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Tian H, Yuan Y, Zhang K. Application of sensory nerve quantitative tests to analyze the subtypes of motor disorders in Parkinson's disease. Neuroreport 2024; 35:361-365. [PMID: 38526953 PMCID: PMC10965128 DOI: 10.1097/wnr.0000000000002016] [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: 01/11/2024] [Accepted: 01/27/2024] [Indexed: 03/27/2024]
Abstract
This study investigated the sensory nerve function in people with different subtypes of Parkinson's disease (PD), which included the tremor-dominant (TD) group (n = 30), postural instability and gait disorder (PIGD) group (n = 33), and healthy-controls (HC) group (n = 33). Sural nerve's current perception threshold (CPT) and pain tolerance threshold (PTT) in both feet were measured at different frequencies. Results were evaluated using the mini-mental state examination (MMSE), Hoehn Yahr scale (H-Y) , and 3-meter timed-up-and-go-test (TUGT). The MMSE scores of the TD and HC groups were higher than those of the PIGD group (TD < HC). The 3-meter TUGT scores of the PIGD group were higher than theTD and HC groups (TD > HC). The PIGD patients experienced a significantly shorter disease duration and higher H-Y score than the TD patients ( P < 0.05). The values of 2 KHz CPT of left-side (CPTL), 2KHz CPT of right-side (CPTR), and 5 Hz CPTR in the PIGD group were significantly higher compared to the TD and HC groups ( P < 0.05, Bonferroni correction). Additionally, the values of 250 Hz CPTL, 5 Hz CPTL, 250 Hz CPTR, 2 kHz PTT of left-side (PTTL), 250 Hz PTTL, and 5 Hz PTTL in the PIGD group were significantly elevated relative to the TD group ( P < 0.05, Bonferroni correction). Distinctive current threshold perception and PTT of the sural nerve can be observed in patients with varying PD subtypes, and sensory nerve conduction threshold electrical diagnostic testing can detect these discrepancies in sensory nerve function.
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Affiliation(s)
- Hongxue Tian
- Nanjing Medical University, Nanjing
- Department of Neurology, The Affiliated Kezhou People’s Hospital of Nanjing Medical University, Kezhou
| | - Yongsheng Yuan
- Nanjing Medical University, Nanjing
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kezhong Zhang
- Nanjing Medical University, Nanjing
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Allen NE, Romaliiska O, Naisby J. Pain and the Non-Pharmacological Management of Pain in People with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S65-S80. [PMID: 38457146 DOI: 10.3233/jpd-230227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Pain is a distressing and universal experience, yet everyone's pain experience is influenced by a complex array of biological, psychological, and social factors. For people with Parkinson's disease (PwP), these biopsychosocial factors include neurodegeneration and the psychological and social factors that accompany living with a chronic, neurodegenerative condition in addition to the factors experienced by those in the general population (e.g., living with co-morbidities such as osteoarthritis). The way these factors influence each individual is likely to determine which pain management strategies are optimal for them. This review first describes pain and the biopsychosocial model of pain. It explores how pain is classified in Parkinson's disease (PD) and describes the three main types of pain: nociceptive, neuropathic, and nociplastic pain. This background provides context for a discussion of non-pharmacological pain management strategies that may aid in the management of pain in PwP; exercise, psychological strategies, acupuncture and massage. While there is little PD-specific research to inform the non-pharmacological management of pain, findings from current PD research are combined with that from chronic pain research to present recommendations for clinical practice. Recommendations include assessment that incorporates potential biopsychosocial contributors to pain that will then guide a holistic, multi-modal approach to management. As exercise provides overall benefits for PwP, those with chronic pain should be carefully monitored with exercise prescribed and adjusted accordingly. Research is needed to develop and evaluate multi-modal approaches to pain management that are delivered in a biopsychosocial framework.
