scholarly journals WED 131 Evaluating the clinical utility of the parkinson’s kinetigraph (PKG)

2018 ◽  
Vol 89 (10) ◽  
pp. A15.1-A15 ◽  
Author(s):  
Lewis Hutchinson ◽  
Thea Dominey ◽  
Emma Pearson ◽  
Fiona Murphy ◽  
Lucy Bell ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Recommendations ◽  
Healthcare Sector ◽  
Patient Questionnaire ◽  
List Type ◽  
Patient Acceptability ◽  
P4 Medicine ◽  
Remote Management ◽  
Centered Care

ObjectiveTo evaluate the utility of the Parkinson’s Kinetigraph (PKG™) in the remote management of Parkinson’s disease (PD).BackgroundThere is a movement in Parkinson’s care from a clinic-based model1 to P4 medicine, meaning medicine that is predictive, preventive, personalised and participatory.2 The development of wearable technology provides an opportunity to monitor patients remotely, and deliver targeted care. The PKG™ is a wrist-worn device that objectively measures Parkinson’s symptoms.AimTo evaluate the utility of the PKG™ in managing PD patients remotely, and the perception of service users.MethodPKG™ data were collated in real time. Patient acceptability data were collated via a patient questionnaire (n=61).ResultsBetween July 2015 and January 2018, 216 PKGs were performed. A variety of symptoms were identified, including different types of ‘OFF’ times (wearing off (25%), delayed on (6%) no drug response (8%)) and non-motor complications (fragmented sleep (33%) and daytime somnolence (21%)), with subsequent treatment recommendations being made. Patient acceptability of the PKG™ was high, 81% of patients being satisfied not having to travel for clinic appointments.ConclusionsThe PKG™ facilitated remote treatment recommendations. Remote management was acceptable to patients. Future evaluations will evaluate patient outcome.References. van der Eijk M, Nijhuis FAP, Faber MJ, Bloem BR. Moving from physician-centered care towards patient-centered care for Parkinson’s disease patients. Parkinsonism Relat Disord [Internet]. Elsevier; 1 November 2013;19(11):923–7. Available from: https://www.sciencedirect.com/science/article/pii/S1353802013001697?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb [cited 2018 February 6]. P4 medicine: how systems medicine will transform the healthcare sector and society. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204402/pdf/nihms532619.pdf [cited 2018 April 6]

scholarly journals Strain- and age-dependent features of the nigro-striatal circuit in three common laboratory mouse strains, C57BL/6J, A/J, and DBA/2J - Implications for Parkinson’s disease modeling

2020 ◽  
Author(s):  
Mélanie H. Thomas ◽  
Mona Karout ◽  
Beatriz Pardo Rodriguez ◽  
Yujuan Gui ◽  
Christian Jaeger ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mouse Brain ◽  
Dopaminergic Neurons ◽  
Mouse Strains ◽  
List Type ◽  
Background Strain ◽  
Age Related ◽  
Health And Disease ◽  
Over Time

AbstractMouse models have been instrumental in understanding genetic determinants of aging and its crucial role in neurodegenerative diseases. However, few studies have analyzed the evolution of the mouse brain over time at baseline. Furthermore, mouse brain studies are commonly conducted on the C57BL/6 strain, limiting the analysis to a specific genetic background. In Parkinson’s disease, the gradual demise of nigral dopaminergic neurons mainly contributes to the motor symptoms. Interestingly, a decline of the dopaminergic neuron function and integrity is also a characteristic of physiological aging in some species. Age-related nigro-striatal features have never been studied in mice of different genetic backgrounds. In this study, we analyze the morphological features in the striatum of three common mouse strains, C57BL/6J, A/J, and DBA/2J at 3-, 9- and 15 months of age. By measuring dopaminergic markers, we uncover age-related changes that differ between strains and evolve dynamically over time. Overall, our results highlight the importance of considering background strain and age when studying the murine nigro-striatal circuit in health and disease.HighlightsStudy of the integrity of the nigro-striatal circuit in C57BL/6J, A/J, and DBA/2J at different agesAge related evolution of essential features of nigral dopaminergic neurons differ between strainsConsider background strain and age is crutial to study the nigrostriatal circuit in health and disease

