Parkinsonism & related disorders最新文献

英文中文

Impact of type 2 diabetes on the development of dementia and death in Parkinson's disease 2型糖尿病对帕金森病患者痴呆发展和死亡的影响

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-06 DOI: 10.1016/j.parkreldis.2026.108187

Seung Hyun Lee , Jooyoung Lee , Mina Kim , Da-woon Kim , Yun Su Hwang , Kye Won Park , Sungyang Jo , Ji-Hoon Kang , Richard J. Cook , Sun Ju Chung

Background

Increasing evidence suggests that type 2 diabetes (T2DM) can influence the progression of Parkinson's disease (PD). However, it remains unclear whether T2DM increases the risk of progression to dementia and death in PD.

Objective

This study aimed to investigate the impact of T2DM on the risk of developing dementia and death following a diagnosis of PD.

Methods

We examined 158,962 individuals (aged 60 years or older) without PD or dementia using the Korean National Health Insurance Service (NHIS)-senior cohort database. A multi-state model was used to estimate the hazard ratios characterizing the effect of T2DM on the risk of PD, dementia, and death while adjusting for potential confounding factors. Results were analyzed according to age and sex.

Results

T2DM increased the risk of development of PD (adjusted hazard ratio [aHR]: 1.26, 95 % confidence interval [CI]: 1.11–1.42), dementia (aHR: 1.31, 95 % CI: 1.24–1.39), or death (aHR: 1.58, 95 % CI: 1.52–1.65) compared to those without T2DM. However, after PD diagnosis, T2DM was not associated with progression to dementia (aHR: 1.09, 95 % CI: 0.96–1.48) and death (aHR: 1.10, 95 % CI: 0.85–1.42) although subgroup analysis showed an elevated risk for the progression from PD to dementia (aHR: 1.41 95 % CI: 1.06–1.89) in individuals under 70 years of age.

Conclusions

T2DM increases the risk of PD, dementia, and death in the elderly population. However, its effect on the progression to dementia and death may occur independently of the onset of PD, despite significant age-related heterogeneity.

越来越多的证据表明，2型糖尿病（T2DM）可以影响帕金森病（PD）的进展。然而，目前尚不清楚T2DM是否会增加PD患者进展为痴呆和死亡的风险。目的本研究旨在探讨T2DM对PD诊断后发生痴呆和死亡风险的影响。方法：我们使用韩国国民健康保险服务（NHIS）老年人队列数据库对158,962名（60岁及以上）无PD或痴呆的个体进行了检查。在校正潜在混杂因素的同时，采用多状态模型估计T2DM对PD、痴呆和死亡风险影响的风险比。结果按年龄和性别进行分析。结果与非T2DM患者相比，st2dm患者发生PD（校正危险比[aHR]: 1.26, 95%可信区间[CI]: 1.11-1.42）、痴呆（aHR: 1.31, 95% CI: 1.24-1.39）或死亡（aHR: 1.58, 95% CI: 1.52-1.65）的风险增加。然而，在PD诊断后，T2DM与进展为痴呆（aHR: 1.09, 95% CI: 0.96-1.48）和死亡（aHR: 1.10, 95% CI: 0.85-1.42）无关，尽管亚组分析显示70岁以下个体从PD进展为痴呆的风险升高（aHR: 1.41 95% CI: 1.06-1.89）。结论st2dm可增加老年人群PD、痴呆和死亡的风险。然而，尽管存在明显的年龄相关性异质性，但其对痴呆进展和死亡的影响可能与PD的发病无关。

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引用次数: 0

Letter to the editor: Acupuncture as a phenotype-specific adjunct for fear-of-falling in Parkinson's disease 致编辑的信：针灸作为一种表型特异性辅助治疗帕金森病的跌倒恐惧

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108185

Dandan Wang , Ying Chen, Zhicun Han

Introduction

Fear-of-falling (FoF) in Parkinson's disease (PD) is a complex symptom with heterogeneous drivers. Recent work by Onder et al. (2026) delineated three distinct FoF phenotypes, highlighting anxiety as an independent predictor and emphasizing the need for personalized therapeutic strategies beyond conventional motor-focused approaches.

Methods

This perspective analyzes the pathophysiological rationale and existing preclinical and clinical evidence supporting acupuncture as a phenotype-specific adjunctive therapy. We evaluate evidence for its mechanisms (e.g., HPA axis modulation, dopaminergic pathway enhancement) and match these to the dominant drivers (anxiety, gait impairment, pervasive motor disability) identified in the FoF phenotypic framework.

