A Comparison of Pain between Parkinson’s Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.

Download Full-text

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

10.21203/rs.3.rs-42395/v1 ◽

2020 ◽

Author(s):

Krishnan V. Chakravarthy ◽

Rahul Chaturvedi ◽

Takashi Agari ◽

Hirokazu Iwamuro ◽

Rajiv Reddy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Mood State ◽

Case Series ◽

Depression Scale ◽

Motor Symptoms ◽

Timed Up And Go ◽

Disease Rating ◽

Vas Scores

Abstract Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS).Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG).Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%.Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.

Download Full-text

Single Arm Prospective Multicenter Case Series on the Use of Burst Stimulation to Improve Pain and Motor Symptoms in Parkinson’s Disease

10.21203/rs.3.rs-42395/v2 ◽

2020 ◽

Author(s):

Krishnan V. Chakravarthy ◽

Rahul Chaturvedi ◽

Takashi Agari ◽

Hirokazu Iwamuro ◽

Rajiv Reddy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Mood State ◽

Case Series ◽

Depression Scale ◽

Motor Symptoms ◽

Timed Up And Go ◽

Disease Rating ◽

Vas Scores

Abstract Background: In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS). Methods: 15 patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst DR stimulation (40Hz, 500Hz, 1000μs), or cycle mode (on time of 10-15 sec, off time of 15-30 sec) with Burst DR (40Hz, 500Hz, 1000μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG). Results: All patients experienced significant improvement in VAS scores. 73% of patients experienced improvement in the 10-meter walk, with a mean improvement of 12%. 82% of patients experienced improvements in the TUG, with a mean improvement of 15%. Conclusions: This study points to the utility of SCS to address both pain and motor symptoms in PD patients who have and have not received DBS therapy.

Download Full-text

Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462009000100010 ◽

2009 ◽

Vol 31 (1) ◽

pp. 39-42 ◽

Cited By ~ 12

Author(s):

Beatriz Azevedo dos Anjos Godke Veiga ◽

Vanderci Borges ◽

Sonia Maria César de Azevedo Silva ◽

Fabrício de Oliveira Goulart ◽

Maysa Seabra Cendoroglo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Major Depression ◽

Beck Depression Inventory ◽

Geriatric Patients ◽

Rating Scale ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Yahr Scale ◽

Disease Rating

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p < 0.001). The scores of the Hamilton Depression Scale and the Beck Depression Inventory were higher in Parkinson's disease patients (p < 0.001). Depressed Parkinson's disease patients had longer duration of Parkinson's disease (p = 0.020) and higher scores on the Unified Parkinson's Disease Rating Scale part 3 (p = 0.029) and the Yahr Scale (p = 0.027). CONCLUSIONS: The frequency (42%) and severity of major depression were higher in Parkinson's disease patients. Longer duration of Parkinson's disease, higher scores on the Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were significantly associated with major depression.

Download Full-text

Serum Butyrylcholinesterase Activity: A Biomarker for Parkinson’s Disease and Related Dementia

BioMed Research International ◽

10.1155/2017/1524107 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Mei-Xue Dong ◽

Xiao-Min Xu ◽

Ling Hu ◽

Yang Liu ◽

Yuan-Jun Huang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sensitivity And Specificity ◽

