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Aamodt WW, Kluger BM, Mirham M, Job A, Lettenberger SE, Mosley PE, Seshadri S. Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022. J Geriatr Psychiatry Neurol 2024; 37:96-113. [PMID: 37551798 PMCID: PMC10802092 DOI: 10.1177/08919887231195219] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Caregiver burden is a term that refers to the adverse effect of caregiving on the physical, emotional, social, spiritual, and financial well-being of the caregiver. Caregiver burden is associated with providing care to an individual with a chronic illness or disability, and the unique symptoms of Parkinson disease (PD) can amplify a patient's needs and reliance on others, leading to adverse outcomes for patients and their caregivers. In this scoping review of the literature from January 2017 through April 2022 that included 114 studies, we provide an updated, evidence-based summary of patient and caregiver-related factors that contribute to caregiver burden in PD. We also describe the impact of caregiver stress and burden on caregivers based on qualitative research studies and review recent interventions to mitigate burden. By providing clinical updates for practitioners, this review is designed to improve recognition of caregiver burden in the post-pandemic era and foster the development of targeted interventions to reduce caregiver burden in PD.
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Affiliation(s)
- Whitley W. Aamodt
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Benzi M. Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Miray Mirham
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - Anna Job
- University of Rochester, Rochester, NY, USA
| | | | - Philip E. Mosley
- School of Medicine, University of Queensland, Herston, QLD, Australia
| | - Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
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Auffret M, Weiss D, Stocchi F, Vérin M, Jost WH. Access to device-aided therapies in advanced Parkinson's disease: navigating clinician biases, patient preference, and prognostic uncertainty. J Neural Transm (Vienna) 2023; 130:1411-1432. [PMID: 37436446 PMCID: PMC10645670 DOI: 10.1007/s00702-023-02668-9] [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: 05/04/2023] [Accepted: 06/24/2023] [Indexed: 07/13/2023]
Abstract
Device-aided therapies (DAT), which include deep brain stimulation and pump-based continuous dopaminergic stimulation with either levodopa or apomorphine, are among the major advances in the clinical management of Parkinson's disease (PD). Although DAT are being increasingly offered earlier in the disease course, their classical indication remains advanced PD. Theoretically, every patient should be offered transition to DAT when faced with refractory motor and nonmotor fluctuations and functional decline. Worldwide clinical reality is far from these ideal, and, therefore, question the "real-world" equal opportunity of access to DAT for PD patients with advanced PD-even within a single health care system. Differences in access to care, referral pattern (timing and frequency), as well as physician biases (unconscious/implicit or conscious/explicit bias), and patients' preferences or health-seeking behaviour are to be considered. Compared to DBS, little information is available concerning infusion therapies, as well as neurologists' and patients' attitudes towards them. This viewpoint aims to be thought-provoking and to assist clinicians in moving through the process of DAT selection, by including in their decision algorithm their own biases, patient perspective, ethical concerns as well as the current unknowns surrounding PD prognosis and DAT-related long-term side effects for a given patient.
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Affiliation(s)
- Manon Auffret
- France Développement Electronique (FDE), Monswiller, France.
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France.
- Behavior and Basal Ganglia Research Unit, CIC-IT, CIC1414, Pontchaillou University Hospital and University of Rennes, Rennes, France.
| | - Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Fabrizio Stocchi
- University San Raffaele Roma and Institute of Research and Medical Care IRCCS San Raffaele Roma, Rome, Italy
| | - Marc Vérin
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
- Behavior and Basal Ganglia Research Unit, CIC-IT, CIC1414, Pontchaillou University Hospital and University of Rennes, Rennes, France
- Neurology Department, Pontchaillou University Hospital, rue Henri Le Guilloux, 35000, Rennes, France
| | - Wolfgang H Jost
- Parkinson-Klinik Ortenau, Kreuzbergstr. 12-16, 77709, Wolfach, Germany
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Boura I, Qamar MA, Daddoveri F, Leta V, Poplawska-Domaszewicz K, Falup-Pecurariu C, Ray Chaudhuri K. SARS-CoV-2 and Parkinson's Disease: A Review of Where We Are Now. Biomedicines 2023; 11:2524. [PMID: 37760965 PMCID: PMC10526287 DOI: 10.3390/biomedicines11092524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has been discussed in the context of Parkinson's disease (PD) over the last three years. Now that we are entering the long-term phase of this pandemic, we are intrigued to look back and see how and why the community of patients with PD was impacted and what knowledge we have collected so far. The relationship between COVID-19 and PD is likely multifactorial in nature. Similar to other systemic infections, a probable worsening of PD symptoms secondary to COVID-19, either transient or persistent (long COVID), has been demonstrated, while the COVID-19-related mortality of PD patients may be increased compared to the general population. These observations could be attributed to direct or indirect damage from SARS-CoV-2 in the central nervous system (CNS) or could result from general infection-related parameters (e.g., hospitalization or drugs) and the sequelae of the COVID-19 pandemic (e.g., quarantine). A growing number of cases of new-onset parkinsonism or PD following SARS-CoV-2 infection have been reported, either closely (post-infectious) or remotely (para-infectious) after a COVID-19 diagnosis, although such a link remains hypothetical. The pathophysiological substrate of these phenomena remains elusive; however, research studies, particularly pathology studies, have suggested various COVID-19-induced degenerative changes with potential associations with PD/parkinsonism. We review the literature to date for answers considering the relationship between SARS-CoV-2 infection and PD/parkinsonism, examining pathophysiology, clinical manifestations, vaccination, and future directions.
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Affiliation(s)
- Iro Boura
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
- Medical School, University of Crete, Heraklion, 71003 Iraklion, Greece
| | - Mubasher A. Qamar
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
| | - Francesco Daddoveri
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Valentina Leta
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
- Parkinson and Movement Disorders Unit, Department of Clinical Neuroscience, Fondazione, IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, Faculty of Medicine, Transilvania University Brasov, 500019 Brasov, Romania
| | - K. Ray Chaudhuri
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK; (I.B.)
- Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5 Cutcombe Road, London SE5 9RX, UK
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Wolff AW, Haller B, Demleitner AF, Pürner D, Niederschweiberer J, Cordts I, Westenberg E, Lingor P. Long-Lasting Impact of the COVID-19 Pandemic on Patients with Parkinson's Disease and Their Relatives. Mov Disord Clin Pract 2023; 10:819-823. [PMID: 37205245 PMCID: PMC10187008 DOI: 10.1002/mdc3.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/09/2023] [Accepted: 03/03/2023] [Indexed: 05/21/2023] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has heavily impacted medical care of patients with Parkinson's disease (PwP). Objective To assess the longitudinal impact of the COVID-19 pandemic on PwP and their relatives in Germany. Methods Two online, nationwide, cross-sectional surveys were conducted from December 2020 to March 2021 and from July to September 2021. Results A total of 342 PwP and 113 relatives participated. Despite partial resumption of social and group activities, healthcare was continuously disrupted during times of loosened restrictions. Respondents' willingness to use telehealth infrastructure increased, yet the availability remained low. PwP reported worsened symptoms and further deterioration during the pandemic, resulting in an increase in new symptoms and relatives' burden. We identified patients at particular risk: young patients and those with long disease duration. Conclusions The COVID-19 pandemic persistently disrupts the care and quality of life of PwP. Although willingness to use telemedicine services has increased, its availability needs to be improved.
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Affiliation(s)
- Andreas Wolfgang Wolff
- Department of Neurology, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Klinikum rechts der Isar, Technical University of MunichMunichGermany
| | | | - Dominik Pürner
- Department of Neurology, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | | | - Isabell Cordts
- Department of Neurology, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Erica Westenberg
- Department of Neurology, Klinikum rechts der IsarTechnical University of MunichMunichGermany
| | - Paul Lingor
- Department of Neurology, Klinikum rechts der IsarTechnical University of MunichMunichGermany
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
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Bougea A, Georgakopoulou VE, Palkopoulou M, Efthymiopoulou E, Angelopoulou E, Spandidos DA, Zikos P. New‑onset non‑motor symptoms in patients with Parkinson's disease and post‑COVID‑19 syndrome: A prospective cross‑sectional study. MEDICINE INTERNATIONAL 2023; 3:23. [PMID: 37214229 PMCID: PMC10192951 DOI: 10.3892/mi.2023.83] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023]
Abstract
The clinical range of post-coronavirus disease 2019 (COVID-19) symptoms in patients with Parkinson's disease (PD) has not yet been thoroughly characterized, with the exception of a few small case studies. The aim of the present study was to investigate the motor and non-motor progression of patients with PD (PWP) and post-COVID-19 syndrome (PCS) at baseline and at 6 months after infection with COVID-19. A cross-sectional prospective study of 38 PWP+/PCS+ and 20 PWP+/PCS- matched for age, sex and disease duration was conducted. All patients were assessed at baseline and at 6 months using a structured clinicodemographic questionnaire, the Unified Parkinson's Disease Rating Scale Part III (the UPDRS III), the Montreal Cognitive Assessment, the Hoehn and Yahr scale, the Geriatric Depression Scale and the levodopa equivalent daily dose (LEDD). There was a statistically significant difference in the LEDD (P=0.039) and UPDRS III (P=0.001) at baseline and at 6 months after infection with COVID-19 between the PWP with PCS groups. The most common non-motor PCS symptoms were anosmia/hyposmia, sore throat, dysgeusia and skin rashes. There was no statistically significant difference in demographics or specific scores between the two groups, indicating that no prognostic factor for PCS in PWP could be identified. The novelty of the present study is that it suggests the new onset of non-motor PCS symptoms of PWP with a mild to moderate stage.
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Affiliation(s)
- Anastasia Bougea
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Myrto Palkopoulou
- Department of Neurology, Rhodes General Hospital, 85133 Rhodes, Greece
| | - Efthymia Efthymiopoulou
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Panagiotis Zikos
- Department of Neurology, 251 Air Force General Hospital, 11525 Athens, Greece
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Cardoso Mendes L, Abreu Rosa de Sá A, Alves Marques I, Morère Y, de Oliveira Andrade A. RehaBEElitation: the architecture and organization of a serious game to evaluate motor signs in Parkinson's disease. PeerJ Comput Sci 2023; 9:e1267. [PMID: 37346638 PMCID: PMC10280492 DOI: 10.7717/peerj-cs.1267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/08/2023] [Indexed: 06/23/2023]
Abstract
Background The use of serious games (SG) has received increasing attention in health care, and can be applied for both rehabilitation and evaluation of motor signs of several diseases, such as Parkinson's disease (PD). However, the use of these instruments in clinical practice is poorly observed, since there is a scarcity of games that, during their development process, simultaneously address issues of usability and architectural design, contributing to the non-satisfaction of the actual needs of professionals and patients. Thus, this study aimed to present the architecture and usability evaluation at the design stage of a serious game, so-called RehaBEElitation, and assess the accessibility of the game. Methods The game was created by a multidisciplinary team with experience in game development and PD, taking into consideration design guidelines for the development of SG. The user must control the movements of a bee in a 3D environment. The game tasks were designed to mimic the following movements found in the gold-standard method tool-Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS)-for the assessment of individuals with PD: hand opening and closing, hand extension and flexion, hand adduction and abduction, finger tapping, and forearm supination and pronation. The user interacts with the game using a wearable interface device that embeds inertial and tactile sensors. The architecture of RehaBEElitation was detailed using the business process model (BPM) notation and the usability of the architecture was evaluated using the Nielsen-Shneiderman heuristics. Game accessibility was evaluated by comparing the overall scores of each phase between 15 healthy participants and 15 PD patients. The PD group interacted with the game in both the ON and OFF states. Results The system was modularized in order to implement parallel, simultaneous and independent programming at different levels, requiring less computational effort and enabling fluidity between the game and the control of the interface elements in real time. The developed architecture allows the inclusion of new elements for patient status monitoring, extending the functionality of the tool without changing its fundamental characteristics. The heuristic evaluation contemplated all the 14 heuristics proposed by Shneiderman, which enabled the implementation of improvements in the game. The evaluation of accessibility revealed no statistically significant differences (p < 0.05) between groups, except for the healthy group and the PD group in the OFF state of medication during Phase 3 of the game. Conclusions The proposed architecture was presented in order to facilitate the reproduction of the system and extend its application to other scenarios. In the same way, the heuristic evaluation performed can serve as a contribution to the advancement of the SG design for PD. The accessibility evaluation revealed that the game is accessible to individuals with PD.
