Approaches to the Diagnosis of Parkinson’s Disease during the Pre-motor Phase

US Neurology ◽  
2011 ◽  
Vol 07 (01) ◽  
pp. 15
Author(s):  
Nuri Jacoby ◽  
Jacqueline B Stone ◽  
Claire Henchcliffe ◽  
◽  
◽  
...  
Keyword(s):  
At Risk ◽  
Motor Symptoms ◽  
Disease Modifying Drugs ◽  
Autonomic Changes ◽  
Genomic Analyses ◽  
Time Motor ◽  
Development And Validation ◽  
Non Motor Symptoms ◽  
Underlying Pathology ◽  
Neuroimaging Techniques

Parkinson’s disease (PD) remains a clinical diagnosis based primarily upon motor features of tremor, rigidity, and bradykinesia. However, by the time motor symptoms occur, the underlying pathology may be widespread. Approaches using a combination of clinical batteries and sophisticated biomarker technology now hold promise for identifying individuals earlier in the course of the disease, including those at risk of PD who may not yet have manifested any motor symptoms. Non-motor symptoms, such as specific sleep disorders, olfactory dysfunction, and autonomic changes, occur during a pre-motor phase, and their use in PD risk stratification is being actively evaluated. Neuroimaging techniques, in particular those focused upon measuring dopamine transporter density, are now in use in many specialist centers, molecular markers are in development and validation phases, and the use of genomic analyses has expanded the number of loci identified as contributing to PD risk. Identifying those at risk of developing PD will aid in the clinical management of the disease, and perhaps enable the use of disease-modifying drugs at as early a stage as possible.

scholarly journals Comparison Analysis of GLCM and PCA on Parkinson's Disease Using Structural MRI

2022 ◽  
Vol 12 (1) ◽  
pp. 1-15
Author(s):  
Sanjana Tomer ◽  
Ketna Khanna ◽  
Sapna Gambhir ◽  
Mohit Gambhir
Keyword(s):  
Feature Extraction ◽  
Principal Component ◽  
Structural Mri ◽  
Dopamine Neurons ◽  
Motor Symptoms ◽  
Non Invasive ◽  
Invasive Method ◽  
Occurrence Matrix ◽  
Time Motor ◽  
Non Motor Symptoms

Parkinson disease (PD) is a neurological disorder where the dopaminergic neurons experience deterioration. It is caused from the death of the dopamine neurons present in the substantia nigra i.e., the mid part of the brain. The symptoms of this disease emerge slowly, the onset of the earlier stages shows some non-motor symptoms and with time motor symptoms can also be gauged. Parkinson is incurable but can be treated to improve the condition of the sufferer. No definite method for diagnosing PD has been concluded yet. However, researchers have suggested their own framework out of which MRI gave better results and is also a non-invasive method. In this study, the MRI images are used for extracting the features. For performing the feature extraction techniques Gray Level Co-occurrence Matrix and Principal Component Analysis are performed and are analysed. Feature extraction reduces the dimensionality of data. It aims to reduce the feature of data by generating new features from the original one.

Gender effect on non-motor symptoms in Parkinson's disease: are men more at risk?

2017 ◽  
Vol 35 ◽  
pp. 69-74 ◽  
Author(s):  
A. Nicoletti ◽  
R. Vasta ◽  
G. Mostile ◽  
G. Nicoletti ◽  
G. Arabia ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
At Risk ◽  
Parkinson's Disease ◽  
Gender Effect ◽  
Motor Symptoms ◽  
Non Motor Symptoms

scholarly journals The Parkinson’s Real-World Impact Assessment (PRISM) Study: A European Survey of the Burden of Parkinson’s Disease in Patients and their Carers

2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impact Assessment ◽  
Real World ◽  
European Countries ◽  
Life Questionnaire ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.

scholarly journals Study of cognitive impairment and genetic polymorphism of SLC41A1 (rs11240569 allele) in Parkinson’s disease in Upper Egypt: case-control study

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Hamdy N. El-Tallawy ◽  
Tahia H. Saleem ◽  
Wafaa M. Farghaly ◽  
Heba Mohamed Saad Eldien ◽  
Ashraf Khodaery ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Motor Symptoms ◽  
And Control ◽  
Non Motor Symptoms ◽  
Control Study

