scholarly journals Relationship between Freezing of Gait and Anxiety in Parkinson’s Disease Patients: A Systemic Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-24 ◽  
Author(s):  
Ivan Witt ◽  
Hooman Ganjavi ◽  
Penny MacDonald
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Outcome Measures ◽  
English Language ◽  
Case Reports ◽  
Freezing Of Gait ◽  
Anxiety Reduction ◽  
Motor Symptom ◽  
Number Of Patients

Freezing of gait (FOG) is experienced by a significant number of patients with Parkinson’s disease (PD). The pathophysiology of this disabling motor symptom remains unclear, and there are no effective therapies. Anxiety has previously been posited as a contributing factor to gait freezing. There have been few studies directly investigating this topic, and a comprehensive literature review is lacking. The objective of this paper was to systematically review the evidence associating anxiety with the presence, severity, and progression of FOG in PD patients. The PubMed, EMBASE, and PsycINFO databases were searched up to September 19, 2018, for English-language, peer-reviewed articles that explored anxiety and FOG as outcome measures in a PD population base. Review articles, case reports, and articles that assessed gait disorders other than FOG were excluded, yielding a total of 26 articles in the final analysis. Of these 26 studies, 16 had a significant relationship between anxiety outcome measure and either presence or severity of FOG. There was great variability among studies in terms of outcome measures for both FOG and anxiety. Despite this heterogeneity, most studies relate anxiety and FOG. Standardized, high-validity outcome measures of anxiety and FOG are needed. Future exploration should aim to clarify the role of anxiety in FOG as a causal factor, pathophysiological marker, and manifestation of a common pathophysiological process versus a consequence of FOG itself. Clarifying the relationship between anxiety and FOG could reveal anxiety reduction as a therapy for FOG.

scholarly journals Abnormal Olfaction in Parkinson’s Disease Is Related to Faster Disease Progression

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sara Cavaco ◽  
Alexandra Gonçalves ◽  
Alexandre Mendes ◽  
Nuno Vila-Chã ◽  
Inês Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Identification Test ◽  
Disease Rating ◽  
Abnormal Performance ◽  
Smell Identification

Introduction. A possible association between olfactory dysfunction and Parkinson’s disease (PD) severity has been a topic of contention for the past 40 years. Conflicting reports may be partially explained by procedural differences in olfactory assessment and motor symptom evaluation.Methods. One hundred and sixty-six nondemented PD patients performed the Brief-Smell Identification Test and test scores below the estimated 20th percentile as a function of sex, age, and education (i.e., 80% specificity) were considered demographically abnormal. Patients underwent motor examination after 12 h without antiparkinsonian medication.Results. Eighty-two percent of PD patients had abnormal olfaction. Abnormal performance on the Brief-Smell Identification Test was associated with higher disease severity (i.e., Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III, Freezing of Gait questionnaire, and levodopa equivalent dose), even when disease duration was taken into account.Conclusions. Abnormal olfaction in PD is associated with increased severity and faster disease progression.

Levodopa Therapy and the Risk of Malignant Melanoma

2000 ◽  
Vol 34 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Jolene F Siple ◽  
Diana C Schneider ◽  
Wendy A Wanlass ◽  
Burton K Rosenblatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Malignant Melanoma ◽  
English Language ◽  
Case Reports ◽  
Levodopa Therapy ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms

OBJECTIVE: To evaluate the use of levodopa therapy in patients with Parkinson's disease and malignant melanoma. DATA SOURCES: A MEDLINE search (January 1966–September 1999) of English-language articles was conducted. Key search terms included levodopa, melanoma, and Parkinson's disease; 34 case reports were identified. DATA SYNTHESIS: Carbidopa/levodopa continues to be a mainstay in the treatment of Parkinson's disease. Since the late 1970s, a warning has appeared in the prescribing literature for levodopa regarding the risk of activating malignant melanoma. An evaluation was conducted of the case reports in which a causal relationship between levodopa and melanoma was suggested. CONCLUSIONS: There is an unlikely association between levodopa and induction or exacerbation of malignant melanoma.

scholarly journals Towards Real-Time Prediction of Freezing of Gait in Patients With Parkinson’s Disease: Addressing the Class Imbalance Problem

Sensors ◽  
2019 ◽  
Vol 19 (18) ◽  
pp. 3898 ◽  
Author(s):  
Nader Naghavi ◽  
Aaron Miller ◽  
Eric Wade
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Class Imbalance ◽  
Ensemble Classifier ◽  
Motor Symptom ◽  
Support Vector ◽  
Ensemble Classifiers ◽  
Class Imbalance Problem ◽  
K Nearest Neighbors

