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Angelini G, Malvaso A, Schirripa A, Campione F, D'Addario SL, Toschi N, Caligiore D. Unraveling sex differences in Parkinson's disease through explainable machine learning. J Neurol Sci 2024; 462:123091. [PMID: 38870732 DOI: 10.1016/j.jns.2024.123091] [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: 03/26/2024] [Revised: 05/24/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
Sex differences affect Parkinson's disease (PD) development and manifestation. Yet, current PD identification and treatments underuse these distinctions. Sex-focused PD literature often prioritizes prevalence rates over feature importance analysis. However, underlying aspects could make a feature significant for predicting PD, despite its score. Interactions between features require consideration, as do distinctions between scoring disparities and actual feature importance. For instance, a higher score in males for a certain feature doesn't necessarily mean it's less important for characterizing PD in females. This article proposes an explainable Machine Learning (ML) model to elucidate these underlying factors, emphasizing the importance of features. This insight could be critical for personalized medicine, suggesting the need to tailor data collection and analysis for males and females. The model identifies sex-specific differences in PD, aiding in predicting outcomes as "Healthy" or "Pathological". It adopts a system-level approach, integrating heterogeneous data - clinical, imaging, genetics, and demographics - to study new biomarkers for diagnosis. The explainable ML approach aids non-ML experts in understanding model decisions, fostering trust and facilitating interpretation of complex ML outcomes, thus enhancing usability and translational research. The ML model identifies muscle rigidity, autonomic and cognitive assessments, and family history as key contributors to PD diagnosis, with sex differences noted. The genetic variant SNCA-rs356181 may be more significant in characterizing PD in males. Interaction analysis reveals a greater occurrence of feature interplay among males compared to females. These disparities offer insights into PD pathophysiology and could guide the development of sex-specific diagnostic and therapeutic approaches.
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Affiliation(s)
- Gianfrancesco Angelini
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy
| | - Antonio Malvaso
- Department of Brain and Behavioral Sciences, IRCCS Mondino Foundation, National Neurological Institute, University of Pavia, Via Mondino 2, 27100 Pavia, Italy; Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via Gian Domenico Romagnosi, 18A, 00196 Rome, Italy
| | - Aurelia Schirripa
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via Gian Domenico Romagnosi, 18A, 00196 Rome, Italy
| | - Francesca Campione
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via Gian Domenico Romagnosi, 18A, 00196 Rome, Italy
| | - Sebastian Luca D'Addario
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via Gian Domenico Romagnosi, 18A, 00196 Rome, Italy; IRCCS Fondazione Santa Lucia, Via Del Fosso di Fiorano, 64, 00143 Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA
| | - Daniele Caligiore
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via Gian Domenico Romagnosi, 18A, 00196 Rome, Italy; AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, 00199 Rome, Italy.
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Ojo OA, Gyebi GA, Ezenabor EH, Iyobhebhe M, Emmanuel DA, Adelowo OA, Olujinmi FE, Ogunwale TE, Babatunde DE, Ogunlakin AD, Ojo AB, Adeyemi OS. Exploring beetroot ( Beta vulgaris L.) for diabetes mellitus and Alzheimer's disease dual therapy: in vitro and computational studies. RSC Adv 2024; 14:19362-19380. [PMID: 38887650 PMCID: PMC11181461 DOI: 10.1039/d4ra03638g] [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: 05/17/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
This study explored the flavonoid-rich extract of beetroot (Beta vulgaris L.) for type 2 diabetes mellitus (T2D) and Alzheimer's disease (AD) dual therapy by using in vitro and molecular simulation studies. Flavonoid-rich extracts of B. vulgaris fruit were evaluated for their antidiabetic and anti-alzheimic activities. Molecular docking and dynamic simulation were performed to identify potential bioactive flavonoids with dual therapeutic effects on T2D and AD. Flavonoid-rich extracts of B. vulgaris fruit (IC50 = 73.062 ± 0.480 μg mL-1) had moderate activity against α-amylase compared to the standard acarbose (IC50 = 27.104 ± 0.270 μg mL-1). Compared with acarbose, flavonoid-rich extracts of B. vulgaris fruit had appreciable activity against α-glucosidase (IC50 = 17.389 ± 0.436 μg mL-1) (IC50 = 37.564 ± 0.620 μg mL-1). For AChE inhibition, flavonoid-rich extracts of B. vulgaris fruit exhibited (p < 0.0001) inhibitory activity (IC50 = 723.260 ± 5.466 μg mL-1), albeit weaker than that of the standard control, galantamine (IC50 = 27.950 ± 0.122 μg mL-1). Similarly, flavonoid-rich extracts of B. vulgaris fruit showed considerable (p < 0.0001) inhibitory effects on BChE (IC50 = 649.112 ± 0.683 μg mL-1). In contrast, galantamine (IC50 = 23.126 ± 0.683 μg mL-1) is more potent than the extracts of B. vulgaris fruit. Monoamine oxidase (MAO) activity increased in FeSO4-induced brain damage. In contrast, flavonoid-rich extracts of B. vulgaris fruit protected against Fe2+-mediated brain damage by suppressing MAO activity in a concentration-dependent manner. HPLC-DAD profiling of the extracts identified quercetrin, apigenin, rutin, myricetin, iso-quercetrin, p-coumaric acid, ferulic acid, caffeic acid, and gallic acid. Molecular docking studies revealed quercetrin, apigenin, rutin, iso-queretrin, and myricetin were the top docked bioactive flavonoids against the five top target proteins (α-amylase, α-glucosidase AchE, BchE, and MAO). Molecular dynamic simulations revealed that the complexes formed remained stable over the course of the simulation. Collectively, the findings support the prospect of flavonoid-rich extracts of B. vulgaris root functioning as a dual therapy for T2D and AD.
