Application of Depression Rating Scales in Patients with Parkinson's Disease with and without Co-Occurring Anxiety

Background: Bradykinesia is the defining motor feature of Parkinson’s disease (PD). There are limitations to its assessment using standard clinical rating scales, especially in the early stages of PD when a floor effect may be observed. Objective: To develop a quantitative method to track repetitive tapping movements and to compare people in the early stages of PD, healthy controls, and individuals with idiopathic anosmia. Methods: This was a cross-sectional study of 99 participants (early-stage PD = 26, controls = 64, idiopathic anosmia = 9). For each participant, repetitive finger tapping was recorded over 20 seconds using a smartphone at 240 frames per second. From each video, amplitude between fingers, frequency (number of taps per second), and velocity (distance travelled per second) was extracted. Clinical assessment was based on the motor section of the MDS-UPDRS. Results: People in the early stage of PD performed the task with slower velocity (p < 0.001) and with greater frequency slope than controls (p = 0.003). The combination of reduced velocity and greater frequency slope obtained the best accuracy to separate early-stage PD from controls based on metric thresholds alone (AUC = 0.88). Individuals with anosmia exhibited slower velocity (p = 0.001) and smaller amplitude (p < 0.001) compared with controls. Conclusion: We present a simple, proof-of-concept method to detect early motor dysfunction in PD. Mean tap velocity appeared to be the best parameter to differentiate patients with PD from controls. Patients with anosmia also showed detectable differences in motor performance compared with controls which may suggest that some are in the prodromal phase of PD.

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Parkinson’s Disease Progression and Statins: Hydrophobicity Matters

Journal of Parkinson s Disease ◽

10.3233/jpd-212819 ◽

2021 ◽

pp. 1-10

Author(s):

Mechelle M. Lewis ◽

Richard M. Albertson ◽

Guangwei Du ◽

Lan Kong ◽

Andrew Foy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Motor Symptoms ◽

Clinical Progression ◽

Mixed Effect ◽

Lipophilic Statin ◽

Hydrophilic Statin ◽

Non Motor Symptoms ◽

Statin Use

Background: Recent randomized clinical trials using hydrophobic statins reported no influence on Parkinson’s disease (PD) clinical progression. Hydrophobicity is a key determinant for blood-brain barrier penetrance. Objective: Investigate a potential effect of statins on PD progression. Methods: Statin use was determined at baseline and subtyped according to hydrophobicity in 125 PD patients participated PD Biomarker Program (PDBP, 2012–2015) at our site. Clinical (N = 125) and susceptibility MRI (N = 86) data were obtained at baseline and 18-months. Movement Disorders Society-Unified PD Rating Scales were used to track progression of non-motor (MDS-UPDRS-I) and motor (MDS-UPDRS-II) symptoms, and rater-based scores (MDS-UPDRS-III) of patients in the “on” drug state. R2 * values were used to capture pathological progression in the substantia nigra. Associations between statin use, its subtypes, and PD progression were evaluated with linear mixed effect regressions. Results: Compared to statin non-users, overall statin or lipophilic statin use did not significantly influence PD clinical or imaging progression. Hydrophilic statin users, however, demonstrated faster clinical progression of non-motor symptoms [MDS-UPDRS-I (β= 4.8, p = 0.010)] and nigral R2 * (β= 3.7, p = 0.043). A similar trend was found for MDS-UPDRS-II (β= 3.9, p = 0.10), but an opposite trend was observed for rater-based MDS-UPDRS-III (β= –7.3, p = 0.10). Compared to lipophilic statin users, hydrophilic statin users also showed significantly faster clinical progression of non-motor symptoms [MDS-UPDRS-I (β= 5.0, p = 0.020)], but R2 * did not reach statistical significance (β= 2.5, p = 0.24). Conclusion: This study suggests that hydrophilic, but not lipophilic, statins may be associated with faster PD progression. Future studies may have clinical and scientific implications.

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Does carotid intima-media thickness correlate to clinical rating scales in Parkinson's disease?

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2020.06.189 ◽

2020 ◽

Vol 79 ◽

pp. e47-e48

Author(s):

S.A. Castillo Torres ◽

D.G. Martínez-Roque ◽

J. Duarte-Bravo ◽

C.A. Soto-Rincón ◽

F. Flores-Alfaro ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Media Thickness ◽

Clinical Rating

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Systematic evaluation of rating scales for impairment and disability in Parkinson's disease

Movement Disorders ◽

10.1002/mds.10248 ◽

2002 ◽

Vol 17 (5) ◽

pp. 867-876 ◽

Cited By ~ 341

Author(s):

Claudia Ramaker ◽

Johan Marinus ◽

Anne Margarethe Stiggelbout ◽

Bob Johannes van Hilten

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Systematic Evaluation

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Assessment of depression in Parkinson's disease: The contribution of somatic symptoms to the clinimetric performance of the Hamilton and Montgomery–Åsberg rating scales

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2009.10.006 ◽

2010 ◽

Vol 68 (6) ◽

pp. 561-565 ◽

Cited By ~ 22

Author(s):

Jennifer S.A.M. Reijnders ◽

Richel Lousberg ◽

Albert F.G. Leentjens

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Somatic Symptoms

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Radiofrequency Lesioning for Movement and Psychiatric Disorders-Experience of 107 Cases

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.673848 ◽

2021 ◽

Vol 15 ◽

Author(s):

Paresh K. Doshi

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Focused Ultrasound ◽

Rating Scale ◽

Paper Analysis ◽

Complication Rates ◽

Obsessive Compulsive ◽

Select Group ◽

Obsessive Compulsive Disorders

BackgroundRadiofrequency lesioning (RFL) though used since the 1950s, had been replaced by DBS in the 1990s. The availability of magnetic resonance-guided focused ultrasound for lesioning has renewed the interest in RFL.ObjectiveThis paper analysis RFL in contemporary Functional Neurosurgery for various indications and its outcome. Complication rates of RFL are compared with the same author’s experience of DBS.MethodsOne hundred and seven patients underwent RFL between 1998 and 2019. Indications included Parkinson’s Disease (PD), tremors, dystonia, and obsessive-compulsive disorders (OCD). The surgeries performed include thalamotomy (29), pallidotomy (49), subthalamotomy (23), and anterior capsulotomy/nucleus accumbens lesioning (6). Appropriate rating scales were used for preoperative and postoperative evaluations.ResultsThere was a 25% recurrence rate of tremors for PD after thalamotomy. Writer’s cramp rating scale improved from a mean of 10.54–1.6 in task specific dystonia (TSD) patients, after thalamotomy. In PD patients, after pallidotomy, contralateral motor Unified Parkinson’s Disease Rating Scale (UPDRS) and dyskinesia scores, improved by 41 and 57%, respectively, at 1-year. Burke-Fahn-Marsden Dystonia Rating Scale in hemidystonia patients improved from 18.04 to 6.91, at 1-year. There was 32 and 31% improvement in total and motor UPDRS, respectively, in the subthalamotomy patients, at 2-year. All patients of OCD were in remission. There were three deaths in the pallidotomy group. Postoperative, dysarthria, confusion, hemiparesis, dyskinesia, and paraesthesia occurred in 12 patients, of which, 7 were transient.ConclusionRFL is a useful option in a select group of patients with tremors and dystonia. It is our preferred treatment option for TSD and OCD.

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