scholarly journals Identification of Changing Lower Limb Neuromuscular Activation in Parkinson’s Disease during Treadmill Gait with and without Levodopa Using a Nonlinear Analysis Index

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Amir Pourmoghaddam ◽  
Marius Dettmer ◽  
Daniel P. O’Connor ◽  
William H. Paloski ◽  
Charles S. Layne
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Clinical Settings ◽  
Current Experiment ◽  
Simple Manner ◽  
Muscle Activations ◽  
Index Value ◽  
Walking Speeds

Analysis of electromyographic (EMG) data is a cornerstone of research related to motor control in Parkinson’s disease. Nonlinear EMG analysis tools have shown to be valuable, but analysis is often complex and interpretation of the data may be difficult. A previously introduced algorithm (SYNERGOS) that provides a single index value based on simultaneous multiple muscle activations (MMA) has been shown to be effective in detecting changes in EMG activation due to modifications of walking speeds in healthy adults. In this study, we investigated if SYNERGOS detects MMA changes associated with both different walking speeds and levodopa intake. Nine male Parkinsonian patients walked on a treadmill with increasing speed while on or off medication. We collected EMG data and computed SYNERGOS indices and employed a restricted maximum likelihood linear mixed model to the values. SYNERGOS was sensitive to neuromuscular modifications due to both alterations of gait speed and intake of levodopa. We believe that the current experiment provides evidence for the potential value of SYNERGOS as a nonlinear tool in clinical settings, by providing a single value index of MMA. This could help clinicians to evaluate the efficacy of interventions and treatments in Parkinson’s disease in a simple manner.

scholarly journals Thalamic white matter macrostructure and subnuclei volumes in Parkinson’s disease depression

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
R. Bhome ◽  
A. Zarkali ◽  
G. E. C. Thomas ◽  
J. E. Iglesias ◽  
J. H. Cole ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
White Matter ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Neural Structure ◽  
Generalised Linear Mixed Model ◽  
Antidepressant Use ◽  
The Relationship

AbstractDepression is a common non-motor feature of Parkinson’s disease (PD) which confers significant morbidity and is challenging to treat. The thalamus is a key component in the basal ganglia-thalamocortical network critical to the pathogenesis of PD and depression but the precise thalamic subnuclei involved in PD depression have not been identified. We performed structural and diffusion-weighted imaging (DWI) on 76 participants with PD to evaluate the relationship between PD depression and grey and white matter thalamic subnuclear changes. We used a thalamic segmentation method to divide the thalamus into its 50 constituent subnuclei (25 each hemisphere). Fixel-based analysis was used to calculate mean fibre cross-section (FC) for white matter tracts connected to each subnucleus. We assessed volume and FC at baseline and 14–20 months follow-up. A generalised linear mixed model was used to evaluate the relationship between depression, subnuclei volume and mean FC for each thalamic subnucleus. We found that depression scores in PD were associated with lower right pulvinar anterior (PuA) subnucleus volume. Antidepressant use was associated with higher right PuA volume suggesting a possible protective effect of treatment. After follow-up, depression scores were associated with reduced white matter tract macrostructure across almost all tracts connected to thalamic subnuclei. In conclusion, our work implicates the right PuA as a relevant neural structure in PD depression and future work should evaluate its potential as a therapeutic target for PD depression.

scholarly journals Effects of dance on gait and dual-task gait in Parkinson’s disease

2019 ◽  
Author(s):  
Nadeesha Kalyani Hewa Haputhanthirige ◽  
Karen Sullivan ◽  
Gene Moyle ◽  
Sandy Brauer ◽  
Erica Rose Jeffrey ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Verbal Fluency ◽  
Large Scale ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Step Length ◽  
Gait Velocity ◽  
Control Group

Abstract Background Gait impairments in Parkinson’s disease (PD) limit independence and quality of life. While dance based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to perform a feasibility study of the effects of a dance intervention, based on the Dance for PD®(DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted.Methods A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke’s score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III) participated in the study. The DG undertook a one-hour DfPD®based class, twice weekly for 12 weeks. The CG had treatment as usual. Gait analysis was performed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions (regular walking; dual-task: verbal-fluency, serial-subtraction). The data was analysed by means of a linear mixed model. ResultsThe DG improved significantly compared to the CG in gait velocity, cadence, step-length, and stride-length when even surface walking, with and without a dual-task. On the uneven surface the DG walked more cautiously during regular walking but had improved gait velocity, cadence and step-length when performing serial-subtractions. Conclusions DfPD®-based classes produced clinically significant improvement on spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted.Trial registration A protocol for this study has been registered retrospectively at Australian New Zealand Clinical Trials Registry on 12.11.2018. Identifier: ACTRN12618001834246.