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Affiliation(s)
- Oluwafemi Adeleke Ojo
- Biochemistry Programme, Bowen University Iwo 232102 Nigeria +2347037824647
- Good Health and Wellbeing Research Clusters (SDG 03) Bowen University Iwo 232102 Nigeria
| | - Gideon Ampoma Gyebi
- Natural Products and Structural (Bio-Chem)-Informatics Research Laboratory (NpsBC-RI), Department of Biochemistry, Bingham University Karu Nigeria
| | | | | | | | | | | | | | | | - Akingbolabo Daniel Ogunlakin
- Biochemistry Programme, Bowen University Iwo 232102 Nigeria +2347037824647
- Good Health and Wellbeing Research Clusters (SDG 03) Bowen University Iwo 232102 Nigeria
| | | | - Oluyomi Stephen Adeyemi
- Biochemistry Programme, Bowen University Iwo 232102 Nigeria +2347037824647
- Good Health and Wellbeing Research Clusters (SDG 03) Bowen University Iwo 232102 Nigeria
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Diaconu S, Monescu V, Filip R, Marian L, Kakucs C, Murasan I, Chaudhuri KR, Jianu DC, Falup-Pecurariu C, Opritoiu B. The Impact of Fatigue on Sleep and Other Non-Motor Symptoms in Parkinson's Disease. Brain Sci 2024; 14:397. [PMID: 38672046 PMCID: PMC11048391 DOI: 10.3390/brainsci14040397] [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: 03/26/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Fatigue is a common non-motor symptom in Parkinson's disease (PD), but even so, it may still be underdiagnosed or misdiagnosed in current practice due to its non-specific manifestations. The aims of this study were to investigate the prevalence of fatigue in PD patients compared to healthy controls and to identify the main characteristics and associations of fatigue with other non-motor symptoms and the impact of fatigue on sleep disturbances in Parkinson's disease. MATERIALS AND METHODS case-control study in which 131 PD patients and 131 age- and sex-matched controls were enrolled. Main characteristics of fatigue, sleep, and other non-motor symptoms were assessed using specific validated questionnaires. RESULTS According to the Chalder fatigue scale, fatigue is more prevalent in PD patients (38.16%) compared to healthy controls (26.71%). Fatigue was identified in 46.54% of the PD patients using the Parkinson's Fatigue Scale (PFS-16). PD patients with fatigue presented a worse motor status, more sleep disturbances (insomnia, daytime sleepiness), a broader spectrum of non-motor symptoms (pain, anxiety, urinary disturbances), worse cognitive performances, a lower level of happiness, and worse quality of life compared to PD patients without fatigue. CONCLUSION Fatigue is a common symptom of PD and needs to be assessed, considering its consequences on quality of life. Sleep disturbances have a great influence over fatigue in PD patients.
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Affiliation(s)
- Stefania Diaconu
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Vlad Monescu
- Faculty of Mathematics and Informatics, Transilvania University, 500036 Brașov, Romania
| | - Rafaela Filip
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Laura Marian
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Cristian Kakucs
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Iulia Murasan
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
| | - K. Ray Chaudhuri
- Parkinson’s Foundation Centre of Excellence, King’s College Hospital, Denmark Hill, London SE5 9RS, UK;
- 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
| | - Dragos Catalin Jianu
- Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- “Pius Branzeu” Clinical Emergency County Hospital, 300736 Timisoara, Romania
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, 500365 Brașov, Romania; (S.D.); (R.F.); (L.M.); (I.M.); (C.F.-P.)
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
| | - Bianca Opritoiu
- Faculty of Medicine, Transilvania University, 500036 Brașov, Romania; (C.K.); (B.O.)
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Lee J, Sohn YH, Chung SJ, Kim E, Kim Y. Presentations of nonmotor symptoms by sex and onset age in people with Parkinson's disease. Int J Nurs Pract 2024; 30:e13177. [PMID: 37394896 DOI: 10.1111/ijn.13177] [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: 01/15/2023] [Revised: 05/18/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. AIM The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. DESIGN This is a cross-sectional descriptive study. METHODS A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. RESULTS All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young-onset people with Parkinson's disease reported more depression than late-onset people with Parkinson's disease. CONCLUSION This study contributes to the understanding of symptom experience beyond motor-related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age-specific symptoms, rather than addressing with all nonmotor symptoms.
