scholarly journals Profiling the most elderly parkinson’s disease patients: Does age or disease duration matter?

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261302
Author(s):  
Sasivimol Virameteekul ◽  
Onanong Phokaewvarangkul ◽  
Roongroj Bhidayasiri
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Old Age ◽  
Disease Duration ◽  
Visual Hallucinations ◽  
Old Patients ◽  
Gastrointestinal Problems ◽  
Significant Difference ◽  
Young Old

Background Despite our ageing populations, elderly patients are underrepresented in clinical research, and ageing research is often separate from that of Parkinson’s disease (PD). To our knowledge, no previous study has focused on the most elderly (‘old-old’, age ≥ 85 years) patients with PD to reveal how age directly influences PD clinical progression. Objective We compared the clinical characteristics and pharmacological profiles, including complications of levodopa treatment, disease progression, disabilities, and comorbidities of the old-old with those of comparable younger (‘young-old’, age 60–75 years) PD patients. In addition, within the old-old group, we compared those with a short disease duration (< 10 years at the time of diagnosis) to those with a long disease duration ≥10 years to investigate whether prognosis was related to disease progression or aging. Methods This single-centre, case-control study compared 60 old-old to 92 young-old PD patients, matched for disease duration. Patients in the old-old group were also divided equally (30:30) into two subgroups (short and long disease duration) with the same mean age. We compared the groups based on several clinical measures using a conditional logistic regression. Results By study design, there were no differences between age groups when comparing disease duration, however, the proportion of men decreased with age (p = 0.002). At a comparable length of PD duration of 10 years, the old-old PD patients predominantly had significantly greater postural instability and gait disturbance (p = 0.006), higher motor scope of the Unified Parkinson’s Disease Rating Scale (UPDRS-III, p<0.0001), and more advanced Hoehn & Yahr (H&Y) stage (p<0.0001). The Non-Motor Symptoms Questionnaire (NMSQuest) score was also significantly higher among the old-old (p<0.0001) compared to the young-old patients. Moreover, the distribution of NMS also differed between ages, with features of gastrointestinal problems (p<0.0001), urinary problems (p = 0.004), sleep disturbances and fatigue (p = 0.032), and cognitive impairment (p<0.0001) significantly more common in the old-old group, whereas sexual problems (p = 0.012), depression, and anxiety (p = 0.032) were more common in the young-old. No differences were found in visual hallucinations, cerebrovascular disease, and miscellaneous domains. While young-old PD patients received higher levodopa equivalent daily doses (p<0.0001) and developed a significant greater rate of dyskinesia (p = 0.002), no significant difference was observed in the rate of wearing-off (p = 0.378). Old-old patients also had greater disability, as measured by the Schwab and England scale (p<0.0001) and had greater milestone frequency specifically for dementia (p<0.0001), wheelchair placement (p<0.0001), nursing home placement (p = 0.019), and hospitalisation in the past 1 year (p = 0.05). Neither recurrent falls (p = 0.443) nor visual hallucinations (p = 0.607) were documented significantly more often in the old-old patients. Conclusions Age and disease duration were independently associated with clinical presentation, course, and progression of PD. Age was the main predictor, but disease duration also had a strong effect, suggesting that factors of the ageing process beyond the disease process itself cause PD in the most elderly to be more severe.

scholarly journals A.01 Parkinson’s disease prognosis by early motor subtypes

2018 ◽  
Vol 45 (s2) ◽  
pp. S9-S9
Author(s):  
N Hey ◽  
ML Rajput ◽  
AH Rajput ◽  
A Rajput
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Symptom Onset ◽  
Primary Outcome ◽  
Disease Duration ◽  
Motor Symptom ◽  
Future Studies ◽  
Disease Prognosis ◽  
Significant Difference

