EXIT 360°—EXecutive-Functions Innovative Tool 360°—A Simple and Effective Way to Study Executive Functions in Parkinson’s Disease by Using 360° Videos

Executive dysfunction represents a common non-motor symptom in Parkinson’s disease (PD), with a substantial negative impact on daily functioning and quality of life. Assessing executive functions (EFs) with ecological tools is therefore essential. The ecological limitations of traditional neuropsychological tests have led to increased use of virtual reality and 360° environment-based tools for the assessment of EFs in real life. The study aims to evaluate the efficacy and usability of the EXecutive-Functions Innovative Tool 360° (EXIT 360°), a 360°-based tool for the evaluation of EFs in PD. Twenty-five individuals with PD and 25 healthy controls (HC) were assessed with a conventional neuropsychological battery and EXIT 360° delivered via a head-mounted display. EXIT 360° will show a domestic scenario and seven different subtasks of increasing complexity, and will collect verbal responses, reaction times, and physiological data. We expect that EXIT 360° will be judged usable, engaging, and challenging. Moreover, we expect to find a highly convergent (conventional test and EXIT 360°) and diagnostic validity (individuals with PD vs. HC). The validation of EXIT 360° will allow for the adoption of a fast, ecological, and useful instrument for PD screening, likely transforming the assessment for the clinic and the patient.

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A Simple and Effective Way to Study Executive Functions by Using 360° Videos

Frontiers in Neuroscience ◽

10.3389/fnins.2021.622095 ◽

2021 ◽

Vol 15 ◽

Author(s):

Francesca Borgnis ◽

Francesca Baglio ◽

Elisa Pedroli ◽

Federica Rossetto ◽

Giuseppe Riva ◽

...

Keyword(s):

Executive Functions ◽

Real Life ◽

Reaction Times ◽

Public Health Problem ◽

Executive Dysfunction ◽

Physiological Data ◽

Planning Problem ◽

Eye Tracker ◽

Verbal Responses ◽

Executive Dysfunctions

Executive dysfunctions constitute a significant public health problem due to their high impact on everyday life and personal independence. Therefore, the identification of early strategies to assess and rehabilitate these impairments appears to be a priority. The ecological limitations of traditional neuropsychological tests and the numerous difficulties in administering tests in real-life scenarios have led to the increasing use of virtual reality (VR) and 360° environment-based tools for assessing executive functions (EFs) in real life. This perspective aims at proposing the development and implementation of Executive-functions Innovative Tool 360° (EXIT 360°), an innovative, enjoyable, and ecologically valid tool for a multidimensional and multicomponent evaluation of executive dysfunctions. EXIT 360° allows a complete and integrated executive functioning assessment through an original task for EFs delivered via a mobile-powered VR headset combined with eye tracker (ET) and electroencephalograms (EEG). Our tool is born as a 360°-based instrument, easily accessible and clinically usable, that will radically transform clinicians’ and patient’s assessment experience. In EXIT 360°, patients are engaged in a “game for health,” where they must perform everyday subtasks in 360° daily life environments. In this way, the clinicians can obtain quickly more ecologically valid information about several aspects of EFs (e.g., planning, problem-solving). Moreover, the multimodal approach allows completing the assessment of EFs by integrating verbal responses, reaction times, and physiological data (eye movements and brain activation). Overall, EXIT 360° will allow obtaining simultaneously and in real time more information about executive dysfunction and its impact in real life, allowing clinicians to tailor the rehabilitation to the subject’s needs.

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EXecutive-Functions Innovative Tool (EXIT 360°): A Usability and User Experience Study of an Original 360°-Based Assessment Instrument

Sensors ◽

10.3390/s21175867 ◽

2021 ◽

Vol 21 (17) ◽

pp. 5867

Author(s):

Francesca Borgnis ◽

Francesca Baglio ◽

Elisa Pedroli ◽

Federica Rossetto ◽

Sara Isernia ◽

...