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Affiliation(s)
- JuHee Lee
- Mo-Im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Centre of Korea: A Joanna Briggs Institute of Excellence, College of Nursing, Yonsei University, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Eunyoung Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Yielin Kim
- Division of Nursing, Severance Hospital, Yonsei University Health System, Seoul, South Korea
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Hong J, Xie H, Chen Y, Liu D, Wang T, Xiong K, Mao Z. Effects of STN-DBS on cognition and mood in young-onset Parkinson's disease: a two-year follow-up. Front Aging Neurosci 2024; 15:1177889. [PMID: 38292047 PMCID: PMC10824910 DOI: 10.3389/fnagi.2023.1177889] [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: 03/02/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the cognition and mood of patients with PD are still not uniformly concluded, and young-onset Parkinson's disease (YOPD) is even less explored. Objective To observe the effectiveness of STN-DBS on the cognition and mood of YOPD patients. Methods A total of 27 subjects, with a mean age at onset of 39.48 ± 6.24 and age at surgery for STN-DBS of 48.44 ± 4.85, were followed up preoperatively and for 2 years postoperatively. Using the Unified Parkinson disease rating scale (UPDRS), H&Y(Hoehn and Yahr stage), 39-Item Parkinson's Disease Questionnaire (PDQ-39), Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) to assess motor, cognition, and mood. Results At the 2-year follow-up after STN-DBS, YOPD patients showed significant improvements in motor and quality of life (UPDRS III: p < 0.001, PDQ-39: p < 0.001); overall cognition was not significantly different from preoperative (MMSE: p = 0.275, MoCA: p = 0.913), although language function was significantly impaired compared to preoperative (MMSE: p = 0.004, MoCA: p = 0.009); depression and anxiety symptoms also improved significantly (HAMD: p < 0.001, HAMA: p < 0.001) and the depression score correlated significantly with motor (preoperative: r = 0.493, p = 0.009), disease duration (preoperative: r = 0.519, p = 0.006; postoperative: r = 0.406, p = 0.036) and H&Y (preoperative: r = 0.430, p = 0.025; postoperative: r = 0.387, p = 0.046); total anxiety scores were also significantly correlated with motor (preoperative: r = 0.553, p = 0.003; postoperative: r = 0.444, p = 0.020), disease duration (preoperative: r = 0.417, p = 0.031), PDQ-39 (preoperative: r = 0.464, p = 0.015) and H&Y (preoperative: r = 0.440, p = 0.022; postoperative: r = 0.526, p = 0.005). Conclusion STN-DBS is a safe and effective treatment for YOPD. The mood improved significantly, and overall cognition was not impaired, were only verbal fluency decreased but did not affect the improvement in quality of life.
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Affiliation(s)
- Jun Hong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Huimin Xie
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Yuhua Chen
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Di Liu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Tianyu Wang
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
- Hebei Key Laboratory of Nerve Injury and Repair, Chengde Medical University, Chengde, China
| | - Kun Xiong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, China
| | - Zhiqi Mao
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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Patwardhan A, Kamble N, Bhattacharya A, Holla V, Yadav R, Pal PK. Impact of Non-Motor Symptoms on Quality of Life in Patients with Early-Onset Parkinson's Disease. Can J Neurol Sci 2024:1-10. [PMID: 38178714 DOI: 10.1017/cjn.2023.336] [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: 01/06/2024]
Abstract
BACKGROUND Early-onset Parkinson's disease (EOPD) refers to patients with Parkinson's disease (PD) whose age at disease onset is less than 50 years. Literature on the non-motor symptoms (NMS) in these patients is very limited in the Indian context. We aimed to study the NMS in patients with EOPD and its impact on the quality of life (QoL). METHODS We included 124 patients with EOPD with a mean age at disease onset between 21 and 45 years and 60 healthy controls (HC). NMS were assessed using validated scales, and the QoL domains were evaluated using the PD QoL-39 scale (PDQ-39). RESULTS The mean age at disease onset in EOPD patients was 37.33 ± 6.36 years. Majority of the patients were male (66.12%). The average disease duration was 6.62 ± 5.3 years. EOPD patients exhibited a significantly higher number of NMS per patient (7.97 ± 4.69) compared to HC (1.3 ± 1.39; p < 0.001). The most common NMS reported were urinary dysfunction, body pain, poor sleep quality, constipation, anxiety, depression, cognitive impairment, and REM sleep behavior disorder. The total NMS burden correlated with the QoL measures. Distinctive patterns of QoL subdomain involvement were identified, with sleep/fatigue, mood/cognition, and urinary dysfunction independently influencing QoL metrics. CONCLUSIONS Our study provides valuable insights into the NMS profile and its impact on QoL in patients with EOPD, addressing an important knowledge gap in the Indian context. By understanding the specific NMS and their influence on QoL, healthcare professionals can develop targeted interventions to address these symptoms and improve the overall QoL.
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Affiliation(s)
- Ameya Patwardhan
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Vikram Holla
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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Houle N, Feaster T, Mira A, Meeks K, Stepp CE. Sex Differences in the Speech of Persons With and Without Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:96-116. [PMID: 37889201 PMCID: PMC11000784 DOI: 10.1044/2023_ajslp-22-00350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/24/2023] [Accepted: 08/30/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Sex differences are apparent in the prevalence and the clinical presentation of Parkinson's disease (PD), but their effects on speech have been less studied. METHOD Speech acoustics of persons with (34 females and 34 males) and without (age- and sex-matched) PD were examined, assessing the effects of PD diagnosis and sex on ratings of dysarthria severity and acoustic measures of phonation (fundamental frequency standard deviation, smoothed cepstral peak prominence), speech rate (net syllables per second, percent pause ratio), and articulation (articulatory-acoustic vowel space, release burst precision). RESULTS Most measures were affected by PD (dysarthria severity, fundamental frequency standard deviation) and sex (smoothed cepstral peak prominence, net syllables per second, percent pause ratio, articulatory-acoustic vowel space), but without interactions between them. Release burst precision was differentially affected by sex in PD. Relative to those without PD, persons with PD produced fewer plosives with a single burst: females more frequently produced multiple bursts, whereas males more frequently produced no burst at all. CONCLUSIONS Most metrics did not indicate that speech production is differentially affected by sex in PD. Sex was, however, associated with disparate effects on release burst precision in PD, which deserves further study. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24388666.
