Snoring is Associated with an Impaired Motor Function, Disease Severity and the Quality of Life but not with Excessive Daytime Sleepiness in Patients with Parkinson's Disease

Introduction: Mutations in the Parkin gene are the most common cause of autosomal recessive early-onset Parkinson's disease (PD). However, little is known about the quality of life (QoL) in Parkin-related PD. Here, we investigated the patterns of QoL in newly diagnosed Parkin-related PD patients.Methods: Newly diagnosed PD patients (diagnosis made within 12 months) who had an age of onset (AOO) below 40 and underwent a PD-related genetic testing, were recruited (n = 148). Among them, 24 patients carried bi-allelic variants in Parkin (PD-Parkin) and 24 patients did not have any known causative PD mutations, or risk variants (GU-EOPD). The clinical materials, relevant factors and determinants of QoL were analyzed.Results: PD-Parkin patients had a younger AOO (p = 0.003) and longer disease duration (p = 0.005). After adjustment for AOO and disease duration, more dystonia (p = 0.034), and worse scores of non-motor symptoms including Beck depression inventory (BDI, p = 0.035), Epworth sleepiness scale (ESS, p = 0.044), and subdomains of depression/anxiety (p = 0.015) and sleep disorders (p = 0.005) in Non-motor symptoms questionnaire, were found in PD-Parkin comparing with GU-EOPD. PD-Parkin patients had poorer QoL (adjusted p = 0.045), especially in the mobility (adjusted p = 0.025), emotional well-being (adjusted p = 0.015) and bodily discomfort dimensions (adjusted p = 0.016). BDI scores (p = 0.005) and ESS scores (p = 0.047) were significant determinants of QoL in PD-Parkin.Conclusion: Newly diagnosed PD-Parkin patients showed worse QoL. More depression and excessive daytime sleepiness predicted worse QoL. For clinicians, management of depression and excessive daytime sleepiness is suggested to better improve QoL in patients with Parkin mutations.

Download Full-text

Selegiline Improves Excessive Daytime Sleepiness in Parkinson’s Disease: An Open Trial

10.21203/rs.3.rs-708038/v1 ◽

2021 ◽

Author(s):

Jinru Zhang ◽

Ju-ping Chen ◽

Jia Li ◽

Jian Li ◽

Hong Miao ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Motor Fluctuation ◽

Life Questionnaire ◽

Open Label ◽

Multi Center Study

Abstract Excessive daytime sleepiness (EDS) is common in Parkinson’s disease (PD) and may respond to dopaminergic therapies. The aim of this open-label trial was to assess the efficacy and safety of selegiline as a treatment for EDS in PD patients. In this multi-center study, 141 PD subjects were enrolled between December 2019 and October 2020, and 121 patients completed the 8-week study. Selegiline was administered at 5 mg/day in the first week and was increased to 10 mg per day during the following weeks. EDS was evaluated using the Epworth Sleepiness Scale (ESS) at baseline, week 3, and week 8. Changes in motor complications, sleep quality, and quality of life were also assessed in patients with PD. As primary outcomes, ESS scores decreased significantly in PD patients who received selegiline for 8 weeks (P < 0.001). As secondary outcomes, the scores of Parkinson's disease sleep scale (PDSS) and Parkinson’s disease quality of life questionnaire 39 (PDQ-39) also improved after the treatment. The severity of motor fluctuation improved (P=0.037), while the percentage of patients with dyskinesia and the severity of dyskinesia did not increase significantly compared with baseline. Participants treated with selegiline showed an improvement in EDS and good tolerance of the drug. This study demonstrated the efficacy of selegiline for the treatment of daytime sleepiness in PD patients.Trial registration: clinicaltrials, NCT04870372. Registered 5 May 2021 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009J06&selectaction=Edit&uid=U00026CP&ts=2&cx=ruz8uy.

