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Essam M, Hamid E, Abushady E, El-Balkimy M, Antonini A, Shalash A. Role of zonisamide in advanced Parkinson's disease: a randomized placebo-controlled study. Neurol Sci 2024; 45:1725-1734. [PMID: 38376645 PMCID: PMC10943138 DOI: 10.1007/s10072-024-07396-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Zonisamide (ZNS) has shown some efficacy in motor symptoms of PD; however, more evidence is lacking, and its effects on nonmotor symptoms (NMSs) and quality of life (QoL) remain to be investigated. This randomized double-blinded placebo-controlled crossover study investigated the effect of ZNS on motor and NMS symptoms and QoL in advanced PD. METHODS PD patients with Hoehn and Yahr stage ≥ 2 ("On" state) and at least 2 h off time daily were randomized to groups: ZNS 25 mg, ZNS 50 mg and placebo. Groups were assessed at baseline and at the 1- and 3-month follow-ups. The primary endpoint was the change in the total MDS-UPDRS III "On", while the secondary endpoint was the change in the total and parts I and IV MDS-UPDRS, Nonmotor Symptoms Scale and Parkinson's disease questionnaire-39 at the final assessment. RESULTS Sixty-nine patients were assessed for efficacy at the 1-month follow-up, and 58 patients were assessed at the 3-month follow-up. The primary endpoint showed significant improvement in the ZNS 25 mg group compared to the placebo group (p = 0.009). At the final assessment, the ZNS 25 mg group showed significant improvement of total and part VI MDS-UPDRS, bradykinesia, tremor and functional impact of fluctuations compared to placebo. There was no change in dyskinesia, NMSs, QoL or side effects except for sedation. CONCLUSION ZNS has a favourable effect on motor symptoms in patients with wearing off as adjunctive therapy with other dopaminergic drugs, with no exacerbation of dyskinesia and a limited impact on NMSs and QoL. TRIAL REGISTRATION Clinicaltrials.gov, NCT04182399, in 24/11/2019.
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Affiliation(s)
- Mohamed Essam
- Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbassia Square, Cairo, Egypt
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbassia Square, Cairo, Egypt
| | - Eman Abushady
- Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbassia Square, Cairo, Egypt
| | - Mahmoud El-Balkimy
- Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbassia Square, Cairo, Egypt
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, 35131, Padua, Italy
| | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, 38 Abbassia Square, Cairo, Egypt.
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George P, Roushdy T, Fathy M, Hamid E, Ibrahim YA, El-Belkimy M, Abdulghani MO, Shalash A. The clinical and neuroimaging differences between vascular parkinsonism and Parkinson's disease: a case-control study. BMC Neurol 2024; 24:56. [PMID: 38321372 PMCID: PMC10845551 DOI: 10.1186/s12883-024-03556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/29/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) and vascular parkinsonism (VaP) have highly overlapping phenotypes, and different prognosis. This study comprehensively investigated the clinical, brain MRI and transcranial sonography differences between VaP and PD. METHODS Forty-eight patients with PD, 27 patients with VaP, and 29 healthy controls were compared. All patients were assessed using the MDS-UPDRS, Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), Time Up and Go Test, and Non-Motor Symptoms Scale. Beck Depression Inventory, PD questionnaire- 39, international urine incontinence scale, cognitive assessment scales, MRI brain and transcranial colour-coded doppler. The study was registered on clinical-Trial.gov (NCT04308135) on 03/12/2020. RESULTS VaP patients showed significantly older age of onset, shorter disease duration, lower drug doses and levodopa responsiveness, higher On and Off axial scores, On and Off BBS, higher On scores for PIGD, rigidity, bradykinesia and total motor MDS-UPDRS, lower On and Off tremor, lower-half predominance, lower asymmetrical presentation and symmetric index than PD patients. VaP patients had worse non-motor symptoms Scale (NMSS) than controls except for perceptual problems/hallucinations but better symptoms than PD patients except for urinary dysfunction. Quality of life (QoL) was impaired in VaP patients and was correlated with motor function and NMSs. The VaP group had significantly higher white matter lesions and brain atrophy, with lower hyperechogenicity of the substantia nigra and more impaired cerebral vascular resistance and vasoreactivity than the PD group. CONCLUSIONS VaP has a characteristic motor and non-motor profile, with impaired QoL, white matter, and transcranial sonography abnormalities that differentiate it from PD. Further studies are warranted to explore the role of vascular lesions in the pathogenesis of VaP. TRIAL REGISTRATION The registered identifier NCT04308135 on clinical-Trial.gov. Registered on 03/12/2020.
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Affiliation(s)
- Peter George
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Roushdy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mai Fathy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mahmoud El-Belkimy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Ghasemi M, Roshandel E, Mohammadian M, Farhadihosseinabadi B, Akbarzadehlaleh P, Shamsasenjan K. Mesenchymal stromal cell-derived secretome-based therapy for neurodegenerative diseases: overview of clinical trials. Stem Cell Res Ther 2023; 14:122. [PMID: 37143147 PMCID: PMC10161443 DOI: 10.1186/s13287-023-03264-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 03/06/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Over the past few years, mesenchymal stromal cells (MSCs) have attracted a great deal of scientific attention owing to their promising results in the treatment of incurable diseases. However, there are several concerns about their possible side effects after direct cell transplantation, including host immune response, time-consuming cell culture procedures, and the dependence of cell quality on the donor, which limit the application of MSCs in clinical trials. On the other hand, it is well accepted that the beneficial effects of MSCs are mediated by secretome rather than cell replacement. MSC secretome refers to a variety of bioactive molecules involved in different biological processes, specifically neuro-regeneration. MAIN BODY Due to the limited ability of the central nervous system to compensate for neuronal loss and relieve disease progress, mesenchymal stem cell products may be used as a potential cure for central nervous system disorders. In the present study, the therapeutic effects of MSC secretome were reviewed and discussed the possible mechanisms in the three most prevalent central nervous system disorders, namely Alzheimer's disease, multiple sclerosis, and Parkinson's disease. The current work aimed to help discover new medicine for the mentioned complications. CONCLUSION The use of MSC-derived secretomes in the treatment of the mentioned diseases has encouraging results, so it can be considered as a treatment option for which no treatment has been introduced so far.
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Affiliation(s)
- Maryam Ghasemi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Roshandel
- Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhdeh Mohammadian
- Department of Hematology, School of Medicine, Tarbiat Modares University (TMU), Tehran, Iran
| | | | - Parvin Akbarzadehlaleh
- Pharmaceutical Biotechnology Department, Pharmacy Faculty, Tabriz University of Medical Science, Tabriz, Iran.
| | - Karim Shamsasenjan
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Fothergill-Misbah N. The lived experience of stigma and parkinson's disease in Kenya: a public health challenge. BMC Public Health 2023; 23:364. [PMID: 36803768 PMCID: PMC9940067 DOI: 10.1186/s12889-023-15278-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND As a disease characterised by non-motor and very visible motor symptoms, Parkinson's disease has been associated with multiple forms of stigma, while awareness about the disease globally remains low. The experience of stigma relating to Parkinson's disease from high-income nations is well-documented, while less is known about low- and middle-income countries (LMICs). Literature on stigma and disease from Africa and the Global South has described the added complexities people face resulting from structural violence, as well as perceptions about symptoms and disease associated with supernatural beliefs, which can have significant implications for access to healthcare and support. Stigma is a recognised barrier to health-seeking behaviour and a social determinant of population health. METHODS This study draws on qualitative data collected as part of a wider ethnographic study to explore the lived experience of Parkinson's disease in Kenya. Participants include 55 people diagnosed with Parkinson's and 23 caregivers. The paper draws on the Health Stigma and Discrimination Framework as a tool to understand stigma as a process. RESULTS Data from interviews identified the drivers and facilitators of stigma, including poor awareness of Parkinson's, lack of clinical capacity, supernatural beliefs, stereotypes, fear of contagion and blame. Participants reported their lived realities of stigma, and experiences of stigma practices, which had significant negative health and social outcomes, including social isolation and difficulty accessing treatment. Ultimately, stigma had a negative and corrosive effect on the health and wellbeing of patients. CONCLUSION This paper highlights the interplay of structural constraints and the negative consequences of stigma experienced by people living with Parkinson's in Kenya. The deep understanding of stigma made possible through this ethnographic research leads us to see stigma as a process, something that is embodied and enacted. Targeted and nuanced ways of tackling stigma are suggested, including educational and awareness campaigns, training, and the development of support groups. Importantly, the paper shows that awareness of, and advocacy for the recognition of, Parkinson's globally needs to improve. This recommendation is in line with the World Health Organization's Technical Brief on Parkinson disease, which responds to the growing public health challenge posed by Parkinson's.