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Affiliation(s)
- Luanne Cardoso Mendes
- Centre for Innovation and Technology Assessment in Health (NIATS), Faculty of Electrical Engineering, Federal University of Uberlândia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
- Laboratoire de Conception, d’Optimisation et de Modélisation des Systèmes (LCOMS), Université de Lorraine, Metz, Moselle, France
| | - Angela Abreu Rosa de Sá
- Assistive Technology Laboratory, Faculty of Electrical Engineering (NTA), Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Isabela Alves Marques
- Centre for Innovation and Technology Assessment in Health (NIATS), Faculty of Electrical Engineering, Federal University of Uberlândia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
- Laboratoire de Conception, d’Optimisation et de Modélisation des Systèmes (LCOMS), Université de Lorraine, Metz, Moselle, France
| | - Yann Morère
- Laboratoire de Conception, d’Optimisation et de Modélisation des Systèmes (LCOMS), Université de Lorraine, Metz, Moselle, France
| | - Adriano de Oliveira Andrade
- Centre for Innovation and Technology Assessment in Health (NIATS), Faculty of Electrical Engineering, Federal University of Uberlândia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
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Manfredini A, Pisano F, Incoccia C, Marangolo P. The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4889. [PMID: 36981800 PMCID: PMC10049620 DOI: 10.3390/ijerph20064889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic severely affected people's mental health all over the world. This review aims to present a comprehensive overview of the literature related to the effects of COVID-19 lockdown measures and COVID-19 infection on cognitive functioning in both healthy people and people with neurological conditions by considering only standardized tests. We performed a narrative review of the literature via two databases, PUBMED and SCOPUS, from December 2019 to December 2022. In total, 62 out of 1356 articles were selected and organized into three time periods: short-term (1-4 months), medium-term (5-8 months), and long-term (9-12 months), according to the time in which the tests were performed. Regardless of the time period, most studies showed a general worsening in cognitive performance in people with neurological conditions due to COVID-19 lockdown measures and in healthy individuals recovered from COVID-19 infection. Our review is the first to highlight the importance of considering standardized tests as reliable measures to quantify the presence of cognitive deficits due to COVID-19. Indeed, we believe that they provide an objective measure of the cognitive difficulties encountered in the different populations, while allowing clinicians to plan rehabilitation treatments that can be of great help to many patients who still, nowadays, experience post-COVID-19 symptoms.
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Affiliation(s)
- Alessio Manfredini
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Francesca Pisano
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | | | - Paola Marangolo
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
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Rezayi S, Rahmani Katigari M, Shahmoradi L, Nilashi M. Vulnerability of Parkinson's Patients to COVID-19 and Its Consequences and Effects on Them: A Systematic Review. PARKINSON'S DISEASE 2023; 2023:6272982. [PMID: 37144210 PMCID: PMC10151717 DOI: 10.1155/2023/6272982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/08/2023] [Accepted: 04/09/2023] [Indexed: 05/06/2023]
Abstract
Introduction Parkinson's disease (PD) is the second most common neurological disorder. Patients with PD were affected by the COVID-19 pandemic in many different ways. This study's principal purpose is to assess PD patients' vulnerability to COVID-19 and its consequences. Method This systematic review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. A thorough search was conducted in the Medline (through PubMed) and Scopus databases from inception to January 30, 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the studies. Results Most of the studies (38%) had been conducted in Italy. Of the total number of studies, 17 (58%) were cross-sectional, seven (22%) were cohort, four (12%) were quasiexperimental, two (6%) were case-control, and one (3%) was a qualitative study. The PD duration in patients ranged from 3.26 to 13.40 years (IQR1: 5.7 yrs., median: 3.688 yrs., and IQR3: 8.815 yrs.). Meanwhile, the sample size ranged from 12 to 30872 participants (IQR1: 46, median: 96, and IQR3: 211). Despite worsening PD symptoms in the targeted population (persons with COVID-19 and Parkinson's disease), some studies found PD to be a risk factor for more severe COVID-19 disease. There are many adverse effects during the pandemic period in PD patients such as abnormalities of motor, nonmotor functioning, clinical outcomes, activities of daily living, and other outcomes. Conclusion This study confirmed the negative effect of the COVID-19 pandemic on health-related quality of life and its determinants in patients with PD and their caregivers. Thus, due to the worsening symptoms of PD patients in the current pandemic, these people should be given more care and supervision to minimize their coronavirus exposure.
