Parkinson's Disease最新文献

Background: Parkinson's disease (PD) is characterized by motor symptoms but also includes nonmotor impairments such as sensory disturbances. Temporal discrimination (TD) deficits have been repeatedly demonstrated, while proprioceptive dysfunction is also common in PD. The exact significance of these alterations, and whether they represent related aspects of a common pathophysiological process, remains elusive.

Methods: We investigated somatosensory and kinesthetic TD as well as proprioceptive accuracy in 20 PD patients and compared 20 age- and sex-matched healthy controls (HCs). Somatosensory TD threshold (STDT) was assessed using paired cutaneous electrical stimuli and TD motor thresholds (TDMTs) by electrically induced wrist flexions. Proprioception was measured with two tasks requiring wrist flexion to predefined angles (LED task) or to reproduce angular ranges (ARROW task), without visual feedback. Clinical assessment comprised MDS-UPDRS III, Hoehn and Yahr stage, levodopa dosage, and disease duration.

Results: PD patients exhibited significantly elevated thresholds compared to HC for both STDT (120.3 ± 42.3 ms vs. 80.8 ± 17.1 ms, p = 0.001) and TDMT (107.1 ± 43.7 ms vs. 77.0 ± 16.3 ms, p = 0.011). Proprioceptive errors were also higher in PD for the LED (6.7° ± 2.2° vs. 3.2° ± 1.9°, p < 0.001) and ARROW tasks (14.2° ± 3.4° vs. 2.1° ± 0.8°,p < 0.001). No significant correlations were observed between TD, proprioceptive measures, or clinical severity indices.

Conclusions: PD patients show pronounced impairments in both TD and proprioceptive accuracy, confirming sensory processing deficits beyond motor dysfunction. The absence of correlations suggests distinct mechanisms, highlighting the need for further neurophysiological research.

Background: Online exercise groups for people with Parkinson's disease (PwP) are increasing in popularity, but little is known about PwP's experiences with them.

Objective: To explore the views and experiences of PwP who have utilised Parkinson's disease-specific online exercise groups.

Methods: A qualitative study utilising semistructured interviews and thematic analysis in a purposive sample of PwP who had participated in an online exercise group.

Results: Nine participants (5 females) with a mean age of 69.5 (63-78) years and a mean disease duration of 9.1 (3-20) years participated. Analysis revealed three overarching themes: 'Considerations of online exercise groups for PwP', which highlighted the pros and cons of attending online exercise classes; 'Online exercise class qualities', including the importance of a tailored approach, clearly communicated aims and the importance of a well-informed instructor; and 'Accessibility', which included considerations of convenience of access, costs and technological access.

Conclusion: Online exercise groups may play an important role in future Parkinson's disease management by offering greater access to exercise. They may also perpetuate inequalities for PwP and lack the social engagement many PwP seek. Hybrid group exercise, a combination of online and face-to-face classes, could provide this. Providers must develop classes that are tailored to PwP and delivered by well-informed instructors.

Background: Fatigue is a common and disabling nonmotor symptom of Parkinson's disease (PD), which significantly impacts gait and overall mobility. In spite of its clinical significance, the biomechanical consequences of different fatigue induction protocols on gait performance in PD are not yet well understood.

Objective: To systematically review fatigue induction protocols in gait studies of individuals with PD and to examine how different types of fatigue (local, general, and cognitive) and assessment methods influence gait outcomes.

Methods: In accordance with PRISMA guidelines registered under PROSPERO (CRD420251038246), five databases were systematically searched from January 2004 to March 2025. Seven studies met the inclusion criteria and were reviewed and analyzed through descriptive synthesis.

Results: Repeated sit-to-stand tasks were the most effective in inducing lower-limb fatigue and produced consistent changes in gait, including reduced stride length, slower speed, and impaired turning. General aerobic or functional tasks had inconsistent effects, and no study directly tested cognitive fatigue on gait. Fatigue assessment methods varied widely, including force decline, perceived exertion, and fatigue scales. Gait outcome measures were also heterogeneous, limiting comparability.

Conclusion: Targeted lower-limb fatigue protocols are effective in revealing gait impairments in PD. There is a clear need for standardized fatigue induction procedures and gait evaluation methods to improve consistency and comparability across research. Clinically, assessing gait under fatigue conditions may uncover subtle mobility impairments and inform more personalized rehabilitation strategies.

Background: There is a notable gap in racial and ethnic representation in Parkinson's disease (PD) research, particularly among American Indian and Alaska Native (AIAN) populations, despite a higher prevalence of PD in these groups. This study investigated research participation among AIAN individuals in terms of perceived access to research opportunities, willingness to participate, and potential concerns about participation.

