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Gronostay A, Jost ST, Silverdale M, Rizos A, Loehrer PA, Evans J, Sauerbier A, Indi D, Leta V, Reker P, Fink GR, Ashkan K, Antonini A, Nimsky C, Visser-Vandewalle V, Martinez-Martin P, Ray Chaudhuri K, Timmermann L, Dafsari HS. Stratifying quality of life outcome in subthalamic stimulation for Parkinson's disease. J Neurol Neurosurg Psychiatry 2024; 95:630-638. [PMID: 38124227 DOI: 10.1136/jnnp-2023-332272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Subthalamic nucleus deep brain stimulation (STN-DBS) for Parkinson's disease (PD) improves quality of life (QoL), motor and non-motor symptoms (NMS). However, in previous studies, 43%-49% of patients did not experience clinically relevant postoperative QoL improvement. To inform individualised prediction of postoperative QoL improvement, we developed a stratification analysis of QoL outcomes based on preoperative non-motor total burden, severity of motor progression and motor response in levodopa challenge tests. METHODS This was a prospective, open-label, multicentre, international study with a 6-month follow-up. A distribution-based threshold identified 'QoL responders' in the PDQuestionnaire-8 Summary Index (PDQ-8 SI). After baseline stratification based on the NMS Scale, Hoehn and Yahr Scale and levodopa response assessed with the Unified PD Rating Scale-III, we compared postoperative QoL response between these strata. To assess the clinical usefulness and statistical feasibility of stratifications, we compared cumulative distribution function curves, respectively PDQ-8 within-stratum variation. RESULTS All main outcomes improved postoperatively. Based on the 8.1 points threshold for clinically meaningful PDQ-8 SI improvement, only 80/161 patients were classified as 'QoL responders'. The absolute risk reductions for QoL non-response among respective non-motor, motor progression and levodopa response strata were 23%, 8% and 3%, respectively. Only non-motor stratification reduced PDQ-8 within-stratum variation compared with the overall cohort. CONCLUSIONS Non-motor stratification, but not motor progression or levodopa response stratification, is clinically useful and statistically feasible for personalised preoperative prediction of postoperative QoL outcome of STN-DBS for PD. Our findings highlight that non-motor assessments are necessary components of a case-based, holistic approach of DBS indication evaluations geared towards optimising postoperative QoL outcomes. TRIAL REGISTRATION NUMBER GermanClinicalTrialsRegister: #6735.
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Affiliation(s)
- Alexandra Gronostay
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Stefanie Theresa Jost
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Monty Silverdale
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Greater Manchester, UK
| | - Alexandra Rizos
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | | | - Julian Evans
- Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, Greater Manchester, UK
| | - Anna Sauerbier
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Donya Indi
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Valentina Leta
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Paul Reker
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Gereon Rudolf Fink
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
| | - Keyoumars Ashkan
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Christopher Nimsky
- Department of Neurosurgery, Philipps-University Marburg, Marburg, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - K Ray Chaudhuri
- Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lars Timmermann
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Haidar S Dafsari
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Raccagni C, Sidoroff V, Paraschiv-Ionescu A, Roth N, Schönherr G, Eskofier B, Gassner H, Kluge F, Teatini F, Seppi K, Goebel G, Benninger DH, Aminian K, Klucken J, Wenning G. Effects of physiotherapy and home-based training in parkinsonian syndromes: protocol for a randomised controlled trial (MobilityAPP). BMJ Open 2024; 14:e081317. [PMID: 38692728 PMCID: PMC11086482 DOI: 10.1136/bmjopen-2023-081317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/14/2023] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Gait and mobility impairment are pivotal signs of parkinsonism, and they are particularly severe in atypical parkinsonian disorders including multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). A pilot study demonstrated a significant improvement of gait in patients with MSA of parkinsonian type (MSA-P) after physiotherapy and matching home-based exercise, as reflected by sensor-based gait parameters. In this study, we aim to investigate whether a gait-focused physiotherapy (GPT) and matching home-based exercise lead to a greater improvement of gait performance compared with a standard physiotherapy/home-based exercise programme (standard physiotherapy, SPT). METHODS AND ANALYSIS This protocol was deployed to evaluate the effects of a GPT versus an active control undergoing SPT and matching home-based exercise with regard to laboratory gait parameters, physical activity measures and clinical scales in patients with Parkinson's disease (PD), MSA-P and PSP. The primary outcomes of the trial are sensor-based laboratory gait parameters, while the secondary outcome measures comprise real-world derived parameters, clinical rating scales and patient questionnaires. We aim to enrol 48 patients per disease group into this double-blind, randomised-controlled trial. The study starts with a 1 week wearable sensor-based monitoring of physical activity. After randomisation, patients undergo a 2 week daily inpatient physiotherapy, followed by 5 week matching unsupervised home-based training. A 1 week physical activity monitoring is repeated during the last week of intervention. ETHICS AND DISSEMINATION This study, registered as 'Mobility in Atypical Parkinsonism: a Trial of Physiotherapy (Mobility_APP)' at clinicaltrials.gov (NCT04608604), received ethics approval by local committees of the involved centres. The patient's recruitment takes place at the Movement Disorders Units of Innsbruck (Austria), Erlangen (Germany), Lausanne (Switzerland), Luxembourg (Luxembourg) and Bolzano (Italy). The data resulting from this project will be submitted to peer-reviewed journals, presented at international congresses and made publicly available at the end of the trial. TRIAL REGISTRATION NUMBER NCT04608604.
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Affiliation(s)
- Cecilia Raccagni
- Department of Neurology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano, Italy
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Victoria Sidoroff
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Nils Roth
- Artificial Intelligence in Biomedical Engineering, FAU, Erlangen, Germany
| | - Gudrun Schönherr
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Björn Eskofier
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heiko Gassner
- Department of Molecular Neurology, Erlangen University Hospital, Erlangen, Germany
| | - Felix Kluge
- Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Francesco Teatini
- Department of Neurology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano, Italy
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Georg Goebel
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - David H Benninger
- Service de Neurologie, Départment des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Kamiar Aminian
- Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Jochen Klucken
- Department of Molecular Neurology, Friedrich-Alexander University Erlangen, Nürnberg, Germany
- Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Digital Medicine - Dep. of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Digital Medicine, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Gregor Wenning
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Ruotolo I, Sellitto G, Berardi A, Simeon R, Panuccio F, Amadio E, Ugolini A, Fabbrini G, Galeoto G. Psychometric properties of the Parkinson's disease Questionnaire-39 and its short form Parkinson's disease Questionnaire-8: A systematic review and meta-analysis. J Clin Neurosci 2024; 123:100-117. [PMID: 38564966 DOI: 10.1016/j.jocn.2024.03.032] [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: 01/09/2024] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024]
Abstract
Parkinson's disease (PD) affects Quality of Life (QoL), since it is responsible for cognitive impairment, non-motor, and motor symptoms. Outcome measures are fundamental for evaluating treatment's effect on QoL over time. This systematic review aimed to identify the psychometric properties of PDQ-39 and PDQ-8 in the different populations in which they were validated. The electronic databases systematically searched are MEDLINE (via PubMed), CINAHL, SCOPUS, and Web of Science; the research was conducted in July 2023. The psychometric properties considered were those of the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Risk of bias was assessed using the COSMIN checklist. The search identified 1306 articles. 398 duplicates were eliminated; 908 articles were analyzed reading title and abstract; 799 were finally excluded because used PDQ-39 and PDQ-8 as outcome measures or were not dealing with psychometric properties; 66 articles were excluded after reading the full text. 43 articles were included in the review; meta-analysis showed all the Cronbach's alpha values were statistically significant for all the subscales of PDQ-39 and PDQ-8. PDQ-39 demonstrated to be a specific HRQoL questionnaire that is correlated with generic HRQoL questionnaires, in fact in many studies included in the review, correlations with SF-36 were found. In the last studies about psychometric properties of PDQ-8 emerged that it is a practical and informative instrument that can be easily used in clinical settings, especially in busy ones, but also in large-scale studies in which a brief instrument would be preferred.
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Affiliation(s)
- Ilaria Ruotolo
- Department of Human Neurosciences, Sapienza University of Rome, Italy.
| | - Giovanni Sellitto
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Italy
| | | | | | | | | | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, IS, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Italy; IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, IS, Italy
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Saleem S, Miles A, Allen J. Investigating Parkinson's disease with dual high resolution pharyngeal manometry with impedance and videofluoroscopy. Neurogastroenterol Motil 2024; 36:e14737. [PMID: 38225798 DOI: 10.1111/nmo.14737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE To characterize pharyngeal function in people with Parkinson's Disease using both high resolution impedance manometry (HRIM) and videofluoroscopy (VFSS) and to explore correlations between VFSS and HRIM metrics. METHODS All participants received both VFSS and HRIM within 24 h-time window. A standard VFSS protocol (IDDSI 0: 1 mL, 3 mL, 20 mL, and 100 mL) was performed. A solid-state unidirectional catheter (36 pressure sensors) was used to acquire manometric data for triplicate swallows (IDDSI 0: 5 mL, 10 mL, 20 mL), quantitative swallow analysis was completed through Swallowtail™ and SwallowGateway™. Parameters were compared to published norms and statistical tests explored correlational associations (p < 0.05). RESULTS Twenty-one participants (76% male; mean age 70 years, SD7.16) with mild-moderate severity PD were recruited with 73% reporting Eating Assessment Tool (EAT-10) scores ≥3 indicating swallow impairment. Compared to normal metrics, one third of participants had abnormally elevated hypopharyngeal contractile integral (HPCI), hypopharyngeal peak pressure, upper esophageal sphincter (UES) integrated relaxation pressure (UES IRP), and reduced UES maximum admittance. Five participants showed compromised swallow safety (Penetration-Aspiration Scale score ≥6). One third of participants had abnormal VFSS values for pharyngoesophageal segment (PES) opening duration, maximum PES opening distance, and maximum hyoid displacement measures. Some HRIM metrics had a strong correlation with pharyngeal VFSS measures (r > 0.60, p < 0.05). CONCLUSION This study identifies early manometric signs of pharyngeal dysfunction in people with PD. The congruence of the VFSS and HRIM measures confirms the hypothesis of insidious early decline in swallow function in PD despite maintenance of airway safety (i.e., low aspiration rates).
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Affiliation(s)
- Shakeela Saleem
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
- Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Jacqueline Allen
- Department of Surgery, The University of Auckland, Auckland, New Zealand
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Zarotti N, Deane KHO, Ford CEL, Simpson J. Perceived control as a predictor of medication adherence in people with Parkinson's: a large-scale cross-sectional study. Disabil Rehabil 2024; 46:478-488. [PMID: 36824021 DOI: 10.1080/09638288.2023.2181409] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Medication adherence is a multi-faceted construct associated with several positive consequences in people with chronic conditions. However, non-adherence currently represents a major issue in Parkinson's, potentially due to low perceptions of control. This study investigated the predictive ability of several aspects of perceived control on adherence in people with Parkinson's, while accounting for previously established predictors such as depression and medication variables. MATERIALS AND METHODS An online cross-sectional survey was carried out with 1210 adults with Parkinson's from 15 English-speaking countries. Demographic and clinical questions, as well as measures of depression, aspects of perceived control, and medication adherence were included. Pearson's correlations and a 4-block hierarchical regression analysis were performed to assess the relationship between the variables. RESULTS Perceived control explained a slightly higher amount of variance in medication adherence compared to medication variables when entered in the last block. Unexpectedly, depression was not significantly related with adherence. Internal locus of control was an independent negative predictor of adherence, while external dimensions of locus of control emerged as independent positive predictors. CONCLUSIONS In people with Parkinson's, perceptions of control may have a larger impact on adherence compared to medication variables. Implications for clinical practice and future research are discussed.Implications for RehabilitationPerceived control and depression are considered important constructs for medication adherence in Parkinson's, which in turn is often problematic for affected individuals.The specific predictive value of different aspects of perceived control on medication adherence in Parkinson's is currently unclear.This large-scale study found that perceptions of control may have a larger impact on adherence compared to medication variables, while depression was unrelated to it.A need for psychologically-informed interventions, person-centred approaches to medication management, and Parkinson-specific measures of adherence are highlighted.
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Affiliation(s)
- Nicolò Zarotti
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Catherine Elaine Longworth Ford
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jane Simpson
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Devigili G, Straccia G, Cereda E, Garavaglia B, Fedeli A, Elia AE, Piacentini SHMJ, Prioni S, Amami P, Invernizzi F, Andreasi NG, Romito LM, Eleopra R, Cilia R. Unraveling Autonomic Dysfunction in GBA-Related Parkinson's Disease. Mov Disord Clin Pract 2023; 10:1620-1638. [PMID: 38026514 PMCID: PMC10654845 DOI: 10.1002/mdc3.13892] [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: 03/10/2023] [Revised: 08/13/2023] [Accepted: 09/08/2023] [Indexed: 12/01/2023] Open
Abstract
Background Patients with Parkinson's disease (PD) and GBA gene mutations (GBA-PD) develop nonmotor complications more frequently than noncarriers. However, an objective characterization of both cardiovascular and sudomotor autonomic dysfunction using extensive clinical and instrumental measures has never been provided so far. Survival is reduced in GBA-PD regardless of age and dementia, suggesting that other hitherto unrecognized factors are involved. Objectives To provide instrumental measures of pattern and severity of autonomic dysfunction in GBA-PD and explore their correlation with other non-motor symptoms and implications for clinical practice. Methods In this cross-sectional study, 21 GBA-PD and 24 matched PD noncarriers underwent extensive assessment of motor and non-motor features, including neuropsychological testing. Cardiovascular autonomic function was explored through a comprehensive battery of indexes, including power spectral analysis of the R-R intervals and blood pressure short-term variability during resting state and active maneuvers. Dynamic Sweat Test was used to assess post-ganglionic sudomotor dysfunction. Results Despite minimal or absent clinical correlates, cardiovagal and sympathetic indexes, heart rate variability parameters and sudomotor postganglionic function were more severely impaired in GBA-PD than noncarriers (overcoming relatively preserved compensatory peripheral sympathetic function), suggesting more prominent cardiac sympatho-vagal demodulation, efferent baroreflex failure and peripheral sympathetic dysfunction in GBA-PD. Cardiovascular dysautonomia showed marginal correlations with cognitive impairment. Conclusions Compared to PD noncarriers, GBA-PD display more severe instrumental autonomic abnormalities, which may be underestimated by purely clinical measures, despite their relevance on morbidity and mortality. This supports the necessity of implementing instrumental autonomic assessment in all GBA-PD, regardless of clinically overt symptoms.
