1
|
Li Y, Luo X, Zhang A, Ying F, Wang J, Huang G. The potential of arts therapies in Parkinson's disease rehabilitation: A comprehensive review. Heliyon 2024; 10:e35765. [PMID: 39229526 PMCID: PMC11369473 DOI: 10.1016/j.heliyon.2024.e35765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/02/2024] [Accepted: 08/02/2024] [Indexed: 09/05/2024] Open
Abstract
Background and purpose Parkinson's disease (PD) causes a decline in motor function, cognitive decline, and impacts the mental health of patients. Due to the high cost and side effects of conventional treatments, the medical community has begun to explore safer and more cost-effective alternative therapies. In this context, arts therapies have gained increasing attention as innovative treatments. This review plans to explore the role and potential of various arts therapies in the rehabilitation of PD patients by analyzing existing literature and case studies. Methods This review comprehensively searched the literature in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure, to assess the effectiveness of different arts therapies in the rehabilitation of patients with PD. Results From 3440 articles screened, 16 met the inclusion criteria. These studies included a variety of therapies, including music, meditation, yoga, art, dance, theatre, video games and play therapy. These different types of arts therapies had a positive impact on the motor, psychological and cognitive rehabilitation of PD patients, respectively. Conclusion The existing literature highlights the great potential of arts therapies in the rehabilitation of people with PD, further confirming the efficacy of arts therapies in enhancing the motor, psychological and cognitive rehabilitation process of people with PD. In addition, this review identifies research gaps in the use of color therapy in PD rehabilitation and highlights the need for further exploration of various arts therapies modalities.
Collapse
Affiliation(s)
- Yiyuan Li
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Aijia Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
| | - Fangtian Ying
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Zhejiang University, Hangzhou, 310027, China
| | - Jue Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, Guangdong, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, China
- Zhuhai M.U.S.T. Science and Technology Research Institute, Zhuhai, Guangdong, China
| |
Collapse
|
2
|
Rabini G, Meli C, Prodomi G, Speranza C, Anzini F, Funghi G, Pierotti E, Saviola F, Fumagalli GG, Di Giacopo R, Malaguti MC, Jovicich J, Dodich A, Papagno C, Turella L. Tango and physiotherapy interventions in Parkinson's disease: a pilot study on efficacy outcomes on motor and cognitive skills. Sci Rep 2024; 14:11855. [PMID: 38789492 PMCID: PMC11126665 DOI: 10.1038/s41598-024-62786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Pharmacological treatments in Parkinson's disease (PD), albeit effective in alleviating many motor symptoms, have limited effects in non-motor signatures as cognitive impairment, as well as in other aspects included postural instability. Consequently, complementary interventions are nowadays a prerogative of clinical practice managing PD symptomatology. In this pilot longitudinal study, we recruited twenty-four PD patients participating in one of two interventions: adapted Argentine Tango or group-based physiotherapy. Participants underwent a motor and neuropsychological evaluation before and after four months of activities, carried out twice a week. We found a general stabilization of motor and cognitive abilities, with significant improvements in several motor skills, mainly pertaining to static and dynamic balance, similarly in both groups. At cognitive level, we measured a significant improvement in both groups in the Action Naming task. Interestingly, only PD patients in the Tango group improved their performance in the test measuring facial emotion recognition. These findings highlight the crucial role that physical activities have in the stabilization and slowdown of disease's progression in PD. They further highlight the beneficial effects of a group-based physical intervention, which, especially in the case of Tango, could lead to behavioral ameliorations in domains other than the motor, such as emotion recognition.
Collapse
Affiliation(s)
- Giuseppe Rabini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Prodomi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Chiara Speranza
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Federica Anzini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Enrica Pierotti
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Francesca Saviola
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giorgio Giulio Fumagalli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Raffaella Di Giacopo
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Maria Chiara Malaguti
- Neurology Unit, Rovereto Hospital, Azienda Provinciale per i Servizi Sanitari (APSS) di Trento, Trento, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Luca Turella
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| |
Collapse
|
3
|
Miron RJ, Estrin NE, Sculean A, Zhang Y. Understanding exosomes: Part 2-Emerging leaders in regenerative medicine. Periodontol 2000 2024; 94:257-414. [PMID: 38591622 DOI: 10.1111/prd.12561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024]
Abstract
Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with the ability to communicate with other tissues and cell types over long distances. Their use in regenerative medicine has gained tremendous momentum recently due to their ability to be utilized as therapeutic options for a wide array of diseases/conditions. Over 5000 publications are currently being published yearly on this topic, and this number is only expected to dramatically increase as novel therapeutic strategies continue to be developed. Today exosomes have been applied in numerous contexts including neurodegenerative disorders (Alzheimer's disease, central nervous system, depression, multiple sclerosis, Parkinson's disease, post-traumatic stress disorders, traumatic brain injury, peripheral nerve injury), damaged organs (heart, kidney, liver, stroke, myocardial infarctions, myocardial infarctions, ovaries), degenerative processes (atherosclerosis, diabetes, hematology disorders, musculoskeletal degeneration, osteoradionecrosis, respiratory disease), infectious diseases (COVID-19, hepatitis), regenerative procedures (antiaging, bone regeneration, cartilage/joint regeneration, osteoarthritis, cutaneous wounds, dental regeneration, dermatology/skin regeneration, erectile dysfunction, hair regrowth, intervertebral disc repair, spinal cord injury, vascular regeneration), and cancer therapy (breast, colorectal, gastric cancer and osteosarcomas), immune function (allergy, autoimmune disorders, immune regulation, inflammatory diseases, lupus, rheumatoid arthritis). This scoping review is a first of its kind aimed at summarizing the extensive regenerative potential of exosomes over a broad range of diseases and disorders.
Collapse
Affiliation(s)
- Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Nathan E Estrin
- Advanced PRF Education, Venice, Florida, USA
- School of Dental Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Yufeng Zhang
- Department of Oral Implantology, University of Wuhan, Wuhan, China
| |
Collapse
|
4
|
Das J, Barry G, Walker R, Vitorio R, Morris R, Stuart S. The integration of technology into a home-based visuo-cognitive training intervention for people with Parkinson's: Is the future digital? PLoS One 2023; 18:e0285100. [PMID: 37319251 PMCID: PMC10270359 DOI: 10.1371/journal.pone.0285100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/14/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Mobile applications and technology (e.g., stroboscopic glasses) are increasingly being used to deliver combined visual and cognitive (termed visuo-cognitive) training that replaces standard pen and paper-based interventions. These 'technological visuo-cognitive training' (TVT) interventions could help address the complex problems associated with visuo-cognitive dysfunction in people with long term neurological conditions such as Parkinson's disease. As data emerges to support the effectiveness of these technologies, patient perspectives offer an insight into how novel TVT is received by people living with long term neurological conditions. OBJECTIVE To explore experiences of people with Parkinson's in using technology as part of a home-based visuo-cognitive training programme compared to traditional approaches to rehabilitation. METHODS Eight people with Parkinson's who took part in a pilot randomised cross-over trial, investigating the efficacy and feasibility of TVT compared to standard care, were interviewed to explore their experiences of each arm of the training they received. Integration of Normalisation Process Theory (NPT) into the analysis enabled examination of the potential to embed novel TVT into a home-based rehabilitation intervention for people with Parkinson's disease. RESULTS Three key themes emerged from the thematic analysis as factors influencing the implementation potential of TVT for people with Parkinson's disease: perceived value of technology, perceived ease of use and support mechanisms. Further examination of the data through the lens of NPT revealed that the implantation and embedding of novel technology was dependent on positive user experience, individual disease manifestation and engagement with a professional. CONCLUSIONS Our findings provide insights into the challenges of engaging with technology-based interventions while living with a progressive and fluctuating disease. When implementing technology-based interventions for people with Parkinson's, we recommend that patients and clinicians collaborate to determine whether the technology fits the capacity, preference, and treatment needs of the individual patient.
Collapse
Affiliation(s)
- Julia Das
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle upon Tyne, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle upon Tyne, United Kingdom
| | - Rodrigo Vitorio
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle upon Tyne, United Kingdom
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
5
|
DeBroff J, Omer N, Cohen B, Giladi N, Kestenbaum M, Shirvan JC, Cedarbaum JM, Gana‐Weisz M, Goldstein O, Orr‐Urtreger A, Mirelman A, Thaler A. The Influence of GBA and LRRK2 on Mood Disorders in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:606-616. [PMID: 37070047 PMCID: PMC10105114 DOI: 10.1002/mdc3.13722] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023] Open
Abstract
Background Mood disorders have emerged as major non-motor comorbidities in Parkinson's disease (PD) even at the prodromal stage of the disease. Mutations in the LRRK2 and GBA genes are common among Ashkenazi Jews, with more severe phenotype reported for GBA-PD. Objective To explore the association between genetic status and mood related disorders before and after diagnosis of PD and the association between mood-related medications, phenotype, and genetic status. Methods Participants were genotyped for mutations in the LRRK2 and GBA genes. State of depression, anxiety and non-motor features were evaluated using validated questionnaires. History of mood disorders prior to diagnosis of PD and use of mood-related medications were assessed. Results The study included 105 idiopathic PD (iPD), 55 LRRK2-PD and 94 GBA-PD. Scores on mood related questionnaires and frequency of depression and anxiety before diagnosis were similar between the groups (p>0.05). However, more GBA-PD patients used mood related medications before PD diagnosis than LRRK2-PD and iPD (16.5% vs 7.1% and 8.2%, p=0.044). LRRK2-PD and GBA-PD receiving mood-related medications at time of assessment had worse motor and non-motor phenotype compared to those that did not (p<0.05). LRRK2-PD receiving mood related-medications at time of assessment, scored higher on mood-related questionnaires compared to LRRK2-PD not receiving such medications (p<0.04). Conclusions Prodromal GBA-PD are more frequently treated with mood related-medications despite equal rates of reported mood-related disorders, while LRRK2-PD with mood-related disorders experience high rates of anxiety and depression despite treatment, attesting to the need of more precise assessment and treatment of these genetic subgroups.