Abstract Background Parkinson’s disease is one of the neurodegenerative disorders that is caused by genetic and environmental factors or interaction between them. Solute carrier family 41 member 1 within the PARK16 locus has been reported to be associated with Parkinson’s disease. Cognitive impairment is one of the non-motor symptoms that is considered a challenge in Parkinson’s disease patients. This study aimed to investigate the association of rs11240569 polymorphism; a synonymous coding variant in SLC41A1 in Parkinson’s disease patients in addition to the assessment of cognitive impairment in those patients. Results In a case -control study, rs11240569 single nucleotide polymorphisms in SLC41A1, genes were genotyped in 48 Parkinson’s disease patients and 48 controls. Motor and non-motor performance in Parkinson's disease patients were assessed by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The genotype and allele frequencies were compared between the two groups and revealed no significant differences between case and control groups for rs11240569 in SLC41A1 gene with P value .523 and .54, respectively. Cognition was evaluated and showed the mean ± standard deviation (SD) of WAIS score of PD patients 80.4 ± 9.13 and the range was from 61 to 105, in addition to MMSE that showed mean ± SD 21.96 ± 3.8. Conclusion Genetic testing of the present study showed that rs11240569 polymorphism of SLC41A1 gene has no significant differences in distributions of alleles and genotypes between cases and control group, in addition to cognitive impairment that is present in a large proportion of PD patients and in addition to the strong correlation between cognitive impairment and motor and non-motor symptoms progression.

scholarly journals Weeding through the haze: a survey on cannabis use among people living with Parkinson’s disease in the US

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Megan P. Feeney ◽  
Danny Bega ◽  
Benzi M. Kluger ◽  
A. Jon Stoessl ◽  
Christiana M. Evers ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Scientific Evidence ◽  
Symptom Control ◽  
Cannabis Use ◽  
Symptom Improvement ◽  
Motor Symptoms ◽  
The Us ◽  
Alternative Means ◽  
Non Motor Symptoms

AbstractSymptomatic management of Parkinson’s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1339 responses (17.6%). 1064 complete responses were available for analysis. Respondents represented 49 states with a mean age of 71.2 years (±8.3) and mean PD duration of 7.4 years (±6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Age and gender were found to be predictors of cannabis use in this sample (Age OR = 0.95, 95% CI 0.93 to 0.97; Male OR = 1.44, 95% CI 1.03 to 2.03). Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p = 0.03). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%), and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.

scholarly journals A mobile app for tracking non-motor symptoms of people with Parkinson’s disease: A usability study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 890-890
Author(s):  
JuHee Lee ◽  
Yujin Suh ◽  
Yielin Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Tracking System ◽  
Smart Phone ◽  
Telephone Counseling ◽  
Mobile App ◽  
Motor Symptoms ◽  
Hand Tremor ◽  
Non Motor Symptoms

Abstract Smart phone-based technology for people with Parkinson’s disease has been developed worldwide. Unmonitored non-motor symptoms decrease quality of life of people with Parkinson’s disease, so the needs for technology to manage non-motor symptoms are increasing. The technology is needed to detect subtle changes in non-motor symptoms by healthcare professional. There is no mobile app which manage comprehensive symptoms of Parkinson’s disease including non-motor symptoms. It is necessary to develop a new tracking system that can effectively manage non-motor symptoms as well as motor symptoms of Parkinson’s disease. We developed a prototype of mobile app for Android smartphones, with cooperation with Mazelone company. we also have shaped functions for monitoring of motor symptoms and medication adherence. It also provided a section for caregivers to use on behalf of people with Parkinson’s disease who have difficulty to use app due to hand tremor. Through Delphi technique, we obtained content validity from eight medical and nursing experts on the contents of the application. We provided regular telephone counseling to improve and encourage their app usage. Fifteen participants used the app for 6 weeks. To evaluate usability of mobile app, we provided constructed questionnaire and conducted individual telephone interview. A mobile app for tracking non-motor symptoms demonstrated high usability and satisfaction. We learned lessons about facilitators and barriers when implementing an app such as perception and acceptance of mobile technology. The mobile app will improve continuum of care. Future studies need to improve the contents and refine technical approach for people with Parkinson’s disease.

scholarly journals A systematic review of non-motor symptom evaluation in clinical trials for amyotrophic lateral sclerosis

2021 ◽  
Author(s):  
Emily Beswick ◽  
Deborah Forbes ◽  
Zack Hassan ◽  
Charis Wong ◽  
Judith Newton ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Amyotrophic Lateral Sclerosis ◽  
Sleep Disturbances ◽  
Neuropsychiatric Symptoms ◽  
Behavioural Change ◽  
Motor Symptom ◽  
Motor Symptoms ◽  
Behavioural Changes ◽  
Non Motor Symptoms ◽  
Lateral Sclerosis

