Brain Disorders, Journal Year: 2025, Volume and Issue: unknown, P. 100209 - 100209
Published: March 1, 2025
Language: Английский
The Lancet, Journal Year: 2024, Volume and Issue: 403(10423), P. 305 - 324
Published: Jan. 1, 2024
Language: Английский
Citations
73
New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 391(5), P. 442 - 452
Published: July 31, 2024
Parkinson's disease is a multisystem neurodegenerative disorder with motor and prominent, sometimes premonitory, nonmotor symptoms. Detection of gene variants may inform prognosis and, potentially, treatment.
Language: Английский
Citations
34
JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(1), P. e2352177 - e2352177
Published: Jan. 18, 2024
Importance Deep brain stimulation of the subthalamic nucleus (STN-DBS) improves quality life (QOL) in patients with advanced Parkinson disease (PD). However, controlled studies more than 3 years follow-up are lacking. Objective To investigate long-term effects STN-DBS on QOL compared standard-of-care medication (MED). Design, Setting, and Participants In this prospective, observational, quasi-experimental, longitudinal nonrandomized trial, 183 were screened for eligibility 167 enrolled from March 1, 2011, to May 31, 2017, at European university centers. Propensity score matching demographic clinical characteristics was applied 108 PD (62 group 46 MED group), resulting a well-balanced, matched subcohort 25 per group. Data analysis performed September 2022 January 2023. Exposure Treatment or MED. Main Outcomes Measures Assessments included Parkinson’s Disease Questionnaire 8 (PDQ-8), Unified Rating Scale–motor examination, Scales PD–activities daily living (ADL) motor complications, levodopa-equivalent dose. Within-group outcome changes, between-group differences, correlations change scores analyzed. Results The study population (mean [SD] age, 63.7 [8.3] years; 66 [61.1%] male). At 5-year follow-up, PDQ-8 ADL worsened only (PDQ-8 change, −10.9; 95% CI, −19.0 −2.7; P = .01; change: −2.0; −3.1 −0.8; .002), whereas both outcomes remained stable −4.3; −13.2 4.7; .34; −2.5 1.0; .38). Changes correlated moderately ( r s .40, .008). Furthermore, favorable complications (median difference between MED, −4.0 −1.0; .003), mobility (−1.0; −2.0 0; .03), dose reduction (−821.4; −1111.9 −530.8; < .001). Conclusions Relevance This provides evidence differences (stable) (worsened), mainly driven by effect (class IIb evidence). association changes ADL, but not impairment highlights relative importance DBS assessments. Trial Registration German ClinicalTrials Registry: DRKS00006735
Language: Английский
Citations
17
Tremor and Other Hyperkinetic Movements, Journal Year: 2022, Volume and Issue: 12(1)
Published: Jan. 1, 2022
Background: Tremor is one of the most prevalent symptoms in Parkinson's Disease (PD). The progression and management tremor PD can be challenging, as response to dopaminergic agents might relatively poor, particularly patients with tremor-dominant compared akinetic/rigid subtype. In this review, we aim highlight recent advances underlying pathogenesis treatment modalities for PD. Methods: A structured literature search through Embase was conducted using terms "Parkinson's Disease" AND "tremor" OR "etiology" "management" "drug resistance" "therapy" "rehabilitation" "surgery." After initial screening, eligible articles were selected a focus on published last 10 years. Discussion: pathophysiology remains complex incompletely understood. Neurodegeneration neurons retrorubral area, addition high-power neural oscillations cerebello-thalamo-cortical circuit basal ganglia, play major role. Levodopa first-line therapeutic option all motor symptoms, including tremor. dopamine agonists or anticholinergics lead further reduction. Botulinum toxin injection an effective alternative pharmacological-resistant who are not seeking advanced therapies. Deep brain stimulation well-established therapy owing its long-term efficacy, reversibility, effectiveness other fluctuations. Magnetic resonance-guided focused ultrasound promising modality, which has advantage being incisionless. Cortical peripheral electrical non-invasive innovatory techniques that have demonstrated good efficacy suppressing intractable
Language: Английский
Citations
45
Neurology and Therapy, Journal Year: 2023, Volume and Issue: 12(2), P. 391 - 424
Published: Jan. 12, 2023