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Affiliation(s)
- Grazia Devigili
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
| | - Giulia Straccia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
- Neurology and Stroke UnitC.T.O. Hospital, A.O.R.N Ospedali dei ColliNaplesItaly
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics UnitFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Barbara Garavaglia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Medical Genetics and NeurogeneticsMilanItaly
| | - Alessandro Fedeli
- Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Antonio Emanuele Elia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
| | | | - Sara Prioni
- Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Paolo Amami
- Neuropsychology UnitFondazione IRCCS Istituto Neurologico Carlo BestaMilanItaly
| | - Federica Invernizzi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Unit of Medical Genetics and NeurogeneticsMilanItaly
| | - Nico Golfrè Andreasi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
| | - Luigi Michele Romito
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
| | - Roberto Eleopra
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
| | - Roberto Cilia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders UnitMilanItaly
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Mendorf S, Teschner U, Lehmann T, Prell T, Mühlhammer HM. Tailored interventions to improve adherence to medication in elderly patients with Parkinson's disease: a study protocol for a randomized controlled trial (AdhCare). Trials 2023; 24:668. [PMID: 37828583 PMCID: PMC10571350 DOI: 10.1186/s13063-023-07663-9] [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: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Nonadherence to medication is a major issue in patients with chronic disorders such as Parkinson's disease (PD). Many interventions for increasing adherence have been tested, and these have shown weak-to-moderate efficiency. Although the best methods to improve adherence remain unclear, it is reasonable to use tailored interventions instead of the "one-size-fits-all" approach. METHODS A randomized, controlled, triple-blinded trial in elderly patients with PD is conducted to test the efficacy of AdhCare, a tailored intervention to enhance adherence compared with that achieved with routine care (64 participants per arm). Motor function, quality of life, and adherence measures will be assessed at baseline and at 3 and 6 months of follow-up. The type of intervention depends on the main personal reason for nonadherence (e.g., forgetting to take the medication or poor knowledge about the medication). DISCUSSION The results of this study will provide valuable information for health professionals and policymakers on the effectiveness of tailored interventions in elderly patients with PD. TRIAL REGISTRATION German Clinical Trials Register DRKS00023655. Registered on 24 February 2021. Last update on 22 March 2023.
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Affiliation(s)
- Sarah Mendorf
- Department of Neurology, Jena University Hospital, Jena, Germany.
| | - Ulrike Teschner
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Thomas Lehmann
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Hannah Maria Mühlhammer
- Department of Neurology, Jena University Hospital, Jena, Germany
- Department of Geriatrics, Halle University Hospital, Halle, Germany
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Soke F, Ozcan Gulsen E, Erkoc Ataoglu NE, Kocer B, Gulsen C, Turker D, Comoglu SS, Bora Tokcaer A. The coin rotation test: a reliable and valid test in people with Parkinson's disease. Disabil Rehabil 2023; 45:879-888. [PMID: 35263197 DOI: 10.1080/09638288.2022.2044925] [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] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate: (1) the interrater, and test-retest reliability of the coin rotation test (CRT) in people with Parkinson's Disease (PwPD); (2) the minimum detectable change in the CRT; (3) the concurrent and known-groups validity of the CRT; and (4) the cut-off times that best discriminate PwPD from healthy people and functionally dependent PwPD from functionally independent PwPD. METHOD Forty-eight PwPD and 33 healthy people were included. The CRT was administered with the nine-hole peg test, Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Scale, Parkinson's Disease Questionnaire-8, and Schwab and England Scale. RESULTS The CRT had excellent interrater and test-retest reliability. Minimal detectable changes were 5.96 and 8.23 s for the dominant and non-dominant hand, respectively. The CRT correlated with other outcome measures. Significant differences in the CRT times were found between PwPD and healthy people, and between functionally dependent PwPD and functionally independent PwPD. The cut-off times of 12.66 s on the dominant hand and 15.76 s on the non-dominant best discriminated PwPD from healthy people, while 22.99 s on the dominant hand and 23.48 s on the non-dominant best discriminated functionally dependent PwPD from functionally independent PwPD. CONCLUSIONS The CRT is a reliable, and clinically available tool for assessing manual dexterity in PwPD.Implications for rehabilitationThe coin rotation test is a reliable, valid, and clinically available tool for assessing manual dexterity in Parkinson's Disease.The minimal detectable changes of the coin rotation test are 5.96 s for dominant hand and 8.23 s for the non-dominant hand, which may useful for clinicians and researchers to detect in any true change in manual dexterity after any intervention.The coin rotation test correlated with Parkinson's Disease-specific measurement tools.The coin rotation test times may detect impaired manual dexterity between people with Parkinson's Disease and healthy people, and between functionally dependent and functionally independent in Parkinson's Disease population.
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Affiliation(s)
- Fatih Soke
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Physiotherapy and Rehabilitation, Fatih Soke, University of Health Sciences, Ankara, Turkey
| | - Elvan Ozcan Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Elvan Ozcan Gulsen, Yuksek Ihtisas University, Ankara, Turkey
| | - Nigar Esra Erkoc Ataoglu
- Department of Neurology, Faculty of Medicine, Nigar Esra Erkoc Ataoglu, Gazi University, Ankara, Turkey
| | - Bilge Kocer
- Department of Neurology, Bilge Kocer, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cagri Gulsen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Cagri Gulsen, Gazi University, Ankara, Turkey
| | - Duygu Turker
- Department of Physiotherapy and Rehabilitation, Gulhane Faculty of Physiotherapy and Rehabilitation, Fatih Soke, University of Health Sciences, Ankara, Turkey
| | - Selim Selcuk Comoglu
- Department of Neurology, Bilge Kocer, Diskapi Yildirim Beyazit Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ayse Bora Tokcaer
- Department of Neurology, Faculty of Medicine, Nigar Esra Erkoc Ataoglu, Gazi University, Ankara, Turkey
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Mameli F, Ruggiero F, Dini M, Marceglia S, Prenassi M, Borellini L, Cogiamanian F, Pirola E, Remore LG, Fiore G, Reitano MR, Maiorana N, Poletti B, Locatelli M, Barbieri S, Priori A, Ferrucci R. Energy Delivered by Subthalamic Deep Brain Stimulation for Parkinson Disease Correlates With Depressive Personality Trait Shift. Neuromodulation 2023; 26:394-402. [PMID: 35221204 DOI: 10.1016/j.neurom.2022.01.004] [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: 10/21/2021] [Revised: 12/09/2021] [Accepted: 01/07/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Despite the large amount of literature examining the potential influence of subthalamic nucleus deep brain stimulation (STN-DBS) on psychiatric symptoms and cognitive disorders, only a few studies have focused on its effect on personality. We investigated the correlation between total electrical energy delivered (TEED) and the occurrence of depressive traits in patients with Parkinson disease (PD) after one year of DBS. MATERIALS AND METHODS Our study involved 20 patients with PD (12 women, mean [±SD] age 57.60 ± 7.63 years) who underwent bilateral STN-DBS, whose personality characteristics were assessed using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), according to the core assessment program for surgical interventional therapies in Parkinson's disease (CAPSIT-PD) procedure. RESULTS We found that despite a marked improvement in motor functions and quality of life after 12 months, patients showed a significant increase in MMPI-2 subscales for depression (D scale and Depression scale) and in other content component scales (low self-esteem, work interference, and negative treatment indicators). Interestingly, only the TEED on the right side was inversely correlated with the changes in scale D (rs = -0.681, p = 0.007), whereas depressive traits did not correlate with disease duration, levodopa equivalent daily dose (LEDD) reduction, patient's age, or severity of motor symptoms. CONCLUSIONS Our preliminary observations indicate that despite the excellent motor outcome and general improvement in quality of life, DBS treatment can result in patients poorly adjusting to their personal, familiar, and socio-professional life. Different influences and multiple factors (such as TEED, intra/postsurgical procedure, coping mechanisms, and outcome expectations) may affect depressive traits. Further advances are expected to improve stimulation methods.
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Affiliation(s)
- Francesca Mameli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Fabiana Ruggiero
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Michelangelo Dini
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Sara Marceglia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Marco Prenassi
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Linda Borellini
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Filippo Cogiamanian
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Elena Pirola
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Luigi Gianmaria Remore
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Giorgio Fiore
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Maria Rita Reitano
- Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Natale Maiorana
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Locatelli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Sergio Barbieri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neuroscience and Mental Health, Milan, Italy
| | - Alberto Priori
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy; Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Roberta Ferrucci
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy; Neurology Unit I, San Paolo University Hospital, ASST Santi Paolo e Carlo, Milan, Italy.
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10
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Artusi CA, Montanaro E, Erro R, Margraf N, Geroin C, Pilotto A, Magistrelli L, Spagnolo F, Marchet A, Sarro L, Cuoco S, Sacchetti M, Riello M, Capellero B, Berchialla P, Moeller B, Vullriede B, Zibetti M, Rini AM, Barone P, Comi C, Padovani A, Tinazzi M, Lopiano L. Visuospatial Deficits Are Associated with Pisa Syndrome and not Camptocormia in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:64-73. [PMID: 36704069 PMCID: PMC9847315 DOI: 10.1002/mdc3.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 01/29/2023] Open
Abstract
Background Pisa syndrome (PS) and camptocormia (CC) are postural abnormalities frequently associated with Parkinson's disease (PD). Their pathophysiology remains unclear, but the role of cognitive deficits has been postulated. Objectives To identify differences in the neuropsychological functioning of patients with PD with PS or CC compared with matched patients with PD without postural abnormalities. Methods We performed a case-control study including 57 patients with PD with PS (PS+) or CC (CC+) and 57 PD controls without postural abnormalities matched for sex, age, PD duration, phenotype, and stage. Patients were divided into four groups: PS+ (n = 32), PS+ controls (PS-, n = 32), CC+ (n = 25), and CC+ controls (CC-, n = 25). We compared PS+ versus PS- and CC+ versus CC- using a neuropsychological battery assessing memory, attention, executive functions, visuospatial abilities, and language. Subjective visual vertical (SVV) perception was assessed by the Bucket test as a sign of vestibular function; the misperception of trunk position, defined as a mismatch between the objective versus subjective evaluation of the trunk bending angle >5°, was evaluated in PS+ and CC+. Results PS+ showed significantly worse visuospatial performances (P = 0.025) and SVV perception (P = 0.038) than their controls, whereas CC+ did not show significant differences compared with their control group. Reduced awareness of postural abnormality was observed in >60% of patients with PS or CC. Conclusions Low visuospatial performances and vestibular tone imbalance are significantly associated with PS but not with CC. These findings suggest different pathophysiology for the two main postural abnormalities associated with PD and can foster adequate therapeutic and prevention strategies.
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Affiliation(s)
- Carlo Alberto Artusi
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Elisa Montanaro
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Nils Margraf
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Christian Geroin
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | | | - Luca Magistrelli
- Department of Translational Medicine, Section of NeurologyUniversity of Eastern PiedmontNovaraItaly
| | | | - Alberto Marchet
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Lidia Sarro
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Sofia Cuoco
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Marta Sacchetti
- Clinical Psychology UnitAzienda ospedaliero universitaria Maggiore della Carità di NovaraNovaraItaly
| | - Marianna Riello
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | - Barbara Capellero
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Paola Berchialla
- Department of Clinical and Biological SciencesUniversity of TorinoTorinoItaly
| | - Bettina Moeller
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Beeke Vullriede
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Maurizio Zibetti
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | | | - Paolo Barone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Cristoforo Comi
- Department of Translational Medicine, Section of NeurologyUniversity of Eastern PiedmontNovaraItaly
| | | | - Michele Tinazzi
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | - Leonardo Lopiano
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
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Cárdenas Soriano P, Rodriguez-Blazquez C, Forjaz MJ, Ayala A, Rojo-Perez F, Fernandez-Mayoralas G, Molina-Martinez MA, de Arenaza Escribano CP, Rodriguez-Rodriguez V. Validation of the Spanish Version of the Fear of COVID-19 Scale (FCV-19S) in Long-Term Care Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16183. [PMID: 36498256 PMCID: PMC9741095 DOI: 10.3390/ijerph192316183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Fear of coronavirus disease 2019 (COVID-19) is one of the main psychological impacts of the actual pandemic, especially among the population groups with higher mortality rates. The Fear of COVID-19 Scale (FCV-19S) has been used in different scenarios to assess fear associated with COVID-19, but this has not been done frequently in people living in long-term care (LTC) settings. The present study is aimed at measuring the psychometric properties of the Spanish version of the FCV-19S in residents in LTC settings, following both the classical test theory (CTT) and Rasch model frameworks. The participants (n = 447), aged 60 years or older, were asked to complete the FCV-19S and to report, among other issues, their levels of depression, resilience, emotional wellbeing and health-related quality of life with validated scales. The mean FCV-19S score was 18.36 (SD 8.28, range 7−35), with higher scores for women, participants with lower education (primary or less) and higher adherence to preventive measures (all, p < 0.05). The Cronbach’s alpha for the FCV-19S was 0.94. After eliminating two items due to a lack of fit, the FCV-19S showed a good fit to the Rasch model (χ2 (20) = 30.24, p = 0.019, PSI = 0.87), with unidimensionality (binomial 95% CI 0.001 to 0.045) and item local independency. Question 5 showed differential item functioning by sex. The present study shows that the FCV-19S has satisfactory reliability and validity, which supports its use to effectively measure fear in older people living in LTC settings. This tool could help identify risk groups that may need specific health education and effective communication strategies to lower fear levels. This might have a beneficial impact on adherence to preventive measures.