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Hou L, Liu J, Sun F, Huang R, Chang R, Ruan Z, Wang Y, Zhao J, Wang Q. Integrin Mac1 mediates paraquat and maneb-induced learning and memory impairments in mice through NADPH oxidase-NLRP3 inflammasome axis-dependent microglial activation. J Neuroinflammation 2023; 20:42. [PMID: 36804009 PMCID: PMC9938991 DOI: 10.1186/s12974-023-02732-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/13/2023] [Indexed: 02/20/2023] Open
Abstract
INTRODUCTION The mechanisms of cognitive impairments in Parkinson's disease (PD) remain unknown. Accumulating evidence revealed that brain neuroinflammatory response mediated by microglial cells contributes to cognitive deficits in neuropathological conditions and macrophage antigen complex-1 (Mac1) is a key factor in controlling microglial activation. OBJECTIVES To explore whether Mac1-mediated microglial activation participates in cognitive dysfunction in PD using paraquat and maneb-generated mouse PD model. METHODS Cognitive performance was measured in wild type and Mac1-/- mice using Morris water maze test. The role and mechanisms of NADPH oxidase (NOX)-NLRP3 inflammasome axis in Mac1-mediated microglial dysfunction, neuronal damage, synaptic degeneration and phosphorylation (Ser129) of α-synuclein were explored by immunohistochemistry, Western blot and RT-PCR. RESULTS Genetic deletion of Mac1 significantly ameliorated learning and memory impairments, neuronal damage, synaptic loss and α-synuclein phosphorylation (Ser129) caused by paraquat and maneb in mice. Subsequently, blocking Mac1 activation was found to mitigate paraquat and maneb-elicited microglial NLRP3 inflammasome activation in both in vivo and in vitro. Interestingly, stimulating activation of NOX by phorbol myristate acetate abolished the inhibitory effects of Mac1 blocking peptide RGD on paraquat and maneb-provoked NLRP3 inflammasome activation, indicating a key role of NOX in Mac1-mediated NLRP3 inflammasome activation. Furthermore, NOX1 and NOX2, two members of NOX family, and downstream PAK1 and MAPK pathways were recognized to be essential for NOX to regulate NLRP3 inflammasome activation. Finally, a NLRP3 inflammasome inhibitor glybenclamide abrogated microglial M1 activation, neurodegeneration and phosphorylation (Ser129) of α-synuclein elicited by paraquat and maneb, which were accompanied by improved cognitive capacity in mice. CONCLUSIONS Mac1 was involved in cognitive dysfunction in a mouse PD model through NOX-NLRP3 inflammasome axis-dependent microglial activation, providing a novel mechanistic basis of cognitive decline in PD.
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Affiliation(s)
- Liyan Hou
- grid.411971.b0000 0000 9558 1426Dalian Medical University Library, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China ,grid.411971.b0000 0000 9558 1426National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, 116044 China
| | - Jianing Liu
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Fuqiang Sun
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Ruixue Huang
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Rui Chang
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Zhengzheng Ruan
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Ying Wang
- grid.411971.b0000 0000 9558 1426School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044 China
| | - Jie Zhao
- National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, 116044, China.
| | - Qingshan Wang
- National-Local Joint Engineering Research Center for Drug-Research and Development (R & D) of Neurodegenerative Diseases, Dalian Medical University, Dalian, 116044, China. .,School of Public Health, Dalian Medical University, No. 9 W. Lvshun South Road, Dalian, 116044, China.
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Mengesha AT. Frequency and Factors Associated with Orthostatic Hypotension in Individuals with Parkinson's Disease: A Case-Control Observational Study. Ethiop J Health Sci 2022; 32:1167-1174. [PMID: 36475248 PMCID: PMC9692141 DOI: 10.4314/ejhs.v32i6.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/15/2022] [Indexed: 12/13/2022] Open
Abstract
Background Orthostatic hypotension (OH) is a common and considered the most incapacitating non-motor symptom of Parkinson's disease (PD). Little is known about OH in Ethiopian PD patients. The objectives of the present study were to determine the frequency and factors associated with OH in individuals diagnosed with PD compared to a healthy control. Methods A multi-center case-control observational study was conducted. A total of 53 PD cases and 53 age and sex matched healthy controls were included. Both descriptive and Chi-square proportional statistical analysis were used. Results The mean age distribution was comparable between the two study groups (61.9 vs. 59.9 years). Distribution of male gender was comparable between PD and control groups (71.7% vs. 67.9%). Nearly all the individuals diagnosed with PD were on levodopa treatment, and close to half of them were on anticholinergic drugs. Hypertension was the commonest comorbid disorder in both groups. The prevalence of orthostatic hypotension was higher in PD patients (22.6%) compared to the control group (9.4%). The proportion of constipation (p=0.007), urinary urgency (p=0.007), and nocturia (p<0.0001) was significantly higher among Parkinson's disease patients compared to the healthy control group. Falls and excessive sweating were only reported by PD patients. Conclusion The present study shows the frequency of orthostatic hypotension in Ethiopian Parkinson's disease patients is comparable to other regions. The presence of constipation, urinary urgency, and nocturia was associated with Parkinson's disease compared to the control group.
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Affiliation(s)
- Abenet Tafesse Mengesha
- Associate Professor of Neurology, Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Kim J, Daadi EW, Oh T, Daadi ES, Daadi MM. Human Induced Pluripotent Stem Cell Phenotyping and Preclinical Modeling of Familial Parkinson's Disease. Genes (Basel) 2022; 13:1937. [PMID: 36360174 PMCID: PMC9689743 DOI: 10.3390/genes13111937] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 12/05/2022] Open
Abstract
Parkinson's disease (PD) is primarily idiopathic and a highly heterogenous neurodegenerative disease with patients experiencing a wide array of motor and non-motor symptoms. A major challenge for understanding susceptibility to PD is to determine the genetic and environmental factors that influence the mechanisms underlying the variations in disease-associated traits. The pathological hallmark of PD is the degeneration of dopaminergic neurons in the substantia nigra pars compacta region of the brain and post-mortem Lewy pathology, which leads to the loss of projecting axons innervating the striatum and to impaired motor and cognitive functions. While the cause of PD is still largely unknown, genome-wide association studies provide evidence that numerous polymorphic variants in various genes contribute to sporadic PD, and 10 to 15% of all cases are linked to some form of hereditary mutations, either autosomal dominant or recessive. Among the most common mutations observed in PD patients are in the genes LRRK2, SNCA, GBA1, PINK1, PRKN, and PARK7/DJ-1. In this review, we cover these PD-related mutations, the use of induced pluripotent stem cells as a disease in a dish model, and genetic animal models to better understand the diversity in the pathogenesis and long-term outcomes seen in PD patients.
