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Ibarra-Gutiérrez MT, Serrano-García N, Alcaraz-Zubeldia M, Pedraza-Chaverri J, Orozco-Ibarra M. An exploratory study on the ability of manganese to supplement rotenone neurotoxicity in rats. Brain Res 2024; 1839:149017. [PMID: 38768935 DOI: 10.1016/j.brainres.2024.149017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/21/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
Parkinson's disease (PD) is a complex disorder, primarily of idiopathic origin, with environmental stressors like rotenone and manganese linked to its development. This study explores their potential interaction and resulting neurotoxicity, aiming to understand how environmental factors contribute to PD. In an eight-day experiment, male Wistar rats weighing 280-300 g were subjected to rotenone, manganese, or a combination of both. Various parameters were assessed, including body weight, behavior, serum markers, tissue damage, protein levels (tyrosine hydroxylase, Dopamine- and cAMP-regulated neuronal phosphoprotein -DARPP-32-, and α-synuclein), and mitochondrial function. Manganese heightened rotenone's impact on reducing food intake without causing kidney or liver dysfunction. However, the combined exposure intensified neurotoxicity, which was evident in augmented broken nuclei and decreased tyrosine hydroxylase and DARPP-32 levels in the striatum. While overall mitochondrial function was preserved, co-administration reduced complex IV activity in the midbrain and liver. In conclusion, our findings revealed a parallel toxic effect induced by rotenone and manganese. Notably, while these substances do not target the same dopaminergic regions, a notable escalation in toxicity is evident in the striatum, the brain region where their toxic effects converge. This study highlights the need for further exploration regarding the interaction of environmental factors and their possible impact on the etiology of PD.
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Affiliation(s)
- María Teresa Ibarra-Gutiérrez
- Laboratorio de Neurobiología Molecular y Celular, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Col. La Fama, Tlalpan, C.P. 14269 Ciudad de México, Mexico
| | - Norma Serrano-García
- Laboratorio de Neurofisiología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Col. La Fama, Tlalpan, C.P. 14269 Ciudad de México, Mexico.
| | - Mireya Alcaraz-Zubeldia
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Col. La Fama, Tlalpan, C.P. 14269 Ciudad de México, Mexico.
| | - José Pedraza-Chaverri
- Laboratorio F-315, Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Av. Universidad No. 3000, Col. Copilco Universidad, Coyoacán, C.P. 04510 Ciudad de México, Mexico.
| | - Marisol Orozco-Ibarra
- Laboratorio de Neurobiología Molecular y Celular, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Col. La Fama, Tlalpan, C.P. 14269 Ciudad de México, Mexico; Departamento de Bioquímica, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Col. Belisario Domínguez - Sección XVI, Tlalpan, C.P. 14080 Ciudad de México, Mexico.
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Shih LC, Lin RJ, Chen YL, Fu SC. Unravelling the mechanisms of underweight in Parkinson's disease by investigating into the role of gut microbiome. NPJ Parkinsons Dis 2024; 10:28. [PMID: 38267447 PMCID: PMC10808448 DOI: 10.1038/s41531-023-00587-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/03/2023] [Indexed: 01/26/2024] Open
Abstract
Approximately half of patients with Parkinson's disease (PD) suffer from unintentional weight loss and are underweight, complicating the clinical course of PD patients. Gut microbiota alteration has been proven to be associated with PD, and recent studies have shown that gut microbiota could lead to muscle wasting, implying a possible role of gut microbiota in underweight PD. In this study, we aimed to (1) investigate the mechanism underlying underweight in PD patients with respect to gut microbiota and (2) estimate the extent to which gut microbiota may mediate PD-related underweight through mediation analysis. The data were adapted from Hill-Burns et al., in which 330 participants (199 PD, 131 controls) were enrolled in the study. Fecal samples were collected from participants for microbiome analysis. 16S rRNA gene sequence data were processed using DADA2. Mediation analysis was performed to quantify the effect of intestinal microbial alteration on the causal effect of PD on underweight and to identify the key bacteria that significantly mediated PD-related underweight. The results showed that the PD group had significantly more underweight patients (body mass index (BMI) < 18.5) after controlling for age and sex. Ten genera and four species were significantly different in relative abundance between the underweight and non-underweight individuals in the PD group. Mediation analysis showed that 42.29% and 37.91% of the effect of PD on underweight was mediated through intestinal microbial alterations at the genus and species levels, respectively. Five genera (Agathobacter, Eisenbergiella, Fusicatenibacter, Roseburia, Ruminococcaceae_UCG_013) showed significant mediation effects. In conclusion, we found that up to 42.29% of underweight PD cases are mediated by gut microbiota, with increased pro-inflammatory bacteria and decreased SCFA-producing bacteria, which indicates that the pro-inflammatory state, disturbance of metabolism, and interference of appetite regulation may be involved in the mechanism of underweight PD.
