Journal of the Neurological Sciences, Journal Year: 2024, Volume and Issue: 463, P. 123144 - 123144
Published: July 16, 2024
Smartphone applications (apps) are instruments that assist with objective measurements during the clinical assessment of patients movement disorders. We aim to test hypothesis Parkinson's disease (PD) will exhibit an increase in tapping variability and a decrease speed over one-year period, compared healthy controls (HC).
Language: Английский
Journal of Clinical Medicine, Journal Year: 2020, Volume and Issue: 9(12), P. 3931 - 3931
Published: Dec. 4, 2020
Despite being introduced in clinical practice more than 20 years ago, selection criteria for deep brain stimulation (DBS) Parkinson's disease (PD) rely on a document published 1999 called 'Core Assessment Program Surgical Interventional Therapies Disease'. These are useful supporting the of candidates. However, they both restrictive and out-of-date, because knowledge PD progression phenotyping has massively evolved. Advances understanding heterogeneity presentation, courses, phenotypes, genotypes, render better identification good DBS outcome predictors research priority. Additionally, invasiveness, cost, possibility serious adverse events make it mandatory to predict as accurately possible when informing patients about their suitability surgery. In this viewpoint, we analyzed pre-surgical assessment according following topics: early versus delayed DBS; evolution levodopa challenge test; relevance axial symptoms; patient-centered measures; non-motor genetics. Based literature, encourage rethinking process PD, which should move toward broad instrumental symptoms, quantitative measurement gait, posture, balance, in-depth genotypic phenotypic characterization.
Language: Английский
Citations
52
Journal of Parkinson s Disease, Journal Year: 2023, Volume and Issue: 13(7), P. 1079 - 1106
Published: Oct. 31, 2023
The increasing global burden of Parkinson’s disease (PD), termed the PD pandemic, is exceeding expectations related purely to population aging and likely driven in part by lifestyle changes environmental factors. Pesticides are well recognized risk factors for PD, supported both epidemiological experimental evidence, with multiple detrimental effects beyond dopaminergic neuron damage alone. microbiome-gut-brain axis has gained much attention recent years considered be a significant contributor driver pathogenesis. In this narrative review, we first focus on how pesticides microbiome may influence initiation progression independently, describing pesticide-related central peripheral neurotoxicity microbiome-related local systemic due dysbiosis microbial metabolites. We then depict bidirectional interplay between context synthesizing current knowledge about pesticide-induced dysbiosis, microbiome-mediated alterations pesticide availability, metabolism toxicity, complex pesticide-microbiome-host interactions inflammatory metabolic pathways, insulin resistance other mechanisms. An overview unknowns follows, role pesticide-microbiome proposed body-/brain-first phenotypes complexity exposures gene-environment discussed. final deals possible further steps translation, consisting recommendations future use research as an outline promising preventive/therapeutic approaches targeted strengthening or restoring healthy gut microbiome, closing summary gaps perspectives field.
Language: Английский
Citations
20
npj Parkinson s Disease, Journal Year: 2022, Volume and Issue: 8(1)
Published: Sept. 24, 2022
In this retrospective study, we longitudinally analyzed axial impairment and falls in people with Parkinson's disease (PD) subthalamic nucleus deep brain stimulation (STN-DBS). Axial scores falling frequency were examined at baseline, 1, 10, 15 years after surgery. Preoperative demographic clinical data, including PD duration severity, phenotype, motor cognitive scales, medications, vascular changes on neuroimaging as possible risk factors through Kaplan-Meier Cox regression analyses. Of 302 individuals before 1 year surgery, 102 57 available also 10 of follow-up, respectively. similar baseline but worsened years. The prevalence rate frequent fallers progressively increased from to scores, frontal dysfunction age onset for progression akinetic/rigid surgery predicted falls. Overall, signs over the long-term period following STN-DBS, likely related PD, especially a subgroup subjects specific factors.
Language: Английский
Citations
26
CNS Drugs, Journal Year: 2024, Volume and Issue: 38(5), P. 333 - 347
Published: April 8, 2024
Parkinson's disease (PD) is associated with the development of psychosis (PDP), including hallucinations and delusions, in more than half patient population. Optimal PD management must therefore involve considerations about both motor non-motor symptoms. Often, clinicians fail to diagnosis patients and, when it recognized, treat suboptimally, despite availability multiple interventions. In this paper, we provide a summary current guidelines clinical evidence for treating PDP antipsychotics. We also recommendations follow-up. Finally, an updated treatment algorithm that incorporates use pimavanserin, only US FDA-approved drug PDP, was developed by extrapolating from limited base bridge practice using expert opinion experience. Because pimavanserin approved US, other parts world algorithms be considered.