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Affiliation(s)
- Jeffrey Kim
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
- Cell Systems and Anatomy, San Antonio, TX 78229, USA
| | - Etienne W. Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Thomas Oh
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Elyas S. Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Marcel M. Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, TX 78227, USA
- Cell Systems and Anatomy, San Antonio, TX 78229, USA
- Department of Radiology, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, TX 78229, USA
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Shaheen S, Ali RM, Farghaly M, El-Serafy O, Hegazy MI. Screening for non-motor symptoms in Egyptian patients with Parkinson’s disease. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00541-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Most of the patients with Parkinson’s disease (PD) suffer from non-motor symptoms (NMS). Despite their marked effect on patients’ quality of life, NMS remain under-estimated by physicians, patients and caregivers. The aim of this study was to suggest a battery to screen for the presence of NMS in PD patients in the setting of an outpatient clinic and to assess the NMS of PD in Egyptian patients and factors affecting them.
Results
This study was conducted on 50 patients with PD, 35 males (70%) and 15 females (30%) whom their age ranged from 36 to 80 years with a mean of 62.88 ± 8.74 years. All patients were assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Apathy Scale (AS), Montreal Cognitive Assessment (MOCA), Hamilton Depression Rating Scale (HDRS) and Parkinson’s Disease Sleep Scale (PDSS). The mean age at disease onset was 59.10 ± 9.34 years and the mean disease duration was 3.76 ± 3.16 years. 98% of patients (49 out of 50) had at least one non-motor symptom. The mean MDS-UPDRS scores were 15.74 ± 7.93 for part I, 17.94 ± 11.61 for part II and 42.32 ± 22.74 for part III. The mean score for AS was 9.90 ± 10.66 with 70% of patients considered apathetic. The mean MOCA score was 21.12 ± 4.73 with 38 patients (76%) found to be cognitively impaired. The mean HDRS score was 12.26 ± 8.52 with 34 patients (68%) found to be depressed. The mean PDSS score was 92.22 ± 32.53 with sleep disturbances found in 38 patients (76%). A statistically significant negative correlation was found between the HDRS and PDSS scores (P value < 0.001). Age of patients, age at disease onset and disease duration were not correlated to MDS-UPDRS, AS, MOCA, HDRS and PDSS scores.
Conclusions
Most of the patients with PD were found to suffer from NMS including apathy, cognitive impairment, depression and sleep disturbances. Physicians need to screen their PD patients for NMS on regular basis using the appropriate tools. Self-administered questionnaires could function as reliable screening tools for NMS in PD patients.
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Shah H, Usman O, Ur Rehman H, Jhaveri S, Avanthika C, Hussain K, Islam H, I.S.K S. Deep Brain Stimulation in the Treatment of Parkinson’s Disease. Cureus 2022; 14:e28760. [PMID: 36211107 PMCID: PMC9531694 DOI: 10.7759/cureus.28760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 11/16/2022] Open
Abstract
Parkinson’s disease (PD) is a common progressive neurodegenerative movement disorder. The cardinal feature of Parkinson's is neuronal degeneration causing a dopamine deficit in the brain which leads to a host of clinical features in the patient. However, consensus over specific clinical criteria for diagnosis remains to be established. Parkinson’s does not have a cure yet, but a variety of diagnostic and treatment protocols have been developed over the years with a primary focus on pharmacological therapy. Anti-parkinsonian drugs such as levodopa lose their efficacy over time and are needed in higher doses as the disease inevitably progresses. An alternative to pharmacological therapy is deep brain stimulation (DBS). Deep brain stimulation involves transcranial placement of unilateral or bilateral leads (wires) most commonly in the sub-thalamic nucleus or the globus pallidus interna of the brain by stereotactic surgery. Given the multiple hypotheses explaining the different effects of DBS with sometimes conflicting mechanisms, it is difficult to pinpoint the exact way in which DBS operates. Nevertheless, it has proven to be significantly effective. DBS, although being a cost-effective treatment measure for Parkinson's patients, is not without limitations. A careful selection of patients is required preoperatively that determines the response and tolerance to the therapy in patients. This review aims to summarize the current literature on DBS in Parkinson's with a focus on the hypothesized mechanisms, selection criteria, advantages and its limitations.
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A 6-month longitudinal study on worsening of Parkinson’s disease during the COVID-19 pandemic. NPJ Parkinsons Dis 2022; 8:111. [PMID: 36045133 PMCID: PMC9428872 DOI: 10.1038/s41531-022-00376-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 08/12/2022] [Indexed: 12/04/2022] Open
Abstract
Further studies are required to investigate the impact of the COVID-19 pandemic on Parkinson’s disease (PD) progression. This study investigated the motor and non-motor progression of people with PD (PWP) at 6 months during the COVID-19 pandemic compared with that during the pre-pandemic period. Patients were recruited from Ain Shams University Hospitals, Cairo, in the period between April 2019 and December 2020. Fifty patients were included, of whom 17 and 33 patients were followed for 6 months before and during the pandemic, respectively. All patients were assessed at baseline and at 6 months using the MDS-UPDRS, Schwab and England scale (S&E), Hoehn and Yahr scale (H&Y), Berg Balance Scale, Timed Up and Go test (TUG), International Physical Activity Questionnaire, New Freezing of Gait Questionnaire, Non-Motor Symptoms Scale, and Beck Depression Inventory (BDI). Both groups were matched in age, gender, and disease characteristics. Patients followed during the pandemic showed more significant worsening of the total, part I and motor part of MDS-UPDRS, and balance scores (p < 0.001) than those followed during the pre-COVID-19 period. Gait (TUG), balance, and physical activity worsening were significantly correlated with baseline BDI, gait and balance scores, total and part I MDS-UPDRS scores, H&Y, and S&E OFF scores. Gait deterioration (TUG) was correlated with baseline physical activity (r = −0.510, p = 0.002). PWP showed worsening of motor and non-motor symptoms during the COVID-19 pandemic at the 6-month follow-up. Worsening of gait, balance, and physical activity was correlated with baseline motor and physical activity OFF scores.
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Buhmann C. Prevalence, clinical presentations and impact on relationship of sexual dysfunction in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:1-19. [PMID: 35397782 DOI: 10.1016/bs.irn.2021.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Sexual dysfunction is one of the commonest non-motor symptoms in Parkinson's disease (PD) and has been found about twice as high in PD patients compared to age-matched controls. The quality of sexual life is reduced in PD patients compared to healthy peers and impairment affects wide aspects of physical sexual function as well as sexual desire, sexual satisfaction and sexual partnership. Overall, male PD patients are more frequently affected by sexual disorders than females and seem to suffer more from sexual impairment. The reported frequencies and presentations of various sexual dysfunctions vary widely in the literature, which is likely related to the patient cohorts examined, in particular with regard to age and gender, duration and severity of disease and applied measurement instruments. This chapter gives an overview of the prevalence, phenotype and clinical presentation of sexual dysfunction in PD and its influence on the partnership.
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Affiliation(s)
- Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Helmy A, Hamid E, Salama M, Gaber A, El-Belkimy M, Shalash A. Baseline predictors of progression of Parkinson's disease in a sample of Egyptian patients: clinical and biochemical. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58:9. [PMID: 35068922 PMCID: PMC8760567 DOI: 10.1186/s41983-022-00445-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/01/2022] [Indexed: 01/21/2023] Open
Abstract
Background Clinical progression of Parkinson’s disease (PD) is highly heterogeneous, and its predictors are generally lacking. Identifying predictors of early disease progression is important for patients’ management and follow-up. The current study aims to identify clinical, neuroimaging and biochemical baseline predictors of motor progression in patients with PD. Forty-five PD patients were assessed at baseline, 6 months and 1 year using MDS-UPDRS total and subscores, Hoehn and Yahr (H&Y), Schwab and England (S&E), International Physical Activity Questionnaire (IPAQ). Baseline New Freezing of Gait Questionnaire (NFOG-Q), Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), and Time Up and Go Test (TUG), Non-Motor Symptoms Scale (NMSS), Beck Depression Inventory (BDI), PD questionnaire 39 (PDQ-39), MRI brain, uric acid, lipid profile and glycated hemoglobin were performed. Results Significant worsening of MDS-UPDRS total, part III scores, H&Y, S&E and IPAQ (p < 0.001) was detected. One-year progression of H&Y and S&E were significantly correlated to disease duration (p = 0.014, p = 0.025, respectively). Progression of H&Y was correlated to baseline TUG (p = 0.035). S&E progression was correlated to baseline MDS-UPDRS total score (rho = 0.478, p = 0.001) and part III (rho = 0.350, p = 0.020), H&Y (rho = 0.401, p = 0.007), PIGD (rho = 0.591, p < 0.001), NFOG-Q (rho = 0.498, p = 0.001), and TUG (rho = 0.565, p = 0.001). Using linear regression, there was no predictors of clinical progression among the used baseline variables. Conclusion Despite the significant motor and physical activity progression over 1 year that was correlated to baseline motor and gait severity, but without predictive value, further similar and longitudinal studies are warranted to detect predictors of early progression and confirm findings. Supplementary Information The online version contains supplementary material available at 10.1186/s41983-022-00445-1.
