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Sun W, Wan K, Li S, Shen G, Dong X, Yu G, Feng Z, Zheng C. Dysphagia in Parkinson's disease: A bibliometric and visualization analysis from 2002 to 2022. Heliyon 2024; 10:e30191. [PMID: 38707269 PMCID: PMC11066392 DOI: 10.1016/j.heliyon.2024.e30191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Background Dysphagia, or difficulty swallowing, is a prevalent complication of Parkinson's disease (PD), which can significantly impair quality of life. Despite the numerous studies on dysphagia in PD published in various journals, there remains a dearth of bibliometric analysis within this domain. This study thus aims to examine the global patterns of research on dysphagia after PD over the past 20 years, employing a visual analysis. Material and methods This investigation aimed to gather pertinent publications concerning dysphagia in PD from the SCI-Expanded database of the Web of Science Core Collection (WoSCC), covering the period from 2002 to 2022. To dissect and visually represent the collated corpus, we harnessed the capacities of CiteSpace, VOSviewer and R software for meticulous bibliometric scrutiny. Results The bibliometric study encompassed a total of 692 publications. Within the scope of autocratic nations, the USA emerged as the leading country in the quantity of research outputs. The University of Florida stood out as the most prolific academic entity, with Troche MS being the foremost author, contributing to 21 publications. The journal "Dysphagia" featured as the prime venue for publication. Key trending terms identified over the last 20 years include "Parkinson's disease," "dysphagia," "oropharyngeal dysphagia," and "prevalence." Conclusion Bibliometric analysis on dysphagia in PD offers a detailed overview of the development of scholarly publications, enabling scholars to grasp the current state of research within their field. It also serves as a benchmark for shaping future research directions.
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Affiliation(s)
- Weiming Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Keqi Wan
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Shilin Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Guojian Shen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Xiangli Dong
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
- Department of Psychosomatic Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Guohua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Postdoctoral Innovation Practice Base, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Rehabilitation Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Chafeng Zheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- The First Clinical Medical College, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
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Xie T, Warnke PC. Comment on: "A Transatlantic Viewpoint on the Role of Pallidal Stimulation for Parkinson's Disease". Mov Disord 2024; 39:760-761. [PMID: 38661038 DOI: 10.1002/mds.29782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Tao Xie
- Department of Neurology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Peter C Warnke
- Department of Neurological Surgery, University of Chicago Medicine, Chicago, Illinois, USA
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Boogers A, Fasano A. Reply to: Comment on: A Transatlantic Viewpoint on the Role of Pallidal Stimulation for Parkinson's Disease. Mov Disord 2024; 39:761. [PMID: 38661042 DOI: 10.1002/mds.29780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Alexandra Boogers
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, and Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, and Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, Ontario, Canada
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4
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Wei KC, Wang TG, Hsiao MY. The Cortical and Subcortical Neural Control of Swallowing: A Narrative Review. Dysphagia 2024; 39:177-197. [PMID: 37603047 DOI: 10.1007/s00455-023-10613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 08/03/2023] [Indexed: 08/22/2023]
Abstract
Swallowing is a sophisticated process involving the precise and timely coordination of the central and peripheral nervous systems, along with the musculatures of the oral cavity, pharynx, and airway. The role of the infratentorial neural structure, including the swallowing central pattern generator and cranial nerve nuclei, has been described in greater detail compared with both the cortical and subcortical neural structures. Nonetheless, accumulated data from analysis of swallowing performance in patients with different neurological diseases and conditions, along with results from neurophysiological studies of normal swallowing have gradually enhanced understanding of the role of cortical and subcortical neural structures in swallowing, potentially leading to the development of treatment modalities for patients suffering from dysphagia. This review article summarizes findings about the role of both cortical and subcortical neural structures in swallowing based on results from neurophysiological studies and studies of various neurological diseases. In sum, cortical regions are mainly in charge of initiation and coordination of swallowing after receiving afferent information, while subcortical structures including basal ganglia and thalamus are responsible for movement control and regulation during swallowing through the cortico-basal ganglia-thalamo-cortical loop. This article also presents how cortical and subcortical neural structures interact with each other to generate the swallowing response. In addition, we provided the updated evidence about the clinical applications and efficacy of neuromodulation techniques, including both non-invasive brain stimulation and deep brain stimulation on dysphagia.
