scholarly journals Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
N. Vila-Chã ◽  
S. Cavaco ◽  
A. Mendes ◽  
A. Gonçalves ◽  
I. Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Rating Scale ◽  
Short Form ◽  
Structured Interview ◽  
Smoking Habits ◽  
Addictive Behaviors ◽  
Study Results ◽  
Compulsive Behaviors

Introduction. Pain is a major nonmotor symptom of Parkinson’s disease (PD), and central parkinsonian pain is the core feature of the putative Park pain subtype of PD. This study aimed to explore the cognitive and behavioral profile of PD patients with central parkinsonian pain. Material and Methods. A structured interview was used to identify and characterize pain in a cohort of 260 consecutive PD patients. The Ford classification of pain was applied. The Dementia Rating Scale-2 (DRS-2) and the Impulse Control Disorders in Parkinson’s Disease Short Form (QUIP-S) were administered, and patients’ smoking habits were recorded. The Unified Parkinson’s Disease Rating Scale (UPDRS) was used to assess motor and nonmotor symptoms in off and on conditions. Results. One hundred and eighty-eight patients (68%) reported pain; and in 41 (22%) of them, the pain was classified as central parkinsonian pain. PD patients with central parkinsonian pain had better cognitive performance in DRS-2 Initiation/Perseveration and Conceptualization subscales but reported more other compulsive behaviors (e.g., hobbyism, punding, and walkabout) and had more current smoking habits than those without pain or with non-central parkinsonian pain. Multiple logistic regression analyses revealed that the DRS-2 Conceptualization subscale, other compulsive behaviors, and smoking habits remained statistically associated with central parkinsonian pain even when other significant covariates were considered. Only patients with pain, regardless of type, had a gambling disorder. Discussion. The study results provide further evidence that pain revealed that patients with central parkinsonian pain are more likely to present compulsive or addictive behaviors, despite having more preserved cognitive performance. Patients with central parkinsonian pain appear to have a distinct phenotype of PD.

scholarly journals Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

2019 ◽  
Vol 267 (1) ◽  
pp. 259-266
Author(s):  
Aleksander H. Erga ◽  
Guido Alves ◽  
Ole Bjørn Tysnes ◽  
Kenn Freddy Pedersen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Short Form ◽  
Population Based ◽  
Self Report ◽  
Cognitive Changes ◽  
Compulsive Behaviors ◽  
Changes Over Time ◽  
Over Time

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

scholarly journals Evaluation of the safety and immunomodulatory effects of sargramostim in a randomized, double-blind phase 1 clinical Parkinson’s disease trial

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Howard E. Gendelman ◽  
Yuning Zhang ◽  
Pamela Santamaria ◽  
Katherine E. Olson ◽  
Charles R. Schutt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Clinical Investigation ◽  
Phase 1 ◽  
Additional Patient ◽  
Double Blind ◽  
Modest Improvement ◽  
Cell Counts ◽  
Study Results

Abstract A potential therapeutic role for immune transformation in Parkinson’s disease evolves from more than a decade of animal investigations demonstrating regulatory T cell (Treg) nigrostriatal neuroprotection. To bridge these results to human disease, we conducted a randomized, placebo-controlled double-blind phase 1 trial with a well-studied immune modulator, sargramostim (granulocyte-macrophage colony-stimulating factor). We enrolled 17 age-matched non-Parkinsonian subjects as non-treated controls and 20 Parkinson’s disease patients. Both Parkinson’s disease patients and controls were monitored for 2 months for baseline profiling. Parkinson’s disease patients were then randomized into two equal groups to self-administer placebo (saline) or sargramostim subcutaneously at 6 μg/kg/day for 56 days. Adverse events for the sargramostim and placebo groups were 100% (10/10) and 80% (8/10), respectively. These included injection site reactions, increased total white cell counts, and upper extremity bone pain. One urticarial and one vasculitis reaction were found to be drug and benzyl alcohol related, respectively. An additional patient with a history of cerebrovascular disease suffered a stroke on study. Unified Parkinson’s disease rating scale, Part III scores in the sargramostim group showed modest improvement after 6 and 8 weeks of treatment when compared with placebo. This paralleled improved magnetoencephalography-recorded cortical motor activities and Treg numbers and function compared with pretreated Parkinson’s disease patients and non-Parkinsonian controls. Peripheral Treg transformation was linked to serum tryptophan metabolites, including L-kynurenine, quinolinic acid, and serotonin. These data offer a potential paradigm shift in modulating immune responses for potential therapeutic gain for Parkinson’s disease. Confirmation of these early study results requires larger numbers of enrolled patients and further clinical investigation.

