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Sujith P, Arjunan P, Iype T, Natarajan V. Correlation Between Depression and Quality of Life Among Patients With Parkinson's Disease: An Analytical Cross-Sectional Study. Cureus 2024; 16:e54736. [PMID: 38523931 PMCID: PMC10960943 DOI: 10.7759/cureus.54736] [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] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Parkinson's disease (PD) is a progressive complex degenerative disorder characterised by several motor and non-motor symptoms that result in disability and deterioration of the patient's quality of life (QOL). Depression is the most common non-motor symptom that may severely alter the QOL. The objective of this study was to examine the correlation between depression and QOL among patients with PD who received treatment from a movement disorder clinic of a tertiary care teaching hospital in South India. Methods This was an analytical cross-sectional study conducted among 220 PD patients who received treatment from a movement disorder clinic of a tertiary care teaching hospital in South India. The participants aged between 40 and 80 years, who can comprehend Malayalam or English and were clinically diagnosed with PD according to United Kingdom PD Society Brain Bank criteria were included in the study. Depression was assessed using the Hospital Anxiety and Depression Scale, motor function using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III, and the quality of life was assessed using the Parkinson's Disease Questionnaire 39. Results The results of this study showed that there was a significant positive correlation between depression and QOL (r=0.699, p<0.01) among patients with PD who received treatment from a tertiary care teaching hospital. The correlation with domains of QOL also identified that depression was significantly correlated with all domains of QOL and more to the emotional domain of QOL (r=0.799, p<0.01). Conclusion Depression is the most common neuropsychiatric condition in PD and the most important determinant of QOL. Depression may occur at any stage of PD and can significantly impact the QOL of patients and their caregivers. Hence it should be recognized early and managed by pharmacological and nonpharmacological measures to improve the QOL.
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Affiliation(s)
- Priya Sujith
- Nursing, Government College of Nursing, Thiruvananthapuram, IND
- Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Porkodi Arjunan
- Medical Surgical Nursing, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Thomas Iype
- Neurology, Medical College Thiruvananthapuram, Thiruvananthapuram, IND
| | - Venkatesh Natarajan
- Physiotherapy, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
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Grall-Bronnec M, Verholleman A, Victorri-Vigneau C, Leboucher J, Thiabaud E, Hardouin JB, Schreck B, Rouaud T, Roy M, Derkinderen P, Challet-Bouju G. Parkinson's Disease, Impulsive-Compulsive Behaviors, and Health-Related Quality of Life. J Mov Disord 2024; 17:82-88. [PMID: 37926510 PMCID: PMC10846971 DOI: 10.14802/jmd.23042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/30/2023] [Accepted: 11/03/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE A large body of literature has examined the links between the use of dopamine replacement therapy (DRT) in Parkinson's disease (PD) and the development of "impulsive-compulsive behaviors (ICBs)." Little is known regarding the link between the development of ICBs and health-related quality of life (HRQOL). We aimed to explore the factors that are associated with poorer HRQOL, especially in relation to DRT-induced ICBs, in a sample of PD patients. METHODS This PARKADD (PARK: PARKinson's disease; ADD: behavioral ADDictions) study was a prospective case‒control study initially designed to assess the factors associated with ICBs in PD patients. A prospective clinical follow-up was added, aiming to capture the long-term evolution of HRQOL in relation to ICBs occurring or worsening after the beginning of PD. We focused on sociodemographic and PD characteristics and the history or presence of ICBs. HRQOL was measured using the Parkinson's Disease Questionnaire-8. A multivariate linear regression was performed to identify factors related to poorer HRQOL. RESULTS A total of 169 patients were eligible for the follow-up study. The presence of an ICB, a higher levodopa equivalent daily dose (LEDD) and a longer PD duration were significantly associated with poorer HRQOL, with an interaction between LEDD and PD duration. CONCLUSION The presence of an ICB was related to poorer HRQOL and should be considered a crucial factor for the management of PD patients. Several studies were recently published that provide guidelines for the management of these patients, with recommendations based on two key principles: prevention and specific treatment.
