Pub Date : 2025-01-06DOI: 10.1016/j.parkreldis.2025.107266
Shuqi Cao , Xia Fu , Wenjing Li , Peixi Wang , Chunyu Li , Huifang Shang
Introduction
Evidence have indicated relation between apolipoproteins and neurodegenerative disorders (NDDs). However, previous studies have produced inconsistent results, and a comprehensive analysis of apolipoproteins in NDDs is currently lacking.
Methods
Using Cox proportional hazards regression analysis based on data from UK Biobank, we examined the association between baseline serum levels of apolipoprotein A (ApoA) and apolipoprotein B (ApoB) and risk of Parkinson's disease (PD), Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and multiple sclerosis.
Results
Elevated baseline levels of serum ApoA (HR = 0.84, 95 % CI: 0.71–0.99, P = 0.047) and ApoB (HR = 0.67, 95 % CI: 0.57–0.78, P = 3.18E-07) were associated with a reduced risk of incident PD. Subgroup analyses suggested the protective effect of serum ApoA was more significant for older participants and those with lower alcohol consumption, while higher serum ApoB was a more significant protective factor in males and those without stroke. No significant associations were found between apolipoproteins and other NDDs.
Conclusion
Increased baseline levels of serum ApoA and ApoB are linked to a lower risk of PD. These findings enhance understanding of the role of apolipoproteins in PD, and have implications for the development of therapeutic strategies in clinical trials.
{"title":"Protective role of apolipoprotein A and B in Parkinson's disease: A prospective study from UK Biobank","authors":"Shuqi Cao , Xia Fu , Wenjing Li , Peixi Wang , Chunyu Li , Huifang Shang","doi":"10.1016/j.parkreldis.2025.107266","DOIUrl":"10.1016/j.parkreldis.2025.107266","url":null,"abstract":"<div><h3>Introduction</h3><div>Evidence have indicated relation between apolipoproteins and neurodegenerative disorders (NDDs). However, previous studies have produced inconsistent results, and a comprehensive analysis of apolipoproteins in NDDs is currently lacking.</div></div><div><h3>Methods</h3><div>Using Cox proportional hazards regression analysis based on data from UK Biobank, we examined the association between baseline serum levels of apolipoprotein A (ApoA) and apolipoprotein B (ApoB) and risk of Parkinson's disease (PD), Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and multiple sclerosis.</div></div><div><h3>Results</h3><div>Elevated baseline levels of serum ApoA (HR = 0.84, 95 % CI: 0.71–0.99, P = 0.047) and ApoB (HR = 0.67, 95 % CI: 0.57–0.78, P = 3.18E-07) were associated with a reduced risk of incident PD. Subgroup analyses suggested the protective effect of serum ApoA was more significant for older participants and those with lower alcohol consumption, while higher serum ApoB was a more significant protective factor in males and those without stroke. No significant associations were found between apolipoproteins and other NDDs.</div></div><div><h3>Conclusion</h3><div>Increased baseline levels of serum ApoA and ApoB are linked to a lower risk of PD. These findings enhance understanding of the role of apolipoproteins in PD, and have implications for the development of therapeutic strategies in clinical trials.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"132 ","pages":"Article 107266"},"PeriodicalIF":3.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case report of Cerebrotendinous Xanthomatosis: Progressive gait difficulties and juvenile cataracts in a 33-year-old male.","authors":"Villa-Lopez Marta, Sugumar Tripthi, Suchowersky Oksana","doi":"10.1016/j.parkreldis.2024.107259","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2024.107259","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107259"},"PeriodicalIF":3.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1016/j.parkreldis.2025.107267
Eun Jin Yoon , Jee-Young Lee , Kyung Ah Woo , Seoyeon Kim , Heejung Kim , Hyunwoong Park , Ryul Kim , Bora Jin , Seungmin Lee , Hyunwoo Nam , Yu Kyeong Kim
Introduction
In isolated REM sleep behavior disorder (iRBD), the evidence of cognitive impairment and co-existing amyloid pathology suggests that mild behavioral impairment (MBI) may be associated with disease progression. In this study, we investigated MBI and its association with cognitive function, brain amyloid load and glucose metabolism in iRBD patients to evaluate the utility of MBI as a predictive marker of disease progression.
Methods
Patients with iRBD underwent a neuropsychological evaluation, 18F-florbetaben (FBB) PET, and 18F-fluorodeoxyglucose (FDG) PET. MBI was evaluated using the MBI-checklist (MBI-C). Comparisons between MBI-positive and MBI-negative groups and correlations with MBI-C total scores were examined on neuropsychological performances and PET regional standardized uptake value ratios (SUVRs). Additionally, associations between regional amyloid burden and glucose metabolism and mediating role of MBI status on these associations were evaluated in all iRBD patients.