Delivering patient-centered care in Parkinson's disease: Challenges and consensus from an international panel

2020 ◽  
Vol 72 ◽  
pp. 82-87 ◽  
Author(s):  
Roongroj Bhidayasiri ◽  
Pattamon Panyakaew ◽  
Claudia Trenkwalder ◽  
Beomseok Jeon ◽  
Nobutaka Hattori ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Patient Centered Care ◽  
Patient Centered ◽  
International Panel ◽  
Centered Care

scholarly journals Physiotherapy in Parkinson’s Disease: Building ParkinsonNet in Czechia

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ota Gal ◽  
Martin Srp ◽  
Romana Konvalinkova ◽  
Martina Hoskovcova ◽  
Vaclav Capek ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapists ◽  
Patient Questionnaire ◽  
Inclusion Criteria ◽  
Model Of Care ◽  
Yahr Stage ◽  
Healthcare Model ◽  
Core Areas

Objective. We conducted a questionnaire survey to investigate the availability and quality of physiotherapy (PT) for Parkinson’s disease (PD). Background. Despite evidence about the benefits of PT, there is no data regarding its use in Czechia. Methods. Questionnaires were sent to 368 PD patients seen in a single movement disorders centre within two years (inclusion criteria: idiopathic PD, Hoehn and Yahr stage <5, and residence in Prague) and to 211 physical therapists (PTs) registered in Prague. The patient questionnaire evaluated limitations in 6 core areas and in activities of daily living and inquired about experience with PT. The PTs questionnaire evaluated knowledge about PD, number of PD patients treated yearly, and details of therapy. Results. Questionnaires were returned by 248 patients and 157 PTs. PT was prescribed to 70/248 patients. The effects were satisfactory in 79% and lasted >3 months in 60/64. About half of the PTs have no experience with PD patients, 26% reported <3, and 5% see >10 yearly. The most widely used techniques were neurodevelopmental treatments. Conclusion. Present PD healthcare model in Czechia is suboptimal (low PT prescription, non-evidence-based PT). Implementation of European PT Guidelines for PD and the introduction of an efficient model of care are needed.

scholarly journals IPSC-derived midbrain astrocytes from Parkinson’s disease patients carrying pathogenic SNCA mutations exhibit alpha-synuclein aggregation, mitochondrial fragmentation and excess calcium release

2020 ◽  
Author(s):  
Peter A. Barbuti ◽  
Paul Antony ◽  
Gabriella Novak ◽  
Simone B. Larsen ◽  
Clara Berenguer-Escuder ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Calcium Release ◽  
Cytosolic Calcium ◽  
Alpha Synuclein ◽  
List Type ◽  
Cellular Model ◽  
Functional Impairments ◽  
Mitochondrial Fragmentation ◽  
Serum Free

AbstractParkinson’s disease (PD) is characterized by the loss of A9 midbrain dopaminergic neurons and the accumulation of alpha-synuclein aggregates in remaining neurons. Many studies of the molecular and cellular basis of neurodegeneration in PD have made use of iPSC-derived neurons from patients with familial PD mutations. However, approximately half of the cells in the brain are glia, and their role facilitating neurodegeneration is unclear. We developed a novel serum-free protocol to generate midbrain astrocytes from patient-derived iPSCs harbouring the pathogenic p.A30P, p.A53T mutations in SNCA, as well as duplication and triplication of the SNCA locus. In our cellular model, aggregates of alpha-synuclein occurred only within the GFAP+ astrocytes carrying the pathogenic SNCA mutations. Assessment of spontaneous cytosolic calcium (Ca2+) release using Fluo4 revealed that SNCA mutant astrocytes released excess Ca2+ compared to controls. Unbiased evaluation of 3D mitochondrial morphometric parameters showed that these SNCA mutant astrocytes had increased mitochondrial fragmentation and decreased mitochondrial connectivity compared to controls, and reduced mitochondrial bioenergetic function. This comprehensive assessment of different pathogenic SNCA mutations derived from PD patients using the same cellular model enabled assessment of the mutation effect, showing that p.A53T and triplication astrocytes were the most severely affected. Together, our results indicate that astrocytes harbouring the familial PD mutations in SNCA are dysfunctional, suggesting a contributory role for dysfunctional astrocytes in the disease mechanism and pathogenesis of PD.Table of Contents ImageMain PointsWe used a novel serum-free protocol to generate midbrain-specific functional astrocytes from Parkinson’s disease patients carrying pathological mutations in SNCAPatient-derived astrocytes show morphological and functional impairments

scholarly journals Akkermansia muciniphila secretome promotes α-synuclein aggregation in enteroendocrine cells