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Affiliation(s)
- Nichole Houle
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Taylor Feaster
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Amna Mira
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Kirsten Meeks
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
| | - Cara E. Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston University, MA
- Department of Otolaryngology–Head & Neck Surgery, Boston University School of Medicine, MA
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Raheel K, Deegan G, Di Giulio I, Cash D, Ilic K, Gnoni V, Chaudhuri KR, Drakatos P, Moran R, Rosenzweig I. Sex differences in alpha-synucleinopathies: a systematic review. Front Neurol 2023; 14:1204104. [PMID: 37545736 PMCID: PMC10398394 DOI: 10.3389/fneur.2023.1204104] [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: 04/11/2023] [Accepted: 06/13/2023] [Indexed: 08/08/2023] Open
Abstract
Background Past research indicates a higher prevalence, incidence, and severe clinical manifestations of alpha-synucleinopathies in men, leading to a suggestion of neuroprotective properties of female sex hormones (especially estrogen). The potential pathomechanisms of any such effect on alpha-synucleinopathies, however, are far from understood. With that aim, we undertook to systematically review, and to critically assess, contemporary evidence on sex and gender differences in alpha-synucleinopathies using a bench-to-bedside approach. Methods In this systematic review, studies investigating sex and gender differences in alpha-synucleinopathies (Rapid Eye Movement (REM) Behavior Disorder (RBD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA)) from 2012 to 2022 were identified using electronic database searches of PubMed, Embase and Ovid. Results One hundred sixty-two studies were included; 5 RBD, 6 MSA, 20 DLB and 131 PD studies. Overall, there is conclusive evidence to suggest sex-and gender-specific manifestation in demographics, biomarkers, genetics, clinical features, interventions, and quality of life in alpha-synucleinopathies. Only limited data exists on the effects of distinct sex hormones, with majority of studies concentrating on estrogen and its speculated neuroprotective effects. Conclusion Future studies disentangling the underlying sex-specific mechanisms of alpha-synucleinopathies are urgently needed in order to enable novel sex-specific therapeutics.
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Affiliation(s)
- Kausar Raheel
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Gemma Deegan
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
| | - Irene Di Giulio
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom
| | - Diana Cash
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Katarina Ilic
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- BRAIN, Imaging Centre, CNS, King’s College London, London, United Kingdom
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Valentina Gnoni
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Lecce, Italy
| | - K. Ray Chaudhuri
- Movement Disorders Unit, King’s College Hospital and Department of Clinical and Basic Neurosciences, Institute of Psychiatry, Psychology and Neuroscience and Parkinson Foundation Centre of Excellence, King’s College London, London, United Kingdom
| | - Panagis Drakatos
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Rosalyn Moran
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
| | - Ivana Rosenzweig
- Sleep and Brain Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom
- Sleep Disorders Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
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Nicoletti A, Baschi R, Cicero CE, Iacono S, Re VL, Luca A, Schirò G, Monastero R. Sex and gender differences in Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis: a narrative review. Mech Ageing Dev 2023; 212:111821. [PMID: 37127082 DOI: 10.1016/j.mad.2023.111821] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023]
Abstract
Neurodegenerative diseases (NDs), including Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS), exhibit high phenotypic variability and they are very common in the general population. These diseases are associated with poor prognosis and a significant burden on patients and their caregivers. Although increasing evidence suggests that biological sex is an important factor for the development and phenotypical expression of some NDs, the role of sex and gender in the diagnosis and prognosis of NDs has been poorly explored. Current knowledge relating to sex- and gender-related differences in the epidemiology, clinical features, biomarkers, and treatment of AD, PD, and ALS will be summarized in this narrative review. The cumulative evidence hitherto collected suggests that sex and gender are factors to be considered in explaining the heterogeneity of these NDs. Clarifying the role of sex and gender in AD, PD, and ALS is a key topic in precision medicine, which will facilitate sex-specific prevention and treatment strategies to be implemented in the near future.
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Affiliation(s)
- Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Roberta Baschi
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Salvatore Iacono
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Vincenzina Lo Re
- Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy; Women's Brain Project, Guntershausen, Switzerland
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy
| | - Roberto Monastero
- Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Via La Loggia 1, 90129 Palermo, Italy.
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10
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Sex Differences in Motor and Non-Motor Symptoms among Spanish Patients with Parkinson's Disease. J Clin Med 2023; 12:jcm12041329. [PMID: 36835866 PMCID: PMC9960095 DOI: 10.3390/jcm12041329] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Sex plays a role in Parkinson's disease (PD) mechanisms. We analyzed sex difference manifestations among Spanish patients with PD. PATIENTS AND METHODS PD patients who were recruited from the Spanish cohort COPPADIS from January 2016 to November 2017 were included. A cross-sectional and a two-year follow-up analysis were conducted. Univariate analyses and general linear model repeated measure were used. RESULTS At baseline, data from 681 PD patients (mean age 62.54 ± 8.93) fit the criteria for analysis. Of them, 410 (60.2%) were males and 271 (39.8%) females. There were no differences between the groups in mean age (62.36 ± 8.73 vs. 62.8 ± 9.24; p = 0.297) or in the time from symptoms onset (5.66 ± 4.65 vs. 5.21 ± 4.11; p = 0.259). Symptoms such as depression (p < 0.0001), fatigue (p < 0.0001), and pain (p < 0.00001) were more frequent and/or severe in females, whereas other symptoms such as hypomimia (p < 0.0001), speech problems (p < 0.0001), rigidity (p < 0.0001), and hypersexuality (p < 0.0001) were more noted in males. Women received a lower levodopa equivalent daily dose (p = 0.002). Perception of quality of life was generally worse in females (PDQ-39, p = 0.002; EUROHIS-QOL8, p = 0.009). After the two-year follow-up, the NMS burden (Non-Motor Symptoms Scale total score) increased more significantly in males (p = 0.012) but the functional capacity (Schwab and England Activities of Daily Living Scale) was more impaired in females (p = 0.001). CONCLUSION The present study demonstrates that there are important sex differences in PD. Long-term prospective comparative studies are needed.