Factors associated with depression in Parkinson’s disease: a cross-sectional study in a Polish population

2006 ◽  
Vol 21 (8) ◽  
pp. 516-520 ◽  
Author(s):  
Hubert M. Wichowicz ◽  
Jarosław Sławek ◽  
Mirosława Derejko ◽  
Wiesław Jerzy Cubała
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Polish Population ◽  
Cross Sectional ◽  
Disability Scale ◽  
Yahr Scale ◽  
Specific Outcome

AbstractObjectiveThe aim of this study was to assess the prevalence and factors influencing depression in PD patients in a cross-sectional outpatient clinic - based Polish patients sample.Materials and methodsOne hundred consecutive PD patients were included in this study; 35 of them fulfilled DSM-IV criteria for Major Depression and its severity was assessed with Montgomery–Asberg Depression Rating Scale (MADRS). A structured interview and a neurological examination, including Hoehn and Yahr scale (H–Y), Schwab–England disability scale, II, III, IV parts of Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Examination (MMSE) were performed. The parameters obtained were analysed between the depressed and non-depressed PD patients.ResultsThe prevalence of depression in PD in Polish population was established at the level of 35%. PD patients with depression scored significantly higher in all UPDRS scales (except for the subscale of clinical fluctuation) and in H–Y scale. PD with depression was also associated with longer PD duration, higher doses of L-dopa equivalents, patients' age, general impairment of daily living in Schwab and England disability scale, lower MMSE and higher clinical fluctuations. However, those six differences were insignificant.ConclusionsDepression prevalence rate among PD patients in Polish population is slightly lower than in most of other published studies. This may result from strict selection criteria, use of specific outcome measures and restricted criteria for depression that were applied.

The efficacy of cognitive-cycling dual-task training in patients with early-stage Parkinson’s disease: A pilot study

2020 ◽  
Vol 47 (4) ◽  
pp. 415-426
Author(s):  
Hsiu-Chen Chang ◽  
Chiung-Chu Chen ◽  
Yi-Hsin Weng ◽  
Wei-Da Chiou ◽  
Ya-Ju Chang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Dual Task ◽  
Rating Scale ◽  
Early Stage ◽  
Freezing Of Gait ◽  
Timed Up And Go ◽  
Gait Performance ◽  
The Mean

BACKGROUND: Recent studies have suggested that cognitive-motor dual-task (DT) training might improve gait performance, locomotion automaticity, balance, and cognition in patients with Parkinson’s disease (PD). OBJECTIVE: We aimed to investigate the efficacy of cognitive-cycling DT training in patients with early-stage PD. METHODS: Participants were scheduled to perform cognitive tasks simultaneously with the cycling training twice per week for eight weeks for a total of 16 sessions during their on-states. Clinical assessments were conducted using the unified Parkinson’s disease rating scale (UPDRS), modified Hoehn and Yahr stage, Timed Up and Go (TUG) test, gait and cognitive performances under dual-task paradigm, the new freezing of gait questionnaire, Schwab and England Activities of Daily Living scale, 39-item Parkinson’s disease questionnaire, and cognitive performance. RESULTS: Thirteen eligible patients were enrolled in the study. The mean age was 60.64±5.32 years, and the mean disease duration was 7.02±3.23 years. Twelve PD patients completed 16 serial cognitive-cycling sessions for two months. After 16 sessions of training (T2), the UPDRS III scores improved significantly in both the off- and on-states, and TUG were significantly less than those at pretraining (T0). During both the single-task and the DT situations, gait performance and spatial memory cognitive performance significantly improved from T0 to T2. CONCLUSION: The present study demonstrated that cognitive-cycling DT training improves the motor functions, gait and cognitive performances of PD patients.

