scholarly journals Diagnostic prediction model for levodopa-induced dyskinesia in Parkinson’s disease

2020 ◽  
Vol 78 (4) ◽  
pp. 206-216 ◽  
Author(s):  
Bruno Lopes SANTOS-LOBATO ◽  
Artur F. SCHUMACHER-SCHUH ◽  
Carlos R. M. RIEDER ◽  
Mara H. HUTZ ◽  
Vanderci BORGES ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Prediction Model ◽  
Disease Duration ◽  
Motor Symptom ◽  
Clinical Prediction ◽  
Reasonable Accuracy ◽  
Dopaminergic Agonists ◽  
Clinical Prediction Model ◽  
Clinical Variables

Abstract Background: There are currently no methods to predict the development of levodopa-induced dyskinesia (LID), a frequent complication of Parkinson's disease (PD) treatment. Clinical predictors and single nucleotide polymorphisms (SNP) have been associated to LID in PD. Objective: To investigate the association of clinical and genetic variables with LID and to develop a diagnostic prediction model for LID in PD. Methods: We studied 430 PD patients using levodopa. The presence of LID was defined as an MDS-UPDRS Part IV score ≥1 on item 4.1. We tested the association between specific clinical variables and seven SNPs and the development of LID, using logistic regression models. Results: Regarding clinical variables, age of PD onset, disease duration, initial motor symptom and use of dopaminergic agonists were associated to LID. Only CC genotype of ADORA2A rs2298383 SNP was associated to LID after adjustment. We developed two diagnostic prediction models with reasonable accuracy, but we suggest that the clinical prediction model be used. This prediction model has an area under the curve of 0.817 (95% confidence interval [95%CI] 0.77‒0.85) and no significant lack of fit (Hosmer-Lemeshow goodness-of-fit test p=0.61). Conclusion: Predicted probability of LID can be estimated with reasonable accuracy using a diagnostic clinical prediction model which combines age of PD onset, disease duration, initial motor symptom and use of dopaminergic agonists.

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 The Impact of Clinical and Cognitive Variables on Social Functioning in Parkinson's Disease: Patient versus Examiner Estimates

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Patrick McNamara ◽  
Karina Stavitsky ◽  
Raymon Durso ◽  
Erica Harris
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Social Functioning ◽  
Disease Patient ◽  
Social Adaptation ◽  
Motor Symptom ◽  
Clinical Variables ◽  
Self Evaluation ◽  
Assessment And Treatment ◽  
The Impact

Purpose. To assess the impact of clinical variables on social skills and behaviors in Parkinson's disease (PD) patients and patient versus examiner estimates of social functioning.Methods. Twenty-eight patients with PD and 32 controls with chronic disease were assessed with a battery of neuropsychologic, personality, mood, and social function tests.Results. Patients' estimates of their own social functioning were not significantly different from examiners' estimates. The impact of clinical variables on social functioning in PD revealed depression to be the strongest association of social functioning in PD on both the patient and the examiner version of the Social Adaptation Self-Evaluation Scale.Conclusions. PD patients appear to be well aware of their social strengths and weaknesses. Depression and motor symptom severity are significant predictors of both self- and examiner reported social functioning in patients with PD. Assessment and treatment of depression in patients with PD may improve social functioning and overall quality of life.

Simple clinical variables predict liver histology in hepatitis C: Prospective validation of a clinical prediction model

2005 ◽  
Vol 40 (11) ◽  
pp. 1365-1371 ◽  
Author(s):  
Joseph Romagnuolo ◽  
Christopher N. Andrews ◽  
Vincent G. Bain ◽  
Maurizio Bonacini ◽  
Scott J. Cotler ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Prediction Model ◽  
Liver Histology ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Clinical Variables

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 Glucocerebrosidase Activity is Reduced in Cryopreserved Parkinson’s Disease Patient Monocytes and Inversely Correlates with Motor Severity

2021 ◽  
pp. 1-9
Author(s):  
Laura P. Hughes ◽  
Marilia M.M. Pereira ◽  
Deborah A. Hammond ◽  
John B. Kwok ◽  
Glenda M. Halliday ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Rating Scale ◽  
Disease Patient ◽  
Motor Symptom ◽  
Blood Monocytes ◽  
Peripheral Blood Monocytes ◽  
Classical Monocytes

