Cortical Synaptic Mechanism for Chronic Pain and Anxiety in Parkinson's Disease

The Combined Use of Levodopa/Benserazide and Pramipexole Proves Beneficial for Managing Parkinson's Disease

BACKGROUND

Parkinson's disease (PD), a prevalent neurological condition, is characterized by the progressive degeneration of dopamine-producing neurons, leading to motor dysfunction and non-motor symptoms. Therefore, this study aimed to evaluate the impact of combining levodopa/benserazide with pramipexole on PD patients, focusing on cognitive function, plasma monoamine neurotransmitter levels, and serum growth differentiation factor-15 (GDF-15) and angiopoietin-1 (Ang-1) levels.

METHODS

This retrospective study included 120 PD patients admitted to the hospital between January 2021 and January 2023. Based on the treatment approaches, the patients were categorized into the control group (n = 61) and the observation group (n = 59). The control group received oral levodopa/benserazide tablets, while the observation group was treated with levodopa/benserazide tablets combined with pramipexole. The two experimental groups were assessed and compared across several parameters, including PD symptoms [Unified Parkinson's Disease Rating Scale (UPDRS)], cognitive function [Montreal Cognitive Assessment (MoCA)], the levels of plasma monoamine neurotransmitters, and serum GDF-15 and Ang-1 levels.

RESULTS

The response rate to treatment was more significant in the observation group (96.55%) compared to the control group (87.93%, p = 0.162). Post-treatment, both groups demonstrated a decline in their UPDRS and overall scores, with the observation group indicating substantially lower scores than the control group (p < 0.05). Furthermore, both groups showed improvements in MoCA scores, with the observation group exhibiting higher scores than the control group (p < 0.05). Similarly, we observed significantly increased dopamine, 5-hydroxytryptamine, and norepinephrine levels in both groups, with the observation group showing a more pronounced increase (p < 0.05). Additionally, we observed a significant decrease in serum GDF-15 levels and an increase in Ang-1 levels across both groups after treatment. However, the observation group exhibited lower GDF-15 levels and higher Ang-1 levels than the control group (p < 0.05).

CONCLUSIONS

The combined use of levodopa/benserazide and pramipexole proves beneficial for managing PD. This therapeutic regimen can improve cognitive abilities and plasma monoamine neurotransmitter levels in PD patients, reduce brain tissue damage and decrease serum levels of GDF-15.

Meta-analysis of the association of prosaposin polymorphisms rs4747203 and rs885828 with risk of Parkinson's disease

BACKGROUND

Previous research has established a connection between polymorphisms rs4747203 and rs885828 in the prosaposin (PSAP) gene and an increased risk of Parkinson's disease (PD). However, other studies have found no significant difference in risk compared to the general population.

METHODS

To evaluate the current evidence linking rs4747203 and rs885828 to PD risk, we conducted a comprehensive search of PubMed, the Web of Science, Embase, and the Cochrane Library for relevant studies up until May 2023. In addition, we analyzed data from the publicly available "PD Variant Browser". We performed a meta-analysis using Stata 17.0 to synthesize the findings from the selected studies.

RESULTS

Our meta-analysis, which included data from six published studies and the public database, revealed no significant association between PD risk and either rs4747203 [OR (95% CI) = 0.99 (0.93-1.05), I2 = 90.3%, P = 0.635] or rs885828 [OR (95% CI) = 1.01 (0.95-1.07), I2 = 90.7%, P = 0.773]. These results remained consistent when examining subgroups of individuals within or outside of Asia.

CONCLUSION

The available evidence does not support an association between the genotype at rs4747203 or rs885828 and the risk of PD.

MRI brain structural and functional networks changes in Parkinson disease with REM sleep behavior disorders

Background

Rapid eye movement sleep behavior disorder (RBD) is common in individuals with Parkinson's disease (PD). In spite of that, the precise mechanism underlying the pathophysiology of RBD among PD remains unclear.

Objective

The aim of the present study was to analyze gray matter volumes (GMVs) as well as the changes of functional connectivity (FC) among PD patients with RBD (PD-RBD) by employing a combination of voxel-based morphometry (VBM) and FC methods.

Methods

A total of 65 PD patients and 21 healthy control (HC) subjects were included in this study. VBM analyses were performed on all subjects. Subsequently, regions with significant different GMVs between PD patients with and without RBD (PD-nRBD) were selected for further analysis of FC. Correlations between altered GMVs and FC values with RBD scores were also investigated. Additionally, receiver operating characteristic (ROC) curves were employed for the evaluation of the predictive value of GMVs and FC in identifying RBD in PD.

Results

PD-RBD patients exhibited lower GMVs in the left middle temporal gyrus (MTG) and bilateral cuneus. Furthermore, we observed higher FC between the left MTG and the right postcentral gyrus (PoCG), as well as lower FC between the bilateral cuneus (CUN) and the right middle frontal gyrus (MFG) among PD-RBD patients in contrast with PD-nRBD patients. Moreover, the GMVs of MTG (extending to the right PoCG) was positively correlated with RBD severity [as measured by REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score]. Conversely, the FC value between the bilateral CUN and the right MTG in PD-RBD patients was negatively correlated with RBDSQ score.

Conclusion

This study revealed the presence replace with GMV and FC changes among PD-RBD patients, which were closely linked to the severity of RBD symptoms. Furthermore, the combination of basic clinical characteristics, GMVs and FC values effectively predicted RBD for individuals with PD.

Pain and the Non-Pharmacological Management of Pain in People with Parkinson's Disease

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.