Collapse
Affiliation(s)
| | - Nurit Omer
- Sackler School of MedicineTel‐Aviv University
- Movement Disorders UnitNeurological Institute, Tel‐Aviv Medical Center
- Laboratory of Early Markers of NeurodegenerationNeurological Institute, Tel‐Aviv Medical Center
| | - Batsheva Cohen
- Laboratory of Early Markers of NeurodegenerationNeurological Institute, Tel‐Aviv Medical Center
| | - Nir Giladi
- Sackler School of MedicineTel‐Aviv University
- Movement Disorders UnitNeurological Institute, Tel‐Aviv Medical Center
- Sagol School of NeuroscienceTel‐Aviv University
| | - Meir Kestenbaum
- Sackler School of MedicineTel‐Aviv University
- Neurology departmentMeir HospitalKfar‐SabaIsrael
| | | | | | - Mali Gana‐Weisz
- Genomic Research Laboratory for NeurodegenerationTel‐Aviv Medical CenterTel‐AvivIsrael
| | - Orly Goldstein
- Genomic Research Laboratory for NeurodegenerationTel‐Aviv Medical CenterTel‐AvivIsrael
| | - Avi Orr‐Urtreger
- Sackler School of MedicineTel‐Aviv University
- Sagol School of NeuroscienceTel‐Aviv University
- Genomic Research Laboratory for NeurodegenerationTel‐Aviv Medical CenterTel‐AvivIsrael
| | - Anat Mirelman
- Sackler School of MedicineTel‐Aviv University
- Laboratory of Early Markers of NeurodegenerationNeurological Institute, Tel‐Aviv Medical Center
- Sagol School of NeuroscienceTel‐Aviv University
| | - Avner Thaler
- Sackler School of MedicineTel‐Aviv University
- Movement Disorders UnitNeurological Institute, Tel‐Aviv Medical Center
- Laboratory of Early Markers of NeurodegenerationNeurological Institute, Tel‐Aviv Medical Center
- Sagol School of NeuroscienceTel‐Aviv University
| |
Collapse
|
6
|
Vortioxetine Improves Depressive Symptoms and Cognition in Parkinson's Disease Patients with Major Depression: An Open-Label Prospective Study. Brain Sci 2022; 12:brainsci12111466. [PMID: 36358393 PMCID: PMC9688230 DOI: 10.3390/brainsci12111466] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Depression is frequent in Parkinson’s disease (PD) patients, but the evidence for many antidepressant agents to treat it in PD is insufficient. The aim of the present prospective open-label single-arm study (VOPARK, an open-label study of the effectiveness and safety of VOrtioxetine in PARKinson’s disease patients with depression) was to analyze the effectiveness of vortioxetine on depressive symptoms in PD patients with major depression. The primary efficacy outcome was the change from baseline (VB) at the end of the observational period (12 weeks ± 14 days; V12w) in the 17-item Hamilton Depression Rating Scale (HAM-D17) total score. At VB, all patients had a HAM-D17 total score ≥16. A total of 30 patients (age 66.23 ± 10.27; 73.3% males) were included between February 2021 (first patient, 12/FEB/21) and March 2022 (last patient, 14/MAR/22). At 12 weeks, 27 patients completed the follow-up (90%). The total HAM-D17 total score was reduced by 52.7% (from 21.5 ± 4.75 at VB to 10.44 ± 7.54 at V12w; Cohen’s effect size = −2.5; p < 0.0001) and the response and remission rates were 50% and 43.3%, respectively. Apathy (Apathy Scale; p < 0.0001), cognition (PD-Cognitive Rating Scale; p = 0.007), fatigue (Fatigue Severity Scale; p = 0.014), and quality of life (PDQ-39 (p = 0.001) and EUROHIS-QOL8 (p < 0.0001)) improved at 3 weeks as well. A total of 11 adverse events in 10 patients (33.3%) were reported, one of which was severe (vomiting related to vortioxetine with full recovery after drug withdrawal). Vortioxetine was safe and well tolerated and improved depressive symptoms and other non-motor symptoms in PD patients.
Collapse
|
7
|
Therapeutic targeting of mitophagy in Parkinson's disease. Biochem Soc Trans 2022; 50:783-797. [PMID: 35311891 PMCID: PMC9162468 DOI: 10.1042/bst20211107] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/21/2022]
Abstract
Parkinson's disease is a neurodegenerative disorder characterised by cardinal motor symptoms and a diverse range of non-motor disorders in patients. Parkinson's disease is the fastest growing neurodegenerative condition and was described for the first time over 200 years ago, yet there are still no reliable diagnostic markers and there are only treatments that temporarily alleviate symptoms in patients. Early-onset Parkinson's disease is often linked to defects in specific genes, including PINK1 and Parkin, that encode proteins involved in mitophagy, the process of selective autophagic elimination of damaged mitochondria. Impaired mitophagy has been associated with sporadic Parkinson's and agents that damage mitochondria are known to induce Parkinson's-like motor symptoms in humans and animal models. Thus, modulating mitophagy pathways may be an avenue to treat a subset of early-onset Parkinson's disease that may additionally provide therapeutic opportunities in sporadic disease. The PINK1/Parkin mitophagy pathway, as well as alternative mitophagy pathways controlled by BNIP3L/Nix and FUNDC1, are emerging targets to enhance mitophagy to treat Parkinson's disease. In this review, we report the current state of the art of mitophagy-targeted therapeutics and discuss the approaches being used to overcome existing limitations to develop innovative new therapies for Parkinson's disease. Key approaches include the use of engineered mouse models that harbour pathogenic mutations, which will aid in the preclinical development of agents that can modulate mitophagy. Furthermore, the recent development of chimeric molecules (AUTACs) that can bypass mitophagy pathways to eliminate damaged mitochondria thorough selective autophagy offer new opportunities.
Collapse
|
8
|
Parrella E, Del Gallo F, Porrini V, Gussago C, Benarese M, Fabene PF, Pizzi M. Age-Dependent Neuropsychiatric Symptoms in the NF-κB/c-Rel Knockout Mouse Model of Parkinson’s Disease. Front Behav Neurosci 2022; 16:831664. [PMID: 35368305 PMCID: PMC8965703 DOI: 10.3389/fnbeh.2022.831664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Non-motor symptoms are frequently observed in Parkinson’s disease (PD) and precede the onset of motor deficits by years. Among them, neuropsychiatric symptoms, including anxiety, depression, and apathy, are increasingly considered as a major challenge for patients with PD and their caregivers. We recently reported that mice lacking the nuclear factor-κB (NF-κB)/c-Rel protein (c-rel–/– mice) develop an age-dependent PD-like pathology and phenotype characterized by the onset of non-motor symptoms, including constipation and hyposmia, starting at 2 months of age, and motor deficits at 18 months. To assess whether c-rel–/– mice also suffer from neuropsychiatric symptoms, in this study we tested different cohorts of wild-type (wt) and c-rel–/– mice at 3, 6, 12, and 18–20 months with different behavioral tests. Mice lacking c-Rel displayed anxiety and depressive-like behavior starting in the premotor phase at 12 months, as indicated by the analysis with the open field (OF) test and the forced swim test with water wheel (FST), respectively. A deficit in the goal-oriented nesting building test was detected at 18–20 months, suggesting apathetic behavior. Taken together, these results indicate that c-rel–/– mice recapitulate the onset and the progression of PD-related neuropsychiatric symptoms. Therefore, this animal model may represent a valuable tool to study the prodromal stage of PD and for testing new therapeutic strategies to alleviate neuropsychiatric symptoms.
Collapse
Affiliation(s)
- Edoardo Parrella
- Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- *Correspondence: Edoardo Parrella,
| | - Federico Del Gallo
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, School of Medicine, University of Verona, Verona, Italy
| | - Vanessa Porrini
- Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cristina Gussago
- Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Marina Benarese
- Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Paolo Francesco Fabene
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, School of Medicine, University of Verona, Verona, Italy
| | - Marina Pizzi
- Division of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| |
Collapse
|
9
|
Hattori N, Kogo Y, Koebis M, Ishida T, Suzuki I, Tsuboi Y, Nomoto M. The Effects of Safinamide Adjunct Therapy on Depression and Apathy in Patients With Parkinson's Disease: Post-hoc Analysis of a Japanese Phase 2/3 Study. Front Neurol 2022; 12:752632. [PMID: 35222225 PMCID: PMC8869178 DOI: 10.3389/fneur.2021.752632] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose Neuropsychiatric symptoms in Parkinson's disease (PD) have been shown to significantly affect quality of life (QOL). We investigated the impact of safinamide on depression and apathy when administered as an adjunct to levodopa in Japanese patients with PD. Methods This was a post-hoc analysis of data from a phase 2/3 clinical study of safinamide in Japanese patients with PD experiencing wearing-off (JapicCTI-153056; https://www.clinicaltrials.jp/cti-user/trial/ShowDirect.jsp?japicId=JapicCTI-153056). Patients received placebo, safinamide 50 mg, or safinamide 100 mg as an adjunct therapy. The endpoints for this analysis were changes from baseline to Week 24 in the Unified Parkinson's Disease Rating Scale (UPDRS) Part I item 3 (depression) and item 4 (apathy) scores and the Parkinson's Disease Questionnaire (PDQ-39) “emotional well-being” domain score. Subgroup analyses investigated the relationship between neuropsychologic symptoms and improvements in motor fluctuation and assessed which patient populations might be expected to obtain neuropsychologic benefit from safinamide. Results Compared with placebo, safinamide (both doses) significantly improved UPDRS Part I item 3 scores in the overall analysis population, and the 100-mg dose improved UPDRS Part I item 4 scores in the population with apathy at baseline. Changes in the PDQ-39 “emotional well-being” score showed numerical, but not significant, dose-related improvements. Notable reductions in depression were associated with a change in daily ON-time ≥1 h, pain during OFF-time at baseline, and female sex. Conclusions The results from this post-hoc analysis of the Japanese phase 2/3 study suggest that safinamide could bring benefits to patients with PD who have mild depression, pain during the OFF phase. In addition, safinamide might provide particular benefits for patients with PD who have mild apathy and female.
