Long-Term Improvement of Parkinson Disease Motor Symptoms Derived From Lesions of Prelemniscal Fiber Tract Components

Background:Burden of care might be highly dependent of specific characteristics of the disease (Lee et al., 2019). Uncertainties remain about factors that influence burden of care in Parkinson Disease (PD).Aim:To identify a list of ICF-related domains identified by caregivers of older patients with PD.Methods:Caregivers of people with PD were recruited in Portugal Parkinson Foundation, if they take care of someone with PD older than 65 yrs, and for more than 6 hours/day. A focus group was video recorded, based on the following questions: Can you please tell us how did you spent your day before you're a caregiver; there are any differences in your daily routine now? How do you feel or think when you're caring for a relative? Can you tell us if there is any kind of daily activity more pleasant or more embarrassing? Verbal interactions during focus group were transcribed and codified using International Classification of Functioning and Disability (ICF) domains.Results:Seven caregivers (5 females; 40-73 yrs; 5 were spousal) were enrolled. Thirty-six caregivers’ references were about body functions and structures (91.67% - mental functions: “I feel tired…it is a constant monotony”); fifty-seven references were about activities and participation (“I need to assist him with bathing”; “when he wants to standing from his favourite chair, he always need help…and his body is very stiff”);eleven references were about environmental factors, mostly about medication and family/health professionals assistance.Discussion:Our results demonstrated that caregivers are worried about their mental health and routine preservation, which is in accordance with previous studies in this topic (Tessitore et al.,2018). However, new caregivers’ perceptions were found in our study, which are very specific domains in PD: body motion rigidity and medication for patients’ psychomotor agitation. A previous study stated that control of mental symptoms in PD are the most powerful predictors of caregivers' burden (Hooker et al., 2000), but do not consider the importance of Parkinson’s motor symptoms.Conclusion:Burden of care in PD is mostly associated with the need of preservation in daily routines, but also with management of mental and motor symptoms in PD.

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Impacts of dance on non-motor symptoms, participation, and quality of life in Parkinson disease and healthy older adults

Maturitas ◽

10.1016/j.maturitas.2015.08.002 ◽

2015 ◽

Vol 82 (4) ◽

pp. 336-341 ◽

Cited By ~ 30

Author(s):

M.E. McNeely ◽

R.P. Duncan ◽

G.M. Earhart

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Parkinson Disease ◽

Motor Symptoms ◽

Healthy Older Adults ◽

Non Motor Symptoms

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Parkinson Disease: The Relationship Between Non-motor Symptoms and Motor Phenotype

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2015.328 ◽

2015 ◽

Vol 43 (2) ◽

pp. 261-267 ◽

Cited By ~ 23

Author(s):

Fang Ba ◽

Mona Obaid ◽

Marguerite Wieler ◽

Richard Camicioli ◽

W.R. Wayne Martin

Keyword(s):

Parkinson Disease ◽

Rating Scales ◽

Advanced Disease ◽

Axial Component ◽

Motor Symptoms ◽

Linear Regression Models ◽

Cross Sectional ◽

The Relationship ◽

Non Motor Symptoms ◽

Motor Phenotype

AbstractBackground: Parkinson disease (PD) presents with motor and non-motor symptoms (NMS). The NMS often precede the onset of motor symptoms, but may progress throughout the disease course. Tremor dominant, postural instability gait difficulty (PIGD), and indeterminate phenotypes can be distinguished using Unified PD Rating scales (UPDRS-III). We hypothesized that the PIGD phenotype would be more likely to develop NMS, and that the non-dopamine–responsive axial signs would correlate with NMS severity. Methods: We conducted a retrospective cross-sectional chart review to assess the relationship between NMS and PD motor phenotypes. PD patients were administered the NMS Questionnaire, the UPDRS-III, and the Mini-Mental State Examination score. The relationship between NMS burden and PD subtypes was examined using linear regression models. The prevalence of each NMS among difference PD motor subtypes was analyzed using chi-square test. Results: PD patients with more advanced disease based on their UPDRS-III had higher NMS Questionnaire scores. The axial component of UPDRS-III correlated with higher NMS. There was no correlation between NMS and tremor scores. There was a significant correlation between PIGD score and higher NMS burden. PIGD group had higher prevalence in most NMS domains when compared with tremor dominant and indeterminate groups independent of disease duration and severity. Conclusions: NMS profile and severity vary according to motor phenotype. We conclude that in the PD population, patients with a PIGD phenotype who have more axial involvement, associated with advanced disease and poor motor response, have a higher risk for a higher NMS burden.

