Course of cognitive decline in Parkinson's disease: A meta-analysis

A meta-analysis was conducted on 25 longitudinal studies involving 901 initially non-demented Parkinson's disease (PD) patients to examine the magnitude of decline across multiple cognitive domains associated with disease progression. Pooled effect sizes reflecting the standardized difference between baseline and follow-up neuropsychological performance were calculated for 8 cognitive domains using a random-effects model. Relatively small effect sizes were found across all cognitive domains (d= .00 − .40). During a mean follow-up interval of 29 months, significant declines were detected in global cognitive ability (d= .40), visuoconstructive skills (d= .32), and memory (d= .29). Age showed a significant relation with decline in global cognitive ability and memory. Lower educational level was associated with greater decline in all cognitive domains. Studies with longer follow-up intervals yielded larger effect sizes for global cognitive ability. In non-demented PD patients, changes in cognitive functions over time appear to be modest. Educational level, age, and length of the follow-up interval are likely to affect the magnitude of decline in several domains. Methodological flaws, such as selection bias and uncontrolled practice effects, may have caused underestimation of the true extent of decline (JINS, 2007,13, 920–932.)

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The Effect of Caffeine on the Risk and Progression of Parkinson’s Disease: A Meta-Analysis

Nutrients ◽

10.3390/nu12061860 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1860 ◽

Cited By ~ 5

Author(s):

Chien Tai Hong ◽

Lung Chan ◽

Chyi-Huey Bai

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Risk ◽

Meta Analysis ◽

Motor Fluctuation ◽

New Drugs ◽

Caffeine Consumption ◽

Healthy Cohort ◽

Adenosine 2A Receptor

Coffee and caffeine are speculated to be associated with the reduced risk of Parkinson’s disease (PD). The present study aimed to investigate the disease-modifying potential of caffeine on PD, either for healthy people or patients, through a meta-analysis. The electronic databases were searched using terms related to PD and coffee and caffeinated food products. Articles were included only upon fulfillment of clear diagnostic criteria for PD and details regarding their caffeine content. Reference lists of relevant articles were reviewed to identify eligible studies not shortlisted using these terms. In total, the present study enrolled 13 studies, nine were categorized into a healthy cohort and the rest into a PD cohort. The individuals in the healthy cohort with regular caffeine consumption had a significantly lower risk of PD during follow-up evaluation (hazard ratio (HR) = 0.797, 95% CI = 0.748–0.849, p < 0.001). The outcomes of disease progression in PD cohorts included dyskinesia, motor fluctuation, symptom onset, and levodopa initiation. Individuals consuming caffeine presented a significantly lower rate of PD progression (HR = 0.834, 95% CI = 0.707–0.984, p = 0.03). In conclusion, caffeine modified disease risk and progression in PD, among both healthy individuals or those with PD. Potential biological benefits, such as those obtained from adenosine 2A receptor antagonism, may require further investigation for designing new drugs.

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A Meta-Analysis on the Efficacy of Tai Chi in Patients with Parkinson’s Disease between 2008 and 2014

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/593263 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Ji Zhou ◽

Tao Yin ◽

Qian Gao ◽

Xiao Cun Yang

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Tai Chi ◽

Meta Analysis ◽

Sufficient Evidence ◽

Gait Velocity ◽

Valid Evidence

Objective. The purpose of this systematic review is to evaluate the evidence on the effect of Tai Chi for Parkinson’s disease (PD).Methods. Six electronic databases up to June 2014 were searched. The methodological quality was assessed with PEDro scale. Standardised mean difference and 95% confidence intervals of random-effects model were calculated.Results. Nine studies were included in our review. The aggregated results are in favor of Tai Chi on improving motor function (P=0.002) and balance (P<0.00001) in patients with PD. However, there is no sufficient evidence to support or refute the value of Tai Chi on improving gait velocity (P=0.11), stride length (P=0.21), or quality of life (P=0.40). And there is no valid evidence in follow-up effects of Tai Chi for PD. Conclusion. The current results suggest that Tai Chi can significantly improve the motor function and balance in patients with PD, but there is indeed not enough evidence to conclude that Tai Chi is effective for PD because of the small treatment effect, methodological flaws of eligible studies, and insufficient follow-up. Consequently, high-quality studies with long follow-up are warranted to confirm current beneficial findings.