Download Full-text

Excessive daytime sleepiness decreases the quality of life and daytime activity in Parkinson’s disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2017.11.237 ◽

2018 ◽

Vol 46 ◽

pp. e69

Author(s):

O. Babkina ◽

M. Poluektov ◽

O. Levin

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Daytime Activity

Download Full-text

Excessive daytime sleepiness and its impact on quality of life in de novo Parkinson’s disease

Neurological Sciences ◽

10.1007/s10072-019-03785-8 ◽

2019 ◽

Vol 40 (6) ◽

pp. 1151-1156 ◽

Cited By ~ 3

Author(s):

Sang-Won Yoo ◽

Joong-Seok Kim ◽

Yoon-Sang Oh ◽

Dong-Woo Ryu ◽

Kwang-Soo Lee

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

De Novo

Download Full-text

Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: A systematic review and meta-analysis

Clinical Rehabilitation ◽

10.1177/0269215521990526 ◽

2021 ◽

pp. 026921552199052

Author(s):

Zonglei Zhou ◽

Ruzhen Zhou ◽

Wen Wei ◽

Rongsheng Luan ◽

Kunpeng Li

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Meta Analysis ◽

Freezing Of Gait ◽

Movement Therapy ◽

Walking Velocity

Objective: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson’s disease. Data sources: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. Review methods: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger’s regression test. “Trim and fill” analysis was performed to adjust any potential publication bias. Results: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson’s Disease Rating Scale motor subscale, MD = −5.44, P = 0.002; Timed Up and Go Test, MD = −1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = −2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = −0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. Conclusion: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease.

Download Full-text

The Impact of Mind-Body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010031 ◽

2019 ◽

Vol 17 (1) ◽

pp. 31 ◽

Cited By ~ 6

Author(s):

Xiaohu Jin ◽

Lin Wang ◽

Shijie Liu ◽

Lin Zhu ◽

Paul Dinneen Loprinzi ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Motor Function ◽

Exercise Intervention ◽

Meta Analysis ◽

Cochrane Library ◽

The Impact

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

Download Full-text

Efficacy of osteopathic manipulative treatment in patients with Parkinson’s disease: a narrative review

Journal of Osteopathic Medicine ◽

10.1515/jom-2021-0081 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Raymond Li ◽

Ann Jose ◽

Jessica Poon ◽

Cindy Zou ◽

Maria Istafanos ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Manual Therapy ◽

Symptom Management ◽

Future Research ◽

Osteopathic Manipulative Treatment ◽

Literature Searches

Abstract Context Parkinson’s disease (PD) is a neurodegenerative disease that leads to impaired motor and non-motor function in patients. PD is non-curative and gradually reduces quality of life, leading patients to seek treatment for symptom management. Osteopathic manipulative treatment (OMT) applies the biomechanical, neurologic, circulatory, metabolic, and psychosocial models in approaching and treating the major symptomatology of PD patients. Objectives This article evaluates the literature published in the past 10 years analyzing evidence on OMT and its functional application on gait, balance, motor function, bradykinesia, and autonomic dysfunctions, and to identify promising avenues for further investigation. Methods The authors obtained studies from the research databases MEDLINE/PubMed, ScienceDaily, and EBSCO, as well as the Journal of American Osteopathic Association’s published archives. Searches were conducted in December 2020 utilizing the search phrases “OMM” (osteopathic manipulative medicine), “OMT,” “osteopathic,” “Parkinson Disease,” “manual therapy,” “physical therapy,” “training,” “autonomics,” “gait,” and “balance.” Articles published between 2010 and 2021 including subjects with Parkinson’s disease and the use of OMT or any other form of manual therapy were included. Five authors independently performed literature searches and methodically resolved any disagreements over article selection together. Results There were a total of 10,064 hits, from which 53 articles were considered, and five articles were selected based on the criteria. Conclusions The progressive nature of PD places symptom management on the forefront of maintaining patients’ quality of life. OMT has demonstrated the greatest efficacy on managing motor-related and neurologic symptoms and assists in treating the greater prevalence of somatic dysfunctions that arise from the disease. Research in this field remains limited and should be the target of future research.

