Clinical and Dopamine Depletion Patterns in Hyposmia- and Dysautonomia-Dominant Parkinson’s Disease

2021 ◽  
pp. 1-11
Author(s):  
Han Soo Yoo ◽  
Young-gun Lee ◽  
Seong Ho Jeong ◽  
Byoung Seok Ye ◽  
Young H. Sohn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Characteristics ◽  
Ventral Striatum ◽  
Neuropsychiatric Symptoms ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Rem Sleep Behavior Disorder ◽  
Dopamine Depletion ◽  
Prodromal Symptoms

Background: Olfactory or autonomic dysfunction is one of the earliest prodromal symptoms of Parkinson’s disease (PD). It has not been investigated whether PD patients have different phenotypes depending on the presence of these prodromal symptoms. Objective: To investigate whether hyposmia-dominant and dysautonomia-dominant patients with early PD have different clinical manifestations and nigrostriatal degeneration. Methods: This cross-sectional study recruited 168 drug-naive PD patients and 34 control subjects. PD patients were classified as patients without hyposmia and dysautonomia (PD–H–D–, n = 51), hyposmia-dominant patients (PD–H+D–, n = 36), dysautonomia-dominant patients (PD–H–D+, n = 33), and patients with hyposmia and dysautonomia (PD–H+D+, n = 48). We then compared the baseline clinical characteristics, striatal specific to non-specific binding ratio (SNBR), neuropsychological performance, and neuropsychiatric symptoms among the groups. Results: The PD–H+D–group had a lower SNBR in the ventral striatum (p = 0.013), a greater asymmetric index of striatal SNBRs, and higher prevalence of apathy (p = 0.021) than the PD–H–D+ group. The PD–H–D+ group had older age at onset (p = 0.043) and a higher prevalence of REM sleep behavior disorder (p = 0.041) than the PD–H+D–group. The PD–H+D+ group had higher motor deficits, lower cognitive function, and lower SNBRs in all striatal subregions than the PD–H–D–group. Decreased SNBRs in the anterior caudate, posterior caudate, and ventral striatum were associated with the presence of apathy. Conclusion: The present study suggests that hyposmia-dominant and dysautonomia-dominant PD have different clinical characteristics and patterns of striatal dopamine depletion.

scholarly journals Cognitive and Neuropsychiatric Profiles in Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Parkinson’s Disease

2021 ◽  
Vol 11 (1) ◽  
pp. 51
Author(s):  
Francesca Assogna ◽  
Claudio Liguori ◽  
Luca Cravello ◽  
Lucia Macchiusi ◽  
Claudia Belli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Eye Movement ◽  
Verbal Memory ◽  
Neuropsychiatric Symptoms ◽  
Clinical Manifestations ◽  
Behavior Disorder ◽  
Rapid Eye Movement ◽  
Sleep Behavior

Rapid eye movement (REM) sleep behavior disorder (RBD) is a risk factor for developing Parkinson’s disease (PD) and may represent its prodromal state. We compared neuropsychological and neuropsychiatric phenotypes of idiopathic (i) RBD, PD and healthy comparators (HC) in order to identify iRBD specific characteristics. Thirty-eight patients with iRBD, 38 PD patients with RBD (PD + RBD), 38 PD patients without RBD (PD-RBD) and 38 HC underwent a comprehensive neurological, neuropsychological and neuropsychiatric evaluation. iRBD, PD + RBD and PD-RBD performed worse than HC in short-term verbal memory, praxia, language and executive functions. iRBD had higher levels of anxiety, depression, apathy and alexithymia than HC. iRBD had higher levels of apathy than PD + RBD. Both PD groups had higher levels of anxiety and depression than HC. Surprisingly, iRBD performed better than all groups in long-term verbal memory. Patients diagnosed with iRBD are characterized by poor global cognitive performance, but better long-term memory and higher levels of depression, anxiety, alexithymia and apathy. Alexithymia and apathy in patients diagnosed with iRBD may be the expression of precocious derangement of emotional regulation, subsequently observed also in PD. Cognitive and neuropsychiatric symptoms of iRBD are early clinical manifestations of widespread neurodegeneration.

