Influence of functional movement rehabilitation on quality of life in people with Parkinson's disease

A framework for relating natural movement to length and quality of life in human and non-human animals

Natural movement is clearly related to health, however, it is also highly complex and difficult to measure. Most attempts to measure it focus on functional movements in humans, and while this a valid and popular approach, assays focussed on particular movements cannot capture the range of natural movement that occurs outside them. It is also difficult to use current techniques to compare movement across animal species. Interspecies comparison may be useful for identifying conserved biomechanical and/ or computational principles of movement that could inform human and veterinary medicine, plus several other fields of research. It is therefore important that research develops a system for quantifying movement in freely moving animals in natural environments and relating it to length and quality of life (LQOL). The present text proposes a novel theoretical framework for doing so, based on screening movement ability (MA). MA is calculated from three major variables - Movement Quality, Movement Complexity, and Movement Quantity. These may represent the most important components of movement as it relates to LQOL, and offer insight into how and why differences in the relationship between movement and LQOL occur. A constrained version of the framework is validated in Drosophila, which suggests that MA may indeed represent a useful new paradigm for understanding the relationship between movement and length and quality of life.

Aucubin alleviates glial cell activation and preserves dopaminergic neurons in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonian mice

Aucubin (AUC) is a major bioactive ingredient in Eucommia ulmoides, Plantain asiatica, and Aucuba japonica, and has been shown to exert anti-inflammatory, antioxidative, and neuroprotective effects. We explore the neuroprotective effects of AUC in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonian mice. Mice were administered MPTP (30 mg/kg) daily for 5 days, followed by treatment with AUC for 7 days. Measurement of dopamine levels was performed by high-performance liquid chromatography and tyrosine hydroxylase expression was assessed by western blot. Our results showed that AUC treatment improved mobility in the pole descent test and the traction test, and reduced the loss of dopaminergic neurons in MPTP-induced parkinsonian mice. AUC treatment rescued the decreased dopamine and tyrosine hydroxylase levels in the striatum of parkinsonian mice. Furthermore, AUC treatment reduced both microglia and astrocyte activation in the substantia nigra of parkinsonian mice. These findings suggest that AUC exerts neuroprotective effects, in part by reducing inflammation and preserving dopaminergic neurons. Possible protection mechanisms involved in MPTP-induced parkinsonian mice need to be clarified further.

Subjective Self-Rated Speech Intelligibility and Quality of Life in Patients with Parkinson’s Disease in a Malaysian Sample

Objectives:

This study compared the Quality of Life (QOL) of individuals with Parkinson’s disease (PD) with a healthy control from a sample in Malaysia. The relationship between the QOL, age, gender, duration of disease, self-rated speech scale, and life satisfaction level was examined.

Methods:

Fifty-four individuals with PD and 55 non-PD control adults completed the Parkinson’s Disease Questionnaire-39 (PDQ-39) and rated their speech intelligibility [Self-Rated Speech Scale (SRSS)] and life satisfaction level [Life Satisfaction Scale (LSS)] on a 10-point scale.

Results:

PD participants reported significantly lower QOL scores than the control group (Mann-Whitney U). Although there was no significant relationship between the QOL, age, gender, and duration of disease for PD participants, moderately significant correlations were observed between QOL, LSS and SRSS ratings (Spearman correlation). Individuals with PD showed lower QOL and higher concern in their communication than the control group.

Conclusion:

Identifying patients’ perception of their speech performance could help clinicians to better understand patients’ needs when delivering speech therapy services.

Neuroprotective effects of Astilbin on MPTP-induced Parkinson's disease mice: Glial reaction, α-synuclein expression and oxidative stress

Astilbin (AST), a dihydro-flavonol glycoside, is a major bioactive ingredient in Astilbe thunbergii, Engelhardia roxburghiana, Smilax corbularia and Erythroxylum gonocladum, and has been shown to have anti-inflammatory, antioxidative and neuroprotective effects, suggesting potential therapeutic value in the treatment of Parkinson's disease (PD). We explored the neuroprotective effects of AST in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease mice. Mice were administered with MPTP (30 mg/kg, i.p) daily for 5 days, to establish a subacute Parkinson's disease model, followed by daily treatment with AST or saline for 7 days. Pole and traction tests showed that AST ameliorated the impaired motor functions in MPTP-induced Parkinson's disease mice. High performance liquid chromatography analysis revealed that AST treatment prevented MPTP-induced decreases in striatal dopamine levels. Immunofluorescence assays showed that AST reduced the loss of dopaminergic neurons and the activation of microglia and astrocytes in the substantia nigra. Western blot analyses revealed that AST suppressed α-synuclein overexpression and activated PI3K/Akt in the striatum following MPTP treatment. AST also prevented the MPTP-induced reduction in total superoxide dismutase and glutathione activity in the striatum. AST exerts neuroprotective effects on MPTP-induced PD mice by suppressing gliosis, α-synuclein overexpression and oxidative stress, suggesting that AST could serve as a therapeutic drug to ameliorate PD.