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Affiliation(s)
- Natalie Elizabeth Allen
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Oksana Romaliiska
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
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Li L, Wang Z, You Z, Huang J. Prevalence and Influencing Factors of Depression in Patients with Parkinson's Disease. ALPHA PSYCHIATRY 2023; 24:234-238. [PMID: 38313445 PMCID: PMC10837606 DOI: 10.5152/alphapsychiatry.2023.231253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/24/2023] [Indexed: 02/06/2024]
Abstract
Objective The aim was to explore the prevalence and influencing factors of depression in patients with Parkinson's disease (PD). Methods This was a cross-sectional study of the clinical data of 179 PD patients for retrospective analysis. Using the self-rating depression scale (SDS) and the Hamilton depression scale-21 (HAMD-21), we evaluated the prevalence of depression and analyzed the factors influencing depression in PD. Results The prevalence of depression in PD patients was 45.25%, and the degree of depression was mainly mild to moderate. Sleep status, daily use of levodopa, a high Hoehn and Yahr stage, a high unified Parkinson's disease rating scale (UPDRS) II score, and a high UPDRS III score were all risk factors for depression in PD patients. Conclusion The prevalence of depression in PD patients is high, and the degree of depression is closely related to many factors, which should receive close attention in clinical work.
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Affiliation(s)
- Ling Li
- Department of Neurology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, Jiangsu, China
| | - Zhengyang Wang
- Department of Neurology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, Jiangsu, China
| | - Zhifei You
- Department of Neurology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, Jiangsu, China
| | - Jing Huang
- Department of Neurology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, Jiangsu, China
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Cao Y, Cao S, Ge RL, Bao H, Mou Y, Ji W. Brain-aging related protein expression and imaging characteristics of mice exposed to chronic hypoxia at high altitude. Front Aging Neurosci 2023; 15:1268230. [PMID: 37849650 PMCID: PMC10577427 DOI: 10.3389/fnagi.2023.1268230] [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: 07/27/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Objective To determine changes in protein expression related to brain aging and imaging features in mice after chronic hypoxia exposure at high altitude. Method A total of 24 healthy 4-week-old mice were randomly divided into high altitude hypoxia (HH) and plain control (PC) groups (n = 8 per group). HH mice were transported from Xi'an (450 m above sea level) to Maduo (4,300 m above sea level) while PC mice were raised in Xi'an. After 6 months, 7.0T magnetic resonance imaging (MRI) was performed. All mice completed T2-weighted imaging (T2WI), diffusion tensor imaging (DTI), resting-state functional MRI (rs-fMRI), arterial spin labeling (ASL), and magnetic resonance angiography (MRA) examinations. Next, brain slices were prepared and Nissl staining was used to observe morphological changes in neurons. Ultrastructural changes in neurons were observed by transmission electron microscopy. Expression changes of Caspase-3, klotho, P16, P21, and P53 at the gene and protein levels were detected by real-time PCR (RT-PCR) and Western blot. Results The number of neuronal Nissl bodies in the hippocampus and frontal cortex was significantly decreased in the HH group compared to the PC group. Some hippocampal and frontal cortical neurons were apoptotic, the nuclei were wrinkled, chromatin was aggregated, and most mitochondria were mildly swollen (crista lysis, fracture). Compared with the PC group, the HH group showed elevated expression of caspase-3 mRNA, P16 mRNA, P21 mRNA, and P53 mRNA in the hippocampus and frontal cortex. Expression of Klotho mRNA in the frontal cortex was also significantly decreased. Western blot results showed that caspase-3 protein expression in the hippocampus and frontal cortex of the HH group was increased compared with the PC group. Moreover, there was decreased Klotho protein expression and significantly increased P-P53 protein expression. Compared with the PC group, expression of P16 protein in the frontal cortex of the HH group was increased and the gray matter (GM) volume in the left visceral area, left caudate nucleus, and left piriform cortex was decreased. Furthermore, the amplitude of low frequency fluctuation was decreased in the left posterior nongranular insular lobe, right small cell reticular nucleus, left flocculus, left accessory flocculus, and left primary auditory area, but increased in the GM layer of the left superior colliculus. Regional homogeneity was decreased in the left and right olfactory regions, but increased in the left bed nucleus. After exposure to high altitude, functional connectivity (FC) between the bilateral caudate nucleus and thalamus, corpus callosum, cingulate gyrus, anterior limbic cortex, globus pallidus, and hippocampus was weakened. FC between the right caudate nucleus and hypothalamus and entorhinal cortex was also weakened. The fractional anisotropy value of the left hippocampus was decreased in the HH group. Compared with the PC group, the HH group showed significantly increased inner diameters of the bilateral common carotid artery and left internal carotid artery. The cerebral blood flow values of the bilateral cortex and bilateral hippocampus in the HH group did not change significantly. Conclusion Taken together, our findings show that chronic hypoxia exposure at high altitude may promote neuronal apoptosis and abnormal expression of related proteins, changing the structure and function of brain. These changes may contribute to brain aging.