Methods: Data were obtained from the online Fox Insight (FI) study. A total sample of 4412 individuals who self-reported their race as White (n = 4363) or AIAN (n = 49) were selected. The Attitudes and Beliefs Regarding Research and Genetic Testing for PD survey was administered to assess participants' attitudes and knowledge about the research process, opportunities, and preferences.

Results: A significantly smaller proportion of AIAN individuals (34.7%) reported concurrent or past participation in PD research compared with White non-AIAN participants (52.9%). Despite this lower participation rate and limited knowledge of research opportunities, a large majority of AIAN individuals (89.8%) expressed a willingness to participate in research. Additionally, both AIAN and White non-AIAN participants reported similar rates of concerns about research participation. Among AIAN individuals, the most common barriers were distance from research site, transportation, and time commitments.

Conclusion: These findings highlight that low research participation among AIAN individuals may be more associated with low engagement from the research community rather than unwillingness or relatively greater research concerns. Building stronger partnerships with tribal communities and involving community leaders to build trust may improve research representation among AIAN populations.

Objective: The main goal of this study is to explore the link between herpes simplex virus 1 (HSV-1) infection and Parkinson's disease (PD) from the genome-wide association studies (GWAS) data and find the shared molecular signature for mechanism understanding and drug repurposing from the transcriptomics data.

Methods: We used summary-level GWAS data for causal inference, exploring the association between herpes keratitis (mainly caused by HSV-1) and PD, and used transcriptomics data to study the shared molecular signature for mechanism understanding and drug repurposing.

Results: The causal inference analysis implied that HSV-1 infection is related to PD. The upregulated shared gene set between HSV-1 infection and PD is mainly enriched in neuroinflammation, while the downregulated shared gene set is mainly enriched in stem cell and cellular metabolism, and the drug repurposing targeted the shared molecular signature nalfurafine.

Conclusion: HSV-1 infection is related to PD, and these two diseases had shared molecular signature such as neuroinflammation and stem cell, which could be targeted for drug repurposing.

Oxidative stress is a major contributor to the pathogenesis of Parkinson's disease, promoting neuronal degeneration through the production of excessive reactive oxygen species. In this context, natural products such as essential oils are attracting increasing attention for their potential to protect neurons. Clove essential oil (CEO), which is extracted from the flower buds of the plant Syzygium aromaticum, is renowned for its antioxidant activity. This study aimed to investigate the chemical composition, antioxidant properties, and protective effects of CEO on SH-SY5Y cells, which are used as a cellular model of Parkinson's disease. The CEO was obtained by hydrodistillation (yield: 15%) and is primarily composed of eugenol (84.49%) and acetyl-eugenol (10.05%). Its antioxidant activity was confirmed via DPPH radical scavenging (IC₅₀ = 0.081 ± 0.001 mg/mL) and iron chelation (110.32 ± 0.67 mg EDTA equivalent/g essential oil (EO)). qRT-PCR, Western blot, and slot blot techniques demonstrated that CEO pretreatment at concentrations of 2.5, 5, and 10 μg/mL significantly reduced 6-OHDA-induced oxidative DNA damage and restored the gene and protein expression of key antioxidant enzymes (GPx1, GPx4, SOD1, and CAT). These results highlight the powerful antioxidant and neuroprotective properties of CEO, supporting its potential as a therapeutic agent for neurodegenerative disorders related to oxidative stress, such as Parkinson's disease.

Empowerment and implementation of self-management strategies are vital components in the future care of chronic, neurological patient groups, including people with Parkinson's disease (PD). This study aimed to evaluate the feasibility and effectiveness of an 8-week self-management intervention designed for people with PD (PwP) with follow-up assessments at 3 and 6 months postintervention. The program focused on developing self-management skills, coping strategies, disease education, mindfulness, exercise routines, and individual goal-setting tools. Objective measurements using Parkinson's KinetiGraph™ (PKG) were employed to monitor motor symptoms, immobility levels, and burden of nonmotor symptoms (self-reported in the PKG portal). Participants, serving as their own controls, were recruited from movement disorder clinics, private neurologists, and a specialized rehabilitation center. Primary endpoints were change in Health Education Impact Questionnaire (HeiQ) and Health Literacy Questionnaire (HLQ-14) scores, assessed at baseline and at 3- and 6-month follow-up. Secondary endpoints included changes in quality of life, self-efficacy, motor symptoms (PKG data), nonmotor symptoms, contacts to the clinics 6 months before and after the intervention, and time spent with immobility. Eighty PwP completed the program, and 59 caregivers attended the educational sessions. Statistically significant changes were found between baseline and follow-up in the motor symptom burden, self-efficacy, and reduced clinical contacts. Although no statistical changes were observed in health literacy, quality of life, and nonmotor symptoms, sustained positive trends were observed. The findings suggest that the program may enhance empowerment and self-management strategies in PwP, particularly in self-efficacy level, managing motor symptoms, and less need of contact to the clinics.