Rating Scale ◽

Roc Curves ◽

Healthy Controls ◽

Bche Activity ◽

Disease Rating ◽

Independent Risk Factors ◽

Butyrylcholinesterase Activity

Objective. This study aim to determine changes of serum butyrylcholinesterase (BChE) activity in PD patients and related dementia. Patients and Methods. Consecutive PD patients and healthy controls were included and clinical data were collected. Fast serum BChE activity was determined and compared between healthy controls and PD patients. Independent risk factors were performed for BChE activity, PD, and related dementia. The relationship between BChE activity and disease severity was also evaluated. Receiver operating characteristic (ROC) curves were obtained to explore serum BChE activity in distinguishing PD patients and related dementia. Results. Serum BChE activity mainly independently correlated with gender, albumin, triglyceride, body mass index, and PD. Serum BChE activity decreased in PD patients compared with healthy controls. Based on the ROC curve, the optimal cut-off point was 6864.08 IU/L for distinguishing PD patients, and the sensitivity and specificity values were 61.8% and 72.1%. It inversely correlated with Unified Parkinson’s Disease Rating Scale score. BChE activity decreased in PD-related dementia compared with those without dementia. The sensitivity and specificity values were 70.6% and 76.3%, respectively, with an optimal cut-off point of 6550.00 IU/L. Conclusions. Serum BChE activity can be regarded as a biomarker for PD and related dementia.

Download Full-text

Levodopa Reduces the Phase lag Index of Parkinson’s Disease Patients: A Magnetoencephalographic Study

Clinical EEG and Neuroscience ◽

10.1177/1550059418781693 ◽

2018 ◽

Vol 50 (2) ◽

pp. 134-140 ◽

Cited By ~ 1

Author(s):

Chunyan Cao ◽

Dianyou Li ◽

Ke Zeng ◽

Shikun Zhan ◽

Peng Huang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Phase Lag ◽

Healthy Controls ◽

Levodopa Treatment ◽

Parietal Area ◽

Sensorimotor Area ◽

Disease Rating ◽

Duration Of Disease

Objectives. As a method of measuring the phase difference between 2 signals, the phase lag index (PLI) of the alpha and beta bands in patients with Parkinson’s disease (PD) was investigated by using magnetoencephalography (MEG). Methods. Eighteen PD patients were measured by MEG in the state of overnight withdrawal of levodopa and after levodopa treatment; meanwhile, Unified Parkinson’s Disease Rating Scale (UPDRS) III scale was evaluated. Results. Compared with healthy controls, alpha (8-13 Hz) PLI in the frontal and parietal areas elevated in PD patients, while the elevation was reversed by the levodopa treatment. The alterations of the UPDRS III total scale ( rs = 0.552, P = .013, n = 16) and the changes of akinesia scale ( rs = 0.622, P = .005, n = 16) were correlated to the change of beta (13-30 Hz) PLI in the left parietal area. The change of the UPDRS total scale was negatively correlated to duration of disease ( rs = 0.432, P = .047, n = 16). There was a negative correlation between the age of PD patients and the change of alpha PLI in the left frontal area ( rs = 0.519, P = .020, n = 16). Conclusions. PD patients showed a higher mu PLI in the sensorimotor area relative to the healthy controls. The improvement of motor symptoms of PD patients by levodopa was correlated to the inhibition of beta PLI in the sensorimotor area.

Download Full-text

Brazilian version of the Multidimensional Fatigue Inventory for Parkinson’s disease

Fisioterapia em Movimento ◽

10.1590/1980-5918.033.ao61 ◽

2020 ◽

Vol 33 ◽

Author(s):