Results

Acupuncture demonstrates potential for modulating neurobiological substrates relevant to different FoF phenotypes. For the anxiety-dominant phenotype, it may alleviate symptoms via autonomic regulation. For motor-dominant phenotypes, it may improve postural stability and gait parameters, possibly through neuromodulation of motor circuits. Its favorable safety profile supports its feasibility as an adjunctive intervention.

Conclusion

The phenotypic model of FoF provides a critical framework for personalizing treatment. Acupuncture represents a promising, tailored adjunctive therapy targeting the specific neuropsychiatric and motor mechanisms underlying different FoF phenotypes. Future high-quality, phenotype-stratified clinical trials are warranted to evaluate its efficacy and integrate it into comprehensive PD management.

帕金森病（PD）中的害怕跌倒（FoF）是一种具有异质性驱动因素的复杂症状。Onder等人（2026）最近的工作描述了三种不同的FoF表型，强调焦虑是一个独立的预测因素，并强调需要个性化的治疗策略，而不是传统的以运动为中心的方法。方法本视角分析了支持针灸作为表型特异性辅助治疗的病理生理学原理和现有的临床前和临床证据。我们评估了其机制的证据（例如，HPA轴调节，多巴胺能通路增强），并将这些与FoF表型框架中确定的主要驱动因素（焦虑，步态障碍，广泛性运动障碍）相匹配。结果针刺具有调节与不同FoF表型相关的神经生物学底物的潜力。对于焦虑显性表型，它可能通过自主调节来缓解症状。对于运动显性表型，它可能通过运动回路的神经调节来改善姿势稳定性和步态参数。其良好的安全性支持其作为辅助干预措施的可行性。结论FoF的表型模型为个体化治疗提供了重要框架。针灸是一种有前途的、量身定制的辅助疗法，针对不同FoF表型背后的特定神经精神和运动机制。未来需要高质量的、表型分层的临床试验来评估其疗效，并将其纳入帕金森病的综合治疗中。

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引用次数: 0

Late-onset cerebellar ataxia associated with XRCC1: Expanding the phenotypic spectrum 与XRCC1相关的晚发型小脑性共济失调：扩大表型谱

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108184

引用次数: 0

Compartment-specific correlation of pathological α-synuclein in prodromal Parkinson's disease 前驱帕金森病病理性α-突触核蛋白的室特异性相关性

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108178

Sinah Röttgen , Michael Sommerauer , Shijun Yan , Carolin Hungerland , Gereon R. Fink , Anja Ophey , Michael T. Barbe , Laura Müller , Gültekin Tamgüney , George K. Tofaris

Introduction

Neuronal α-synuclein dyshomeostasis and aggregation are essential features of early Parkinson's disease, as seen in isolated REM sleep behavior disorder (iRBD). The link between these pathologies across body compartments remains unclear. Our aim was to assess correlations between α-synuclein aggregates in stool and urine with α-synuclein content in neuronally derived L1CAM extracellular vesicles (L1EVs) from serum in iRBD.

Methods

We conducted a cross-sectional study, analyzing concurrent biobank samples from 46 individuals with iRBD to quantify α-synuclein aggregates in stool and urine with surface-based fluorescence intensity distribution analysis (sFIDA) and α-synuclein content in L1EVs using electrochemiluminescence.

Results

Corrected for age and sex, α-synuclein concentrations in L1EVs significantly correlated with stool aggregate concentration. No significant correlation was observed between α-synuclein concentration in L1EVs and urine, nor between urine and stool aggregates.

Conclusion

The correlation of serum and stool α-synuclein suggests shared or linked pathology across these compartments, whereas the urinary compartment may be pathophysiologically distinct in prodromal Parkinson's Disease.