Results
Of 36 iRBD patients, about one-third were classified as MBI-positive. Although we did not find the differences between the MBI groups and correlations with MBI-C total scores in neuropsychological performances and brain glucose metabolism, the MBI-positive group revealed higher FBB SUVRs in the anterior cingulate cortex, prefrontal cortex, caudate nucleus, and putamen than the MBI-negative group. The FBB SUVR of caudate nucleus was negatively correlated with glucose metabolism in the precuneus, which was not directly mediated by the MBI.
Conclusion
Characteristic amyloid accumulation in prefrontal and subcortical structures in MBI-positive iRBD patients suggests that MBI may be associated with early amyloid pathology that can be an integral role in disease progression.
{"title":"Mild behavioral impairment and its relation to amyloid load in isolated REM sleep behavior disorder","authors":"Eun Jin Yoon , Jee-Young Lee , Kyung Ah Woo , Seoyeon Kim , Heejung Kim , Hyunwoong Park , Ryul Kim , Bora Jin , Seungmin Lee , Hyunwoo Nam , Yu Kyeong Kim","doi":"10.1016/j.parkreldis.2025.107267","DOIUrl":"10.1016/j.parkreldis.2025.107267","url":null,"abstract":"<div><h3>Introduction</h3><div>In isolated REM sleep behavior disorder (iRBD), the evidence of cognitive impairment and co-existing amyloid pathology suggests that mild behavioral impairment (MBI) may be associated with disease progression. In this study, we investigated MBI and its association with cognitive function, brain amyloid load and glucose metabolism in iRBD patients to evaluate the utility of MBI as a predictive marker of disease progression.</div></div><div><h3>Methods</h3><div>Patients with iRBD underwent a neuropsychological evaluation, <sup>18</sup>F-florbetaben (FBB) PET, and <sup>18</sup>F-fluorodeoxyglucose (FDG) PET. MBI was evaluated using the MBI-checklist (MBI-C). Comparisons between MBI-positive and MBI-negative groups and correlations with MBI-C total scores were examined on neuropsychological performances and PET regional standardized uptake value ratios (SUVRs). Additionally, associations between regional amyloid burden and glucose metabolism and mediating role of MBI status on these associations were evaluated in all iRBD patients.</div></div><div><h3>Results</h3><div>Of 36 iRBD patients, about one-third were classified as MBI-positive. Although we did not find the differences between the MBI groups and correlations with MBI-C total scores in neuropsychological performances and brain glucose metabolism, the MBI-positive group revealed higher FBB SUVRs in the anterior cingulate cortex, prefrontal cortex, caudate nucleus, and putamen than the MBI-negative group. The FBB SUVR of caudate nucleus was negatively correlated with glucose metabolism in the precuneus, which was not directly mediated by the MBI.</div></div><div><h3>Conclusion</h3><div>Characteristic amyloid accumulation in prefrontal and subcortical structures in MBI-positive iRBD patients suggests that MBI may be associated with early amyloid pathology that can be an integral role in disease progression.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"132 ","pages":"Article 107267"},"PeriodicalIF":3.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-04DOI: 10.1016/j.parkreldis.2025.107262
Vito Luigi Colona, Giacomo Garone, Francesco Nicita, Lorena Travaglini, Stefano Pro, Maria Camilla Rossi-Espagnet, Anna Piluso, Eleonora Bisozzi, Donatella Lettori, Enrico Bertini, Gessica Vasco
Segmental Brainstem Myoclonus (SBM) is a rare movement disorder characterized by rhythmic contractions of muscles innervated by brainstem segments. We report a 20-year-old patient with ADCK3-related spinocerebellar ataxia type 9 (SCAR9) presenting with sudden-onset myoclonic movements of the throat, tongue, and soft palate. Brain MRI showed stable findings, including dentate nucleus hyperintensities. This case suggests a possible association between SBM and SCAR9, warranting further investigation.