Motor fluctuations (MF) are deemed by patients with Parkinson's disease (PD) as the most troublesome feature resulting from increasing impairment in responsiveness to dopaminergic drug treatments. MF characterized loss of a stable response levodopa over nychthemeron reappearance motor (and non-motor) parkinsonian clinical signs at various moments during day and night. They normally appear after few years treatment variable, though overall severity, course. The armamentarium first-line options has widened last decade new once-a-daily compounds, including catechol O-methyltransferase inhibitor – Opicapone-, two MAO-B inhibitors plus channel blocker Zonisamide Safinamide one amantadine extended-release formulation ADS5012. In addition apomorphine injection or oral dispersible tablets, which have been available for long time, on-demand therapies such sublingual inhaled formulations recently shown efficacy rescue Off-time treatment. When management becomes difficult spite oral/on-demand options, more complex should be considered, surgical, i.e. deep brain stimulation, device-aided pump systems delivering continuous subcutaneous intestinal formulation. Older less commonly used ablative techniques (radiofrequency pallidotomy) may also effective while there is still scarce data regarding reduction using lesional approach, magnetic resonance-guided focused ultrasound. choice between different advanced shared decision that consider physician opinion on contraindication/main target symptom, patients' preference, caregiver's availability together public health socio-economic environment. right/first add-on matter debate well proper time an therapy considered. this narrative review, we discuss all above cited aspects PD, their phenomenology, management, means pharmacological therapies, on-going trials future research perspectives.
Language: Английский
Citations
30
Mechanisms of Ageing and Development, Journal Year: 2023, Volume and Issue: 212, P. 111821 - 111821
Published: April 30, 2023
Language: Английский
Citations
27
Signal Transduction and Targeted Therapy, Journal Year: 2024, Volume and Issue: 9(1)
Published: Sept. 10, 2024
Abstract Sex characteristics exhibit significant disparities in various human diseases, including prevalent cardiovascular cancers, metabolic disorders, autoimmune and neurodegenerative diseases. Risk profiles pathological manifestations of these diseases notable variations between sexes. The underlying reasons for sex encompass multifactorial elements, such as physiology, genetics, environment. Recent studies have shown that body systems demonstrate sex-specific gene expression during critical developmental stages editing processes. These genes, differentially expressed based on different sex, may be regulated by androgen or estrogen-responsive thereby influencing the incidence presentation cardiovascular, oncological, metabolic, immune, neurological across However, despite existence differences patients with treatment guidelines predominantly rely male data due to underrepresentation women clinical trials. At present, there exists a substantial knowledge gap concerning mechanisms treatments diverse Therefore, this review aims elucidate advances examining epidemiological factors, pathogenesis, innovative progress accordance distinctive risk each disease provide new theoretical practical basis further optimizing individualized improving patient prognosis.
Language: Английский
Citations
9
Cambridge University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 280 - 289
Published: Jan. 7, 2025
Language: Английский
Citations
1
Expert Review of Neurotherapeutics, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 21
Published: Jan. 7, 2025
Introduction Cognitive impairment in Parkinson's disease (PD) substantially affects patient outcomes, function, and quality of life. PD-related cognitive dysfunction is often heterogeneous clinical presentation rates progression. As changes occur many people with PD, it essential to evaluate cognition, provide education, implement management strategies for symptoms.
Language: Английский
Citations
1
Journal of Neurology, Journal Year: 2025, Volume and Issue: 272(3)
Published: Feb. 22, 2025
Abstract Background Parkinson’s disease (PD) is characterized by hypokinetic motor symptoms, tremor, and various non-motor symptoms with frequent fluctuations of in advanced stages. Invasive therapies, such as deep brain stimulation (DBS), ablative continuous subcutaneous or intrajejunal delivery dopaminergic drugs via pump therapies are available for the management this complex symptomatology may also impact symptoms. The recent update clinical guideline on PD German Neurological Society (Deutsche Gesellschaft für Neurologie e.V.; DGN) offers clear guidance indications applications these treatment options. Methods committee formulated diagnostic questions invasive structured them according to PICOS framework (Population–Intervention–Comparisons–Outcome–Studies). A systematic literature review was conducted. Questions were addressed using findings from consented committee. Results Specific recommendations given regarding (i) optimal timing starting (ii) application DBS, (iii) use PD, (iv) procedures, selecting most appropriate therapy individual patient characteristics. Conclusion This an adapted excerpt chapters novel PD. Clear options provided.
Language: Английский
Citations
1