Josiane Lopes ◽

Hayslenne Andressa Gonçalves de Oliveira Araújo ◽

Suhaila Mahmoud Smaili

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Psychometric Properties ◽

Rating Scale ◽

Intraclass Correlation ◽

Depression Scale ◽

Multidimensional Fatigue Inventory ◽

Brazilian Version ◽

Disease Rating ◽

Fatigue Severity

Abstract Introduction: The multidimensional fatigue inventory (MFI) has not been applied in Brazilian Parkinson`s disease (PD) population due to the lack of validation. Objective: The aim of this study was to cross-culturally adapt, to validate, and investigate the psychometric properties of Brazilian version of the MFI in PD. Method: Idiopathic PD individuals (N = 90) were recruited. The MFI was translated into Brazilian Portuguese using established forward-backward translation procedures, and the psychometric properties were evaluated. All individuals were assessed by socio-clinical questionnaire, Mini-Mental State Examination (MMSE), Unified Parkinson’s Disease Rating Scale (MDS-UPDRS Part I-IV), Hoehn-Yahr disability scale (HY), hospital anxiety and depression scale (HADS), fatigue severity scale (FSS), Parkinson Fatigue Scale (PFS-16) and MFI-PD/ BR with retest of the MFI-PD/BR after seven days. Results: The adaptation phase kept the same items of original MFI-PD. No data missing, floor nor ceiling effects were found. The overall Cronbach's alpha coefficient for the 20 items was 0.81, ranging from 0.73 to 0.81 for each of the five subscales. Bland and Altman analysis showed no systematic differences between assessments. The intraclass correlation coefficient test-retest was higher or equal 0.70 (p < 0.01) for the MFI-PD/BR score, which was moderately correlated with the HADS, MDS-UPDRS score (motor examination, motor and non-motor experiences of daily living and motor complications), FSS and PFS-16. It was revealed the MFI-PD/ BR > 55 points as cut-off point to indicate fatigued subjects with accuracy of 0.84 (p < 0.001). Conclusion: The MFI-PD/BR can be considered a valid and reproducible instrument for assessing PD-related fatigue.

Download Full-text

Single arm prospective multicenter case series on the use of burst stimulation to improve pain and motor symptoms in Parkinson’s disease

Bioelectronic Medicine ◽

10.1186/s42234-020-00055-3 ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Krishnan V. Chakravarthy ◽

Rahul Chaturvedi ◽

Takashi Agari ◽

Hirokazu Iwamuro ◽

Rajiv Reddy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Case Series ◽

Depression Scale ◽

Motor Symptoms ◽

Burst Stimulation ◽

Average Improvement ◽

Vas Scores ◽

40 Hz

Abstract Background In this study we analyze new clinical data in the use of spinal cord stimulation (SCS) for the treatment of pain and motor symptoms in patients with Parkinson’s Disease (PD), as both a singular bioelectric therapy and as a salvage therapy after deep brain stimulation (DBS). Methods Fifteen patients were recruited and had percutaneous electrodes implanted at the level of the thoracic or cervical spine. Participants were set to one of three stimulation modes: continuous tonic stimulation, continuous Burst stimulation (40 Hz, 500 Hz, 1000 μs), or cycle mode (on time of 10–15 s, off time of 15–30 s) with Burst (40 Hz, 500 Hz, 1000 μs). Patients completed the Visual Analogue Scale (VAS), Unified Parkinson’s Disease Rating Scale, Self-Rating Depression Scale, Hamilton Depression Rating Scale, Profile of Mood State, 10-meter walking test, and the Timed Up and Go (TUG). Results All patients experienced significant improvement in VAS scores with a mean reduction of 59% across all patients. Patients who chose the cycling burst stimulation parameter had an average 67% reduction in VAS scores, as compared to the continuous burst parameter group, which had an average 48% reduction in VAS scores. Seventy-three percent of patients experienced improvement in the 10-meter walk, with an average improvement of 12%. Sixty-four percent of patients experienced clinically relevant improvements in the TUG, with an average improvement of 21%. Conclusions This study points to the potential utility of SCS to address both pain and certain aspects of motor symptoms in PD patients who have and have not received DBS therapy.

Download Full-text

“Does the Response to Morning Medication Predict the ADL-Level of the Day in Parkinson’s Disease?”

Parkinson s Disease ◽

10.1155/2020/7140984 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Trine Hørmann Thomsen ◽