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Affiliation(s)
- Pilar Cárdenas Soriano
- Department of Preventive Medicine, University Hospital of Albacete, ES-02006 Albacete, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and Network Centre for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Maria João Forjaz
- National Centre of Epidemiology and Health Service Research Network on Chronic Diseases (REDISSEC) and Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Alba Ayala
- Department of Statistics, University Carlos III of Madrid, and Health Service Research Network on Chronic Diseases (REDISSEC), Carlos III Institute of Health, ES-28029 Madrid, Spain
| | - Fermina Rojo-Perez
- Grupo de Investigacion Sobre Envejecimiento (GIE), IEGD, CSIC, ES-28037 Madrid, Spain
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12
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Rodriguez-Blazquez C, Romay-Barja M, Falcon M, Ayala A, Forjaz MJ. Psychometric Properties of the COVID-19 Pandemic Fatigue Scale: Cross-sectional Online Survey Study. JMIR Public Health Surveill 2022; 8:e34675. [PMID: 35785547 PMCID: PMC9501671 DOI: 10.2196/34675] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/18/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Pandemic fatigue is defined as feelings of demotivation to follow preventive measures against COVID-19, together with decreased trust in government and frequency of information-seeking behaviors. Objective This study aims to analyze the psychometric properties of the COVID-19–specific pandemic fatigue scale according to classical test theory (CTT) and Rasch model approaches in the general Spanish population. Methods This was a cross-sectional study in a representative sample of 1018 adults who completed an online survey in November 2020 in the framework of the COVID-19 Snapshot Monitoring (COSMO)-Spain project. The assessments included the 6-item COVID-19 Pandemic Fatigue Scale (CPFS) and other COVID-19–related variables: COVID-19 infection, adherence to preventive behaviors, information-seeking behavior, self-efficacy, worry, and cognitive and affective risk perception. Data quality, acceptability, reliability, and validity were analyzed according to CTT, and the fit to the Rasch model, unidimensionality, appropriateness of the response scale, item local independency, reliability (person-separation index [PSI]), and item-person distribution were also calculated. Results The mean CPFS score was 17.06 (SD 5.04, range 6-30), with higher scores for women, younger participants, participants who never seek information on COVID-19, those who think they would contract a mild disease in case of infection, those with higher level of worry about coronavirus/COVID-19, and those who felt depressed or felt the coronavirus/COVID-19 is spreading slowly (all P<.01). The Cronbach alpha for the CPFS was 0.74. In the confirmatory factor analysis, one factor was identified (root mean square error of approximation [RMSEA]=.02; comparative fit index [CFI]=.99; χ25=8.06, P=.15). The CPFS showed good fit to the Rasch model (χ 224=42.025, P=.01, PSI=.642), unidimensionality (binomial 95% CI –.005 to .045), and item local independency. Conclusions Our results suggest that the CPFS has moderate reliability and internal consistency and it is composed of a single dimension. It is a useful tool to ascertain the level of pandemic fatigue in the general population, which may help to guide the communication and information strategies to face the COVID-19 pandemic.
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Affiliation(s)
| | - Maria Romay-Barja
- Nacional Center of Tropical Diseases, Carlos III Health Institute, Madrid, Spain
| | - Maria Falcon
- School of Medicine, University of Murcia, Murcia, Spain
| | - Alba Ayala
- Department of Statistics, Carlos III University, Getafe, Spain
| | - Maria João Forjaz
- National Epidemiology Center, Carlos III Health Institute, Madrid, Spain
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13
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Meinert E, Milne-Ives M, Chaudhuri KR, Harding T, Whipps J, Whipps S, Carroll C. The impact of a digital artificial intelligence system on the monitoring and self-management of non-motor symptoms in People with Parkinson’s: Proposal for a Phase 1 implementation study (Preprint). JMIR Res Protoc 2022; 11:e40317. [PMID: 36155396 PMCID: PMC9555326 DOI: 10.2196/40317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Nonmotor symptoms of Parkinson disease are a major factor of disease burden but are often underreported in clinical appointments. A digital tool has been developed to support the monitoring and management of nonmotor symptoms. Objective The aim of this study is to establish evidence of the impact of the system on patient confidence, knowledge, and skills for self-management of nonmotor symptoms, symptom burden, and quality of life of people with Parkinson and their care partners. It will also evaluate the usability, acceptability, and potential for adoption of the system for people with Parkinson, care partners, and health care professionals. Methods A mixed methods implementation and feasibility study based on the nonadoption, abandonment, scale-up, spread, and sustainability framework will be conducted with 60 person with Parkinson–care partner dyads and their associated health care professionals. Participants will be recruited from outpatient clinics at the University Hospitals Plymouth NHS Trust Parkinson service. The primary outcome, patient activation, will be measured over the 12-month intervention period; secondary outcomes include the system’s impact on health and well-being outcomes, safety, usability, acceptability, engagement, and costs. Semistructured interviews with a subset of participants will gather a more in-depth understanding of user perspectives and experiences with the system. Repeated measures analysis of variance will analyze change over time and thematic analysis will be conducted on qualitative data. The study was peer reviewed by the Parkinson’s UK Non-Drug Approaches grant board and is pending ethical approval. Results The study won funding in August 2021; data collection is expected to begin in December 2022. Conclusions The study’s success criteria will be affirming evidence regarding the system’s feasibility, usability and acceptability, no serious safety risks identified, and an observed positive impact on patient activation. Results will be disseminated in academic peer-reviewed journals and in platforms and formats that are accessible to the general public, guided by patient and public collaborators. Trial Registration ClinicalTrials.gov NCT05414071; https://clinicaltrials.gov/ct2/show/NCT05414071 International Registered Report Identifier (IRRID) PRR1-10.2196/40317
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Affiliation(s)
- Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Madison Milne-Ives
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, United Kingdom
| | - Tracey Harding
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - John Whipps
- University of Plymouth, Plymouth, United Kingdom
| | - Susan Whipps
- University of Plymouth, Plymouth, United Kingdom
| | - Camille Carroll
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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14
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Koh J, Takahashi M, Ohmae Y, Taruya J, Sakata M, Yasui M, Terada M, Ito H. A single-arm open-label pilot study of brief mindfulness meditation to control impulsivity in Parkinson’s disease. PLoS One 2022; 17:e0266354. [PMID: 35385563 PMCID: PMC8985985 DOI: 10.1371/journal.pone.0266354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background Impulse control disorders are detrimental neuropsychiatric symptoms of Parkinson’s disease. Increased impulsivity is a predisposing factor for impulse control disorders and should therefore be controlled. Recently, mindfulness meditation as a non-drug therapy has been reported to be useful in improving neuropsychiatric symptoms, such as impulsivity. Methods We performed a prospective single-arm, open-label pilot trial to investigate the effectiveness of mindfulness meditation to control impulsivity in patients with Parkinson’s disease (UMIN clinical trials registry: UMIN000037779). Results Twenty patients with Parkinson’s disease were enrolled in an 8-week mindfulness meditation program. As a primary outcome, we investigated whether the score of the Barratt Impulsiveness Scale (BIS-11) was significantly reduced after the intervention. As an exploratory examination, functional connectivity changes were also assessed by resting-state functional magnetic resonance imaging. After the intervention, the BIS-11 score was decreased from 59.5 [55.6, 63.3] (mean [95% confidence interval]) to 55.2 [50.3, 60.1] (ΔBIS-11: -4.2, [-7.5, -0.9]). Functional connectivity was increased in the default mode network (DMN) at a cluster including the precuneus, posterior cingulate gyrus, and left posterior lobe (false discovery rate-adjusted p [FDR-p] = 0.046) and in the right frontoparietal network (FPN) at the medial frontal lobe (FDR-p = 0.039). Conclusions This open-label, single-arm pilot study provided preliminary data for mindfulness meditation to control the impulsivity of patients with PD. A brief mindfulness meditation program may be effective in controlling impulsivity in PD and may change the functional connectivity of the DMN and right FPN.
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Affiliation(s)
- Jinsoo Koh
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
- * E-mail:
| | - Maiko Takahashi
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Yasuhiko Ohmae
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Junko Taruya
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Mayumi Sakata
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Masaaki Yasui
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Masaki Terada
- Wakayama-Minami Radiology Clinic, Wakayama, Wakayama Prefecture, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
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Pongmala C, Artusi CA, Zibetti M, Pitakpatapee Y, Wangthumrong T, Sangpeamsook T, Srikajon J, Srivanitchapoom P, Youn J, Cho JW, Kim M, Zamil Shinawi HM, Obaid MT, Baumann A, Margraf NG, Pona-Ferreira F, Leitão M, Lobo T, Ferreira JJ, Fabbri M, Lopiano L. Postural abnormalities in Asian and Caucasian Parkinson's disease patients: A multicenter study. Parkinsonism Relat Disord 2022; 97:91-98. [PMID: 35378428 DOI: 10.1016/j.parkreldis.2022.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Postural abnormalities (PA) are disabling features of Parkinson's disease (PD). Indirect analyses suggested a higher prevalence of PA among Asian patients compared to Caucasian ones, but no direct comparisons have been performed so far. METHODS An international, multicenter, cross-sectional study was performed in 6 European and Asian movement disorders centers with the aim to clarify differences and similarities of prevalence and characteristics of PA in Asian vs. Caucasian PD patients. Axial PA, encompassing antecollis (AC), camptocormia (CC), and Pisa syndrome (PS), and appendicular PA (appPA) were systematically searched and analysed in consecutive patients. RESULTS 88 (27%) of 326 PD patients had PA (29.1% in Asians and 24.3% in Caucasians, p: 0.331). Prevalence of axial PA was 23.6% in Asians and 24.3% in Caucasians (p = 0.886), in spite of a longer disease duration among Caucasians, but a longer PA duration among Asians. No differences in prevalence between AC, CC, and PS were found between the two ethnicities. The prevalence of appPA was higher in Asians (p = 0.036), but the regression analysis did not confirm a significant difference related to ethnicity. Considering the whole population, male gender (OR, 4.036; 95% CI, 1.926-8.456; p < 0.005), a longer disease duration (OR, 2.61; 95% CI, 1.024-6.653; p = 0.044), and a higher axial score (OR, 1.242; 95% CI, 1.122-1.375; p < 0.0005) were the factors associated with axial PA. CONCLUSION The prevalence of axial PA in PD patients is not influenced by ethnicity. However, Asian PD patients tend to develop PA earlier in the disease course, particularly AC.
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Affiliation(s)
- Chatkaew Pongmala
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy.
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
| | - Yuvadee Pitakpatapee
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Takarn Wangthumrong
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanita Sangpeamsook
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jindapa Srikajon
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prachaya Srivanitchapoom
- Faculty of Medicine, Division of Neurology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jinyoung Youn
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Jin Whan Cho
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Minkyeong Kim
- Department of Neurology, Gyeongsang National University Hospital, Jinju, South Korea
| | | | - Mona Talib Obaid
- National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Alexander Baumann
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Nils G Margraf
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | | | | - Teresa Lobo
- CNS-Campus Neurológico, Torres Vedras, Portugal
| | - Joaquim J Ferreira
- CNS-Campus Neurológico, Torres Vedras, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Instituto Medicina Molecular João Lobo Antunes, Lisbon, Portugal
| | - Margherita Fabbri
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center; Toulouse University Hospital; INSERM; University of Toulouse 3; Toulouse, France
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10124, Turin, Italy
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Söke F, OZCAN GÜLSEN ELVAN, Erkoc Ataoglu NE, Gülşen Ç, Kocer B, BORA TOKCAER A. The Reliability and Validity of the Manual Ability Measure-36 in Patients with Parkinson's Disease. TURKISH JOURNAL OF NEUROLOGY 2022. [DOI: 10.4274/tnd.2022.99836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Pedrosa DJ, Gandor F, Jost WH, Arlt C, Onuk K, Timmermann L. Characterization of advanced Parkinson's disease in Germany: results of the non-interventional OBSERVE-PD study. Neurol Res Pract 2022; 4:9. [PMID: 35292120 PMCID: PMC8922845 DOI: 10.1186/s42466-022-00176-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive, neurodegenerative disorder. In the advanced stages it can result in severe disability despite optimal treatment. Data suggests heterogeneous classification of PD stages among physicians in different countries. The purpose of the OBSERVE-PD study was to evaluate the proportion of patients with advanced PD (APD) according to physicians' judgments in an international cohort. METHODS A cross-sectional, observational study was conducted in 18 countries. Data were collected during a single patient visit. Demographic data, disease status, current medical treatment, and quality of life were evaluated for the German cohort and compared to the international cohort. Potential prognostic factors of physicians' classification of APD in the German and international cohorts were identified using logistic regression. RESULTS In total, 177 German and 2438 international patients were enrolled. 68.9% of the German and 50.0% of the international patients were classified by physicians as APD. Despite similar demographics and comparable disease severity, motor fluctuations (odds ratio [OR], 49.7; 95% confidence interval [CI], 8.5-291.9) and current device-aided treatment (OR 8.7; CI 5.5-13.8) showed the strongest association to physicians' classification of APD in the German and the international cohorts, respectively. The number of different oral anti-Parkinson-medications showed opposed associations with APD-classification between the international (OR 1.19; CI 1.03-1.37) and German (OR 0.46; CI 0.18-1.18) cohort. Although 58.2% of the German patients diagnosed with APD were considered eligible for device-aided treatment, only 40.8% actually received it. CONCLUSIONS This study highlights the challenges in the recognition and the effective management of APD in Germany and emphasizes the necessity of complying with standard diagnostic criteria for identification of patients with APD. Therapeutic approaches differed internationally, with a tendency in Germany towards a more complex oral medication regimen for patients with APD. In view of similar quality of life and disease status in both cohorts, our findings may prompt further exploration of parameters for disease classifications, and consideration of optimal treatment strategies.
