Ultrasonography of the Vagus Nerve in the Diagnosis of Parkinson’s Disease

Background. It is currently impossible to diagnose Parkinson’s disease (PD) in the premotor phase even though at the time of motor symptom onset the number of already degenerated dopaminergic substantia nigra neurons is considerable. Degeneration of the dorsal nucleus of the vagus nerve (VN) has been reported early in the disease course, and it could lead to impaired function of the VN, resulting in certain nonmotor symptoms of PD. Therefore, we raised a hypothesis that the loss of VN neurons could result in a smaller diameter of the VN among PD patients. Methods. 20 PD patients and 20 age- and gender-matched individuals without any neurodegenerative disease were enrolled in a pilot study. The diameters of the right and left VNs were measured using ultrasonography, their average was calculated, and the narrower VN diameter was noted separately. Results. No difference was found between the PD and control groups neither in the average VN diameter (mean 1.17; 95% confidence interval (CI) 1.10–1.24 vs. 1.13; 1.07–1.18, mm; p=0.353) nor in the narrower VN diameter (mean 1.11; 95% confidence interval (CI) 1.02–1.20 vs. 1.07; 1.02–1.13, mm; p=0.421). The narrower VN diameter and the average VN diameter were not able to distinguish between PD patients and controls (area under curve (AUC) = 0.588, 95% CI = 0.408–0.767, and p=0.344; and AUC = 0.578, 95% CI = 0.396–0.759, and p=0.402). Conclusions. To conclude, no differences were found in VN diameter between the PD and control groups. Therefore, our data do not support the hypothesis that PD could be associated with a smaller diameter of the VN.

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Vagus Nerve Cross-Sectional Area in Patients With Parkinson's Disease—An Ultrasound Case-Control Study

Frontiers in Neurology ◽

10.3389/fneur.2021.681413 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jacob Horsager ◽

Uwe Walter ◽

Tatyana D. Fedorova ◽

Katrine B. Andersen ◽

Casper Skjærbæk ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Vagus Nerve ◽

Cross Sectional ◽

Parasympathetic Neurons ◽

High Frequency Transducer ◽

Ultrasound System ◽

The Right ◽

Control Study ◽

Left Vagus

Background: Vagal parasympathetic neurons are prone to degeneration in Parkinson's disease (PD). High-resolution ultrasound can precisely estimate the cross-sectional (CSA) area of peripheral nerves. Here, we tested the hypothesis that vagus CSA is reduced in PD.Methods: We included 56 healthy controls (HCs) and 63 patients with PD. Using a high-end ultrasound system equipped with a high-frequency transducer, five images were obtained of each nerve. The hypoechoic neuronal tissue was delineated offline with dedicated software and the CSA extracted.Results: In the initial PD vs. HC comparison, no statistically significant differences were observed in mean left vagus CSA (HC: 1.97 mm2, PD: 1.89 mm2, P = 0.36) nor in mean right vagus CSA (HC: 2.37 mm2, PD: 2.23 mm2, P = 0.17). The right vagus CSA was significantly larger than the left vagus CSA in both groups (P < 0.0001). Females were overrepresented in the HC group and presented with generally smaller vagus CSAs. Consequently, sex-adjusted CSA was significantly smaller for the right vagus nerve of the PD group (P = 0.041), but not for the left.Conclusion: A small but significant reduction in sex-adjusted right vagus CSA was observed in patients with PD. The left vagus CSA was not significantly reduced in patients with PD. Ultrasound may not be a suitable method to detecting vagal axonal loss in individual patients.

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Effect of Coffee, Tobacco, and Alcohol on Parkinson’s Disease

Journal of the Korean Neurological Association ◽

10.17340/jkna.2021.3.3 ◽

2021 ◽

Vol 39 (3) ◽

pp. 129-133

Author(s):

Wongi Seol ◽

Hyejung Kim ◽

Ilhong Son

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Trials ◽

Clinical Studies ◽

Control Groups ◽

Neuroprotective Effects ◽

Effective Components ◽

And Control

Since the neuroprotective effects of coffee and tobacco on Parkinson’s disease have been reported more than 50 years ago, clinical studies using caffeine and nicotine that were presumed as effective components of coffee and tobacco, respectively, are being actively executed. However, most results failed to show significant differences between the tested and control groups, and some studies revealed contradictory results to the neuroprotection. The reason for this might be that the effective components are something other than nicotine or caffeine, and/or differences to design the clinical trials such as patients recruiting, prescribed amount and period, and analyzed criteria etc. The review summarizes recent results for effect of coffee, tobacco as well as alcohol, representatives of indulgent food, on Parkinson’s disease.