Download Full-text

Apathy-Related Symptoms Appear Early in Parkinson’s Disease

Healthcare ◽

10.3390/healthcare10010091 ◽

2022 ◽

Vol 10 (1) ◽

pp. 91

Author(s):

Emmie Cohen ◽

Allison A. Bay ◽

Liang Ni ◽

Madeleine E. Hackney

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Diagnosis ◽

Disease Severity ◽

Regression Models ◽

Cognitive Status ◽

Stage Of Disease

Background: Apathy, often-unrecognized in Parkinson’s Disease (PD), adversely impacts quality-of-life (QOL) and may increase with disease severity. Identifying apathy early can aid treatment and enhance prognoses. Whether feelings related to apathy (e.g., loss of pleasure) are present in mild PD and how apathy and related feelings increase with disease severity is unknown. Methods: 120 individuals (M age: 69.0 ± 8.2 y) with mild (stages 1–2, n = 71) and moderate (stages 2.5–4; n = 49) PD were assessed for apathy and apathy-related constructs including loss of pleasure, energy, interest in people or activities, and sex. Correlations were used to determine the association of apathy with apathy-related constructs. Regression models, adjusted for age, cognitive status, and transportation, compared groups for prevalence of apathy and apathy-related feelings. Results: Apathy-related constructs and apathy were significantly correlated. Apathy was present in one in five participants with mild PD and doubled in participants with moderate PD. Except for loss of energy, apathy-related constructs were observed in mild PD at a prevalence of 41% or greater. Strong associations were noted between all apathy-related constructs and greater disease severity. After adjustment for transportation status serving as a proxy for independence, stage of disease remained significant only for loss of pleasure and loss of energy. Conclusion: People with mild PD showed signs of apathy and apathy-related feelings. Loss of pleasure and energy are apathy-related feelings impacted by disease severity. Clinicians should consider evaluating for feelings related to apathy to enhance early diagnosis in individuals who might otherwise not exhibit psychopathology.

Download Full-text

Respiratory muscle strength and lung function in the stages of Parkinson’s disease

Jornal Brasileiro de Pneumologia ◽

10.1590/1806-3713/e20180148 ◽

2019 ◽

Vol 45 (6) ◽

Author(s):

Rejane Barreto dos Santos ◽

Anderson Santos Fraga ◽

Maria das Graças Wanderley de Sales Coriolano ◽

Bruna Ferreira Tiburtino ◽

Otávio Gomes Lins ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Muscle Strength ◽

Lung Function ◽

Motor Function ◽

Respiratory Muscle ◽

Respiratory Muscle Strength ◽

And Control

ABSTRACT Objective: To investigate parameters of lung function and respiratory muscle strength in different stages of Parkinson’s disease (PD), as well as to determine their correlation with motor function and quality of life. Methods: This was a cross-sectional study conducted at a referral center for PD in the city of Recife, Brazil. Respiratory muscle strength and lung function, as well as their relationship with motor function and quality of life, were evaluated in patients with PD, stratified by the level of severity, and were compared with the data obtained for a control group. After confirming the normality of data distribution, we performed one-way ANOVA with a post hoc t-test. Results: The sample comprised 66 individuals, in two groups: PD (n = 49) and control (n = 17). All of the parameters investigated showed inverse correlations with PD severity, and there were significant differences among the levels of severity, as well as between the PD and control groups, in terms of the MIP, MEP, FVC, FEV1, and FEF25-75%. The lung function parameters also showed moderate to weak inverse correlations with bradykinesia and rigidity. On a quality of life questionnaire, the total score and mobility domain score both presented a moderate inverse correlation with FVC, FEV1, PEF, and MEP. Conclusions: Respiratory muscle strength and some lung function parameters are impaired from the early stages of PD onward, bradykinesia and rigidity being the cardinal signs that correlate most strongly with impairment of those parameters. Such alterations negatively affect the quality of life of patients with PD.

Download Full-text