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Affiliation(s)
- Asmaa Helmy
- Department of Neurology, Faculty of Medicine, Ain Shams University, 168 Elnozha St, Saint Fatima Square, Heliopolis, Cairo, Egypt
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, 168 Elnozha St, Saint Fatima Square, Heliopolis, Cairo, Egypt
| | - Mohamed Salama
- Institute of Global Health and Human Ecology (I-GHHE), The American University in Cairo, Cairo, Egypt.,Faculty of Medicine, Al-Mansoura University, Mansoura, Egypt
| | - Ahmed Gaber
- Department of Neurology, Faculty of Medicine, Ain Shams University, 168 Elnozha St, Saint Fatima Square, Heliopolis, Cairo, Egypt
| | - Mahmoud El-Belkimy
- Department of Neurology, Faculty of Medicine, Ain Shams University, 168 Elnozha St, Saint Fatima Square, Heliopolis, Cairo, Egypt
| | - Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, 168 Elnozha St, Saint Fatima Square, Heliopolis, Cairo, Egypt
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van der Lijn I, de Haan GA, Huizinga F, van der Feen FE, Rutgers AWF, Stellingwerf C, van Laar T, Heutink J. Self-Reported Visual Complaints in People with Parkinson's Disease: A Systematic Review. JOURNAL OF PARKINSON'S DISEASE 2022; 12:785-806. [PMID: 35001897 PMCID: PMC9108577 DOI: 10.3233/jpd-202324] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Scientific research increasingly focuses on visual symptoms of people with Parkinson's disease (PD). However, this mostly involves functional measures, whereas self-reported data are equally important for guiding clinical care. OBJECTIVE This review provides an overview of the nature and prevalence of self-reported visual complaints by people with PD, compared to healthy controls. METHODS A systematic literature search was performed. Studies from three databases (PubMed, PsycInfo, and Web of Science) were screened for eligibility. Only studies that reported results of visual self-reports in people with idiopathic PD were included. RESULTS One hundred and thirty-nine eligible articles were analyzed. Visual complaints ranged from function-related complaints (e.g., blurred vision, double vision, increased sensitivity to light or changes in contrast sensitivity) to activity-related complaints (e.g., difficulty reading, reaching, or driving). Visual complaints were more prevalent in people with PD compared to healthy controls. The presence of visual complaints leads to a reduced quality of life (QoL). Increased prevalence and severity of visual complaints in people with PD are related to longer disease duration, higher disease severity, and off-state. CONCLUSION A large proportion of people with PD have visual complaints, which negatively affect QoL. Complaints are diverse in nature, and specific and active questioning by clinicians is advised to foster timely recognition, acknowledgement, and management of these complaints.
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Affiliation(s)
- Iris van der Lijn
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Gera A. de Haan
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Famke Huizinga
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, Groningen, the Netherlands
| | - Fleur E. van der Feen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | | | - Catherina Stellingwerf
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Teus van Laar
- Department of Neurology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Joost Heutink
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
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14
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Kumar A, Patil S, Singh VK, Pathak A, Chaurasia RN, Mishra VN, Joshi D. Assessment of Non-Motor Symptoms of Parkinson's Disease and Their Impact on the Quality of Life: An Observatiobnal Study. Ann Indian Acad Neurol 2022; 25:909-915. [PMID: 36561034 PMCID: PMC9764934 DOI: 10.4103/aian.aian_647_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/09/2021] [Accepted: 07/09/2022] [Indexed: 12/25/2022] Open
Abstract
Background During the past decade the view of Parkinson's disease (PD) as a motor disorder has changed significantly and currently it is recognized as a multisystem disorder with diverse non-motor symptoms (NMS). Aims The present study aimed to evaluate and characterize the NMS and study their impact on quality of life (QoL) in a PD patient cohort. Material and Methods This was a cross-sectional study where 92 PD patients fulfilling the UK Parkinson's disease society brain bank criteria were enrolled from a movement disorder clinic. All patients were evaluated using unified Parkinson's disease rating scale, non-motor symptoms scale (NMSS) for the non-motor symptoms, and Parkinson's disease questionnaire-39 (PDQ-39) for the QoL. The impact of NMS on QoL was assessed statistically. Results A total of 92 patients were enrolled with a mean age of 55.40 ± 7.37 years, mean age of onset of disease 51.62 ± 6.38 years, and mean disease duration of 3.78 ± 1.54 years. Type of disease was akinetic rigid variant in 29.3% (n = 27), tremor predominant type in 36.9%(n = 34), and mixed type in 33.6% (n = 31). Mean Hoehn and Yahr stage was 2.12 ± 0.54. In the NMSS, most common symptom was sleep and fatigue (83%), followed by urinary tract symptoms (63%), mood and cognition (51%), cardiovascular symptoms and falls (43%), gastrointestinal tract symptoms (38%), and sexual function (33%). Univariate analyses showed that all NMS domains had a significant correlation with PDQ-39 with P < 001. Conclusion Our study shows that NMS in PDare fairly common and significantly impact the QoL.
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Affiliation(s)
- Anand Kumar
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sooraj Patil
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Varun K. Singh
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Abhishek Pathak
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rameshwar Nath Chaurasia
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vijaya N. Mishra
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Deepika Joshi
- Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India,Address for correspondence: Prof. Deepika Joshi, Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh - 221 005, India. E-mail
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15
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Tran TN, Ha UNL, Nguyen TM, Nguyen TD, Vo KNC, Dang TH, Trinh PMP, Truong D. The effect of Non-Motor symptoms on Health-Related quality of life in patients with young onset Parkinson's Disease: A single center Vietnamese Cross-Sectional study. Clin Park Relat Disord 2021; 5:100118. [PMID: 34927047 PMCID: PMC8649388 DOI: 10.1016/j.prdoa.2021.100118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/21/2021] [Accepted: 11/14/2021] [Indexed: 11/24/2022] Open
Abstract
Non-motor features may negatively impact those with young-onset Parkinson disease. Sleep/fatigue was the most severely affected, followed by mood/cognition. These domains independently predicted health-related quality of life (HRQoL).
