scholarly journals Prevalence and Relationship of Rest Tremor and Action Tremor in Parkinson’s Disease

Author(s):  
Deepak K. Gupta ◽  
Massimo Marano ◽  
Cole Zweber ◽  
James T. Boyd ◽  
Sheng-Han Kuo

AbstractBackgroundDespite the significance of tremor in Parkinson’s disease (PD) diagnosis, classification, and patient’s quality of life, there is a relative lack of data on prevalence and relationship of different tremor types in PD.MethodsThe presence of rest tremor (RT) and action tremor (AT; defined as combination of both postural and kinetic tremor) was determined and RT severity was defined using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) at baseline in the Progression Marker Initiative (PPMI, n=423), the Fox Investigation for New Discovery of Biomarkers (BioFIND, n=118) and the Parkinson’s Disease Biomarkers Program (PDBP, n=873) cohorts.ResultsAcross baseline data of all three cohorts, RT prevalence (58.2%) was higher than AT prevalence (39.0%). Patients with RT had significantly higher (Chi-square test, p<0.05) prevalence of AT compared to patients without RT in the PPMI (40.0% versus 30.1%), BioFIND (48.0% versus 40.0%) and PDBP (49.9% versus 21.0%) cohorts. Furthermore, patients with AT had significantly (Student t-test, p<0.05) higher RT severity that those without AT in PPMI (5.7 ± 5.4 versus 3.9 ± 3.3), BioFIND, 6.4 ± 6.3 versus 3.8 ± 4.4) and PDBP (6.4 ± 6.6 versus 3.7 ± 4.4) cohorts.DiscussionThe RT is the most frequent tremor type and present in more than half of the PD patients. However, AT is also present in nearly one-third of the PD patients. Our results also indicate that RT and AT may have cross-interactions in PD.

2020 ◽  
Author(s):  
Hirotaka IWAKI ◽  
Hampton L. Leonard ◽  
Sara Bandres Ciga ◽  
Cornelis Blauwendraat ◽  
Mary B. Makarious ◽  
...  

BACKGROUND: There is a need for reliable, objective, and easily accessible biomarkers for Parkinson's disease. OBJECTIVES: The purpose of this study was to screen biomarkers from vital signs and routine blood tests. METHODS: Longitudinal data of up to 7 years of vital signs and routine blood tests from 418 patients with Parkinson's disease (PD) untreated at baseline and 185 individuals without any neurological disease were analyzed using linear mixed models. We nominated the biomarkers whose main associations with the measurements were significant as differentiating biomarkers. Similarly, we nominated the interaction effects between biomarkers and time from baseline as progression biomarkers. We tested for 49 biomarkers, and multiple comparison was corrected with the false-discovery-rate of 0.05. We further evaluated the potential biomarkers with regard to their importance in diagnosis prediction and their association with sub-scores on the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). We also assessed the relationship of the associations using bioinformatics. RESULTS: Heart rate, systolic blood pressure, white blood cell fractions, neutrophil counts, serum albumin, sodium and AST were different between PD and controls. The causality or genetic correlations of these biomarkers to PD were not observed. Chronological changes in height, albumin, hemoglobin, and bicarbonate were different in PD. These biomarkers were associated with MDS-UPDRS sub-scores. Conclusions In this study, the potential of some easily accessible biomarkers for diagnosis and disease progression was presented. Further investigation of the mechanisms underlying these associations is important for a deeper understanding of the disease and the better management of patients.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Giulia Di Lazzaro ◽  
Tommaso Schirinzi ◽  
Maria Pia Giambrone ◽  
Roberta Di Mauro ◽  
Maria Giuseppina Palmieri ◽  
...  