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Affiliation(s)
| | - Ru-Jen Lin
- National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan, ROC
| | - Yan-Lin Chen
- Institute of Statistics, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan, ROC
| | - Shih-Chen Fu
- Department of Life Science, National Dong Hwa University, Hualien, Taiwan, ROC.
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Gątarek P, Kałużna-Czaplińska J. Integrated metabolomics and proteomics analysis of plasma lipid metabolism in Parkinson's disease. Expert Rev Proteomics 2024; 21:13-25. [PMID: 38346207 DOI: 10.1080/14789450.2024.2315193] [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: 11/19/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Metabolomics and proteomics are two growing fields of science which may shed light on the molecular mechanisms that contribute to neurodegenerative diseases. Studies focusing on these aspects can reveal specific metabolites and proteins that can halt or reverse the progressive neurodegenerative process leading to dopaminergic cell death in the brain. AREAS COVERED In this article, an overview of the current status of metabolomic and proteomic profiling in the neurodegenerative disease such as Parkinson's disease (PD) is presented. We discuss the importance of state-of-the-art metabolomics and proteomics using advanced analytical methodologies and their potential for discovering new biomarkers in PD. We critically review the research to date, highlighting how metabolomics and proteomics can have an important impact on early disease diagnosis, future therapy development and the identification of new biomarkers. Finally, we will discuss interactions between lipids and α-synuclein (SNCA) and also consider the role of SNCA in lipid metabolism. EXPERT OPINION Metabolomic and proteomic studies contribute to understanding the biological basis of PD pathogenesis, identifying potential biomarkers and introducing new therapeutic strategies. The complexity and multifactorial nature of this disease requires a comprehensive approach, which can be achieved by integrating just these two omic studies.
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Affiliation(s)
- Paulina Gątarek
- Institute Of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz University of Technology, Lodz, Poland
| | - Joanna Kałużna-Czaplińska
- Institute Of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Lodz, Poland
- CONEM Poland Chemistry and Nutrition Research Group, Lodz University of Technology, Lodz, Poland
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Prevalence of Malnutrition in Patients with Parkinson's Disease: A Systematic Review. Nutrients 2022; 14:nu14235194. [PMID: 36501224 PMCID: PMC9738273 DOI: 10.3390/nu14235194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This systematic review analyzed the prevalence of malnutrition in patients with Parkinson's Disease. STUDY DESIGN a systematic review. METHOD Four databases-Cochrane, PubMed, Embase and Web of Science-were searched from October 2021 to June 2022 by two independent researchers. The inclusion criteria were as follows: patients above 18 years old with confirmed Parkinson's Disease, performed screening nutritional assessment, cohort studies, case-control studies, and cross-sectional studies. Patients without Parkinson's Disease and with other parkinsonian syndromes were excluded. RESULTS 49 studies were included in this systematic review. Patients ranged in age from 20 to 96 years. There were 5613 subjects included. According to Mini Nutritional Assessment, 23.9% (n = 634) participants were at risk of malnutrition and 11.1% (n = 294) were malnourished. According to BMI score, most patients were either obese or overweight. CONCLUSIONS the prevalence of malnutrition or risk of malnutrition in the study group was significant. Therefore, more specific and detailed studies on the prevalence of malnutrition in patients with Parkinson's Disease are needed.
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Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and affects about 1% of the population over the age of 60 years in industrialised countries. The aim of this review is to examine nutrition in PD across three domains: dietary intake and the development of PD; whole body metabolism in PD and the effects of PD symptoms and treatment on nutritional status. In most cases, PD is believed to be caused by a combination of genetic and environmental factors and although there has been much research in the area, evidence suggests that poor dietary intake is not a risk factor for the development of PD. The evidence about body weight changes in both the prodromal and symptomatic phases of PD is inconclusive and is confounded by many factors. Malnutrition in PD has been documented as has sarcopaenia, although the prevalence of the latter remains uncertain due to a lack of consensus in the definition of sarcopaenia. PD symptoms, including those which are gastrointestinal and non-gastrointestinal, are known to adversely affect nutritional status. Similarly, PD treatments can cause nausea, vomiting and constipation, all of which can adversely affect nutritional status. Given that the prevalence of PD will increase as the population ages, it is important to understand the interplay between PD, comorbidities and nutritional status. Further research may contribute to the development of interventional strategies to improve symptoms, augment care and importantly, enhance the quality of life for patients living with this complex neurodegenerative disease.