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Affiliation(s)
- Kuo-Chang Wei
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Jinshan Branch, New Taipei City, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan
| | - Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan.
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No. 7, Zhongshan South Road, Zhongzheng District, Taipei, 100, Taiwan.
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5
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Krause A, Anderson DG, Ferreira-Correia A, Dawson J, Baine-Savanhu F, Li PP, Margolis RL. Huntington disease-like 2: insight into neurodegeneration from an African disease. Nat Rev Neurol 2024; 20:36-49. [PMID: 38114648 DOI: 10.1038/s41582-023-00906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/21/2023]
Abstract
Huntington disease (HD)-like 2 (HDL2) is a rare genetic disease caused by an expanded trinucleotide repeat in the JPH3 gene (encoding junctophilin 3) that shows remarkable clinical similarity to HD. To date, HDL2 has been reported only in patients with definite or probable African ancestry. A single haplotype background is shared by patients with HDL2 from different populations, supporting a common African origin for the expansion mutation. Nevertheless, outside South Africa, reports of patients with HDL2 in Africa are scarce, probably owing to limited clinical services across the continent. Systematic comparisons of HDL2 and HD have revealed closely overlapping motor, cognitive and psychiatric features and similar patterns of cerebral and striatal atrophy. The pathogenesis of HDL2 remains unclear but it is proposed to occur through several mechanisms, including loss of protein function and RNA and/or protein toxicity. This Review summarizes our current knowledge of this African-specific HD phenocopy and highlights key areas of overlap between HDL2 and HD. Given the aforementioned similarities in clinical phenotype and pathology, an improved understanding of HDL2 could provide novel insights into HD and other neurodegenerative and/or trinucleotide repeat expansion disorders.
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Affiliation(s)
- Amanda Krause
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - David G Anderson
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- University of Glasgow, Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, UK
| | - Aline Ferreira-Correia
- Department of Psychology, School of Human and Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Jessica Dawson
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fiona Baine-Savanhu
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pan P Li
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Russell L Margolis
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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6
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Olson MC, Shill H, Ponce F, Aslam S. Deep brain stimulation in PD: risk of complications, morbidity, and hospitalizations: a systematic review. Front Aging Neurosci 2023; 15:1258190. [PMID: 38046469 PMCID: PMC10690827 DOI: 10.3389/fnagi.2023.1258190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Parkinson's disease (PD) is a progressive and debilitating neurological disorder. While dopaminergic medication improves PD symptoms, continued management is complicated by continued symptom progression, increasing medication fluctuations, and medication-related dyskinesia. Deep brain stimulation (DBS) surgery is a well-accepted and widespread treatment often utilized to address these symptoms in advanced PD. However, DBS may also lead to complications requiring hospitalization. In addition, patients with PD and DBS may have specialized care needs during hospitalization. Methods This systematic review seeks to characterize the complications and risk of hospitalization following DBS surgery. Patient risk factors and modifications to DBS surgical techniques that may affect surgical risk are also discussed. Results It is found that, when candidates are carefully screened, DBS is a relatively low-risk procedure, but rate of hospitalization is somewhat increased for DBS patients. Discussion More research is needed to determine the relative influence of more advanced disease vs. DBS itself in increased rate of hospitalization, but education about DBS and PD is important to insure effective patient care within the hospital.