Background: Studies of autopsy-confirmed cases suggest that Parkinson’s disease (PD) prognosis can be predicted using motor symptom severity at first visit. We evaluated the association between motor symptom subtype at first visit and severity at eight years disease duration among clinically-diagnosed cases at the Saskatchewan Movement Disorder Program. Methods: Retrospective data review identified 374 patients with first visit within three years of symptom onset, a clinical diagnosis of idiopathic PD, and a follow-up visit eight years after symptom onset. Subtypes were grouped as tremor-dominant (TD) if tremor was greater than rigidity and bradykinesia, akinetic-rigid (AR) if rigidity or bradykinesia was greater than tremor, and mixed (MX) if patient was neither TD nor AR based on assessment of all four limbs. Primary outcome was disease severity as measured by Hoehn & Yahr score at eight years after symptom onset. Results: The most common subtype was AR (n=164) followed by MX (n=156). TD was least common (n=54). There was no significant difference between subtypes in H&Y scores at eight years disease duration. Conclusions: These findings suggest that early PD prognosis cannot be predicted based on motor symptoms in all four limbs at first visit. Earlier studies had longer follow-up and future studies will examine progression at longer periods of disease duration.

scholarly journals Non-motor correlates of wrist-worn wearable sensor use in Parkinson’s disease: an exploratory analysis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Daniel J. van Wamelen ◽  
Shweta Hota ◽  
Aleksandra Podlewska ◽  
Valentina Leta ◽  
Dhaval Trivedi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gastrointestinal Tract ◽  
Large Scale ◽  
Disease Duration ◽  
Wearable Sensors ◽  
International Study ◽  
Exploratory Analysis ◽  
College Hospital ◽  
Gastrointestinal Problems

Abstract Wearable sensors are becoming increasingly more available in Parkinson’s disease and are used to measure motor function. Whether non-motor symptoms (NMS) can also be measured with these wearable sensors remains unclear. We therefore performed a retrospective, exploratory, analysis of 108 patients with a diagnosis of idiopathic Parkinson’s disease enroled in the Non-motor Longitudinal International Study (UKCRN No. 10084) at King’s College Hospital, London, to determine the association between the range and nature of NMS and an accelerometer-based outcome measure of bradykinesia (BKS) and dyskinesia (DKS). NMS were assessed by the validated NMS Scale, and included, e.g., cognition, mood and sleep, and gastrointestinal, urinary and sexual problems. Multiple linear regression modelling was used to identify NMS associated with BKS and DKS. We found that BKS was associated with domains 6 (gastrointestinal tract; p = 0.006) and 8 (sexual function; p = 0.003) of the NMS scale. DKS was associated with domains 3 (mood/cognition; p = 0.016), 4 (perceptual problems; p = 0.025), 6 (gastrointestinal tract; p = 0.029) and 9 (miscellaneous, p = 0.003). In the separate domains, constipation was significantly associated with BKS. Delusions, dysphagia, hyposmia, weight change and hyperhidrosis were identified as significantly associated with DKS. None of the NMSS domains were associated with disease duration (p ≥ 0.08). In conclusion, measures of BKS and DKS were mainly associated with gastrointestinal problems, independent of disease duration, showing the potential for wearable devices to pick up on these symptoms. These exploratory results deserve further exploration, and more research on this topic in the form of comprehensive large-scale studies is needed.

scholarly journals PO-225 The Effects on Mitochondria of Exercise Intervention PINK1 RNAi Drosophila Model of Parkinson's Disease Progression

2018 ◽  
Vol 1 (5) ◽  
Author(s):  
Liying Huang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Exercise Training ◽  
Disease Progression ◽  
Complex I ◽  
Exercise Intervention ◽  
Drosophila Model ◽  
Significant Difference ◽  
Climbing Ability ◽  
Mitochondria Complex I