scholarly journals The Association betweenLRRK2G2385R and Phenotype of Parkinson’s Disease in Asian Population: A Meta-Analysis of Comparative Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Di ◽  
Zhiyong Zeng ◽  
Jingyan Li ◽  
Xiaoling Liu ◽  
Minzhi Bo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Family History ◽  
Clinical Characteristics ◽  
Disease Duration ◽  
Meta Analysis ◽  
Age At Onset ◽  
Asian Population ◽  
Related Case ◽  
Initial Symptoms

Numerous studies have investigated the relationship between theLRRK2G2385R variant and clinical characteristics in Parkinson’s disease (PD), but the results have been inconsistent. This study investigated whether theLRRK2G2385R variant was associated with a unique clinical phenotype of PD in the Asian population, using a meta-analysis. The PubMed, Web of Science, EMBASE, CNKI, and WANFANG databases were searched until September 2017. The strict selection criteria and exclusion criteria were determined, and mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI) were used to assess the strength of associations. Statistical analyses and graphics were performed using Review Manager 5.3. Sixteen related case-control studies were included in the meta-analysis. TheLRRK2G2385R carriers significantly more often presented a family history (OR: 1.98; 95% CI: 1.16−3.39;P=0.01) and had a longer disease duration (MD = 0.47, 95% CI: 0.01−0.93,P=0.04) and a higher MMSE score (MD = 1.02, 95% CI: 0.43–1.62P=0.0007) thanLRRK2G2385R noncarriers. There were no significant differences in sex distribution, age at onset, initial symptoms, motor symptoms, depression, levodopa-equivalent dose, and related complications betweenLRRK2G2385R-carrier andLRRK2G2385R-noncarrier PD patients. Our results suggested that most of the clinical characteristics of PD patients withLRRK2G2385R mutations are similar to those ofLRRK2G2385R noncarriers among Asian PD patients, except for the more common family history, relatively longer disease duration, and higher MMSE scores in the former group.

scholarly journals Advancing Personalized Medicine in Common Forms of Parkinson’s Disease through Genetics: Current Therapeutics and the Future of Individualized Management

2021 ◽  
Vol 11 (3) ◽  
pp. 169
Author(s):  
Xylena Reed ◽  
Artur Schumacher-Schuh ◽  
Jing Hu ◽  
Sara Bandres-Ciga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Personalized Medicine ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Clinical Trial Design ◽  
Variable Response ◽  
Current State ◽  
Individualized Management ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is a condition with heterogeneous clinical manifestations that vary in age at onset, rate of progression, disease course, severity, motor and non-motor symptoms, and a variable response to antiparkinsonian drugs. It is considered that there are multiple PD etiological subtypes, some of which could be predicted by genetics. The characterization and prediction of these distinct molecular entities provides a growing opportunity to use individualized management and personalized therapies. Dissecting the genetic architecture of PD is a critical step in identifying therapeutic targets, and genetics represents a step forward to sub-categorize and predict PD risk and progression. A better understanding and separation of genetic subtypes has immediate implications in clinical trial design by unraveling the different flavors of clinical presentation and development. Personalized medicine is a nascent area of research and represents a paramount challenge in the treatment and cure of PD. This manuscript summarizes the current state of precision medicine in the PD field and discusses how genetics has become the engine to gain insights into disease during our constant effort to develop potential etiological based interventions.

scholarly journals Autonomic Dysfunctions in Parkinson’s Disease: Prevalence, Clinical Characteristics, Potential Diagnostic Markers, and Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Zhe Zhang ◽  
Sheng-Di Chen
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Characteristics ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Disease Prevalence ◽  
Autonomic Dysfunctions