scholarly journals Rate of Progression in Activity and Participation Outcomes in Exercisers with Parkinson’s Disease: A Five-Year Prospective Longitudinal Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Stephanie A. Miller ◽  
Mindy Mayol ◽  
Elizabeth S. Moore ◽  
Audra Heron ◽  
Victoria Nicholos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Longitudinal Study ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Long Term Effects ◽  
Prospective Longitudinal Study ◽  
Time Points ◽  
Balance Functions ◽  
Prospective Longitudinal

Background. Rates of progression of motor symptoms and physical performance show declines between 2% and 7% annually in community samples with Parkinson’s disease (PD). However, the effects of ongoing exercise behaviors on progression rates have not been considered. Objective. The primary purpose of this prospective, longitudinal study was to examine the annual rates of progression in activity and participation measures over five years in community-based exercisers with PD. Methods. A cohort of 55 regular exercisers with idiopathic PD was assessed at baseline and 1, 2, and 5 years. Regular exercise was defined as scores of 4-5 on the Stages for Readiness to Exercise Scale and a self-reported average of at least 60 minutes of exercise/week within six months of each testing session. Unadjusted and adjusted annual progression rates for activity and participation measures were calculated with a standardized equation of change from baseline. A linear mixed model with covariates of age at PD diagnosis and PD subtype was used to determine adjusted change scores. Results. Annual progression rates for unadjusted and adjusted variables were similar, and none exceeded 1.7% across time points for this group of exercisers with PD. Older age at PD diagnosis significantly contributed to faster progression of walking and balance functions. A nonlinear trajectory of the PD progression was demonstrated across most activity and participation outcomes. Conclusions. Annual progression rates demonstrated by this sample of exercisers were lower than those previously reported for motor decline in general samples with PD. Assessing activity and participation outcomes longitudinally at interim time points was important for understanding the trajectory of change over time. The lower rates of progression in this study warrant further investigation into the long-term effects of exercise in PD.

scholarly journals Parkinson’s disease GWAS-linked Park16 carriers show greater motor progression

2019 ◽  
Vol 56 (11) ◽  
pp. 765-768 ◽  
Author(s):  
Xiao Deng ◽  
Bin Xiao ◽  
John Carson Allen ◽  
Ebonne Ng ◽  
Jia Nee Foo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Genome Wide Association Study ◽  
Rating Scale ◽  
Time Frame ◽  
Mixed Model Analysis ◽  
Risk Patients

BackgroundData on the long-term motor outcomes of genome-wide association study (GWAS)-linked Parkinson disease (PD) carriers are useful for clinical management.ObjectivesTo characterise the association between GWAS-linked PARK16 gene variant and disease progression in PD over a 9-year time frame.MethodsOver a 9-year period, carriers of PARK16 rs11240572 variant and non-carriers were followed up and evaluated using the modified Hoehn and Yahr (H&Y) staging scale and Unified Parkinson’s Disease Rating Scale (UPDRS) part III. A longitudinal, linear mixed model was performed to compare the changes of H&Y staging scale, UPDRS motor score and UPDRS subscores between the two groups.ResultsA total of 156 patients (41 PARK16 carriers and 115 non-carriers) were evaluated and followed up for up to 9 years. Using longitudinal linear mixed model analysis, there was a greater rate of deterioration in the motor function as measured by the UPDRS scores compared with non-carriers after 5 years from the date of diagnosis (p=0.009). In addition, we demonstrated that PARK16 variant carriers had worse gait scores (p=0.043) and greater motor progression than non-carriers after 6 years based on the modified H&Y staging scale (p=0.040).ConclusionsIn a 9-year longitudinal study, we demonstrated that PD PARK16 variant carriers exhibited greater motor progression after 5 years of disease compared with non-carriers, suggesting that GWAS-linked gene variants may influence disease progression over time. Closer monitoring and management of these higher risk patients can facilitate a better quality of life.

Neuropsychiatric Burden Is a Predictor of Early Freezing and Motor Progression in Drug-Naïve Parkinson’s Disease

2021 ◽  
pp. 1-10
Author(s):  
Seong Ho Jeong ◽  
Han Soo Yoo ◽  
Seok Jong Chung ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Model Analysis ◽  
Mixed Model Analysis ◽  
Linear Mixed Model Analysis ◽  
Drug Naïve