Pelvic Floor Health in Women with Parkinson’s Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 857-864 ◽  
Author(s):  
Ankita Gupta ◽  
Kathrin LaFaver ◽  
Kevin R. Duque ◽  
Anushree Lingaiah ◽  
Kate V. Meriwether ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pelvic Floor ◽  
Rating Scale ◽  
Short Form ◽  
Pelvic Floor Dysfunction ◽  
Measurement Information ◽  
Cognitive Score ◽  
Patient Reported ◽  
The Difference

Background: Urinary dysfunction and constipation, manifestations of pelvic floor dysfunction are common sources of disability and impaired quality of life in women with Parkinson’s disease (PD). Objective: We sought to evaluate the pelvic floor health amongst women with PD and their reporting of bladder and bowel symptoms. Methods: We surveyed women with PD and age-matched controls about pelvic floor health using validated questionnaires. All participants completed the Pelvic Floor Disability Index (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS) short form version 2.0 Cognitive Function 8a. Additionally, PD patients underwent the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) scale and the Montreal Cognition Assessment (MoCA). Results: Women with PD (n = 59; age, 70.4±8.6 years, PROMIS cognitive score, 52.0±7.8) self-reported urinary symptoms to a greater extent than controls (n = 59; age, 70.2±8.7 years, PROMIS cognitive score, 51.0±10) (68% vs 43%, p < 0.01). The difference was mirrored by higher (worse) scores on both PFDI-20 (35.4 vs 15.6; p = 0.01) and PFIQ-7 (4.8 vs 0; p < 0.01) for PD women compared to controls. Only 63% of all participants with self-reported pelvic floor symptoms had previously reported these symptoms to a health care provider. There was no difference in utilization of specialty care between the two groups (30% vs 46%, p = 0.2). Conclusion: Pelvic floor dysfunction, more common amongst women with PD, is underreported and undertreated. Our study identifies a key gap in care of women with PD.

scholarly journals Studies across subspecialties of neurology (SON) report noninferiority of telemedicine (TM) compared with face-to-face intervention (FTF-I)

2021 ◽  
Author(s):  
Paulo Eduardo Lahoz Fernandez ◽  
Guilherme Diogo Silva ◽  
Eduardo Genaro Mutarelli
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Short Form ◽  
Neurological Diseases ◽  
Clinical Care ◽  
Demyelinating Diseases ◽  
Symptom Scale ◽  
Vestibular Diseases ◽  
Face To Face