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Jiang Z, Ou R, Chen Y, Zhang L, Wei Q, Hou Y, Gu X, Cao B, Liu K, Shang H, Song W. Prevalence and associated factors of malnutrition in patients with Parkinson's disease using CONUT and GNRI. Parkinsonism Relat Disord 2021; 95:115-121. [PMID: 34876346 DOI: 10.1016/j.parkreldis.2021.11.032] [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: 08/23/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) is a common neurodegenerative disease, but its nutritional problems have not received enough attention. This study aims to identify the prevalence and associated factors of malnutrition in PD patients using two simple nutritional tools. METHODS We conducted a large-scale cross-sectional study with 1478 PD patients and equal healthy controls (HC). The controlling nutritional status score (CONUT) and geriatric nutritional risk index (GNRI) were used for malnutrition stratification. RESULTS By CONUT or GNRI, the prevalence of malnutrition in PD patients was higher than that in HC (40.7% vs. 25.3% and 11.1% vs. 2.1%, respectively). The binary logistic regression model showed that malnutrition in PD was associated with male sex (OR = 0.600, P < 0.001), older age (OR = 1.015, P = 0.003), lower body mass index (BMI) (OR = 0.942, P < 0.001), higher levodopa equivalent daily doses (LEDD) (OR = 1.001, P < 0.001), worse motor symptoms (OR = 1.012, P = 0.004), more serious perceptual problems/hallucinations (OR = 1.067, P = 0.019) by CONUT. In comparison, older age (OR = 1.045, P < 0.001), lower blood lymphocyte count (OR = 0.607, P = 0.006), lower serum total cholesterol levels (OR = 0.991, P < 0.001), dyskinesia (OR = 2.231, P = 0.002), worse motor symptoms (OR = 1.016, P = 0.015), more severe depression (OR = 1.028, P = 0.008) and perceptual problems/hallucinations (OR = 1.061, P = 0.033) were associated with malnutrition in PD by GNRI. CONCLUSIONS Our study indicated that malnutrition is more prevalent in PD patients than HC. Multidimensional risk factors for malnutrition in PD should be taken seriously.
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Affiliation(s)
- Zheng Jiang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruwei Ou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yongping Chen
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lingyu Zhang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Wei
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanbing Hou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaojing Gu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bei Cao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kuncheng Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Wei Song
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Rivadeneyra J, Verhagen O, Bartulos M, Mariscal‐Pérez N, Collazo C, Garcia‐Bustillo A, Calvo S, Cubo E. The Impact of Dietary Intake and Physical Activity on Body Composition in Parkinson's Disease. Mov Disord Clin Pract 2021; 8:896-903. [PMID: 34405097 PMCID: PMC8354079 DOI: 10.1002/mdc3.13263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Skeletal muscle loss has been associated with declining physical performance and a negative prognostic effect on falls, disability, and mortality risk in Parkinson's disease. OBJECTIVES We aimed to analyze the clinical correlates associated with skeletal muscle wasting in Parkinson's disease. METHODS This was a cross-sectional, case-control, observational study. We collected information on dietary intake with a 24-hour recall questionnaire, body composition with bioelectrical impedance, motor severity with the Unified Parkinson's disease Rating Scale, and physical activity with the Global Physical Activity Questionnaire. We used multivariate linear regression analysis to analyze the sociodemographic and clinical correlates associated with skeletal muscle loss after adjusting for confounding variables. RESULTS Forty-three patients with Parkinson's disease and 21 matched family members were included. Patients and family members had similar body composition, anthropometrics, and nutritional parameters. Advanced patients had similar nutrient intakes compared to patients with mild-to-moderate Parkinson's disease. In the multivariate linear regression analysis, female patients with low physical activity and low energy intake were more likely to have skeletal muscle loss. CONCLUSIONS Skeletal muscle wasting is a complex multifactorial problem. Dietary strategies and physical exercise should be recommended, especially to females with Parkinson's disease, to prevent significant skeletal muscle wasting.