Keyword(s):

Executive Functions ◽

User Experience ◽

Negative Impact ◽

Executive Dysfunction ◽

Assessment Instrument ◽

Clinical Population ◽

Negative Effects ◽

Everyday Functioning ◽

System Usability Scale ◽

Innovative Tool

Over the last few decades, several studies have shown the feasibility, acceptability, and efficacy of VR-based instruments in the early evaluation of executive dysfunction (ED) in psychiatric and neurologic conditions. Due to the negative impact of ED in everyday functioning, identifying innovative strategies for evaluating ED allows clinicians to detect executive impairment early and minimize its effects. This work aimed to test the usability and user experience (UX) of EXecutive-functions Innovative Tool 360° (EXIT 360°), a 360°-based tool for assessing ED. Seventy-six healthy subjects underwent an evaluation that involved (1) usability assessment using System Usability Scale and (2) evaluation of UX using the ICT-Sense of Presence and UX Questionnaire. Results showed a satisfactory level of usability (mean = 75.9 ± 12.8), with good scores for usability and learnability. As regards UX, EXIT 360° showed an absence of negative effects (mean = 1.79 ± 0.95) and high scores in ecological validity (mean = 4.32 ± 0.54) and engagement (mean = 3.76 ± 0.56). Moreover, it obtained good scores in efficiency (mean = 1.84 ± 0.84), originality (mean = 2.49 ± 0.71), and attractiveness (mean = 1.93 ± 0.98). Interestingly, demographic characteristics and technological expertise had no impact on the performance (p > 0.05). Overall, EXIT 360° appeared to be a usable, learn-to-use, engaging, and creative tool with irrelevant negative effects. Further studies will be conducted to evaluate these aspects in the clinical population.

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Glucocerebrosidase Activity is Reduced in Cryopreserved Parkinson’s Disease Patient Monocytes and Inversely Correlates with Motor Severity

Journal of Parkinson s Disease ◽

10.3233/jpd-202508 ◽

2021 ◽

pp. 1-9

Author(s):

Laura P. Hughes ◽

Marilia M.M. Pereira ◽

Deborah A. Hammond ◽

John B. Kwok ◽

Glenda M. Halliday ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Peripheral Blood ◽

Mononuclear Cells ◽

Rating Scale ◽

Disease Patient ◽

Motor Symptom ◽

Blood Monocytes ◽

Peripheral Blood Monocytes ◽

Classical Monocytes

Background: Reduced activity of lysosomal glucocerebrosidase is found in brain tissue from Parkinson’s disease patients. Glucocerebrosidase is also highly expressed in peripheral blood monocytes where its activity is decreased in Parkinson’s disease patients, even in the absence of GBA mutation. Objective: To measure glucocerebrosidase activity in cryopreserved peripheral blood monocytes from 30 Parkinson’s disease patients and 30 matched controls and identify any clinical correlation with disease severity. Methods: Flow cytometry was used to measure lysosomal glucocerebrosidase activity in total, classical, intermediate, and non-classical monocytes. All participants underwent neurological examination and motor severity was assessed by the Movement Disorders Society Unified Parkinson’s Disease Rating Scale. Results: Glucocerebrosidase activity was significantly reduced in the total and classical monocyte populations from the Parkinson’s disease patients compared to controls. GCase activity in classical monocytes was inversely correlated to motor symptom severity. Conclusion: Significant differences in monocyte glucocerebrosidase activity can be detected in Parkinson’s disease patients using cryopreserved mononuclear cells and monocyte GCase activity correlated with motor features of disease. Being able to use cryopreserved cells will facilitate the larger multi-site trials needed to validate monocyte GCase activity as a Parkinson’s disease biomarker.

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The Profile of People with Parkinson’s Disease Included in Community Boxing Exercise Programs

Medical Sciences Forum ◽

10.3390/msf2021005005 ◽

2021 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Josefa Domingos ◽

Tamine Capato ◽

Catarina Godinho

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Negative Impact ◽

Patient Characteristics ◽

Inclusion Criteria ◽

Exercise Programs

Exercise is widely recommended for people with Parkinson (PD). Boxing is a popular mode of training. However, including individuals with less favorable profiles may have a negative impact on participation. We performed a systematic review to study the patient characteristics that were included in boxing exercise programs research and reflect on the possible inclusion criteria that professionals can use for boxing exercise programs. Indications for the best profiles were limited due to the small number of studies. Boxing programs should include people with the diagnosis of PD in earlier stages, independently ambulatory, and without current severe musculoskeletal or cardiovascular conditions.