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Affiliation(s)
- Yaxin Cao
- Tangdu Hospital of Air Force Military Medical University, Xi’an, China
| | - Shundao Cao
- Department of Neurology, Xi’an No. 1 Hospital, Xi’an, China
| | - Ri-Li Ge
- Research Center for High Altitude Medicine, Qinghai University, Xining, China
| | - Haihua Bao
- Department of Medical Imaging Center, Qinghai University Affiliated Hospital, Xining, China
| | - Yalin Mou
- Department of Medical Imaging Center, Qinghai University Affiliated Hospital, Xining, China
| | - Weizhong Ji
- Qinghai Provincial People’s Hospital, Xining, China
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Gong S, Gao Y, Liu J, Li J, Tang X, Ran Q, Tang R, Liao C. The prevalence and associated factors of dysphagia in Parkinson's disease: A systematic review and meta-analysis. Front Neurol 2022; 13:1000527. [PMID: 36277913 PMCID: PMC9582284 DOI: 10.3389/fneur.2022.1000527] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background The prevalence and associated factors of dysphagia in Parkinson's disease (PD) are different in studies conducted in different countries. The purpose of our systematic review and meta-analysis was to evaluate the prevalence of dysphagia in PD and to clarify its associated factors. Methods Two researchers systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, SinoMed and VIP databases and manually searched references in the retrieved articles to identify potential research subjects. The last search was conducted on June 28, 2022. Finally, a total of 58 studies including 60 observations with 20,530 PD patients were included in our meta-analysis. Results The meta-analysis estimated that the pooled prevalence rate of dysphagia in PD was 36.9% (95% CI: 30.7–43.6%) and instrumental examination showed a higher prevalence (57.3%, 95% CI: 44.3–69.1%). Oceania showed the highest prevalence of dysphagia in PD (56.3%) compared to Africa (39.5%), Asia (38.6%), Europe (36.1%) and America (28.9%). Dysphagia in PD was associated with older age, lower body mass index, longer disease duration, higher Hoehn and Yahr stage and levodopa equivalent daily dose, PIGD subtype, severe motor symptoms, drooling and higher levels of depression, and lower quality of life. Conclusions In conclusion, our meta-analysis showed that dysphagia occurs in more than one-third of PD patients and was associated with several demographic characteristics and PD-related characteristics, motor symptoms, non-motor symptoms, as well as decreased quality of life. It deserves early screening, diagnosis, and treatment in clinical practice to prevent serious complications from dysphagia.
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Affiliation(s)
- Siyuan Gong
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Gao
- Nursing Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jihong Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueqin Tang
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Ran
- Endocrinology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rongzhu Tang
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chunlian Liao
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Chunlian Liao
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Davies TC. The position of geochemical variables as causal co-factors of diseases of unknown aetiology. SN APPLIED SCIENCES 2022; 4:236. [PMID: 35909942 PMCID: PMC9326422 DOI: 10.1007/s42452-022-05113-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract The term diseases of unknown aetiology (DUA) or idiopathic diseases is used to describe diseases that are of uncertain or unknown cause or origin. Among plausible geoenvironmental co-factors in causation of DUA, this article focusses on the entry of trace elements, including metals and metalloids into humans, and their involvement in humoral and cellular immune responses, representing potentially toxic agents with implications as co-factors for certain DUA. Several trace elements/metals/metalloids (micronutrients) play vital roles as co-factors for essential enzymes and antioxidant molecules, thus, conferring protection against disease. However, inborn errors of trace element/metal/metalloid metabolisms can occur to produce toxicity, such as when there are basic defects in the element transport mechanism. Ultimately, it is the amount of trace element, metal or metalloid that is taken up, its mode of accumulation in human tissues, and related geomedical attributes such as the chemical form and bioavailability that decisively determine whether the exerted effects are toxic or beneficial. Several case descriptions of DUA that are common worldwide are given to illustrate our knowledge so far of how trace element/metal/metalloid interactions in the immune system may engender its dysregulation and be implicated as causal co-factors of DUA. Article highlights The importance of a proper understanding of geochemical perturbations in human metabolisms is emphasisedIt is proferred that such an understanding would aid greatly in the decipherment of diseases of unknown aetiology (DUA)The thesis presented may pave the way towards better diagnosis and therapy of DUA.