Background Young onset Parkinson’s disease (YOPD) is a distinct entity from typical late onset Parkinson’s disease (LOPD). The influene of non-motor features on the health - related quality of life (HRQoL) in LOPD has been previously reported, but little is known about the impact of non-motor features in YOPD. Objective The aim of this study was to explore the relationship between non-motor burden and HRQoL in patients with YOPD. Methods This was an observational, cross-sectional study in patients with a PD, whose age at disease onset ranged from 21 to 40 years (YOPD). Participants were assessed with the MDS Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS) and the 39-item Parkinson’s Disease Questionnaire (PDQ-39; range 0–100). Spearman’s rank test was used to identify correlations between NMSS domains and several dimension of HRQoL. Stepwise multiple linear regression analysis was performed to identify the independent predictors of HRQoL as measured by PDQ-39 summary index. Results 89 patients with YOPD mean (SD) age = 42.15 (5.84) participated. Patients reported 10.17 (4.74) non-motor symptoms, the most common (75%) and severe (median = 3) of which was was fatigue (IQR = 7). The most frequently reported and severely affected NMSS domain was sleep/fatigue (89.9%, median = 8; IQR = 13) followed by mood/cognition (83.1%, median = 6; IQR = 18) and attention/memory (82%, median = 5; IQR = 8). The mean (SD) summary index of PDQ-39 was 32.89 (16.8). The means (SD) of each PDQ-39 dimensions were: mobility 37.33 (21.96), ADL 42.93 (25.33), emotional well-being 39.77 (25.47), stigma 38.19 (28.44), social support 19.03 (22.89), cognition 29.59 (20.63), communication 26.96 (23.57), and bodily discomfort 29.96 (23.19). With the exception of gastrointestinal tract and sexual function, all other NMSS domain scores were correlated with the PDQ-39 summary index. The multivariate model revealed that three NMSS domains including sleep/fatigue, mood/cognition and attention/memory accompanied with UPDRS part III were independent predictors of HRQoL as measured by PDQ-39SI. Conclusions Non-motor symptoms pertaining to sleep disturbances/fatigue, mood/cognition and attention/memory negatively impact HRQoL in patients with YOPD.
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Affiliation(s)
- Tai Ngoc Tran
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Uyen Ngoc Le Ha
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Tuan Manh Nguyen
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Thuan Duc Nguyen
- Neurology Department, 103 Military Medical University, Hanoi, Viet Nam
| | - Khang Ngoc Chung Vo
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Thuong Huyen Dang
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Paula Mai Phuong Trinh
- Movement Disorder Unit, Neurology Department, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Daniel Truong
- The Parkinson and Movement Disorder Institute, Fountain Valley, CA 92708, USA.,Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, CA, USA
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16
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Ojo OO, Wahab KW, Bello AH, Abubakar SA, Ekeh BC, Otubogun FM, Iwuozo EU, Farombi TH, Adeniji O, Ojini FI, Imarhiagbe FA, Nyandaiti Y, Komolafe MA, Fawale MB, Onwuegbuzie GA, Zubair Y, Williams UE, Taiwo FT, Oyakhire SI, Oshinaike OO, Osemwegie N, Osaigbovo GO, Odiase FE, Odeniyi OA, Obiabo YO, Obehighe EE, Nwazor EO, Nwani PO, Kehinde AJ, Erameh CO, Ekenze OS, Dike FO, Balarabe SA, Arigbodi O, Arabambi B, Ani-Osheku I, Ali MW, Akpekpe JE, Akinyemi RO, Agulanna U, Agu CE, Agabi OP, Ademiluyi BA, Adebowale AA, Achoru CO, Abiodun OV, Rizig M, Okubadejo NU. A Cross-Sectional Comprehensive Assessment of the Profile and Burden of Non-motor Symptoms in Relation to Motor Phenotype in the Nigeria Parkinson Disease Registry Cohort. Mov Disord Clin Pract 2021; 8:1206-1215. [PMID: 34765688 DOI: 10.1002/mdc3.13346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/26/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background Data on non-motor symptoms (NMS) in black Africans with Parkinson's disease (PD) are sparse. Objective To describe the profile of NMS in the Nigeria PD Registry (NPDR) cohort and explore the relationship between NMS and PD motor phenotype. Methods We conducted a cross-sectional study of the frequency and burden of NMS, based on the non-motor symptoms scale (NMSS) and the Chaudhuri method respectively in our cohort. Baseline demographics, disease characteristics (Hoehn and Yahr stage, MDS-UPDRS total score and Part III motor score), motor phenotype (based on Stebbin et al's algorithm), and levodopa equivalent daily dose (LEDD) were documented. Results Data are presented for 825 PD whose mean age at study was 63.7 ± 10.1 years, female sex-221 [26.8%] while median PD duration was 36 months. PD phenotypes included tremor-dominant 466 (56.5%), postural instability and gait disorder (PIGD) 259 (31.4%), and indeterminate 100 (12.1%). 82.6% were on treatment (median LEDD of 500 mg/24 hours). 804 (97.5%) endorsed at least 1 NMS. The median NMSS score was 26.0 while subscores for urinary and sexual function domains were significantly higher in males (P < 0.05). PIGD-PD had more frequent NMS and higher frequency of severe/very severe NMSS burden (P = 0.000 for both). Nocturia and fatigue were the most prevalent NMS overall and across motor subtypes. PIGD phenotype and total UPDRS scores were the independent determinants of NMSS scores (P = 0.000). Conclusion The profile and burden of NMS, and association with motor subtype in our black African cohort is largely similar to descriptions from other populations.
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Affiliation(s)
- Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences College of Medicine, University of Lagos Lagos Nigeria.,Neurology Unit, Department of Medicine Lagos University Teaching Hospital Lagos Nigeria
| | - Kolawole W Wahab
- Department of Medicine University of Ilorin/University of Ilorin Teaching Hospital Ilorin Nigeria
| | | | - Sani A Abubakar
- Department of Medicine Ahmadu Bello University/Ahmadu Bello University Teaching Hospital Zaria Nigeria
| | - Bertha C Ekeh
- University of Uyo Teaching Hospital/Ibom Specialist Hospital Uyo Nigeria
| | | | - Emmanuel U Iwuozo
- Neurology Unit Benue State University/Benue State University Teaching Hospital Makurdi Nigeria
| | - Temitope H Farombi
- Chief Tony Anenih Geriatrics Center, University College Hospital Ibadan, Oyo Nigeria
| | | | - Francis I Ojini
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences College of Medicine, University of Lagos Lagos Nigeria.,Neurology Unit, Department of Medicine Lagos University Teaching Hospital Lagos Nigeria
| | - Frank A Imarhiagbe
- University of Benin/University of Benin Teaching Hospital Benin City Nigeria
| | - Yakub Nyandaiti
- University of Maiduguri/University of Maiduguri Teaching Hospital Maiduguri Nigeria
| | - Morenikeji A Komolafe
- Neurology Unit, Department of Medicine Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | - Michael B Fawale
- Neurology Unit, Department of Medicine Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | | | - Yusuf Zubair
- Department of Internal Medicine National Hospital Abuja Nigeria
| | - Uduak E Williams
- Department of Internal Medicine University of Calabar/University of Calabar Teaching Hospital Calabar Nigeria
| | - Funlola T Taiwo
- Department of Medicine University College Hospital Ibadan Nigeria
| | | | - Olajumoke O Oshinaike
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences Lagos State University College of Medicine Ikeja Nigeria
| | - Nosakhare Osemwegie
- University of Port Harcourt/University of Port Harcourt Teaching Hospital Port Harcourt Nigeria
| | | | - Francis E Odiase
- University of Benin/University of Benin Teaching Hospital Benin City Nigeria
| | | | - Yahaya O Obiabo
- Department of Internal Medicine Delta State University/Delta State University Teaching Hospital Oghara Nigeria
| | | | - Ernest O Nwazor
- Department of Medicine Madonna University College of Medical Sciences/Federal Medical Center Elele/Owerri Nigeria
| | - Paul O Nwani
- Nnamdi Azikiwe University/Nnamdi Azikiwe University Teaching Hospital Nnewi Nigeria
| | - Abiodun J Kehinde
- Federal Medical Center, Jabi, Federal Capital Territory Abuja Nigeria
| | | | - Oluchi S Ekenze
- Neurology Unit, Department of Medicine, Faculty of Medical Sciences University of Nigeria/University of Nigeria Teaching Hospital Ituku Ozalla Nigeria
| | - Franklin O Dike
- University of Uyo Teaching Hospital/Ibom Specialist Hospital Uyo Nigeria
| | - Salisu A Balarabe
- Department of Medicine College of Health Sciences, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria
| | - Ohwotemu Arigbodi
- Department of Internal Medicine Delta State University Teaching Hospital Oghara Nigeria
| | | | | | | | | | - Rufus O Akinyemi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan Ibadan Nigeria
| | - Uchechi Agulanna