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Affiliation(s)
- Sorayya Rezayi
- Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Leila Shahmoradi
- Health Information Management and Medical Informatics Department, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrbakhsh Nilashi
- UCSI Graduate Business School, UCSI University, No. 1 Jalan Menara Gading, UCSI Heights, 56000 Cheras, Kuala Lumpur, Malaysia
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9
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Hu M, Xu Y, Bu D, Luo K, Chang L, Mao C. The psychological stress response of COVID-19 to medical staff and prevention: A large sample study from China. Front Psychol 2023; 14:1125847. [PMID: 37034918 PMCID: PMC10074311 DOI: 10.3389/fpsyg.2023.1125847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Objectives In the face of the COVID-19 pandemic, medical staff in China were more likely to suffer from psychological problems. By investigating the actual state of psychological stress response of medical staff during the COVID-19 outbreak, the study discussed and analyzed the influencing factors of different psychological states in order to prevent the occurrence of serious adverse emotional events in medical staff. Methods In the Xiangyang Central Hospital, 1,466 medical staff members have adopted the Psychological Questionnaire for Emergencies Events of Public Health (PQEEPH), which includes questions about depression, neurasthenia, fear, obsessive anxiety, and hypochondriac disorders. The questionnaire also asks about gender, age, education level, health, department, position, and whether personnel exposure history correlation analysis has been confirmed. Results The survey revealed that 55% had depression, 26.7% had neurasthenia, 95% had fear, 47.9% had obsessive anxiety, and 69.3% had hypochondria. The effects of depression and hypochondriac emotional stress were significantly greater in female workers than in male workers (p < 0.05). Those with higher educational levels had a stronger emotional stress response. Medical professionals with or without contact histories, those who were suspected or confirmed, as well as those in various positions and departments, all demonstrated significant differences in their stress emotions (p < 0.05). Conclusion Emotional stress affected medical professionals, especially doctors and nurses, who were on the front lines of clinical work in the face of significant public health emergencies. Therefore, to reduce the stress burden and enhance mental health on medical staff, hospitals were suggested to improve their emergency management practices. In addition, the sensitization knowledge training and psychological counseling for front-line clinical staff should be strengthened.
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Affiliation(s)
- Mei Hu
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Yuan Xu
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- *Correspondence: Yuan Xu,
| | - Dengying Bu
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Kai Luo
- School of Food Science and Technology and School of Chemical Engineering, Hubei University of Arts and Science, Xiangyang, China
- Kai Luo,
| | - Liying Chang
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- Comprehensive Stroke Center, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Chun Mao
- Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
- School of Clinical Medicine, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
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10
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Jellinger KA. The pathobiological basis of depression in Parkinson disease: challenges and outlooks. J Neural Transm (Vienna) 2022; 129:1397-1418. [PMID: 36322206 PMCID: PMC9628588 DOI: 10.1007/s00702-022-02559-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Depression, with an estimated prevalence of about 40% is a most common neuropsychiatric disorder in Parkinson disease (PD), with a negative impact on quality of life, cognitive impairment and functional disability, yet the underlying neurobiology is poorly understood. Depression in PD (DPD), one of its most common non-motor symptoms, can precede the onset of motor symptoms but can occur at any stage of the disease. Although its diagnosis is based on standard criteria, due to overlap with other symptoms related to PD or to side effects of treatment, depression is frequently underdiagnosed and undertreated. DPD has been related to a variety of pathogenic mechanisms associated with the underlying neurodegenerative process, in particular dysfunction of neurotransmitter systems (dopaminergic, serotonergic and noradrenergic), as well as to disturbances of cortico-limbic, striato-thalamic-prefrontal, mediotemporal-limbic networks, with disruption in the topological organization of functional mood-related, motor and other essential brain network connections due to alterations in the blood-oxygen-level-dependent (BOLD) fluctuations in multiple brain areas. Other hypothetic mechanisms involve neuroinflammation, neuroimmune dysregulation, stress hormones, neurotrophic, toxic or metabolic factors. The pathophysiology and pathogenesis of DPD are multifactorial and complex, and its interactions with genetic factors, age-related changes, cognitive disposition and other co-morbidities awaits further elucidation.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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Afraie M, Moradi G, Mohammadzedeh P, Azami M, Riyahifar S, Moradi Y. COVID-19 and Parkinson’s disease: a systematic review and meta-analysis. Acta Neurol Belg 2022:10.1007/s13760-022-02141-6. [PMCID: PMC9668237 DOI: 10.1007/s13760-022-02141-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022]
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12
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Pisano F, Manfredini A, Brachi D, Landi L, Sorrentino L, Bottone M, Incoccia C, Marangolo P. How Has COVID-19 Impacted Our Language Use? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13836. [PMID: 36360715 PMCID: PMC9656816 DOI: 10.3390/ijerph192113836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has led to severe consequences for people's mental health. The pandemic has also influenced our language use, shaping our word formation habits. The overuse of new metaphorical meanings has received particular attention from the media. Here, we wanted to investigate whether these metaphors have led to the formation of new semantic associations in memory. A sample of 120 university students was asked to decide whether a target word was or was not related to a prime stimulus. Responses for pandemic pairs in which the target referred to the newly acquired metaphorical meaning of the prime (i.e., "trench"-"hospital") were compared to pre-existing semantically related pairs (i.e., "trench"-"soldier") and neutral pairs (i.e., "trench"-"response"). Results revealed greater accuracy and faster response times for pandemic pairs than for semantic pairs and for semantic pairs compared to neutral ones. These findings suggest that the newly learned pandemic associations have created stronger semantic links in our memory compared to the pre-existing ones. Thus, this work confirms the adaptive nature of human language, and it underlines how the overuse of metaphors evoking dramatic images has been, in part, responsible for many psychological disorders still reported among people nowadays.