Troels Wesenberg Kjær ◽

Lene Bastrup Jørgensen ◽

Anita Haahr ◽

Kristian Winge

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Strong Predictor ◽

Early Morning ◽

Cross Sectional Study ◽

Poor Responders ◽

Slow Response ◽

Cross Sectional ◽

Disease Rating

Background. Individuals with Parkinson’s Disease (PD) have bradykinesia during mobility tasks in the morning before intake of dopaminergic treatment and have difficulties managing Activities of Daily Living (ADLs). Early morning off (EMO) refers to off-states in the morning where the severity of bradykinesia is increased and causes a decrease in mobility related to wearing off of effects of medication. Measurements from devices capable of continuously recording motor symptoms may provide insight into the patient’s response to medication and possible impact on ADLs. Objectives. To test whether poor or slow response to medication in the morning predicts the overall ADL-level and to assess the association between change in bradykinesia score (BKS) and the risk of having disabilities within three selected ADL-items. Methods. In this cross-sectional study, the sample consists of 34 patients with light to moderate PD. Data collection encompasses measurements from the Parkinson KinetiGraph, and the ADL-limitations are assessed by the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part II. Results. The association between UPDRS- II and BKS from the algorithm was −0.082 (p<0.01), 95% CL:−0.113; −0.042). The individuals experienced disabilities in performing “Speech” (p=0.004) and “Doing hobbies” (p=0.038) when being slow or poor responders to dopaminergic therapy. The PD patients’ L-dopa equivalent dose seems to be a strong predictor of the ADL-level in the morning. Conclusion. Slow response to the medication dosages in the morning is correlated with disabilities in the overall ADL-level in PD. The combination of PD-drugs and precise, timely dosages must be considered in the improvement of the ADL-level in PD patients.

Download Full-text

Probable RBD Associates with the Development of RLS in Parkinson’s Disease: A Cross-Sectional Study

Behavioural Neurology ◽

10.1155/2019/7470904 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Yewei Qu ◽

Lu Zhang ◽

Dongfang Shen ◽

Wangzikang Zhang ◽

Mingsha Zhang ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Hamilton Depression Scale ◽

Sectional Study ◽

Contributing Factors ◽

Cross Sectional ◽

Sleep Behavior

Objectives. We aimed to investigate the prevalence of restless leg syndrome (RLS) and exploring the contributing factors that affect the development of RLS in Parkinson’s disease (PD) patients. Methods. A cross-sectional study was conducted consisting of 178 consecutive PD patients from our hospital between October 2015 and August 2016. We divided the participants into two groups, which were PD with RLS and PD with non-RLS. Then, we recorded their demographics and clinical data to draw a comparison between PD with RLS and PD with non-RLS. Results. 23 (12.92%) were diagnosed with RLS among all the enrolled PD patients. Unified Parkinson’s Disease Rating Scale III (UPDRS III) and Hamilton Depression Scale (HAMD) scores, probable rapid eye movement sleep behavior disorder (PRBD), and daily levodopa equivalent dose (LED) in the PD with the RLS group were significantly different from those in the PD with the non-RLS group. Daily LED and the scores of UPDRS III and HAMD in PD patients with RLS were all higher than those in PD patients with non-RLS. PRBD, daily LED, and HAMD scores were significantly independent factors contributing to the development of RLS (OR=4.678, 95% CI 1.372~15.944, P=0.014; OR=1.003, 95% CI 1.001~1.005, P=0.019; OR=1.094, 95% CI 1.002~1.193, P=0.045). The severity of RLS was positively correlated with the duration of PD and daily LED (r=0.438, P=0.036; r=0.637, P=0.001). Conclusion. PRBD existence, daily LED, and HAMD scores are independent factors for developing RLS in PD patients. PRBD existence is firstly proposed as an independent factor in developing RLS among PD patients. RLS severity in PD patients are positively associated with the duration of PD and daily LED.

Download Full-text

Postural instability and falls are more frequent in Parkinson’s disease patients with worse trunk mobility

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160074 ◽

2016 ◽

Vol 74 (7) ◽

pp. 519-523 ◽

Cited By ~ 6

Author(s):

Nathalie Ribeiro Artigas ◽

Clarissa Franco ◽

Paula Leão ◽

Carlos R. M. Rieder

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Daily Living ◽

Rating Scale ◽

Cross Sectional Study ◽

Postural Instability ◽

Cross Sectional ◽

Risk Of Falls ◽

History Of ◽

Disease Rating

ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.

Download Full-text