- Neurology Unit, Department of Medicine Lagos University Teaching Hospital Lagos Nigeria
| | | | - Osigwe P Agabi
- Neurology Unit, Department of Medicine Lagos University Teaching Hospital Lagos Nigeria
| | | | - Akintunde A Adebowale
- Neurology Unit, Department of Medicine Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria
| | | | | | - Mie Rizig
- Department of Molecular Neuroscience University College London Institute of Neurology London United Kingdom
| | - Njideka U Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences College of Medicine, University of Lagos Lagos Nigeria.,Neurology Unit, Department of Medicine Lagos University Teaching Hospital Lagos Nigeria
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Jamali F, Aldughmi M, Khasawneh MW, Dahbour S, Salameh AA, Awidi A. A New Tool for Safety Evaluation and a Combination of Measures for Efficacy Assessment of Cotransplanting Human Allogenic Neuronal Stem Cells and Mesenchymal Stem Cells for the Treatment of Parkinson Disease: Protocol for an Interventional Study. JMIR Res Protoc 2021; 10:e29695. [PMID: 34677138 PMCID: PMC8571682 DOI: 10.2196/29695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 01/24/2023] Open
Abstract
Background Parkinson disease (PD) is a neurodegenerative disorder associated with a broad spectrum of motor and nonmotor symptoms. Any proposed cure needs to address the many aspects of the disease. Stem cell therapy may have potential in this regard as indicated in recent preclinical and clinical studies. Objective This protocol aims to examine the safety and therapeutic benefit of human Wharton jelly-derived mesenchymal stem cells (WJ-MScs) and their derivatives, neuronal stem cells (NSCs) in PD. Methods This clinical trial is a double-arm, single-blinded, phase I-II interventional study. Participants have been allocated to 1 of 2 groups: one receiving allogeneic WJ-MSCs alone, the other receiving NSCs and WJ-MScs. Participants are being followed-up and assessed over a period of 6 months. To assess safety, an incidence of treatment-emergent adverse events (TEAEs) tool tailored for PD is being used immediately and up to 6 months after treatment. For efficacy assessment, a number of factors are being used, including the gold standard severity test and the Unified Parkinson Disease Rating Scale. In addition, the following standardized assessments for different common symptoms in PD are being included: motor (both subjectively and objectively assessed with wearable sensors), sensory, quality of life and psychological well-being, cognition, and sleep quality. Furthermore, immune-modulatory cytokines and neuronal damage versus regeneration markers in PD, including the neuronal protein linked to PD, α-synuclein, are being monitored. Results Ten patients have been enrolled in this study and thus participant recruitment has been completed. The study status is active and beyond the recruiting stage. Study chart implementation, data collection, and analysis are ongoing. Conclusions The combination of NSCs and MSCs in PD may be useful for harnessing the best of the immunomodulation and neural repair characteristics of these cell types. The tailored comprehensive and scaled TEAEs and the variety of evaluation tools used enables a comprehensive assessment of this cellular therapy treatment protocol. A consideration of this expanded tool set is important in the design of future clinical studies for PD. Trial Registration ClinicalTrials.gov NCT03684122; https://clinicaltrials.gov/ct2/show/NCT03684122 International Registered Report Identifier (IRRID) DERR1-10.2196/29695
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Affiliation(s)
- Fatima Jamali
- Cell Therapy Center, University of Jordan, Amman, Jordan
| | - Mayis Aldughmi
- Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | | | - Said Dahbour
- Medical Faculty, University of Jordan, Amman, Jordan.,Neurology Division, Jordan University Hospital, Amman, Jordan
| | - Alaa A Salameh
- Cell Therapy Center, University of Jordan, Amman, Jordan
| | - Abdalla Awidi
- Cell Therapy Center, University of Jordan, Amman, Jordan.,Hematology Department, Jordan University Hospital, Amman, Jordan
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Ayele BA, Zewde YZ, Tafesse A, Sultan A, Friedman JH, Bower JH. Non-Motor Symptoms and Associated Factors in Parkinson's Disease Patients in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study. Ethiop J Health Sci 2021; 31:837-846. [PMID: 34703184 PMCID: PMC8512934 DOI: 10.4314/ejhs.v31i4.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Non-motor symptoms (NMSs) of Parkinson's disease (PD) were often overlooked and less studied. Little is known about NMSs in Ethiopia. The aim of the study was to determine the prevalence of NMSs and associated factors. METHODS A multi-center cross-sectional observational study was conducted. NMS questionnaire was used to screen for the NMSs. Both descriptive and analytical statistics were used to analyze the data. RESULTS Total of 123 PD patients with median of 4 years were investigated. The mean age of PD patients was 62.9 years. The mean age of PD onset was 58.3 years. In 23.6% the age of onset was below age 50. Males accounted 72.4%. Majority of the patients were on Levodopa alone and 31.7% were on levodopa plus trihexyphenidyl. Longer duration of illness was associated with frequent occurrence of NMSs. Constipation was the commonest NMS (78%), followed by urinary urgency (67.5%) and nocturia (63.4%). An unexplained pain was reported by 45.5 %, cognitive impairment (45.5%), and sleep disturbance was reported by 45.5% of the study participants. Neurophysciatric symptoms were reported by small proportion of the patients. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness. CONCLUSION The prevalence of NMS was high among PD patients in Ethiopia. Constipation was the commonest NMS. Longer duration of illness was associated with frequent occurrence of NMSs. Lower monthly earning was associated with swallowing problem, unexplained weight change, and lighheadness.
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Affiliation(s)
- Biniyam A Ayele
- Department of Neurology, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Yared Zenebe Zewde
- Department of Neurology, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Amir Sultan
- Gastroenterology and Hepatology Division, Department of Internal Medicine, College of Health Sciences, Addis Ababa University
| | - Joseph H Friedman
- Stanley Aronson Chair in Neurodegenerative Disorders, Director of Movement Disorders Program, Butler Hospital, Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - James H Bower
- Chair of Division of Movement Disorders, Department of Neurology, Mayo clinic, Rochester, Minnesota, USA
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Wang W, Lv R, Zhang J, Liu Y. circSAMD4A participates in the apoptosis and autophagy of dopaminergic neurons via the miR‑29c‑3p‑mediated AMPK/mTOR pathway in Parkinson's disease. Mol Med Rep 2021; 24:540. [PMID: 34080649 PMCID: PMC8170871 DOI: 10.3892/mmr.2021.12179] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease (PD) can lead to movement injury and cognitive dysfunction. Although advances have been made in attenuating PD, the effect of inhibiting the development of PD remains disappointing. Therefore, the present study aimed at investigating the etiology of Parkinson's disease and developing an alternative therapeutic strategy for patients with PD. A PD mouse model was established using an intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP-HCl; 30 mg/kg/day for 5 days), and a PD cellular model was established by treating SH-SY5Y cells with different concentrations of 1-methyl-4-phenylpyridinium (MPP+) for 24 h. The expression levels of circular RNA sterile α motif domain containing 4A (circSAMD4A) and microRNA (miR)-29c-3p in both midbrain tissues and SH-SY5Y cells were detected via reverse transcription-quantitative PCR. The interaction between circSAMD4A and miR-29c-3p was verified using a dual-luciferase reporter experiment. Apoptosis-, autophagy- and 5′AMP-activated protein kinase (AMPK)/mTOR cascade-associated proteins in midbrain tissues and SH-SY5Y cells were detected using western blotting. Furthermore, TUNEL staining and flow cytometry were used to analyze cell apoptosis. It was found that circSAMD4A was upregulated, while miR-29c-3p was downregulated in both PD animal and cellular models. Moreover, circSAMD4A directly targeted and negatively regulated miR-29c-3p. Further studies identified that circSAMD4A knockdown inhibited MPTP- or MPP+-induced apoptosis and autophagy; however, these effects were abolished by an miR-29c-3p inhibitor. In addition, circSAMD4A knockdown repressed phosphorylated-AMPK expression and increased mTOR expression in MPTP- or MPP+-induced PD models, the effects of which were reversed by a miR-29c-3p inhibitor. Collectively, these results suggested that circSAMD4A participated in the apoptosis and autophagy of dopaminergic neurons by modulating the AMPK/mTOR cascade via miR-29c-3p in PD.