Collapse
Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuki Kogo
- Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan
| | | | | | - Ippei Suzuki
- Medicine Development Center, Eisai Co., Ltd., Tokyo, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Masahiro Nomoto
- Department of Neurology, Saiseikai Imabari Center for Health and Welfare, Ehime, Japan
| |
Collapse
|
10
|
Santos-García D, De Deus FT, Cores BC, Valdés AL, Suárez CE, Aneiros Á, Jesús S, Aguilar M, Pastor P, Planellas L, Cosgaya M, García CJ, Caballol N, Legarda I, Hernández VJ, Cabo I, López ML, González AI, Ávila RMA, José CM, Nogueira V, Puente V, García MJM, Borrué C, Solano VB, Álvarez SM, Vela L, Escalante S, Cubo E, Carrillo PF, Martínez CJC, Sánchez AP, Alonso LMG, López AN, Gastón I, Kulisevsky J, Blázquez EM, Seijo M, Rúiz MJ, Valero C, Kurtis M, de Fábregues-Boixar O, González AJ, Prieto JC, López DL, McAfee D, Mir P. Mood in Parkinson's disease: From early- to late-stage disease. Int J Geriatr Psychiatry 2021; 36:627-646. [PMID: 33169885 DOI: 10.1002/gps.5461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/01/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although depression is known to be frequent in Parkinson's disease (PD), it is unclear how mood can change and/or impact on patient's quality of life (QoL) over time. Our aim was to analyze the frequency of depression, mood related factors and the contribution of mood to a patient's QoL perception in regard to disease duration. METHODS PD patients recruited from the COPPADIS cohort from January 2016 to November 2017 were included in this cross-sectional study. Three groups were defined: <5 years (Group A); from 5 to <10 years (Group B); ≥10 years (Group C). Analysis with well-planned linear regression models was conducted to determine how different factors contribute to mood (Beck Depression Inventory-II [BDI-II] as dependent variable), to health-related QoL (39-item Parkinson's Disease Questionnaire [PDQ-39SI] as dependent variable) and to global QoL (European Health Interview Survey - Quality of Life Eight-Item Index [EUROHIS-QOL8] as dependent variable). RESULTS Six hundred and sixty-three PD patients (62.6 ± 8.9 years old, 59.6% males) were included: Group A, 50.1% (n = 332); Group B, 33.3% (n = 221) and Group C, 16.6% (n = 110). There were no differences between the three groups in terms of the frequency of depressive symptoms nor the frequency of depression type (major vs. minor vs. subthreshold) (p = 0.729). However, the unique percent variance of PDQ-39SI and EUROHIS-QOL8 explained by BDI-II total score was 2 (23.7%) and threefold (26.9%), respectively, in Group C compared to the other two groups. EUROHIS-QOL8 total score provided the highest unique contribution to mood (16.8%). CONCLUSIONS Although depression-type frequency does not appear to change over time in PD; the contribution of mood on QoL perception is greater in patients with longer disease duration.
Collapse
Affiliation(s)
| | | | - Bartolome C Cores
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - Aymerich L Valdés
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - Castro E Suárez
- Complejo Hospitalario Universitario de Ferrol (CHUF), A Coruña, Spain
| | - Ángel Aneiros
- Complejo Hospitalario Universitario de Ferrol (CHUF), A Coruña, Spain
| | - Silvia Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Miquel Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | - Pau Pastor
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | | | - Nuria Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - Inés Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | - Iria Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - Aramburu I González
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Rivera M A Ávila
- Consorci Sanitari Integral, Hospital General de L´Hospitalet, Barcelona, Spain
| | - Catalán M José
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - Vila B Solano
- Institut d'Assistència Sanitària (IAS) - Institut Català de la Salut, Girona, Spain
| | | | - Lydia Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - Sonia Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, Tarragona, Spain
| | - Esther Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Padilla F Carrillo
- Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | | | | | - Losada M G Alonso
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | | | - Jaime Kulisevsky
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Hospital de Sant Pau, Barcelona, Spain
| | | | - Manuel Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | | | | | | | | | | | - Díaz L López
- Complejo Hospitalario Universitario de Orense (CHUO), Orense, Spain
| | - Darrian McAfee
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pablo Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain.,Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | | |
Collapse
|
11
|
Lovegrove CJ, Bannigan K. What is the lived experience of anxiety for people with Parkinson's? A phenomenological study. PLoS One 2021; 16:e0249390. [PMID: 33831029 PMCID: PMC8031398 DOI: 10.1371/journal.pone.0249390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Anxiety is a common non-motor symptom of Parkinson's and there is no specific pharmacological intervention for people with Parkinson's who experience anxiety. Yet there is little specific research documenting how individuals with this condition experience anxiety. It is important to explore the experiences of people with Parkinson's to identify potential issues in developing future non-pharmacological interventions. This study explored the lived experience of anxiety for people with Parkinson's. MATERIALS AND METHODS Six participants were recruited into a descriptive phenomenological study, through the charity Parkinson's UK, using a maximum variation sampling strategy. Face to face interviews were conducted. Data analysis employed thematic analysis. RESULTS Three key themes encapsulated the data: Finding ways to cope to "Try not to let it rule your life", Amplifies symptoms "It's emotionally draining it it's also physically draining" and "Anxiety is a funny thing" experienced in myriad ways. A model of the experience of PWP experience of anxiety is proposed. CONCLUSIONS Anxiety is a complex experience constructed of interlinked parts affecting people with Parkinson's in myriad ways. Researchers and healthcare professionals should take these findings into account when designing future studies and interventions.
Collapse
Affiliation(s)
- Christopher J. Lovegrove
- Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom
- School of Health Professions, Faculty of Health & Human Sciences, University of Plymouth, Plymouth, United Kingdom
| | - Katrina Bannigan
- Department of Occupational Therapy and Human Nutrition and Dietetics, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| |
Collapse
|
12
|
Santos-García D, de Deus Fonticoba T, Cores Bartolomé C, Suárez Castro E, Jesús S, Mir P, Pascual-Sedano B, Pagonabarraga J, Kulisevsky J, Hernández-Vara J, Planellas LL, Cabo-López I, Seijo-Martínez M, Legarda I, Carrillo Padilla F, Caballol N, Cubo E, Nogueira V, Alonso Losada MG, López Ariztegui N, González Aramburu I, García Caldentey J, Borrue C, Valero C, Sánchez Alonso P. Depression is Associated with Impulse-compulsive Behaviors in Parkinson's disease. J Affect Disord 2021; 280:77-89. [PMID: 33242731 DOI: 10.1016/j.jad.2020.11.075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/26/2020] [Accepted: 11/08/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression and impulse control disorders (ICDs) are both common in Parkinson's disease (PD) patients and their coexistence is frequent. Our aim was to determine the relationship between depression and impulsive-compulsive behaviors (ICBs) in a large cohort of PD patients. METHODS PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were included in the study. The QUIP-RS (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale) was used for screening ICDs (cutoff points: gambling ≥6, buying ≥8, sex≥8, eating≥7) and compulsive behaviors (CBs) (cutoff points: hobbyism-punding ≥7). Mood was assessed with the BDI-II (Beck Depression Inventory - II) and major, minor, and subthreshold depression were defined. RESULTS Depression was more frequent in PD patients with ICBs than in those without: 66.3% (69/104) vs 47.5% (242/509); p<0.0001. Major depression was more frequent in this group as well: 22.1% [23/104] vs 14.5% [74/509]; p=0.041. Considering types of ICBs individually, depression was more frequent in patients with pathological gambling (88.9% [8/9] vs 50.2% [303/603]; p=0.021), compulsive eating behavior (65.9% [27/41] vs 49.7% [284/572]; p=0.032), and hobbyism-punding (69% [29/42] vs 49.4% [282/571]; p=0.010) than in those without, respectively. The presence of ICBs was also associated with depression (OR=1.831; 95%CI 1.048-3.201; p=0.034) after adjusting for age, sex, civil status, disease duration, equivalent daily levodopa dose, antidepressant treatment, Hoehn&Yahr stage, non-motor symptoms burden, autonomy for activities of daily living, and global perception of QoL. LIMITATIONS Cross-sectional design. CONCLUSIONS Depression is associated with ICBs in PD. Specifically, with pathological gambling, compulsive eating behavior, and hobbyism-punding.
Collapse
Affiliation(s)
- D Santos-García
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Cores Bartolomé
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - S Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - B Pascual-Sedano
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - J Pagonabarraga
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona
| | - J Kulisevsky
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - J Hernández-Vara
- Hospital Universitario Vall d'Hebron and Neurodegenerative Diseases Research Group, Vall D Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - I Cabo-López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | - M Seijo-Martínez
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - F Carrillo Padilla
- Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - V Nogueira
- Hospital Da Costa de Burela, Lugo, Spain
| | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - I González Aramburu
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - C Borrue
- Hospital Infanta Sofía, Madrid, Spain
| | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - P Sánchez Alonso
- Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Hospital Universitario Puerta de Hierro, Madrid, Spain
| |
Collapse
|
13
|
Stanojlovic M, Pallais JP, Kotz CM. Inhibition of Orexin/Hypocretin Neurons Ameliorates Elevated Physical Activity and Energy Expenditure in the A53T Mouse Model of Parkinson's Disease. Int J Mol Sci 2021; 22:E795. [PMID: 33466831 PMCID: PMC7830608 DOI: 10.3390/ijms22020795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 11/17/2022] Open
Abstract
Aside from the classical motor symptoms, Parkinson's disease also has various non-classical symptoms. Interestingly, orexin neurons, involved in the regulation of exploratory locomotion, spontaneous physical activity, and energy expenditure, are affected in Parkinson's. In this study, we hypothesized that Parkinson's-disease-associated pathology affects orexin neurons and therefore impairs functions they regulate. To test this, we used a transgenic animal model of Parkinson's, the A53T mouse. We measured body composition, exploratory locomotion, spontaneous physical activity, and energy expenditure. Further, we assessed alpha-synuclein accumulation, inflammation, and astrogliosis. Finally, we hypothesized that chemogenetic inhibition of orexin neurons would ameliorate observed impairments in the A53T mice. We showed that aging in A53T mice was accompanied by reductions in fat mass and increases in exploratory locomotion, spontaneous physical activity, and energy expenditure. We detected the presence of alpha-synuclein accumulations in orexin neurons, increased astrogliosis, and microglial activation. Moreover, loss of inhibitory pre-synaptic terminals and a reduced number of orexin cells were observed in A53T mice. As hypothesized, this chemogenetic intervention mitigated the behavioral disturbances induced by Parkinson's disease pathology. This study implicates the involvement of orexin in early Parkinson's-disease-associated impairment of hypothalamic-regulated physiological functions and highlights the importance of orexin neurons in Parkinson's disease symptomology.