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Affiliation(s)
| | | | - Monica Bartulos
- Neurology DepartmentHospital Universitario BurgosBurgosSpain
| | | | - Carla Collazo
- Research UnitHospital Universitario BurgosBurgosSpain
| | | | - Sara Calvo
- Research UnitHospital Universitario BurgosBurgosSpain
| | - Esther Cubo
- Neurology DepartmentHospital Universitario BurgosBurgosSpain
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Fu J, Li Z, Wang F, Yu K. Prevalence of malnutrition/malnutrition risk and nutrition-related risk factors among patients with Parkinson's disease: systematic review and meta-analysis. Nutr Neurosci 2021; 25:2228-2238. [PMID: 34238139 DOI: 10.1080/1028415x.2021.1948655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION The clinical symptoms and nutritional status of patients with Parkinson's disease (PwP) are interrelated, and the clinical outcomes in malnourished patients are often poor. Only a few studies have reviewed the prevalence of malnutrition and nutrition-related risk factors in PwP. OBJECTIVE To explore the prevalence of malnutrition/ malnutrition risk among PwP, and estimate nutrition-related risk factors. METHODS PubMed, EMBASE, and Cochrane Library were systematically searched. Literatures published between 1 January 1995 and 1 November 2020, subjects were patients with idiopathic PD underwent Mini Nutritional Assessment (MNA) were included. RESULT Sixteen articles, including 1650 PwP from 13 countries/regions, were included in the meta-analysis. The prevalence of malnutrition and malnutrition risk were 8.8% (Confidence interval [CI] 95%, 5.3%-12.2%) and 35.3% (CI 95%, 29.0%-41.7%), and the prevalence of nutritional disorders was 42.3% (CI 95%, 33.7%-51%). The prevalence of malnutrition in developing countries was higher than that in the developed countries. Meta-analysis reveals there were significant differences in the course of the disease (0.88 years; 95% CI, 0.26-1.50), levodopa equivalent daily dose (LEDD; 60.77 mg/day; 95% CI, 2.7-118.8), Hoehn and Yahr (H&Y) staging (0.323; CI 95%, 0.164-0.482), and unified Parkinson's disease rating scale (UPDRS) scores (total: 13.66, CI 95%: 10.57-16.75 and part III: 5.52, CI 95%: 3.79-7.25) between normal and nutritional disorder groups. CONCLUSIONS Malnutrition/malnutrition risk prevalence in PwP are high. The duration of the disease, LEDD, H&Y staging, and UPDRS score (part III and total) may be nutrition-related risk factors in PwP.
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Affiliation(s)
- Ji Fu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Zhuo Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Peking Union Medical College (PUMC) and Chinese Academy of Medical Sciences (CAMS), Beijing, China
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Abstract
The links between diet and Parkinson's disease (PD) are unclear and incomprehensible. However, numerous studies have demonstrated the correlation between diet, nutrients and health condition in PD patients. They indicate the possibility of management of the disease, which might be possible through nutrition. Pharmaceutical treatment as well as a complementary holistic approach to the patients should be considered. It is of critical importance to understand how the diet and nutrients might influence PD. A better understanding of the relationship between diet and PD could help to better manage the disease explain promising therapeutic approaches, minimize motor and nonmotor symptoms and disease progression based on a personalized diet. In this review, the recent literature on the observed nutrition disorders and the possible role of diet and nutrients in the prevention and potential regression of PD, as well as dietary interventions and supplementation used to manage the disease is revised.
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Affiliation(s)
- Paulina Gątarek
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Lodz, Poland
| | - Joanna Kałużna-Czaplińska
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Lodz, Poland
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The Relationship Between Anxiety Disorders and Parkinson's Disease: Clinical and Therapeutic Issues. Curr Psychiatry Rep 2021; 23:20. [PMID: 33660146 DOI: 10.1007/s11920-021-01229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW This paper seeks to describe anxiety's different symptomatologic presentations in Parkinson's disease (PD), its longitudinal course and predictors, as well as its motor and non-motor correlates. It also reviews the available screening tools and different treatment modalities. RECENT FINDINGS In PD, longitudinal predictors of anxiety are mostly non-motor non-dopaminergic symptoms. The longitudinal course of anxiety is mainly a stable one. The Parkinson Anxiety Scale and the Geriatric Anxiety Scale are the 2 recommended screening tools. A third of PD patients suffer from an anxiety disorder at any time point. It can precede or follow PD motor symptoms. Anxiety is associated with demographic, disease-related motor and non-motor features. There is a lack of studies evaluating psychotropic treatment of anxiety in PD. Adjustment of dopaminergic treatment is indicated when anxiety is associated with motor fluctuations. DBS can be useful as well as CBT and body-mind interventions.