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Affiliation(s)
- David J Pedrosa
- Klinik für Neurologie, Universitätsklinikum Gießen and Marburg, Marburg site, 35043, Marburg, Germany.
| | - Florin Gandor
- Neurologisches Fachkrankenhaus für Bewegungsstörungen/Parkinson, Kliniken Beelitz, 14547, Beelitz-Heilstätten, Germany.,Klinik für Neurologie, Otto-Von-Guericke-Universität Magdeburg, 39120, Magdeburg, Germany
| | | | - Carolin Arlt
- AbbVie Deutschland GmbH & Co. KG, 65189, Wiesbaden, Germany
| | - Koray Onuk
- AbbVie Inc., North Chicago, IL, 60064, USA
| | - Lars Timmermann
- Klinik für Neurologie, Universitätsklinikum Gießen and Marburg, Marburg site, 35043, Marburg, Germany
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Stathis P, Papadopoulos G. Evaluation and validation of a patient-reported quality-of-life questionnaire for Parkinson's disease. J Patient Rep Outcomes 2022; 6:17. [PMID: 35235090 PMCID: PMC8891413 DOI: 10.1186/s41687-022-00427-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background Parkinson’s disease (PD) is a chronic, progressive illness with a profound impact on the health-related quality of life (HRQoL). Disease-specific patient-reported HRQoL measures, such as PDQ-39 and its short version PDQ-8, are increasingly used in clinical practice to address the consequences of PD on everyday life. Due to limitations in the content, especially in non-motor symptoms and sleep disturbances of PDQ-8, PDQoL7, a 7-item, short-term, self-reported, PD-specific HRQoL questionnaire was developed. Methods A representative sample of 60 adults with idiopathic PD completed the PDQoL7 questionnaire and the existing validated PDQ-8 and EQ-5D-5L questionnaires (all in Greek). Results PDQoL7 summary index strongly correlated with PDQ-8 (rs = 0.833, P < 0.001) and EQ-5D-5L (rs = − 0.852, P < 0.001). The correlation between PDQoL7 and EQ-5D-5L was statistically significantly stronger compared to PDQ-8 and EQ-5D-5L (rs = − 0.852 vs rs = − 0.789 respectively, P < 0.001). The internal consistency of PDQoL7 was not affected by item deletion (positive item to total correlations: 0.29–0.63). No redundant items (with inter-item correlation coefficients greater than 0.80) were identified. Cronbach’s α for PDQoL7 was comparable to PDQ-8 (0.804 versus 0.799 respectively). As PDQoL7 had three-dimensional structure, omega coefficient analysis confirmed its reliability (omega total: 0.88; omega hierarchical: 0.58). Conclusions PDQoL7 is an acceptable, easy to use, valid and reliable tool for the determination of HRQoL in PD patients that is potentially more comprehensive than PDQ-8 based on the available evidence. PDQoL7 could allow for a more thorough evaluation of the impact of PD and contribute to guiding healthcare decisions. This will be confirmed in subsequent analysis on larger patient cohorts. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00427-0.
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Affiliation(s)
- Pantelis Stathis
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece.
| | - George Papadopoulos
- Department of Neurology, Mediterraneo Hospital, 8-12 Ilias Street, 16675, Glyfada, Athens, Greece
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Parkinson's disease severity clustering based on tapping activity on mobile device. Sci Rep 2022; 12:3142. [PMID: 35210451 PMCID: PMC8873556 DOI: 10.1038/s41598-022-06572-2] [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: 08/23/2021] [Accepted: 02/01/2022] [Indexed: 11/09/2022] Open
Abstract
In this study, we investigated the relationship between finger tapping tasks on the smartphone and the MDS-UPDRS I–II and PDQ-8 using the mPower dataset. mPower is a mobile application-based study for monitoring key indicators of PD progression and diagnosis. Currently, it is one of the largest, open access, mobile Parkinson’s Disease studies. Data from seven modules with a total of 8,320 participants who provided the data of at least one task were released to the public researcher. The modules comprise demographics, MDS-UPDRS I–II, PDQ-8, memory, tapping, voice, and walking. Finger-tapping is one of the tasks that easy to perform and has been analyzed for the quantitative measurement of PD. Therefore, participants who performed both the tapping activity and MDS-UPDRS I–II rating scale were selected for our analysis. Note that the MDS-UPDRS mPower Survey only contains parts of the original scale and has not been clinimetrically tested for validity and reliability. We obtained a total of 1851 samples that contained the tapping activity and MDS-UPDRS I–II for the analysis. Nine features were selected to represent tapping activity. K-mean was applied as an unsupervised clustering algorithm in our study. For determining the number of clusters, the elbow method, Sihouette score, and Davies–Bouldin index, were employed as supporting evaluation metrics. Based on these metrics and expert opinion, we decide that three clusters were appropriate for our study. The statistical analysis found that the tapping features could separate participants into three severity groups. Each group has different characteristics and could represent different PD severity based on the MDS-UPDRS I–II and PDQ-8 scores. Currently, the severity assessment of a movement disorder is based on clinical observation. Therefore, it is highly dependant on the skills and experiences of the trained movement disorder specialist who performs the procedure. We believe that any additional methods that could potentially assist with quantitative assessment of disease severity, without the need for a clinical visit would be beneficial to both the healthcare professionals and patients.
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Liang Y, Chen D, Ou R, Zhao B, Song W, Yi X, Yang R, Chen X. Current Status of Acceptance of Disability and the Correlation With the Life Quality in Parkinson's Disease in Southwest China. Front Med (Lausanne) 2022; 8:767215. [PMID: 35118084 PMCID: PMC8804473 DOI: 10.3389/fmed.2021.767215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background Acceptance of disability (AOD) is a process that a patient must undergo to cope with altered abilities, but its effect in Parkinson's disease (PD) remains unclear. The present study aimed to determine the level of AOD, examine the influence of sociodemographic variables and disease characteristics on the AOD level, and evaluate the relation between AOD level and quality of life in a cohort of PD patients from Southwest of China. Methods A total of 336 PD patients were consecutively recruited from November 2018 to October 2020. At enrollment, demographic and clinical data were obtained using a questionnaire, and the Acceptance of Disability Scale-Revised (AODS-R) scale was used to measure the AOD level. Results The mean total score of AOD is 87.28, indicating a moderate level of disability acceptance in PD patients. Statistical analysis showed that understanding of PD, family support, and UPDRS-II score were major factors affecting AOD level, and patients with low AOD levels were more likely to have poorer quality of life. Conclusion AOD is a serious problem in PD patients in Southwest China, especially among individuals with insufficient family support and a lack of recognition of the disease. AOD was also associated with motor function and daily living ability, thus suggesting that evaluation of the AOD and promotion of the awareness may be helpful to improve the quality of life in patients with PD.
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Affiliation(s)
- Yan Liang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Dezhi Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Zhao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Song
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaojiang Yi
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Rong Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xueping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xueping Chen
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Valdés-Badilla P, Herrera-Valenzuela T, Guzmán-Muñoz E, Delgado-Floody P, Núñez-Espinosa C, Monsalves-Álvarez M, Andrade DC. Effects of Olympic Combat Sports on Health-Related Quality of Life in Middle-Aged and Older People: A Systematic Review. Front Psychol 2022; 12:797537. [PMID: 35069389 PMCID: PMC8769282 DOI: 10.3389/fpsyg.2021.797537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022] Open
Abstract
Olympic combat sports are unconventional physical activity strategies to train middle-aged and older people with and without health problems. This systematic review aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports interventions (boxing, fencing, judo, karate, taekwondo, wrestling) on health-related quality of life in adults aged 45 and older. The search was carried out in five generic databases until July 2021 and the protocol was registered in PROSPERO (code: CRD42021244161). The PRISMA guidelines were followed and the Downs and Black checklist was used to assessed the methodological quality of the studies. After reviewing 1,151 records, only seven studies met the inclusion criteria, adding 212 participants (43.4% female) with a mean age of 63.7 years. Six studies (two with middle-aged participants and four with older people) provided data to calculate the effect size (ES) in the Olympic combat sports groups (No research that used taekwondo or wrestling as an intervention modality was found). Three studies reported beneficial changes with a small ES for the total score (d < 0.40) of the health-related quality of life. Two studies reported a beneficial change with a small ES (d = 0.49) and strong ES (d = 4.45) for physical health. One study reported improvements with a small ES for emotional (d = 0.23) and functional (d = 0.26) well-being. In conclusion, interventions based on Olympic combat sports produce beneficial effects with a small and moderate ES on health-related quality of life in male and female aged 45 and older who are healthy participants, participants with Parkinson's disease, and participants with breast cancer. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, PROSPERO: CRD42021244161.
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Affiliation(s)
- Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, Chile
- Carrera de Entrenador Deportivo, Escuela de Educación, Universidad Viña del Mar, Viña del Mar, Chile
| | - Tomás Herrera-Valenzuela
- Department of Physical Activity, Sports and Health Sciences, Faculty of Medical Sciences, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Eduardo Guzmán-Muñoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Pedro Delgado-Floody
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Cristian Núñez-Espinosa
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas, Chile
- School of Medicine, Universidad de Magallanes, Punta Arenas, Chile
| | - Matias Monsalves-Álvarez
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
- Human Performance Laboratory, Motion Training, Rehab & Nutrition, Lo Barnechea, Chile
| | - David Cristóbal Andrade
- Departamento Biomédico, Centro de Investigación en Fisiología y Medicina de Altura (MedAlt), Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
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Advanced Parkinson's Disease Treatment Simplification and Long-Term Outcomes with Levodopa Carbidopa Intestinal Gel: COSMOS Romanian Subanalysis. Brain Sci 2021; 11:brainsci11121566. [PMID: 34942868 PMCID: PMC8699449 DOI: 10.3390/brainsci11121566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/04/2022] Open
Abstract
The aim of the COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS) was to assess the use of levodopa/carbidopa intestinal gel (LCIG) as monotherapy in patients with advanced Parkinson’s disease (APD) in routine clinical practice. COSMOS was an international observational study with one cross-sectional visit and retrospective data collection. In Romania, 95 adult patients with APD on LCIG treatment for at least 12 months were enrolled and stratified according to their LCIG therapy after 12 months: monotherapy (without any add-on PD medication), monotherapy with night PD medication and LCIG + add-on medication. Compared to the moment of LCIG initiation, the percentage of patients on monotherapy increased at three months after LCIG initiation and remained constant up to 12 months, when 30.5% of the patients were on LCIG monotherapy and 11.6% were on monotherapy with night medication. “Off” time and “On” time with dyskinesia decreased from LCIG initiation to patient visit in all groups. LCIG monotherapy with or without night medication may provide a simplified treatment option for selected APD patients, with long-term efficacy similar to that of LCIG plus add-on medication.
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Zanin E, Aiello EN, Diana L, Fusi G, Bonato M, Niang A, Ognibene F, Corvaglia A, De Caro C, Cintoli S, Marchetti G, Vestri A. Tele-neuropsychological assessment tools in Italy: a systematic review on psychometric properties and usability. Neurol Sci 2021; 43:125-138. [PMID: 34751849 PMCID: PMC8576086 DOI: 10.1007/s10072-021-05719-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/30/2021] [Indexed: 02/06/2023]
Abstract
Background The current COVID-19 pandemic has abruptly catalysed a shift towards remote assessment in neuropsychological practice (tele-neuropsychology, t-NPs). Although the validity of t-NPs diagnostics is gaining recognition worldwide, little is known about its implementation in Italy. The present review by the Italian working group on tele-neuropsychology (TELA) aims at describing the availability, psychometric properties, and feasibility of t-NPs tools currently available in Italy. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. This work was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO; CRD42021239687). Observational studies reporting telephone-, videoconference- or web-based assessment of cognition/behaviour in Italian both healthy participants (HPs) and patients were included. Bias assessment was performed through ad hoc scales. Results Fourteen studies were included from an initial N = 895 (4 databases searched). Studies were subdivided into those focused on psychometric properties and those characterized by a predominant applied nature. The majority of studies addressed either adult/elderly HPs or neurological/internal patients. Multi-domain screening tools for cognition, behaviour, mood/anxiety and quality of life were the most represented. Findings regarding validity, reliability, sensitivity, specificity and clinical usability were reported for cognitive screenings — the telephone- and videoconference-based Mini-Mental State Examination and the Telephone Interview for Cognitive Status. Discussion Positive albeit preliminary evidence regarding psychometric properties and feasibility in both clinical and non-clinical populations of Italian t-NPs brief screening tools are herewith provided. Further studies exploring clinical usability of t-NPs and psychometric properties/feasibility of tests for the in-depth assessment of specific cognitive domains are necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05719-9.