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Ventilatory Impairments Associated with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Respiration ◽

10.1159/000506234 ◽

2021 ◽

pp. 1-9

Author(s):

Laura López-López ◽

Janet Remedios Rodríguez-Torres ◽

Lawrence Patrick Cahalin ◽

Irene Cabrera-Martos ◽

Irene Torres Sánchez ◽

...

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Vital Capacity ◽

Meta Analysis ◽

Forced Expiratory Volume ◽

Cochrane Library ◽

Respiratory Impairment ◽

Future Studies

Background: The peripheral and central repercussions of Parkinson’s disease (PD) affect the neuromuscular system producing a loss of muscle strength that can influence the respiratory system. Although several studies have examined various respiratory aspects of PD, to the best of our knowledge no study to date has systematically reviewed the existing data. Objectives: To examine the available literature related to the respiratory impairment in PD patients. Methods: We used PRISMA guidelines when reporting this review. We searched Pubmed, Cinhal, SciELO, and Cochrane Library, from inception until August 2018. Main variables assessed were forced vital capacity percent predicted (FVC%) and forced expiratory volume in 1 s percent predicted (FEV1%) for PD patients. Results: Six studies were included in this systematic review and meta-analysis. The obtained results concluded that PD patients present poorer pulmonary function when compared to healthy controls. When PD patients were compared between ON and OFF states, the results reviewed are in favour of the ON state. In the meta-analysis performed for FVC% and FEV1%, the results fail to find significant differences between PD patients and controls (p = 0.336 and p = 0.281, respectively), and between PD ON and OFF states (p = 0.109 and p = 0.059, respectively). Conclusions: We conclude that PD patients have impaired respiratory capacities that are related to the PD severity, time since diagnosis, and OFF state. Adequate follow-up of the respiratory function and studies focused on PD phenotypes have to be considered in future studies.

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Hyposmia as a Predictive Marker of Parkinson’s Disease: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/3753786 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Xin Sui ◽

Changli Zhou ◽

Jinwei Li ◽

Lei Chen ◽

Xige Yang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Predictive Marker ◽

Cochrane Library ◽

Random Effects Models ◽

Pooled Data ◽

Increased Risk ◽

Newcastle Ottawa Scale

Background. Hyposmia is one of the most common and best-characterized conditions that is also one of the first nonmotor features of Parkinson’s disease (PD). The association of hyposmia with PD is widely accepted; however the likelihood of developing PD is unclear. Our meta-analysis aimed to investigate the risk of PD in individuals with hyposmia.Methods. Prospective studies on humans published before December4th, 2018, were searched for in PubMed, Embase, Web of Science, and Cochrane Library databases. Two independent reviewers screened studies for inclusion and extracted data. We assessed the quality of studies using the Newcastle–Ottawa Scale and pooled data for analysis using random-effects models.Results. Of the 1774 studies retrieved, seven met the inclusion criteria for this review. A total of 3272 hyposmia and 176 PD events were reported over follow-up periods ranging from 3 to 17 years. Hyposmia was associated with a 3.84-fold risk of developing PD (pooled relative risk: 3.84, 95% CI 2.12−6.95). Subgroup analyses identified few differences between different hyposmia assessment methodologies and follow-up periods.Conclusions. Our findings suggest that deficiencies in olfaction are associated with an increased risk of developing PD. Future studies are needed to investigate whether hyposmia is a promising and feasible biomarker for the early diagnosis of PD.

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Deep brain stimulation for Parkinson’s disease: meta-analysis of results of randomized trials at varying lengths of follow-up

Journal of Neurosurgery ◽

10.3171/2016.11.jns16715 ◽

2018 ◽

Vol 128 (4) ◽

pp. 1199-1213 ◽

Cited By ~ 24

Author(s):

Alireza Mansouri ◽

Shervin Taslimi ◽

Jetan H. Badhiwala ◽

Christopher D. Witiw ◽

Farshad Nassiri ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Activities Of Daily Living ◽