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Affiliation(s)
- Wensheng Wang
- Department of Neurology, Ningbo No. 6 Hospital, Ningbo, Zhejiang 315040, P.R. China
| | - Rongxiang Lv
- Department of Neurology, Ningbo No. 6 Hospital, Ningbo, Zhejiang 315040, P.R. China
| | - Jingjing Zhang
- Department of Neurology, Ningbo No. 6 Hospital, Ningbo, Zhejiang 315040, P.R. China
| | - Yu Liu
- Department of Neurology, Ningbo No. 6 Hospital, Ningbo, Zhejiang 315040, P.R. China
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20
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Tsunemi T, Oyama G, Saiki S, Hatano T, Fukae J, Shimo Y, Hattori N. Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review. Mov Disord 2021; 36:1759-1771. [PMID: 33899262 PMCID: PMC9290931 DOI: 10.1002/mds.28595] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/18/2021] [Accepted: 03/05/2021] [Indexed: 02/01/2023] Open
Abstract
Advanced Parkinson's disease is inconsistently defined, and evidence is lacking in relation to device‐aided therapies. To update existing reviews of intrajejunal infusion of levodopa/carbidopa (LCIG), we performed a literature search for relevant articles (to November 3, 2020) using PubMed supplemented by hand searching. Retrieved articles were categorized by relevance to identified research questions, including motor complications and symptoms; nonmotor symptoms; functioning, quality of life, and caregiver burden; optimal timing of treatment initiation and administration duration; discontinuation; and complications. Most eligible studies (n = 56) were open‐label, observational studies including relatively small patient numbers. LCIG consistently reduces OFF time and increased ON time without troublesome dyskinesia with varying effects regarding ON time with troublesome dyskinesia and the possibility of diphasic dyskinesia. More recent evidence provides some increased support for the benefits of LCIG in relation to nonmotor symptoms, quality of life, activities of daily living, and reduced caregiver burden. Patient age does not appear to significantly impact the effectiveness of LCIG. Discontinuation rates with LCIG (~17%–26%) commonly relate to device‐related issues, although the ability to easily discontinue LCIG may represent a potential benefit. LCIG may be a favorable option for patients with advanced Parkinson's disease who show predominant nonmotor symptoms and vulnerability to complications of other advanced therapy modalities. Larger, well‐controlled studies, including precise investigation of cost effectiveness, would further assist treatment selection. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Taiji Tsunemi
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.,Neurodegenerative and Demented Disorders, Juntendo University School of Medicine, Tokyo, Japan.,Home Medical Care System Based on Information and Communications Technology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shinji Saiki
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.,Neurodegenerative and Demented Disorders, Juntendo University School of Medicine, Tokyo, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo Nerima Hospital, Tokyo, Japan.,Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.,Neurodegenerative and Demented Disorders, Juntendo University School of Medicine, Tokyo, Japan.,Home Medical Care System Based on Information and Communications Technology, Juntendo University School of Medicine, Tokyo, Japan.,Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, Tokyo, Japan
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21
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Shalash AS, Hamid E, Elrassas H, Bahbah EI, Mansour AH, Mohamed H, Elbalkimy M. Non-motor symptoms in essential tremor, akinetic rigid and tremor-dominant subtypes of Parkinson's disease. PLoS One 2021; 16:e0245918. [PMID: 33503062 PMCID: PMC7840014 DOI: 10.1371/journal.pone.0245918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/10/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives To compare non-motor symptoms (NMSs) among patients with essential tremor (ET), Parkinson’s disease (PD) subtypes (akinetic-rigid type (ART) and tremor-dominant type (TDT)), and healthy controls. Patients and methods This retrospective study included 129 participants, 72 PD (33 PD-ART, 33 PD-TDT, and 6 Mixed), 29 ET patients, and 28 controls. PD patients were assessed by the unified Parkinson’s disease rating scale (UPDRS), Hoehn, and Yahr scale (H&Y), while ET patients were evaluated by the Fahn Tolosa Marin Tremor Rating Scale. All subjects were evaluated by non-motor symptoms scale (NMSS) for NMSs and Beck depression inventory (BDI) for depression. Results PD subtypes groups, ET, and controls were age and gender-matched. Compared to controls, all PD, PD subtypes, and ET showed significantly worse most of NMSs (p<0.001) and depression. Compared to ET, all PD and PD-ART had significantly worse gastrointestinal (p = 0.002), urinary symptoms (p = 0.001, p = 0.003) and depression (p = 0.002) and PD-TDT worse depression, while ET patients showed worse memory/attention than PD subtypes. Total NMSS of ET is highly correlated to depression and moderately to tremor severity and age of onset, while total of NMSS is highly correlated to depression, disease severity, and disability. Conclusion The current study demonstrated several comparable domains of NMSs of PD subtypes and ET, except worse gastrointestinal and urinary symptoms among PD-ART. Identifying different NMSs profiles is important for predicting, better assessing, and tailoring management of ET and PD subtypes.
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Affiliation(s)
- Ali S Shalash
- Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Eman Hamid
- Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Hanan Elrassas
- Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Eshak I Bahbah
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Alia H Mansour
- Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Hadeer Mohamed
- Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elbalkimy
- Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt
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22
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Han NR, Kim YK, Ahn S, Hwang TY, Lee H, Park HJ. A Comprehensive Phenotype of Non-motor Impairments and Distribution of Alpha-Synuclein Deposition in Parkinsonism-Induced Mice by a Combination Injection of MPTP and Probenecid. Front Aging Neurosci 2021; 12:599045. [PMID: 33519420 PMCID: PMC7838388 DOI: 10.3389/fnagi.2020.599045] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is characterized by non-motor symptoms as well as motor deficits. The non-motor symptoms rarely appear individually and occur simultaneously with motor deficits or independently. However, a comprehensive research on the non-motor symptoms using an experimental model of PD remains poorly understood. The aim of the current study is to establish a chronic mouse model of PD mimicking the comprehensive non-motor symptoms of human PD by injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and probenecid (MPTP/p). The non-motor and motor symptoms were evaluated by performing buried food, short-term olfactory memory, hot plate, open field, tail suspension, Y maze, novel object recognition, bead expulsion, one-h stool collection, rotarod, rearing, catalepsy, and akinesia tests after 10 injections of MPTP/p into mice. The expression levels of α-synuclein, glial fibrillary acidic protein (GFAP), tyrosine hydroxylase (TH) or DJ-1 were analyzed by Western blotting or immunostaining. MPTP/p-treated mice achieved to reproduce the key features of non-motor symptoms including olfactory deficit, thermal hyperalgesia, anxiety, depression, cognitive decline, and gastrointestinal dysfunction in addition to motor deficits. The MPTP/p-treated mice also showed the high levels of α-synuclein and low levels of TH and DJ-1 in striatum, substantia nigra, olfactory bulb, hippocampus, amygdala, prefrontal cortex, locus coeruleus, or colon. In addition, the expression levels of phosphorylated-α-synuclein and GFAP were elevated in the striatum and substantia nigra in the MPTP/p-treated mice. Taken together, our study clarifies that the chronic MPTP/p-treated mice have a variety of non-motor dysfunctions as well as motor abnormalities by α-synuclein overexpression and dopaminergic depletion. Therefore, the study of comprehensive phenotypes of non-motor symptoms in one PD model would advance in-depth understandings of neuropathological alternations and contribute to future strategies for PD treatment.