Freezing of gait (FoG) is a common motor symptom in patients with Parkinson’s disease (PD). FoG impairs gait initiation and walking and increases fall risk. Intelligent external cueing systems implementing FoG detection algorithms have been developed to help patients recover gait after freezing. However, predicting FoG before its occurrence enables preemptive cueing and may prevent FoG. Such prediction remains challenging given the relative infrequency of freezing compared to non-freezing events. In this study, we investigated the ability of individual and ensemble classifiers to predict FoG. We also studied the effect of the ADAptive SYNthetic (ADASYN) sampling algorithm and classification cost on classifier performance. Eighteen PD patients performed a series of daily walking tasks wearing accelerometers on their ankles, with nine experiencing FoG. The ensemble classifier formed by Support Vector Machines, K-Nearest Neighbors, and Multi-Layer Perceptron using bagging techniques demonstrated highest performance (F1 = 90.7) when synthetic FoG samples were added to the training set and class cost was set as twice that of normal gait. The model identified 97.4% of the events, with 66.7% being predicted. This study demonstrates our algorithm’s potential for accurate prediction of gait events and the provision of preventive cueing in spite of limited event frequency.

scholarly journals Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Elisa Pelosin ◽  
Roberta Barella ◽  
Cristina Bet ◽  
Elisabetta Magioncalda ◽  
Martina Putzolu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measures ◽  
Physical Training ◽  
Action Observation ◽  
Freezing Of Gait ◽  
Berg Balance Scale ◽  
Control Group ◽  
Timed Up And Go ◽  
Balance Scale

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson’s disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

Hand Function as Predictor of Motor Symptom Severity in Individuals with Parkinson’s Disease

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Thiago da Silva Rocha Paz ◽  
Vera Lúcia Santos de Britto ◽  
Bruna Yamaguchi ◽  
Vera Lúcia Israel ◽  
Alessandra Swarowsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Symptom Severity ◽  
Rating Scale ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Hand Function ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Cross Sectional

<b><i>Introduction:</i></b> Parkinson’s disease (PD) leads to deficits in upper limb strength and manual dexterity and consequently resulting in functional impairment. Handgrip strength is correlated with the motor symptom severity of the disease, but there is a gap in the literature about the influence of freezing in PD patients. <b><i>Objective:</i></b> The objective is to study the correlation between handgrip strength and motor symptom severity considering the freezing phenomenon and to verify variables that can predict Unified Parkinson’s Disease Rating Scale (UPDRS) III. <b><i>Methods:</i></b> This is a multicenter cross-sectional study in PD. 101 patients were divided into 2 groups: freezing of gait (FOG) (<i>n</i> = 51) and nonfreezing (nFOG) (<i>n</i> = 52). Freezing of Gait Questionnaire (FOGQ); UPDRS II and III sections; Hoehn and Yahr (HY) scale; handgrip dynamometry (HD); 9 Hole Peg Test (9-HPT) were assessed. <b><i>Results:</i></b> In both groups, HD was correlated to UPDRS III (nFOG: −0.308; FOG: −0.301), UPDRS total (nFOG: −0.379; FOG: −0.368), UPDRS item 23 (nFOG: −0.404; FOG: −0.605), and UPDRS item 24 (nFOG: −0.405; FOG: −0.515). For the correlation to UPDRS II (0.320) and 9-HPT (−0.323), only nFOG group presented significance. For the UPDRS 25 (−0.437), only FOG group presented statistical significance. The UPDRS III can be predicted by 9-HPT, age, and HY in nFOG patients (Adjusted <i>R</i><sup>2</sup> = 0.416). In FOG group, UPDRS III can be predicted by HD, 9-HPT, age, and HY (Adjusted <i>R</i><sup>2</sup> = 0.491). <b><i>Conclusion:</i></b> Handgrip strength showed to be predictive of motor impairment only in the FOG group. Our results showed clinical profile differences of motor symptoms considering freezers and nonfreezers with PD.

scholarly journals Effects of Gait Inducing Assist for Patients with Parkinson’s Disease on Double Support Phase During Gait

2020 ◽  
Vol 32 (4) ◽  
pp. 798-811
Author(s):  
Ai Higuchi ◽  
Junichiro Shiraishi ◽  
Yuichi Kurita ◽  
Tomohiro Shibata ◽  
◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Step Length ◽  
Motor Symptom ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Wide Range ◽  
Healthy Elderly Subjects ◽  
Support Phase

Parkinson’s disease (PD) is a common progressive neurodegenerative disease that affects a wide range of motor and non-motor symptoms. Freezing of gait (FOG) is such a motor symptom of PD that frequently results in falling, and almost half of PD patients suffer from FOG. In this study, we investigated the effectiveness of a robotic assistance system called UPS-PD, which was developed to suppress FOG. The double limb support phase (DLS) in a 10-m straight-line walking task, the gait time and step counts were measured in five PD subjects. In addition, the safety of the UPS-PD in a healthy person was investigated using OpenSim, and the DLS parameters in four healthy elderly subjects were evaluated. In the experiment with the PD patients, the DLS parameters of two subjects showed an improvement. Furthermore, the step length of one subject and the step length and walking speed of the other subject were improved. Moreover, there were no problems in terms of instability of gait in both the PD patients. The UPS-PD did not adversely affect the gait of healthy elderly subjects and the walking of a healthy subject model in the simulation. Therefore, the UPS-PD is considered to be a useful device for improving walking in PD patients.

