HRQOL) as a comprehensive view of the patient's well-being, guiding concept for the treating clinician, and therapeutic trial outcome measure for patients with Parkinson disease (PwPD). The key determinants of HRQOL have not been investigated in large populations of PwPD. Our objective was to evaluate correlates of HRQOL in a large, online cohort of PwPD. Methods As part of an ongoing online cohort study, we performed a cross-sectional analysis at enrollment of 23,058 PwPD. We conducted univariate and stepwise multivariate linear regression analyses of HRQOL as measured by the EQ-5D-5L tool. In addition, we performed an interaction analysis to evaluate heterogeneity of the effect of motor symptoms on HRQOL and Spearman correlation analysis to evaluate the association of nonmotor symptoms with HRQOL. Results In the multivariate linear regression model, participants with moderate or severe depression, more severe motor symptoms, and a higher burden of medical comorbidities had the most substantially decreased HRQOL as measured by the EQ index (β −0.11, −0.18, −0.02, −0.01, respectively; p < 0.001 for all). An interaction analysis showed that more severe motor symptoms had a higher effect on individuals with female sex, lower educational level, lower income, more severe depression, or more severe cognitive impairment (p ≤ 0.01 for interaction terms). Neuropsychiatric symptoms and falls had the most negative associations with HRQOL (ρ −0.31 to 0.37; p < 0.0001). Discussion Potentially treatable motor and nonmotor symptoms, particularly neuropsychiatric symptoms, account for a large amount of the variation in HRQOL in PwPD. Motor symptoms may have differential effects on HRQOL in different demographic and clinical subpopulations, highlighting important areas for future health disparities research. Our findings provide targets for clinician intervention and future research on symptom management to optimize HRQOL in PD. Classification of Evidence This study provides Class II evidence that motor and neuropsychiatric symptoms are associated with HRQOL in PwPD.
Collapse
Affiliation(s)
- Meredith A Bock
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco .,Mental Illness Research, Education, and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco
| | - Ethan G Brown
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco
| | - Li Zhang
- Department of Medicine, University of California, San Francisco.,Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Caroline Tanner
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco.,Parkinson's Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco
| |
Collapse
|
47
|
Bandopadhyay R, Mishra N, Rana R, Kaur G, Ghoneim MM, Alshehri S, Mustafa G, Ahmad J, Alhakamy NA, Mishra A. Molecular Mechanisms and Therapeutic Strategies for Levodopa-Induced Dyskinesia in Parkinson's Disease: A Perspective Through Preclinical and Clinical Evidence. Front Pharmacol 2022; 13:805388. [PMID: 35462934 PMCID: PMC9021725 DOI: 10.3389/fphar.2022.805388] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/21/2022] [Indexed: 12/20/2022] Open
Abstract
Parkinson's disease (PD) is the second leading neurodegenerative disease that is characterized by severe locomotor abnormalities. Levodopa (L-DOPA) treatment has been considered a mainstay for the management of PD; however, its prolonged treatment is often associated with abnormal involuntary movements and results in L-DOPA-induced dyskinesia (LID). Although LID is encountered after chronic administration of L-DOPA, the appearance of dyskinesia after weeks or months of the L-DOPA treatment has complicated our understanding of its pathogenesis. Pathophysiology of LID is mainly associated with alteration of direct and indirect pathways of the cortico-basal ganglia-thalamic loop, which regulates normal fine motor movements. Hypersensitivity of dopamine receptors has been involved in the development of LID; moreover, these symptoms are worsened by concurrent non-dopaminergic innervations including glutamatergic, serotonergic, and peptidergic neurotransmission. The present study is focused on discussing the recent updates in molecular mechanisms and therapeutic approaches for the effective management of LID in PD patients.
Collapse
Affiliation(s)
- Ritam Bandopadhyay
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | - Nainshi Mishra
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | - Ruhi Rana
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | - Gagandeep Kaur
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Gulam Mustafa
- College of Pharmacy (Boys), Al-Dawadmi Campus, Shaqra University, Riyadh, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Nabil. A. Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)—Guwahati, Guwahati, India
| |
Collapse
|
48
|
Giustiniani A, Maistrello L, Danesin L, Rigon E, Burgio F. Effects of cognitive rehabilitation in Parkinson disease: a meta-analysis. Neurol Sci 2022; 43:2323-2337. [DOI: 10.1007/s10072-021-05772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
|
49
|
Opicapone Improves Global Non-Motor Symptoms Burden in Parkinson's Disease: An Open-Label Prospective Study. Brain Sci 2022; 12:brainsci12030383. [PMID: 35326339 PMCID: PMC8945982 DOI: 10.3390/brainsci12030383] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/23/2022] Open
Abstract
Patients with Parkinson’s disease (PD) can improve some non-motor symptoms (NMS) after starting treatment with opicapone. The aim of this study was to analyze the effectiveness of opicapone on global NMS burden in PD. OPEN-PD (Opicapone Effectiveness on Non-motor symptoms in Parkinson’s Disease) is a prospective open-label single-arm study conducted in 5 centers from Spain. The primary efficacy outcome was the change from baseline (V0) to the end of the observational period (6 months ± 30 days) (V2) in the Non-Motor Symptoms Scale (NMSS) total score. Different scales were used for analyzing the change in motor, NMS, quality of life (QoL), and disability. Thirty-three patients were included between JUL/2019 and JUN/2021 (age 63.3 ± 7.91; 60.6% males; 7.48 ± 4.22 years from symptoms onset). At 6 months, 30 patients completed the follow-up (90.9%). The NMSS total score was reduced by 27.3% (from 71.67 ± 37.12 at V0 to 52.1 ± 34.76 at V2; Cohen’s effect size = −0.97; p = 0.002). By domains, improvement was observed in sleep/fatigue (−40.1%; p < 0.0001), mood/apathy (−46.6%; p = 0.001), gastrointestinal symptoms (−20.7%; p = 0.029), and miscellaneous (−44.94%; p = 0.021). QoL also improved with a 18.4% reduction in the 39-item Parkinson’s Disease Quality of Life Questionnaire Summary Index (from 26.67 ± 17.61 at V0 to 21.75 ± 14.9 at V2; p = 0.001). A total of 13 adverse events in 11 patients (33.3%) were reported, 1 of which was severe (not related to opicapone). Dyskinesias and nausea were the most frequent (6.1%). Opicapone is well tolerated and improves global NMS burden and QoL in PD patients at 6 months.
Collapse
|
50
|
Li Q, Kang B, Wang L, Chen T, Zhao Y, Feng S, Li R, Zhang H. Microfluidics embedded with microelectrodes for electrostimulation of neural stem cells proliferation. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|