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Affiliation(s)
- Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients Centered Outcomes And HEalth ResEarch, SPHERE, Nantes, France
| | - Audrey Verholleman
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Caroline Victorri-Vigneau
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients Centered Outcomes And HEalth ResEarch, SPHERE, Nantes, France
- Nantes Université, CHU Nantes, Department of Pharmacology, Nantes, France
| | - Juliette Leboucher
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Elsa Thiabaud
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
| | - Jean-Benoit Hardouin
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients Centered Outcomes And HEalth ResEarch, SPHERE, Nantes, France
- Nantes Université, CHU Nantes, Biostatistics and Methodology Unit, Department of Clinical Research and Innovation, Nantes, France
| | - Benoit Schreck
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients Centered Outcomes And HEalth ResEarch, SPHERE, Nantes, France
| | - Tiphaine Rouaud
- Nantes Université, CHU Nantes, Department of Neurology, Nantes, France
| | - Monica Roy
- Nantes Université, CHU Nantes, Department of Neurology, Nantes, France
| | - Pascal Derkinderen
- Nantes Université, CHU Nantes, Department of Neurology, Nantes, France
- Nantes Université, CHU Nantes, INSERM, Nantes, France
| | - Gaëlle Challet-Bouju
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients Centered Outcomes And HEalth ResEarch, SPHERE, Nantes, France
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3
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Pytel A, Beszlej JA, Biercewicz M, Roszmann A, Krówczyńska D, Kołtuniuk A. The Effect of Frailty Syndrome on the Quality of Life of Individuals with Parkinson's Disease: A Pilot Observational and Multicenter Study on the Polish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15226. [PMID: 36429942 PMCID: PMC9690024 DOI: 10.3390/ijerph192215226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder involving decreased dopamine release and atrophy of dopaminergic neurons of the substantia nigra. Frailty syndrome (FS) is common in older adults, which, in combination with PD symptoms, can substantially affect the quality of life (QOL). This study aimed to assess the prevalence of FS among PD patients and to identify variables affecting their QOL with particular attention to FS. The study included 296 patients (n = 173 women) with a mean age of 70.3 ± 5.7 years suffering from PD for an average of 8.2 ± 5.6 years. Patients were classified as at least stage II according to the Hoehn and Yahr scale. The following standardized questionnaires were used in the study: Schwab and England Activities of Daily Living (SE-ADL), Parkinson's Disease Questionnaire (PDQ-39), Beck Depression Inventory (BDI), Unified Parkinson's Disease Rating Scale (UPDRS), and Tilburg Frailty Indicator (TFI). FS was found in 96% (n = 283) of the PD patients studied. No depression occurred in 30% (n = 89) of subjects, moderate depression in 48% (n = 141) of subjects, and severe depression in 22% (n = 66) of subjects. The mean score of the PDQ-39 questionnaire in PD subjects with FS was 41.6 pts (min-max: 5.2-81.5 pts; SD = 17.4 pts), which was statistically significantly higher than in subjects without FS (p < 0.05). FS has been shown to be present in most of the subjects with PD. FS occurs more frequently with a longer PD period, which is associated with reduced physical capacity and QOL. Physical activity improves QOL and reduces disease progression. FS, similar to PD, is a common cause of disability in older adults and their dependency. Predictors such as depression, advanced stage of the disease, higher education, and low professional and economic status significantly affect the QOL level of PD patients. However, the results obtained among the Polish population of PD patients do not confirm the impact of FS on the QOL, so there is a need to conduct further research on this subject.
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Affiliation(s)
- Aleksandra Pytel
- Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | | | - Monika Biercewicz
- Clinic of Geriatrics, Faculty of Health Science, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 85-094 Toruń, Poland
| | - Anna Roszmann
- Division of Neurological and Psychiatric Nursing, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Dorota Krówczyńska
- Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland
- Department of Nursing and Obstetrics, Collegium Mazovia, 08-110 Siedlce, Poland
| | - Aleksandra Kołtuniuk
- Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
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Shen J, Amari N, Zack R, Skrinak RT, Unger TL, Posavi M, Tropea TF, Xie SX, Van Deerlin VM, Dewey RB, Weintraub D, Trojanowski JQ, Chen-Plotkin AS. Plasma MIA, CRP, and Albumin Predict Cognitive Decline in Parkinson's Disease. Ann Neurol 2022; 92:255-269. [PMID: 35593028 PMCID: PMC9329215 DOI: 10.1002/ana.26410] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Using a multi-cohort, discovery-replication-validation design, we sought new plasma biomarkers that predict which individuals with Parkinson's disease (PD) will experience cognitive decline. METHODS In 108 discovery cohort PD individuals and 83 replication cohort PD individuals, we measured 940 plasma proteins on an aptamer-based platform. Using proteins associated with subsequent cognitive decline in both cohorts, we trained a logistic regression model to predict which patients with PD showed fast (> = 1 point drop/year on Montreal Cognitive Assessment [MoCA]) versus slow (< 1 point drop/year on MoCA) cognitive decline in the discovery cohort, testing it in the replication cohort. We developed alternate assays for the top 3 proteins and confirmed their ability to predict cognitive decline - defined by change in MoCA or development of incident mild cognitive impairment (MCI) or dementia - in a validation cohort of 118 individuals with PD. We investigated the top plasma biomarker for causal influence by Mendelian randomization (MR). RESULTS A model with only 3 proteins (melanoma inhibitory activity protein [MIA], C-reactive protein [CRP], and albumin) separated fast versus slow cognitive decline subgroups with an area under the curve (AUC) of 0.80 in the validation cohort. The individuals with PD in the validation cohort in the top quartile of risk for cognitive decline based on this model were 4.4 times more likely to develop incident MCI or dementia than those in the lowest quartile. Genotypes at MIA single nucleotide polymorphism (SNP) rs2233154 associated with MIA levels and cognitive decline, providing evidence for MIA's causal influence. CONCLUSIONS An easily obtained plasma-based predictor identifies individuals with PD at risk for cognitive decline. MIA may participate causally in development of cognitive decline. ANN NEUROL 2022.