Background: Reduced activity of lysosomal glucocerebrosidase is found in brain tissue from Parkinson’s disease patients. Glucocerebrosidase is also highly expressed in peripheral blood monocytes where its activity is decreased in Parkinson’s disease patients, even in the absence of GBA mutation. Objective: To measure glucocerebrosidase activity in cryopreserved peripheral blood monocytes from 30 Parkinson’s disease patients and 30 matched controls and identify any clinical correlation with disease severity. Methods: Flow cytometry was used to measure lysosomal glucocerebrosidase activity in total, classical, intermediate, and non-classical monocytes. All participants underwent neurological examination and motor severity was assessed by the Movement Disorders Society Unified Parkinson’s Disease Rating Scale. Results: Glucocerebrosidase activity was significantly reduced in the total and classical monocyte populations from the Parkinson’s disease patients compared to controls. GCase activity in classical monocytes was inversely correlated to motor symptom severity. Conclusion: Significant differences in monocyte glucocerebrosidase activity can be detected in Parkinson’s disease patients using cryopreserved mononuclear cells and monocyte GCase activity correlated with motor features of disease. Being able to use cryopreserved cells will facilitate the larger multi-site trials needed to validate monocyte GCase activity as a Parkinson’s disease biomarker.

scholarly journals Life with Parkinson’s Disease During the COVID-19 Pandemic: The Pressure Is “OFF”

2021 ◽  
pp. 1-5
Author(s):  
Trine HØrmann Thomsen ◽  
Susanna M. Wallerstedt ◽  
Kristian Winge ◽  
Filip Bergquist
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Symptom ◽  
Free Text ◽  
Symptom Scores ◽  
Related Quality ◽  
Health Related ◽  
Potential Impact ◽  
Swedish Cohort

People with Parkinson’s disease (PwP) have been suggested to be more vulnerable to negative psychological and psycho-social effects of the COVID-19 pandemic. Our aim was to assess the potential impact of the COVID-19 pandemic in PwP. A Danish/Swedish cohort of 67 PwP was analysed. Health-related quality of life (HRQL), depression, anxiety, apathy, sleep and motor symptom-scores were included in the analysis. Additionally, the Danish participants provided free-text descriptions of life during the pandemic. Overall, the participants reported significantly better HRQL during the COVID-19 period compared with before. Reduced social pressure may be part of the explanation. Despite worsened anxiety, night sleep improved.

scholarly journals Minimum sample size for external validation of a clinical prediction model with a binary outcome

2021 ◽  
Author(s):  
Richard D. Riley ◽  
Thomas P. A. Debray ◽  
Gary S. Collins ◽  
Lucinda Archer ◽  
Joie Ensor ◽  
...  
Keyword(s):  
Prediction Model ◽  
Sample Size ◽  
External Validation ◽  
Minimum Sample Size ◽  
Binary Outcome ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Minimum Sample

Develop a Clinical Prediction Model for Postoperative Cognitive Dysfunction after Major Noncardiac Surgery in Elderly Patients: A Protocol for a Prospective Observational Study

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Yang Shen ◽  
Xianchen Li ◽  
Junyan Yao
Keyword(s):  
Observational Study ◽  
Prediction Model ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Prospective Observational Study ◽  
Postoperative Cognitive Dysfunction ◽  
Noncardiac Surgery ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Postoperative Cognitive Decline

Perioperative neurocognitive disorders (PNDs) refer to cognitive decline identified in the preoperative or postoperative period. It has been reported that the incidence of postoperative neurocognitive impairment after noncardiac surgery in patients older than 65 at 1 week was 25.8∼41.4%, and at 3 months 9.9∼12.7%. PNDs will last months or even develop to permanent dementia, leading to prolonged hospital stays, reduced quality of life, and increased mortality within 1 year. Despite the high incidence and poor prognosis of PNDs in the aged population, no effective clinical prediction model has been established to predict postoperative cognitive decline preoperatively. To develop a clinical prediction model for postoperative neurocognitive dysfunction, a prospective observational study (Clinical trial registration number: ChiCTR2000036304) will be performed in the Shanghai General Hospital during January 2021 to October 2022. A sample size of 675 patients aged &#x3e;65 years old, male or female, and scheduled for elective major noncardiac surgery will be recruited. A battery of neuropsychological tests will be used to test the cognitive function of patients at 1 week, 1 month, and 3 months postoperatively. We will evaluate the associations of PNDs with a bunch of candidate predictors including general characteristics of patients, blood biomarkers, indices associated with anesthesia and surgery, retinal nerve-fiber layer thickness, and frailty index to develop the clinical prediction model by using multiple logistic regression analysis and least absolute shrinkage and the selection operator (LASSO) method. The <i>k</i>-fold cross-validation method will be utilized to validate the clinical prediction model. In conclusion, this study was aimed to develop a clinical prediction model for postoperative cognitive dysfunction of old patients. It is anticipated that the knowledge gained from this study will facilitate clinical decision-making for anesthetists and surgeons managing the aged patients undergoing noncardiac surgery.

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