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Affiliation(s)
- Francesca Pisano
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Alessio Manfredini
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Daniela Brachi
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Luana Landi
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Lucia Sorrentino
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Marianna Bottone
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | | | - Paola Marangolo
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
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13
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Mai AS, Yong JH, Tan BJW, Xiao B, Tan EK. Impact of COVID-19 pandemic on patients with Parkinson's disease: A meta-analysis of 13,878 patients. Ann Clin Transl Neurol 2022; 9:1504-1513. [PMID: 36065787 PMCID: PMC9538738 DOI: 10.1002/acn3.51616] [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: 03/31/2022] [Revised: 05/16/2022] [Accepted: 06/14/2022] [Indexed: 11/08/2022] Open
Abstract
Background The clinical, neuropsychological, and socioeconomic factors affecting Parkinson's disease (PD) during COVID‐19 pandemic across different populations have not been systematically studied. To address this, we conducted a meta‐analysis of factors that impact the well‐being of PD patients during the pandemic. Methods Medline and Embase were searched for articles published between 2020 and 2022. We conducted random‐effects pooling of estimates and meta‐regression. Results Twenty‐seven studies involving 13,878 patients from America, Europe, Asia, and Africa were included. There is a high prevalence of decreased physical activity and exercise, and worsening motor and neuropsychiatric symptoms (17–56%). Patients in lower‐income countries more frequently reported worsening anxiety (adjusted OR [aOR] 8.94, 95% confidence interval [CI] 1.62–49.28, p = 0.012), sleep (aOR 5.16, 95% CI 1.15–23.17, p = 0.032), and PD symptoms (aOR 3.57, 95% CI 0.96–13.34, p = 0.058). Lockdown was associated with decreased exercise levels (aOR 0.13, 95% CI 0.02–0.78, p = 0.025) and worsening mood (aOR 0.48, 95% CI 0.24–0.95, p = 0.035). Younger age correlated with decreased physical activity (β −0.30, 95% CI −0.53 to −0.07, p = 0.012), exercise (β −0.11, 95% CI −0.15 to −0.07, p < 0.001), worsening PD symptoms (β −0.08, 95% CI −0.15 to −0.01, p = 0.018), and sleep (β −0.14, 95% CI −0.27 to 0, p = 0.044). Female PD patients reported a greater decrease in physical activity (β 11.94, 95% CI 2.17–21.71, p = 0.017) and worse sleep (β 10.76, 95% CI 2.81–18.70, p = 0.008). Conclusion This large meta‐analysis of PD patients in diverse populations identified a high prevalence of physical and mental worsening during the COVID‐19 pandemic, with patients in lower‐income countries being exceptionally vulnerable.
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Affiliation(s)
- Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jung Hahn Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brendan Jen-Wei Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Bin Xiao
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore
| | - Eng-King Tan
- Department of Neurology, Singapore General Hospital Campus, National Neuroscience Institute, Singapore.,Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore
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14
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Seshadri S, Norton SA, Stahl T, Shah M, Dini M, Yarab N, Holtrop JS, Kluger BM. Between a Rock and a Hard Place: The Challenges of Caregiving During a Pandemic for Parkinson's Family Care Partners. Am J Hosp Palliat Care 2022:10499091221119462. [PMID: 35943434 DOI: 10.1177/10499091221119462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aim: To understand Parkinson's Disease (PD) care partners' a) specific challenges that led to worsening strain and b) their suggestions for supports to help them during the ongoing pandemic. Method: Using a qualitative descriptive design, semi-structured interviews with family care partners (n = 19) were completed. Participants were recruited from 10 sites across the United States that varied in size, demographics of patient population served, and geographic location (urban, suburban, rural). Interviews were audio-recorded, de-identified, transcribed verbatim, and coded in a phased manner. The research team analyzed the data and identified themes. Results: During the pandemic, the already difficult task of caregiving was made worse by having to choose between poor options. Five themes exemplified PD care partner experiences: (1) Managing risks and benefits of medical care in settings outside the home vs meeting these needs at home; (2) Struggling to maintain employment benefits with the costs of care and risks of bringing in outside caregivers; (3) Struggling to balance caregiving and self-care; (4) Struggling to be supportive and taking on new caregiving roles in the face of less support services; and (5) Wanting social connections and feeling pressured to maintain isolation. Care partners wanted timely access to, and guidance from healthcare teams to help them. Conclusions: Care partner burden was worsened by lack of guidance when confronted by choices that could lead to negative outcomes. Movement disorder and palliative care providers may be able to alleviate some care partner burden through building systems for timely access and guidance.
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Affiliation(s)
- Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Sally A Norton
- University of Rochester School of Nursing, Rochester NY, USA
| | - Tyler Stahl
- 6927University of Rochester, Rochester, NY, USA
| | - Mina Shah
- 6927University of Rochester, Rochester, NY, USA
| | - Megan Dini
- Parkinson's Foundation, New York, NY, USA
| | | | - Jodi Summers Holtrop
- 12225Department of Family Medicine at the University of Colorado School of Medicine and the Adult and Child Center for Outcomes Research and Delivery (ACCORDS) at the University of Colorado Anschutz Medical Campus
| | - Benzi M Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
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15
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Hallé MC, Delorme C, Coulombe É, Rekik O, Verduyckt I. Participants' perspective on a COVID-19 online vocal group stimulation for people with Parkinson's disease. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:951426. [PMID: 36189073 PMCID: PMC9397883 DOI: 10.3389/fresc.2022.951426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/12/2022] [Indexed: 11/15/2022]
Abstract
The COVID-19 related confinement and social distancing had negative consequences on the health of individuals living with Parkinson's Disease (PD). In collaboration with a non-profit organization, we developed and implemented a daily online vocal stimulation group named “Musculation de la Voix” (MdlV) in April 2020. To better understand the potential of MdlV to diversify existing services available to people with PD experiencing vocal symptoms, this study aimed to explore participants' experience and perception of MdlV in terms of participation, motivations, feelings, perceived changes, and appreciation. The 45 individuals who registered to the Summer 2020 Semester of MdlV were invited to complete an online ten-question survey. Responses to the four close-ended questions were analyzed using descriptive statistics while statements provided in response to the six open-ended questions were subjected to an inductive qualitative content analysis. Thirty seven participants completed the survey. Results revealed that the sample of respondents was mostly constituted of individuals who were engaged in this activity since its very beginning (62,2%), participated daily (59,5%), intended to keep participating in the activity (97,3%), and had never received speech-language therapy (SLT) services before (72,97%). The qualitative analysis yielded one theme relating to prior services: “Previous SLT services are variable and perceived as beneficial but with limitations,” and three themes pertaining to MdlV: “Seeking improvement and support as initial motivations to engage in MdlV,” “Unanticipated benefits and desired gains catalyzing motivation to participate in MdlV,” and “Perceived limitations of MdlV and persisting needs.” Our study participants' engagement and motivation toward MdlV as well as the benefits they perceived in relation to this activity suggest that an online vocal stimulation group may be a promising complement to currently limited SLT services. As limitations and persisting needs were also identified, future studies are required to elucidate what aspect of MdlV works, for whom and how.