Collapse
Affiliation(s)
- Milos Stanojlovic
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Bünteweg 17, 30559 Hannover, Germany
| | - Jean Pierre Pallais
- Integrative Biology and Physiology, University of Minnesota, Minneapolis, 321 Church St SE, Minneapolis, MN 55455, USA; (J.P.P.); (C.M.K.)
| | - Catherine M. Kotz
- Integrative Biology and Physiology, University of Minnesota, Minneapolis, 321 Church St SE, Minneapolis, MN 55455, USA; (J.P.P.); (C.M.K.)
- Minneapolis VA Health Care System, GRECC, 1 Veterans Dr, Minneapolis, MN 55417, USA
| |
Collapse
|
14
|
Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, Cores Bartolomé C, Feal Panceiras MJ, Paz González JM, Valdés Aymerich L, García Moreno JM, Blázquez Estrada M, Jesús S, Mir P, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Cabo López I, López Manzanares L, Ávila Rivera MA, Catalán MJ, López Díaz LM, Borrué C, Álvarez Sauco M, Vela L, Cubo E, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Pascual-Sedano B, Seijo M, Ruíz Martínez J, Valero C, Kurtis M, González Ardura J, Prieto Jurczynska C, Martinez-Martin P. Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression. J Neurol Sci 2020; 418:117109. [PMID: 32927370 DOI: 10.1016/j.jns.2020.117109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. MATERIAL AND METHODS PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. RESULTS The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. CONCLUSIONS SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.
Collapse
Affiliation(s)
- D Santos-García
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Valdés Aymerich
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L M López Díaz
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B Pascual-Sedano
- Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | | | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; CIBERNED, Instituto de Salud Carlos III, Madrid. COPPADIS Study Group, Spain
| | | |
Collapse
|
15
|
Multifaceted targeting of neurodegeneration with bioactive molecules of saffron (Crocus sativus): An insilco evidence-based hypothesis. Med Hypotheses 2020; 143:109872. [DOI: 10.1016/j.mehy.2020.109872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/12/2020] [Accepted: 05/21/2020] [Indexed: 12/16/2022]
|
16
|
Almeida SS, Zizzi FB, Cattaneo A, Comandini A, Di Dato G, Lubrano E, Pellicano C, Spallone V, Tongiani S, Torta R. Management and Treatment of Patients With Major Depressive Disorder and Chronic Diseases: A Multidisciplinary Approach. Front Psychol 2020; 11:542444. [PMID: 33101117 PMCID: PMC7546762 DOI: 10.3389/fpsyg.2020.542444] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
In patients with physical chronic diseases, the prevalence of major depressive disorder (MDD) is approximately 2- to 3-fold higher than in the general population, and it can reach up to 20-40%. The comorbidity of MDD with chronic medical diseases is associated with poorer quality of life, increased medical symptom burden, poor adherence to self-care regimens, increased risk of functional impairment, morbidity, and mortality, and also higher medical costs. Despite this evidence, in routine practice, psychological issues and concerns are frequently inadequately managed. This consensus document proposes that a proper diagnosis, a multidisciplinary approach, and a personalized treatment plan would allow patients with MDD and chronic comorbidities to be more compliant, to improve the outcomes, to reduce possible relapses in the long term, and to prevent or better manage complications and adverse events. This proposal might be useful for any health professionals who deal with patients with chronic diseases, as it can help to pay more attention to the emotional impact of these conditions, in particular in terms of depressive symptoms.
Collapse
Affiliation(s)
- Susana Sousa Almeida
- Portuguese Institute of Oncology Porto (IPO Porto), Hospital Cuf Porto (HCuf Porto), University of Porto (FMUP), Porto, Portugal
| | | | - Agnese Cattaneo
- Angelini RR&D (Research, Regulatory & Development) - Angelini S.p.A, Rome, Italy
| | - Alessandro Comandini
- Angelini RR&D (Research, Regulatory & Development) - Angelini S.p.A, Rome, Italy
| | - Giorgio Di Dato
- Angelini RR&D (Research, Regulatory & Development) - Angelini S.p.A, Rome, Italy
| | - Ennio Lubrano
- Academic Rheumatology Unit, Dipartimento di Medicina e Scienze della salute "Vincenzo Tiberio", Università degli Studi del Molise, Campobasso, Italy
| | - Clelia Pellicano
- Laboratory of Neuropsychiatry, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Vincenza Spallone
- Division of Endocrinology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Serena Tongiani
- Angelini RR&D (Research, Regulatory & Development) - Angelini S.p.A, Rome, Italy
| | - Riccardo Torta
- Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, A.O.U. "Città della Salute e della Scienza" Hospital, Turin, Italy
| |
Collapse
|
17
|
Lee S, Chung SJ, Shin HW. Neuropsychiatric Symptoms and Quality of Life in Patients With Adult-Onset Idiopathic Focal Dystonia and Essential Tremor. Front Neurol 2020; 11:1030. [PMID: 33041977 PMCID: PMC7517043 DOI: 10.3389/fneur.2020.01030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/06/2020] [Indexed: 01/29/2023] Open
Abstract
Background: While idiopathic focal dystonia (IFD) and essential tremor (ET) have been considered pure movement disorders, they reportedly induce neuropsychiatric manifestations and may thus be more accurately described as network disorders. Methods: The present multi-center, cross-sectional, case-control study evaluated the severity of depression and anxiety with the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively; the frequency of neuropsychiatric disorders with the Korean-Mini International Neuropsychiatry Interview; and QoL with the Short-Form 36 (SF-36). Results: Seventy-four subjects participated in this study (IFD, 27; ET, 24; controls, 23). The BDI and BAI scores were higher in the IFD and ET groups than in the control group. Although the frequency of neuropsychiatric disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I was comparable among the groups, the prevalence of major depressive disorder tended to be high among patients with IFD. QoL was correlated with the severity of depression and anxiety across the groups. Conclusions: Depression and anxiety are more severe in patients with IFD and ET compared to healthy controls, while their severity is similar among patients with IFD and ET. Axis I major depressive disorder is relatively more prevalent in patients with IFD. Neuropsychiatric symptoms affect QoL regardless of the affected individual's condition, addressing neuropsychiatric symptoms in patients with movement disorders may be crucial to improving their QoL.
Collapse
Affiliation(s)
- Sangjin Lee
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, Ulsan University College of Medicine, Seoul, South Korea
| | - Hae-Won Shin
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, South Korea
| |
Collapse
|
18
|
Stanojlovic M, Pallais JP, Lee MK, Kotz CM. Pharmacological and chemogenetic orexin/hypocretin intervention ameliorates Hipp-dependent memory impairment in the A53T mice model of Parkinson's disease. Mol Brain 2019; 12:87. [PMID: 31666100 PMCID: PMC6822428 DOI: 10.1186/s13041-019-0514-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/18/2019] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD), classically defined as a progressive motor disorder accompanied with dopaminergic neuron loss and presence of Lewy bodies, is the second most common neurodegenerative disease. PD also has various non-classical symptoms, including cognitive impairments. In addition, inflammation and astrogliosis are recognized as an integral part of PD pathology. The hippocampus (Hipp) is a brain region involved in cognition and memory, and the neuropeptide orexin has been shown to enhance learning and memory. Previous studies show impairments in Hipp-dependent memory in a transgenic mouse model of Parkinson's disease (A53T mice), and we hypothesized that increasing orexin tone will reverse this. To test this, we subjected 3, 5, and 7-month old A53T mice to a Barnes maze and a contextual object recognition test to determine Hipp dependent memory. Inflammation and astrogliosis markers in the Hipp were assessed by immuno-fluorescence densitometry. The data show that early cognitive impairment is coupled with an increase in expression of inflammatory and astrogliosis markers. Next, in two separate experiments, mice were given intra-hippocampal injections of orexin or chemogenetic viral injections of an orexin neuron specific Designer Receptor Exclusively Activated by Designer Drug (DREADD). For the pharmacological approach mice were intracranially treated with orexin A, whereas the chemogenetic approach utilized clozapine N-oxide (CNO). Both pharmacological orexin A intervention as well as chemogenetic activation of orexin neurons ameliorated Hipp-dependent early memory impairment observed in A53T mice. This study implicates orexin in PD-associated cognitive impairment and suggests that exogenous orexin treatment and/or manipulation of endogenous orexin levels may be a potential strategy for addressing early cognitive loss in PD.
