Patient-reported and performance-based measures of walking in mild-moderate Parkinson's disease

Objectives. The goal of this study is to describe modifiable lifestyle variables associated with reduced rate of Parkinson’s disease (PD) progression.Methods. The patient-reported outcomes in PD (PRO-PD) were used as the primary outcome measure, and a food frequency questionnaire (FFQ) was used to assess dietary intake. In this cross-sectional analysis, regression analysis was performed on baseline data to identify the nutritional and pharmacological interventions associated with the rate of PD progression. All analyses were adjusted for age, gender, and years since diagnosis.Results. 1053 individuals with self-reported idiopathic PD were available for analysis. Foods associated with the reduced rate of PD progression included fresh vegetables, fresh fruit, nuts and seeds, nonfried fish, olive oil, wine, coconut oil, fresh herbs, and spices (P<0.05). Foods associated with more rapid PD progression include canned fruits and vegetables, diet and nondiet soda, fried foods, beef, ice cream, yogurt, and cheese (P<0.05). Nutritional supplements coenzyme Q10 and fish oil were associated with reduced PD progression (P=0.026andP=0.019, resp.), and iron supplementation was associated with faster progression (P=0.022).Discussion. These are the first data to provide evidence that targeted nutrition is associated with the rate of PD progression.

Download Full-text

Levodopa improves handwriting and instrumental tasks in previously treated patients with Parkinson’s disease

Journal of Neural Transmission ◽

10.1007/s00702-020-02246-3 ◽

2020 ◽

Vol 127 (10) ◽

pp. 1369-1376

Author(s):

Thomas Müller ◽

Ali Harati

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Behavior ◽

Fine Motor ◽

Motor Symptoms ◽

Execution Speed ◽

Previously Treated Patients ◽

Previously Treated ◽

And Performance ◽

The Individual

Abstract Motor symptoms in patients with Parkinson’s disease may be determined with instrumental tests and rating procedures. Their outcomes reflect the functioning and the impairment of the individual patient when patients are tested off and on dopamine substituting drugs. Objectives were to investigate whether the execution speed of a handwriting task, instrumentally assessed fine motor behavior, and rating scores improve after soluble levodopa application. 38 right-handed patients were taken off their regular drug therapy for at least 12 h before scoring, handwriting, and performance of instrumental devices before and 1 h after 100 mg levodopa intake. The outcomes of all performed procedures improved. The easy-to-perform handwriting task and the instrumental tests demand for fast and precise execution of movement sequences with considerable cognitive load in the domains' attention and concentration. These investigations may serve as additional tools for the testing of the dopaminergic response.

Download Full-text

Modernizing Daily Function Assessment in Parkinson's Disease Using Capacity, Perception, and Performance Measures

Movement Disorders ◽

10.1002/mds.28377 ◽

2020 ◽

Author(s):

Walter Maetzler ◽

Lynn Rochester ◽

Roongroj Bhidayasiri ◽

Alberto J. Espay ◽

Alvaro Sánchez‐Ferro ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Performance Measures ◽

And Performance ◽

Daily Function ◽

Function Assessment

Download Full-text

Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life

npj Parkinson s Disease ◽

10.1038/s41531-020-00128-9 ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Indu Subramanian ◽

Joshua Farahnik ◽

Laurie K. Mischley

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Social Isolation ◽

Support Groups ◽

Symptom Severity ◽

Social Performance ◽

Social Distancing ◽

Patient Reported

Abstract Social isolation and its deleterious effects on health increases with age in the general population. People with Parkinson’s Disease (PWP) are no exception. Social isolation is a risk factor for worsened health outcomes and increased mortality. Symptoms such as depression and sleep dysfunction are adversely affected by loneliness. There is a paucity of research on social isolation in Parkinson’s disease (PD), which is all the more critical now in the setting of social distancing due to COVID-19. The goal of this study was to survey individuals with PD to evaluate whether social isolation is associated with PD symptom severity and quality of life. Only individuals reporting a diagnosis of idiopathic PD were included in this analysis. The primary outcome measures were the Patient-Reported Outcomes in PD (PRO-PD) and questions from PROMIS Global related to social health. PRO-PD scores increased as social performance and social satisfaction scores diminished. Individuals who reported being lonely experienced a 55% greater symptom severity than those who were not lonely (P < 0.01). Individuals who documented having a lot of friends had 21% fewer symptoms than those with few or no friends (P < 0.01). Social isolation was associated with greater patient-reported PD severity and lower quality of life, although it is unclear whether this is the cause and/or a consequence of the disease. In essence, the Parkinson pandemic and the pandemic of social isolation have been further compounded by the recent COVID-19 pandemic. The results emphasize the need to keep PWP socially connected and prevent loneliness in this time of social distancing. Proactive use of virtual modalities for support groups and social prescribing should be explored.

Download Full-text

Predictors of second-sided deep brain stimulation for Parkinson’s disease

Journal of Neurosurgery ◽

10.3171/2019.12.jns19638 ◽

2020 ◽

pp. 1-7

Author(s):

Joshua L. Golubovsky ◽

Hong Li ◽

Arbaz Momin ◽

Jianning Shao ◽

Maxwell Y. Lee ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Rating Scale ◽

Intraoperative Complications ◽

Cohort Analysis ◽

Initial Surgery ◽

Patient Reported ◽

Deep Brain

OBJECTIVEParkinson’s disease (PD) is a progressive neurological movement disorder that is commonly treated with deep brain stimulation (DBS) surgery in advanced stages. The purpose of this study was to investigate factors that affect time to placement of a second-sided DBS lead for PD when a unilateral lead is initially placed for asymmetrical presentation. The decision whether to initially perform unilateral or bilateral DBS is largely based on physician and/or patient preference.METHODSThis study was a retrospective cohort analysis of patients with PD undergoing initial unilateral DBS for asymmetrical disease between January 1999 and December 2017 at the authors’ institution. Patients treated with DBS for essential tremor or other conditions were excluded. Variables collected included demographics at surgery, time since diagnosis, Unified Parkinson’s Disease Rating Scale motor scores (UPDRS-III), patient-reported quality-of-life outcomes, side of operation, DBS target, intraoperative complications, and date of follow-up. Paired t-tests were used to assess mean changes in UPDRS-III. Cox proportional hazards analysis and the Kaplan-Meier method were used to determine factors associated with time to second lead insertion over 5 years.RESULTSThe final cohort included 105 patients who underwent initial unilateral DBS for asymmetrical PD; 59% of patients had a second-sided lead placed within 5 years with a median time of 34 months. Factors found to be significantly associated with early second-sided DBS included patient age 65 years or younger, globus pallidus internus (GPi) target, and greater off-medication reduction in UPDRS-III score following initial surgery. Older age was also found to be associated with a smaller preoperative UPDRS-III levodopa responsiveness score and with a smaller preoperative to postoperative medication-off UPDRS-III change.CONCLUSIONSYounger patients, those undergoing GPi-targeted unilateral DBS, and patients who responded better to the initial DBS were more likely to undergo early second-sided lead placement. Therefore, these patients, and patients who are more responsive to medication preoperatively (as a proxy for DBS responsiveness), may benefit from consideration of initial bilateral DBS.

Download Full-text