Parkinson's Disease最新文献

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.

Introduction: Early-onset Parkinson's disease (EOPD) shares similar clinical features to the late-onset form, but the risk of injury remains unclear. This study aimed to evaluate the risk of traumatic injury, including fracture, in patients with EOPD.

Methods: This matched cohort study used a Japanese administrative claims database to compare the risk of traumatic injury and fracture between EOPD patients and the general population. EOPD was defined by diagnosis between ages 21 and 49 together with the initiation of anti-PD medication. Crude incidence rates and adjusted hazard ratios (aHRs) were estimated using Poisson and Cox regression models. Subgroup analyses were performed by age and sex.

Results: In 368 EOPD patients and 1586 matched individuals from the general population, the traumatic injury rate was slightly higher in EOPD patients (9.5 vs. 7.9 events per 100 person-years), but the difference was not substantial (aHR, 1.2; 95% confidence interval [CI], 0.9-1.5). Fracture risk in the groups was similar, at 1.4 events per 100 person-years (aHR, 0.9; 95% CI, 0.5-1.6). Subgroup analyses showed an increased traumatic injury risk in EOPD patients aged 40-49 years (aHR, 1.4; 95% CI, 1.0-1.8) and in females (aHR, 1.3; 95% CI, 1.0-1.8). No clear differences were observed in other comparisons.

Conclusion: No major difference in traumatic injury or fracture risk was found between EOPD patients and the general population. However, preventive interventions may be warranted for patients aged 40-49 years and for females due to their elevated injury risk.

Background: Parkinson's disease (PD) is an age-related neurodegenerative condition with a range of motor and nonmotor symptoms. Nonmotor symptoms such as constipation and orthostatic hypotension can occur at any stage, while dysphagia is common in later stages of the disease. Previous work by our group showed that people with PD who lose weight within a year of diagnosis had a poorer prognosis. In this study, we explored whether fluid intake was also reduced in people with newly diagnosed PD.

Materials and methods: We invited people with newly diagnosed PD (within 6 months of a diagnosis or longer if not requiring treatment) to join the study. Controls were household members of the participants with PD. Participants all underwent the same assessments, including a 24-h dietary recall, a video-recorded swallowing assessment, and grading of stool sample consistency using the Bristol Stool Chart.

Results: We recruited 30 participants, 19 with PD and 11 household controls. People living with PD reported significantly lower fluid intake from drinks (control median = 1799 mL, PD median = 1124 mL, p=0.005 for difference in medians). People with PD drank fluid slightly slower than the controls, 6.0 mL/second vs 7.5 mL/second, but this did not reach statistical significance. Participants with PD had significantly harder stools than controls, with a mean Bristol Stool Chart number of 3.2 vs 4.6 for controls (p=0.01).

Conclusion: PD is associated with significantly reduced intake of fluids from beverages around the time of diagnosis, which may contribute to constipation and orthostatic hypotension.