{"title":"Segmental brainstem myoclonus in ADCK3-Related ataxia: A novel phenomenon?","authors":"Vito Luigi Colona, Giacomo Garone, Francesco Nicita, Lorena Travaglini, Stefano Pro, Maria Camilla Rossi-Espagnet, Anna Piluso, Eleonora Bisozzi, Donatella Lettori, Enrico Bertini, Gessica Vasco","doi":"10.1016/j.parkreldis.2025.107262","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.107262","url":null,"abstract":"<p><p>Segmental Brainstem Myoclonus (SBM) is a rare movement disorder characterized by rhythmic contractions of muscles innervated by brainstem segments. We report a 20-year-old patient with ADCK3-related spinocerebellar ataxia type 9 (SCAR9) presenting with sudden-onset myoclonic movements of the throat, tongue, and soft palate. Brain MRI showed stable findings, including dentate nucleus hyperintensities. This case suggests a possible association between SBM and SCAR9, warranting further investigation.</p>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"107262"},"PeriodicalIF":3.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.parkreldis.2024.107196
Petra Schwingenschuh , Madelein Van der Stouwe , Sanjay Pandey , Stephanie Hirschbichler , Pattamon Panyakaew , Maja Kojovic , Adreesh Mukherjee , Marina AJ. Tijssen , Shabbir Hussain I. Merchant , Felipe Vial , the MDS Clinical neurophysiology Study group
Background
A thorough history and physical examination may be insufficient for comprehensively studying patients with tremor. In such instances, neurophysiology serves as an adjunct to the physical examination.
Objectives
Our aim is to present compelling evidence supporting the utilization of neurophysiological studies in various tremor conditions.
Methods
A panel of global experts, convened by the Study Group on Clinical Neurophysiology for Movement Disorders, examined the application and utility of neurophysiology across diverse movement disorders.
Results
This manuscript provides a detailed methodology for electrophysiological studies in tremors helping to differentiate them from myoclonus, comparing tremor in parkinson vs atypical parkinsonisms, describing dystonic tremor, describing the differences between Parkinson and essential tremor and the characteristics of functional tremor.
Conclusions
Neurophysiological studies play a crucial role in characterizing tremor syndromes and aiding in their differentiation from other hyperkinetic movement disorders.
{"title":"Clinical neurophysiology for tremor: Common questions in clinical practice","authors":"Petra Schwingenschuh , Madelein Van der Stouwe , Sanjay Pandey , Stephanie Hirschbichler , Pattamon Panyakaew , Maja Kojovic , Adreesh Mukherjee , Marina AJ. Tijssen , Shabbir Hussain I. Merchant , Felipe Vial , the MDS Clinical neurophysiology Study group","doi":"10.1016/j.parkreldis.2024.107196","DOIUrl":"10.1016/j.parkreldis.2024.107196","url":null,"abstract":"<div><h3>Background</h3><div>A thorough history and physical examination may be insufficient for comprehensively studying patients with tremor. In such instances, neurophysiology serves as an adjunct to the physical examination.</div></div><div><h3>Objectives</h3><div>Our aim is to present compelling evidence supporting the utilization of neurophysiological studies in various tremor conditions.</div></div><div><h3>Methods</h3><div>A panel of global experts, convened by the Study Group on Clinical Neurophysiology for Movement Disorders, examined the application and utility of neurophysiology across diverse movement disorders.</div></div><div><h3>Results</h3><div>This manuscript provides a detailed methodology for electrophysiological studies in tremors helping to differentiate them from myoclonus, comparing tremor in parkinson vs atypical parkinsonisms, describing dystonic tremor, describing the differences between Parkinson and essential tremor and the characteristics of functional tremor.</div></div><div><h3>Conclusions</h3><div>Neurophysiological studies play a crucial role in characterizing tremor syndromes and aiding in their differentiation from other hyperkinetic movement disorders.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"130 ","pages":"Article 107196"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.parkreldis.2024.106945
Laxmi Patil, Gaurav Mehta, Annu Aggarwal
{"title":"Elderly-onset severe parkinsonism in Wilson disease: Expert commentary","authors":"Laxmi Patil, Gaurav Mehta, Annu Aggarwal","doi":"10.1016/j.parkreldis.2024.106945","DOIUrl":"10.1016/j.parkreldis.2024.106945","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"130 ","pages":"Article 106945"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.parkreldis.2023.105924
Ke-Fan Li , Jun Li , Ya-Ping Liao , Si-Huan Zhu , Jagadish K. Chhetri , Huai-Zhen Chen , Wen-Ming Yang
{"title":"Elderly-onset severe parkinsonism in Wilson disease: A case report","authors":"Ke-Fan Li , Jun Li , Ya-Ping Liao , Si-Huan Zhu , Jagadish K. Chhetri , Huai-Zhen Chen , Wen-Ming Yang","doi":"10.1016/j.parkreldis.2023.105924","DOIUrl":"10.1016/j.parkreldis.2023.105924","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"130 ","pages":"Article 105924"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.parkreldis.2024.107162
Shen-Yang Lim, Azalea T. Pajo, Alfand Marl F. Dy Closas, Jia Wei Hor, Tzi Shin Toh, Su Juen Ngim, Yi Zhe Lim, Ai Huey Tan
Recent studies highlight an over-representation of progressive supranuclear palsy, with atypical features, in South Asians. We offer additional insights, including an over-representation of PSP among Malaysian patients of Indian compared to other Asian ancestries. However, RBD symptoms, hallucinations, and early onset were not more frequent in Indians vs. Chinese.