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Affiliation(s)
- Marie-Christine Hallé
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Charline Delorme
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Édith Coulombe
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Ouswa Rekik
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Ingrid Verduyckt
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
- *Correspondence: Ingrid Verduyckt
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Mameli F, Zirone E, Capetti B, Mellace D, Ferrucci R, Franco G, Di Fonzo A, Barbieri S, Ruggiero F. Changes in non-motor symptoms in patients with Parkinson's disease following COVID-19 pandemic restrictions: A systematic review. Front Psychol 2022; 13:939520. [PMID: 35936298 PMCID: PMC9355666 DOI: 10.3389/fpsyg.2022.939520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022] Open
Abstract
This review discussed the effects of the impact of the Coronavirus Disease 2019 (COVID-19) pandemic on the psychological wellbeing of people with Parkinson's disease (PD) focusing specifically on depressive symptoms, anxiety levels, sleep, and quality of life (QoL). Together with motor symptoms, psychological symptoms are common and disabling conditions in the clinical course of PD becoming a relevant topic as a result of the lockdown measure due to alter their everyday life. We searched on PubMed online electronic databases for English articles published between January 2020 and 31 December 2021. Twenty-eight relevant studies were found and included in the review. Heterogeneous data emerged from the topics analyzed. Overall, data from depression studies showed significant depressive symptoms if the patient was analyzed longitudinally or vs. a control group consisting in healthy subjects, while these differences become minimal when the control group is a family member. Differently, in most of the studies reviewed there is no evidence of a statistically significant impact on anxiety disorders, nor on the quality of sleep. Conversely, PD patients showed a statistically significant negative impact of QoL compared with control groups or other neurological conditions. Although these findings must be interpreted carefully in the light of the studies' limitations, both in methodology and design, collectively our review showed that COVID-19 pandemic has had negative effects on the mental health of people with PD, due to disruption of healthcare services, loss of usual activities and supports and reduction in physical activity.
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Affiliation(s)
- Francesca Mameli
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Francesca Mameli
| | - Eleonora Zirone
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Benedetta Capetti
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Denise Mellace
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Ferrucci
- “Aldo Ravelli” Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giulia Franco
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessio Di Fonzo
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sergio Barbieri
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabiana Ruggiero
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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17
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Nabizadeh F, Seyedalhosseini Z, Balabandian M, Reza Rostami M. Psychological outcomes of the COVID-19 pandemic in patients with Parkinson's disease: A systematic review. J Clin Neurosci 2022; 102:101-108. [PMID: 35777112 PMCID: PMC9237130 DOI: 10.1016/j.jocn.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/02/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
Background There were concerns about the psychological outcomes of coronavirus disease from the beginning of the pandemic. Parkinson’s disease (PD) patients seem to be more vulnerable to mental health disorders like stress, depression, anxiety, or worsening quality of life during COVID-19 lockdown. We aimed to conduct a systematic review to investigate the psychological outcomes of COVID-19 among the PD population. Methods A systematic search was conducted using PubMed, Scopus, and Web of Science. We included original studies which reported the psychological impact of COVID-19 in the PD population with a minimum of 10 cases. Results After the screening, 21 studies with a total of 5236 PD cases were included in our qualitative synthesis. Depression, anxiety, and to less extent sleep disorders and apathy are the most studied psychological outcomes. Most of the studies indicated that the severity or the prevalence of psychiatric disturbance increased due to the COVID-19 pandemic in PD patients. The prevalence of anxiety was 14% to 66.5%, while depression was reported in 0% to 50% of PD patients during and after the pandemic. Also, sleep problems were reported in 35.4% to 68.9% of PD patients. Conclusion Considering the overall trend of increment in the severity of the main psychological outcomes observed in the present systematic review, it is suggested that future studies conduct a more accurate analysis of the prevalence, severity, and associated pathology of psychological outcomes of COVID-19 in PD patients.