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Affiliation(s)
- Junchao Shen
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Noor Amari
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rebecca Zack
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - R Tyler Skrinak
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Travis L Unger
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Marijan Posavi
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas F Tropea
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sharon X Xie
- Departments of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Vivianna M Van Deerlin
- Departments of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Richard B Dewey
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Daniel Weintraub
- Departments of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA
| | - John Q Trojanowski
- Departments of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alice S Chen-Plotkin
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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5
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Bock MA, Brown EG, Zhang L, Tanner C. Association of Motor and Nonmotor Symptoms With Health-Related Quality of Life in a Large Online Cohort of People With Parkinson Disease. Neurology 2022; 98:e2194-e2203. [PMID: 35418456 PMCID: PMC9162165 DOI: 10.1212/wnl.0000000000200113] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives There is growing interest in health-related quality of life (HRQOL) as a comprehensive view of the patient's well-being, guiding concept for the treating clinician, and therapeutic trial outcome measure for patients with Parkinson disease (PwPD). The key determinants of HRQOL have not been investigated in large populations of PwPD. Our objective was to evaluate correlates of HRQOL in a large, online cohort of PwPD. Methods As part of an ongoing online cohort study, we performed a cross-sectional analysis at enrollment of 23,058 PwPD. We conducted univariate and stepwise multivariate linear regression analyses of HRQOL as measured by the EQ-5D-5L tool. In addition, we performed an interaction analysis to evaluate heterogeneity of the effect of motor symptoms on HRQOL and Spearman correlation analysis to evaluate the association of nonmotor symptoms with HRQOL. Results In the multivariate linear regression model, participants with moderate or severe depression, more severe motor symptoms, and a higher burden of medical comorbidities had the most substantially decreased HRQOL as measured by the EQ index (β −0.11, −0.18, −0.02, −0.01, respectively; p < 0.001 for all). An interaction analysis showed that more severe motor symptoms had a higher effect on individuals with female sex, lower educational level, lower income, more severe depression, or more severe cognitive impairment (p ≤ 0.01 for interaction terms). Neuropsychiatric symptoms and falls had the most negative associations with HRQOL (ρ −0.31 to 0.37; p < 0.0001). Discussion Potentially treatable motor and nonmotor symptoms, particularly neuropsychiatric symptoms, account for a large amount of the variation in HRQOL in PwPD. Motor symptoms may have differential effects on HRQOL in different demographic and clinical subpopulations, highlighting important areas for future health disparities research. Our findings provide targets for clinician intervention and future research on symptom management to optimize HRQOL in PD. Classification of Evidence This study provides Class II evidence that motor and neuropsychiatric symptoms are associated with HRQOL in PwPD.
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Affiliation(s)
- Meredith A Bock
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco .,Mental Illness Research, Education, and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco
| | - Ethan G Brown
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco
| | - Li Zhang
- Department of Medicine, University of California, San Francisco.,Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Caroline Tanner
- Movement Disorders and Neuromodulation Center, Department of Neurology, Weill Institute for Neuroscience, University of California, San Francisco.,Parkinson's Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Health Care System, San Francisco
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6
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Hattori N, Takeda A, Hanya Y, Kitagawa T, Arai M, Furusawa Y, Mochizuki H, Nagai M, Takahashi R. Effects of rasagiline on Parkinson’s Disease Questionnaire (PDQ-39) emotional well-being domain in patients with Parkinson’s disease: A post-hoc analysis of clinical trials in Japan. PLoS One 2022; 17:e0262796. [PMID: 35077474 PMCID: PMC8789184 DOI: 10.1371/journal.pone.0262796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Identifying the factors that influence health-related quality of life (HRQoL) is of great scientific interest, but a potential causal relationship between treatment and HRQoL has yet to be fully elucidated. Japanese patients reported better HRQoL outcomes on the Parkinson’s Disease Questionnaire (PDQ-39) emotional well-being domain, a 6-question subset of the PDQ-39 which is considered to reflect the emotional aspects of the disease-specific HRQoL, when treated with rasagiline, than placebo, in both a monotherapy clinical trial (NCT02337725) and an adjunctive therapy clinical trial in patients with wearing-off phenomena (NCT02337738).