Background: Neuropsychiatric symptoms (NPS) are the most common non-motor symptom in Parkinson’s disease (PD). Objective: To investigate the association between the burden of NPS and motor prognosis in patients with PD. Methods: We enrolled 329 drug-naïve patients with PD, who was non-demented and followed-up≥2 years after their first visit to the clinic with baseline dopamine transporter (DAT) imaging and neuropsychiatric inventory (NPI) scores. We performed a survival analysis and a linear mixed model analysis to assess longitudinal motor outcomes according to the NPI total score. Results: The Kaplan-Meier analysis showed no difference in the development of levodopa-induced dyskinesia and wearing-off according to the NPI total score. However, higher burden of NPI total score was associated with earlier freezing of gait (FOG) development in the time-dependent Cox regression models after adjusting for age at symptom onset, sex, disease duration, Unified PD Rating Scale motor score, baseline Mini-Mental State Examination score, DAT activity in the posterior putamen and levodopa-equivalent daily dose (LEDD) (Hazard ratio 1.047, p = 0.002). A linear mixed model analysis revealed that patients with a higher NPI total score had a more rapid LEDD increment (NPI×time, p = 0.003). Among 52 patients with PD who eventually developed FOG during the follow-up period, there was a significant correlation between the NPI total score and time with FOG development (γ= –0.472; p = 0.001) after adjusting for confounding factors. Conclusion: The present study demonstrated that the severity of NPS is a predictor of early freezing and motor progression in patients with PD.

scholarly journals Creatinine and C-reactive protein in amyotrophic lateral sclerosis, multiple sclerosis and Parkinson’s disease

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Can Cui ◽  
Jiangwei Sun ◽  
Yudi Pawitan ◽  
Fredrik Piehl ◽  
Honglei Chen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Amyotrophic Lateral Sclerosis ◽  
Serum Creatinine ◽  
Linear Mixed Model ◽  
Temporal Patterns ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lateral Sclerosis

Abstract Serum creatinine and C-reactive protein have been proposed as potential biomarkers for neurodegenerative diseases, including amyotrophic lateral sclerosis, multiple sclerosis and Parkinson’s disease. However, longitudinal studies investigating temporal patterns of these biomarkers, including the phase before diagnosis, are rare. We performed a case–control study including all newly diagnosed patients with amyotrophic lateral sclerosis (N = 525), multiple sclerosis (N = 1815) or Parkinson’s disease (N = 3797) during 2006–2013 in Stockholm, Sweden, who participated in the Stockholm CREAtinine Measurements (SCREAM) project. For each case, we randomly selected up to five controls from SCREAM that were individually matched to the case by age, sex and county of residence (N = 2625 for amyotrophic lateral sclerosis, N = 9063 for multiple sclerosis and 18 960 for Parkinson’s disease). We collected for both the cases and the controls testing results of serum creatinine and C-reactive protein performed by healthcare providers in Stockholm during the study period. Median levels of creatinine and C-reactive protein were visualized using locally weighted smoothing curves among cases and controls. A linear mixed model was also applied to explore temporal changes within an individual. Compared to controls, patients with amyotrophic lateral sclerosis had lower levels of creatinine from 2 years before diagnosis onwards. In contrast, patients with amyotrophic lateral sclerosis had lower levels of C-reactive protein before diagnosis but higher levels after diagnosis, compared to controls. Focusing the 2 years before to 2 years after diagnosis, patients with amyotrophic lateral sclerosis displayed statistically significantly decreasing level of creatinine from 1 year before diagnosis until 2 years after diagnosis, whereas increasing level of C-reactive protein from diagnosis until 2 years after diagnosis. There were no similar patterns noted among patients with multiple sclerosis or Parkinson’s disease, or the controls of the three patient groups. Patients with amyotrophic lateral sclerosis display distinct temporal patterns of creatinine and C-reactive protein before and after diagnosis, compared to amyotrophic lateral sclerosis-free controls or patients with multiple sclerosis and Parkinson’s disease.

scholarly journals Development and Validation of a Plasma FAM19A5 and MRI-Based Radiomics Model for Prediction of Parkinson’s Disease and Parkinson’s Disease With Depression

2021 ◽  
Vol 15 ◽  
Author(s):  
Xue-ning Li ◽  
Da-peng Hao ◽  
Mei-jie Qu ◽  
Meng Zhang ◽  
An-bang Ma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sequence Similarity ◽  
Red Nucleus ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Settings ◽  
Logistic Regression Models ◽  
Development And Validation ◽  
Radiomics Signature