2021 ◽  
Author(s):  
Dionísio Pedro Amorim Neto ◽  
Beatriz Pelegrini Bosque ◽  
João Vitor Pereira de Godoy ◽  
Paulla Vieira Rodrigues ◽  
Dario Donoso Meneses ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Calcium Release ◽  
Ryanodine Receptors ◽  
Enteroendocrine Cells ◽  
Ros Generation ◽  
List Type ◽  
Functional Link ◽  
Akkermansia Muciniphila ◽  
Intracellular Ca

ABSTRACTThe notion that the gut microbiota play a role in neurodevelopment, behavior and outcome of neurodegenerative disorders is recently taking place. A number of studies have consistently reported a greater abundance of Akkermansia muciniphila in Parkinson’s disease (PD) fecal samples. Nevertheless, a functional link between A.muciniphila and sporadic PD remained unexplored. Here, we investigated whether A.muciniphila secretome could initiate the misfolding process of α-synuclein (αSyn) in enteroendocrine cells (EECs), which are part of the gut epithelium and possess many neuron-like properties. We found that A.muciniphila secretome is directly modulated by mucin, induces intracellular calcium (Ca2+) release, and causes increased mitochondrial Ca2+ uptake in EECs, which in turn leads to production of reactive oxygen species (ROS) and αSyn aggregation. However, these events were efficiently inhibited once we buffered mitochondrial Ca2+. Thereby, these molecular insights provided here offer evidence that bacterial secretome is capable of inducing αSyn aggregation in enteroendocrine cells.SYNOPSIS FIGURE DESCRIPTIONThe secretome isolated from the commensal gut bacterium Akkermansia muciniphila triggers intracellular Ca2+ signaling in enteroendocrine cells, leading to increased mitochondrial Ca2+ uptake. Mitochondrial Ca2+ overload leads to ROS generation culminating with αSyn phosphorylation and aggregation (left panel). All these events were inhibited once mitochondrial Ca2+ is buffered (right panel).Gram-negative gut bacterium Akkermansia muciniphila is consistently found more abundant in Parkinson’s disease patients.Akkermansia muciniphila protein secretome composition is directly modulated by mucin and induces an IP3-independent endoplasmic reticulum (ER)-calcium release in enteroendocrine cells.This Ca2+ release is triggered by direct activation of Ryanodine Receptors leading to increased mitochondrial Ca2+ uptake.Mitochondrial Ca2+ overload leads to ROS generation culminating with αSyn aggregation.Buffering mitochondrial Ca2+ efficiently inhibits A.muciniphila-induced αSyn aggregation in enteroendocrine cells.

scholarly journals Introducing the Parkinson’s KinetiGraph into Routine Parkinson’s Disease Care: A 3-Year Single Centre Experience

2020 ◽  
Vol 10 (4) ◽  
pp. 1827-1832
Author(s):  
Thea Dominey ◽  
Angie A. Kehagia ◽  
Terry Gorst ◽  
Emma Pearson ◽  
Fiona Murphy ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Unmet Need ◽  
Resource Limitation ◽  
Digital Data ◽  
Continuous Measure ◽  
Remote Management ◽  
Single Centre Experience ◽  
The Face ◽  
Increasing Demand

In an effort to provide timely clinical input for people with Parkinson’s disease (PD) in the face of increasing demand and resource limitation in our UK based service, we introduced remote management in place of clinic appointment, including the use of the Parkinson’s KinetiGraph (PKG™), a wrist-worn device that provides a continuous measure of movement. We evaluated our reporting methods and findings, the nature of unmet need we identified, our treatment recommendations and the degree of their implementation in our patients whose feedback guided our service developments. Our evaluation highlighted opportunities and challenges associated with incorporating digital data into care traditionally delivered via in-person contact.