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11
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García-Martín E, Pastor P, Gómez-Tabales J, Alonso-Navarro H, Alvarez I, Buongiorno M, Cerezo-Arias MDLO, Aguilar M, Agúndez JAG, Jiménez-Jiménez FJ. Association between LAG3/CD4 gene variants and risk of Parkinson's disease. Eur J Clin Invest 2022; 52:e13847. [PMID: 36224715 PMCID: PMC9787747 DOI: 10.1111/eci.13847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVES Several recent studies suggest a possible role of lymphocyte activation 3 (LAG3) protein. LAG3 can behave as an α-synuclein ligand, and serum and cerebrospinal fluid-soluble LAG3 levels have been proposed as a marker of Parkinson's disease (PD). In this study, we aimed to investigate whether there is an association between 3 common single-nucleotide variations (SNVs) in the LAG3 gene and its closely related CD4 molecule gene and the risk of PD in a Caucasian Spanish population. Two of them have been previously associated with the risk of PD in Chinese females. METHODS We analysed genotypes and allele frequencies for CD4 rs1922452, CD4 951818 and LAG3 rs870849 SNVs, by using specifically designed TaqMan assays, in a cohort composed of 629 PD patients and 865 age- and gender-matched healthy controls. RESULTS The frequencies of the CD4 rs1922452 A/A genotype, according to the dominant and recessive genetic models, and of the CD4 rs1922452/A allelic variant were significantly lower, and the frequencies of the CD4 rs951818 A/A genotype, according to the dominant genetic model, and of the CD4 rs951818/A allele, were significantly higher in PD patients than in controls. The differences were not significant after stratifying by sex. These two SNVs showed strong linkage. Regression models showed a lack of relation between the 3 SNVs studied and the age at onset of PD. CONCLUSIONS These data suggest a possible role of CD4 rs1922452 and CD4 rs951818 polymorphisms in the risk of PD.
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Affiliation(s)
- Elena García-Martín
- University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, ARADyAL, Cáceres, Spain
| | - Pau Pastor
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, Terrassa, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Mutua de Terrassa, Terrassa, Spain
| | - Javier Gómez-Tabales
- University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, ARADyAL, Cáceres, Spain
| | | | - Ignacio Alvarez
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, Terrassa, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Mutua de Terrassa, Terrassa, Spain
| | - Mariateresa Buongiorno
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, Terrassa, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Mutua de Terrassa, Terrassa, Spain
| | | | - Miquel Aguilar
- Fundació per la Recerca Biomèdica i Social Mútua de Terrassa, Terrassa, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Mutua de Terrassa, Terrassa, Spain
| | - José A G Agúndez
- University Institute of Molecular Pathology Biomarkers, Universidad de Extremadura, ARADyAL, Cáceres, Spain
| | - Félix Javier Jiménez-Jiménez
- Section of Neurology, Hospital Universitario del Sureste, Madrid, Spain.,Department of Medicine-Neurology, Hospital 'Príncipe de Asturias', Universidad de Alcalá, Alcalá de Henares, Spain
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12
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Sex Differences in Parkinson’s Disease: From Bench to Bedside. Brain Sci 2022; 12:brainsci12070917. [PMID: 35884724 PMCID: PMC9313069 DOI: 10.3390/brainsci12070917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease and gender differences have been described on several aspects of PD. In the present commentary, we aimed to collect and discuss the currently available evidence on gender differences in PD regarding biomarkers, genetic factors, motor and non-motor symptoms, therapeutic management (including pharmacological and surgical treatment) as well as preclinical studies. Methods: A systematic literature review was performed by searching the Pubmed and Scopus databases with the search strings “biomarkers”, “deep brain stimulation”, “female”, “gender”, “genetic”, “levodopa”, “men”, “male”, “motor symptoms”, “non-motor symptoms”, “Parkinson disease”, “sex”, “surgery”, and “women”. Results: The present review confirms the existence of differences between men and women in Parkinson Disease, pointing out new information regarding evidence from animal models, genetic factors, biomarkers, clinical features and pharmacological and surgical treatment. Conclusions: The overall goal is to acquire new informations about sex and gender differences in Parkinson Disease, in order to develop tailored intervetions.
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13
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Wang XL, Feng ST, Wang YT, Chen B, Wang ZZ, Chen NH, Zhang Y. Comparative efficacy and acceptability of drug treatments for Parkinson's disease with depression: A systematic review with network meta-analysis. Eur J Pharmacol 2022; 927:175070. [PMID: 35659968 DOI: 10.1016/j.ejphar.2022.175070] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022]
Abstract
Depressive symptom is the prevailing non-motor symptom of Parkinson's disease (PD). Drug treatments for depressed PD (dPD) can mitigate the symptoms of patients. However, the results are discordant and need further analysis. This systematic review with network meta-analysis aims to evaluate the drug treatments for dPD. We included double-blind, randomized controlled trials to compare antidepressants with placebo or other antidepressants in dPD. We performed traditional pairwise analysis and network meta-analysis concerning the efficacy, acceptability, depression score, and adverse effect. The surface under the cumulative ranking curve was to assess the ranking probabilities of the enrolled agents. We enrolled 62 studies, including 12,353 subjects, to analyze these estimates. For the traditional pairwise meta-analysis, dopamine agonist (DOP; OR = 2.20 [95% CI, 1.46 to 3.33]) and selective serotonin reuptake inhibitor (SSRI; OR = 2.30 [95% CI, 1.15 to 4.60]) were observed to improve the efficacy compared with placebo. For network meta-analysis, DOP was observed to improve the efficacy compared with placebo (OR = -0.84 [95% CI, -1.20 to -0.48]). Both direct and indirect evidence showed that several treatments, e.g., DOP, monoamine-oxidase inhibitor, serotonin-norepinephrine reuptake inhibitors, SSRI, and tricyclic antidepressants, significantly improved depressive symptoms. DOP and SSRI had good efficacy and improved symptoms considerably in dPD, but the adverse effect of these agents was needed to follow closely.