神经元α-突触核蛋白失衡和聚集是早期帕金森病的基本特征，这在孤立的快速眼动睡眠行为障碍（iRBD）中可见。这些疾病在身体各部分之间的联系尚不清楚。我们的目的是评估iRBD患者血清中神经元来源的L1CAM细胞外囊泡（L1EVs）中α-突触核蛋白含量与粪便和尿液中α-突触核蛋白聚集的相关性。方法采用横断面研究方法，分析46例iRBD患者的同期生物样本，采用表面荧光强度分布分析（sFIDA）定量粪便和尿液中的α-突触核蛋白聚集物，采用电化学发光法定量L1EVs中α-突触核蛋白含量。结果经年龄和性别校正后，l1ev体内α-synuclein浓度与粪便聚集物浓度显著相关。l1ev中α-突触核蛋白浓度与尿液、尿液和粪便聚集物之间均无显著相关性。结论血清α-突触核蛋白与粪便α-突触核蛋白的相关性提示这些腔室之间存在共同或相关的病理，而前驱帕金森病的尿腔室可能具有不同的病理生理特征。

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引用次数: 0

Exploring regional BOLD fluctuations to understand the pathophysiology of mild cognitive impairments in individuals with Parkinson's disease 探索区域BOLD波动以了解帕金森病患者轻度认知障碍的病理生理学

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108177

Narayan D. Chaurasiya , Taylor Davis , Gaurav N. Rathi , Jessica ZK. Caldwell , Aaron Ritter , Zoltan Mari , Virendra R. Mishra

Introduction

This study investigated whether z-standardized fractional amplitude of low-frequency fluctuations (zfALFF) and z-standardized regional homogeneity (zKcc ReHo) capture functional brain alterations associated with mild cognitive impairment (MCI) in Parkinson's disease (PD) and their relationships with clinical and cognitive measures.

Methods

Forty-seven participants (16 healthy controls [HC], 31 with PD) were recruited, with MCI identified using Litvan's criteria. After preprocessing, 45 participants were analyzed: HC (n = 15), PD with normal cognition (PD-NC, n = 12), and PD with MCI (PD-MCI, n = 18). Voxelwise zfALFF and zKcc ReHo maps were examined using nonparametric regression (PALM) for group differences and associations with disease duration, medication dose (LEDD), motor severity (UPDRS-III ON), and cognitive domains, adjusting for demographic and brain volume factors (FDR p < 0.05).

Results

PD-MCI showed reduced zfALFF and zKcc ReHo in frontoparietal and midline regions linked to executive and default mode networks, while PD-NC exhibited increased activity and synchrony in subcortical–frontal and occipital areas. In PD-MCI, LEDD correlated positively with both metrics in frontostriatal and occipitotemporal regions; UPDRS-ON correlated positively with zKcc ReHo. In PD-NC, UPDRS-ON correlated positively with zfALFF in attention-related areas. Cognitive analyses indicated executive attention coupling in PD-NC and memory-related changes in PD-MCI.

Conclusions

zfALFF and zKcc ReHo reveal stage-specific alterations in neural activity and synchrony in PD that reflect disease severity and cognitive vulnerability, highlighting their promise as complementary neuroimaging biomarkers.

本研究探讨了z-标准化低频波动分数幅度（zfALFF）和z-标准化区域均匀性（zKcc ReHo）是否能捕捉帕金森病（PD）中与轻度认知障碍（MCI）相关的功能性脑改变，以及它们与临床和认知测量的关系。方法招募47名参与者（16名健康对照[HC]， 31名PD患者），使用Litvan标准确定MCI。经预处理后，对45名参与者进行分析：HC （n = 15）、PD- nc （n = 12）和PD-MCI （n = 18）。体素上zfALFF和zKcc ReHo图使用非参数回归（PALM）检查组间差异以及与疾病持续时间、用药剂量（LEDD）、运动严重程度（UPDRS-III ON）和认知域的关联，调整人口统计学和脑容量因素（FDR p < 0.05）。结果spd - mci显示与执行和默认模式网络相关的额顶和中线区域zfALFF和zKcc ReHo减少，而PD-NC显示皮层下额和枕区的活动和同步性增加。在PD-MCI中，led与额纹状体和枕颞区的指标均呈正相关；UPDRS-ON与zKcc ReHo呈正相关。在PD-NC中，UPDRS-ON与zfALFF在注意相关区域呈正相关。认知分析表明PD-NC的执行注意耦合和PD-MCI的记忆相关变化。结论falff和zKcc ReHo揭示了PD患者神经活动和同步性的分期特异性改变，反映了疾病的严重程度和认知易感性，突出了它们作为补充神经成像生物标志物的前景。