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Affiliation(s)
- Markey C. Olson
- Department of Neurology, Muhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
- Department of Neurosurgery, Barrow Brain and Spine, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
| | - Holly Shill
- Department of Neurology, Muhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
| | - Francisco Ponce
- Department of Neurosurgery, Barrow Brain and Spine, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
| | - Sana Aslam
- Department of Neurology, Muhammad Ali Movement Disorders Clinic, Barrow Neurological Institute, St Joseph’s Hospital and Medical Center, Phoenix, AZ, United States
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Najera RA, Mahavadi AK, Khan AU, Boddeti U, Del Bene VA, Walker HC, Bentley JN. Alternative patterns of deep brain stimulation in neurologic and neuropsychiatric disorders. Front Neuroinform 2023; 17:1156818. [PMID: 37415779 PMCID: PMC10320008 DOI: 10.3389/fninf.2023.1156818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Deep brain stimulation (DBS) is a widely used clinical therapy that modulates neuronal firing in subcortical structures, eliciting downstream network effects. Its effectiveness is determined by electrode geometry and location as well as adjustable stimulation parameters including pulse width, interstimulus interval, frequency, and amplitude. These parameters are often determined empirically during clinical or intraoperative programming and can be altered to an almost unlimited number of combinations. Conventional high-frequency stimulation uses a continuous high-frequency square-wave pulse (typically 130-160 Hz), but other stimulation patterns may prove efficacious, such as continuous or bursting theta-frequencies, variable frequencies, and coordinated reset stimulation. Here we summarize the current landscape and potential clinical applications for novel stimulation patterns.
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Affiliation(s)
- Ricardo A. Najera
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Anil K. Mahavadi
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Anas U. Khan
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ujwal Boddeti
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Victor A. Del Bene
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Harrison C. Walker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - J. Nicole Bentley
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, United States
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Youn J, Umemoto G, Oh E, Park J, Jang W, Oh YS, Kim HT, Cho JW, Fujioka S, Tsuboi Y. Cardiac sympathetic denervation could be associated with dysphagia in Parkinson's disease. Front Neurol 2022; 13:1010006. [PMID: 36303556 PMCID: PMC9592804 DOI: 10.3389/fneur.2022.1010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDysphagia is an important non-motor symptom that is closely associated with quality of living and mortality in Parkinson's disease (PD). However, the pathophysiology of dysphagia in PD remains inconclusive. We tried to confirm whether the occurrence of dysphagia could be related to sympathetic degeneration using cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy.MethodsWe prospectively recruited 27 PD patients and classified them into two groups (PD with dysphagia vs. PD without dysphagia) by Swallowing Disturbance Questionnaire (SDQ) score and compared the clinical characteristics, videofluoroscopic swallowing study (VFSS) findings and parameters from cardiac MIBG scintigraphy.ResultsThe mean early and late H/M ratios were significantly lower in the PD with dysphagia group than those in the PD without dysphagia group (1.39 ± 0.21 vs. 1.86 ± 0.21, p < 0.01; 1.26 ± 0.18 vs. 1.82 ± 0.29, p < 0.01). In the correlation analysis, both the early and late H/M ratios were negatively correlated with the SDQ score and total VDS score (r = −0.65, p < 0.01; r = −0.53, p < 0.01; r = −0.65, p < 0.01, r = −0.58, p < 0.01).ConclusionWe confirmed that cardiac sympathetic denervation might be associated with the presence and severity of dysphagia. This finding indicates that dysphagia in PD could be associated with a nondopaminergic mechanism.
