scholarly journals Predicting the onset of freezing of gait in de novo Parkinson’s disease

2021 ◽  
Author(s):  
Fengting Wang ◽  
Yixin Pan ◽  
Miao Zhang ◽  
Kejia Hu
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Freezing Of Gait ◽  
Poor Quality ◽  
Csf Biomarkers ◽  
Genetic Characteristics ◽  
Progression Markers ◽  
Independent Risk Factors

AbstractFreezing of gait (FoG) is a debilitating symptom of Parkinson’s disease (PD) related to higher risks of falls and poor quality of life. In this study, we predicted the onset of FoG in PD patients using a battery of risk factors from patients enrolled in the Parkinson’s Progression Markers Initiative (PPMI) cohort. The endpoint was the presence of FoG, which was assessed every year during the five-year follow-up visit. Overall, 212 PD patients were included in analysis. Seventy patients (33.0%) developed FoG during the visit (pre-FoG group). Age, bradykinesia, TD/PIGD classification, fatigue, cognitive impairment, impaired autonomic functions and sleep disorder were found to be significantly different in patients from pre-FoG and non-FoG groups at baseline. The logistic regression model showed that motor factors such as TD/PIGD classification (OR = 2.67, 95% CI = 1.41-5.09), MDS-UPDRS part III score (OR = 1.05, 95% CI = 1.01-1.09) were associated with FoG occurrence. Several indicators representing non-motor symptoms such as SDMT total score (OR = 0.95, 95% CI = 0.91-0.98), HVLT immediate/Total recall (OR = 0.91, 95% CI = 0.86-0.97), MOCA (OR = 0.87, 95% CI = 0.76-0.99), Epworth Sleepiness Scale (OR = 1.13, 95% CI = 1.03-1.24), fatigue(OR = 1.98, 95% CI = 1.32-3.06), SCOPA-AUT gastrointestinal score (OR = 1.27, 95% CI = 1.09-1.49) and SCOPA-AUT urinary score (OR = 1.18, 95% CI = 1.06-1.32) were found to have the predictive value. PD patients that developed FoG showed a significant reduction of DAT uptake in the striatum. However, no difference at baseline was observed in genetic characteristics and CSF biomarkers between the two patient sets. Our model indicated that TD/PIGD classification, MDS-UPDRS total score, and Symbol Digit Modalities score were independent risk factors for the onset of FoG in PD patients. In conclusion, the combination of motor and non-motor features including the akinetic subtype and poor cognitive functions should be considered in identifying PD patients with high risks of FoG onset.

scholarly journals Sex-Related Longitudinal Change of Motor, Non-Motor, and Biological Features in Early Parkinson’s Disease

2021 ◽  
pp. 1-16
Author(s):  
Marina Picillo ◽  
David-Erick LaFontant ◽  
Susan Bressman ◽  
Chelsea Caspell-Garcia ◽  
Christopher Coffey ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Longitudinal Change ◽  
Csf Biomarkers ◽  
Longitudinal Changes ◽  
Multiplicative Factor ◽  
Progression Markers ◽  
And Biological Markers ◽  
Updrs Part

Background: Investigation of sex-related motor and non-motor differences and biological markers in Parkinson’s disease (PD) may improve precision medicine approach. Objective: To examine sex-related longitudinal changes in motor and non-motor features and biologic biomarkers in early PD. Methods: We compared 5-year longitudinal changes in de novo, untreated PD men and women (at baseline N = 423; 65.5%male) of the Parkinson’s Progression Markers Initiative (PPMI), assessing motor and non-motor manifestations of disease; and biologic measures in cerebrospinal fluid (CSF) and dopamine transporter deficit on DaTscanTM uptake. Results: Men experienced greater longitudinal decline in self-reported motor (p <  0.001) and non-motor (p = 0.009) aspects of experiences of daily living, such that men had a yearly increase in MDS-UPDRS part II by a multiplicative factor of 1.27 compared to women at 0.7, while men had a yearly increase in MDS-UPDRS part I by a multiplicative factor of 0.98, compared to women at 0.67. Compared to women, men had more longitudinal progression in clinician-assessed motor features in the ON medication state (p = 0.010) and required higher dopaminergic medication dosages over time (p = 0.014). Time to reach specific disease milestones and longitudinal changes in CSF biomarkers and DaTscanTM uptake were not different by sex. Conclusion: Men showed higher self-assessed motor and non-motor burden of disease, with possible contributions from suboptimal dopaminergic therapeutic response in men. However, motor features of disease evaluated with clinician-based scales in the OFF medication state, as well as biological biomarkers do not show specific sex-related progression patterns.