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Affiliation(s)
- Na-Ra Han
- Integrative Parkinson's Disease Research Group, Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, South Korea.,Department of Anatomy & Information Sciences, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Yu-Kang Kim
- Integrative Parkinson's Disease Research Group, Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, South Korea.,Department of Anatomy & Information Sciences, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Sora Ahn
- Integrative Parkinson's Disease Research Group, Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, South Korea
| | - Tae-Yeon Hwang
- Integrative Parkinson's Disease Research Group, Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, South Korea.,Department of Meridian & Acupoints, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Hyejung Lee
- Department of Meridian & Acupoints, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Hi-Joon Park
- Integrative Parkinson's Disease Research Group, Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, South Korea.,Department of Anatomy & Information Sciences, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
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23
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Khedr EM, Abdelrahman AA, Elserogy Y, Zaki AF, Gamea A. Depression and anxiety among patients with Parkinson’s disease: frequency, risk factors, and impact on quality of life. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00253-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Depression and anxiety are non-motor symptoms of Parkinson’s disease (PD) that are often overlooked and underrated. This study aimed to highlight the frequency and risk factors of depression and anxiety among subjects with PD.
Methods
Sixty-four patients with PD who were diagnosed according to United Kingdom Parkinson’s Disease Society (UKPDS) Brain Bank Criteria and 50 sex- and age-matched healthy control subjects are evaluated for depression and anxiety. PD severity and staging were assessed using Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr scale. Depression and anxiety were diagnosed using DSM-IV TR criteria and scored using Hamilton Depression and Hamilton Anxiety Rating Scales (HAM-D and HAM-A). The World Health Organization Quality of Life (WHOQOL)-BREF was used to assess impact of depression and anxiety on quality of life.
Results
31.25% of patients with PD had depression while 40.6% of patients had anxiety disorder. Depression was higher in females and patients with history of depression and low socioeconomic status (SES). Anxiety was common in young patients and those who had history of anxiety. Overlap between depression and anxiety was recorded in 23.4%. Total UPDRS and Hoehn and Yahr scale accounted for 33.4% of variance for depression. Total UPDRS and earlier age of onset accounted for 39% of variance for anxiety. Advanced disease stage and severity were independent predictors for depression while disease severity and younger age of onset were the main predictors for anxiety. Depression and anxiety have a negative impact on the overall quality of life of PD patients especially on physical and psychosocial domains.
Conclusion
Depression and anxiety are relatively common in PD. Female gender, low SES, and history of depression were the main risk factors for developing depression. Young age and history of anxiety were risk factors for anxiety. Both had negative impact on quality of life.
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24
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Sexual dysfunction in male patients with Parkinson's disease: related factors and impact on quality of life. Neurol Sci 2020; 41:2201-2206. [PMID: 32172403 DOI: 10.1007/s10072-020-04328-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 03/05/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Sexual dysfunction (SD) is a common, yet under-reported, non-motor symptom (NMS) of Parkinson's disease (PD). The present study investigated the sexual functions in PD male patients, its correlation with motor and other NMSs, and their impact on health-related quality of life (HRQoL). METHODS The sexual functions of 40 PD male patients were assessed using the International Index of Erectile Function (IIEF) and compared to 25 healthy age-matched controls. Patients were evaluated using the NMS Scale (NMSS) and the Arabic version of the Parkinson's-Disease Questionnaire (PDQ-39). We compared the sexual functions of younger (≤ 55 years) and elder (> 55 years) males and tested the correlations between sexual functions and motor, other NMSs, and HRQoL. RESULTS Seventy percent of PD male patients reported erectile dysfunction. They showed significantly worse total (p < 0.001) and subscores of IIEF, compared to healthy controls. The total IIEF was inversely correlated to age of patients (p = 0.013), age at onset (p = 0.043), total, cognitive/mood, gastrointestinal and urinary domains of NMSS, and the cognitive domain of PDQ-39 (p = 0.013). Age was the main predictor (ß = - 0.581, p = 0.006) of SD. Elder patients showed worse sexual functions, stronger correlations to other NMSs, and more impact on HRQoL than younger patients. CONCLUSION Sexual functions are worse among PD male patients with age as the main predictor. SD was associated with worse cognitive/mood and urinary domains of NMSS and has a negative impact on the patients' HRQoL among elder males.
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Shalash AS, Mohamed H, Mansour AH, Elkady A, Elrassas H, Hamid E, Elbalkimy MH. Clinical Profile of Non-Motor Symptoms in Patients with Essential Tremor: Impact on Quality of Life and Age-Related Differences. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2019; 9:tre-09-736. [PMID: 31867132 PMCID: PMC6898893 DOI: 10.7916/tohm.v0.736] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/08/2019] [Indexed: 12/18/2022]
Abstract
Background Identifying the clinical phenotypes of non-motor symptoms (NMSs) of essential tremor (ET) among different populations is necessary due to their impact on the quality of life (QoL). This study aimed to investigate the clinical phenotype and impact of NMSs on QoL in Egyptian patients with ET. Methods Thirty ET patients were compared to 30 matched controls. Subjects were evaluated by the Fahn-Tolosa-Marin Tremor Rating Scale, Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment, Hamilton Anxiety Rating Scale, Beck Depression Inventory, Pittsburgh Sleep quality Index, and the Short Form 36 Health Survey Questionnaire. Both groups were divided into two subgroups of younger (<45 years, 14 patients) and older age (>45 years, 16 patients) groups, to investigate age-related differences. Results ET patients showed significantly worse cognition, depression, anxiety, sleep and NMSS domains (p < 0.001), compared to controls, that negatively affected and predicted QoL. Older patients had more cognitive impairment (p = 0.003) and worse sleep/fatigue (p = 0.032) and sexual functions (p = 0.006), compared to younger group. Discussion The study supports that NMSs are integral part of ET, negatively affect QoL, and similarly affect younger and older patients. Therefore, NMSs should be explored for proper care of ET patients.
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Affiliation(s)
- Ali S Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
| | - Hadeer Mohamed
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
| | - Alia H Mansour
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
| | - Ahmed Elkady
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
| | - Hanan Elrassas
- Okasha Institute of Psychiatry, Ain Shams University, Cairo, EG
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
| | - Mahmoud H Elbalkimy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, EG
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26
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Ragab OA, Elheneedy YA, Bahnasy WS. Non-motor symptoms in newly diagnosed Parkinson’s disease patients. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0070-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Ball N, Teo WP, Chandra S, Chapman J. Parkinson's Disease and the Environment. Front Neurol 2019; 10:218. [PMID: 30941085 PMCID: PMC6433887 DOI: 10.3389/fneur.2019.00218] [Citation(s) in RCA: 227] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 02/20/2019] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder that affects an estimated 10 million sufferers worldwide. The two forms of PD include familial and sporadic, and while the etiology of PD is still largely unknown, the condition is likely to be multifactorial with genetic and environmental factors contributing to disease genesis. Diagnosis of the condition is attained through the observation of cardinal clinical manifestations including resting tremor, muscle rigidity, slowness or loss of movement, and postural instability. Unfortunately, by the time these features become apparent extensive neurological damage has already occurred. A cure for PD has not been identified and the current therapy options are pharmaceutical- and/or surgical-based interventions to treat condition symptoms. There is no specific test for PD and most diagnoses are confirmed by a combination of clinical symptoms and positive responses to dopaminergic drug therapies. The prevalence and incidence of PD vary worldwide influenced by several factors such as age, gender, ethnicity, genetic susceptibilities, and environmental exposures. Here, we will present environmental factors implicated in sporadic PD onset. By understanding the mechanisms in which environmental factors interact with, and affect the brain we can stride toward finding the underlying cause(s) of PD.
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Affiliation(s)
- Nicole Ball
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Wei-Peng Teo
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia.,Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Shaneel Chandra
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - James Chapman
- School of Science, RMIT University, Melbourne, VIC, Australia
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