Background: Parkinson's disease (PD) is a progressive neurodegenerative disorder impacting the quality of life, with a notable prevalence worldwide, including China. Rotigotine, a silicone-based patch that transdermally delivers a dopamine agonist, has shown promise as a PD treatment option.

Objective: This study aimed to evaluate the safety and effectiveness of rotigotine in a real-world Chinese population.

Method: This multicenter, prospective, noninterventional postmarketing surveillance study was conducted across 27 hospitals in China from March 2021 to June 2023. It included adult patients with early and advanced idiopathic PD, newly initiating rotigotine (includes receiving rotigotine up to four weeks prior to enrollment). Safety was assessed through treatment-emergent adverse drug reactions (ADRs), serious adverse events (AEs) (SAEs), and treatment discontinuations due to AEs. Effectiveness was evaluated using the Patient Global Impression of Change (PGIC), Wearing-Off Questionnaire-9 (WOQ-9), and PD Questionnaire-8 (PDQ-8).

Results: Of 829 enrolled patients, 803 were included in the safety set and 572 in the full analysis set. The study reported a safety profile consistent with previous studies, with the most common AE being application site pruritus. The incidence of ADRs was 17.6%, lower than in previous Chinese Phase 3 studies and a Japanese noninterventional study. Over half of the patients reported improvement in PD symptoms as per PGIC, and PDQ-8 scores indicated an overall improvement in quality of life, particularly in patients with advanced PD.

Conclusions: This study reaffirms the safety and effectiveness of rotigotine in a real-world Chinese PD population, including both early and advanced stages, aligning with previous research findings.

Background: Although patients with Parkinson's disease eventually experience motor complications and gait problems including falls, introducing the necessity for gait assistance, or freezing of gait, there may be a medication dose at which patients do not experience both in the early stage of the disease.

Objectives: To identify the medication dose at which Parkinson's disease patients, diagnosed and treated at our hospital, did not experience motor complications and gait problems.

Methods: We retrospectively reviewed the clinical course, including motor complications and gait problems, of 119 newly diagnosed patients with Parkinson's disease for 24 months after the introduction of medical treatment. According to the presence of motor complications and/or gait problems, we categorized the patients into Groups 1-3. We estimated the median latency of motor complications or gait problems by Kaplan-Meier survival analysis. We calculated the levodopa equivalent dose.

Results: Group 1 contained 25 patients with neither motor complications nor gait problems; Group 2 contained 40 patients who experienced motor complications first with a median latency of 11 months; and Group 3 contained 54 patients who experienced gait problems first with a median latency of 9 months. There were significant differences in the levodopa equivalent dose at 24 months among the groups: 250 mg in Group 1, 300 mg in Group 2, and 225 mg in Group 3.

Conclusions: Patients with Parkinson's disease receiving a levodopa equivalent dose between 225 and 300 mg did not experience motor complications and gait problems for 24 months after the introduction of medical treatment.

Background: Parkinson's disease (PD) is the second most common neurodegenerative disorder with significant social costs, mainly owing to hospitalization, which is frequently associated with high levodopa equivalent daily dose (LEDD) and polypharmacy rather than neurological symptoms alone. Integrative treatment combining Western and Korean medicine may help control these factors and reduce the need for hospitalization. We investigated the potential impact of integrative treatment on LEDD and polypharmacy in patients with PD > 5 years postdiagnosis.

Methods: Fifteen patients with PD (KCD code G20), diagnosed > 5 years earlier, who received integrative treatment at Gwangju Korean Medicine Hospital, Wonkwang University, from April 1, 2022, to July 30, 2024, were enrolled. A retrospective chart review was conducted to collect demographic and clinical data, including LEDD, medication count, and treatment details. Summary statistics were presented as median (IQR) and mean ± SD.

Results: In the integrative treatment cohort, the prevalence of both LEDD and polypharmacy was lower than that in studies involving conventional treatment alone. The mean LEDD was 321.71 (median, 200.0) mg, while only two patients exceeded the LEDD threshold of 300 mg, which was associated with motor complications. Polypharmacy was observed in 13.3% of patients and hyperpolypharmacy in 6.7%, representing lower proportions compared with previous reports on conventional treatments. Representative cases highlighted symptom improvement and a reduced need for medication with integrative approaches, particularly acupuncture and herbal medicine.

Conclusion: These findings suggest that integrative treatment may contribute to lowering LEDD and medication counts in patients with PD, which could potentially reduce hospitalization rates and the associated social costs. Further prospective studies comparing the integrative and nonintegrative treatment groups are needed to clarify these findings and evaluate the role of integrative treatment in the long-term management of PD.