Objective
To investigate how rasagiline exerts its effect on the PDQ-39 emotional well-being domain in Japanese patients with Parkinson’s disease.
Methods
A path analysis was performed to assess the direct treatment effects of rasagiline on the PDQ-39 emotional well-being domain and the effects mediated indirectly through the influence on items related to motor symptoms by a post-hoc analysis of two clinical trials in Japan.
Results
In the monotherapy trial, the PDQ-39 emotional well-being domain was mainly affected indirectly through items related to motor symptoms (80.7%) composed of the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part II (67.2%) and Part III (13.5%). In the adjunctive therapy trial, the PDQ-39 emotional well-being domain was also mainly influenced indirectly through effects on items related to motor symptoms (1 mg/day: 54.7%, 0.5 mg/day: 57.6%) composed of MDS-UPDRS Part II (1 mg/day: 35.6%, 0.5 mg/day: 40.9%), Part III (1 mg/day: 8.0%, 0.5 mg/day: 8.3%) and mean daily OFF-time (1 mg/day: 11.1%, 0.5 mg/day: 8.4%).
Conclusions
The effects of rasagiline on the PDQ-39 emotional well-being domain were mediated primarily by influence on the subjective aspects of motor experiences of daily living.
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Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
- * E-mail:
| | - Atsushi Takeda
- Department of Neurology, National Hospital Organization Sendai Nishitaga Hospital, Miyagi, Japan
- Department of Cognitive & Motor Aging, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Yuki Hanya
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Tadayuki Kitagawa
- Japan Development Center, Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Masaki Arai
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Yoshihiko Furusawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Nagai
- Clinical Research Support Center, Ehime University Hospital, Ehime, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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7
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Chiu SF, Wu YR, Tsay PK, Chiu YC. The Mediating Effect of Spiritual Well-Being and Quality of Life for Persons with Parkinson's Disease in Northern Taiwan. JOURNAL OF PARKINSON'S DISEASE 2022; 12:173-184. [PMID: 34690150 DOI: 10.3233/jpd-212764] [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: 06/13/2023]
Abstract
BACKGROUND Parkinson's disease (PD), a degenerative disease with irreversible motor dysfunction, impacts patients' quality of life (QoL). Spirituality can provide a sense of hope and meaning when individuals are faced with adverse life events, such as a diagnosis of PD. However, few studies have examined the relationship between spiritual well-being and QoL for persons with PD. OBJECTIVE To explore the relationships between the disease characteristics, spirituality and QoL for persons with PD, and verify the mediating effects of spirituality on the relationship. METHODS This cross-sectional study recruited patients with PD (n = 110) by convenience sampling from a neurological clinic in northern Taiwan. Variables were measured using the Spirituality Index of Well-Being Chinese version (SIWB-C) and the 39-item Parkinson's disease Quality of Life Questionnaire Chinese version (PDQ-39-C) self-report questionnaires. Descriptive analysis and linear hierarchical regression were conducted to examine the studied variables and explore the mediating effect of spiritual wellbeing. RESULTS Those whose scores were significantly better in PDQ-39 were younger, employed, with shorter disease duration and less severe condition with better functioning on their early stages and lower LEDD; additionally, those who had better quality of life also experienced better spiritual wellbeing than the counterparts. The regression model demonstrated spiritual self-efficacy had mediating effects between disease characteristics and QoL, explaining 69.8%of the variance (adjusted R2 = 65.3%). CONCLUSION The results can be the references for future strategies and interventions, focusing on increasing spiritual self-efficacy and reducing the impact of disease severity to improve QoL for persons with PD.
