scholarly journals Therapeutic Applications of Botulinum Neurotoxin for Autonomic Symptoms in Parkinson’s Disease: An Updated Review

Toxins ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 226
Author(s):  
Steven D. Mitchell ◽  
Christos Sidiropoulos
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Botulinum Neurotoxin ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Autonomic Nervous System Dysfunction ◽  
Autonomic Symptoms ◽  
Age Related ◽  
Non Motor Symptoms

Parkinson’s disease is the most common age-related motoric neurodegenerative disease. In addition to the cardinal motor symptoms of tremor, rigidity, bradykinesia, and postural instability, there are numerous non-motor symptoms as well. Among the non-motor symptoms, autonomic nervous system dysfunction is common. Autonomic symptoms associated with Parkinson’s disease include sialorrhea, hyperhidrosis, gastrointestinal dysfunction, and urinary dysfunction. Botulinum neurotoxin has been shown to potentially improve these autonomic symptoms. In this review, the varied uses of botulinum neurotoxin for autonomic dysfunction in Parkinson’s disease are discussed. This review also includes discussion of some additional indications for the use of botulinum neurotoxin in Parkinson’s disease, including pain.

scholarly journals Evaluation of fecal microbiota transplantation in Parkinson's disease patients with constipation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiao-yi Kuai ◽  
Xiao-han Yao ◽  
Li-juan Xu ◽  
Yu-qing Zhou ◽  
Li-ping Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Before And After ◽  
Non Motor Symptoms

AbstractParkinson’s disease (PD) is a neurodegenerative disorder and 70–80% of PD patients suffer from gastrointestinal dysfunction such as constipation. We aimed to assess the efficacy and safety of fecal microbiota transplantation (FMT) for treating PD related to gastrointestinal dysfunction. We conducted a prospective, single- study. Eleven patients with PD received FMT. Fecal samples were collected before and after FMT and subjected to 16S ribosomal DNA (rDNA) gene sequencing. Hoehn-Yahr (H-Y) grade, Unified Parkinson's Disease Rating Scale (UPDRS) score, and the Non-Motion Symptom Questionnaire (NMSS) were used to assess improvements in motor and non-motor symptoms. PAC-QOL score and Wexner constipation score were used to assess the patient's constipation symptoms. All patients were tested by the small intestine breath hydrogen test, performed before and after FMT. Community richness (chao) and microbial structure in before-FMT PD patients were significantly different from the after-FMT. We observed an increased abundance of Blautia and Prevotella in PD patients after FMT, while the abundance of Bacteroidetes decreased dramatically. After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.

scholarly journals Non–motor Symptoms in Parkinson’s Disease: It’s Relationship with Age of Onset, Duration and Stage of Disease and the Dose and Duration of Levodopa Usage

1970 ◽  
Vol 21 (1) ◽  
pp. 12-17
Author(s):  
M Ahmed Ali ◽  
Anisul Haque ◽  
AKM Anwarulla ◽  
Quamruddin Ahmad
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychiatric Symptoms ◽  
Disease Onset ◽  
Motor Symptoms ◽  
Autonomic Symptoms ◽  
Prolonged Duration ◽  
Relationship Of ◽  
The Relationship ◽  
Non Motor Symptoms

Parkinson's disease is a disease of motor manifestations but non-motor symptoms are also common in Parkinson's disease. Little emphasis is put on non-motor symptoms of PD and there is little data on the relationship of non-motor symptoms to different aspects of the patient and the disease. In this study the relationship of non-motor symptoms to age at onset, duration and stage of the disease, and dose and duration of levodopa use are studied.128 patients of PD were studied for non-motor symptoms. 111 patients had different types of sensory, autonomic or psychiatric symptoms. Sensory and autonomic symptoms were significantly more common in patients with early age of disease onset and more prolonged duration of the disease, but psychiatric symptoms had no relationship with these factors. In this study it was also found that the frequencies of non-motor symptoms were related to the stage of the disease, longer the duration of the disease more and more non-motor symptoms appear so that 100% patients in stage 5 of the disease had non-motor symptoms. Also sensory and autonomic symptoms were significantly more common in patients with longer duration and higher dose of levodopa use but psychiatric symptoms were significantly commoner in patients with prolonged duration of levodopa use but not to dose of levodopa used.   doi: 10.3329/taj.v21i1.3211 TAJ 2008; 21(1): 12-17

scholarly journals Could Small Heat Shock Protein HSP27 Be a First-Line Target for Preventing Protein Aggregation in Parkinson’s Disease?