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The Utilization of Mobile Applications for Self-Care in People With Parkinson Disease: Systematic Review (Preprint)

10.2196/preprints.33944 ◽

2021 ◽

Author(s):

JuHee Hee ◽

Insun Yeom ◽

Misook Lee Chung ◽

Yielin Kim ◽

Subin Yoo ◽

...

Keyword(s):

Parkinson Disease ◽

Task Performance ◽

Systematic Reviews ◽

Mobile Applications ◽

Symptom Management ◽

Neurodegenerative Disorder ◽

Self Care ◽

Cochrane Library ◽

Symptom Improvement ◽

Motor Symptoms

BACKGROUND Self-care is essential for people with Parkinson disease (PD) to minimize their disability and adapt to alterations in physical abilities due to progressive neurodegenerative disorder. With rapid developments in mobile technology, many health-related mobile applications for PD have been developed and utilized. However, insufficient research has investigated mobile application-based self-care in PD. OBJECTIVE This study aimed to explore the features and characteristics of the utilization of mobile applications for self-care in people with PD. METHODS This study was performed sequentially according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Referred databases are PubMed, Embase, CINAHL, Cochrane Library, Web of Science and PsycINFO in consultation with a librarian on June 8, 2021. We used keywords including ‘Parkinson disease’ and ‘mobile.’ RESULTS A total of 17 studies were selected by the inclusion criteria, including 3 randomized controlled trials and 14 observational studies/quasi-experimental studies. The utilization of mobile applications for self-care in people with PD focused on symptom monitoring, especially tracking motor symptoms. Motor symptoms were objectively measured mainly through the sensors of smartphones or wearable devices and task performance. Non-motor symptoms were monitored through task performance or self-reported questionnaires in mobile applications. Most studies focused on clinical symptom assessment in people with PD, and there was a lack of studies focusing on symptom management. CONCLUSIONS Mobile applications for people with PD have been developed and utilized, but strategies for self-management are insufficient. We recommend the development of mobile applications focused on self-care that can enhance symptom management and health promotion practices. Studies should also evaluate the effects of mobile applications on symptom improvement and quality of life in people with PD. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42021267374.

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Long-term effects of bilateral subthalamic nucleus stimulation in advanced Parkinson disease: a four year follow-up study

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2004.10.011 ◽

2005 ◽

Vol 11 (3) ◽

pp. 157-165 ◽

Cited By ~ 93

Author(s):

Veerle Visser-Vandewalle ◽

Chris van der Linden ◽

Yasin Temel ◽

Halime Celik ◽

Linda Ackermans ◽

...

Keyword(s):

Parkinson Disease ◽

Subthalamic Nucleus ◽

Long Term Effects ◽

Follow Up Study ◽

Subthalamic Nucleus Stimulation

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Long-term Effect of Initiating Pramipexole vs Levodopa in Early Parkinson Disease

Archives of Neurology ◽

10.1001/archneurol.2009.32 ◽

2009 ◽

Vol 66 (5) ◽

pp. 563 ◽

Cited By ~ 130

Keyword(s):

Parkinson Disease ◽

Term Effect ◽

Long Term Effect

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Association between White Matter Lesions and Non-Motor Symptoms in Parkinson Disease

Neurodegenerative Diseases ◽

10.1159/000489311 ◽

2018 ◽

Vol 18 (2-3) ◽

pp. 127-132 ◽

Cited By ~ 3

Author(s):