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Association between malnutrition, clinical parameters and health-related quality of life in elderly hospitalized patients with Parkinson's disease: A cross-sectional study. PLoS One 2020; 15:e0232764. [PMID: 32365092 PMCID: PMC7197805 DOI: 10.1371/journal.pone.0232764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/21/2020] [Indexed: 12/22/2022] Open
Abstract
Objective This study aimed to explore the association between malnutrition, clinical parameters, and health-related quality of life in elderly hospitalized patients with Parkinson’s disease (PD). Methods Cross-sectional study of 92 hospitalized elderly patients with PD (mean age 73.6 ± 6.7 years) without dementia. The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. Motor impairment and non-motor symptoms burden (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Non-Motor Symptoms Questionnaire, and Hoehn & Yahr staging), depression (Becks Depression Inventory-II), and health-related quality of life (PD quality of life Questionnaire-39) were assessed. Results Every second patient was malnourished or at risk of malnutrition. In the multivariable analysis, male gender, longer disease duration, higher Hoehn & Yahr and depression were associated with total MNA score. Besides non-motor symptoms and motor impairment, malnutrition was an independent predictor of poor health-related quality of life. In the multivariate analysis, malnutrition had a statistically significant effect on emotional well-being, mobility, social support, stigmatization, and cognition. The strongest association was found between malnutrition and emotional well-being. Conclusion Elderly male persons with longer PD duration and higher disease stages are more likely to be malnourished or at risk for malnutrition. Malnutrition was mainly associated with poor emotional well-being, suggesting that treatment of depression and anxiety beside diet and physical activity can help improving nutrition status in these subjects. The MNA should not be used independent of other measures of cognition and depression in people with advanced PD.
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Pisciotta MS, Fusco D, Grande G, Brandi V, Lo Monaco MR, Laudisio A, Onder G, Bentivoglio AR, Ricciardi D, Bernabei R, Zuccalà G, Vetrano DL. Untangling the relationship between fat distribution, nutritional status and Parkinson's disease severity. Aging Clin Exp Res 2020; 32:77-84. [PMID: 30877644 PMCID: PMC6974508 DOI: 10.1007/s40520-019-01166-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/28/2019] [Indexed: 02/05/2023]
Abstract
Background Parkinson’s disease (PD) is responsible for significant changes in body composition. Aims We aimed to test the association between PD severity and fat distribution patterns, and to investigate the potential modifier effect of nutritional status in this association. Methods We enrolled 195 PD subjects consecutively admitted to a university geriatric day hospital. All participants underwent comprehensive clinical evaluation, including assessment of total and regional body composition (dual-energy X-ray absorptiometry, DXA), body mass index, nutritional status (Mini-Nutritional Assessment, MNA), motor disease severity (UPDRS III), comorbidities, and pharmacotherapy. Results The fully adjusted linear regression model showed a negative association between UPDRS III and total body fat in kg and percentage (respectively, B − 0.79; 95% CI − 1.54 to − 0.05 and B − 0.55; 95% CI − 1.04 to − 0.05), percentage android fat (B − 1.07; 95% CI − 1.75 to − 0.39), trunk–leg fat ratio (B − 0.02; 95% CI − 0.04 to − 0.01), trunk–limb fat ratio (B − 0.01; 95% CI − 0.06 to − 0.01) and android–gynoid fat ratio (B − 0.01; 95% CI − 0.03 to − 0.01). After stratification by MNA score, all the parameters of android-like fat distribution resulted negatively associated (p < 0.001 for all) with UPDRS III, but only among subjects with a MNA < 23.5 (risk of malnutrition or malnutrition). Conclusion We found a negative association between severity of motor impairment and total fat mass in PD, more specific with respect to an android pattern of fat distribution. This association seems to be driven by nutritional status, and is significant only among patients at risk of malnutrition or with overt malnutrition.