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引用次数: 0

Comment on “SGK1 downregulation co-occurs with leukocyte oligomeric α-synuclein accumulation in Parkinson's disease” 关于“帕金森病中SGK1下调与白细胞寡聚体α-突触核蛋白积聚共同发生”的评论。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108181

Bhumesh Tyagi , Leelabati Toppo , Aishwarya Biradar

引用次数: 0

Subjective cognitive complaints in cognitively normal patients with Parkinson's disease predict development of dementia: A 5-year longitudinal observation 认知正常帕金森病患者的主观认知抱怨预测痴呆的发展：一项为期5年的纵向观察

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108179

Han-Kyeol Kim , Min Seok Baek , Jeehyun Ham , Jin Yong Hong

Objective

This study aimed to examine whether subjective cognitive complaints (SCCs) measured by the SCCQ-PD questionnaire can predict the development of dementia in initially cognitively normal patients with Parkinson's disease (PD).

Methods

We retrospectively analyzed 53 PD patients with normal cognition at baseline who were followed for an average of 5 years. SCCs were assessed using the SCCQ-PD, a self-reported questionnaire, and subjects were classified into three tertile groups based on SCCQ-PD scores (score 0–2, 3–5, and 6–12). Cox proportional hazard models were used to identify predictors of dementia.

Results

Baseline demographic characteristics and cognitive performance did not differ significantly among groups, while patients with high tertile group (SCCQ-PD score 6–12) showed poorer instrumental activities of daily living than those with low tertile group (score 0–2). During follow-up, 17 (32.1 %) patients developed dementia. Patients with the high tertile group were significantly associated with an increased risk of future dementia (adjusted hazard ratio = 5.37; 95 % confidential interval, 1.33–21.67; p = 0.018) after controlling for age and disease duration at baseline.

Conclusions

SCCs assessed using the SCCQ-PD questionnaire may be associated with an increased risk of future dementia in cognitively normal patients with PD. Prospective validation in larger cohorts is required to confirm the predictive value of the SCCQ-PD.

目的本研究旨在探讨SCCQ-PD问卷测量的主观认知主诉（SCCs）是否可以预测帕金森病（PD）患者早期认知正常的痴呆发展。方法回顾性分析53例认知正常的帕金森病患者，平均随访5年。使用SCCQ-PD（一种自我报告的问卷）评估SCCs，并根据SCCQ-PD得分（得分0-2、3-5和6-12）将受试者分为三个五分位组。Cox比例风险模型用于识别痴呆的预测因子。结果各组患者的基线人口学特征和认知表现无显著差异，而高分值组（SCCQ-PD评分6-12）患者的日常生活工具活动较低分值组（得分0-2）患者差。在随访期间，17例（32.1%）患者发展为痴呆。在控制了基线年龄和病程后，高不育组患者与未来痴呆的风险增加显著相关（校正风险比= 5.37；95%保密区间，1.33-21.67;p = 0.018）。结论：使用SCCQ-PD问卷评估的sccs可能与认知正常的PD患者未来痴呆的风险增加有关。需要在更大的队列中进行前瞻性验证，以确认SCCQ-PD的预测价值。

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引用次数: 0

Unraveling the heterogeneity of infection-related movement disorders: A call for a mechanism-based classification. 揭示感染相关运动障碍的异质性：呼吁基于机制的分类。

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-05 DOI: 10.1016/j.parkreldis.2026.108180

Yusa Pan, Tiantian Zhang, Chao Zhang

引用次数: 0

Quality of life in early-onset Parkinson's disease: A multivariate examination of psychosocial and demographic correlates 早发性帕金森病的生活质量：社会心理和人口学相关因素的多变量检查

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2026-01-02 DOI: 10.1016/j.parkreldis.2025.108174

Bradley McDaniels , Heerak Choi , Byung Jin Kim , Ripley Fricano , Indu Subramanian

Introduction

Early-onset Parkinson's disease (EOPD) presents a unique and multifaceted challenge, but its psychosocial dimensions remain underexplored, limiting patient-centered interventions. Given that psychosocial factors may influence quality of life (QoL) more than motor symptoms, addressing these needs is essential.

Methods

We conducted a cross-sectional survey of 262 adults with EOPD through a national patient support organization between November 2022 and February 2023 to identify the demographic and psychosocial factors that contribute to quality of life.

