scholarly journals Olfactory Deficits in the Freezing of Gait Phenotype of Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Aliyah Glover ◽  
Lakshmi Pillai ◽  
Rohit Dhall ◽  
Tuhin Virmani

Background: Olfactory dysfunction often occurs before motor onset in Parkinson's disease (PD) and can be detected with the University of Pennsylvania Smell Identification Test (UPSIT). Based on the Braak hypothesis, the olfactory bulb is one of two sites where disease pathology may start and spread to deeper brain structures.Objective: To evaluate whether a specific pattern of odorant identification on the UPSIT discriminated Parkinson's disease patients with and without freezing of gait.Methods: One hundred and twenty four consecutive participants (33 controls, 31 non-freezers, and 60 freezers) were administered the UPSIT. Using the chi-square test, each odorant on the UPSIT was ranked based on the differential ability of freezers and non-freezers to identify them correctly. Using predictive statistics and confusion matrices, the best combination of odorants and a cut-off score was determined.Results: Freezers had a shift toward a more severe hyposmia classification based on age and sex based normative values. The correct identification of nine odors (bubblegum, chocolate, smoke, wintergreen, paint thinner, orange, strawberry, grass, and peanut) was significantly worse in freezers compared to non-freezers. Correctly identifying ≤ 2 out of 3-odorants (bubblegum, chocolate, and smoke) had a 77% sensitivity and 61% specificity for categorizing freezers. The 3-odorant score was not correlated with disease duration, motor or total UPDRS scores, MoCA scores or age at testing. The predictive statistics were similar when sexes were separately categorized.Conclusions: A 3-odorant score helped categorize freezers and non-freezers with similar sensitivity and specificity to short odorant Parkinson's disease identification batteries.

2021 ◽  
Vol 42 (4) ◽  
pp. 130-142
Author(s):  
Hyo Won Bae ◽  
Tae Wook Lee ◽  
Byung Tae Choi ◽  
Hwa Kyoung Shin ◽  
Young Ju Yun

Objectives: The prevalence of Parkinson’s disease is on an upward trend along with an increase in the aging population but there is no available treatment that halts the progression of neurodegeneration. This study reports a numerical analysis on Donguibogam and suggests novel herbal drugs, which have never been researched before but found to be deemed effective in this study.Methods: Referring to 71 Korean medicine symptom terms that represent the symptoms of Parkinson’s disease, 4170 prescriptions described in Donguibogam were classified into two groups based on whether their main effects were effective for Parkinson’s disease or not. Comparing the two groups, the chi-square test was performed to select statistically significant herbs, while the t-test, Wilcoxon test, and descriptive statistics were performed to determine the appropriate dose.Results: One hundred and twenty-seven prescriptions effective for Parkinson’s disease were identified. The chi-square test determined 17 herbs that are effective for symptomatic treatment. Among the medicinal herbs, the authors suggest Osterici seu Notopterygii Radix et Rhizoma, Ephedrae Herba, Aconiti Tuber, Myrrha, Sinomeni Caulis et Rhizoma, and Aconiti Kusnezoffii Tuber as herbal candidates that have never been studied for Parkinson’s disease. Through the statistical tests, it was judged that the mean value of the dose of the entire prescription was the appropriate dose for each herb.Conclusions: Seventeen herbs were selected for Parkinson’s disease and the appropriate daily dose were calculated. Furthermore, this study presented a new process that applies a statistical method to traditional medical literature and preselecting herbs deemed effective for specific diseases.


2020 ◽  
Author(s):  
Deepak K. Gupta ◽  
Massimo Marano ◽  
Cole Zweber ◽  
James T. Boyd ◽  
Sheng-Han Kuo

AbstractBackgroundDespite the significance of tremor in Parkinson’s disease (PD) diagnosis, classification, and patient’s quality of life, there is a relative lack of data on prevalence and relationship of different tremor types in PD.MethodsThe presence of rest tremor (RT) and action tremor (AT; defined as combination of both postural and kinetic tremor) was determined and RT severity was defined using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) at baseline in the Progression Marker Initiative (PPMI, n=423), the Fox Investigation for New Discovery of Biomarkers (BioFIND, n=118) and the Parkinson’s Disease Biomarkers Program (PDBP, n=873) cohorts.ResultsAcross baseline data of all three cohorts, RT prevalence (58.2%) was higher than AT prevalence (39.0%). Patients with RT had significantly higher (Chi-square test, p<0.05) prevalence of AT compared to patients without RT in the PPMI (40.0% versus 30.1%), BioFIND (48.0% versus 40.0%) and PDBP (49.9% versus 21.0%) cohorts. Furthermore, patients with AT had significantly (Student t-test, p<0.05) higher RT severity that those without AT in PPMI (5.7 ± 5.4 versus 3.9 ± 3.3), BioFIND, 6.4 ± 6.3 versus 3.8 ± 4.4) and PDBP (6.4 ± 6.6 versus 3.7 ± 4.4) cohorts.DiscussionThe RT is the most frequent tremor type and present in more than half of the PD patients. However, AT is also present in nearly one-third of the PD patients. Our results also indicate that RT and AT may have cross-interactions in PD.


Author(s):  
Marcos SERRANO-DUEÑAS ◽  
Luis MASABANDA ◽  
Maria-Rosario LUQUIN

ABSTRACT Background: Parkinson’s disease (PD) is a chronic disease that presents a multitude of symptoms, with symptoms of both motor and nonmotor nature. The Delphi method is widely used to create consensuses among experts in a field of knowledge. Objective: In order to reach a consensus on the values that should be assigned to the different motor and nonmotor manifestations of Parkinson’s disease, a linear evaluation index (LEI) was created. Subsequently, the metric properties of this index were studied. Methods: 120 consecutive patients with a Parkinson’s diagnosis were chosen in accordance with the UKPDSBB criteria. The Delphi method was used to reach a consensus among experts regarding the values of each of the manifestations included. Subsequently, the following attributes were analyzed: quality and acceptability of the data; reliability, in terms of internal consistency, reliability index, Cronbach’s alpha and standard error of measurement; and validity, in terms of convergent validity and validity for known groups. Results: Twenty-five experts participated. The importance factor did not differ between the first round and the second round (chi-square test). We analyzed the responses that assigned percentage values to the 10 dimensions of the LEI. Both in the first and in the second round, the values of the scattering coefficient Vr were always close to 0. The homogeneity index was 0.36; the corrected-item total correlation values ranged from 0.02 to 0.7; Cronbach’s α was 0.69; and the SEM was 4.23 (55.1%). Conclusions: The LEI was obtained through rigorous recommended methodology. The results showed adequate metric properties.


2019 ◽  
Vol 9 (4) ◽  
pp. 741-747 ◽  
Author(s):  
Young Eun Kim ◽  
Beomseok Jeon ◽  
Ji Young Yun ◽  
Hui-Jun Yang ◽  
Han-Joon Kim

2021 ◽  
pp. 026921552199052
Author(s):  
Zonglei Zhou ◽  
Ruzhen Zhou ◽  
Wen Wei ◽  
Rongsheng Luan ◽  
Kunpeng Li

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.


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