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Sexual Dysfunction Among Egyptian Idiopathic Parkinson’s Disease Patients

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/08919887211063810 ◽

2021 ◽

pp. 089198872110638

Author(s):

Ahmed M. Elshamy ◽

Ehab S. Mohamed ◽

Ayman M. Al-Malt ◽

Osama A. Ragab

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sexual Dysfunction ◽

Rating Scale ◽

Sexual Experience ◽

Motor Symptom ◽

Control Group ◽

Idiopathic Parkinson’S Disease ◽

Idiopathic Parkinson's Disease ◽

And Gender

Background One of the non-motor features of idiopathic Parkinson’s disease (IPD) is sexual dysfunction (SD) which is under-recognized and, consequently, undertreated. This study aimed to evaluate SD in patients with IPD. Patients and methods The study was conducted on 67 IPD patients; 30 healthy subjects with age and gender matching with the patients served as the control group. All participants were subjected to sexual function assessment using the Arabic version of Arizona Sexual Experience Scale (ASEX), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI), while the severity of IPD was assessed using the modified Hoehn and Yahr scoring scale and MDS-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Results There were no statistically significant differences between patients with IPD and the control group regarding MMSE, hypertension, diabetes mellitus, or dyslipidemia. However, BDI scores were significantly higher in patients with IPD. The rate of SD among our patients was 64% compared to 30% in the control group. The total score and subscales of ASEX were significantly higher in IPD patients than in controls. SD showed a significant correlation with the severity of the IPD irrespective of other variables, including patient age, sex, disease duration, hypertension, diabetes, dyslipidemia, smoking, and dose of L-dopa. Conclusion SD is a commonly underrated feature in patients with IPD; it should be investigated carefully as it is an important non-motor symptom that correlates with disease severity.

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Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson’s Disease

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2016/5935782 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 11

Author(s):

Xiao Lei Liu ◽

Shihui Chen ◽

Yongtai Wang

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Repeated Measures ◽

The Body ◽

Control Group ◽

Control Groups ◽

Timed Up And Go ◽

Muscle Hardness ◽

Hand Eye Coordination ◽

And Control

The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson’s disease (PD). Fifty-four moderate PD patients (N=54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P<0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson’s disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD.

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Kinesiophobia Levels in Patients with Parkinson’s Disease: A Case-Control Investigation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094791 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4791

Author(s):

Ana María Jiménez-Cebrián ◽

Ricardo Becerro-de-Bengoa-Vallejo ◽

Marta Elena Losa-Iglesias ◽

Carmen de Labra ◽

César Calvo-Lobo ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Case Control Study ◽

Well Being ◽

Case Control ◽

Daily Activities ◽

Healthy Controls ◽

Control Groups ◽

And Control ◽

Control Study

Background: Kinesiophobia can be an obstacle to physical and motor activity in patients with Parkinson’s disease (PD). PD affects patients’ independence in carrying out daily activities. It also impacts a patient’s biopsychosocial well-being. The objective of this study was to analyze the levels and scores of kinesiophobia in PD patients and compare them with healthy volunteers. Methods: We deployed a case-control study and recruited 124 subjects (mean age 69.18 ± 9.12). PD patients were recruited from a center of excellence for Parkinson’s disease (cases n = 62). Control subjects were recruited from the same hospital (control n = 62). Kinesiophobia total scores and categories were self-reported using the Spanish version of the Tampa Scale of Kinesiophobia (TSK-11). Results: Differences between cases and control groups were analyzed using the Mann–Whitney U test. Statistically significant differences (p < 0.05) were shown between groups when comparing kinesiophobia categories (or levels) and total scores, revealing higher kinesiophobia symptoms and levels in PD patients. All of the PD patients reported some degree of kinesiophobia (TSK-11 ≥ 18), while the majority of PD patients (77.3%) had kinesiophobia scores rated as moderate to severe (TSK-11 ≥ 25). On the other hand, ~45.1% of controls reported no or slight kinesiophobia and 53.2% reported moderate kinesiophobia. Conclusions: Total kinesiophobia scores were significantly higher in PD patients compared with healthy controls, with moderate to severe kinesiophobia levels prevailing in PD patients. Therefore, individuals living with PD should be evaluated and controlled in order to detect initial kinesiophobia symptoms.