Introduction. Pisa syndrome (PS) is a postural complication of Parkinson’s disease (PD). Yet, its pathophysiology remains unclear, although a multifactorial component is probable. Cervical vestibular evoked myogenic potentials (cVEMPs) explore vestibulospinal pathway, but they have not been measured yet in PD patients with PS (PDPS) to assess a potential vestibular impairment. Materials and Methods. We enrolled 15 PD patients, 15 PDPS patients, and 30 healthy controls (HCs). They underwent neurological examination and were examined with Unified Parkinson’s Disease Rating Scale II-III (UPDRSII-III), audiovestibular workup, and cVEMP recordings. Data were analysed with Chi-square, one-way ANOVA, multinomial regression, nonparametric, and Spearman’s tests. Results. cVEMPs were significantly impaired in both PD and PDPS compared with HCs. PDPS exhibited more severe cVEMP abnormalities with prevalent bilateral loss of potentials, compared with the PD group, in which a prevalent unilateral loss was instead observed. No clinical-neurophysiological correlations emerged. Conclusions. Differently from HC, cVEMPs are altered in PD. Severity of cVEMPs alterations increases from PD without PS to PDPS, suggesting an involvement of vestibulospinal pathway in the pathophysiology of PS. Our results provide evidence for a significant impairment of cVEMPs in PDPS patients and encourage further studies to test validity of cVEMPs as diagnostic and prognostic biomarkers of PD progression.


2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Jagruti Wandrekar ◽  
Nicole D'Souza ◽  
Dr. Maria Barretto

This study examined the relationship of caregiver burden with various patient and caregiver variables. 50 individuals with Parkinson’s Disease were administered the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Hoehn and Yahr’s Scale (HY), Mini Mental Status examination (MMSE), and their caregivers were administered the Zarit Burden Interview (ZBI). Kruskal Wallis ANOVAs and Mann Whitney U tests showed that caregivers suffering from ill health (Ux=402, p= 0.03) and the patients’ MDS-UPDRS scores significantly affected caregiver burden. Simultaneous multiple regression analysis showed that MDS-UPDRS Part I,II and III were significant predictors of burden (R2= 0.72, p<0.0001) of which the motor examination emerged as the most significant predictor of burden.


2020 ◽  
Vol 10 (0) ◽  
pp. 58
Author(s):  
Deepak K. Gupta ◽  
Massimo Marano ◽  
Cole Zweber ◽  
James T. Boyd ◽  
Sheng-Han Kuo

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giorgio Leodori ◽  
Maria Ilenia De Bartolo ◽  
Daniele Belvisi ◽  
Alessia Ciogli ◽  
Andrea Fabbrini ◽  
...  

AbstractWe aimed to investigate salivary caffeine content, caffeine absorption and metabolism in Parkinson’s disease (PD) and verify whether salivary caffeine can be used as a biomarker of PD. We enrolled 98 PD patients and 92 healthy subjects. Caffeine and its major metabolite, paraxanthine, were measured in saliva samples collected before and 4 h after the oral intake of caffeine (100 mg). We measured caffeine absorption as the normalized increase in caffeine levels, and caffeine metabolism as the paraxanthine/caffeine ratio. The Movement Disorder Society Unified Parkinson's Disease Rating Scale part III, the Hoehn & Yahr, the presence of motor complications, and levodopa equivalent dose (LED) were assessed and correlated with caffeine levels, absorption, and metabolism. The effects of demographic and environmental features possibly influencing caffeine levels were also investigated. Caffeine levels were decreased in patients with moderate/advanced PD, while caffeine levels were normal in patients with early and de-novo PD, unrelated to caffeine intake. Caffeine absorption and metabolism were normal in PD. Decreased salivary caffeine levels in PD were associated with higher disease severity, longer duration, and the presence of motor complications, no significant association was found with LED. Salivary caffeine decrease correlates with PD progression.


Author(s):  
Mattia Siciliano ◽  
Lugi Trojano ◽  
Rosa De Micco ◽  
Valeria Sant’Elia ◽  
Alfonso Giordano ◽  
...  

Abstract Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p < 0.01). Logistic regression confirmed that FSS and BDI scores distinguished the “Underestimators” group from the others (p < 0.05). Linear regression analyses also indicated that FSS and BDI scores positively related to objective-subjective cognitive discrepancy (p < 0.01). “Overestimators” scored lower than other groups on the MoCA’s total score and attention and working memory subscores (p < 0.01). Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting.


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