Abstract Background Amyotrophic lateral sclerosis (ALS) is increasingly recognised as a multi-system disorder, presenting with common and impactful non-motor symptoms, such as neuropsychiatric symtpoms, cognitive and behavioural changes, pain, disordered sleep, fatigue and problematic saliva. Aim/hypothesis We aimed to systematically review 25 years of ALS clinical trials data to identify if non-motor features were evaluated, in addition to the traditional measures of motor functioning and survival, and where evaluated to describe the instruments used to assess. We hypothesised that assessment of non-motor symptoms has been largely neglected in trial design and not evaluated with ALS-suitable instruments. Methods We reviewed clinical trials of investigative medicinal products in ALS, since the licensing of riluzole in 1994. Trial registry databases including WHO International Trials Registry, European Clinical Trials Register, clinicaltrials.gov, and PubMed were systematically searched for Phase II, III or IV trials registered, completed or published between 01/01/1994 and 16/09/2020. No language restrictions were applied. Results 237 clinical trials, including over 29,222 participants, were investigated for their use of non-motor outcome measures. These trials evaluated neuropsychiatric symptoms (75, 32%), cognitive impairment (16, 6.8%), behavioural change (34, 14%), pain (55, 23%), sleep disturbances (12, 5%) and fatigue (18, 8%). Problematic saliva was assessed as part of composite ALS-FRS(R) scores in 184 trials (78%) but with no focus on this as an isolated symptom. 31 (13%) trials including 3585 participants did not include any assessment of non-motor symptoms. Conclusions Non-motor symptoms such as neuropsychiatric, cognitive and behavioural changes, pain, disordered sleep, fatigue, and problematic saliva have not been consistently evaluated in trials for people with ALS. Where evaluated, non-symptoms were primarily assessed using instruments and impairment thresholds that are not adapted for people with ALS. Future trials should include non-motor symptom assessments to evaluate the additional potential therapeutic benefit of candidate drugs. PROPSERO registration CRD42020223648.

scholarly journals Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-yi Kuai ◽  
Xiao-han Yao ◽  
Li-juan Xu ◽  
Yu-qing Zhou ◽  
Li-ping Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Before And After ◽  
Non Motor Symptoms

AbstractParkinson’s disease (PD) is a neurodegenerative disorder and 70–80% of PD patients suffer from gastrointestinal dysfunction such as constipation. We aimed to assess the efficacy and safety of fecal microbiota transplantation (FMT) for treating PD related to gastrointestinal dysfunction. We conducted a prospective, single- study. Eleven patients with PD received FMT. Fecal samples were collected before and after FMT and subjected to 16S ribosomal DNA (rDNA) gene sequencing. Hoehn-Yahr (H-Y) grade, Unified Parkinson's Disease Rating Scale (UPDRS) score, and the Non-Motion Symptom Questionnaire (NMSS) were used to assess improvements in motor and non-motor symptoms. PAC-QOL score and Wexner constipation score were used to assess the patient's constipation symptoms. All patients were tested by the small intestine breath hydrogen test, performed before and after FMT. Community richness (chao) and microbial structure in before-FMT PD patients were significantly different from the after-FMT. We observed an increased abundance of Blautia and Prevotella in PD patients after FMT, while the abundance of Bacteroidetes decreased dramatically. After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.

Constipation is Associated with Development of Cognitive Impairment in de novo Parkinson’s Disease: A Longitudinal Analysis of Two International Cohorts

2021 ◽  
pp. 1-11
Author(s):  
Valentina Leta ◽  
Daniele Urso ◽  
Lucia Batzu ◽  
Daniel Weintraub ◽  
Nataliya Titova ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
De Novo ◽  
Motor Dysfunction ◽  
Group Differences ◽  
Motor Symptoms ◽  
Kaplan Meier ◽  
Patients At Risk ◽  
Non Motor Symptoms

Background: Constipation is regarded as one of the prodromal features of Parkinson’s disease (PD) and there is emerging evidence linking gastrointestinal dysfunction and cognitive impairment (CI) in PD. Objective: We explored whether constipation is associated with development of CI in two independent cohorts of de novo PD patients (n = 196 from the Non-motor International Longitudinal Study [NILS] and n = 423 from the Parkinson’s Progression Markers Initiative [PPMI] study). Methods: Constipation was clinically defined using the Non-Motor Symptoms Scale (NMSS) item-21 [NILS] and Scales for Outcomes in PD-Autonomic (SCOPA-AUT) item-5 [PPMI]. We assessed baseline group differences (PD with or without constipation) in CI, global non-motor symptoms burden, motor dysfunction, and striatal dopaminergic denervation. Kaplan-Meier method estimated group differences in cumulative proportion of patients with incident CI over three years. In PPMI, we subsequently performed univariate and multivariate Cox survival analyses to evaluate whether constipation predicts incident mild cognitive impairment or dementia over a 6-year period, including constipation and other known predictors of CI as covariates. Results: Patients with constipation had greater motor and global non-motor burden in both cohorts at baseline (p <  0.05). Kaplan-Meier plots showed faster conversion to CI in patients with constipation in both cohorts (p <  0.05). In PPMI, 37 subjects developed dementia during a mean follow-up of 4.9 years, and constipation was an independent predictor of dementia onset (hazard ratio = 2.311; p = 0.02). Conclusion: Constipation in de novo PD patients is associated with development of cognitive decline and may serve as a clinical biomarker for identification of patients at risk for cognitive impairment.

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