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Affiliation(s)
- Shu-Fen Chiu
- Department of Neurosurgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang-Gung Memorial Hospital, Linkou Medical Center, and Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Pei-Kwei Tsay
- Department of Public Health and Parasitology, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chen Chiu
- Graduate Institute of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Dementia Center, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan, Taiwan
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8
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Kanegusuku H, Ritti-Dias RM, Barbosa PYI, das Neves Guelfi ET, Okamoto E, Miranda CS, de Paula Oliveira T, Piemonte MEP. Influence of motor impairment on exercise capacity and quality of life in patients with Parkinson disease. J Exerc Rehabil 2021; 17:241-246. [PMID: 34527635 PMCID: PMC8413915 DOI: 10.12965/jer.2142290.145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/18/2021] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the impact of motor impairment (MI) on exercise capacity and quality of life in patients with Parkinson disease (PD). One hundred ninety-two patients (≥50 years old) were divided according to the Hoehn and Yahr stages in: mild (stage I), mild to moderate (stage II), moderate (stage III), and advanced MI (stage IV). Exercise capacity (6-min walk test [6MWT]) and quality of life (Parkinson's Disease Questionnaire [PDQ-39]) were obtained. In this context, 6MWT was progressively worse with increasing the severity of MI (P<0.01). Patients with advanced MI achieved 39% of predicted 6MWT of healthy subject, while subjects with mild MI achieved 83% of healthy subject (P<0.01). In addition, patients with advanced MI presented higher (i.e., worse) PDQ-39 scores in summary index, cognition, mobility and activities of daily live domains compared to other groups (P<0.01). Patients with moderate MI also presented worse scores in PDQ-39 summary index, mobility and activities of daily live domains in comparison with mild MI patients (P<0.01). Higher MI was correlated with worse exercise capacity (6MWT: r=-0.46, P<0.01), with worse PDQ-39 summary index and the mobility and activities of daily live domains scores (r=0.38, r=0.46, and r=0.43, P<0.01). In conclusion, MI is related to lower exercise capacity and quality of life (i.e., PDQ-39 summary index and mobility and activities of daily live domains) in patients with PD.
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Affiliation(s)
| | - Raphael M Ritti-Dias
- Graduated Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil
| | - Pâmela Yuki Igarasi Barbosa
- Faculty of Medical Science, University of São Paulo, São Paulo, Brazil.,Brazil Parkinson Association, São Paulo, Brazil
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9
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Koutsouras GW, Levine K, Duroseau N, Ciraco C, Chan V, Pergament K, Chan T, Mancini JD, Leder AN, Krishnamachari B. Effects of depression and exercise on health-related quality of life in patients with Parkinson's disease. Chronic Illn 2020; 16:190-200. [PMID: 30185064 DOI: 10.1177/1742395318796166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES There is limited literature describing the effect exercise may have on depression and an individual's health-related quality of life (HRQoL) in Parkinson's Disease (PD). We aim to quantify this effect. METHODS A cross-sectional questionnaire was administered to 60 PD subjects. The Parkinson's Disease Questionnaire-39 (PDQ-39) summary index and the Geriatric Depression Scale-30 were used to quantify HRQoL and depression, respectively. Data were obtained on exercise habits. ANOVA and multivariate linear regression analysis were used to calculate mean differences in HRQoL. RESULTS Depression was consistently related to HRQoL (p < 0.05). Of those who exercised as an adult before PD diagnosis, 49.02% (n = 25) reported depression as compared to 88.89% (n = 8) of those who did not report adult exercise (p = 0.03). Those who exercised frequently as an adult prior to PD diagnosis had a better PDQ-39 Cognitive Index (p = 0.03). Those who were not depressed and were currently exercising had a significantly higher HRQoL than those who were depressed and did not exercise (p < 0.01). DISCUSSION Exercising and depression may interact to affect HRQoL. Thus, coordination of mental health evaluation and exercise regimens in persons with PD may improve HRQoL.