2021 ◽  
Vol 22 (6) ◽  
pp. 3038
Author(s):  
Javier Navarro-Zaragoza ◽  
Lorena Cuenca-Bermejo ◽  
Pilar Almela ◽  
María-Luisa Laorden ◽  
María-Trinidad Herrero
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Heat Shock ◽  
Stress Proteins ◽  
Small Heat Shock Protein ◽  
Substantia Nigra Pars Compacta ◽  
Motor Symptoms ◽  
Dopaminergic Drugs ◽  
Non Motor Symptoms

Small heat shock proteins (HSPs), such as HSP27, are ubiquitously expressed molecular chaperones and are essential for cellular homeostasis. The major functions of HSP27 include chaperoning misfolded or unfolded polypeptides and protecting cells from toxic stress. Dysregulation of stress proteins is associated with many human diseases including neurodegenerative diseases, such as Parkinson’s disease (PD). PD is characterized by the presence of aggregates of α-synuclein in the central and peripheral nervous system, which induces the degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and in the autonomic nervous system. Autonomic dysfunction is an important non-motor phenotype of PD, which includes cardiovascular dysregulation, among others. Nowadays, the therapies for PD focus on dopamine (DA) replacement. However, certain non-motor symptoms with a great impact on quality of life do not respond to dopaminergic drugs; therefore, the development and testing of new treatments for non-motor symptoms of PD remain a priority. Since small HSP27 was shown to prevent α-synuclein aggregation and cytotoxicity, this protein might constitute a suitable target to prevent or delay the motor and non-motor symptoms of PD. In the first part of our review, we focus on the cardiovascular dysregulation observed in PD patients. In the second part, we present data on the possible role of HSP27 in preventing the accumulation of amyloid fibrils and aggregated forms of α-synuclein. We also include our own studies, highlighting the possible protective cardiac effects induced by L-DOPA treatment through the enhancement of HSP27 levels and activity.

scholarly journals Microbiota and Parkinson's disease (overview)

2020 ◽  
pp. 10-14
Author(s):  
R. R. Tyutina ◽  
A. A. Pilipovich ◽  
V. L. Golubev ◽  
Al. B. Danilov
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Substantia Nigra ◽  
Subsequent Development ◽  
Alpha Synuclein ◽  
Intestinal Wall ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Parkinson's disease (PD) is characterized by both motor (hypokinesia, resting tremor, rigidity, postural instability) and non-motor symptoms. It is known that some non-motor manifestations, such as disturbances in smell, sleep, depression, gastrointestinal dysfunction, and others, may precede motor symptoms. Replenishment of dopamine deficiency, which, as known, develops in PD due to the death of dopaminergic neurons of the substantia nigra, makes it possible to influence most motor and some non-motor symptoms of parkinsonism, however many non-motor manifestations remain resistant to this therapy. In addition, it has only a symptomatic effect, and the pathogenetic treatment of PD is currently unavailable, which is primarily due to insufficient knowledge about the etiology and mechanisms of the development of the disease. In particular, it has already been established that alpha synuclein (a pathomorphological marker of PD) begins to be deposited in the intestinal wall, in the enteric nervous system (ENS) long before it appears in neurons of the substantia nigra. Understanding the mechanism of interaction along the axis “intestine – brain”, the role of intestinal wall dysfunction in the onset and development of PD can lead to the development of new directions in the treatment of this disease. Today, the role of microbiota, in particular the intestinal microbiota, in the functioning of the human body, its various systems, including the nervous system, is widely studied in the world. The influence of its imbalance on the activation of inflammatory reactions in the ENS and the possibility of the subsequent development of PD are considered. This review provides some evidence supporting the hypothesis that PD can be initiated in the gut. In addition, the possibilities of influencing the course of BP using pre-, pro-, syn- and metabiotics are considered.

scholarly journals Parkinson’s disease and translational research

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Elisabeth Dinter ◽  
Theodora Saridaki ◽  
Leonie Diederichs ◽  
Heinz Reichmann ◽  
Björn H. Falkenburger
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Translational Research ◽  
Dopaminergic Neurons ◽  
Therapeutic Options ◽  
Motor Symptoms ◽  
New Approaches ◽  
Biological Phenomena ◽  
Non Motor Symptoms

AbstractParkinson’s disease (PD) is diagnosed when patients exhibit bradykinesia with tremor and/or rigidity, and when these symptoms respond to dopaminergic medications. Yet in the last years there was a greater recognition of additional aspects of the disease including non-motor symptoms and prodromal states with associated pathology in various regions of the nervous system. In this review we discuss current concepts of two major alterations found during the course of the disease: cytoplasmic aggregates of the protein α-synuclein and the degeneration of dopaminergic neurons. We provide an overview of new approaches in this field based on current concepts and latest literature. In many areas, translational research on PD has advanced the understanding of the disease but there is still a need for more effective therapeutic options based on the insights into the basic biological phenomena.

scholarly journals Evaluation of Fecal Microbiota Transplantation in Parkinson's Disease Patients With Constipation

2021 ◽  
Author(s):  
Xiao-yi Kuai ◽  
Xiao-han Yao ◽  
Li-Juan Xu ◽  
Yu-qing Zhou ◽  
Li-ping Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Before And After ◽  
Non Motor Symptoms