Analyses of Visuospatial and Visuoperceptual Errors as Predictors of Dementia in Parkinson’s Disease Patients with Subjective Cognitive Decline and Mild Cognitive Impairment

2020 ◽  
pp. 1-11
Author(s):  
Iván Galtier ◽  
Antonieta Nieto ◽  
María Mata ◽  
Jesús N. Lorenzo ◽  
José Barroso
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Poor Performance ◽  
Subjective Cognitive Decline ◽  
Independent Risk Factors

ABSTRACT Objective: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in Parkinson’s disease (PD) are considered as the risk factors for dementia (PDD). Posterior cortically based functions, such as visuospatial and visuoperceptual (VS-VP) processing, have been described as predictors of PDD. However, no investigations have focused on the qualitative analysis of the Judgment of Line Orientation Test (JLOT) and the Facial Recognition Test (FRT) in PD-SCD and PD-MCI. The aim of this work was to study the VS-VP errors in JLOT and FRT. Moreover, these variables are considered as predictors of PDD. Method: Forty-two PD patients and 19 controls were evaluated with a neuropsychological protocol. Patients were classified as PD-SCD and PD-MCI. Analyses of errors were conducted following the procedure described by Ska, Poissant, and Joanette (1990). Follow-up assessment was conducted to a mean of 7.5 years after the baseline. Results: PD-MCI patients showed a poor performance in JLOT and FRT total score and made a greater proportion of severe intraquadrant (QO2) and interquadrant errors (IQO). PD-SCD showed a poor performance in FRT and made mild errors in JLOT. PD-MCI and QO2/IQO errors were independent risk factors for PDD during the follow-up. Moreover, the combination of both PD-MCI diagnosis and QO2/IQO errors was associated with a greater risk. Conclusions: PD-MCI patients presented a greater alteration in VS-VP processing observable by the presence of severe misjudgments. PD-SCD patients also showed mild difficulties in VS-SP functions. Finally, QO2/IQO errors in PD-MCI are a useful predictor of PDD, more than PD-MCI diagnosis alone.

scholarly journals Risk Factors of Fatigue in Idiopathic Parkinson’s Disease in a Polish Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Monika Gołąb-Janowska ◽  
Dariusz Kotlęga ◽  
Krzysztof Safranow ◽  
Agnieszka Meller ◽  
Anna Budzianowska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Everyday Activity ◽  
Activity Intensity ◽  
Fatigue Syndrome ◽  
Moderate Depression ◽  
Fatigue Severity ◽  
Independent Risk Factors ◽  
Severity Of The Disease

Introduction.Fatigue syndrome is one of the nonmotor symptoms in Parkinson’s disease (PD). The aim of the study was assessment of prevalence of fatigue syndrome in PD and answering the question what are the independent risk factors connected with intensity of fatigue in PD.Methods. 114 patients with idiopathic PD (mean age 62.2 + 10.8 years) were enrolled. The fatigue was assessed according to the Fatigue Severity Scale (FSS). We analyzed associations between fatigue and sex, age, education, duration and severity of the disease, everyday activity, intensity of the main symptoms, treatment, presence of dyskinesias and fluctuations, depression and excessive sleep during the day, and presence of pain and nycturia.Results. The fatigue syndrome was detected in 57.9% of patients. The score in the FSS was 1 to 7 points, 4.3 average. Greater fatigue intensity correlated with higher total daily levodopa equivalent dose. Patients with moderate depression had significantly greater fatigue.Conclusions. Fatigue syndrome affects 57.9% of patients with PD. Use of higher LED and presence of moderate depression are independent risk factors of greater intensity of fatigue.