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Affiliation(s)
- Elia Zanin
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, Italy
| | - Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. .,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Lorenzo Diana
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Giulia Fusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Mario Bonato
- Department of General Psychology, University of Padua, Padova, Italy
| | - Aida Niang
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Alessia Corvaglia
- Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | | | - Simona Cintoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Marchetti
- Department of General Psychology, University of Padua, Padova, Italy
| | - Alec Vestri
- Unit for the Rehabilitation of Acquired Neuropsychological Disorders, IRCCS E. Medea, Pieve di Soligo, Italy
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Mañago MM, Swink LA, Hager ER, Gisbert R, Earhart GM, Christiansen CL, Schenkman M. The Impact of COVID-19 on Community-Based Exercise Classes for People With Parkinson Disease. Phys Ther 2021; 101:pzab203. [PMID: 34473303 PMCID: PMC8522385 DOI: 10.1093/ptj/pzab203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/21/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE he purpose of the study was to determine the impact of novel coronavirus 2019 (COVID-19) restrictions on community-based exercise classes for people with Parkinson disease (PD) and their instructors. METHODS Data were collected via custom-designed electronic surveys for people with PD and class instructors who reported attending or teaching PD-specific exercise class ≥1 time/week for ≥3 months prior to pandemic restrictions (March 2020). The PD group also completed the Godin Leisure-Time Questionnaire, Self-Efficacy for Exercise scale, Schwab-England scale, and Parkinson's Disease Questionnaire 8. RESULTS Eighty-seven people with PD (mean = 70 [7.3] years old) and 43 instructors (51 [12.1] years old) from the United States completed surveys (October 2020 to February 2021). Mean Schwab-England (84 [16]) and Parkinson's Disease Questionnaire 8 (21 [15]) scores indicated low-to-moderate disability in the PD group. Ninety-five percent of the PD group had COVID-19 exposure concerns, and 54% reported leaving home ≤1 time/week. Although 77% of the PD group scored "active" on the Godin Leisure-Time Questionnaire, the mean Self-Efficacy for Exercise Scale score (55 [24]) indicated only moderate exercise self-efficacy, and >50% reported decreased exercise quantity/intensity compared with pre-COVID. There was decreased in-person and increased virtual class participation for both groups. The top in-person class barrier for the PD (63%) and instructor (51%) groups was fear of participant COVID-19 exposure. The top virtual class barriers were lack of socialization (20% of PD group) and technology problems (74% of instructor group). CONCLUSION During COVID-19, there has been less in-person and more virtual exercise class participation in people with PD and decreased exercise quantity and intensity. Virtual classes may not fully meet the needs of people with PD, and primary barriers include technology and lack of socialization. IMPACT As COVID-19 restrictions wane, it is imperative to help people with PD increase exercise and activity. The barriers, needs, and facilitators identified in this study might help inform approaches to increase participation in exercise and activity for people with PD. LAY SUMMARY During COVID-19, there has been less in-person and more virtual exercise class participation in people with PD and a decrease in exercise quantity and intensity. If you have PD, virtual classes might not fully meet your needs. Primary barriers may include technology problems and lack of social interaction.
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Affiliation(s)
- Mark M Mañago
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Laura A Swink
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Emily R Hager
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Robyn Gisbert
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Cory L Christiansen
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, United States
| | - Margaret Schenkman
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States
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Shimo Y, Maeda T, Chiu SW, Yamaguchi T, Kashihara K, Tsuboi Y, Nomoto M, Hattori N, Watanabe H, Saiki H. Influence of istradefylline on non-motor symptoms of Parkinson's disease: A subanalysis of a 1-year observational study in Japan (J-FIRST). Parkinsonism Relat Disord 2021; 91:115-120. [PMID: 34583302 DOI: 10.1016/j.parkreldis.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/26/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The non-motor symptoms (NMSs) of Parkinson's disease (PD) significantly impact the patient's health-related quality of life. This subanalysis of the J-FIRST study evaluated the effect of istradefylline, a selective adenosine A2A receptor antagonist, on NMSs in istradefylline-naïve Japanese patients with PD. METHODS Patients with PD and ≥1 NMS and 'wearing-off' with their current antiparkinsonian treatment were observed for up to 52 weeks. The effect of istradefylline on NMSs was measured in terms of changes in the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part 1 total, individual sub-items scores and the 8 item PD questionnaire (PDQ-8) estimated by the marginal structural model. RESULTS Overall, 732 patients were istradefylline-naïve prior to the study, of whom 171 were treated with istradefylline for ≥8 weeks during the observation period (istradefylline-treated patients). At baseline, istradefylline-treated patients were more likely to have a dyskinesia (49.7% vs 40.8%) and received a significantly higher daily dose of levodopa (462.8 mg vs 413.0 mg) than those who did not receive istradefylline (n = 561). MDS-UPDRS Part 1 total score at the end of the 52-week observational period slightly increased in patients who received istradefylline and those who did not (0.49 ± 0.41 vs 0.07 ± 0.20; P = 0.36). There were no statistically significant differences between the two groups of patients in terms of changes in the MDS-UPDRS Part 1 total score or any sub-items, or in the PDQ-8 total score. CONCLUSION NMSs remained generally controlled in istradefylline-treated Japanese patients with PD who exhibited wearing-off with their current antiparkinsonian treatment. Istradefylline could be a feasible treatment option for patients with advanced PD, without worsening existing NMSs.
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Affiliation(s)
- Yasushi Shimo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan.
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan; Department of Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan
| | - Shih-Wei Chiu
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenichi Kashihara
- Okayama Kyokuto Hospital, Okayama, Japan; Okayama Neurology Clinic, Okayama, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masahiro Nomoto
- Ehime University Graduate School of Medicine, Tohon, Japan; Department of Neurology, Saiseikai Imabari Center for Health and Welfare, Imabari, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Hidemoto Saiki
- Parkinson's Disease Advanced Therapy Center, Aichi Medical University Hospital, Aichi, Japan
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Silva-Batista C, Coelho DB, Júnior RCF, Almeida LR, Guimarães A, Nóbrega KCC, Machado Sanchez H, Lindquist ARR, Israel VL, Kanegusuku H, Guimarães R, Beckmann Bosaipo N, Barbosa R, Correa CL, Finatto MJ, Mendes FADS, Piemonte MEP. Multidimensional Factors Can Explain the Clinical Worsening in People With Parkinson's Disease During the COVID-19 Pandemic: A Multicenter Cross-Sectional Trial. Front Neurol 2021; 12:708433. [PMID: 34393984 PMCID: PMC8362931 DOI: 10.3389/fneur.2021.708433] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious. Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes. Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume. Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale—parts IB and II—emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05). Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.
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Affiliation(s)
- Carla Silva-Batista
- Exercise Neuroscience Research Group, University of São Paulo, Sao Paulo, Brazil
| | - Daniel Boari Coelho
- Biomedical Engineering, Federal University of ABC, Sao Bernardo do Campo, Brazil
| | | | - Lorena Rosa Almeida
- Movement Disorders and Parkinson's Disease Clinic, Roberto Santos General Hospital/SESAB, Salvador, Brazil.,Motor Behavior and Neurorehabilitation Research Group, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Adriana Guimarães
- Department of Physical Education, State University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | - Vera Lúcia Israel
- Department of Physiotherapy, Federal University of Parana, Curitiba, Brazil
| | - Hélcio Kanegusuku
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, Sáo Paulo, Brazil
| | - Rachel Guimarães
- Laboratory of Neuroimaging, University of Campinas, Sáo Paulo, Brazil
| | - Nayanne Beckmann Bosaipo
- Setor de Distúrbios do Movimento e Neurologia Comportamental do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Sáo Paulo, Brazil
| | - Richelma Barbosa
- Department of Physiotherapy, University of Pará State, Santarém, Brazil
| | - Clynton Lourenço Correa
- Graduate Program of Physical Education, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria José Finatto
- Department of Linguistics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Fleisher J, Hess S, Sennott B, Myrick E, Wallace EK, Lee J, Sanghvi M, Woo K, Ouyang B, Wilkinson J, Beck J, Johnson T, Hall D, Chodosh J. Longitudinal, Interdisciplinary Home Visits vs. Usual Care for Homebound People with Advanced Parkinson's Disease (IN-HOME-PD): Study protocol for a controlled trial. JMIR Res Protoc 2021; 10:e31690. [PMID: 34238753 PMCID: PMC8479607 DOI: 10.2196/31690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 01/10/2023] Open
Abstract
Background The current understanding of advanced Parkinson disease (PD) and its treatment is largely based on data from outpatient visits. The most advanced and disabled individuals with PD are disconnected from both care and research. A previous pilot study among older, multimorbid patients with advanced PD demonstrated the feasibility of interdisciplinary home visits to reach the target population, improve care quality, and potentially avoid institutionalization. Objective The aim of this study protocol is to investigate whether interdisciplinary home visits can prevent a decline in quality of life of patients with PD and prevent worsening of caregiver strain. The protocol also explores whether program costs are offset by savings in health care utilization and institutionalization compared with usual care. Methods In this single-center, controlled trial, 65 patient-caregiver dyads affected by advanced PD (Hoehn and Yahr stages 3-5 and homebound) are recruited to receive quarterly interdisciplinary home visits over 1 year. The 1-year intervention is delivered by a nurse and a research coordinator, who travel to the home, and it is supported by a movement disorder specialist and social worker (both present by video). Each dyad is compared with age-, sex-, and Hoehn and Yahr stage–matched control dyads drawn from US participants in the longitudinal Parkinson’s Outcome Project registry. The primary outcome measure is the change in patient quality of life between baseline and 1 year. Secondary outcome measures include changes in Hoehn and Yahr stage, caregiver strain, self-reported fall frequency, emergency room visits, hospital admissions, and time to institutionalization or death. Intervention costs and changes in health care utilization will be analyzed in a budget impact analysis to explore the potential for model adaptation and dissemination. Results The protocol was funded in September 2017 and approved by the Rush Institutional Review Board in October 2017. Recruitment began in May 2018 and closed in November 2019 with 65 patient-caregiver dyads enrolled. All study visits have been completed, and analysis is underway. Conclusions To our knowledge, this is the first controlled trial to investigate the effects of interdisciplinary home visits among homebound individuals with advanced PD and their caregivers. This study also establishes a unique cohort of patients from whom we can study the natural course of advanced PD, its treatments, and unmet needs. Trial Registration ClinicalTrials.gov NCT03189459; http://clinicaltrials.gov/ct2/show/NCT03189459. International Registered Report Identifier (IRRID) PRR1-10.2196/31690
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Affiliation(s)
- Jori Fleisher
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Serena Hess
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Brianna Sennott
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Erica Myrick
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US.,Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, US
| | - Ellen Klostermann Wallace
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Jeanette Lee
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US.,Social Work and Community Health, Rush University Medical Center, Chicago, US
| | - Maya Sanghvi
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US.,Yale College, Yale University, New Haven, US
| | - Katheryn Woo
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University Medical Center, Chicago, US
| | - Jayne Wilkinson
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, US.,Department of Neurology, University of Pennsylvania, Philadelphia, US
| | | | - Tricia Johnson
- Department of Health Systems Management, Rush University Medical Center, Chicago, US
| | - Deborah Hall
- Section of Movement Disorders, Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison StreetSuite 755, Chicago, US
| | - Joshua Chodosh
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Grossman School of Medicine, New York, US.,VA New York Harbor Healthcare System, New York, US
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Characterizing Advanced Parkinson's Disease: Romanian Subanalysis from the OBSERVE-PD Study. PARKINSONS DISEASE 2021; 2021:6635618. [PMID: 33564391 PMCID: PMC7850828 DOI: 10.1155/2021/6635618] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/22/2020] [Accepted: 01/12/2021] [Indexed: 01/10/2023]
Abstract
OBSERVE-PD was a cross-sectional, multicountry, observational study conducted in 128 Movement Disorders Centers (MDCs) in 18 countries. Overall, the study enrolled 2615 patients. The aim was to determine the proportion of patients with advanced Parkinson's disease (APD) versus non-APD from MDCs and to uncover the clinical burden of APD, as well as a correlation between overall assessment of APD and several indicators of APD. The advanced stage of the disease and severity were assessed by investigators using their clinical judgement. Data were collected during a single visit between February 2015 and January 2016. Agreement on physician judgement of APD diagnosis and fulfillment of at least one previously established APD indicator was calculated. Motor and nonmotor symptoms (NMSs), activities of daily living, treatment complications, quality of life (QoL), conventional treatments, and device-aided therapy (DAT) eligibility were assessed. Here, country-specific results of 161 Romanian patients with PD are presented. In total, 59.0% of patients were diagnosed with APD and 78.8% met at least one APD indicator. There was only moderate agreement between clinical judgement of APD and overall fulfillment of APD indicators. All scores related to motor symptoms, NMSs, and treatment complications, as well as to QoL, showed a higher disease burden for patients with APD versus non-APD. Physicians considered 73.7% of patients with APD eligible for DAT. The majority of patients eligible for DAT (54.3%) did not receive such treatment. Our results highlight the importance of earlier recognition of APD, by combining clinical judgement with more standardized clinical tools, such as generally recognized APD criteria. However, timely diagnosis of APD alone is not enough to improve patient outcomes. Other critical factors include patient acceptance and access to appropriate treatment.