Objective This research were using PINK1 RNAi drosophila model as object to  investigate the effects of the 3 weeks duration exercise intervention drosophila model of Parkinson’s disease progression. Including mitochondria gather situation and mitochondria complex I activity and climbing activity and wing posture. Trying to prove that Exercise-training can help with the Parkinson disease’s symptom, and also to find out the mechanism of the result.  Methods Two genotype were used in this research, the normal type VAS-mtGFPo  Mhc/Mhc and the Parkinson type VAS-mtGFP/Cyo Mhc-RNAi/TM2 and all with fluorescent labeling mitochondria by GFP. The exercise-training last for 3 weeks, 5 times per week, we separated the Parkinson type in 4 groups by different training time: 0min per day, 30min per day, 60min per day and 90min per day. The healthy type was control group. We measured the climbing ability and the wings posture every week, also used confocal microscope to watch the aggregation of mitochondria of the chest muscle every week. After 3 weeks training, we grinded all the drosophila to get the mitochondria, and measured the activity of mitochondria complex I. At last, we compared every index of each group with T-text by using SPSS 17.0 and the significance level as the criterion. Results 1）The climbing ability: No significant difference found in first week, there was a significant difference between 0min group and 30min group in second week and there was a very significant difference between 0min group and 30min group in third week. （P＜0.01）.2) Wing posture: There was a very significant difference between 0min group and 30min group in third week. （P＜0.01）. 3) Activity of mitochondria complex I: Because of the small sample of this experiment, we can’t get a appropriate concentration of mitochondria, but we still got some changes between 30min and 0min. 4) The pictures of mitochondria by confocal microscope: The 30min group has the least aggregations of the mitochondria but a lot aggregations were found in other pictures of other group.  Conclusions 1)The suitable  Exercise-training can improve the climbing ability and the account of wing posture and extend the life span of drosophila model of Parkinson’s disease. 2) The suitable   Exercise-training can relieve the situation of mitochondrial gathering and improve the activity of mitochondrial complex I. 

scholarly journals Volumetric analysis of subthalamic nucleus and red nucleus in patients of advanced Parkinson’s disease using SWI sequences

2021 ◽  
Vol 12 ◽  
pp. 377
Author(s):  
Swapnil Kolpakwar ◽  
Abhishek J. Arora ◽  
S. Pavan ◽  
Rukmini M. Kandadai ◽  
Rajesh Alugolu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Subthalamic Nucleus ◽  
Disease Duration ◽  
Age Of Onset ◽  
Red Nucleus ◽  
Disease Group ◽  
Advanced Parkinson’S Disease ◽  
Severity Scores

Background: Parkinson’s disease is associated with significant changes in morphometry of subthalamic nucleus (STN); however, not much is known as the disease progresses. The aim of present study was to investigate the volume of STN and Red nucleus (RN) on 3T-magnetic resonance imaging (MRI) and its possible correlation with disease progression in advanced Parkinson’s disease patients. Methods: Patients of advanced Parkinson’s disease were prospectively followed for clinical details, motor severity scores, and radiological evaluation. Volumes of the STN and RN were measured on susceptibility weighted imaging, coronal sections in 3T MRI and were correlated with demographic and clinical features. Results: A total of 52 patients were included in our study. There were 42 (80.77%) males and 10 (19.23%) females. Mean age of onset of Parkinson’s disease was 49.48 + 10.90 years. Average duration of disease in the present cohort was 7.65 + 4.31 years. Average STN and RN volume were 103.46 + 21.17 mm3 and 321.73 + 67.66 mm3. Age of onset, disease duration and Unified Parkinson’s Disease Rating Scale Part III scores were not found to be associated with changes in STN Volumes. Weak positive trend was noted between RN volume and disease duration (Pearson cor. 0.204, P = 0.14). Patients in early-onset Parkinson’s disease group had significantly more volume of RN than patients in late-onset Parkinson’s disease group (P = 0.014). Conclusion: Disease duration and early age of onset in Parkinson’s disease can be associated with increased RN volume. Volume of STN shows relatively no change even with disease progression.

scholarly journals Facial tremor in patients with Parkinson’s disease: prevalence, determinants and impacts on disease progression

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruwei Ou ◽  
Qianqian Wei ◽  
Yanbing Hou ◽  
Lingyu Zhang ◽  
Kuncheng Liu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Regression Models ◽  
Disease Duration ◽  
Rating Scale ◽  
Cox Regression ◽  
Binary Logistic Regression Analysis ◽  
Initial Symptom ◽  
The Impact