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Affiliation(s)
- Jinyoung Youn
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - George Umemoto
- Swallowing Disorders Center, Fukuoka University Hospital, Fukuoka, Japan
| | - Eungseok Oh
- Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Jinse Park
- Department of Neurology, Inje University, Haeundae Paik Hospital, Busan, South Korea
| | - Wooyoung Jang
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
- *Correspondence: Wooyoung Jang
| | - Yoon-Sang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hee-Tae Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul, South Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Shinsuke Fujioka
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Henry KA, Singh R, Zhang N, Lyons MK, McNett K, Neal MT, Mehta SH. Effect of STN/GPi DBS on swallowing function in Parkinson's disease as assessed by Video fluoroscopy: A retrospective study. Parkinsonism Relat Disord 2022; 103:136-140. [PMID: 36115199 DOI: 10.1016/j.parkreldis.2022.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The goal of the study is to objectively assess changes in swallowing (using "gold standard" video fluoroscopy (VFS)) following Deep Brain Stimulation (DBS) surgery in Parkinson's disease (PD) patients. There are few studies on the effect of DBS on swallowing in PD. We use VFS to assess swallowing function pre- and post-DBS. METHODS Our study participants underwent pre- and post-DBS VFS (6 months later) in the practically defined on state. We converted VFS reports into an objective numerical scale. Higher scores denote more severe dysphagia. We used non-parametric test (Wilcoxon signed rank test) to test if the difference between pre- and post-DBS swallow score is significantly different from 0. RESULTS Fifty-four PD patients completed pre- and post-DBS evaluations. Twenty-five patients had bilateral GPi DBS (46.3%) and 29 had bilateral STN DBS (53.7%). The mean (SD) post-DBS swallow score is 1.9 (2.0) and pre-DBS swallow score is 1.6 (1.3). The difference is not significantly different from 0 (p = 0.16). In our study, swallow scores for majority of the patients (39 out of 54) did not change after DBS regardless of lead location. Six (11.1%) PD patients had post-DBS swallow score decrease on average by 1 (SD: 0) points. 9 (16.7%) patients had post-DBS swallow score increase on average by 2.7 (SD: 2.3) points. CONCLUSION There was no statistically significant change in the swallow scores pre-and 6 months post-DBS with VFS when assessed in the practically defined on state, regardless of the site of bilateral lead implantation. Hence, we believe that DBS does not improve or reduce swallow function in a clinically meaningful way in PD.
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Affiliation(s)
- Katharine A Henry
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Rohin Singh
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Nan Zhang
- Department of Biostatics, Mayo Clinic, Scottsdale, AZ, USA
| | - Mark K Lyons
- Department of Neurosurgery, Mayo Clinic, Scottsdale, AZ, USA
| | - Karen McNett
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA
| | - Matthew T Neal
- Department of Neurosurgery, Mayo Clinic, Scottsdale, AZ, USA
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Warnecke T, Schäfer KH, Claus I, Del Tredici K, Jost WH. Gastrointestinal involvement in Parkinson's disease: pathophysiology, diagnosis, and management. NPJ Parkinsons Dis 2022; 8:31. [PMID: 35332158 PMCID: PMC8948218 DOI: 10.1038/s41531-022-00295-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 02/23/2022] [Indexed: 12/12/2022] Open
Abstract
Growing evidence suggests an increasing significance for the extent of gastrointestinal tract (GIT) dysfunction in Parkinson's disease (PD). Most patients suffer from GIT symptoms, including dysphagia, sialorrhea, bloating, nausea, vomiting, gastroparesis, and constipation during the disease course. The underlying pathomechanisms of this α-synucleinopathy play an important role in disease development and progression, i.e., early accumulation of Lewy pathology in the enteric and central nervous systems is implicated in pharyngeal discoordination, esophageal and gastric motility/peristalsis impairment, chronic pain, altered intestinal permeability and autonomic dysfunction of the colon, with subsequent constipation. Severe complications, including malnutrition, dehydration, insufficient drug effects, aspiration pneumonia, intestinal obstruction, and megacolon, frequently result in hospitalization. Sophisticated diagnostic tools are now available that permit more detailed examination of specific GIT impairment patterns. Furthermore, novel treatment approaches have been evaluated, although high-level evidence trials are often missing. Finally, the burgeoning literature devoted to the GIT microbiome reveals its importance for neurologists. We review current knowledge about GIT pathoanatomy, pathophysiology, diagnosis, and treatment in PD and provide recommendations for management in daily practice.
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Affiliation(s)
- T Warnecke
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, 48149, Münster, Germany
| | - K-H Schäfer
- Research and Transfer Working Group Enteric Nervous System (AGENS), University of Applied Sciences Kaiserslautern, Campus Zweibrücken, 66482, Zweibrücken, Germany
| | - I Claus
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, 48149, Münster, Germany
| | - K Del Tredici
- Clinical Neuroanatomy, Department of Neurology, Center for Biomedical Research, University of Ulm, 89081, Ulm, Germany
| | - W H Jost
- Parkinson-Klinik Ortenau, 77709, Wolfach, Germany.