Collapse
Affiliation(s)
- Milos Stanojlovic
- Integrative Biology and Physiology, University of Minnesota, 2231 6th St SE, Minneapolis, MN, 55455, USA.
| | - Jean Pierre Pallais
- Integrative Biology and Physiology, University of Minnesota, 2231 6th St SE, Minneapolis, MN, 55455, USA
| | - Michael K Lee
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA
- Institute for Translational Neuroscience (ITN), University of Minnesota, Minneapolis, MN, USA
| | - Catherine M Kotz
- Integrative Biology and Physiology, University of Minnesota, 2231 6th St SE, Minneapolis, MN, 55455, USA
- Minneapolis VA Health Care System, GRECC, Minneapolis, MN, USA
| |
Collapse
|
19
|
Chronic medical conditions and metabolic syndrome as risk factors for incidence of major depressive disorder: A longitudinal study based on 4.7 million adults in South Korea. J Affect Disord 2019; 257:486-494. [PMID: 31319340 DOI: 10.1016/j.jad.2019.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The assessment of comorbid physical illness and metabolic or cardiovascular risk factors as potential risk factors for onset of major depressive disorder (MDD) is crucial. We aimed to investigate potential risk factors for the development of MDD among individuals with chronic medical conditions and metabolic and behavioral risk factors using a large population-based retrospective cohort from the data of the National Health Insurance Service (NHIS) in South Korea. METHODS The population-based retrospective cohort included data from 2,370,815 adults (age ≥20 years) diagnosed with MDD between January 1, 2010, and December 31, 2016 and age- and gender-matched 2,370,815 healthy controls obtained from the claims data of the NHIS. The data of the regular health checkup provided by the NHIS were also included (age ≥40 years). Logistic regression analyses were performed to investigate the potential risk factors for the incidence of MDD. RESULTS Chronic medical conditions such as Parkinson's disease (odds ratio [OR] = 7.808, 95% confidence interval [CI] = 7.517-8.11), epilepsy (OR = 6.119, 95% CI = 6.019-6.22), multiple sclerosis (OR = 5.532, 95% CI = 4.976-6.151), Huntington's disease (OR = 5.387, 95% CI = 3.258-8.909), migraine (OR = 4.374, 95% CI = 4.341-4.408), stroke (OR = 4.074, 95% CI = 4.032-4.117), and cancer; metabolic syndrome (OR = 1.049, 95% CI = 1.041-1.057) and several of its components including central obesity, elevated fasting blood glucose and triglyceride levels, and reduced high-density lipoprotein level; and cigarette smoking, frequent alcohol consumption, and low physical activity are potential risk factors for the development of MDD. CONCLUSION Our results may support previous evidence on the association between physical conditions and the incidence of MDD as reported by individual population-based studies with modest sample sizes.
Collapse
|
20
|
Stanojlovic M, Pallais JP, Kotz CM. Chemogenetic Modulation of Orexin Neurons Reverses Changes in Anxiety and Locomotor Activity in the A53T Mouse Model of Parkinson's Disease. Front Neurosci 2019; 13:702. [PMID: 31417337 PMCID: PMC6682689 DOI: 10.3389/fnins.2019.00702] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/21/2019] [Indexed: 01/02/2023] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease. PD symptomology is recognized as heterogeneous and in addition to motor function decline includes cognitive, mood, sleep, and metabolic disorders. Previous studies showed early reductions in anxiety and locomotion in the A53T mice model of PD. Since inflammation and astrogliosis are an integral part of PD pathology and impair proper neuronal function, we were keen to investigate if behavioral changes in A53T mice are accompanied by increased inflammation and astrogliosis in the hippocampus (Hipp) and motor cortex (mCtx) brain regions involved in the regulation of anxiety and locomotion, respectively. To test this, we used 3-, 5-, and 7-month-old A53T mice to examine anxiety-like behavior, locomotion, and expression of inflammation and astrogliosis markers in the Hipp and mCtx. Further, we examined the presence of alpha-synuclein accumulation in orexin neurons and orexin neuronal loss. The data show early reductions in anxiety-like behavior as well as increased locomotor activity, which was accompanied by inflammation and astrogliosis in the Hipp and mCtx. Due to the persistence of the orexin neuron population in A53T mice and the involvement of orexin in anxiety and locomotor regulation, we hypothesized that chemogenetic modulation of orexin neurons would reverse the observed reductions in anxiety-like behavior and the increases in locomotor activity in these animals. We showed that chemogenetic activation of orexin neurons in A53T mice restores anxiety-like behavior back to control levels without affecting locomotor activity, whereas the inhibition of orexin neurons reverses the elevated locomotor activity without any effects on anxiety-like behavior. This study exemplifies the complex role of orexin neurons in this model of PD and demonstrates the novel finding that changes in locomotor and anxiety-like behavior are accompanied by inflammation and astrogliosis. Together, these data suggest that the orexin system may play a significant role in early and late stages of PD.
Collapse
Affiliation(s)
- Milos Stanojlovic
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States
| | - Jean Pierre Pallais
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States
| | - Catherine M Kotz
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, United States.,Minneapolis VA Health Care System, Geriatric Research, Education and Clinical Center, Minneapolis, MN, United States
| |
Collapse
|
21
|
Stanojlovic M, Pallais Yllescas JP, Vijayakumar A, Kotz C. Early Sociability and Social Memory Impairment in the A53T Mouse Model of Parkinson's Disease Are Ameliorated by Chemogenetic Modulation of Orexin Neuron Activity. Mol Neurobiol 2019; 56:8435-8450. [PMID: 31250383 DOI: 10.1007/s12035-019-01682-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/14/2019] [Indexed: 02/08/2023]
Abstract
Parkinson's disease (PD) is a multi-layered progressive neurodegenerative disease. Signature motor system impairments are accompanied by a variety of other symptoms such as mood, sleep, metabolic, and cognitive disorders. Interestingly, social cognition impairments can be observed from the earliest stages of the disease, prior to the onset of the motor symptoms. In this study, we investigated age-related reductions in sociability and social memory in the A53T mouse model of PD. Since inflammation and astrogliosis are an integral part of PD pathology and impair proper neuronal function, we examined astrogliosis and inflammation markers and parvalbumin expression in medial pre-frontal cortex (mPFC), part of the brain responsible for social cognition regulation. Finally, we used DREADDs (Designer Receptors Exclusively Activated by Designer Drugs) for the stimulation and inhibition of orexin neuronal activity to modulate sociability and social memory in A53T mice. We observed that social cognition impairment in A53T mice is accompanied by an increase in astrogliosis and inflammation markers, in addition to loss of parvalbumin neurons and inhibitory pre-synaptic terminals in the mPFC. Moreover, DREADD-induced activation of orexin neurons restores social cognition in the A53T mouse model of PD. SIGNIFICANCE STATEMENT: Social cognition is severely affected in the early stages of Parkinson's disease. In this study, we identified the A53T mouse as a model of social cognitive impairment in PD. Observed alterations in sociability and social memory are accompanied by loss of parvalbumin positive neurons and loss of inhibitory input to mPFC. Stimulating orexin neurons using a chemogenetic approach (DREADDs) ameliorated social cognitive impairment. This study identifies a role for orexin neurons in social cognition in PD and suggests potential therapeutic targets for PD-related social cognition impairments.
Collapse
Affiliation(s)
- Milos Stanojlovic
- Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA.
| | | | - Aarthi Vijayakumar
- Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA
| | - Catherine Kotz
- Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA.,GRECC, Minneapolis VA Health Care System, Minneapolis, MN, USA
| |
Collapse
|
22
|
Wyant KJ, Yasuda E, Kotagal V. The 10-year Landscape of United States-Registered Parkinson Disease Clinical Trials: 2007-2016. Mov Disord Clin Pract 2018; 5:512-518. [PMID: 30515440 DOI: 10.1002/mdc3.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/13/2018] [Accepted: 06/19/2018] [Indexed: 11/12/2022] Open
Abstract
Background We know little about how well the goals and results of clinical trials in Parkinson disease (PD) reflect the priorities of patients and the broader PD community. Objectives We conducted a review of registered trials on http://clincialtrials.gov from 2007 to 2016 to explore whether PD trials have moved closer to the therapeutic priority goals articulated by the PD community. Methods Using the search terms: Parkinson, interventional trials, phase "0-4," we categorized therapeutic PD studies from http://clinicaltrials.gov between January 1, 2007 and December 31, 2016. Seven hundred and sixty-six trials met the criteria for analysis. We explored temporal trends in the utilization of balance problems and falls; mood symptoms, including stress and anxiety; cognitive dysfunction, including dementia; and dyskinesias as primary outcomes. We analyzed trials where recruitment was listed as "completed" (n = 391) to explore publication rates. Results Balance problems and falls were listed as primary outcome measures in 125 studies (16.3%), cognitive measures in 48 (6.3%), mood features in 37 (4.8%), and dyskinesias in 30 (3.9%). Trials using balance problems and falls as a primary outcome increased in frequency per year between 2007 and 2016 (Z = -2.128, p = 0.033) unlike the proportion of trials evaluating cognitive dysfunction including dementia (Z = -0.380, p = 0.704), mood symptoms including stress and anxiety (Z = 0.345, p = 0.730), or dyskinesias (Z = 0.340, p = 0.734), which did not show temporal changes. 231 (59.1%) completed trials had results published in manuscript form as of 5/1/2017, leaving 40.9% of trials unpublished. Conclusions PD trials focusing on balance problems and falls are becoming more common. About 40% of completed PD trials are unpublished, reflecting suboptimal utilization of participant efforts.
Collapse
Affiliation(s)
- Kara J Wyant
- Department of Neurology University of Michigan Ann Arbor MI
| | - Erika Yasuda
- Department of Neurology University of Michigan Ann Arbor MI
| | - Vikas Kotagal
- Department of Neurology University of Michigan Ann Arbor MI.,Veterans Affairs Ann Arbor Health System (VAAAHS) & VAAAHS Geriatric Research Education and Clinical Center (GRECC) Ann Arbor Michigan
| |
Collapse
|
23
|
Ortuño-Lizarán I, Esquiva G, Beach TG, Serrano GE, Adler CH, Lax P, Cuenca N. Degeneration of human photosensitive retinal ganglion cells may explain sleep and circadian rhythms disorders in Parkinson's disease. Acta Neuropathol Commun 2018; 6:90. [PMID: 30201049 PMCID: PMC6130068 DOI: 10.1186/s40478-018-0596-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/03/2018] [Indexed: 11/19/2022] Open
Abstract
Parkinson's disease (PD) patients often suffer from non-motor symptoms like sleep dysregulation, mood disturbances or circadian rhythms dysfunction. The melanopsin-containing retinal ganglion cells are involved in the control and regulation of these processes and may be affected in PD, as other retinal and visual implications have been described in the disease. Number and morphology of human melanopsin-containing retinal ganglion cells were evaluated by immunohistochemistry in eyes from donors with PD or control. The Sholl number of intersections, the number of branches, and the number of terminals from the Sholl analysis were significantly reduced in PD melanopsin ganglion cells. Also, the density of these cells significantly decreased in PD compared to controls. Degeneration and impairment of the retinal melanopsin system may affect to sleep and circadian dysfunction reported in PD pathology, and its protection or stimulation may lead to better disease prospect and global quality of life of patients.