Background: Prediction and early diagnosis of Parkinson’s disease (PD) and Parkinson’s disease with depression (PDD) are essential for the clinical management of PD.Objectives: The present study aimed to develop a plasma Family with sequence similarity 19, member A5 (FAM19A5) and MRI-based radiomics nomogram to predict PD and PDD.Methods: The study involved 176 PD patients and 181 healthy controls (HC). Sandwich enzyme-linked immunosorbent assay (ELISA) was used to measure FAM19A5 concentration in the plasma samples collected from all participants. For enrolled subjects, MRI data were collected from 164 individuals (82 in the PD group and 82 in the HC group). The bilateral amygdala, head of the caudate nucleus, putamen, and substantia nigra, and red nucleus were manually labeled on the MR images. Radiomics features of the labeled regions were extracted. Further, machine learning methods were applied to shrink the feature size and build a predictive radiomics signature. The resulting radiomics signature was combined with plasma FAM19A5 concentration and other risk factors to establish logistic regression models for the prediction of PD and PDD.Results: The plasma FAM19A5 levels (2.456 ± 0.517) were recorded to be significantly higher in the PD group as compared to the HC group (2.23 ± 0.457) (P < 0.001). Importantly, the plasma FAM19A5 levels were also significantly higher in the PDD subgroup (2.577 ± 0.408) as compared to the non-depressive subgroup (2.406 ± 0.549) (P = 0.045 < 0.05). The model based on the combination of plasma FAM19A5 and radiomics signature showed excellent predictive validity for PD and PDD, with AUCs of 0.913 (95% CI: 0.861–0.955) and 0.937 (95% CI: 0.845–0.970), respectively.Conclusion: Altogether, the present study reported the development of nomograms incorporating radiomics signature, plasma FAM19A5, and clinical risk factors, which might serve as potential tools for early prediction of PD and PDD in clinical settings.

scholarly journals Effects of Nordic Walking on Gait Symmetry in Mild Parkinson’s Disease

Symmetry ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1481
Author(s):  
Ana Paula J. Zanardi ◽  
Flávia G. Martinez ◽  
Edson S. da Silva ◽  
Marcela Z. Casal ◽  
Valéria F. Martins ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Generalized Estimating Equations ◽  
Aerobic Training ◽  
Nordic Walking ◽  
Post Intervention ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Speeds ◽  
Post Hoc

Individuals with Parkinson’s disease (PD) have gait asymmetries, and exercise therapy may reduce the differences between more and less affected limbs. The Nordic walking (NW) training may contribute to reducing the asymmetry in upper and lower limb movements in people with PD. We compared the effects of 11 weeks of NW aerobic training on asymmetrical variables of gait in subjects with mild PD. Fourteen subjects with idiopathic PD, age: 66.8 ± 9.6 years, and Hoehn and Yard stage of 1.5 points were enrolled. The kinematic analysis was performed pre and post-intervention. Data were collected at two randomized walking speeds (0.28 m·s−1 and 0.83 m·s−1) during five minutes on the treadmill without poles. The more affected and less affected body side symmetries (threshold at 5% between sides) of angular kinematics and spatiotemporal gait parameters were calculated. We used Generalized Estimating Equations with Bonferroni post hoc (α = 0.05). Maximal flexion of the knee (p = 0.007) and maximal abduction of the hip (p = 0.041) were asymmetrical pre and became symmetrical post NW intervention. The differences occurred in the knee was less affected and the hip was more affected. We concluded that 11 weeks of NW training promoted similarities in gait parameters and improved knee and hip angular parameters for PD subjects.

scholarly journals The Anterior Attentional–Intentional System in Patients with Parkinson’s Disease—A Pilot and Feasibility Study

2021 ◽  
Vol 11 (8) ◽  
pp. 1013
Author(s):  
Paulina Beata Golińska ◽  
Artur Józef Sawicki ◽  
Łucja Bieleninik ◽  
Mariola Bidzan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Feasibility Study ◽  
Mixed Model ◽  
Comparison Group ◽  
Reaction Times ◽  
Similar Reaction ◽  
Mixed Model Analysis ◽  
Normal Cognition ◽  
Intentional System

(1) Background: This study compared anterior attentional–intentional system performance between three groups: Parkinson’s disease (PD) patients with normal cognition (PD-NC), with mild cognitive impairment (PD-MCI), and a comparison group (CG). It also evaluated the feasibility of the recruitment and study procedures; (2) Methods: From 45 participants recruited, 39 were allocated (mean age 65.31; 43.59% men) to PD-NC, PD-MCI and CG (13 per group). To assess attention, we used three tasks from the ROtman–Baycrest Battery for Investigating Attention: Simple Reaction time (RT), Choice RT, and Prepare RT. We conducted a mixed-model analysis of variance with a 3 (groups) × 4 (tasks) design to compare reaction times; (3) Results: PD-MCI had slower reaction times than PD-NC (p = 0.028) and the CG (p = 0.052); there was no difference between PD-NC and CG. PD-MCI might perform worse on monitoring tasks than PD-NC, Z = −1.68, p = 0.092. Nearly half the volunteers from the CG and 87% of all eligible patients were enrolled in the study and completed all neuropsychological procedures; (4) Conclusions: General cognitive decline appears related to partial deficits in energization and tends to impair attentional monitoring. Furthermore, PD-NC exhibited similar reaction times to the CG. Results from the feasibility study contributed to the definitive study.

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