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Affiliation(s)
- George W Koutsouras
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kimberly Levine
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Nathalie Duroseau
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Christina Ciraco
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Vivian Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Kathleen Pergament
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Thomas Chan
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Jayme D Mancini
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Adena N Leder
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
| | - Bhuma Krishnamachari
- Department of Clinical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA
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"Does the Response to Morning Medication Predict the ADL-Level of the Day in Parkinson's Disease?". PARKINSONS DISEASE 2020; 2020:7140984. [PMID: 32802307 PMCID: PMC7403929 DOI: 10.1155/2020/7140984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/24/2020] [Accepted: 06/25/2020] [Indexed: 01/01/2023]
Abstract
Background Individuals with Parkinson's Disease (PD) have bradykinesia during mobility tasks in the morning before intake of dopaminergic treatment and have difficulties managing Activities of Daily Living (ADLs). Early morning off (EMO) refers to off-states in the morning where the severity of bradykinesia is increased and causes a decrease in mobility related to wearing off of effects of medication. Measurements from devices capable of continuously recording motor symptoms may provide insight into the patient's response to medication and possible impact on ADLs. Objectives To test whether poor or slow response to medication in the morning predicts the overall ADL-level and to assess the association between change in bradykinesia score (BKS) and the risk of having disabilities within three selected ADL-items. Methods In this cross-sectional study, the sample consists of 34 patients with light to moderate PD. Data collection encompasses measurements from the Parkinson KinetiGraph, and the ADL-limitations are assessed by the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part II. Results The association between UPDRS- II and BKS from the algorithm was -0.082 (p < 0.01), 95% CL:-0.113; -0.042). The individuals experienced disabilities in performing "Speech" (p=0.004) and "Doing hobbies" (p=0.038) when being slow or poor responders to dopaminergic therapy. The PD patients' L-dopa equivalent dose seems to be a strong predictor of the ADL-level in the morning. Conclusion Slow response to the medication dosages in the morning is correlated with disabilities in the overall ADL-level in PD. The combination of PD-drugs and precise, timely dosages must be considered in the improvement of the ADL-level in PD patients.
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Morgan C, Rolinski M, McNaney R, Jones B, Rochester L, Maetzler W, Craddock I, Whone AL. Systematic Review Looking at the Use of Technology to Measure Free-Living Symptom and Activity Outcomes in Parkinson's Disease in the Home or a Home-like Environment. JOURNAL OF PARKINSON'S DISEASE 2020; 10:429-454. [PMID: 32250314 PMCID: PMC7242826 DOI: 10.3233/jpd-191781] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/31/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The emergence of new technologies measuring outcomes in Parkinson's disease (PD) to complement the existing clinical rating scales has introduced the possibility of measurement occurring in patients' own homes whilst they freely live and carry out normal day-to-day activities. OBJECTIVE This systematic review seeks to provide an overview of what technology is being used to test which outcomes in PD from free-living participant activity in the setting of the home environment. Additionally, this review seeks to form an impression of the nature of validation and clinimetric testing carried out on the technological device(s) being used. METHODS Five databases (Medline, Embase, PsycInfo, Cochrane and Web of Science) were systematically searched for papers dating from 2000. Study eligibility criteria included: adults with a PD diagnosis; the use of technology; the setting of a home or home-like environment; outcomes measuring any motor and non-motor aspect relevant to PD, as well as activities of daily living; unrestricted/unscripted activities undertaken by participants. RESULTS 65 studies were selected for data extraction. There were wide varieties of participant sample sizes (<10 up to hundreds) and study durations (<2 weeks up to a year). The metrics evaluated by technology, largely using inertial measurement units in wearable devices, included gait, tremor, physical activity, bradykinesia, dyskinesia and motor fluctuations, posture, falls, typing, sleep and activities of daily living. CONCLUSIONS Home-based free-living testing in PD is being conducted by multiple groups with diverse approaches, focussing mainly on motor symptoms and sleep.
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Affiliation(s)
- Catherine Morgan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Michal Rolinski
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Roisin McNaney
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
| | - Bennet Jones
- Library and Knowledge Service, Learning and Research, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
| | - Lynn Rochester
- Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals National Health Service Foundation Trust, Newcastle Upon Tyne, UK
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts University, Kiel, Germany
| | - Ian Craddock
- School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, Faculty of Engineering, University of Bristol, Bristol, UK
| | - Alan L. Whone
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Movement Disorders Group, Bristol Brain Centre, Southmead Hospital, North Bristol National Health Service Trust, Bristol, UK
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Kuhlman GD, Flanigan JL, Sperling SA, Barrett MJ. Predictors of health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord 2019; 65:86-90. [PMID: 31118162 DOI: 10.1016/j.parkreldis.2019.05.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/17/2019] [Accepted: 05/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Health-related quality of life in Parkinson's disease may be affected by a wide range of motor and non-motor symptoms. Identifying which symptoms are significant predictors of health-related quality of life in Parkinson's disease prioritizes symptoms for treatment, therapeutic development, and clinical outcomes. OBJECTIVES To determine predictors of health-related quality of life in patients with Parkinson's disease. METHODS We recruited 102 subjects into a prospective study to investigate neuropsychiatric symptoms in Parkinson's disease. Health-related quality of life was measured with the 39-item Parkinson's Disease Questionnaire. Subjects completed the Movement Disorder Society Unified Parkinson's Disease Rating Scale Parts I-IV as well as validated scales to assess anxiety, depression, apathy, cognition, psychosis, impulsive-compulsive disorder, autonomic dysfunction, sleep quality, excessive daytime sleepiness, and rapid eye movement sleep behavior disorder. We used univariate analyses to select clinical predictors to construct a multivariate regression model to determine which predictors were independently associated with worse health-related quality of life. RESULTS In a multivariate linear regression model adjusted for age and gender, higher scores for the International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale part II as well more severe symptoms of depression, anxiety, apathy, and excessive daytime sleepiness were associated with worse health-related quality of life. The model explained 78% of the variance of health-related quality of life, and the non-motor symptoms explained 49% of the variance. CONCLUSIONS Anxiety, depression, excessive daytime sleepiness, apathy, and impairment in activities of daily living related to motor symptoms were independently associated with worse health-related quality of life.