Collapse
Affiliation(s)
- Isabel Ortuño-Lizarán
- Department of Physiology, Genetics and Microbiology, University of Alicante, 03690, San Vicente del Raspeig, Spain
| | - Gema Esquiva
- Department of Physiology, Genetics and Microbiology, University of Alicante, 03690, San Vicente del Raspeig, Spain
| | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, AZ, 85351, USA
| | - Geidy E Serrano
- Banner Sun Health Research Institute, Sun City, AZ, 85351, USA
| | | | - Pedro Lax
- Department of Physiology, Genetics and Microbiology, University of Alicante, 03690, San Vicente del Raspeig, Spain
| | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, 03690, San Vicente del Raspeig, Spain.
| |
Collapse
|
24
|
Cattaneo C, Müller T, Bonizzoni E, Lazzeri G, Kottakis I, Keywood C. Long-Term Effects of Safinamide on Mood Fluctuations in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2018; 7:629-634. [PMID: 28777756 PMCID: PMC5676861 DOI: 10.3233/jpd-171143] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Mood disorders are very frequent in Parkinson’s Disease (PD), and their effective treatment is still a major unresolved issue: growing evidence suggests that glutamatergic system dysfunction is directly involved. Safinamide is a drug with an innovative mechanism of action, dopaminergic and non-dopaminergic, that includes the reversible inhibition of the monoamine oxidase-B (MAO-B) enzyme and the modulation of excessive glutamate release through the use- and state-dependent blockade of the sodium channels. Objective: To investigate the effects of safinamide on mood over two-year treatment in PD patients with motor fluctuations. Methods: This was a post-hoc analysis of the data from studies 016 and 018. The analysis focused on outcomes related to mood, namely: scores of the “Emotional well-being” domain of the Parkinson’s Disease Questionnaire (PDQ-39), scores of the GRID Hamilton Rating Scale for Depression (GRID-HAMD) and the proportion of patients reporting depression as an adverse event over the entire treatment period. Results: Safinamide, compared to placebo, significantly improved the PDQ-39 “Emotional well-being” domain after6-months (p = 0.0067) and 2 years (p = 0.0006), as well as the GRID-HAMD (p = 0.0408 after 6 months and p = 0.0027 after 2 years). Significantly fewer patients in the safinamide group, compared to placebo, experienced depression as adverse event (p = 0.0444 after 6 months and p = 0.0057 after 2 years). Conclusion: The favorable effect of safinamide on mood may be explained by the improvement in wearing off and by its modulation of glutamatergic hyperactivity and reversible MAO-B inhibition. Prospective studies are warranted to investigate this potential benefit.
Collapse
Affiliation(s)
| | - Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Berlin, Germany
| | - Erminio Bonizzoni
- Department of Clinical Science and Community, Section of Medical Statistics and Biometry "GA Maccacaro", University of Milan, Milan, Italy
| | | | | | | |
Collapse
|
25
|
Patterns and Predictors of Depression Treatment among Older Adults with Parkinson's Disease and Depression in Ambulatory Care Settings in the United States. PARKINSONS DISEASE 2018; 2018:3402983. [PMID: 29686832 PMCID: PMC5852869 DOI: 10.1155/2018/3402983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD) in the United States (US). The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005-2011) from the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department of the National Hospital Ambulatory Medical Care Survey (NHAMCS). The final study sample consisted of visits by older adults with dPD. Depression treatment was defined as antidepressant use with or without psychotherapy. To identify predictors of depression treatment, multivariate logistic regression analysis was conducted adjusting for predisposing, enabling, and need factors. Individuals with dPD and polypharmacy were 74% more likely to receive depression treatment (odds ratio = 1.743, 95% CI 1.376-2.209), while dPD subjects with comorbid chronic conditions were 44% less likely (odds ratio = 0.559, 95% CI 0.396-0.790) to receive depression treatment. Approximately six out of ten older adults with PD and depression received depression treatment. Treatment options for dPD are underutilized in routine clinical practice, and further research should explore how overall medical complexity presents a barrier to depression treatment.
Collapse
|
26
|
Vijayanathan Y, Lim FT, Lim SM, Long CM, Tan MP, Majeed ABA, Ramasamy K. 6-OHDA-Lesioned Adult Zebrafish as a Useful Parkinson's Disease Model for Dopaminergic Neuroregeneration. Neurotox Res 2017; 32:496-508. [PMID: 28707266 DOI: 10.1007/s12640-017-9778-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 06/14/2017] [Accepted: 06/28/2017] [Indexed: 12/16/2022]
Abstract
Conventional mammalian models of neurodegeneration are often limited by futile axonogenesis with minimal functional recuperation of severed neurons. The emergence of zebrafish, a non-mammalian model with excellent neuroregenerative properties, may address these limitations. This study aimed to establish an adult zebrafish-based, neurotoxin-induced Parkinson's disease (PD) model and subsequently validate the regenerative capability of dopaminergic neurons (DpN). The DpN of adult male zebrafish (Danio rerio) were lesioned by microinjecting 6-hydroxydopamine (6-OHDA) neurotoxin (6.25, 12.5, 18.75, 25, 37.5, 50 and 100 mg/kg) into the ventral diencephalon (Dn). This was facilitated by an optimised protocol that utilised 1,1'-dioctadecyl-3,3,3',3'-tetramethyl-indocarbocyanineperchlorate (DiI) dye to precisely identify the injection site. Immunostaining was utilised to identify the number of tyrosine hydroxylase immunoreactive (TH-ir) DpN in brain regions of interest (i.e. olfactory bulb, telencephalon, preoptic area, posterior tuberculum and hypothalamus). Open tank video recordings were performed for locomotor studies. The Dn was accessed by setting the injection angle of the microinjection capillary to 60° and injection depth to 1200 μm (from the exposed brain surface). 6-OHDA (25 mg/kg) successfully ablated >85% of the Dn DpN (preoptic area, posterior tuberculum and hypothalamus) whilst maintaining a 100% survival. Locomotor analysis of 5-min recordings revealed that 6-OHDA-lesioned adult zebrafish were significantly (p < 0.0001) reduced in speed (cm/s) and distance travelled (cm). Lesioned zebrafish showed full recovery of Dn DpN 30 days post-lesion. This study had successfully developed a stable 6-OHDA-induced PD zebrafish model using a straightforward and reproducible approach. Thus, this developed teleost model poses exceptional potentials to study DpN regeneration.
Collapse
Affiliation(s)
- Yuganthini Vijayanathan
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300, Puncak Alam, Selangor Darul Ehsan, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Fei Tieng Lim
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300, Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Siong Meng Lim
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300, Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Chiau Ming Long
- School of Pharmacy, KPJ Healthcare University College, 71800, Nilai, Negeri Sembilan, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Abu Bakar Abdul Majeed
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300, Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Kalavathy Ramasamy
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), 42300, Puncak Alam, Selangor Darul Ehsan, Malaysia.
| |
Collapse
|
27
|
Santos García D, Suárez Castro E, Expósito I, de Deus T, Tuñas C, Aneiros A, López Fernández M, Núñez Arias D, Bermúdez Torres M. Comorbid conditions associated with Parkinson's disease: A longitudinal and comparative study with Alzheimer disease and control subjects. J Neurol Sci 2016; 373:210-215. [PMID: 28131190 DOI: 10.1016/j.jns.2016.12.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/17/2016] [Accepted: 12/22/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE To study what comorbid conditions were present at baseline and 3years later in a cohort of Spanish Parkinson's disease (PD) patients, to compare comorbidity with both Alzheimer's disease (AD) and control groups and to analyze the role of comorbidity as predictor of mortality. METHODS One hundred and forty-seven non-demented PD patients (57.1% males; 70.9±8.6years old) were included in this 36months follow-up (2012-2015), monocenter, evaluation study. The International Classification of Diseases, Tenth Revision (ICD-10), Charlson Index (CI), Comorbidity-Polypharmacy Score (CPS) and Elixhauser Comorbidity Measure (ECM) were used to assess comorbidity at baseline and at 3years. Forty-four AD patients and 44 control subjects were included as comparator groups. RESULTS Total number of comorbidities (ICD-10) and polypharmacy at baseline were higher in PD and AD patients than controls (4.4±2.3 vs 5.2±2.4 vs 3.4±1.9 [p=0.001] and 81.6% vs 75% vs 56.8% [p=0.003], respectively). Diseases of the circulatory system (ICD-10/chapter-IX) and endocrine, nutritional and metabolic diseases (ICD-10/chapter-IV) were the most frequent in all groups. There was a significant increase in comorbidity (mean, +1.6±2.8) in all groups (p<0.0001) without differences between them. Seventeen patients died and 8 cases were did not follow-up. Comorbidity was a predictor of death in PD patients after adjust for other covariates (including age, sex, disease duration, disease stage, motor status and non-motor symptoms): ICD-10 (total number of comorbidities), hazard ratio 1.285 (95% confidence interval, 1.047-1.577; p=0.017); CI, hazard ratio 1.462 (95% confidence interval, 1.045-2.047; p=0.027). CONCLUSIONS Comorbidity is frequent in PD patients, increases significantly over time and predicts mortality.
Collapse
Affiliation(s)
- D Santos García
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain.
| | - E Suárez Castro
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - I Expósito
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - T de Deus
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - C Tuñas
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - A Aneiros
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - M López Fernández
- Section of Neurology, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital A. Marcide, Ferrol, A Coruña, Spain
| | - D Núñez Arias
- Department of Psychiatry, Complejo Hospitalario Universitario de Ferrol (CHUF), Hospital Naval, Ferrol, A Coruña, Spain
| | - M Bermúdez Torres
- Department of Family Medicine, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| |
Collapse
|
28
|
Abstract
Cognitive and neuropsychiatric symptoms are common in Parkinson's Disease and may surpass motor symptoms as the major factors impacting patient quality of life. The symptoms may be broadly separated into those associated with the disease process and those that represent adverse effects of treatment. Symptoms attributed to the disease arise from pathologic changes within multiple brain regions and are not restricted to dysfunction in the dopaminergic system. Mood symptoms such as depression, anxiety, and apathy are common and may precede the development of motor symptoms by years, while other neuropsychiatric symptoms such as cognitive impairment, dementia, and psychosis are more common in later stages of the disease. Neuropsychiatric symptoms attributed to treatment include impulse control disorders, pathologic use of dopaminergic medications, and psychosis. This manuscript will review the current understanding of neuropsychiatric symptoms in Parkinson's Disease.