Abstract Background Facial (lip and jaw) tremor (FT) is associated with Parkinson’s disease (PD) but few studies have been conducted to explore its clinical profile. We performed this study to investigate the prevalence and clinical correlates of FT in PD, and further to evaluate its effect on disease progression. Methods A retrospective, cross-sectional (n = 2224) and longitudinal (n = 674) study was conducted. The presence of FT was based on a ≥ 1 score in the United PD Rating Scale (UPDRS) item 20A. Group comparisons were conducted, followed by a forward binary logistic regression analysis. Inverse probability of treatment weighting (IPTW) based on the propensity score and weighted or unweighted Cox regression models were used to explore the impact of FT on five clinical milestones including death, UPDRS III 11-point increase, Hoehn and Yahr (H&Y) stage reaching 3, dyskinesia development, and Montreal Cognitive Assessment 3-point decrease. Results FT was presented in 403 patients (18.1%), which showed increasing trends with disease duration and H&Y score. Age (P < 0.001), female (P < 0.001), disease duration (P = 0.001), speech (P = 0.011), rigidity (P = 0.026), rest tremor on limbs (P < 0.001), kinetic tremor on hands (P < 0.001), and axial symptoms (P = 0.013) were independent factors associated with FT. Both unweighted and weighted Cox regression models indicated that baseline FT and FT as the initial symptom were not associated with the five outcomes. Conclusions Our study suggested that FT was not uncommon and provided a deeper insight into the characteristics of FT in PD. The predict value of FT on long-term progronis of PD may need future longer follwe-up study.

Sleep problems affect quality of life in Parkinson's disease along disease progression

2021 ◽  
Vol 81 ◽  
pp. 307-311 ◽  
Author(s):  
Claudio Liguori ◽  
Valentino De Franco ◽  
Rocco Cerroni ◽  
Matteo Spanetta ◽  
Nicola Biagio Mercuri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Sleep Problems

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals Assessment of the Telomere Length and Its Effect on the Symptomatology of Parkinson’s Disease

Antioxidants ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 137
Author(s):  
Tina Levstek ◽  
Sara Redenšek ◽  
Maja Trošt ◽  
Vita Dolžan ◽  
Katarina Trebušak Podkrajšek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Telomere Length ◽  
Repetitive Sequences ◽  
Housekeeping Gene ◽  
Cellular Aging ◽  
Brain Diseases ◽  
Motor Complications ◽  
Telomere Attrition ◽  
Significant Difference

Telomeres, which are repetitive sequences that cap the end of the chromosomes, shorten with each cell division. Besides cellular aging, there are several other factors that influence telomere length (TL), in particular, oxidative stress and inflammation, which play an important role in the pathogenesis of neurodegenerative brain diseases including Parkinson’s disease (PD). So far, the majority of studies have not demonstrated a significant difference in TL between PD patients and healthy individuals. However, studies investigating the effect of TL on the symptomatology and disease progression of PD are scarce, and thus, warranted. We analyzed TL of peripheral blood cells in a sample of 204 PD patients without concomitant autoimmune diseases and analyzed its association with several PD related phenotypes. Monochrome multiplex quantitative PCR (mmqPCR) was used to determine relative TL given as a ratio of the amount of DNA between the telomere and albumin as the housekeeping gene. We found a significant difference in the relative TL between PD patients with and without dementia, where shorter TL presented higher risk for dementia (p = 0.024). However, the correlation was not significant after adjustment for clinical factors (p = 0.509). We found no correlations between TLs and the dose of dopaminergic therapy when the analysis was adjusted for genetic variability in inflammatory or oxidative factors. In addition, TL influenced time to onset of motor complications after levodopa treatment initiation (p = 0.0134), but the association did not remain significant after adjustment for age at inclusion and disease duration (p = 0.0781). Based on the results of our study we conclude that TL contributes to certain PD-related phenotypes, although it may not have a major role in directing the course of the disease. Nevertheless, this expends currently limited knowledge regarding the association of the telomere attrition and the disease severity or motor complications in Parkinson’s disease.

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