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Deep Brain Stimulation Selection Criteria for Parkinson's Disease: Time to Go beyond CAPSIT-PD. J Clin Med 2020; 9:jcm9123931. [PMID: 33291579 PMCID: PMC7761824 DOI: 10.3390/jcm9123931] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022] Open
Abstract
Despite being introduced in clinical practice more than 20 years ago, selection criteria for deep brain stimulation (DBS) in Parkinson's disease (PD) rely on a document published in 1999 called 'Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease'. These criteria are useful in supporting the selection of candidates. However, they are both restrictive and out-of-date, because the knowledge on PD progression and phenotyping has massively evolved. Advances in understanding the heterogeneity of PD presentation, courses, phenotypes, and genotypes, render a better identification of good DBS outcome predictors a research priority. Additionally, DBS invasiveness, cost, and the possibility of serious adverse events make it mandatory to predict as accurately as possible the clinical outcome when informing the patients about their suitability for surgery. In this viewpoint, we analyzed the pre-surgical assessment according to the following topics: early versus delayed DBS; the evolution of the levodopa challenge test; and the relevance of axial symptoms; patient-centered outcome measures; non-motor symptoms; and genetics. Based on the literature, we encourage rethinking of the selection process for DBS in PD, which should move toward a broad clinical and instrumental assessment of non-motor symptoms, quantitative measurement of gait, posture, and balance, and in-depth genotypic and phenotypic characterization.
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Berardi A, Regoli E, Tofani M, Valente D, Fabbrini G, Fabbrini A, Ruggieri M, Panuccio F, Galeoto G. Tools to assess the quality of life in patients with Parkinson's disease: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2020; 21:55-68. [PMID: 33090885 DOI: 10.1080/14737167.2021.1841638] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The clinical, social, and economic implications of Parkinson's disease (PD) are significant; disability occurs leading to a low quality of life (QoL). Information on the QoL of patients with PD and studies on the relationship between QoL and motor and cognitive function are necessary for both research and clinical use to make informed decisions in healthcare and rehabilitation. The aim of this study was to determine which scales are most used to assess QoL in patients with PD. AREA COVERED A literature search was conducted in MEDLINE, Scopus, CINAHL, PsycINFO, and Web of Science. Two authors independently identified eligible studies based on predefined inclusion criteria and extracted the data. Study quality and the risk of bias were assessed using the COSMIN checklist. EXPERT OPINION 116 suitable studies were included, and 42 different instruments were identified. The most frequently used scales were the 39-items and 8-items Parkinson's Disease Questionnaire (PDQ-39) (PDQ-8). These findings suggest further investigation of existing PD outcome measures would benefit patients, researchers, and clinicians. Validated, universal outcome measures are required to allow comparisons across practice; therefore, we recommend that future researchers use a common set of outcome assessments based on the results of this review.
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Affiliation(s)
- Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
| | | | - Marco Tofani
- Department of Neurorehabilitation and Robotics, Bambino Gesù Paediatric Hospital , Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | | | | | | | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
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31
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Jenkins PE, Davey E. The brief (seven-item) eating disorder examination-questionnaire: Evaluation of a non-nested version in men and women. Int J Eat Disord 2020; 53:1809-1817. [PMID: 32767481 DOI: 10.1002/eat.23360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Several recent studies have examined the psychometric properties of brief measures of eating disorder attitudes based on the Eating Disorder Examination Questionnaire (EDE-Q). A seven-item version (the EDE-Q7) has been proposed but, as yet, has only been investigated by looking at the items when presented as part of the longer EDE-Q (i.e., as a nested version). The current study presented the EDE-Q7 as a standalone instrument and examined factor structure fit and measurement invariance across male and female genders. METHODS University students (244 women; 155 men; 1 did not identify with either gender) completed questionnaires as part of two independent studies. All individuals completed the EDE-Q7 and measures of eating disorder behaviors. In a mixed-gender subsample (n = 286), measures of depression and eating disorder-specific quality of life were also included. Confirmatory factor analysis of the EDE-Q7 was conducted on males and females independently, in addition to estimates of internal consistency reliability and validity. Measurement invariance was assessed through multigroup confirmatory factor analysis. RESULTS The EDE-Q7 demonstrated good internal consistency and findings supported measurement invariance by gender. In a mixed-gender subsample, the measure showed positive associations with depression and both eating disorder behaviors and eating disorder-specific quality of life. DISCUSSION The present study adds to the literature supporting the psychometric properties of the EDE-Q7, extending this to use of the questionnaire as a standalone instrument. Measurement invariance suggests that the measure may be appropriate for college-age men and women, although future studies should establish psychometric properties more fully.
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Affiliation(s)
- Paul E Jenkins
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Emily Davey
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Experimental Psychology, University of Oxford, Oxford, UK
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Kurihara K, Nakagawa R, Ishido M, Yoshinaga Y, Watanabe J, Hayashi Y, Mishima T, Fujioka S, Tsuboi Y. Impact of motor and nonmotor symptoms in Parkinson disease for the quality of life: The Japanese Quality-of-Life Survey of Parkinson Disease (JAQPAD) study. J Neurol Sci 2020; 419:117172. [PMID: 33065494 DOI: 10.1016/j.jns.2020.117172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) is characterized by a range of classic motor symptoms and heterogeneous nonmotor symptoms that affect patients' quality of life (QoL). Studies have individually reported the effect of either motor or nonmotor symptoms on patients' QoL; however, a thorough assessment of the symptoms that have the greatest influence on QoL is limited. This JAQPAD study examined the effect of both motor and nonmotor symptoms and patient demographics on QoL in a large population of patients with PD in Japan. METHODS All members of the Japan Parkinson's Disease Association were invited to participate in the study. Questionnaires assessing wearing-off symptoms (the 9-item Wearing-Off Questionnaire [WOQ-9]), nonmotor symptoms (Non-Motor Symptoms Questionnaire [NMSQ]) and QoL (the 8-item Parkinson's Disease Questionnaire [PDQ-8]) were included. Multiple regression analyses assessed the effect of clinical factors on the PDQ-8 Summary Index (PDQ-8 SI). Spearman rank correlation coefficient (r) estimated the correlation between each subdomain score of nine NMSQ domains and the PDQ-8 SI. RESULTS A total of 3022 patients were included in the analysis. The PDQ-8 SI score correlated with off-time, age, duration of PD, work status, and the NMSQ total score and subdomain scores. Memory problems correlated most strongly with the PDQ-8 SI score (r = 0.4419), followed by mood (r = 0.4387) and digestive problems (r = 0.4341; p < 0.0001). CONCLUSIONS Physicians tend to focus on motor symptoms, while nonmotor symptoms often go under-recognized in clinical practice. This JAQPAD study highlights the importance of recognition and management of both motor and nonmotor symptoms, which together significantly affect patient QoL.
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Affiliation(s)
- Kanako Kurihara
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan
| | - Ryoko Nakagawa
- AbbVie GK, Medical, 3-1-21 Shibaura, Minato-ku, Tokyo, 108-0023, Japan
| | - Miwako Ishido
- AbbVie GK, Medical, 3-1-21 Shibaura, Minato-ku, Tokyo, 108-0023, Japan
| | - Yoko Yoshinaga
- AbbVie GK, Medical, 3-1-21 Shibaura, Minato-ku, Tokyo, 108-0023, Japan
| | - Jun Watanabe
- AbbVie GK, Medical, 3-1-21 Shibaura, Minato-ku, Tokyo, 108-0023, Japan
| | - Yuka Hayashi
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan
| | - Takayasu Mishima
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-ku, Fukuoka 814-0180, Japan.
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Dominey T, Kehagia AA, Gorst T, Pearson E, Murphy F, King E, Carroll C. Introducing the Parkinson's KinetiGraph into Routine Parkinson's Disease Care: A 3-Year Single Centre Experience. JOURNAL OF PARKINSONS DISEASE 2020; 10:1827-1832. [PMID: 33016893 PMCID: PMC7683053 DOI: 10.3233/jpd-202101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In an effort to provide timely clinical input for people with Parkinson's disease (PD) in the face of increasing demand and resource limitation in our UK based service, we introduced remote management in place of clinic appointment, including the use of the Parkinson's KinetiGraph (PKG™), a wrist-worn device that provides a continuous measure of movement. We evaluated our reporting methods and findings, the nature of unmet need we identified, our treatment recommendations and the degree of their implementation in our patients whose feedback guided our service developments. Our evaluation highlighted opportunities and challenges associated with incorporating digital data into care traditionally delivered via in-person contact.
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Affiliation(s)
- Thea Dominey
- Applied Parkinson's Research Group, University of Plymouth, Faculty of Health, Plymouth, Devon, United Kingdom
| | - Angie A Kehagia
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Terry Gorst
- Applied Parkinson's Research Group, University of Plymouth, Faculty of Health, Plymouth, Devon, United Kingdom
| | - Emma Pearson
- University Hospitals Plymouth NHS Trust, Plymouth, Devon, United Kingdom
| | - Fiona Murphy
- University Hospitals Plymouth NHS Trust, Plymouth, Devon, United Kingdom
| | - Emma King
- Applied Parkinson's Research Group, University of Plymouth, Faculty of Health, Plymouth, Devon, United Kingdom
| | - Camille Carroll
- Applied Parkinson's Research Group, University of Plymouth, Faculty of Health, Plymouth, Devon, United Kingdom.,University Hospitals Plymouth NHS Trust, Plymouth, Devon, United Kingdom
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Landers MR, Ellis TD. A Mobile App Specifically Designed to Facilitate Exercise in Parkinson Disease: Single-Cohort Pilot Study on Feasibility, Safety, and Signal of Efficacy. JMIR Mhealth Uhealth 2020; 8:e18985. [PMID: 33016887 PMCID: PMC7573700 DOI: 10.2196/18985] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 12/28/2022] Open
Abstract
Background Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. Objective To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. Methods A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise was used for this 12-week pilot study. Participants, who were recruited online, were encouraged to exercise with the full automated app for ≥150 minutes each week. The primary endpoints were feasibility (app usage and usability questions) and safety (adverse events and falls). The primary endpoints for signal of efficacy were a comparison of the in-app baseline and 8-week outcomes on the 30-second Sit-To-Stand (STS) test, Timed Up and Go (TUG) test, and the Parkinson’s Disease Questionnaire 8 (PDQ8). Results For feasibility, of the 28 participants that completed the study, 12 participants averaged >150 minutes of app usage per week (3 averaged 120-150, 4 averaged 90-120, and 9 averaged less than 90 minutes). A majority of participants (>74%) felt the exercise was of value (16/19; 9 nonrespondents), provided adequate instruction (14/19; 9 nonrespondents), and was appropriate for level of function (16/19; 9 nonrespondents). For safety, there were no serious adverse events that occurred during the app-guided exercise. There were 4 reports of strain/sprain injuries while using the app among 3 participants, none of which necessitated medical attention. For signal of efficacy, there was improvement for each of the primary endpoints: STS (P=.01), TUG (P<.001), and PDQ8 (P=.01). Conclusions Independent, video-guided exercise using a mobile app designed for exercise in Parkinson disease was safe and feasible though there was variability in app usage. Despite this, the results provide evidence for a signal of efficacy as there were improvements in 3 of the 3 outcomes. Trial Registration ClinicalTrials.gov NCT03459586; https://clinicaltrials.gov/ct2/show/NCT03459586
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Affiliation(s)
- Merrill R Landers
- Department of Physical Therapy, School of Integrative Health Sciences, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - Terry D Ellis
- Department of Physical Therapy and Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
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Fleisher JE, Sennott BJ, Myrick E, Niemet CJ, Lee M, Whitelock CM, Sanghvi M, Liu Y, Ouyang B, Hall DA, Comella CL, Chodosh J. KICK OUT PD: Feasibility and quality of life in the pilot karate intervention to change kinematic outcomes in Parkinson's Disease. PLoS One 2020; 15:e0237777. [PMID: 32903267 PMCID: PMC7480843 DOI: 10.1371/journal.pone.0237777] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 07/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Multiple exercise modalities and mindfulness activities are beneficial in Parkinson's Disease (PD). Karate is a martial art that combines aerobic and large-amplitude movements, balance and core training, and mindfulness, suggesting a potential benefit for individuals with PD from multiple perspectives. OBJECTIVE To evaluate the feasibility of community-based Shotokan karate classes involving physical activity and mindfulness among individuals with mild- to moderate-stage PD, and to explore the effects of karate on objective and patient-reported outcomes. METHODS We conducted a 10-week, unblinded trial of twice weekly, PD-specific karate classes. Feasibility was assessed by: dropout rates, adherence via attendance records, adverse effects and falls, and continued participation six months post-intervention. Participants completed pre- and post-intervention assessments of disease-related quality of life (Parkinson's Disease Questionnaire-8, PDQ-8), falls, and post-intervention assessment of change in overall wellbeing (Patient Global Impression of Change, PGIC), with exploratory measures of mobility using the Timed Up and Go (TUG), mood using the Hospital Anxiety and Depression Scale (HADS), and cognition using digit span forward and backward and the Symbol Digit Modalities Test (SDMT). RESULTS Of 19 enrolled participants, 15 completed the study (79%). Among completers, mean adherence was 87% during the ten weeks of intervention, and 53% maintained karate participation six months later and endorsed sustained improvement, respectively. No adverse effects or change in fall frequency were detected. Among completers, 53% were women, and mean PD duration was 6 years (range 2-20). Quality of life improved to a clinically significant degree (PDQ-8: mean 25.3 (standard deviation (SD) 20.8) versus 19.3 (SD 19.6), p = 0.01, effect size 0.83). On the PGIC, 87% endorsed feeling moderately or considerably better. Mobility did not change significantly (TUG: 9.6 seconds (SD 2.23) versus 9.0 seconds (SD 1.89), p = 0.12, effect size 0.43), nor were there changes in overall physical activity, mood, or cognition (p = 0.35-0.92). CONCLUSIONS In a small, 10-week, unblinded trial of community-based karate classes for individuals with mild and moderate PD, high adherence was noted. Quality of life and wellbeing improved significantly, without changes in exploratory outcomes of mobility or neuropsychological outcomes. The study was underpowered, particularly for the exploratory outcomes. Controlled and longitudinal investigation is warranted to confirm our pilot findings and explore the long-term effects and sustainability of karate in PD. TRIAL REGISTRATION Clinicaltrials.gov: NCT03555695.