Collapse
Affiliation(s)
- Jeffrey W Cooney
- Duke University School of Medicine, 932 Morreene Rd., Durham, NC, 27705, USA
| | - Mark Stacy
- Duke University School of Medicine, 120a Davison, Durham, NC, 27705, USA.
| |
Collapse
|
29
|
Hendred SK, Foster ER. Use of the World Health Organization Quality of Life Assessment Short Version in Mild to Moderate Parkinson Disease. Arch Phys Med Rehabil 2016; 97:2123-2129.e1. [PMID: 27343346 DOI: 10.1016/j.apmr.2016.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the distribution, internal consistency reliability, and convergent and discriminant validity of the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) in persons with mild to moderate Parkinson disease (PD). DESIGN Cross-sectional. SETTING Movement disorders center. PARTICIPANTS Convenience sample of people with PD (n=96) recruited from a movement disorders center and controls (n=60) recruited from the community (N=156). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE WHOQOL-BREF. RESULTS The WHOQOL-BREF domain data were relatively normally distributed, and internal consistency reliability was acceptable (α=.65-.85). Participants with PD reported lower quality of life (QOL) than controls in all except the environment domain, and physical QOL was the most impaired domain in the PD group. Age, fatigue, and physical activity limitations predicted physical QOL; depression, fatigue, and apathy predicted psychological QOL; education, executive dysfunction, and apathy predicted social QOL; and age, education, depression, and apathy predicted environment QOL. CONCLUSIONS The WHOQOL-BREF is a suitable tool to assess QOL in patients with mild to moderate PD. It is relatively normally distributed and internally consistent; effectively discriminates between individuals with and without PD; and correlates with relevant demographic characteristics, PD-related impairments, and activity limitations.
Collapse
Affiliation(s)
- Sarah K Hendred
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO
| | - Erin R Foster
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO; Department of Neurology, Washington University School of Medicine, St Louis, MO; Department of Psychiatry, Washington University School of Medicine, St Louis, MO.
| |
Collapse
|
30
|
Rossi PJ, Gunduz A, Judy J, Wilson L, Machado A, Giordano JJ, Elias WJ, Rossi MA, Butson CL, Fox MD, McIntyre CC, Pouratian N, Swann NC, de Hemptinne C, Gross RE, Chizeck HJ, Tagliati M, Lozano AM, Goodman W, Langevin JP, Alterman RL, Akbar U, Gerhardt GA, Grill WM, Hallett M, Herrington T, Herron J, van Horne C, Kopell BH, Lang AE, Lungu C, Martinez-Ramirez D, Mogilner AY, Molina R, Opri E, Otto KJ, Oweiss KG, Pathak Y, Shukla A, Shute J, Sheth SA, Shih LC, Steinke GK, Tröster AI, Vanegas N, Zaghloul KA, Cendejas-Zaragoza L, Verhagen L, Foote KD, Okun MS. Proceedings of the Third Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies. Front Neurosci 2016; 10:119. [PMID: 27092042 PMCID: PMC4821860 DOI: 10.3389/fnins.2016.00119] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/11/2016] [Indexed: 11/25/2022] Open
Abstract
The proceedings of the 3rd Annual Deep Brain Stimulation Think Tank summarize the most contemporary clinical, electrophysiological, imaging, and computational work on DBS for the treatment of neurological and neuropsychiatric disease. Significant innovations of the past year are emphasized. The Think Tank's contributors represent a unique multidisciplinary ensemble of expert neurologists, neurosurgeons, neuropsychologists, psychiatrists, scientists, engineers, and members of industry. Presentations and discussions covered a broad range of topics, including policy and advocacy considerations for the future of DBS, connectomic approaches to DBS targeting, developments in electrophysiology and related strides toward responsive DBS systems, and recent developments in sensor and device technologies.
Collapse
Affiliation(s)
- P Justin Rossi
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Aysegul Gunduz
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Jack Judy
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Linda Wilson
- Formerly affiliated with the International Technology Roadmap for Semiconductors (ITRS) Washington, USA
| | - Andre Machado
- Neurological Institute Cleveland Clinic Cleveland, OH, USA
| | - James J Giordano
- Neuroethics Studies Program, Department of Neurology, Georgetown University Medical Center Washington, DC, USA
| | - W Jeff Elias
- Neurological Surgery and Neurology, Stereotactic and Functional Neurosurgery, Department of Neurosurgery, University of Virginia Health Science Center Charlottesville, VA, USA
| | - Marvin A Rossi
- Department of Neurology, Rush University Medical Center Chicago, IL, USA
| | - Christopher L Butson
- Scientific Computing and Imaging Institute, University of Utah Salt Lake City, UT, USA
| | - Michael D Fox
- Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | - Cameron C McIntyre
- Department of Biomedical Engineering, School of Medicine, Case Western Reserve University Cleveland, OH, USA
| | - Nader Pouratian
- Department of Neurosurgery, University of California, Los Angeles Los Angeles, CA, USA
| | - Nicole C Swann
- University of California, San Francisco San Francisco, CA, USA
| | | | | | - Howard J Chizeck
- Department of Electrical Engineering, University of Washington Seattle, WA, USA
| | - Michele Tagliati
- Movement Disorders Program, Department of Neurology, Cedars-Sinai Medical Center Los Angeles, CA, USA
| | - Andres M Lozano
- Department of Neurosurgery, University of Toronto Toronto, ON, Canada
| | - Wayne Goodman
- The Icahn School of Medicine at Mount Sinai New York, NY, USA
| | | | - Ron L Alterman
- Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | - Umer Akbar
- Department of Neurology, Alpert Medical School, Brown University Providence, RI, USA
| | | | - Warren M Grill
- Department of Biomedical Engineering, Duke University Durham, NC, USA
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda, MD, USA
| | - Todd Herrington
- Massachusetts General Hospital, Harvard Medical School Boston, MA, USA
| | - Jeffrey Herron
- Department of Electrical Engineering, University of Washington Seattle, WA, USA
| | | | - Brian H Kopell
- The Icahn School of Medicine at Mount Sinai New York, NY, USA
| | - Anthony E Lang
- Department of Neurosurgery, University of Toronto Toronto, ON, Canada
| | - Codrin Lungu
- National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda, MD, USA
| | - Daniel Martinez-Ramirez
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Alon Y Mogilner
- Department of Neurosurgery-Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Rene Molina
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Enrico Opri
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Kevin J Otto
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Karim G Oweiss
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Yagna Pathak
- Neurological Institute, Columbia University Medical Center New York, NY, USA
| | - Aparna Shukla
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Jonathan Shute
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Sameer A Sheth
- Neurological Institute, Columbia University Medical Center New York, NY, USA
| | - Ludy C Shih
- Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
| | | | - Alexander I Tröster
- Department of Clinical Neuropsychology, Barrow Neurological Institute Phoenix, AZ, USA
| | - Nora Vanegas
- Neurological Institute, Columbia University Medical Center New York, NY, USA
| | - Kareem A Zaghloul
- National Institute of Neurological Disorders and Stroke, National Institutes of Health Bethesda, MD, USA
| | | | - Leonard Verhagen
- Department of Neurology, Rush University Medical Center Chicago, IL, USA
| | - Kelly D Foote
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| | - Michael S Okun
- Department of Neuroscience, Center for Movement Disorders and Neurorestoration, University of Florida Gainesville, FL, USA
| |
Collapse
|
31
|
Wee N, Kandiah N, Acharyya S, Chander RJ, Ng A, Au WL, Tan LCS. Depression and anxiety are co-morbid but dissociable in mild Parkinson's disease: A prospective longitudinal study of patterns and predictors. Parkinsonism Relat Disord 2015; 23:50-6. [PMID: 26711668 DOI: 10.1016/j.parkreldis.2015.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/26/2015] [Accepted: 12/01/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Depression and anxiety are common in Parkinson's disease (PD) and contribute significantly to a reduced quality of life in PD patients. Though they often co-exist, it is unclear whether depression and anxiety result from a shared pathological process. We studied the longitudinal course and determinants of depression and anxiety in PD in order to understand which factors contribute to the development of these symptoms. METHODS We conducted a prospective longitudinal study of 89 mild PD patients over 18 months, measuring depressive and anxiety symptoms at 6 monthly intervals using the Geriatric Depression Scale and Hospital Anxiety and Depression Scale--'Anxiety' subscale. Univariate and multivariate Generalised Estimating Equations were used to investigate the course of depression and anxiety and their association with demographic factors, motor measures, non-motor symptoms, and pharmacological factors. RESULTS Depression and anxiety were co-morbid in 13.5% of the sample. Depressive symptoms remained relatively stable while anxiety symptoms improved over the course of 18 months. Severity of depressive symptoms was associated with female gender, motor fluctuations, apathy, and anxiety, while severity of anxiety was associated with older age, higher educational attainment, shorter disease duration, younger age of disease onset, and excessive daytime sleepiness. CONCLUSIONS Although depression and anxiety are frequently co-morbid in PD, they were dissociable from each other. They had distinct trajectories and different longitudinal relationships with demographic, motor, and non-motor factors that were unique to each disorder.