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Title: Identifying subtypes of treatment effects of subthalamic nucleus deep brain stimulation on motor symptoms in patients of late-stage Parkinson’s disease with cluster analysis. BRAIN HEMORRHAGES 2022. [DOI: 10.1016/j.hest.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Ghosh S. Breathing disorders in neurodegenerative diseases. HANDBOOK OF CLINICAL NEUROLOGY 2022; 189:223-239. [PMID: 36031306 DOI: 10.1016/b978-0-323-91532-8.00008-2] [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: 06/15/2023]
Abstract
Neurodegenerative disorders are a diverse group of conditions caused by progressive degeneration of neurons resulting in cognitive, motor, sensory, and autonomic dysfunction, leading to severe disability and death. Pulmonary dysfunction is relatively common in these conditions, may be present early in the disease, and is less well recognized and treated than other symptoms. There are variable disorders of upper and lower airways, central control of ventilation, strength of respiratory muscles, and breathing during sleep which further impact daily activities and quality of life and have the potential to injure vulnerable neurons. Laryngopharyngeal dysfunction affects speech, swallowing, and clearance of secretions, increases the risk of aspiration pneumonia, and can cause stridor and sudden death. In Parkinson's disease, L-Dopa benefits some pulmonary symptoms but there are limited pharmacological treatment options for pulmonary dysfunction. Targeted treatments include strengthening of respiratory muscles, positive airway pressure in sleep and techniques to improve cough efficacy. Well-designed clinical trials are needed to evaluate the long-term benefits of these interventions. Challenges for the future include earlier identification of pulmonary dysfunction in the clinic, institution of the most effective treatments (based on clinical trials that measure long-term meaningful outcomes) and the development of neuroprotective treatment.
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Affiliation(s)
- Soumya Ghosh
- Perron Institute for Neurological and Translational Science, University of Western Australia and Department of Neurology, Sir Charles Gairdner and Perth Children's Hospitals, Nedlands, WA, Australia.
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Personalized Medicine in Parkinson's Disease: New Options for Advanced Treatments. J Pers Med 2021; 11:jpm11070650. [PMID: 34357117 PMCID: PMC8303729 DOI: 10.3390/jpm11070650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 07/07/2021] [Indexed: 12/11/2022] Open
Abstract
Parkinson’s disease (PD) presents varying motor and non-motor features in each patient owing to their different backgrounds, such as age, gender, genetics, and environmental factors. Furthermore, in the advanced stages, troublesome symptoms vary between patients due to motor and non-motor complications. The treatment of PD has made great progress over recent decades and has directly contributed to an improvement in patients’ quality of life, especially through the progression of advanced treatment. Deep brain stimulation, radiofrequency, MR–guided focused ultrasound, gamma knife, levodopa-carbidopa intestinal gel, and apomorphine are now used in the clinical setting for this disease. With multiple treatment options currently available for all stages of PD, we here discuss the most recent options for advanced treatment, including cell therapy in advanced PD, from the perspective of personalized medicine.
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Xie T, Bloom L, Padmanaban M, Takahashi K, Kang W, Dachman A, MacCracken E, Warnke P. Impact of oral textures on aspiration and changes in swallow dynamics in patients with PD with DBS. J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2020-324579. [PMID: 33243856 DOI: 10.1136/jnnp-2020-324579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Tao Xie
- Department of Neurology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Lisa Bloom
- Speech and Swallowing Section, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Mahesh Padmanaban
- Department of Neurology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Kazutaka Takahashi
- Department of Organismal Biology and Anatomy, University of Chicago, Chicago, Illinois, USA
| | - Wenjun Kang
- Center for Research Informatics, University of Chicago, Chicago, Illinois, USA
| | - Abraham Dachman
- Department of Radiology, University of Chicago Medicine, Chicago, Illinois, USA
| | - Ellen MacCracken
- Speech and Swallowing Section, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA
| | - Peter Warnke
- Department of Neurosurgery, University of Chicago Medicine, Chicago, Illinois, USA
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