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Life with Parkinson’s Disease During the COVID-19 Pandemic: The Pressure Is “OFF”

Journal of Parkinson s Disease ◽

10.3233/jpd-202342 ◽

2021 ◽

pp. 1-5

Author(s):

Trine HØrmann Thomsen ◽

Susanna M. Wallerstedt ◽

Kristian Winge ◽

Filip Bergquist

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Symptom ◽

Free Text ◽

Symptom Scores ◽

Related Quality ◽

Health Related ◽

Potential Impact ◽

Swedish Cohort

People with Parkinson’s disease (PwP) have been suggested to be more vulnerable to negative psychological and psycho-social effects of the COVID-19 pandemic. Our aim was to assess the potential impact of the COVID-19 pandemic in PwP. A Danish/Swedish cohort of 67 PwP was analysed. Health-related quality of life (HRQL), depression, anxiety, apathy, sleep and motor symptom-scores were included in the analysis. Additionally, the Danish participants provided free-text descriptions of life during the pandemic. Overall, the participants reported significantly better HRQL during the COVID-19 period compared with before. Reduced social pressure may be part of the explanation. Despite worsened anxiety, night sleep improved.

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Parkinson’s Disease Motor Symptom Progression Slowed with Multisensory Dance Learning over 3-Years: A Preliminary Longitudinal Investigation

Brain Sciences ◽

10.3390/brainsci11070895 ◽

2021 ◽

Vol 11 (7) ◽

pp. 895

Author(s):

Karolina A. Bearss ◽

Joseph F. X. DeSouza

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Daily Living ◽

Rating Scale ◽

Motor Impairment ◽

Motor Dysfunction ◽

Motor Symptom ◽

Significant Group ◽

Rate Of Decline ◽

Symptom Progression

Parkinson’s disease (PD) is a neurodegenerative disease that has a fast progression of motor dysfunction within the first 5 years of diagnosis, showing an annual motor rate of decline of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) between 5.2 and 8.9 points. We aimed to determine both motor and non-motor PD symptom progression while participating in dance classes once per week over a period of three years. Longitudinal data was assessed for a total of 32 people with PD using MDS-UPDRS scores. Daily motor rate of decline was zero (slope = 0.000146) in PD-Dancers, indicating no motor impairment, whereas the PD-Reference group showed the expected motor decline across three years (p < 0.01). Similarly, non-motor aspects of daily living, motor experiences of daily living, and motor complications showed no significant decline. A significant group (PD-Dancers and PD-Reference) by days interaction showed that PD who train once per week have less motor impairment (M = 18.75) than PD-References who do not train (M = 24.61) over time (p < 0.05). Training is effective at slowing both motor and non-motor PD symptoms over three years as shown in decreased scores of the MDS-UPDRS.

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Cannabis and its derivatives for the use of motor symptoms in Parkinson’s disease: a systematic review and meta-analysis

Therapeutic Advances in Neurological Disorders ◽

10.1177/17562864211018561 ◽

2021 ◽

Vol 14 ◽

pp. 175628642110185

Author(s):

Susan J. Thanabalasingam ◽

Brandan Ranjith ◽

Robyn Jackson ◽

Don Thiwanka Wijeratne

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Function ◽

Observational Studies ◽

Meta Analysis ◽

Risk Of Bias ◽

Motor Symptom ◽

Quality Data ◽

Symptom Improvement ◽

Motor Symptoms

Background: Recent changes to the legal status of cannabis across various countries have renewed interest in exploring its use in Parkinson’s disease (PD). The use of cannabinoids for alleviation of motor symptoms has been extensively explored in pre-clinical studies. Objective: We aim to systematically review and meta-analyze literature on the use of medical cannabis or its derivatives (MC) in PD patients to determine its effect on motor function and its safety profile. Methods: We reviewed and analyzed original, full-text randomized controlled trials (RCTs) and observational studies. Primary outcomes were change in motor function and dyskinesia. Secondary outcomes included adverse events and side effects. All studies were analyzed for risk of bias. Results: Fifteen studies, including six RCTs, were analyzed. Of these, 12/15 (80%) mention concomitant treatment with antiparkinsonian medications, most commonly levodopa. Primary outcomes were most often measured using the Unified Parkinson Disease Rating Scale (UPDRS) among RCTs and patient self-report of symptom improvement was widely used among observational studies. Most of the observational data lacking appropriate controls had effect estimates favoring the intervention. However, the controlled studies demonstrated no significant motor symptom improvement overall. The meta-analysis of three RCTs, including a total of 83 patients, did not demonstrate a statistically significant improvement in UPDRS III score variation (MD −0.21, 95% CI −4.15 to 3.72; p = 0.92) with MC use. Only one study reported statistically significant improvement in dyskinesia ( p < 0.05). The intervention was generally well tolerated. All RCTs had a high risk of bias. Conclusion: Although observational studies establish subjective symptom alleviation and interest in MC among PD patients, there is insufficient evidence to support its integration into clinical practice for motor symptom treatment. This is primarily due to lack of good quality data.