Collapse
Affiliation(s)
- Natalie Wee
- Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Sanchalika Acharyya
- Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Russell J Chander
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Aloysius Ng
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Wing Lok Au
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore
| | - Louis C S Tan
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
| |
Collapse
|
32
|
Physical training prevents depressive symptoms and a decrease in brain-derived neurotrophic factor in Parkinson's disease. Brain Res Bull 2014; 108:106-12. [DOI: 10.1016/j.brainresbull.2014.09.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/30/2014] [Accepted: 09/16/2014] [Indexed: 11/22/2022]
|
33
|
Biemiller R, Richard IH. Managing depression in Parkinson’s patients: risk factors and clinical pearls. Neurodegener Dis Manag 2014; 4:329-36. [DOI: 10.2217/nmt.14.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Parkinson’s disease (PD) is a neurodegenerative condition that is on the rise as the world’s population ages. As our understanding of the disease increases, depression has emerged as a common syndrome in this population that significantly reduces quality of life, making its understanding, recognition and treatment an important area of focus for clinicians and researchers alike. It is hypothesized that depression is a consequence of the disease process itself, sometimes developing prior to the onset of motor symptoms. Many of the diagnostic tools and treatments for depression have not been fully evaluated in the PD population. However, several traditional diagnostic interviews and depression rating scales have been used in recent clinical trials. These study results suggest that some of the currently available antidepressant medications may be effective and well tolerated in this population. This paper reviews our understanding of depression in PD as well as the current recommendations for its diagnosis and treatment.
Collapse
|
34
|
Coakeley S, Martens KE, Almeida QJ. Management of anxiety and motor symptoms in Parkinson’s disease. Expert Rev Neurother 2014; 14:937-46. [DOI: 10.1586/14737175.2014.936388] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
35
|
Abstract
PURPOSE OF REVIEW This review explores recent literature pertaining to affective disorders associated with Parkinson's disease. RECENT FINDINGS Nonmotor symptoms including affective disorders are becoming more widely recognized as complications of Parkinson's disease. As awareness of these symptoms increases, and new neuroimaging tools are developed and become more accessible, more studies are being conducted pertaining to behavioral complications in Parkinson's disease. The functional connectivity of the basal ganglia can predispose people with Parkinson's to develop affective disorders. Furthermore, dopaminergic treatments may exacerbate or trigger behavioral symptoms. It is now understood that changes associated with Parkinson's disease are widespread, affecting striatal and extrastriatal regions and resulting in alterations in gray matter, white matter, blood flow, metabolism, and dopaminergic and serotonergic function. SUMMARY Neuroimaging is advancing our knowledge of the mechanisms involved in Parkinson's disease, and their role in the development of behavioral disorders. An increased understanding of these disorders may lead to the discovery of new therapeutic targets, or the identification of risk factors for the development of these disorders. If preventive therapies become available, identification of risk factors will be important for the identification and treatment of susceptible individuals.
Collapse
|
36
|
Aiello M, Eleopra R, Lettieri C, Mondani M, D'Auria S, Belgrado E, Piani A, De Simone L, Rinaldo S, Rumiati RI. Emotion recognition in Parkinson's disease after subthalamic deep brain stimulation: Differential effects of microlesion and STN stimulation. Cortex 2014; 51:35-45. [DOI: 10.1016/j.cortex.2013.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/25/2013] [Accepted: 11/08/2013] [Indexed: 12/19/2022]
|
37
|
Luo C, Song W, Chen Q, Zheng Z, Chen K, Cao B, Yang J, Li J, Huang X, Gong Q, Shang HF. Reduced functional connectivity in early-stage drug-naive Parkinson's disease: a resting-state fMRI study. Neurobiol Aging 2014; 35:431-41. [DOI: 10.1016/j.neurobiolaging.2013.08.018] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/15/2013] [Accepted: 08/16/2013] [Indexed: 11/29/2022]
|
38
|
Connolly B, Fox SH. Treatment of cognitive, psychiatric, and affective disorders associated with Parkinson's disease. Neurotherapeutics 2014; 11:78-91. [PMID: 24288035 PMCID: PMC3899484 DOI: 10.1007/s13311-013-0238-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Neuropsychiatric symptoms are common in Parkinson's disease (PD) and add significantly to the burden of disease. These symptoms are most commonly part of the disease spectrum owing to pathological changes within relevant brain regions. Neuropsychiatric problems include disorders of cognition, ranging from mild cognitive impairment to dementia, psychotic symptoms, including, most commonly, well-formed visual hallucinations and paranoid delusions, and mood disorders, such as depression and anxiety. The other common cause of neuropsychiatric problem is secondary to use of dopaminergic drugs. Some PD patients may develop behavioral disorders, including impulse control disorders (ICDs) and addictive symptoms. Psychosis can be due to a mixture of underlying pathology, with triggering or worsening of symptoms with changes to PD medications. Currently, management of these disorders primarily uses therapies developed for general psychiatry and cognitive neurology, rather than specifically for PD. However, significant adverse effects, such as worsening of the motor symptoms of PD, can limit use of some drug therapies. Identification of drug-induced symptoms, such as ICDs, enables withdrawal of the offending drug as the principal management strategy. Research is ongoing in an effort to develop more specific therapies for PD-related neuropsychiatric symptoms.
Collapse
Affiliation(s)
- Barbara Connolly
- />Hamilton Health Sciences, McMaster University, Hamilton, Ontario Canada
| | - Susan H. Fox
- />Morton and Gloria Shulman Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, 7th Floor, McLaughlin Pavilion, 399 Bathurst Street, Toronto, Ontario M5T 2S8 Canada
| |
Collapse
|
39
|
Olver JS, Hopwood MJ. Depression and physical illness. Med J Aust 2013; 199:S9-12. [DOI: 10.5694/mja12.10597] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 08/16/2012] [Indexed: 01/28/2023]
Affiliation(s)
- James S Olver
- Department of Psychiatry, University of Melbourne, Melbourne, VIC
| | | |
Collapse
|
40
|
Spadaro L, Bonanno L, Di Lorenzo G, Bramanti P, Marino S. Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy: (An ecological perspective). Neural Regen Res 2013; 8:1615-22. [PMID: 25206458 PMCID: PMC4145963 DOI: 10.3969/j.issn.1673-5374.2013.17.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 04/18/2013] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy. Ninety Parkinson's disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi "Bonino-Pulejo" (Messina), were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale (UPDRS-III) scores, the Parkinson Disease Questionnaire-39 Item scores (as a disease-specific measure of health-related quality of life), scores on the Short Form (36) Health Survey Questionnaire (as a generic measure), and answers to a brief checklist were recorded. A total of 85 Parkinson's disease patients (49% males and 51% females; mean age 70.8 ± 8.6 years; mean UPDRS-III 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years) completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.
Collapse
Affiliation(s)
- Letteria Spadaro
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Lilla Bonanno
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Giuseppe Di Lorenzo
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Placido Bramanti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| | - Silvia Marino
- Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino Pulejo" Via Provinciale Palermo, C.da Casazza 98124 Messina, Italy
| |
Collapse
|
41
|
Daneault JF, Carignan B, Sadikot AF, Panisset M, Duval C. Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia? BMC Med 2013; 11:76. [PMID: 23514355 PMCID: PMC3751666 DOI: 10.1186/1741-7015-11-76] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 03/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management. DISCUSSION The current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed. SUMMARY Clinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.
Collapse
Affiliation(s)
- Jean-François Daneault
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
| | | | | | | | | |
Collapse
|
42
|
Nonmotor symptoms in Parkinson's disease in 2012: relevant clinical aspects. PARKINSONS DISEASE 2012; 2012:198316. [PMID: 22888466 PMCID: PMC3410355 DOI: 10.1155/2012/198316] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 04/18/2012] [Indexed: 01/19/2023]
Abstract
Nonmotor symptoms (NMSs) of Parkinson's disease (PD) are common, but they are often underrecognized in clinical practice, because of the lack of spontaneous complaints by the patients, and partly because of the absence of systematic questioning by the consulting physician. However, valid specific instruments for identification and assessment of these symptoms are available in 2012. The administration of the self-completed screening tool, NMSQuest, associated with questioning during the consultation, improves the diagnosis of NMSs. NMSs play a large role in degradation of quality of life. More relevant NMSs are described in this review, mood disorders, impulse control disorders, cognitive deficits, hallucinations, pain, sleep disorders, and dysautonomia.
Collapse
|
43
|
Abstract
Parkinson's disease (PD) is the most common age-related motoric neurodegenerative disease initially described in the 1800's by James Parkinson as the 'Shaking Palsy'. Loss of the neurotransmitter dopamine was recognized as underlying the pathophysiology of the motor dysfunction; subsequently discovery of dopamine replacement therapies brought substantial symptomatic benefit to PD patients. However, these therapies do not fully treat the clinical syndrome nor do they alter the natural history of this disorder motivating clinicians and researchers to further investigate the clinical phenotype, pathophysiology/pathobiology and etiology of this devastating disease. Although the exact cause of sporadic PD remains enigmatic studies of familial and rare toxicant forms of this disorder have laid the foundation for genome wide explorations and environmental studies. The combination of methodical clinical evaluation, systematic pathological studies and detailed genetic analyses have revealed that PD is a multifaceted disorder with a wide-range of clinical symptoms and pathology that include regions outside the dopamine system. One common thread in PD is the presence of intracytoplasmic inclusions that contain the protein, α-synuclein. The presence of toxic aggregated forms of α-synuclein (e.g., amyloid structures) are purported to be a harbinger of subsequent pathology. In fact, PD is both a cerebral amyloid disease and the most common synucleinopathy, that is, diseases that display accumulations of α-synuclein. Here we present our current understanding of PD etiology, pathology, clinical symptoms and therapeutic approaches with an emphasis on misfolded α-synuclein.
Collapse
Affiliation(s)
- Timothy R. Mhyre
- Department of Neuroscience, Georgetown University Medical Center, NRB EP08, 3970 Reservoir Road NW, 20057, Washington, DC, USA,
| | - James T. Boyd
- University of Vermont College of Medicine, 1 South Prospect Street, DU-Arnold 4416-UHC, 05401, Burlington, VT, USA,
| | - Robert W. Hamill
- Department of Neurology, University of Vermont College of Medicine, 89 Beaumont Avenue, Given Hall Room C225, 05405, Burlington, VT, USA,
| | - Kathleen A. Maguire-Zeiss
- Department of Neuroscience, Center for Neural Injury and RecoveryGeorgetown University Medical Center, 3970 Reservoir Road, NW NRB EP08, 20057, Washington, DC, USA,
| |
Collapse
|