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Affiliation(s)
- Greg D Kuhlman
- Department of Neurology, University of Virginia, Charlottesville, VA, USA; The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
| | - Joseph L Flanigan
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Scott A Sperling
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Matthew J Barrett
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
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13
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Boroojerdi B, Ghaffari R, Mahadevan N, Markowitz M, Melton K, Morey B, Otoul C, Patel S, Phillips J, Sen-Gupta E, Stumpp O, Tatla D, Terricabras D, Claes K, Wright JA, Sheth N. Clinical feasibility of a wearable, conformable sensor patch to monitor motor symptoms in Parkinson's disease. Parkinsonism Relat Disord 2019; 61:70-76. [DOI: 10.1016/j.parkreldis.2018.11.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
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Lewis MM, Du G, Baccon J, Snyder AM, Murie B, Cooper F, Sica C, Mailman RB, Connor JR, Huang X. Susceptibility MRI captures nigral pathology in patients with parkinsonian syndromes. Mov Disord 2018; 33:1432-1439. [PMID: 29756231 PMCID: PMC6185787 DOI: 10.1002/mds.27381] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/21/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinsonisms are neurodegenerative disorders characterized pathologically by α-synuclein-positive (e.g., PD, diffuse Lewy body disease, and MSA) and/or tau-positive (e.g., PSP, cortical basal degeneration) pathology. Using R2* and quantitative susceptibility mapping, susceptibility changes have been reported in the midbrain of living parkinsonian patients, although the exact underlying pathology of these alterations is unknown. OBJECTIVE The current study investigated the pathological correlates of these susceptibility MRI measures. METHODS In vivo MRIs (T1- and T2-weighted, and T2*) and pathology were obtained from 14 subjects enrolled in an NINDS PD Biomarker Program (PDBP). We assessed R2* and quantitative susceptibility mapping values in the SN, semiquantitative α-synuclein, tau, and iron values, as well as neuronal and glial counts. Data were analyzed using age-adjusted Spearman correlations. RESULTS R2* was associated significantly with nigral α-synuclein (r = 0.746; P = 0.003). Quantitative susceptibility mapping correlated significantly with Perls' (r = 0.758; P = 0.003), but not with other pathological measurements. Neither measurement correlated with tau or glial cell counts (r ≤ 0.11; P ≥ 0.129). CONCLUSIONS Susceptibility MRI measurements capture nigral pathologies associated with parkinsonian syndromes. Whereas quantitative susceptibility mapping is more sensitive to iron, R2* may reflect pathological aspects of the disorders beyond iron such as α-synuclein. They may be invaluable tools in diagnosing differential parkinsonian syndromes, and tracking in living patients the dynamic changes associated with the pathological progression of these disorders. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Jennifer Baccon
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pathology and Laboratory Medicine, Akron Children’s Hospital, Akron, OH 44308
| | - Amanda M. Snyder
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Ben Murie
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Felicia Cooper
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Christopher Sica
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - James R. Connor
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
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Wang M, Li Z, Lee EY, Lewis MM, Zhang L, Sterling NW, Wagner D, Eslinger P, Du G, Huang X. Predicting the multi-domain progression of Parkinson's disease: a Bayesian multivariate generalized linear mixed-effect model. BMC Med Res Methodol 2017; 17:147. [PMID: 28946857 PMCID: PMC5613469 DOI: 10.1186/s12874-017-0415-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 08/31/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is challenging for current statistical models to predict clinical progression of Parkinson's disease (PD) because of the involvement of multi-domains and longitudinal data. METHODS Past univariate longitudinal or multivariate analyses from cross-sectional trials have limited power to predict individual outcomes or a single moment. The multivariate generalized linear mixed-effect model (GLMM) under the Bayesian framework was proposed to study multi-domain longitudinal outcomes obtained at baseline, 18-, and 36-month. The outcomes included motor, non-motor, and postural instability scores from the MDS-UPDRS, and demographic and standardized clinical data were utilized as covariates. The dynamic prediction was performed for both internal and external subjects using the samples from the posterior distributions of the parameter estimates and random effects, and also the predictive accuracy was evaluated based on the root of mean square error (RMSE), absolute bias (AB) and the area under the receiver operating characteristic (ROC) curve. RESULTS First, our prediction model identified clinical data that were