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Impaired empathy: A non-motor symptom associated with advanced stages of Parkinson's disease

Basal Ganglia ◽

10.1016/j.baga.2017.02.012 ◽

2017 ◽

Vol 8 ◽

pp. 4

Author(s):

Nele Schmidt ◽

Laura Paschen ◽

Günther Deuschl ◽

Karsten Witt

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Symptom ◽

Advanced Stages

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Stigma Experienced by Parkinson’s Disease Patients: A Descriptive Review of Qualitative Studies

Parkinson s Disease ◽

10.1155/2017/7203259 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 15

Author(s):

Marina Maffoni ◽

Anna Giardini ◽

Antonia Pierobon ◽

Davide Ferrazzoli ◽

Giuseppe Frazzitta

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Literature Review ◽

Subjective Experience ◽

Negative Impact ◽

Social Stigma ◽

Subjective Symptom ◽

Point Of View ◽

Pubmed Database ◽

Related Quality

Parkinson’s disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient’s subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver’s stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients’ and caregiver’s point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.

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A Comparative Study of the Behavioral Profile of the Behavioral Variant of Frontotemporal Dementia and Parkinson’s Disease Dementia

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000512042 ◽

2020 ◽

pp. 182-194

Author(s):

Dinesh Saini ◽

Adreesh Mukherjee ◽

Arijit Roy ◽

Atanu Biswas

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Frontotemporal Dementia ◽

Severe Disease ◽

Executive Dysfunction ◽

Behavioral Symptoms ◽

Parkinson’S Disease Dementia ◽

Subcortical Dementia ◽

Behavioral Profile ◽

Cortical Dementia

Background: Executive dysfunction is the common thread between pure cortical dementia like the behavioral variant of frontotemporal dementia (bvFTD) and subcortical dementia like Parkinson’s disease dementia (PDD). Although there are clinical and cognitive features to differentiate cortical and subcortical dementia, the behavioral symptoms differentiating these 2 conditions are still not well known. Objective: To evaluate the behavioral profile of bvFTD and PDD and compare them to find out which behavioral symptoms can differentiate between the two. Methods: Twenty consecutive patients with bvFTD (>1 year after diagnosis) and 20 PDD patients were recruited according to standard diagnostic criteria. Behavioral symptoms were collected from the reliable caregiver by means of a set of questionnaires and then compared between the 2 groups. Results: bvFTD patients had more severe disease and more behavioral symptoms than PDD. bvFTD patients were different from PDD patients due to their significantly greater: loss of basic emotion (p < 0.001, odds ratio [OR] 44.33), loss of awareness of pain (p < 0.001, OR 44.33), disinhibition (p < 0.001, OR 35.29), utilization phenomenon (p = 0.008, OR 22.78), loss of taste discrimination (p < 0.001, OR 17), neglect of hygiene (p = 0.001, OR 13.22), loss of embarrassment (p = 0.003, OR 10.52), wandering (p = 0.004, OR 9.33), pacing (p = 0.014, OR 9), selfishness (p = 0.014, OR 9), increased smoking (p = 0.014, OR 9), increased alcohol consumption (p = 0.031, OR 7.36), social avoidance (p = 0.012, OR 6.93), mutism (p = 0.041, OR 5.67), and failure to recognize objects (p = 0.027, OR 4.33). The bvFTD patients were also significantly less suspicious (p = 0.001, OR 0.0295), less inclined to have a false belief that people were in their home (p = 0.014, OR 0.11) and had fewer visual illusions/hallucinations (p = 0.004, OR 0.107) than PDD patients. Conclusion: Behavioral symptoms are helpful to distinguish bvFTD from PDD, and thus also cortical dementia with frontal-lobe dysfunction from subcortical dementia.

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