Cortical Thinning Associated with Age and CSF Biomarkers in Early Parkinson’s Disease Is Modified by the SNCA rs356181 Polymorphism

2018 ◽  
Vol 18 (5-6) ◽  
pp. 233-238
Author(s):  
Frederic Sampedro ◽  
Juan Marín-Lahoz ◽  
Saul Martínez-Horta ◽  
Javier Pagonabarraga ◽  
Jaime Kulisevsky
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
De Novo ◽  
Brain Regions ◽  
Cortical Atrophy ◽  
Csf Biomarkers ◽  
Gene Encoding ◽  
Cortical Thinning ◽  
Age Related

The role of cerebrospinal fluid (CSF) biomarkers such as CSF α-synuclein and CSF tau in predicting cognitive decline in Parkinson’s disease (PD) continues to be inconsistent. Here, using a cohort of de novo PD patients with preserved cognition from the Parkinson’s Progression Markers Initiative (PPMI), we show that the SNCA rs356181 single nucleotide polymorphism (SNP) modulates the effect of these CSF biomarkers on cortical thinning. Depending on this SNP’s genotype, cortical atrophy was associated with either higher or lower CSF biomarker levels. Additionally, this SNP modified age-related atrophy. Importantly, the integrity of the brain regions where this phenomenon was observed correlated with cognitive measures. These results suggest that this genetic variation of the gene encoding the α-synuclein protein, known to be involved in the development of PD, also interferes in its subsequent neurodegeneration. Overall, our findings could shed light on the so far incongruent association of common CSF biomarkers with cognitive decline in PD.

Motor Cerebellar Connectivity and Future Development of Freezing of Gait in De Novo Parkinson's Disease

2020 ◽  
Vol 35 (12) ◽  
pp. 2240-2249
Author(s):  
Jin Ho Jung ◽  
Bo‐Hyun Kim ◽  
Seok Jong Chung ◽  
Han Soo Yoo ◽  
Yang Hyun Lee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Future Development ◽  
De Novo ◽  
Freezing Of Gait

scholarly journals Sex Differences in Cognitive Changes in De Novo Parkinson’s Disease

2019 ◽  
Vol 26 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Ece Bayram ◽  
Sarah J. Banks ◽  
Guogen Shan ◽  
Nikki Kaplan ◽  
Jessica Z.K. Caldwell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sex Differences ◽  
Verbal Memory ◽  
Healthy Aging ◽  
De Novo ◽  
Cognitive Changes ◽  
Progression Markers ◽  
Cognitively Intact

AbstractObjective:To evaluate the sex differences in cognitive course over 4 years in Parkinson’s disease (PD) patients with and without mild cognitive impairment (MCI) compared to controls.Methods:Four-year longitudinal cognitive scores of 257 cognitively intact PD, 167 PD-MCI, and 140 controls from the Parkinson’s Progression Markers Initiative were included. Longitudinal scores of men and women, and PD with and without MCI were compared.Results:Women had better verbal memory, men had better visuospatial function. There was no interaction between sex, diagnostic group, and/or time (4-year follow-up period).Conclusions:Sex differences in cognitive course in de novo PD are similar to healthy aging. Cognitive decline rates in PD with and without MCI are similar for the first 4 years of PD.

The Relative Contribution of Physical and Cognitive Fall Risk Factors in People With Parkinson’s Disease

2013 ◽  
Vol 28 (3) ◽  
pp. 282-290 ◽  
Author(s):  
Serene S. Paul ◽  
Catherine Sherrington ◽  
Colleen G. Canning ◽  
Victor S. C. Fung ◽  
Jacqueline C. T. Close ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Strength ◽  
Fall Prevention ◽  
Fall Risk ◽  
Freezing Of Gait ◽  
Prevention Strategies ◽  
Relative Contribution ◽  
Leg Muscle