Background: Studies across subspecialties of neurology (SON) report noninferiority of telemedicine (TM) compared with face-to-face intervention (FTF-I). Clinical scales (CS) are important tools for outcome measures in clinical care. However, which CS in FTF-I can be used in teleneurology is unclear. Objectives: Define the most used CS in studies comparing TM with FTF-I in different SON. Design and Setting/Methods: We searched PubMed and Embase for randomized controlled trials, published from 2011 to April 2021, with Key words ‘’telemedicine’’ cross-referenced with ‘’neurology’’ or neurological diseases, considering the synonyms. Results: 43 eligible studies in 400 records, from 12 countries, with 5600 patients and 8 SON: stroke (10), headache (4), epilepsy (6), cognitive disorders (7), demyelinating diseases (8), movement disorders (3), neuromuscular diseases (3), and vestibular diseases (2). The most used CS: National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) for stroke impairment and limitation; Headache Impact Test (HIT-6) and Migraine Disability Assessment Scale (MIDAS) for headache disability; Quality Of Life in Epilepsy Inventory (QOL-31) for seizure burden; Mini-Mental State Exam (MMSE) and Zarit Burden Interview (ZBI) for cognitive function and caregiver burden in dementia care; Expanded Disability Status Scale (EDSS) and Fatigue Impact Scale (FIS) for disability and fatigue in Multiple Sclerosis; Parkinson’s disease Questionnaire (PDQ-39) and Unified Parkinson’s Disease Rating Scale (UPDRS) for QOL and disability in PD; Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) for severity in ALS; and Vertigo Symptom Scale Short form (VSS-SF) for vertigo. Conclusions: We present feasible CS usually applied in teleneurology that can be used as important tools for future findings in TM research and practice.

scholarly journals Validation of the Parkinson’s Disease Caregiver Burden Questionnaire in Progressive Supranuclear Palsy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Martin Klietz ◽  
Hannah V. Eichel ◽  
Selma Staege ◽  
Anna Kutschenko ◽  
Gesine Respondek ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Progressive Supranuclear Palsy ◽  
Caregiver Burden ◽  
Rating Scale ◽  
Longitudinal Design ◽  
Short Form ◽  
Depression Scale ◽  
Life Questionnaire ◽  
Internal Reliability

Progressive supranuclear palsy (PSP) is an atypical Parkinson syndrome with axial akinetic-rigid symptoms, early postural instability, and ocular motor impairments. Patients experience a rapid loss of autonomy and care dependency; thus, caregivers must assist in the activities of daily living early in the course of the disease. Caregiver burden is an extremely important factor in disease management. However, there are no specific questionnaires for assessment of caregiver burden in PSP. This study aims to validate the Parkinson’s disease caregiver burden questionnaire (PDCB) as a specific measure of caregiver burden in PSP. PSP patients were assessed by the PSP rating scale, PSP quality-of-life questionnaire (PSP-QoL), Montreal cognitive assessment test (MoCA), and geriatric depression scale (GDS-15). Caregivers filled out the short form 36-health survey, GDS-15, PDCB, and the caregiver burden inventory (CBI). 22 patient caregiver pairs completed the study. PDCB showed a highly significant correlation with the CBI (r 0.911; p < 0.001 ). Internal reliability of the PDCB measured by Cronbach’s alpha was favourable at 0.803. These data support the specificity of the PDCB in PSP caregivers. Future studies with larger sample sizes of PSP patients and caregivers and a multicentric longitudinal design should be performed to gain further insight of caregiver burden in PSP.

scholarly journals 29 Shedding light on the relationship between dyskinesia and impulsive compulsive behaviour disorders in Parkinson’s disease

2020 ◽  
Vol 91 (8) ◽  
pp. e20.1-e20
Author(s):  
Lucia Ricciardi ◽  
Andrea De Angelis ◽  
Chiara Siri ◽  
Malcon Horne ◽  
Alison Leake ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonists ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Percent Time ◽  
Binary Regression Analysis ◽  
Compulsive Behaviour ◽  
The Relationship