Parkinson’s disease (PD) is a common neurodegenerative disease in the middle-aged and the elderly. Symptoms of autonomic dysfunctions are frequently seen in PD patients, severely affecting the quality of life. This review summarizes the epidemiology, clinical manifestations, and treatment options of autonomic dysfunctions. The clinical significance of autonomic dysfunctions in PD early diagnosis and differential diagnosis is also discussed.

scholarly journals Mortalidade Hospitalar na Doença de Parkinson: Análise Retrospetiva num Hospital Terciário Português

2016 ◽  
Vol 29 (5) ◽  
pp. 315 ◽  
Author(s):  
Joana Martins ◽  
Adriana Rua ◽  
Nuno Vila Chã
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cardiovascular Diseases ◽  
Clinical Characteristics ◽  
Causes Of Death ◽  
Hospital Admissions ◽  
Advanced Disease ◽  
Age At Onset ◽  
Disease Stage ◽  
Advanced Disease Stage

<p><strong>Introduction:</strong> Parkinson’s disease is associated with high hospital mortality. Male gender, late age at onset, higher disability and the coexistence of cognitive impairment or depression have been suggested to be risk factors of death. Pneumonia and cardiovascular diseases are the leading causes of death.<br /><strong>Objective:</strong> To characterize the mortality (causes of hospital admission and death) of Parkinson’s disease patients in a tertiary hospital, as well as demographic and clinical characteristics.<br /><strong>Material and Methods:</strong> Identification of hospital admissions of Parkinson’s disease patients that resulted in inpatient death between 2008 and 2014. Retrospective review of medical files and inclusion of patients with disease clinically confirmed by a neurologist. Assessment of causes of death and demographic and clinical characteristics of patients.<br /><strong>Results:</strong> 1525 hospital admissions of Parkinson’s disease patients were identified, of which 150 resulted in death. Of these, 52 patients met the inclusion criteria. Mean age at onset of Parkinson’s disease symptoms was 66.8 years (± 8.7) and mean duration of disease was 12.5 years (± 7.9). Sixty-five percent of patients were in stages 4-5 of the Hoehn and Yahr scale. Thirty-three patients (63%) had dementia and eleven (21%) had depression. Infections were the leading cause of death (respiratory in 63% of cases).<br /><strong>Discussion:</strong> Similarly to literature, pneumonia was the leading cause of hospital death and most patients presented advanced disease stage and dementia. Contrarily to other studies, life expectancy was not reduced and cardiovascular diseases and trauma were not causes of death in our population.<br /><strong>Conclusions:</strong> This is the first Portuguese mortality study in Parkinson’s disease. Pneumonia is the leading cause of death. Advanced disease stage and dementia were common features in these patients.</p>

LRRK2, GBA and SMPD1 Founder Mutations and Parkinson's Disease in Ashkenazi Jews

2016 ◽  
Vol 42 (1-2) ◽  
pp. 1-6 ◽  
Author(s):  
Efrat Dagan ◽  
Ilana Schlesinger ◽  
Alina Kurolap ◽  
Mareemar Ayoub ◽  
Maria Nassar ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Characteristics ◽  
Statistical Significance ◽  
Clinical Manifestations ◽  
Age At Diagnosis ◽  
Carrier Status ◽  
Ashkenazi Jews ◽  
Founder Mutations ◽  
Mutation Carriers

Background/Aim: Parkinson's disease (PD) is associated with mutations in LRRK2, GBA, and SMPD1 genes. We describe the clinical characteristics of PD patients related to their carrier status of the Ashkenazi founder mutations in the aforementioned genes. Methods: Ashkenazi PD patients (n = 270) were recruited following informed consent, and tested for the founder Ashkenazi mutations in the above genes. Clinical characteristics were compared between carriers and noncarriers. Homozygotes for mutations in GBA or LRRK2, and those who carried mutations in two causative genes were excluded from the analysis. Results: Five (1.85%), 54 (20%), and 22 (8.1%) PD patients carried mutations in SMPD1, GBA or LRRK2, respectively. By post hoc Bonferroni analysis, GBA carriers were singled at a significantly earlier age at diagnosis compared to noncarriers (58.06 ± 10.84 and 62.65 ± 10.86 years, respectively; p = 0.036), and due to bilateral manifestation at diagnosis compared to all other PD groups (n = 8, 15.7% compared to n = 2, 1.1%, respectively; p < 0.001). Other clinical manifestations were comparable between groups. Conclusion: Although only GBA mutation carriers, compared to noncarriers, reached statistical significance regarding age at diagnosis, it appears that LRRK2 and SMPD1 mutation carriers may reach significance with larger group numbers.