Activities of daily living and manual hand dexterity in persons with idiopathic parkinson disease

[Purpose] The purpose of this study was to evaluate the relationship between daily activities and manual dexterity in persons with Parkinson disease. [Subjects and Methods] The study participants were 25 patients with idiopathic Parkinson disease. This study used two clinical tools, the box-and-block test and Schwab and England Activities of Daily Living scale, to investigate the relationship between manual dexterity and Schwab and England Activities of Daily Living score. [Results] A positive correlation was observed between the Schwab and England Activities of Daily Living and the box-and-block test scores on the more and less affected sides. Moreover, the Schwab and England Activities of Daily Living score had a greater correlation with the box-and-block test score on the less affected side than that on the more affected side. [Conclusion] Manual dexterity and activities of daily living showed a positive correlation in individuals with Parkinson disease. The results of this study suggest that manual dexterity is an important factor for predicting physical performance in daily living in persons with Parkinson disease.

Symptomatic treatment of neurologic symptoms in Wilson disease

Wilson disease (WD) is a potentially treatable neurodegenerative disorder. In the majority of cases, treatment with drugs that induce a negative copper balance (usually chelators or zinc salts) leads to improvements in liver function and neurologic signs. However, some patients show severe neurologic symptoms at diagnosis, such as tremor, dystonia, parkinsonism, and chorea. In this patient group, some neurologic deficits may persist despite adequate treatment, and further neurologic deterioration may be observed after treatment initiation. Such patients may require additional treatment to alleviate neurologic symptoms. Apart from general recommendations for WD anticopper treatment, there are currently no guidelines for managing neurologic symptoms in WD. The aim of this chapter is to summarize possible treatments of neurologic symptoms in WD based on the presently available medical literature.

Protective role of 6-Hydroxy-1-H-Indazole in an MPTP-induced mouse model of Parkinson's disease

This study aimed to explore the neuroprotective role of 6-hydroxy-1H-indazole on dopaminergic neurons in a 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) mouse model of Parkinson's disease (PD). Forty 12-week-old C57BL/6 male mice were were randomized divided into 4 groups. Mice were treated with 2mg/kg and 4mg/kg 6-hydroxy-1H-indazole (i.p.) 1d before the initiation of MPTP administration (30mg/kg), and the 6-hydroxy-1H-indazole were daily injected half an hour before MPTP treatment in the following 5 days. The MPTP group was given normal saline on day 1 (i.p.), followed by 30mg/kg MPTP treatment in the following 5 days. Control group received an equivalent volume of normal saline. Ten days after the final injection of MPTP, the mice were killed. The results showed that MPTP decreased the dopaminergic neurons in the substantia nigra and dopamine in the striatum, downregulated the expression of tyrosine hydroxylase (TH), induced the impairment of behavior and hyperphosphorylation of tau, However, 6-hydroxy-1-H-indazole decreased the loss of dopaminergic neurons, increased dopamine concentration and TH expression, alleviated the behavioral damage and level of phosphor-tau in the MPTP-induced model of PD in C57BL/6 mice. These findings showed that 6-hydroxy-1-H-indazole-mediated neuroprotection was related to the inactivation of tau. In addition, 6-hydroxy-1-H-indazole may be a potential drug candidate for PD.

Bone mass and vitamin D levels in Parkinson's disease: is there any difference between genders?

[Purpose] The aim of this study was to determine the bone mineral density, vitamin D level, and frequencies of osteopenia and osteoporosis in patients with Parkinson's disease and to compare male and female patients with the controls separately. [Subjects and Methods] One hundred fifteen Parkinson's disease patients (47 males, 68 females; age range: 55-85 years) and 117 age- and gender-matched controls (47 males, 70 females) were enrolled in the study. Bone mineral density measured by dual-energy X-ray absorptiometry and serum D vitamin levels of each participant were recorded. [Results] The mean lumbar spine, femur neck, and total femur bone mineral density levels, T-scores, and vitamin D levels were found to be significantly lower in Parkinson's disease patients in both genders. Furthermore, osteoporosis rates were found be significantly higher only in female Parkinson's disease patients compared with female controls. [Conclusion] Data from the present study revealed that while osteoporosis was significantly higher only in female Parkinson's disease patients, all Parkinson's disease patients had lower bone mineral density scores and vitamin D levels compared with the controls regardless of gender, suggesting that clinicians should pay attention to the osteoporosis risk in Parkinson's disease and that adequate preventive measures should be taken in order to limit the future risk due to osteoporotic fractures.