Abstract Parkinson’s disease (PD) is a neurodegenerative disorder and 70–80% of PD patients suffer from gastrointestinal dysfunction such as constipation. We aimed to assess the efficacy and safety of fecal microbiota transplantation (FMT) for treating PD related to gastrointestinal dysfunction. We conducted a prospective, single- study. Eleven patients with PD received FMT. Fecal samples were collected before and after FMT and subjected to 16S ribosomal DNA (rDNA) gene sequencing. Hoehn-Yahr (H-Y) grade, Unified Parkinson's Disease Rating Scale (UPDRS) score, and the Non-Motion Symptom Questionnaire (NMSS) were used to assess improvements in motor and non-motor symptoms. PAC-QOL score and Wexner constipation score were used to assess the patient's constipation symptoms. All patients were tested by the small intestine breath hydrogen test, performed before and after FMT. Community richness (chao) and microbial structure in before-FMT PD patients were significantly different from the after-FMT. We observed an increased abundance of Blautia and Prevotella in PD patients after FMT, while the abundance of Bacteroidetes decreased dramatically. After FMT, the H-Y grade, UPDRS, and NMSS of PD patients decreased significantly. Through the lactulose H2 breath test, the intestinal bacterial overgrowth (SIBO) in PD patients returned to normal. The PAC-QOL score and Wexner constipation score in after-FMT patients decreased significantly. Our study profiles specific characteristics and microbial dysbiosis in the gut of PD patients. FMT might be a therapeutic potential for reconstructing the gut microbiota of PD patients and improving their motor and non-motor symptoms.

Autonomic Symptoms Correlate with Non-Autonomic Non-Motor Symptoms and Sleep Problems in Patients with Parkinson’s Disease

2018 ◽  
Vol 80 (3-4) ◽  
pp. 193-199 ◽  
Author(s):  
Takeo Matsubara ◽  
Keisuke Suzuki ◽  
Hiroaki Fujita ◽  
Yuji Watanabe ◽  
Hirotaka Sakuramoto ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Problems ◽  
Linear Regression Analysis ◽  
Motor Symptom ◽  
Motor Symptoms ◽  
Symptom Scale ◽  
Autonomic Symptoms ◽  
Dat Scan ◽  
Non Motor Symptoms

Objective: The objective of this study was to clarify the relationship between autonomic and non-autonomic non-motor symptoms in patients with Parkinson’s disease (PD). Methods: Sixty-five PD patients were included in this study (27 men and 38 women; aged 68.5 ± 10.0; Hoehn and Yahr (HY) stage 2.6 ± 1.1). The autonomic symptoms were evaluated by the Japanese version of the Scales for outcomes in PD autonomic (SCOPA-AUT) questionnaire. The patients were assessed with the mini-mental state examination (MMSE), PD sleep evaluation scale-2 (PDSS-2), Epworth sleepiness scale (ESS) and Beck’s depression inventory II (BDI-II). The Non-Motor Symptom Scale (NMSS) total scores and subscores of non-autonomic non-motor symptom domains (sleep/fatigue, mood/cognition, perceptual problems/hallucination, and attention/memory) were evaluated. A dopamine transporter (DAT) scan, metaiodobenzylguanidine (MIBG) myocardial scintigraphy, and card type olfactory identification test (open essence [OE, Wako]) were performed. Results: The SCOPA-AUT total score was positively correlated with the disease duration, HY stage, levodopa equivalent dose, PDSS-2, ESS, BDI-II and non-autonomic NMSS and inversely correlated with the MMSE. The high-SCOPA-AUT group (≥9) had lower MMSE scores and higher PDSS-2, ESS, BDI-II and non-motor NMSS scores than the low-SCOPA-AUT group (< 9). The DAT scan, MIBG uptake and OE score did not differ between the groups. In a stepwise linear regression analysis, which excluded possibly overlapping items among the scales, the subtotals of PDSS-2 items, except for item 8 (nocturia), (p < 0.0001) and non-autonomic NMSS domains (p = 0.00040) were significant predictors of the total SCOPA-AUT score. Conclusion: Our study shows significant correlations among autonomic symptoms, PD-related sleep problems and non-autonomic non-motor symptoms in PD patients.

scholarly journals The gut-brain axis in the pathogenesis of Parkinson’s disease

2019 ◽  
Vol 5 (2) ◽  
pp. 73-81 ◽  
Author(s):  
Lanxia Meng ◽  
Xin Yuan ◽  
Xuebing Cao ◽  
Zhentao Zhang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Substantia Nigra ◽  
Enteric Nervous System ◽  
Lewy Bodies ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Neurodegenerative Process ◽  
The Central Nervous System

Parkinson’s disease (PD) is the second most common neurodegenerative disease. Its pathological markers include Lewy bodies and Lewy neuritis, which primarily affect the substantia nigra. However, in recent years, mounting evidence suggests that PD is a multifocal neurodegenerative process that influences several neuronal structures aside from the substantia nigra, one of which is the enteric nervous system. Many clinical studies have reported that patients with PD experience gastrointestinal dysfunction for many years before the onset of motor symptoms. Emerging evidence indicates that α-synuclein deposition may start in the enteric nervous system and then propagate to the central nervous system. The gut-brain axis plays an important role in PD pathogenesis. Recent evidence suggests that these interactions may be primarily affected by the intestinal microbiota. In this review, the authors discuss recent research, and illustrate how changes in the composition of the gut microbiota may trigger inflammation, thus contributing to neurodegeneration in PD.

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