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The cross-sectional area of the vagus nerve is not reduced in Parkinson’s Disease patients

10.1101/2020.10.19.20214973 ◽

2020 ◽

Author(s):

Laura C.J. Sijben ◽

Werner H. Mess ◽

Uwe Walter ◽

A. Miranda L. Janssen ◽

Mark Kuijf ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Vagus Nerve ◽

Cross Sectional Area ◽

List Type ◽

Sectional Area ◽

Cross Sectional ◽

Autonomic Symptoms ◽

The Cross ◽

The Right

AbstractObjectiveRecent studies have revealed the importance of the gut brain axis in the development of Parkinson’s disease (PD). It has also been suggested that the cross-sectional area (CSA) of the vagus nerve can be used in the diagnosis of PD. Here, we hypothesize that the CSA of the vagus nerve is decreased in PD patients compared to control subjects.MethodsIn this study we measured the CSA of the vagus nerve on both sides in 31 patients with PD and 51 healthy controls at the level of the common carotid artery using high-resolution ultrasound.ResultsThe CSA of the vagus nerve was not reduced in PD patients compared to controls (p = 0.391. The mean CSA of the left vagus nerve was significantly smaller than the right (p < 0.001). There was no significant correlation between age, gender and autonomic symptoms with the CSA of the left (p = 0.128) and right vagus nerve (p = 0.166).ConclusionThese findings show that the CSA of the vagus nerve using ultrasonography is not a reliable diagnostic tool in the diagnosis of PD.HighlightsThe cross-sectional area of the vagus nerve is not decreased in Parkinson disease patients.The cross-sectional area of the vagus nerve does not correlate with autonomic symptoms.Measurement of the vagus nerve cross-sectional area has a high inter-observer correlation.

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Motor Symptom Lateralization Influences Cortico-Striatal Functional Connectivity in Parkinson's Disease

Frontiers in Neurology ◽

10.3389/fneur.2021.619631 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wen Su ◽

Kai Li ◽

Chun-Mei Li ◽

Xin-Xin Ma ◽

Hong Zhao ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Functional Connectivity ◽

Orbitofrontal Cortex ◽

Resting State ◽

Right Hemisphere ◽

Motor Symptom ◽

Control Group ◽

Significant Difference ◽

The Right

Objective: The striatum is unevenly impaired bilaterally in Parkinson's disease (PD). Because the striatum plays a key role in cortico-striatal circuits, we assume that lateralization affects cortico-striatal functional connectivity in PD. The present study sought to evaluate the effect of lateralization on various cortico-striatal circuits through resting-state functional magnetic resonance imaging (fMRI).Methods: Thirty left-onset Parkinson's disease (LPD) patients, 27 right-onset Parkinson's disease (RPD) patients, and 32 normal controls with satisfactory data were recruited. Their demographic, clinical, and neuropsychological information was collected. Resting-state fMRI was performed, and functional connectivity changes of seven subdivisions of the striatum were explored in the two PD groups. In addition, the associations between altered functional connectivity and various clinical and neuropsychological characteristics were analyzed by Pearson's or Spearman's correlation.Results: Directly comparing the LPD and RPD patients demonstrated that the LPD patients had lower FC between the left dorsal rostral putamen and the left orbitofrontal cortex than the RPD patients. In addition, the LPD patients showed aberrant functional connectivity involving several striatal subdivisions in the right hemisphere. The right dorsal caudate, ventral rostral putamen, and superior ventral striatum had decreased functional connectivity with the cerebellum and parietal and occipital lobes relative to the normal control group. The comparison between RPD patients and the controls did not obtain significant difference in functional connectivity. The functional connectivity between the left dorsal rostral putamen and the left orbitofrontal cortex was associated with contralateral motor symptom severity in PD patients.Conclusions: Our findings provide new insights into the distinct characteristics of cortico-striatal circuits in LPD and RPD patients. Lateralization of motor symptoms is associated with lateralized striatal functional connectivity.

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Association between CSF1 and CSF1R Polymorphisms and Parkinson’s Disease in Taiwan

Journal of Clinical Medicine ◽

10.3390/jcm8101529 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1529 ◽

Cited By ~ 2

Author(s):

Kuo-Hsuan Chang ◽

Yih-Ru Wu ◽

Yi-Chun Chen ◽

Hsiu-Chuan Wu ◽

Chiung-Mei Chen

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Age At Onset ◽

Genetic Associations ◽

Age And Gender ◽

Control Subjects ◽

Important Pathway ◽

And Gender ◽

And Control ◽

First Time

Background: CSF1/CSF1R neuroinflammatory signaling is emerging as an important pathway involved in the pathogenesis of Parkinson’s disease (PD). However, the genetic associations between CSF1/CSF1R and PD have not yet been explored. Methods: We investigated the effects of two functional genetic variants, including CSF1 rs1058885 and CSF1R rs10079250 in a cohort including 502 Taiwanese patients with PD and 511 age- and gender-matched healthy controls. Results: The CSF1 rs1058885 TT genotype was less frequent in PD patients compared with control subjects (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.43–0.92, p = 0.015). The PD patients also had a lower frequency of the CSF1 rs1058885 T allele compared with the control subjects (OR = 0.80, 95% CI: 0.67–0.96, p = 0.014). No statistically significant differences in allelic and genotypic frequencies of CSF1R rs10079250 between the PD and control subjects were found, even after stratification by age at onset and gender. Conclusion: This study reports a genetic association between CSF1 and PD for the first time.