scholarly journals Drooling in Parkinson’s Disease: Prevalence and Progression from the Non-motor International Longitudinal Study

Dysphagia ◽  
2020 ◽  
Vol 35 (6) ◽  
pp. 955-961 ◽  
Author(s):  
Daniel J. van Wamelen ◽  
Valentina Leta ◽  
Julia Johnson ◽  
Claudia Lazcano Ocampo ◽  
Aleksandra M. Podlewska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Longitudinal Study ◽  
Disease Duration ◽  
Motor Symptom ◽  
Number Of Patients ◽  
Non Motor Symptoms

AbstractSialorrhoea in Parkinson’s disease (PD) is an often neglected yet key non-motor symptom with impact on patient quality of life. However, previous studies have shown a broad range of prevalence figures. To assess prevalence of drooling in PD and its relationship to quality of life, we performed a retrospective analysis of 728 consecutive PD patients who had a baseline and follow-up assessment as part of the Non-motor International Longitudinal Study (NILS), and for whom drooling presence and severity were available, assessed through the Non-Motor Symptoms Scale (NMSS). In addition, we analysed the prevalence of associated dysphagia through self-reported outcomes. Quality of life was assessed through the PDQ-8 scale. Baseline (disease duration 5.6 years) prevalence of drooling was 37.2% (score ≥ 1 NMSS question 19), and after 3.27 ± 1.74 years follow-up, this was 40.1% (p = 0.17). The prevalence of drooling increased with age (p < 0.001). The severity of drooling, however, did not change (p = 0.12). While in 456 patients without drooling at baseline, only 16% (n = 73) had dysphagia (question 20 of the NMSS), in those with drooling this was 34.3% (p < 0.001). At follow-up, the number of patients with dysphagia had increased, 20.4% with no drooling had dysphagia, and 43.6% with drooling had dysphagia. Both at baseline and follow-up, drooling severity was significantly positively associated with quality of life (PDQ-8; r = 0.199; p < 0.001). In moderately advanced PD patients, subjective drooling occurs in over one-third of patients and was significantly associated with decreased quality of life. Dysphagia occurred significantly more often in patients with drooling.

scholarly journals Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-40 ◽  
Author(s):  
Khalid Orayj ◽  
Emma Lane
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Common Factor ◽  
Safety Data ◽  
Prescribing Patterns ◽  
Efficacy And Safety ◽  
Ovid Medline ◽  
Number Of Patients

Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson’s disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients’ factors and prescribers’ factors, with patients’ age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.

scholarly journals Surgical management of camptocormia in Parkinson’s disease: systematic review and meta-analysis

2019 ◽  
Vol 131 (2) ◽  
pp. 368-375 ◽  
Author(s):  
Andrew K. Chan ◽  
Alvin Y. Chan ◽  
Darryl Lau ◽  
Beata Durcanova ◽  
Catherine A. Miller ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Surgical Management ◽  
Sagittal Plane ◽  
Case Reports ◽  
Meta Analysis ◽  
Management Strategies ◽  
Number Of Patients ◽  
Spinal Deformity Surgery ◽  
Surgical Options

OBJECTIVECamptocormia is a potentially debilitating condition in the progression of Parkinson’s disease (PD). It is described as an abnormal forward flexion while standing that resolves when lying supine. Although the condition is relatively common, the underlying pathophysiology and optimal treatment strategy are unclear. In this study, the authors systematically reviewed the current surgical management strategies for camptocormia.METHODSPubMed was queried for primary studies involving surgical intervention for camptocormia in PD patients. Studies were excluded if they described nonsurgical interventions, provided only descriptive data, or were case reports. Secondarily, data from studies describing deep brain stimulation (DBS) to the subthalamic nuclei were extracted for potential meta-analysis. Variables showing correlation to improvement in sagittal plane bending angle (i.e., the vertical angle caused by excessive kyphosis) were subjected to formal meta-analysis.RESULTSThe query resulted in 9 studies detailing treatment of camptocormia: 1 study described repetitive trans-spinal magnetic stimulation (rTSMS), 7 studies described DBS, and 1 study described deformity surgery. Five studies were included for meta-analysis. The total number of patients was 66. The percentage of patients with over 50% decrease in sagittal plane imbalance with DBS was 36.4%. A duration of camptocormia of 2 years or less was predictive of better outcomes (OR 4.15).CONCLUSIONSSurgical options include transient, external spinal stimulation; DBS targeting the subthalamic nuclei; and spinal deformity surgery. Benefit from DBS stimulation was inconsistent. Spine surgery corrected spinal imbalance but was associated with a high complication rate.

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