scholarly journals Classification and Characteristics of Pain Associated with Parkinson’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Marcelo Rezende Young Blood ◽  
Marcelo Machado Ferro ◽  
Renato Puppi Munhoz ◽  
Hélio Afonso Ghizoni Teive ◽  
Carlos Henrique Ferreira Camargo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Characteristics ◽  
Neuropsychiatric Symptoms ◽  
Pain Modulation ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Dopaminergic Drugs ◽  
Lower Back ◽  
System Generation

Neuropsychiatric symptoms and pain are among the most common nonmotor symptoms of Parkinson’s disease (PD). The correlation between pain and PD has been recognized since its classic descriptions. Pain occurs in about 60% of PD patients, two to three times more frequent in this population than in age matched healthy individuals. It is an early and potentially disabling symptom that can precede motor symptoms by several years. The lower back and lower extremities are the most commonly affected areas. The most used classification for pain in PD defines musculoskeletal, dystonic, central, or neuropathic/radicular forms. Its different clinical characteristics, variable relationship with motor symptoms, and inconsistent response to dopaminergic drugs suggest that the mechanism underlying pain in PD is complex and multifaceted, involving the peripheral nervous system, generation and amplification of pain by motor symptoms, and neurodegeneration of areas related to pain modulation. Although pain in DP is common and a significant source of disability, its clinical characteristics, pathophysiology, classification, and management remain to be defined.

Association of the Non-Motor Burden with Patterns of Striatal Dopamine Loss in de novo Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1541-1549
Author(s):  
Seok Jong Chung ◽  
Sangwon Lee ◽  
Han Soo Yoo ◽  
Yang Hyun Lee ◽  
Hye Sun Lee ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
De Novo ◽  
Early Stage ◽  
Striatal Dopamine ◽  
Motor Deficits ◽  
Dopamine Depletion ◽  
Severe Motor ◽  
Severe Group ◽  
Striatal Dopamine Depletion

Background: Striatal dopamine deficits play a key role in the pathogenesis of Parkinson’s disease (PD), and several non-motor symptoms (NMSs) have a dopaminergic component. Objective: To investigate the association between early NMS burden and the patterns of striatal dopamine depletion in patients with de novo PD. Methods: We consecutively recruited 255 patients with drug-naïve early-stage PD who underwent 18F-FP-CIT PET scans. The NMS burden of each patient was assessed using the NMS Questionnaire (NMSQuest), and patients were divided into the mild NMS burden (PDNMS-mild) (NMSQuest score <6; n = 91) and severe NMS burden groups (PDNMS-severe) (NMSQuest score >9; n = 90). We compared the striatal dopamine transporter (DAT) activity between the groups. Results: Patients in the PDNMS-severe group had more severe parkinsonian motor signs than those in the PDNMS-mild group, despite comparable DAT activity in the posterior putamen. DAT activity was more severely depleted in the PDNMS-severe group in the caudate and anterior putamen compared to that in the PDMNS-mild group. The inter-sub-regional ratio of the associative/limbic striatum to the sensorimotor striatum was lower in the PDNMS-severe group, although this value itself lacked fair accuracy for distinguishing between the patients with different NMS burdens. Conclusion: This study demonstrated that PD patients with severe NMS burden exhibited severe motor deficits and relatively diffuse dopamine depletion throughout the striatum. These findings suggest that the level of NMS burden could be associated with distinct patterns of striatal dopamine depletion, which could possibly indicate the overall pathological burden in PD.

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