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Affiliation(s)
- Fardin Nabizadeh
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahrasadat Seyedalhosseini
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Iran; School of Medicine, Shahid Beheshti University of Medical Science, Iran
| | - Mohammad Balabandian
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Rostami
- Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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18
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Bianchini E, Onelli C, Morabito C, Alborghetti M, Rinaldi D, Anibaldi P, Marcolongo A, Salvetti M, Pontieri FE. Feasibility, Safety, and Effectiveness of Telerehabilitation in Mild-to-Moderate Parkinson's Disease. Front Neurol 2022; 13:909197. [PMID: 35785358 PMCID: PMC9245570 DOI: 10.3389/fneur.2022.909197] [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: 03/31/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Parkinson's disease (PD) patients frequently engage in rehabilitation to ameliorate symptoms. During the Coronavirus disease 2019 (COVID-19) pandemic, access to rehabilitation programs has been markedly limited, consequently, telerehabilitation gained popularity. In this prospective, open-label, and pilot study, we aimed to investigate feasibility, safety, and efficacy of telerehabilitation in mild-to-moderate PD patients. Materials and Methods Twenty-three PD patients, with Hoehn and Yahr stage <3, without gait disturbances or dementia and capable of using the televisit platform, were recruited for a 5-week telerehabilitation program, consisting of 1 remote visit with a therapist and a minimum of two sessions of >30-min of self-conducted exercises per week. Patients received video tutorials of exercises and were asked to keep a diary of sessions. At baseline (T0), at the end of the intervention (T1), and 1 month after the end of treatment (T2), patients were remotely assessed with MDS-UPDRS part I-III, PDQ-39, Functional Independence Measure (FIM), and Frontal Assessment Battery scales, respectively. Acceptable compliance to the program was defined as >60% matching of frequency and duration of sessions, whereas optimal compliance was set at >80% matching. Results The dropout rate was 0%. Over 85% of patients reached acceptable adherence cut-off and around 70% reached optimal one. No adverse events were reported during sessions. The repeated measure analysis of variance (rANOVA) showed a significant effect of factor “time” for MDS-UPDRS-III (p < 0.0001) with a mean reduction of 4.217 points between T0 and T1 and return to baseline at T2. No significant effect was found for other outcome measures. Conclusion Our findings demonstrate that telerehabilitation is safe, feasible, and effective on motor symptoms in mild-to-moderate PD patients.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
| | - Camilla Onelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | | | - Marika Alborghetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
| | - Domiziana Rinaldi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy
| | | | | | - Marco Salvetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Mediterraneo (INM) Neuromed, Pozzilli, Italy
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Sant'Andrea University Hospital, Rome, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy
- *Correspondence: Francesco E. Pontieri
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19
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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.
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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.
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20
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Rota S, Boura I, Wan YM, Lazcano-Ocampo C, Rodriguez-Violante M, Antonini A, Chaudhuri KR. Spotlight on non-motor symptoms and Covid-19. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 165:103-133. [PMID: 36208897 PMCID: PMC9270874 DOI: 10.1016/bs.irn.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Coronavirus Disease 2019 (Covid-19) pandemic has profoundly affected the quality of life (QoL) and health of the general population globally over the past 2 years, with a clear impact on people with Parkinson's Disease (PwP, PD). Non-motor symptoms have been widely acknowledged to hold a vital part in the clinical spectrum of PD, and, although often underrecognized, they significantly contribute to patients' and their caregivers' QoL. Up to now, there have been numerous reports of newly emerging or acutely deteriorating non-motor symptoms in PwP who had been infected by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), while some of these symptoms, like fatigue, pain, depression, anxiety and cognitive impairment, have also been identified as part of the long-COVID syndrome due to their persistent nature. The subjacent mechanisms, mediating the appearance or progression of non-motor symptoms in the context of Covid-19, although probably multifactorial in origin, remain largely unknown. Such mechanisms might be, at least partly, related solely to the viral infection per se or the lifestyle changes imposed during the pandemic, as many of the non-motor symptoms seem to be prevalent even among Covid-19 patients without PD. Here, we summarize the available evidence and implications of Covid-19 in non-motor PD symptoms in the acute and chronic, if applicable, phase of the infection, with a special reference on studies of PwP.
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21
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Fründt O, Hanff AM, Mai T, Kirchner C, Bouzanne des Mazery E, Amouzandeh A, Buhmann C, Krüger R, Südmeyer M. Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson's Disease in Germany (Care4PD). Brain Sci 2021; 12:62. [PMID: 35053806 PMCID: PMC8773478 DOI: 10.3390/brainsci12010062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/25/2021] [Accepted: 12/27/2021] [Indexed: 12/23/2022] Open
Abstract
The Care4PD study examined the impact of the COVID-19 pandemic on the care situation of people (PwP) with Parkinson's disease in Germany. A comprehensive, nationwide, anonymous questionnaire for PwP was distributed by the members' journal of the German Parkinson's Disease Association and in several PD specialized in- and outpatient institutions. PwP subjectively evaluated their general care situation and individual impairments during the pandemic. We analyzed 1269 eligible out of 1437 returned questionnaires (88.3%) and compared PwP with (p-LTC) and without (np-LTC) professional long-term care. Both groups rated the general pandemic-related consequences as being rather mild to moderate (e.g., worsening of symptom or concerns). However, familial/social contact restrictions were indicated as most compromising, whereas access to outpatient professional health care providers was less affected. PwP with professional LTC reported more impairment than those without. COVID-19 vaccination rates and acceptance were generally high (p-LTC: 64.3%, np-LTC: 52.3%) at the time of the study, but realization of sanitary measures-especially wearing masks as a patient during care sessions-still needs to be improved. Technical options for telemedicine were principally available but only rarely used. Altogether, during the COVID-19 pandemic, PwP in Germany seemed to have a relatively stable health care access, at least in outpatient settings, while mainly social isolation compromised them. The p-LTC group was more impaired in everyday live compared with the np-LTC group.
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Affiliation(s)
- Odette Fründt
- Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany; (C.K.); (E.B.d.M.); (A.A.); (M.S.)
| | - Anne-Marie Hanff
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), 1A-B, Rue Thomas Edison, L-1445 Luxembourg, Luxembourg; (A.-M.H.); (R.K.)
| | - Tobias Mai
- Department of Nursing Development/Nursing Research, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany;
| | - Christiane Kirchner
- Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany; (C.K.); (E.B.d.M.); (A.A.); (M.S.)
| | - Emma Bouzanne des Mazery
- Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany; (C.K.); (E.B.d.M.); (A.A.); (M.S.)
| | - Ali Amouzandeh
- Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany; (C.K.); (E.B.d.M.); (A.A.); (M.S.)