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Affiliation(s)
- Jori E. Fleisher
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- * E-mail:
| | - Brianna J. Sennott
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Erica Myrick
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Claire J. Niemet
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Monica Lee
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Courtney M. Whitelock
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Maya Sanghvi
- Yale College, Yale University, New Haven, Connecticut, United States of America
| | - Yuanqing Liu
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Deborah A. Hall
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Cynthia L. Comella
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Joshua Chodosh
- Department of Medicine, New York University School of Medicine, New York, New York, United States of America
- Medicine Service, VA New York Harbor Healthcare System, New York, New York, United States of America
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Fleury V, Catalano Chiuvé S, Forjaz MJ, Di Marco M, Messe M, Debove I, Angulo J, Hariz GM, Burkhard PR, Martinez-Martin P, Rodriguez-Blazquez C, Krack P. Embarrassment and Shame in People With Parkinson's Disease: A New Tool for Self-Assessment. Front Neurol 2020; 11:779. [PMID: 32849230 PMCID: PMC7411180 DOI: 10.3389/fneur.2020.00779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Shame and embarrassment related to Parkinson's disease (PD) are rarely addressed in clinical practice nor studied in neuroscience research, partly because no specific tool exists to detect them in PD. Objective: To develop a self-applied assessment tool of shame and embarrassment specifically related to PD or its treatment, to promptly identify the presence and severity of these two emotions in PD. Methods: Identification and selection of relevant items were obtained from the collection of PD patients' opinions during support groups and interviews. Several further items were added following a literature review. Subsequently, a two-phase pilot study was performed for identification of ambiguous items and omissions, and to obtain preliminary data on acceptability, reliability, validity and relevance of the new scale (SPARK). Results: A total of 105 PD patients were enrolled in the study. Embarrassment was reported in 85% of patients, while shame was present in 26%. Fifteen percent of patients did not describe any shame or embarrassment. On average, the intensity of these two emotions was low with a marked floor effect in SPARK items and subscales. However, SPARK total score inter-individual variability was important (range 1-84 out of 99). Acceptability and quality of data were satisfactory with no floor or ceiling effects (2.9% each) or missing data. Internal consistency (Cronbach's alpha) was 0.94 for total score and 0.73-0.87 for subscales. The scale correlated ≥0.60 with instruments measuring related constructs. Content validity was satisfactory. SPARK total score strongly correlated with impaired health-related quality of life (rS = 0.81), the propensity to feel embarrassed or ashamed (rS = 0.68 and 0.66, respectively), and anxiety (rS = 0.72) and depression (rS = 0.63) levels. Moderate to high correlations were observed between SPARK total score and apathy (rS = 0.46) and a more pronounced personality trait directed toward harm avoidance (rS = 0.46). No significant differences in SPARK scores were found by sex, education level, PD duration, Hoehn and Yahr stages or PD phenotype. Conclusion: Preliminary analysis of psychometric properties suggests that SPARK could be an acceptable and reliable instrument for assessing shame and embarrassment in PD. SPARK could help healthcare professionals to identify and characterize PD-induced shame and embarrassment.
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Affiliation(s)
- Vanessa Fleury
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Maria João Forjaz
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Maria Messe
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Julio Angulo
- Morningview Place, Lake Oswego, OR, United States.,Member, Persons With Parkinson's Advisory Council, Parkinson Foundation, Miami, FL, United States.,Member, Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, New York, NY, United States
| | - Gun-Marie Hariz
- Department of Clinical Science, Neuroscience, Umeå University, Umeå, Sweden
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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Swink LA, Fruhauf CA, Atler KE, Fling BW, Klinedinst TC, Schmid AA. Health-related quality of life changes after the merging yoga and occupational therapy for Parkinson's disease program: A mixed-methods study. Complement Ther Clin Pract 2020; 39:101156. [PMID: 32379684 DOI: 10.1016/j.ctcp.2020.101156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/02/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To understand changes in health-related quality of life (HRQoL) after the Merging Yoga and Occupational Therapy for Parkinson's Disease (MY-OT for PD) program. MATERIALS AND METHODS We used a mixed-methods convergent design and administered the Parkinson's Disease Questionnaire-8 (PDQ-8), a measure of HRQoL, with 17 participants. We considered scores 8 weeks before MY-OT for PD, just before, and upon completion. Additionally, we completed two focus groups following the program with 16 participants to assess qualitative changes in HRQoL. RESULTS There were no significant differences in PDQ-8 scores between time points, F(2,32) = 1.60, p = 0.22, partial η2 = 0.09. Participants did discuss improvements in all 8 HRQoL domains, frequently regarding mobility and activities of daily living. CONCLUSION Results diverged, with quantitative results showing no significant improvement in HRQoL and qualitative results indicating participant perceived improvements in all domains of the PDQ-8. The program should be explored further, and longitudinal follow-up completed.
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Affiliation(s)
- Laura A Swink
- Eastern Colorado Veterans Administration, Geriatric Research, Education, and Clinical Center, 80045, USA.
| | - Christine A Fruhauf
- Department of Human Development and Family Studies, Colorado State University, 80523, USA
| | - Karen E Atler
- Department of Occupational Therapy, Colorado State University, 80523, USA
| | - Brett W Fling
- Department of Health and Exercise Science, Colorado State University, 80523, USA; Molecular, Cellular, and Integrative Neuroscience Graduate Program, Colorado State University, 80523, USA
| | - Tara C Klinedinst
- Department of Occupational Therapy, University of Pittsburgh, 15260, USA
| | - Arlene A Schmid
- Department of Occupational Therapy, Colorado State University, 80523, USA
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Validation of an Individualized Measure of Quality of Life, Patient Generated Index, for Use with People with Parkinson's Disease. Neurol Res Int 2020; 2020:6916135. [PMID: 32292601 PMCID: PMC7149443 DOI: 10.1155/2020/6916135] [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: 11/14/2019] [Revised: 02/03/2020] [Accepted: 02/13/2020] [Indexed: 11/18/2022] Open
Abstract
Methods Patients with PD completed the PGI and various standard patient-reported outcome (PRO) measures. The PGI and standard PRO measures were compared at the total score, domain, and item levels. Pearson's correlations and independent t-tests were used, as well as positive and negative predictive values. Results The sample (n = 76) had a mean age of 69 (standard deviation 9) and were predominantly men (59%). The PGI was moderately correlated (r = -0.35) with the standardized disease-specific QOL measure Parkinson's Disease Questionnaire (PDQ-8). Within one severity rating, agreement between the PGI and different standard outcome measures ranged from 85 to 100% for walking, 69 to 100% for fatigue, 38 to 75% for depression, and 20 to 80% for memory/concentration. Conclusion This study demonstrates that nominated areas of QOL on the PGI provide comparable results to standard PRO measures, and provides evidence in support of the validity of this individualized measure in PD.
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Bernini S, Alloni A, Panzarasa S, Picascia M, Quaglini S, Tassorelli C, Sinforiani E. A computer-based cognitive training in Mild Cognitive Impairment in Parkinson's Disease. NeuroRehabilitation 2019; 44:555-567. [PMID: 31256092 DOI: 10.3233/nre-192714] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is no successful pharmacological treatment for cognitive impairment in Parkinson's Disease, therefore treatments capable of slowing down the progression of cognitive dysfunction are needed. OBJECTIVE To evaluate the effectiveness of a cognitive training, supported by the CoRe computerized tool, in patients with Parkinson's Disease Mild Cognitive Impairment. METHODS This is a prospective, open-unblinded, randomized, controlled study. After baseline cognitive assessment (T0), enrolled patients were randomized to receive motor rehabilitation plus cognitive intervention (G1) or motor rehabilitation only (G2). Follow-up assessments were scheduled 4 weeks (T1) and 6 months after (T2). Global cognitive functioning scores (MOCA and MMSE) were considered as primary outcome. Outcome measures at T0, T1 and T2 were compared within- and between-groups. A percentage change score between T0 and next assessments was calculated to identify patients who improved, remain stable or worsened. RESULTS Differently from G2, G1 showed a medium/large effect size improvement in primary (MoCA) and secondary outcome, both between T0 and T1 and T0 and T2. Moreover, within G1, most patients improved their cognitive state compared to the baseline. CONCLUSIONS Patients trained with CoRe showed a better evolution of cognitive decline, while untreated patients tended to get worse over time.
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Affiliation(s)
- Sara Bernini
- Neuropsychology/Alzheimer's Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Anna Alloni
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Silvia Panzarasa
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Marta Picascia
- Neuropsychology/Alzheimer's Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.,Neurorehabilitation Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Sinforiani
- Neuropsychology/Alzheimer's Disease Assessment Unit, IRCCS Mondino Foundation, Pavia, Italy
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Do Upper and Lower Camptocormias Affect Gait and Postural Control in Patients with Parkinson's Disease? An Observational Cross-Sectional Study. PARKINSONS DISEASE 2019; 2019:9026890. [PMID: 31428306 PMCID: PMC6681593 DOI: 10.1155/2019/9026890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/08/2019] [Indexed: 11/28/2022]
Abstract
Gait impairments and camptocormia (CC) are common and debilitating in patients with Parkinson's disease (PD). Two types of CC affect patients with PD, but no studies investigated their relative contribution in worsening gait and postural control. Therefore, we investigated spatiotemporal gait parameters, gait variability, and asymmetry and postural control in PD patients (Hoehn & Yahr ≤4) with upper CC and lower CC and patients without CC. This observational cross-sectional study involving patients with PD and upper CC (n=16) and lower CC (n=14) and without CC (n=16). The primary outcome measure was gait speed assessed by the GAITRite System. The secondary outcome measures were other spatiotemporal parameters, gait variability, and asymmetry. Postural control and balance were assessed with posturography and the Mini-BESTest. Patients with lower CC showed a higher H&Y stage (p=0.003), a worse PDQ8 (p=0.042), and a lower Mini-BESTest score (p=0.006) than patients with PD without CC. Patients with lower CC showed a reduced gait speed (p=0.012), stride length, and velocity than patients with PD without CC. Upper CC patients showed a higher stride length than lower CC ones (p=0.007). In the eyes open and closed condition, patients with lower CC showed a higher (worse) velocity of CoP displacement in mediolateral direction and length of CoP than patients with PD without CC. No significant between-group differences were measured in gait variability and asymmetry. In conclusion, lower CC was associated with more severe gait and postural control impairment than patients with upper CC and without CC. Categorizing CC based on the bending fulcrum is compulsory to identify patients with the worst performance and to implement specific rehabilitation programs.
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Fabbri M, Coelho M, Abreu D, Guedes LC, Rosa MM, Godinho C, Cardoso R, Guimaraes I, Antonini A, Zibetti M, Lopiano L, Ferreira JJ. Dysphagia predicts poor outcome in late-stage Parkinson's disease. Parkinsonism Relat Disord 2019; 64:73-81. [PMID: 30902528 DOI: 10.1016/j.parkreldis.2019.02.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Few data exist on the rate of clinical progression for Parkinson's disease (PD) patients who have entered a late stage of the disease. OBJECTIVE Study the clinical progression of a late-stage PD (LSPD) population over one year follow-up. METHODS 50 LSPD patients (Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 in MED ON) underwent an extensive clinical assessment at baseline and after one year and an acute levodopa test at baseline. RESULTS Mean age of LSPD patients (female 46%) was 77.5 ± 5.9 years and mean disease duration was 15.5 ± 6.5 years. At baseline, 76% had levodopa-induced motor complications (MC), usually non-troublesome, 68% were demented, 54% had psychosis and 68% depression. Caregiver distress was high. l-dopa responsiveness was mild (18% ± 12 of improvement on MDS-UPDRS-III). After one-year, 20% of the patients were dead, institutionalized or HY 5. MDS-UPDRS-motor mean score worsened 7.2 ± 10.3 points although there was heterogeneity between patients, and there was a global worsening of non-motor symptoms, mostly in cognition/mood, urinary and gastrointestinal domains. Nevertheless, MC improved despite similar levodopa equivalent dose. Functional independence and quality of life worsened. Dysphagia severity at baseline predicted a poor outcome (death, institutionalization or HY 5) (Hazard ratio 2.3, 95% CI 1.12-4.4; p = 0.01), whereas magnitude of l-dopa response of LSPD patients did not. CONCLUSIONS LSPD patients still present a significant, although heterogeneous, motor and non-motor progression over 1 year. Dysphagia severity predicts the occurrence of additional disease severity milestones and its management must be prioritized.