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Affiliation(s)
- Xiao-Le Wang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Si-Tong Feng
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ya-Ting Wang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bin Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhen-Zhen Wang
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nai-Hong Chen
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medica & Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Yi Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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14
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Meng D, Jin Z, Gao L, Wang Y, Wang R, Fang J, Qi L, Su Y, Liu A, Fang B. The quality of life in patients with Parkinson's disease: Focus on gender difference. Brain Behav 2022; 12:e2517. [PMID: 35138047 PMCID: PMC8933778 DOI: 10.1002/brb3.2517] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/14/2021] [Accepted: 01/22/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND To improve understanding of gender differences on quality of life (QoL) in patients with Parkinson's disease (PWP) of a different race, the differences of clinical features and health-related quality of life (HRQoL) between male and female PWP were studied in a small cohort early to middle stage of Chinese PWP. METHODS A cross-sectional study was carried out. PWP were consecutively included from April 2020 to July 2021 in Beijing Rehabilitation Hospital. HRQoL, motor symptoms, and nonmotor symptoms in each patient were evaluated. The differences of demographic, motor symptoms assessments, nonmotor symptoms assessments, and QoL between two gender groups were tested using t-test statistics, Mann-Whitney-Wilcoxon test, or χ2 depending on the data type. To eliminate the possible factors contributing to the QoL, linear regression models were constructed to sort out the effect of gender. RESULTS One hundred and sixty-two Parkinson's disease (PD) patients were included. Demographic, clinical characteristics, and symptom scale assessments had no statistical differences except for levodopa equivalent daily dose, Hamilton Anxiety Rating Score, REM sleep behavior disorder sleep questionnaire, and Hyposmia Rating Scale score. After baseline imbalance corrections, a significantly higher score of PD Questionnaire-39 (PDQ-39) in female than in male patients(p<.05) was found. In the questionnaire, summary Index and bodily discomfort, stigma, and emotional well-being subscores were the main contribution differences. CONCLUSIONS Gender differences are associated with the QoL in the early to middle stage PWP in China. Female patients have poorer QoL than male patients, especially bodily discomfort, stigma, and emotional well-being.
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Affiliation(s)
- Detao Meng
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Jin
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Lei Gao
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yixuan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ruidan Wang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Jinping Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Lin Qi
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yuan Su
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Aixian Liu
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Boyan Fang
- Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
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15
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Gassner L, Dabnichki P, Pokan R, Schmoeger M, Willinger U, Maetzler W, Moser H, Zach H. Therapeutic climbing in Parkinson’s disease: Differences in self-reported health and well-being, feasibility and clinical changes. Physiother Theory Pract 2022; 39:1163-1177. [DOI: 10.1080/09593985.2022.2036279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lucia Gassner
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- School of Engineering, RMIT University, VIC Australia
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
| | | | - Rochus Pokan
- Department of Sport Physiology, Institute of Sports Sciences, University of Vienna, Vienna, Austria
| | | | - Ulrike Willinger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Kiel University, Kiel, Germany
| | - Hermann Moser
- Therapy Center Gmundnerberg, Altmünster Am Traunsee, Austria
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Heidemarie Zach
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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16
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Subramanian I, Mathur S, Oosterbaan A, Flanagan R, Keener AM, Moro E. Unmet Needs of Women Living with Parkinson's Disease: Gaps and Controversies. Mov Disord 2022; 37:444-455. [DOI: 10.1002/mds.28921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Indu Subramanian
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | | | - Annelien Oosterbaan
- Department of Neurology Radboud University Medical Center Nijmegen The Netherlands
| | | | - Adrienne M. Keener
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | - Elena Moro
- Grenoble Alpes University, Faculty of Medicine, Division of Neurology CHUGA, Grenoble Institute of Neurosciences Grenoble France
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17
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Does gender differences have a role in determining sleep quality in Parkinson's disease? Acta Neurol Belg 2021; 121:1001-1007. [PMID: 32946048 DOI: 10.1007/s13760-020-01498-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Sleep disturbances in Parkinson's disease (PD) are common. Non -motor symptoms including sleep disturbance have gender difference in PD. The objective is to determine gender differences in PD in relation to the sleep quality. PATIENTS AND METHODS 156 patients with PD with males (n = 119) and females (n = 37) were included. The sleep quality and sleep disturbances were assessed using Pittsburgh sleep quality index (PSQI), Parkinson's disease Sleep Scale (PDSS) and Epworth Sleep Scale (ESS). RESULTS Females with PD had higher frequency with insomnia (56.7%) as compared to males with PD (44.5%) (p = 0.05), nightmares (32.4%) as compared to males with PD (16.8%) (p = 0.04), greater PSQI component score of habitual sleep efficiency (p = 0.008), sleep disturbance (p = 0.03) and daytime dysfunction (p = 0.02), greater global PSQI score (p = 0.03), higher percentage of patients with global PSQI score > 5 (64.8%) than males with PD (41.1%) (p = 0.01), suggesting poor quality of sleep in females with PD. Higher total ESS score (p = 0.03), higher frequency of females with PD with total ESS score > 10 (45.9%) than in males with PD (26.9%) (p = 0.02), and lower total PDSS score (p = 0.009). On correlation analysis, the global PSQI score in females with PD had strong positive correlation with duration of PD, HAM-A and HAM-D scores and negative correlation with MMSE scores. CONCLUSIONS Females with PD had a poor sleep quality with higher frequency of insomnia, nightmares, and daytime sleepiness. The longer duration of PD, higher scores of anxiety and depression scale and lower MMSE scores are associated with poor sleep quality in females with PD.