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
| | - Rejko Krüger
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), 1A-B, Rue Thomas Edison, L-1445 Luxembourg, Luxembourg; (A.-M.H.); (R.K.)
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 6, Avenue du Swing, L-4367 Luxembourg, Luxembourg
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg (CHL), 4, Rue Nicolas Ernest Barblé, L-1210 Luxembourg, Luxembourg
| | - Martin Südmeyer
- Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany; (C.K.); (E.B.d.M.); (A.A.); (M.S.)
- Department of Neurology, University Medical Center Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
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22
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Krey L, Huber MK, Höglinger GU, Wegner F. Can SARS-CoV-2 Infection Lead to Neurodegeneration and Parkinson's Disease? Brain Sci 2021; 11:1654. [PMID: 34942956 PMCID: PMC8699589 DOI: 10.3390/brainsci11121654] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
The SARS-CoV-2 pandemic has affected the daily life of the worldwide population since 2020. Links between the newly discovered viral infection and the pathogenesis of neurodegenerative diseases have been investigated in different studies. This review aims to summarize the literature concerning COVID-19 and Parkinson's disease (PD) to give an overview on the interface between viral infection and neurodegeneration with regard to this current topic. We will highlight SARS-CoV-2 neurotropism, neuropathology and the suspected pathophysiological links between the infection and neurodegeneration as well as the psychosocial impact of the pandemic on patients with PD. Some evidence discussed in this review suggests that the SARS-CoV-2 pandemic might be followed by a higher incidence of neurodegenerative diseases in the future. However, the data generated so far are not sufficient to confirm that COVID-19 can trigger or accelerate neurodegenerative diseases.
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Affiliation(s)
- Lea Krey
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (M.K.H.); (G.U.H.); (F.W.)
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23
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Sabetkish N, Rahmani A. The overall impact of COVID-19 on healthcare during the pandemic: A multidisciplinary point of view. Health Sci Rep 2021; 4:e386. [PMID: 34622020 PMCID: PMC8485600 DOI: 10.1002/hsr2.386] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS The Coronavirus disease 2019 (COVID-19) pandemic globally changed the priorities of medical and surgical procedures. It has caused many healthcare systems to stop performing their routine screenings. Altering medical clinics to COVID-19 referral centers, lockdowns, and the public fear to refer to medical centers caused a significant reduction in the referral rate; especially in the elderly. This short review article highlights the transform in clinical practice during the post-COVID era and the need for future medical revolutions. METHODS A comprehensive literature search was separately performed by both authors. The articles published between 2019 and August 2021 were included in this study and selected according to a quality appraisal method. RESULTS We have summarized the possible corresponding changes in the diagnosis and treatment of all fields of medical care including internal medicine, surgical, and minor subcategories after the COVID-19 pandemic. We have also discussed the potential impacts of the pandemic on all these different categories and subcategories of medicine, including the outpatient setting and clinical work. We do believe that the lack of routine check-ups has led to an increase in the stage of disease in patients with a previously diagnosed problem. On the other hand, the dramatic change in the lifestyle of the population including restricted mobility and increased consumption of unhealthy food has caused metabolic syndrome and other new diseases that have not been diagnosed and properly managed. CONCLUSION Our findings revealed the urgent need for public health awareness. It indicated the need to carry out both psychological and screening approaches in the post-COVID era to not miss patients with a chronic disease and new cases who were undiagnosed during the COVID pandemic.
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Affiliation(s)
- Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical CenterTehran University of Medical SciencesTehranIran
- ImmunologyAsthma and Allergy Research Institute, Tehran University of Medical SciencesTehranIran
| | - Alireza Rahmani
- Research Center for Prevention of Cardiovascular DiseaseInstitute of Endocrinology & Metabolism, Iran University of Medical SciencesTehranIran
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24
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Dommershuijsen LJ, Van der Heide A, Van den Berg EM, Labrecque JA, Ikram MK, Ikram MA, Bloem BR, Helmich RC, Darweesh SKL. Mental health in people with Parkinson's disease during the COVID-19 pandemic: potential for targeted interventions? NPJ Parkinsons Dis 2021; 7:95. [PMID: 34711842 PMCID: PMC8553848 DOI: 10.1038/s41531-021-00238-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic has introduced a myriad of challenges to the social life and care of people with Parkinson’s disease (PD), which could potentially worsen mental health problems. We used baseline data of the PRIME-NL study (N = 844) to examine whether the association between COVID-19 stressors and mental health is disproportionately large in specific subgroups of people with PD and to explore effects of hypothetical reductions in COVID-19 stressors on mental health and quality of life. The mean (SD) age of the study population was 70.3 (7.8) years and 321 (38.0%) were women. The linear regression effect estimate of the association of COVID-19 stressors with mental health was most pronounced in women, highly educated people, people with advanced PD and people prone to distancing or seeking social support. Smaller effect estimates were found in people scoring high on confrontive coping or planful problem solving. The parametric G-formula method was used to calculate the effects of hypothetical interventions on COVID-19 stressors. An intervention reducing stressors with 50% in people with above median MDS-UPDRS-II decreased the Beck Depression Inventory in this group from 14.7 to 10.6, the State-Trait Anxiety Inventory from 81.6 to 73.1 and the Parkinson’s Disease Quality of Life Questionnaire from 35.0 to 24.3. Insights from this cross-sectional study help to inform tailored care interventions to subgroups of people with PD most vulnerable to the impact of COVID-19 on mental health and quality of life.
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Affiliation(s)
- L J Dommershuijsen
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Van der Heide
- Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E M Van den Berg
- Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J A Labrecque
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M K Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - B R Bloem
- Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R C Helmich
- Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S K L Darweesh
- Centre of Expertise for Parkinson & Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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