Measures used for the evaluation of balance in individuals with Parkinson's disease: a systematic review

[Purpose] The present literature review was conducted on the use of different measures for the evaluation of balance in patients with Parkinson's disease. [Materials and Methods] The PubMed, Bireme, SciELO, Lilacs, and PEDro electronic databases were searched for relevant studies. [Results] The searches initially led to the retrieval of 3,623 articles, 540 of which were potentially eligible after limiting the search to clinical trials published in the last five years. A total of 264 duplicates were removed, and 276 articles were excluded based on their titles and abstracts. The full texts of 84 articles were analyzed, and only those with a PEDro score higher than four points (n=25) were included in the review. [Conclusion] Different methods, such as scales, tests, and equipment, are used for the evaluation of balance in patients with Parkinson's disease. More than one measure has been employed in most studies, and there is no consensus on a single precise measure for the evaluation of balance in this population.

Quality of life in people with Parkinson's disease: the relevance of social relationships and communication

[Purpose] Maintaining high quality of life is crucial for the rehabilitation of patients with Parkinson’s disease. The quality of life scales currently in use do not assess all quality of life domains or their importance for each individual. Therefore, a new quality of life measure, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, was used to investigate quality of life in people with Parkinson’s disease. [Subjects and Methods] Fifteen people with idiopathic Parkinson’s disaese (average age = 80.0 years, standard deviation = 10.3 years, Hoehn & Yahr stages 1–4) were interviewed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting. Its quality of life constructs were tested by comparing them against disease-specific quality of life (39-items Parkinson’s Disease Questionnaire), motor functioning (Unified Parkinson’s Disease Rating Scale Part III), and activities of daily living (Barthel Index). [Results] Social connections such as “family” and “friends” were revealed as important constructs of life satisfaction. The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting was not significantly correlated with the 39-items Parkinson’s Disease Questionnaire, Unified Parkinson’s Disease Rating Scale Part III, or Barthel Index but was significantly correlated with the “communication” dimension of the 39-items Parkinson’s Disease Questionnaire. [Conclusion] The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting detected various domains of quality of life, especially social relationships with family and friends. “Being heard” was also revealed as an essential component of life satisfaction, as it provides patients with a feeling of acceptance and assurance, possibly resulting in better quality of life.

Recommendations for health-enhancing physical activities in type 2 diabetes patients

[Purpose] Type 2 diabetes mellitus is a disease of civilization with epidemiological coverage. An integral component of a comprehensive process of type 2 diabetes mellitus prevention and treatment is reasonably proportioned exercise. The aim of the study was to evaluate the weekly physical activity of patients with type 2 diabetes mellitus and healthy subjects with respect to recommendations of the American College of Sports Medicine and American Diabetes Association. [Subjects] The study involved 31 patients with type 2 diabetes mellitus (treatment duration 9 ± 0.8) and 31 healthy people. [Methods] Physical activity levels were determined by the International Physical Activity Questionnaire. A χ² test was applied to determine the percentage of people who met recommendations. [Results] Analysis of the obtained results demonstrated that the intensity of physical activity in patients with diabetes was moderate or low. The men in the control group met the recommendations for standard health-related activities significantly more often than the patients with diabetes. In women, there was no such relationship, since most of the women were insufficiently physically active. [Conclusion] The conclusion to be drawn is that there is an urgent need to develop and implement effective programs to enhance physical activity among people at risk of diseases of civilization, including type 2 diabetes.

Impact in oral health and the prevalence of temporomandibular disorder in individuals with Parkinson's disease

The aims of the present study were to investigate the prevalence of temporomandibular disorder (TMD) in a group of patients with Parkinson’s disease (PD), and to analyze oral health according to the severity of the disease. [Methods] Signs and symptoms of TMD were evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders, and oral health impact was measured using the Oral Health Impact Profile. The unpaired Student’s t-test was used to compare groups with and without TMD. Pearson’s correlation coefficients were calculated to determine correlations between the level of functional independence and oral health impact. Fisher’s exact test was used to test the association between TMD and the severity of symptoms of PD. [Results] Fifty-nine individuals with PD were analyzed. The prevalence of TMD was 20.33%. No statistically significant associations were found between TMD and the severity of PD. Oral health impact was considered weak, but a statistically significant difference between groups with and without TMD was found for psychological disability (p = 0.003). No significant correlation was found between the level of functional independence and oral health impact. [Conclusion] The prevalence of TMD among patients with Parkinson’s disease was 20.33%. A statistically significant difference between groups with and without TMD was found regarding the psychological disability domain.