Brain Stimulation ◽

Daily Living ◽

Meta Analysis ◽

Stn Dbs ◽

Deep Brain

OBJECTIVEDeep brain stimulation (DBS) is effective in the management of patients with advanced Parkinson’s disease (PD). While both the globus pallidus pars interna (GPi) and the subthalamic nucleus (STN) are accepted targets, their relative efficacy in randomized controlled trials (RCTs) has not been established beyond 12 months. The objective of this study was to conduct a meta-analysis of RCTs to compare outcomes among adults with PD undergoing DBS of GPi or STN at various time points, including 36 months of follow-up.METHODSThe MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL databases were searched. Registries for clinical trials, selected conference proceedings, and the table of contents for selected journals were also searched. Screens were conducted independently and in duplicate. Among the 623 studies initially identified (615 through database search, 7 through manual review of bibliographies, and 1 through a repeat screen of literature prior to submission), 19 underwent full-text review; 13 of these were included in the quantitative meta-analysis. Data were extracted independently and in duplicate. The Cochrane Collaboration tool was used to assess the risk of bias. The GRADE evidence profile tool was used to assess the quality of the evidence. Motor scores, medication dosage reduction, activities of daily living, depression, dyskinesias, and adverse events were compared. The influence of disease duration (a priori) and the proportion of male patients within a study (post hoc) were explored as potential subgroups.RESULTSThirteen studies (6 original cohorts) were identified. No difference in motor scores or activities of daily living was identified at 36 months. Medications were significantly reduced with STN stimulation (5 studies, weighted mean difference [WMD] −365.46, 95% CI −599.48 to −131.44, p = 0.002). Beck Depression Inventory scores were significantly better with GPi stimulation (3 studies; WMD 2.53, 95% CI 0.99–4.06 p = 0.001). The motor benefits of GPi and STN DBS for PD are similar.CONCLUSIONSThe motor benefits achieved with GPi and STN DBS for PD are similar. DBS of STN allows for a greater reduction of medication, but not as significant an advantage as DBS of GPi with respect to mood. This difference is sustained at 36 months. Further long-term studies are necessary.

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Effects of safinamide on non-motor, cognitive, and behavioral symptoms in fluctuating Parkinson’s disease patients: a prospective longitudinal study

Neurological Sciences ◽

10.1007/s10072-021-05324-w ◽

2021 ◽

Author(s):

Rosa De Micco ◽

Sara Satolli ◽

Mattia Siciliano ◽

Antonio De Mase ◽

Alfonso Giordano ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Symptom Burden ◽

Motor Fluctuation ◽

Motor Symptom ◽

Behavioral Symptoms ◽

Prospective Longitudinal Study ◽

Cognitive Domains ◽

Prospective Longitudinal

Abstract Introduction Parkinson’s disease (PD) patients in chronic levodopa treatment may experience motor and non-motor fluctuations, which may affect their quality of life. Safinamide is a new monoamine oxidase B inhibitor, also exerting a non-dopaminergic effect, recently approved as add-on therapy in fluctuating PD patients. Methods We performed a longitudinal prospective study in a cohort of 20 fluctuating PD patients, to test whether safinamide 50 mg may improve non-motor, cognitive, and behavioral symptoms over a 6-month treatment period. At each timepoint, clinical features were assessed by means of validated PD-specific scales. Neuropsychological assessment was performed by exploring all five cognitive domains. Results Compared to baseline, significant improvement was found in PD patients at 6-month follow-up in items investigating interest (p = 0.02), motivation (p = 0.02), and urinary disturbances (p = 0.03). Moreover, neuropsychiatric assessment showed a significant decrease in fatigue and apathy scores (p = 0.02 and p = 0.01, respectively). Motor assessment revealed a significant reduction in the total wake-up time spent in OFF state (p = 0.01). Follow-up neuropsychological evaluation did not reveal any change compared to baseline. Conclusions Our data reveal that, along with motor fluctuation improvement, treatment with safinamide 50 mg may significantly decrease non-motor symptom burden in PD patients. Interestingly, non-dopaminergic mechanisms, such as glutamatergic overdrive, have been demonstrated to play a role in many pathways underlying these symptoms. Thus, we hypothesize that the neurotransmitter receptor-binding profile of safinamide may explain our findings.

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Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

Journal of Parkinson s Disease ◽

10.3233/jpd-202170 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1601-1610

Author(s):

Jaimie A. Roper ◽

Abigail C. Schmitt ◽

Hanzhi Gao ◽

Ying He ◽

Samuel Wu ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Study Data ◽

Functional Mobility ◽

Quality Improvement Initiative ◽

Timed Up And Go ◽

Mobility Performance ◽

Risk Of Mortality ◽

The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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