scholarly journals 035 Valproate-induced parkinsonism ‘an early warning’: case reports and review of literature

2019 ◽  
Vol 90 (e7) ◽  
pp. A12.2-A12
Author(s):  
Shoaib Dal ◽  
Scott Whyte
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Case Reports ◽  
The Elderly ◽  
Time Frame ◽  
List Type ◽  
Review Of The Literature ◽  
Hand Tremor ◽  
Wheel Rigidity

IntroductionWe describe two cases of valproate-induced parkinsonism, where the parkinsonian features develop after commencing valproate (VPA), in a time frame and manner well described by previous publications.1 In contrast to the published literature, that has short duration of follow-up, we have had a prolonged follow-up of these two cases, who initially improved on ceasing valproate, but then after a period progressed again, with the development of levodopa-responsive asymmetrical Parkinson’s disease.2Cases67 years old man, on VPA 500 mg twice a day for seizures since 2008, developed new rest, re-emergent left hand tremor and hypomimia in 2012. Within months, the parkinsonism progressed to decremental bradykinesia, cog-wheel rigidity and hypophonia. The symptoms initially improved with changing VPA to levetiracetam; however, the disease reappeared after 6 months and although levodopa-responsive, it has been progressive since then.88 years old man, on VPA 700 mg twice a day for seizures since 2010, developed upper limb decremental bradykinesia, cog-wheel rigidity, camptocormia and rest, re-emergent tremor in hands in 2011. The parkinsonism improved significantly with cessation of VPA; however, the disease re-emerged after 2 years and has been progressive since then.ConclusionVPA may be responsible for unmasking underlying subclinical parkinsonism and these patients represent an earlier onset of Parkinson’s disease related to VPA exposure, rather than a purely drug related parkinsonian dysfunction. These cases also highlight the importance of long-term follow up in VPA-induced parkinsonism. These observations are an important consideration for clinicians treating patients with parkinsonian features secondary to VPA exposure.ReferencesBrugger F, Bhatia KP, Besag FM. Valproate-associated parkinsonism: a critical review of the literature. CNS Drugs 2016;30(6):527–540.Mahmoud F, Tampi RR. Valproic acid-induced parkinsonism in the elderly: a comprehensive review of the literature. Am J Geriatr Pharmacother 2011;9(6):405–412.

scholarly journals Incorporating the Principles of Self-Management into Treatment of Dysarthria Associated with Parkinson's Disease

2017 ◽  
Vol 38 (03) ◽  
pp. 210-219 ◽  
Author(s):  
Carolyn Baylor ◽  
Deanna Britton ◽  
Kathryn Yorkston
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Current Treatment ◽  
Patient Perspectives ◽  
Self Management ◽  
Patient Centered ◽  
Treatment Expectations ◽  
Before And After ◽  
Centered Care ◽  
Speech Loudness

AbstractAlthough understanding patient perspectives on treatment is a major component of patient-centered care, little is known about patient perspectives related to dysarthria treatment in Parkinson's disease (PD). This article attempts to explore the perspective of patients with dysarthria associated with PD by interviewing them before and after treatment. Treatment expectations and experiences are summarized along with a discussion of how patients are using the tools they learned once treatment was completed. Comments about treatment were generally positive and suggested increased awareness and improved speech loudness. However, areas for improvement were also identified including: (1) treatment was not addressing some communication problems that were of concern to patients; (2) therapy programs were not enjoyable; and (3) it was difficult to maintain gains after therapy ended. Principles of self-management are reviewed to address some of the shortcomings of current treatment approaches.

Identification of motor and nonmotor wearing-off in Parkinson's disease: Comparison of a patient questionnaire versus a clinician assessment

2005 ◽  
Vol 20 (6) ◽  
pp. 726-733 ◽  
Author(s):  
Mark Stacy ◽  
Annette Bowron ◽  
Mark Guttman ◽  
Robert Hauser ◽  
Kim Hughes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Patient Questionnaire ◽  
Wearing Off ◽  
Clinician Assessment
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