Results

Hierarchical regression analysis showed that demographic factors explained 15 % of the variance in QoL (R² = .15), with work status (β = .30, p < .001), marital status (β = .17, p < .01), and education (β = .16, p < .05) as significant predictors. Adding psychosocial variables increased the explained variance to 62 % (ΔR² = .47). Perceived stress (β = −.26, p < .001), years since diagnosis (β = −.64, p < .05), and loneliness (β = −.19, p < .001) were strong negative predictors, while meaningful work (β = .21, p < .01) and psychological capital (β = .43, p < .001) were key protective factors.

Conclusions

These findings suggest that while demographic factors contribute to QoL in individuals with EOPD, psychosocial determinants have a more pronounced impact.

早发性帕金森病（EOPD）呈现出一种独特且多方面的挑战，但其社会心理层面仍未得到充分探索，限制了以患者为中心的干预措施。鉴于社会心理因素可能比运动症状更能影响生活质量（QoL），解决这些需求至关重要。方法：我们在2022年11月至2023年2月期间通过国家患者支持组织对262名EOPD成人进行了横断面调查，以确定影响生活质量的人口统计学和社会心理因素。结果：层次回归分析显示，人口统计学因素解释了生活质量方差的15% (R2 = .15)，工作状态（β = .30, p 2 = .47）。结论：这些发现表明，虽然人口因素对EOPD患者的生活质量有影响，但社会心理因素的影响更为显著。

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引用次数: 0

Recruitment strategies for the racial disparities in Parkinson's disease study: Partnering with patients from the Black community 帕金森病研究中种族差异的招募策略：与黑人社区的患者合作

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY

Parkinsonism & related disorders

Pub Date : 2025-12-31 DOI: 10.1016/j.parkreldis.2025.108173

Jacqueline Vanegas , Rebecca Weimer , Nathan Krinickas , Deborah A. Hall , Lisa M. Shulman

Introduction

Most Parkinson's Disease (PD) studies fail to recruit diverse racial and ethnic groups in their study sample. PD research mainly contains data from White PD patients and fails to reflect the experiences of Black PD patients and other individuals from underrepresented groups/minorities. This paper aims to describe effective recruitment strategies in the Black PD population.

Methods

The NIH-funded Racial Disparities in PD project is an ongoing multi-center study comparing phenotype, management, and genotype between Black and White PD patients. A REDCap survey was distributed to all seven study sites to be completed by coordinators from each site. The survey included questions about recruitment strategies, effectiveness of strategies, recruitment barriers, communication strategies, and approaches to follow-up.

Results

The most common recruitment strategies (in order of effectiveness) are monitoring patient schedules through Epic or other software, collaborating with clinical colleagues (referrals), and flyers/posters in public spaces. Study coordinators use in-person or telephone calls as a form of recruitment communication. The major barriers to recruitment are financial or time constraints.

Discussion

The most effective recruitment strategies are monitoring patient schedules and collaborating with the site investigator and other clinicians. Coordinators find that approaching patients in the clinic with study flyers helps sustain recruitment. Clinician-patient relationships are also important to increase recruitment due to preexisting relationships. Fostering trust with participants greatly impacts successful recruitment. Finding solutions to participant barriers has been successful in maintaining recruitment numbers.

大多数帕金森病（PD）研究未能在其研究样本中招募不同的种族和民族群体。PD研究主要包含白人PD患者的数据，未能反映黑人PD患者和其他未被充分代表的群体/少数群体的经历。本文旨在描述黑人PD人群的有效招聘策略。方法美国国立卫生研究院资助的PD种族差异项目是一项正在进行的多中心研究，比较黑人和白人PD患者的表型、管理和基因型。一份REDCap调查被分发到所有七个研究地点，由每个地点的协调员完成。调查的问题包括招聘策略、策略的有效性、招聘障碍、沟通策略和跟进方法。结果最常见的招募策略（按有效性排序）是通过Epic或其他软件监测患者时间表，与临床同事合作（转诊），以及在公共场所张贴传单/海报。研究协调员使用面对面或电话作为招聘沟通的一种形式。招聘的主要障碍是资金或时间限制。最有效的招募策略是监测患者的时间表，并与现场调查员和其他临床医生合作。协调员发现，带着研究传单接近诊所的患者有助于维持招募。由于先前存在的关系，医患关系对于增加招聘也很重要。培养参与者之间的信任对成功招聘有很大影响。寻找解决参与者障碍的办法在维持招聘人数方面取得了成功。

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