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Affiliation(s)
- Margherita Fabbri
- Instituto de Medicina Molecular, Lisbon, Portugal; Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124, Turin, Italy
| | - Miguel Coelho
- Instituto de Medicina Molecular, Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Daisy Abreu
- Instituto de Medicina Molecular, Lisbon, Portugal
| | - Leonor Correia Guedes
- Instituto de Medicina Molecular, Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Mario M Rosa
- Instituto de Medicina Molecular, Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Catarina Godinho
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro de Investigação Multidisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - Rita Cardoso
- Instituto de Medicina Molecular, Lisbon, Portugal; CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Isabel Guimaraes
- Instituto de Medicina Molecular, Lisbon, Portugal; Department of Speech Therapy, Escola Superior de Saúde de Alcoitão, Estoril, Portugal
| | - Angelo Antonini
- Fondazione Ospedale San Camillo"-I.R.C.C.S, Parkinson and Movement Disorders Unit, Venice, Italy
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124, Turin, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Via Cherasco 15, 10124, Turin, Italy
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.
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Dhar SS, Jeenger J, Singroha V, Sharma M, Mathur DM. Psychiatric morbidity, cognitive dysfunction and quality of life in drug-naive patients with Parkinson's disease: A comparative study. Ind Psychiatry J 2019; 28:13-18. [PMID: 31879441 PMCID: PMC6929235 DOI: 10.4103/ipj.ipj_64_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To better understand the psychiatric disorders and cognition in Parkinson's disease (PD) and its impact on quality of life (QoL), patients need to be studied soon after diagnosis, before initiation of dopamine replacement therapy. AIM This study aims to compare the nature and frequency of psychiatric morbidity, cognitive dysfunction, and quality of life in drug-naive patients with PD and healthy controls. MATERIALS AND METHODS The cross-sectional, comparative study was conducted in tertiary care center. Fifty drug-naive PD patients and fifty healthy controls were included and assessed on Modified Hoehn and Yahr scale, PD Questionnaire 8, Kolkata cognitive screening battery, General Health Questionnaire-12, and Hamilton Anxiety and Depression Rating Scale (HAM-A and HAM-D). RESULTS The mean scores of HAM-A and HAM-D of patients with PD were significantly higher than that of the comparison group. The patients with PD had statistically significant impairment in verbal fluency, Mini-Mental State Examination, calculation, memory immediate recall, visuoconstructional ability, and memory (delayed recall and recognition) in comparison to patients without PD. No statistically significant difference was observed with respect to object naming between the two groups. CONCLUSION QoL of a PD patient is adversely affected by both the motor and nonmotor symptoms of the disease such as depression, anxiety, apathy, sleep disturbances, and cognitive impairment. The link between nonmotor symptoms and reduced QoL has important implications for the management of PD because the nonmotor symptoms often appear before patients are given anti-parkinsonian therapy. Screening of nonmotor symptoms in early stage of disease will decrease the morbidity and mortality and improve the QoL.
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Affiliation(s)
- Subhendu Shekhar Dhar
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
| | - Jitendra Jeenger
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
| | - Vikas Singroha
- Department of Psychiatry, Saheed Hasan Khan Mewati Government Medical College, Nuh, Haryana, India
| | - Manu Sharma
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
| | - Devendra Mohan Mathur
- Department of Psychiatry, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
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Wang HT, Wang L, He Y, Yu G. Rotigotine transdermal patch for the treatment of neuropsychiatric symptoms in Parkinson's disease: A meta-analysis of randomized placebo-controlled trials. J Neurol Sci 2018; 393:31-38. [DOI: 10.1016/j.jns.2018.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023]
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Kahraman T, Genç A, Söke F, GÖz E, Çolakoğlu BD, Keskįnoğlu P. Validity and Reliability of the Turkish Version of the 8-Item Parkinson's Disease Questionnaire. Noro Psikiyatr Ars 2018; 55:337-340. [PMID: 30622390 DOI: 10.5152/npa.2017.19343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 10/30/2016] [Indexed: 11/22/2022] Open
Abstract
Introduction Symptomatic control and improvement of health-related quality of life (HRQoL) is a key feature of the management of patients with Parkinson's disease (PD). The 39-item Parkinson's Disease Questionnaire (PDQ) and its short version, PDQ-8, validated disease-specific patient-reported instruments, have been highly recommended to use for assessing HRQoL in patients with PD. The aim of this study was to assess the reliability and validity of the Turkish version of the PDQ-8. Methods Eighty-three patients with PD were recruited for this methodological and cross-sectional study. The PDQ-8 was repeated to assess the test-retest reliability after one-week interval. The participants completed the 36-Item Short Form Health Survey (SF-36) as a generic HRQoL previously validated in Turkey. The Hoehn & Yahr stages of the patients were also determined. The SF-36 and Hoehn & Yahr stages were used to assess the convergent validity of the PDQ-8. Results The Cronbach's alpha coefficient was 0.78 (95% CI: 0.70-0.84, p<0.001) for PDQ-8. The test-retest reliability was very high as the intra-class correlation coefficient was 0.97 (95% CI: 0.93-0.99, p<0.001). The PDQ-8 had significant correlations with the physical and mental component scores of SF-36 (ρ=-0.52, p<0.001 and ρ=-0.64, p<0.001, respectively) and Hoehn & Yahr stages (ρ=0.56, p<0.001). There was no evidence of floor or ceiling effects. Conclusion The results of this study suggest that the Turkish version of the PDQ-8 is a reliable, valid, less time-consuming, and brief disease-specific instrument to assess HRQoL in patients with Parkinson's disease.
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Affiliation(s)
- Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, İzmir Katip Çelebi University Faculty of Health Sciences, İzmir, Turkey
| | - Arzu Genç
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - Fatih Söke
- Department of Physiotherapy and Rehabilitation, Gazi University Faculty of Health Sciences, Ankara, Turkey
| | - Evrim GÖz
- Department of Physiotherapy and Rehabilitation, Balıkesir University Faculty of Health Sciences, Balıkesir, Turkey
| | | | - Pembe Keskįnoğlu
- Department of Basic Medical Sciences, Biostatistics and Medical Informatics, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Wakade C, Giri B, Malik A, Khodadadi H, Morgan JC, Chong RK, Baban B. Niacin modulates macrophage polarization in Parkinson's disease. J Neuroimmunol 2018; 320:76-79. [DOI: 10.1016/j.jneuroim.2018.05.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 12/21/2022]
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Giardini M, Nardone A, Godi M, Guglielmetti S, Arcolin I, Pisano F, Schieppati M. Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson's Disease. Neural Plast 2018; 2018:5614242. [PMID: 29706993 PMCID: PMC5863303 DOI: 10.1155/2018/5614242] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/14/2018] [Indexed: 12/19/2022] Open
Abstract
We hypothesised that rehabilitation specifically addressing balance in Parkinson's disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n = 15, and Exercises, n = 17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a) balancing behaviour, assessed by both Index of Stability (IS) on platform and Mini-BESTest, and (b) gait, assessed by both baropodometry and Timed Up and Go (TUG) test. Falls Efficacy Scale-International (FES-I) and Parkinson's Disease Questionnaire (PDQ-8) were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597.
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Affiliation(s)
- Marica Giardini
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Antonio Nardone
- Centro Studi Attività Motorie, ICS Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
- Neurorehabilitation and Spinal Units, ICS Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Marco Godi
- Posture and Movement Laboratory, Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Italy
| | - Simone Guglielmetti
- Posture and Movement Laboratory, Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Italy
| | - Ilaria Arcolin
- Posture and Movement Laboratory, Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Italy
| | - Fabrizio Pisano
- Neurorehabilitation Division, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, Veruno, Italy
| | - Marco Schieppati
- Department of Exercise and Sport Science, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
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Chen K, Yang YJ, Liu FT, Li DK, Bu LL, Yang K, Wang Y, Shen B, Guan RY, Song J, Wang J, Wu JJ. Evaluation of PDQ-8 and its relationship with PDQ-39 in China: a three-year longitudinal study. Health Qual Life Outcomes 2017; 15:170. [PMID: 28838316 PMCID: PMC5571489 DOI: 10.1186/s12955-017-0742-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 08/16/2017] [Indexed: 01/15/2023] Open
Abstract
Background Parkinson’s disease is characterized by motor and non-motor symptoms with wide ranging impacts on the health-related quality of life. The 39-item Parkinson’s disease Questionnaire (PDQ-39) is the most widely used PD-specific health-related quality-of-life questionnaire. The short-form 8-item Parkinson’s disease Questionnaire (PDQ-8) was found to produce results similar to that of the PDQ-39 cross-culturally. However, there is no evaluation of the PDQ-8 in the mainland of China. Methods In this longitudinal study, 283 patients with Parkinson’s disease were recruited. The PDQ-39, the PDQ-8 and other scales were administered. Patients attended the clinic once annually for three years to complete the scales. Results The PDQ-8 was found to have good validity and reliability. There was a strong correlation between the summary indices of the PDQ-8 and the PDQ-39 (r=0.93, P<0.001). Results suggested that the PDQ-8 was also associated with other clinical scales of mobility, depression and cognition. The convergent validity and discriminant validity of the PDQ-8 were demonstrated by item-to-dimension correlations. There was acceptable internal consistency of the PDQ-8 (Cronbach’s α: 0.80; Item-scale correlation efficient: 0.56–0.72). The PDQ-8 replicated the results of the PDQ-39 well at all follow-up time points (intraclass correlation coefficient: 0.96–0.98). In addition, there was good test-retest reliability of the PDQ-8. Conclusion The PDQ-8 is a valid and reliable instrument assessing health-related quality of life for PD patients in the mainland of China. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0742-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kui Chen
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Yu-Jie Yang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Feng-Tao Liu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.,Department of Neurology, Huashan Hospital North, Fudan University, Shanghai, China
| | - Da-Ke Li
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Lu-Lu Bu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Ke Yang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Ying Wang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Bo Shen
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Rong-Yuan Guan
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Jie Song
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Jian Wang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
| | - Jian-Jun Wu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China. .,Department of Neurology, Jing'an District Centre Hospital of Shanghai, Shanghai, China.
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Horváth K, Aschermann Z, Kovács M, Makkos A, Harmat M, Janszky J, Komoly S, Karádi K, Kovács N. Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant? Neuroepidemiology 2017; 48:1-8. [PMID: 28161701 DOI: 10.1159/000455863] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/03/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Minimal clinically important difference (MCID) is the smallest change in an outcome, which a patient identifies as meaningful. Although the 2 most frequently applied Parkinson's disease (PD) "quality of life" questionnaires (the PDQ-39 and PDQ-8) provide encouragingly similar results, their MCID thresholds appear to be vastly different. Our aim was to calculate the MCID estimates for both PDQ-39 and PDQ-8 Summary Indices (PDQ-39-SI and PDQ-8-SI) by the utilization of both anchor- and distribution-based techniques. METHODS Nine hundred eighty-five paired investigations of 365 patients were included. Three different techniques were used simultaneously to calculate the MCID values. RESULTS First, we replicated the previously published results demonstrating how both PDQ-39-SI and PDQ-8-SI provide similar values and respond in a similar way to changes. Subsequently, we calculated the MCID thresholds. The most optimal estimates for MCID thresholds for PDQ-39-SI were -4.72 and +4.22 for detecting minimal clinically important improvement and worsening. For PDQ-8-SI, these estimates were -5.94 and +4.91 points for detecting minimal clinically important improvement and worsening respectively. CONCLUSIONS Our study is the first one that directly compared the MCID estimates for both PDQ-39-SI and PDQ-8-SI on a large pool of patients including all disease severity stages. These MICD estimates varied across PD severity.
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Affiliation(s)
- Krisztina Horváth
- Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary
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Assessing health-related quality of life with the SCOPA-PS in French individuals with Parkinson's disease having undergone DBS-STN: A validation study. Rev Neurol (Paris) 2016; 172:281-8. [PMID: 27158039 DOI: 10.1016/j.neurol.2015.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aims of this study were to validate the French version of the SCales for Outcomes in Parkinson's Disease-PsychoSocial (SCOPA-PS) in individuals with Parkinson's disease (PD) who underwent deep brain stimulation of the subthalamic nucleus (DBS-STN), to confirm the unifactorial structure of this questionnaire, and to establish its psychometric properties. METHODS Routinely used psychological questionnaires (BDI-II, STAI-Y, PDQ-39, UPDRS III) and the SCOPA-PS were used for a cross-sectional observational study of 154 PD patients. SCOPA-PS acceptability, scaling assumption, reliability, ordinal confirmatory factor analysis and validity were assessed. RESULTS The ICC for two-week test-retest reliability was 0.88. SEM was 8.42. In confirmatory factor analysis, the one-factor model showed an acceptable fit to the data (Chi(2)/df=2.130; CFI=0.976; RMSEA=0.086). No floor or ceiling effects were observed. Skewness was 0.33. Item-total correlation coefficients ranged from 0.47 to 0.71. Cronbach's alpha was 0.86. SCOPA-PS SI correlated with PDQ-39 SI (rs=0.83) and with state-anxiety and depression (rs=0.56 and 0.69 respectively). The SCOPA-PS SI was higher in more depressed patients and in those with the most severe PD motor symptoms. CONCLUSION AND DISCUSSION SCOPA-PS French version is a one-factor scale with satisfactory psychometric properties consistent with other language versions. This short scale can be used to evaluate the psychosocial component of QoL in PD patients treated with DBS-STN.
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Onozawa R, Tsugawa J, Tsuboi Y, Fukae J, Mishima T, Fujioka S. The impact of early morning off in Parkinson's disease on patient quality of life and caregiver burden. J Neurol Sci 2016; 364:1-5. [DOI: 10.1016/j.jns.2016.02.066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 02/03/2016] [Accepted: 02/29/2016] [Indexed: 11/30/2022]
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