Language: Английский
Citations
5
Neurologic Clinics, Journal Year: 2025, Volume and Issue: 43(2), P. 341 - 363
Published: Jan. 22, 2025
Language: Английский
Citations
0
Journal of Neurology, Journal Year: 2025, Volume and Issue: 272(5)
Published: April 9, 2025
Abstract Background Several lines of evidence support the hypothesis brain-first and body-first Parkinson’s disease (PD) subtypes, characterized by distinct origins α-synuclein pathology. However, data on premotor non-motor burden motor progression in these subtypes remain inconsistent. Objective To analyze natural history versus PD subtypes. Methods Data from 400 patients enrolled at a single Italian center were analyzed. All underwent standardized retrospective baseline assessment symptoms onset prospectively followed. Premotor REM sleep behavior disorder (RBD), considered prodromal phenotype subtype, was used to divide into two groups: 81 with probable RBD (PD preRBD+ ) 319 without preRBD− ). Results At onset, older than patients, exhibited less tremor, more frequently presented bilateral symptoms. also reported greater symptoms, including hyposmia, cognitive impairment, pain, constipation, other dysautonomic Over follow-up period, progressed rapidly Hoehn Yahr stage 3, even after adjusting for sex, years schooling, age initial phenotype. Conclusions Our results align providing novel insights their different trajectories.
Language: Английский
Citations
0
Expert Review of Neurotherapeutics, Journal Year: 2023, Volume and Issue: 23(2), P. 107 - 122
Published: Feb. 1, 2023
Although there has been substantial progress in research and innovations symptomatic treatments, similar success not achieved disease-modifying therapy (DMT) for Parkinson's disease (PD). Considering the enormous motor, psychosocial financial burden associated with PD, safe effective DMT is of paramount importance.One reasons lack PD poor or inappropriate design clinical trials. In first part article, authors focus on plausible why previous trials have failed latter part, they provide their perspectives future trials.There are several potential failed, including broad etiopathogenic heterogeneity definition documentation target engagement, appropriate biomarkers outcome measures, short duration follow-up. To address these deficiencies, may consider- (i) a more customized approach to select most suitable participants therapeutic approaches, (ii) explore combination therapies that would multiple pathogenetic mechanisms, (iii) moving beyond targeting only motor symptoms also assessing non-motor features well-designed longitudinal studies.
Language: Английский
Citations
8
Journal of Neurology, Journal Year: 2020, Volume and Issue: 267(12), P. 3444 - 3456
Published: June 27, 2020
Language: Английский
Citations
22
International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(9), P. 4823 - 4823
Published: April 28, 2024
Oligomeric alpha-synuclein (α-syn) in saliva and phosphorylated α-syn deposits the skin have emerged as promising diagnostic biomarkers for Parkinson’s disease (PD). This study aimed to assess compare value of these discriminating between 38 PD patients 24 healthy subjects (HSs) using easily accessible biological samples. Additionally, sought determine potential combining explore their correlations with clinical features. Salivary oligomeric levels were quantified competitive ELISA, while biopsies analyzed through immunofluorescence detect at Ser129 (p-S129). Both individually accurate from HSs, a modest agreement them. The combined positivity salivary oligomers p-S129 aggregates differentiated HSs an excellent discriminative ability AUC 0.9095. observed suggests that they may reflect different aspects pathology, thus providing complementary information when combined. study’s results highlight utilizing multimodal biomarker approach enhance accuracy PD.
Language: Английский
Citations
2
Journal of Parkinson s Disease, Journal Year: 2024, Volume and Issue: 14(6), P. 1139 - 1146
Published: Aug. 2, 2024
Orthostatic hypotension (OH) is the most common manifestation of cardiovascular autonomic dysfunction in Parkinson's disease. In this viewpoint, we discuss five practical questions regarding OH disease: 1) How problem? 2) Why should people with disease and providers care about OH? 3) What are symptoms 4) to confirm a diagnosis And 5) treat an important non-motor symptom for which have available treatments significantly mitigate morbidity possibly positively impact course.
Language: Английский
Citations
2