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Affiliation(s)
- Theophilus C. Davies
- Present Address: Faculty of Natural Sciences, Mangosuthu University of Technology, 511 Mangosuthu Highway, 4031, KwaZulu Natal, South Africa
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Janssen-Aguilar R, Rojas P, Ruiz-Sánchez E, Rodriguez-Violante M, Alcántara-Flores YM, Crail-Meléndez D, Cervantes-Arriaga A, Sánchez-Escandón Ó, Ruiz-Chow ÁA. Naturalistic Study of Depression Associated with Parkinson's Disease in a National Public Neurological Referral Center in Mexico. Brain Sci 2022; 12:326. [PMID: 35326281 PMCID: PMC8945969 DOI: 10.3390/brainsci12030326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023] Open
Abstract
Major depressive disorder (MDD) is a major health problem in Parkinson's disease (PD) patients. We described the clinical and sociodemographic factors of MDD among patients with PD at a national neurological referral center in Mexico. One hundred patients with PD + MDD were included in the study. All the patients were evaluated during the "ON" treatment phase of PD. Clinical scales for cognition (MMSE and MoCA) and MDD (MADRS) were applied. The mean age was 58.49 ± 11.02 years, and 57% of the sample was male. The most frequent symptom of PD was tremor (67%), and onset was more frequent on the right side (57%). Additionally, 49% of the patients with PD had moderate to severe (M/S) MDD. Selective serotonin reuptake inhibitors were the most frequent antidepressant treatment (69%). The scores of the scales were MADRS 21.33 ± 5.49, MoCA 21.06 ± 4.65, and MMSE 26.67 ± 1.20. The females had lower MMSE scores compared to the males (p = 0.043). The patients with M/S MDD had more rigidity at the beginning of PD (p = 0.005), fewer march alterations (p = 0.023), and a greater prevalence of left-side initial disease (p = 0.037). Rigidity was associated with M/S MDD (OR 3.75 p = 0.013). MDD was slightly more frequent in the males than in the females. The MDD symptoms and cognitive impairment were worse in the female population.
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Affiliation(s)
- Reinhard Janssen-Aguilar
- Department of Psychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (R.J.-A.); (D.C.-M.)
| | - Patricia Rojas
- Laboratory of Neurotoxicology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (P.R.); (E.R.-S.); (Y.M.A.-F.)
| | - Elizabeth Ruiz-Sánchez
- Laboratory of Neurotoxicology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (P.R.); (E.R.-S.); (Y.M.A.-F.)
| | - Mayela Rodriguez-Violante
- Movement Disorders Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (M.R.-V.); (A.C.-A.)
| | - Yessica M. Alcántara-Flores
- Laboratory of Neurotoxicology, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (P.R.); (E.R.-S.); (Y.M.A.-F.)
| | - Daniel Crail-Meléndez
- Department of Psychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (R.J.-A.); (D.C.-M.)
| | - Amin Cervantes-Arriaga
- Movement Disorders Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (M.R.-V.); (A.C.-A.)
| | - Óscar Sánchez-Escandón
- Clinic of Sleep Disorders, Metropolitan Autonomous University, Mexico City 14387, Mexico;
| | - Ángel A. Ruiz-Chow
- Department of Psychiatry, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Av. Insurgentes Sur No. 3877, Mexico City 14269, Mexico; (R.J.-A.); (D.C.-M.)
- Liaison Psychiatry, Medical Center ABC, Av. Carlos Graef Fernández 154, Mexico City 05300, Mexico
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