ObjectivesImpulsive compulsive behaviour disorders (ICB) and dyskinesia are common and disabling complications occurring during the course of Parkinson’s disease (PD). Their pathophysiology is not clear yet, however an association has been suggested. In the present study we aimed to evaluate the relationship between the presence of dyskinesia objectively detected using a wearable device and the presence of active and past ICB in PD patients.MethodsPatients’ demographic and clinical characteristics were gathered, PD medications were converted in total levodopa equivalent daily dose (LEDD) and LEDD dopamine-agonists. Patients were assessed with: Unified PD Rating Scale (UPDRS) parts I-IV and Rusk Dyskinesia Rating Scale (RDRS). To objectively measure dyskinesia we used a wearable devise, the Parkinson’s KinetiGraph™ system (PKG®), an accelerometry-based system for automated assessment of dyskinesia and bradykinesia. Past and active ICB were diagnosed with a semi-structured interview.Questionnaire for Impulsive-Compulsive Disorders in PD-Rating Scale (QUIP-RS) was employed to rate ICB severity. Psychiatric symptoms were evaluated including depression, anxiety, apathy and impulsivity.ResultsFifty-five PD patients were evaluated (36 males, mean age 60.7±6.7; mean disease duration 10.5±4.9). Twenty-five patients (45%) had dyskinesia as per PKG ‘Percent Time in Dyskinesia’ score. Nineteen patients had ICB (34%). There was no difference in active/past ICB between patients with and without dyskinesia (p=0.8 and 0.6). Patients with dyskinesia had higher LEDD dopamine-agonists (p=0.005), UPDRS-IV (p=0.02), RDRS (p=0.002). There was no difference between groups in psychiatric symptoms. We categorized patients in 3 groups (none, mild/moderate and severe dyskinesia) and we found no difference among groups in any demographic, clinical, psychiatric and behavioural variable except for LEDD dopamine-agonists (p=0.004), UPDRS-IV (p=0.06), RDRS (p=0.004).Binary regression analysis did not show any association between the presence of dyskinesia and ICB, depression, anxiety, apathy and impulsivity.ConclusionOur data suggest that ICB and dyskinesia are common but unrelated disorders in PD.

scholarly journals Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

2015 ◽  
Vol 73 (11) ◽  
pp. 929-933 ◽  
Author(s):  
Emmanuelle Sobreira ◽  
Márcio A. Pena-Pereira ◽  
Alan L. Eckeli ◽  
Manoel A. Sobreira-Neto ◽  
Marcos H. N. Chagas ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
Structured Interview ◽  
Montreal Cognitive Assessment ◽  
Convenience Sample ◽  
Addenbrooke’S Cognitive Examination

ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD.

scholarly journals B-11 Cognitive Performance in Depressed and Non-Depressed Patients with de novo Parkinson’s disease

2019 ◽  
Vol 34 (6) ◽  
pp. 955-955
Author(s):  
B Honsey ◽  
K WymanChick
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Rating Scale ◽  
Early Stage ◽  
Depression Scale ◽  
Cutoff Score ◽  
Depressed Group ◽  
Significant Difference ◽  
Category Fluency

Abstract Objective Compare cognitive performance in early-stage Parkinson Disease (PD) participants with and without depression. Method Data from the Parkinson’s Progression Marker Initiative were utilized. We examined data from 422 participants diagnosed with PD within the previous two years (age = 61.7±9.7 years, education = 15.6±3.0 years). Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15) using a cutoff score of ≤5 to indicate the absence of clinical depression. Cognitive tests included Hopkins Verbal Memory Test-Revised (HVLT-R), Judgment of Line Orientation (JLO), Letter-Number Sequencing (LNS), Symbol Digit Modalities Test (SDMT), and Category Fluency. Motor scores were measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III. Demographic and clinical variables for the two groups were compared using independent samples t-tests and chi-square analyses. Results The non-depressed group (n = 280) was significantly older; t(246.08) = 2.25, p = .026 and had higher education; t(420) = 2.35, p = .019; and duration of PD symptoms; t(170.58) = -2.13, p = .035 than the depressed group (n = 142). The groups did not differ in terms of race, gender, handedness, side of onset, or severity of motor symptoms. There was no significant differences in performance on HVLT, JLO, SDMT, or Category Fluency; however, the non-depressed group performed better on LNS than the depressed group, t(420) = 2.05, p = .041. Conclusion(s) There is no significant difference in cognitive performance between early-stage PD participants with and without depression, with the exception of significantly lower working memory performance in the depressed group.

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