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18
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Chuquilín-Arista F, Álvarez-Avellón T, Menéndez-González M. Impact of Depression and Anxiety on Dimensions of Health-Related Quality of Life in Subjects with Parkinson's Disease Enrolled in an Association of Patients. Brain Sci 2021; 11:brainsci11060771. [PMID: 34200659 PMCID: PMC8226752 DOI: 10.3390/brainsci11060771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.
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Affiliation(s)
- Fany Chuquilín-Arista
- Community and Family Medicine, Health Area VII—Asturias, Plaza de los Sindicatos Mineros 3, 33600 Mieres, Spain
- Health Science Research, Doctoral School, University of Valladolid, Calle Real de Burgos s/n, 47011 Valladolid, Spain
- Correspondence:
| | - Tania Álvarez-Avellón
- Department of Psychology, Universidad de Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain;
| | - Manuel Menéndez-González
- Department of Neurology, Hospital Universitario Central de Asturias (HUCA), Avenida Roma s/n, 33011 Oviedo, Spain;
- Instituto de Salud del Principado de Asturias (ISPA), Avenida del Hospital Universitario s/n, 33011 Oviedo, Spain
- Department of Medicine, Universidad de Oviedo, Calle Julián Clavería 6, 33006 Oviedo, Spain
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19
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He G, Liu CF, Ye Q, Liu Z, Jin M, Shang H, Chen L, Tuo H, Jiang H, Cai J, Joshi K, Cooper J, Zi L, Chen S. Prevalence and profile of nocturnal disturbances in Chinese patients with advanced-stage Parkinson's disease: a cross-sectional epidemiology study. BMC Neurol 2021; 21:194. [PMID: 33980158 PMCID: PMC8114718 DOI: 10.1186/s12883-021-02217-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/22/2021] [Indexed: 02/08/2023] Open
Abstract
Background The impact of nocturnal disturbance (ND) in Parkinson’s disease on quality of life of patients in Western Countries is increasingly understood. Our study aimed to investigate ND prevalence and its quality of life impact in patients with advanced Parkinson’s disease in China. Methods In a multicenter, tertiary-care hospital, outpatient-based, cross-sectional study, patients with advanced Parkinson’s disease (Modified Hoehn & Yahr [H&Y] Stage II–IV with ≥3 h awake “off” time/day) from 10 tertiary hospitals throughout China completed the Parkinson’s Disease Sleep Scale-2 (PDSS-2) and Parkinson’s Disease Questionnaire-39 (PDQ-39). The primary endpoint was the percentage of patients with significant ND (PDSS-2 total score ≥ 15). Additional endpoints were demographic and clinical characteristics, PDSS-2 and PDQ-39 total and subscale scores, correlation between PDSS-2 and PDQ-39, and risk factors for ND and higher PDSS-2 or PDQ-39 scores. Results Of 448 patients analyzed (mean age 63.5 years, 47.3% female), 70.92% (95% confidence interval: 66.71, 75.13) had significant ND. Presence of ND and higher PDSS-2 scores were associated with longer disease duration and higher H&Y stage. Presence of ND was also associated with more awake “off” time/day and female sex. PDQ-39 scores were significantly worse for patients with ND versus those without ND; worse scores were associated with more awake “off” time/day, female sex, and higher H&Y stage. PDSS-2 and PDQ-39 total scores were associated: Pearson correlation coefficient 0.62 (p < 0.001). Conclusions In China, ND was highly prevalent in patients with advanced Parkinson’s disease and adversely impacted quality of life. This study highlights the importance of early diagnosis and optimized management of ND in patients with Parkinson’s disease in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02217-5.
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Affiliation(s)
- Guiying He
- Department of Neurology, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun-Feng Liu
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qinyong Ye
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhenguo Liu
- Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Miao Jin
- China-Japan Friendship Hospital, Beijing, China
| | - Huifang Shang
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ling Chen
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Houzhen Tuo
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong Jiang
- Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jifu Cai
- The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | | | | | | | - Shengdi Chen
- Department of Neurology, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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20
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Liu M, Luo YJ, Gu HY, Wang YM, Liu MH, Li K, Li J, Zhuang S, Shen Y, Jin H, Chen J, Mao CJ, Liu CF. Sex and onset-age-related features of excessive daytime sleepiness and night-time sleep in patients with Parkinson's disease. BMC Neurol 2021; 21:165. [PMID: 33874914 PMCID: PMC8054359 DOI: 10.1186/s12883-021-02192-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022] Open
Abstract
Background The clinical characteristics of Parkinson’s disease (PD) differ between men and women, and late- and early-onset patients, including motor symptoms and some nonmotor symptoms, such as cognition, anxiety, and depression. Objective To explore the features of excessive daytime sleepiness (EDS) and night-time sleep quality in PD patients of different sexes and age at onset (AAO). Methods Demographic data and clinical characteristics of 586 PD patients were collected. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to investigate the daytime drowsiness and nocturnal sleep. Multivariate logistic regression analysis was used to explore the risk factors of EDS and poor night-time sleep quality. Results Sleep disorders were common in PD patients. EDS was more prominent in men than in women. There was no significant difference in ESS scores between late-onset PD (LOPD) and early-onset PD. LOPD patients had a higher probability of poor night-time sleep quality. Male sex, disease duration, and depression were risk factors for EDS. In all patients of both sexes and all AAO, depression was a risk factor for poor night-time sleep. Conclusion More attention should be paid to sleep disorders of PD patients, especially male LOPD patients. Depression is a common risk factor for EDS and poor sleep quality in PD patients.
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Affiliation(s)
- Ming Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Ya-Jun Luo
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Han-Ying Gu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Yi-Ming Wang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Man-Hua Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Kai Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Jiao Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Sheng Zhuang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Yun Shen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Hong Jin
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China.
