Movement Disorders Clinical Practice最新文献

Background: Anxiety progression in Parkinson's disease (PD) and its link to peripheral inflammation remain unclear.

Objective: This study aimed to determine whether lymphocyte-related inflammatory markers can predict the longitudinal progression of anxiety symptoms in patients with PD.

Methods: This study utilized a large public database to evaluate 13 inflammatory markers associated with lymphocytes. Linear regression and mixed-effects models were employed to assess associations between the inflammatory indicators and anxiety symptoms.

Results: Elevated baseline neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were associated with higher levels of both state and trait anxiety (P < 0.05). An increase in the NLR is indicative of the deterioration of trait anxiety (estimate = 0.455, P = 0.030), especially in late-onset PD (LOPD) patients and males.

Conclusions: The NLR is a potential biomarker for the progression of anxiety in PD patients, indicating that neuroinflammation is related to anxiety.

Background: Psychiatric comorbidities are common in adults with Tourette's Syndrome (TS), and appear to influence both tic severity and quality of life (QOL).

Objective: To assess the association between psychiatric comorbidities, tic severity and QOL in TS.

Methods: We used data from 227 participants in the Calgary and Paris Adult Tic Disorders Clinical Registry. Our aim was to investigate how comorbid psychiatric symptoms impact tic severity, impairment, and QOL. We measured tic severity and impairment with the Yale Global Tic Severity Scale (YGTSS), and QOL with the Gilles de la Tourette Quality of Life Scale (GTS-QOL). Psychiatric symptom severity was assessed using self-report questionnaires: Patient Health Questionnaire 9 (PHQ9) for depression, Generalized Anxiety Disorder 7 (GAD7), Adult ADHD Self-Report Scale (ASRS), and Obsessive-Compulsive Inventory Revised (OCI-R).

Results: Tic severity was higher in participants with ADHD, GAD, or depression, with significant correlations between psychiatric symptom scores and YGTSS scores. Linear regression showed that only the severity of depressive symptoms was significantly associated with tic severity and impairment. Both tic severity and psychiatric symptom severity scores correlated positively with the GTS-QOL Total Score and subscale scores. Depressive symptoms had the strongest correlation with GTS-QOL Total Score, followed by ADHD. Linear regression of GTS-QOL Total scores revealed significant relationships with all symptom severity variables.

Conclusion: Both tic severity and, notably, depression and ADHD, significantly impact QOL. These interactions are complex, underlining the critical need for multidisciplinary care for adults with TS.

Background: Motor speech disorders are early, common, and functionally limiting features of atypical parkinsonian disorders (APDs) such as progressive supranuclear palsy (PSP), corticobasal syndrome (CBS), and multiple system atrophy (MSA). These impairments are underrecognized and undertreated in neurology clinics.

Objectives: This review aims to characterize speech impairment in APDs, offer practical guidance for clinical evaluation, highlight the role of Speech-Language pathologists (SLPs) in diagnosis and management, and outline current and emerging management strategies.

Methods: A narrative review was conducted by the Diagnosis and Treatment Working Group of CurePSP's Centers of Care, integrating literature and clinical experience to summarize evaluation, diagnosis, and treatment of motor speech disorders in APDs.

Results: Speech changes in APDs are often mixed dysarthrias with hypokinetic, spastic, and/or ataxic components, and may include apraxia of speech; these are frequently more severe and progress quicker than in Parkinson's disease. These features can assist in differential diagnosis and should prompt early referral to SLPs. Despite the high prevalence of speech and voice changes, comprehensive assessment of motor speech disorders is uncommon in neurology clinics. Current evidence regarding the efficacy of interventions is mixed. Digital acoustic analysis and neuromodulation offer promising directions for diagnosis and treatment.

Conclusions: Early, collaborative management of motor speech impairment elevates care in APDs. Neurologists and SLPs must work together to improve recognition, diagnosis, and care. Future research should focus on objective biomarkers and personalized therapies to support communication, autonomy, and quality of life for individuals living with APDs.

Background: Little is known about how people with Parkinson's conceptualize "quality of life."

Objective: To describe the meaning of "quality of life" from the perspective of people with Parkinson's.

Methods: Participants (N = 42) were asked "What does the term 'quality of life' mean to you?" Definitions were analyzed using inductive qualitative methods.

Results: Quality of life is captured in a framework illustrating how activities, experiences, and coping strategies generate positive feelings that collectively shape the mental state that defines quality of life.

Conclusions: People with Parkinson's typically define what constitutes a good quality of life, with health status acting as an enabler (or barrier). Multiple factors, varying across individuals and potentially changing with circumstances, shape how people view their quality of life, and offer potential avenues for sustaining it. These personal, subjective and adaptive conceptualizations of quality of life should inform the design of interventions and measurement instruments.