Jeong-Yoon Lee ◽

Ji Sun Kim ◽

Wooyoung Jang ◽

Jinse Park ◽

Eungseok Oh ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

White Matter ◽

Parkinson Disease ◽

Cognitive Dysfunction ◽

Rating Scale ◽

White Matter Lesions ◽

Motor Dysfunction ◽

Motor Symptoms ◽

Non Motor Symptoms

Background: There are only few studies exploring the relationship between white matter lesions (WMLs) and non-motor symptoms in Parkinson disease (PD). This study aimed to investigate the association between WMLs and the severity of non-motor symptoms in PD. Methods: The severity of motor dysfunction, cognitive impairment, and non-motor symptoms was assessed by various scales in 105 PD patients. We used a visual semiquantitative rating scale and divided the subjects into four groups: no, mild, moderate, and severe WMLs. We compared the means of all scores between the four groups and analyzed the association between the severity of WMLs and the specific domain of non-motor symptoms. Results: The non-motor symptoms as assessed by the Non-Motor Symptoms Scale, Parkinson’s Disease Questionnaire (PDQ-39), Parkinson’s Disease Sleep Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neuropsychiatric Inventory (NPI), and Parkinson Fatigue Scale (PFS) were significantly worse in the patients with moderate and severe WMLs than in those without WMLs. Compared with the no WML group, the scores for motor dysfunction were significantly higher in the mild, moderate, and severe WML groups. The scores for cognitive dysfunction were significantly higher in the patients with severe WMLs than in those without WMLs. The severity of WMLs showed linear associations with PFS, BDI, BAI, NPI, and PDQ-39 scores. The severity of WMLs also correlated linearly with scores for motor and cognitive dysfunction. Conclusions: Among the non-motor symptoms, fatigue, depression, anxiety, and quality of life were significantly affected by WMLs in PD. Confirmation of the possible role of WMLs in non-motor symptoms associated with PD in a prospective manner may be crucial not only for understanding non-motor symptoms but also for the development of treatment strategies.

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Speech changes induced by deep brain stimulation of the subthalamic nucleus in Parkinson disease: involvement of the dentatorubrothalamic tract

Journal of Neurosurgery ◽

10.3171/2016.5.jns16243 ◽

2016 ◽

Vol 126 (6) ◽

pp. 2017-2027 ◽

Cited By ~ 19

Author(s):

Albert J. Fenoy ◽

Monica A. McHenry ◽

Mya C. Schiess

Keyword(s):

Deep Brain Stimulation ◽

Parkinson Disease ◽

Brain Stimulation ◽

Spontaneous Speech ◽

Active Electrode ◽

Fiber Tract ◽

Speech Performance ◽

Stn Dbs ◽

Left Electrode ◽

Deep Brain

OBJECTIVEPatients with Parkinson disease (PD) who undergo subthalamic nucleus (STN) deep brain stimulation (DBS) often develop a deterioration in speech performance, but there is no clear consensus on the specific effects seen or the mechanism involved and little description of the impact of DBS on conversational speech. Furthermore, there has been no fiber tract connectivity analysis to identify the structures potentially modulated by DBS to cause such deficits. The main objective of this study was to quantify spontaneous speech performance and identify potential involvement of the dentatorubrothalamic tract (DRTt) in patients who underwent STN DBS, because this tract has been implicated in speech deterioration.METHODSSpontaneous speech samples were obtained with STN DBS in both on and off modes in 35 patients with PD and assessed across multiple domains. Diffusion tensor imaging tractography seeded from the therapeutic DBS contacts was performed to identify the fiber tracts involved and, specifically, the DRTt. The position of active electrode contacts was assessed relative to that of the STN.RESULTSFifteen patients with akinetic-rigid (AR) PD and 20 with tremor-dominant (TD) PD subtypes were identified. In the AR-PD subgroup of patients, in whom there was DRTt involvement, 71% demonstrated much better overall speech and largely improved or unchanged fluency in the DBS-off condition. In patients with TD PD with DRTt involvement, 50% demonstrated better overall speech in the off condition, and equivocal results regarding improved or worsened fluency were found. When there was minimal DRTt involvement, 75% of patients with AR PD had better overall speech in the DBS-on condition and better or minimal fluency changes. Similarly, 83% of patients with TD PD with minimal DRTt involvement had better or minimal overall speech and fluency changes in the on condition. More medially placed left electrode contacts were associated with more DRTt involvement in 77% of patients (10 of 13).CONCLUSIONSTo the authors' knowledge, this is the first study to have investigated a specific fiber tract involved in STN DBS in different subtypes of PD relative to its impact on spontaneous speech. At optimal therapeutic programming of STN DBS, overall spontaneous speech and fluency were affected more negatively in patients with AR PD than in those with TD PD when there was DRTt involvement. After fiber tract analysis and modeling, it was found that medially positioned left electrode contacts more often involved fibers of the DRTt. If possible, avoidance of the DRTt by using active electrode contacts that are positioned less medially, specifically in patients with AR PD, might result in less speech deterioration.

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