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Lim KE, Kim SR, Sung YH, Oh SY, Kim MS, Chung SJ. Factors influencing self-management in Parkinson's disease: A cross-sectional study. Geriatr Nurs 2019; 41:254-260. [PMID: 31784296 DOI: 10.1016/j.gerinurse.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022]
Abstract
This study aimed to identify factors influencing self-management in patients with Parkinson's disease (PD) based on social cognitive theory. A cross-sectional design was used; data were collected at three tertiary medical centers in Korea from a convenience sample of 356 PD patients. Higher self-management scores were associated with higher education level, having a religion, and higher family income. Self-management score was positively correlated with activities of daily living, self-efficacy, and social support, and negatively correlated with non-motor symptoms. Hierarchical regression analysis revealed that demographic factors and non-motor symptoms explained 26.2% of the variance in self-management in PD. The explanatory power increased by 7.5% when self-efficacy was added, and by 6.7% when social support was added. Assessment of self-management in patients with PD should consider self-efficacy and social support, along with demographic factors and non-motor symptoms. Self-management programs that reflect these factors may be useful for improving self-management in PD patients.
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Affiliation(s)
- Kyeung Eun Lim
- College of Nursing, Chonbuk National University, Jeonju, Republic of Korea.
| | - Sung Reul Kim
- College of Nursing, Korea University, Anam-ro 145, Seongbuk-gu, Seoul 02841, Republic of Korea.
| | - Young Hee Sung
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
| | - Sun-Young Oh
- Department of Neurology, Medical School of Chonbuk National University, Jeonju, Republic of Korea.
| | - Mi Sun Kim
- Department of Nursing, Asan Medical Center, Seoul, Republic of Korea.
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Kim SR, Kim JY, Kim HY, Nho JH, Kim YH, Min SY. Factors related to malnutrition in community-dwelling patients with schizophrenia. Perspect Psychiatr Care 2019; 55:415-423. [PMID: 30430589 DOI: 10.1111/ppc.12327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 09/03/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study aims to identify demographic, clinical, and nutritional factors related to malnutrition in community-dwelling patients with schizophrenia. DESIGN AND METHODS We used a descriptive cross-sectional design. Between June and July 2016, 188 community-dwelling patients with schizophrenia were included in this study. FINDINGS Of the 188 participants, 4.3% were classified as malnourished, and 40.4% were at risk of malnutrition. Living status, body weight, and appetite were significant factors related to malnutrition in community-dwelling patients with schizophrenia. PRACTICE IMPLICATION Assessment of nutritional status should be considered along with demographic and nutritional factors in community-dwelling patients with schizophrenia.
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Affiliation(s)
- Sung Reul Kim
- Department of Nursing, Korea University, Seoul, South Korea
| | - Ji Young Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Hye Young Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Ju-Hee Nho
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - Young Hwa Kim
- Department of Nursing, Chonbuk National University, Jeonju, South Korea
| | - So-Young Min
- Department of Nursing, Semyung University, Jecheon, South Korea
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15
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Ma K, Xiong N, Shen Y, Han C, Liu L, Zhang G, Wang L, Guo S, Guo X, Xia Y, Wan F, Huang J, Lin Z, Wang T. Weight Loss and Malnutrition in Patients with Parkinson's Disease: Current Knowledge and Future Prospects. Front Aging Neurosci 2018; 10:1. [PMID: 29403371 PMCID: PMC5780404 DOI: 10.3389/fnagi.2018.00001] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/04/2018] [Indexed: 12/28/2022] Open
Abstract
Parkinson's Disease (PD) is currently considered a systemic neurodegenerative disease manifested with not only motor but also non-motor symptoms. In particular, weight loss and malnutrition, a set of frequently neglected non-motor symptoms, are indeed negatively associated with the life quality of PD patients. Moreover, comorbidity of weight loss and malnutrition may impact disease progression, giving rise to dyskinesia, cognitive decline and orthostatic hypotension, and even resulting in disability and mortality. Nevertheless, the underlying mechanism of weight loss and malnutrition in PD remains obscure and possibly involving multitudinous, exogenous or endogenous, factors. What is more, there still does not exist any weight loss and malnutrition appraision standards and management strategies. Given this, here in this review, we elaborate the weight loss and malnutrition study status in PD and summarize potential determinants and mechanisms as well. In conclusion, we present current knowledge and future prospects of weight loss and malnutrition in the context of PD, aiming to appeal clinicians and researchers to pay a closer attention to this phenomena and enable better management and therapeutic strategies in future clinical practice.
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Affiliation(s)
- Kai Ma
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nian Xiong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Shen
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Han
- Department of Neurology, Anhui Provincial Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Ling Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guoxin Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Luxi Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiyi Guo
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingfang Guo
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Xia
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Wan
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsha Huang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhicheng Lin
- Department of Psychiatry, Harvard Medical School, Division of Basic Neuroscience, and Mailman Neuroscience Research Center, McLean Hospital, Belmont, MA, United States
| | - Tao Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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