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P.043 Perceptual descriptors and clinical determinants of pain in Parkinson’s disease: focus on patients’ experiences

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.147 ◽

2016 ◽

Vol 43 (S2) ◽

pp. S31-S31

Author(s):

A Rana ◽

U Saeed ◽

I Abdullah

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Symptom ◽

Structured Interviews ◽

Clinical Predictors ◽

Yahr Stage ◽

Clinical Pain ◽

Pain Prevalence ◽

Perceived Effects ◽

The Right

Background: Pain is a disabling non-motor symptom of Parkinson’s disease (PD), which remains underacknowledged, undertreated and often undeclared by patients in the clinical practice. Prevalence of pain ranges from 40-75% among PD patients; however, clinical determinants and self-reported perceptual experiences of pain require further research. Methods: 121 PD patients (age: 67.3±11.4) from community-based clinic were analyzed cross-sectionally. Perceptual experiences and clinical predictors of pain were assessed using structured interviews, questionnaires and neurological examinations. Results: 80 (66%) PD patients reported pain; 65 (54%) described the severity as ‘moderate/high’. Dystonic was the most frequent clinical pain 37/80 (48%), followed by neuropathic (36%), akathisia (29%) and musculoskeletal (28%). More than one type of clinical pain was assessed in 22 (28%) patients. Aching was the most common perceptual descriptor of pain (46%), followed by sharp/deep (30%), tension (18%) and dull (14%). PD localized on the right side quadrupled the odds of pain on the right (OR=4.4, 95%CI [1.1-18.2]); and pain described as ‘sharp’ predicted neuropathic pain (OR=5.6, 95%CI [1.1-29.2]). Pain prevalence also increased with progressive Hoehn-and-Yahr stage. Interestingly, only 51% of patients perceived effects of PD medications on pain symptomology. Conclusions: Perceptual descriptors of pain can provide novel approaches to classify, treat and manage PD. Longitudinal investigations with larger sample are warranted.

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Effectiveness of Exergaming-based Interventions for Mobility Performance in Older Adults with Parkinson’s Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Preprint)

10.2196/preprints.35326 ◽

2021 ◽

Author(s):

Jiaxin ZHANG ◽

Yan LUXIMON ◽

Hailiang WANG

Keyword(s):

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Balance Function ◽

Control Groups ◽

Mobility Performance ◽

Randomized Controlled ◽

Mobility Function ◽

And Control

BACKGROUND Background: Although physical exercises can help older adults with Parkinson’s disease to retain their mobility function, older adults are less motivated to attend repeated and intensive physical training. Exergaming-based interventions have the potential to provide a more engaged and enjoyable therapy. However, few meta-analysis studies discussed the effectiveness of exergaming-based interventions on the mobility performance of older adults with Parkinson’s disease. OBJECTIVE Objective: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to examine the effectiveness of exergaming-based interventions on mobility performance in older adults with Parkinson’s disease. METHODS Methods: Seven databases (Web of Science, Medline, Academic Search Premier, CINAHL Complete, PsycINFO, PsychARTICLE, and PubMed) were searched to identify the RCTs which examined the effectiveness of exergaming on the mobility performance of older adults with Parkinson’s disease up to September 2021. Using meta-analysis, we assessed mobility performance between intervention groups and control groups by comparing basic mobility function with the Timed Up and Go (TUG), walking capability with 6-Minute Walk Test (6MWT), postural balance function with the Berg Balance Scale (BBS), and gait ability with gait velocity, stride length, and the Functional Gait Assessment (FGA). RESULTS Results: After scanning 1110 articles, we identified and meta-analyzed 16 trials, including a total of 508 older adults with Parkinson’s disease. The results revealed statistical differences between intervention groups and control groups in the TUG (MD = -0.87; 95% CI = -1.60 to -0.15; P = .018), 6MWT (MD = 39.56; 95% CI = 1.21 to 77.91; P = 0.043), BBS (MD = 2.28; 95% CI = 1.42 to 3.14; P < .001), and FGA (MD = 1.40; 95% CI = -0.03 to 2.82; P = .054). The detectable clinically difference of the outcomes were discussed and the implications were provided. CONCLUSIONS Conclusions: Exergaming is superior to traditional training in improving PD older adults’ basic mobility skills, walking capability, and postural balance function, while it has an equal effect with traditional physical training in enhancing PD older adults’ gait ability.

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