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu Province, China.,Department of Neurology, Suqian First Hospital, Suqian, China
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Nehra A, Sharma P, Narain A, Sharma S, Joshi G, Bhat P, Singh RK, Rajan R, Goyal V, Srivastava AK. Enhancing Quality of Life in Indian Parkinson's Disease Patients with Improved Measurement of Psychological Domains: A Perspective. Ann Indian Acad Neurol 2021; 24:132-137. [PMID: 34220053 PMCID: PMC8232502 DOI: 10.4103/aian.aian_410_20] [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: 04/23/2020] [Revised: 06/11/2020] [Accepted: 09/11/2020] [Indexed: 12/03/2022] Open
Abstract
Parkinson's disease (PD) is the second most common progressive neuro-degenerative disorder. Research in PD is gradually increasing in India due to increased clinical cases, which could double by 2030 worldwide. Although its prevalence is low in India as compared to other countries, the total burden is much higher due to the large population size. PD is progressively debilitating, with pronounced motor and nonmotor symptoms (NMSs) that severely affect the quality of life (QoL) of patients and their caregivers. The progressive nature of the disease lays great emphasis on doctors to focus on the patients' QoL. As a consequence, Health-related QoL (HRQoL) has gradually become one of the main indicators for assessing health-related outcome. There is a growing need to pay attention to the NMSs and a pressing need to look at the QoL of Indian patients with PD through a culture and value specific lens. Research into the holistic QoL assessment with emphasis on psychological domains may allow for the early evaluation and intervention of depressive and cognitive symptoms in PD. This could result into increased productivity, reduced morbidity, and healthcare cost, which would in turn result into better QoL of Indian PD patients.
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Affiliation(s)
- Ashima Nehra
- Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India
| | - Priya Sharma
- Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India
| | - Avneesh Narain
- Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India
| | - Shivani Sharma
- Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India
| | - Garima Joshi
- Neuropsychology, Neurosciences Centre, AIIMS, New Delhi, India
| | | | | | - Roopa Rajan
- Department of Neurology, AIIMS, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, Medanta, Gurgaon, Haryana, India
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22
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Emergency Room Visit Prevention for Older Patients with Parkinsonism in a Geriatric Clinic. Can J Neurol Sci 2020; 48:666-675. [PMID: 33183363 DOI: 10.1017/cjn.2020.253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Older persons with parkinsonism (PWP) are at high risk for hospitalization and adverse outcomes. Few effective strategies exist to prevent Emergency Department (ED) visits and hospitalization. The interdisciplinary Geriatrics Clinic for Parkinson's ("our clinic") was founded to address the complexity of parkinsonism in older patients, supported by a pharmacist-led telephone intervention (TI) service. Our primary objective was to study whether TI could avert ED visits in older PWP. METHODS Using a prospective, observational cohort, we collected data from all calls in 2016, including who initiated and reasons for the calls, patient demographics, number of comorbidities and medications, diagnoses, duration of disease, and intervention provided. Calls with intention to visit ED were classified as "crisis calls". Outcome of whether patients visited ED was collected within 1 week, and user satisfaction by anonymous survey within 3 weeks. RESULTS We received 337 calls concerning 114 patients, of which 82 (24%) were "crisis calls". Eighty-one percent of calls were initiated by caregivers. Ninety-three percent of "crisis calls" resolved without ED visit after TI. The main reasons for "crisis calls" were non-motor symptoms (NMS) (39%), adverse drug effects (ADE) (29%), and motor symptoms (18%). Ninety-seven percent of callers were satisfied with the TI. CONCLUSION Pharmacist-led TI in a Geriatrics Clinic for Parkinson's was effective in preventing ED visits in a population of older PWP, with high user satisfaction. Most calls were initiated by caregivers. Main reasons for crisis calls were NMS and ADE. These factors should be considered in care planning for older PWP.
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Kim R, Shin JH, Park S, Kim HJ, Jeon B. Longitudinal evolution of non-motor symptoms according to age at onset in early Parkinson's disease. J Neurol Sci 2020; 418:117157. [DOI: 10.1016/j.jns.2020.117157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
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Li Z, Liu W, Xiao C, Wang X, Zhang X, Yu M, Hu X, Qian L. Abnormal white matter microstructures in Parkinson's disease and comorbid depression: A whole-brain diffusion tensor imaging study. Neurosci Lett 2020; 735:135238. [PMID: 32645398 DOI: 10.1016/j.neulet.2020.135238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Depressive symptoms are the most common non-motor symptom accompanying Parkinson's disease (PD); however, the neural basis of depression in PD remains unclear. The aim of this study was to characterize possible depression-related white matter microstructural differences in patients with PD and comorbid depression compared with PD patients and healthy controls (HC) without depression. METHODS We used diffusion tensor imaging (DTI) to analyze white matter integrity in depressed PD patients (n = 30), non-depressed PD patients (n = 43), and HC (n = 91). Five MRI-derived indices were estimated: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and white matter volume (WMV). RESULTS Compared with HC and non-depressed PD, depressed PD patients showed significantly increased AD values in the body of corpus callosum, right anterior corona radiate, and left hippocampal part of the cingulum, as well as increased MD values in the left hippocampal part of the cingulum. CONCLUSIONS Our results show that frontal and limbic white matter integrity is impaired in depressed PD patients. These findings can be used to better understand potential mechanisms of depression in PD.
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Affiliation(s)
- Zonghong Li
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiguo Liu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chaoyong Xiao
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Wang
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiangrong Zhang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Miao Yu
- Department of Neurology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Hu
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Long Qian
- Department of Biomedical Engineering, Peking University, Beijing, 100871, China; Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China; McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
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