Background. In order to develop multifaceted fall prevention strategies for people with Parkinson’s disease (PD), greater understanding of the impact of physical and cognitive performance on falls is required. Objective. We aimed to identify the relative contribution of a comprehensive range of physical and cognitive risk factors to prospectively-measured falls in a large sample of people with PD and develop an explanatory multivariate fall risk model in this group. Methods. Measures of PD signs and symptoms, freezing of gait, balance, mobility, proprioception, leg muscle strength, and cognition were collected on 205 community-dwelling people with PD. Falls were monitored prospectively for 6 months using falls diaries. Results. A total of 120 participants (59%) fell during follow-up. Freezing of gait ( P < .001), dyskinesia ( P = .02), impaired anticipatory and reactive balance ( P < .001), impaired cognition ( P = .002), reduced leg muscle strength ( P = .006), and reduced proprioception ( P = .04) were significantly associated with future falls in univariate analyses. Freezing of gait (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.00-1.05, P = .02), impaired anticipatory (RR = 1.01, 95% CI = 1.00-1.02, P = .03) and reactive (RR = 1.26, 95% CI = 1.01-1.58, P = .04) balance, and impaired orientation (RR = 1.28, 95% CI = 1.01-1.62, P = .04) maintained significant associations with falls in multivariate analysis. Conclusion. The study findings elucidate important physical and cognitive determinants of falls in people with PD and may assist in developing efficacious fall prevention strategies for this high-risk group.

scholarly journals Attention/Memory Impairment is Correlated with Motor Speech Disorder in Parkinson’s Disease

2019 ◽  
Author(s):  
Ying Liu ◽  
Yuchang Gui ◽  
Jincui Hu ◽  
Shanshan Liang ◽  
Sixia Mo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Educational Level ◽  
Cognitive Intervention ◽  
Speech Disorder ◽  
Motor Speech ◽  
Motor Speech Disorder ◽  
Independent Risk Factors ◽  
Attention Memory

Abstract Background The mechanisms underlying the online modulation of motor speech in Parkinson’s disease (PD) have not been determined. Moreover, medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis. Methods To compare risk factors in PD patients with MSD to those without MSD (non-MSD) and determine predictive independent risk factors correlated with the MSD phenotype, we enrolled 314 PD patients, including 250 with and 64 without MSD. We compared demographic, characteristic data, as well as PD-associated evaluations between the MSD group and non-MSD group. Results Univariate analysis showed that demographic characteristics, including occupation, educational level, monthly income and speaking background; clinical characteristics, including lesions in the frontal and temporal lobes, and concurrent dysphagia; and PD-associated evaluations, including the activity of daily living (ADL) score, non-motor symptoms scale (NMSS) domain 4 score (perceptual problem), and NMSS domain 5 score (attention/memory) were all significantly different between the MSD and non-MSD group (all P < 0.05). Multivariate logistic regression analysis showed that educational level, frontal lesions, and NMSS domain 5 score (attention/memory) were independent risk factors for PD-associated MSD (all P < 0.005). Conclusions We determined an association between MSD phenotype and cognitive impairment, reflected by low-level education and related clinical profiles. Moreover, attention and memory dysfunction may play key roles in the progression of MSD in PD patients. Further studies are required to detail the mechanism underlying abnormal speech motor modulation in PD patients. Early cognitive intervention may enhance rehabilitation management and motor speech function in patients with PD-associated MSD.

scholarly journals Network structure of brain atrophy in de novo Parkinson's disease

eLife ◽  
2015 ◽  
Vol 4 ◽  
Author(s):  
Yashar Zeighami ◽  
Miguel Ulla ◽  
Yasser Iturria-Medina ◽  
Mahsa Dadar ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Medial Temporal Lobe ◽  
Healthy Aging ◽  
De Novo ◽  
Progression Markers ◽  
Magnetic Resonance Imaging Mri ◽  
Cortical Regions ◽  
Clinical Measures ◽  
Deformation Based Morphometry

We mapped the distribution of atrophy in Parkinson's disease (PD) using magnetic resonance imaging (MRI) and clinical data from 232 PD patients and 117 controls from the Parkinson's Progression Markers Initiative. Deformation-based morphometry and independent component analysis identified PD-specific atrophy in the midbrain, basal ganglia, basal forebrain, medial temporal lobe, and discrete cortical regions. The degree of atrophy reflected clinical measures of disease severity. The spatial pattern of atrophy demonstrated overlap with intrinsic networks present in healthy brain, as derived from functional MRI. Moreover, the degree of atrophy in each brain region reflected its functional and anatomical proximity to a presumed disease epicenter in the substantia nigra, compatible with a trans-neuronal spread of the disease. These results support a network-spread mechanism in PD. Finally, the atrophy pattern in PD was also seen in healthy aging, where it also correlated with the loss of striatal dopaminergic innervation.

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