differentially associated with motor, non-motor, and postural stability scores. Second, the predictive accuracy of our model for the training data was assessed, and improved prediction was gained in particularly for non-motor (RMSE and AB: 2.89 and 2.20) compared to univariate analysis (RMSE and AB: 3.04 and 2.35). Third, the individual-level predictions of longitudinal trajectories for the testing data were performed, with ~80% observed values falling within the 95% credible intervals. CONCLUSIONS Multivariate general mixed models hold promise to predict clinical progression of individual outcomes in PD. TRIAL REGISTRATION The data was obtained from Dr. Xuemei Huang's NIH grant R01 NS060722 , part of NINDS PD Biomarker Program (PDBP). All data was entered within 24 h of collection to the Data Management Repository (DMR), which is publically available ( https://pdbp.ninds.nih.gov/data-management ).
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Affiliation(s)
- Ming Wang
- Departments of Public Health Sciences, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Zheng Li
- Departments of Public Health Sciences, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Eun Young Lee
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Lijun Zhang
- Department of Biochemistry and Molecular Biology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
- Institute of Personalized Medicine, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Nicholas W. Sterling
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Daymond Wagner
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Paul Eslinger
- Departments of Public Health Sciences, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
- Departments of Pharmacology, Radiology, Neurosurgery, and Kinesiology, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033 USA
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Gwinn K, David KK, Swanson-Fischer C, Albin R, Hillaire-Clarke CS, Sieber BA, Lungu C, Bowman FD, Alcalay RN, Babcock D, Dawson TM, Dewey RB, Foroud T, German D, Huang X, Petyuk V, Potashkin JA, Saunders-Pullman R, Sutherland M, Walt DR, West AB, Zhang J, Chen-Plotkin A, Scherzer CR, Vaillancourt DE, Rosenthal LS. Parkinson's disease biomarkers: perspective from the NINDS Parkinson's Disease Biomarkers Program. Biomark Med 2017; 11:451-473. [PMID: 28644039 PMCID: PMC5619098 DOI: 10.2217/bmm-2016-0370] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/11/2017] [Indexed: 11/21/2022] Open
Abstract
Biomarkers for Parkinson's disease (PD) diagnosis, prognostication and clinical trial cohort selection are an urgent need. While many promising markers have been discovered through the National Institute of Neurological Disorders and Stroke Parkinson's Disease Biomarker Program (PDBP) and other mechanisms, no single PD marker or set of markers are ready for clinical use. Here we discuss the current state of biomarker discovery for platforms relevant to PDBP. We discuss the role of the PDBP in PD biomarker identification and present guidelines to facilitate their development. These guidelines include: harmonizing procedures for biofluid acquisition and clinical assessments, replication of the most promising biomarkers, support and encouragement of publications that report negative findings, longitudinal follow-up of current cohorts including the PDBP, testing of wearable technologies to capture readouts between study visits and development of recently diagnosed (de novo) cohorts to foster identification of the earliest markers of disease onset.
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Affiliation(s)
- Katrina Gwinn
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Karen K David
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christine Swanson-Fischer
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roger Albin
- Neurology Service & GRECC, VAAAHS, UM Udall Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Beth-Anne Sieber
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - F DuBois Bowman
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University, New York, NY, USA
| | - Debra Babcock
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ted M Dawson
- Neuroregeneration & Stem Cell Programs, Institute for Cell Engineering, Solomon H Snyder Department of Neuroscience, Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard B Dewey
- Department of Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tatiana Foroud
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Vlad Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Judith A Potashkin
- Department of Cellular & Molecular Pharmacology, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel & Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sutherland
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - David R Walt
- Department of Chemistry, Tufts University, Medford, MA, USA
| | - Andrew B West
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Clemens R Scherzer
- Department of Neurology, Harvard Medical School, Brigham & Women's Hospital, Cambridge, MA, USA
| | - David E Vaillancourt
- Departments of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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