{"title":"Response to the letter regarding “Differences in progressive supranuclear palsy in patients of Asian ancestry?”","authors":"Shen-Yang Lim, Azalea T. Pajo, Alfand Marl F. Dy Closas, Jia Wei Hor, Tzi Shin Toh, Su Juen Ngim, Yi Zhe Lim, Ai Huey Tan","doi":"10.1016/j.parkreldis.2024.107162","DOIUrl":"10.1016/j.parkreldis.2024.107162","url":null,"abstract":"<div><div>Recent studies highlight an over-representation of progressive supranuclear palsy, with atypical features, in South Asians. We offer additional insights, including an over-representation of PSP among Malaysian patients of Indian compared to other Asian ancestries. However, RBD symptoms, hallucinations, and early onset were not more frequent in Indians vs. Chinese.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"130 ","pages":"Article 107162"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.parkreldis.2024.107210
Milene Vitória Sampaio Sobral , Victor Gonçalves Soares , João Lucas de Magalhães Leal Moreira , Livia Kneipp Rodrigues , Paula Rocha , Lucas Cael Azevedo Ramos Bendaham , Ocílio Ribeiro Gonçalves , Rafaela da Cunha Pirolla , Lucas Veronezi Vilela , Victoria Städler de Abreu , Kelson James Almeida
Introduction
Recent studies have demonstrated an association between hypoglycemic medications and neuroprotective action in neurodegenerative diseases, such as Parkinson's disease (PD). Therefore, in this meta-analysis, our objective was to evaluate the efficacy of these medications, compared to placebo, as disease-modifying therapy in patients with PD.
Methods
We systematically searched PubMed, Embase, and Cochrane for studies comparing the use of hypoglycemic drugs and placebo in patients with PD. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) with 95 % confidence intervals (CI) were pooled across trials. Outcomes of interest were change in Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I, II, III, IV, and Parkinson's Disease Questionnaire 39 (PDQ-39).
Results
This meta-analysis included six randomized controlled trials (RCT) reporting data on 787 patients. Among them, 480 (61 %) received hypoglycemic drugs. Follow-up ranged from 36 to 61 weeks. At the end of follow-up, improvement in MDS-UPDRS part III score during OFF state occurred when subjects received any hypoglycemic agents at their lowest dose (MD -1.36; 95 % IC -2.78 to −0.47; I2 = 38 %), as well as highest doses (MD -1.58; 95 % IC -3.07 to −0.09; I2 = 50 %). Changes in MDS-UPDRS part III score in patients examined in the ON state who received any dose of any hypoglycemic agents (MD -3.32; 95 % IC -5.28 to −1.36; I2 = 0 %) were significant. There was no significant difference between groups MDS-UPDRS parts I, II, IV, and PDQ-39.
Conclusion
In patients with PD, the use of hypoglycemic agents showed efficacy on symptomatic PD treatment with an improvement in MDS-UPDRS part III.
引言最近的研究表明，降糖药物与帕金森病等神经退行性疾病的神经保护作用有关。因此，在这项荟萃分析中，我们的目标是评估这些药物作为帕金森病患者的疾病调节疗法与安慰剂相比的疗效：我们系统地检索了PubMed、Embase和Cochrane上关于PD患者使用降糖药和安慰剂的比较研究。统计分析使用 R Studio 4.3.2 进行。对各试验的平均差 (MD) 和 95 % 置信区间 (CI) 进行了汇总。研究结果包括运动障碍协会-统一帕金森病评分量表（MDS-UPDRS）I、II、III、IV部分和帕金森病问卷39（PDQ-39）的变化：这项荟萃分析包括六项随机对照试验（RCT），报告了 787 名患者的数据。其中，480 人（61%）接受了降糖药物治疗。随访时间从 36 周到 61 周不等。随访结束时，当受试者接受任何降糖药物的最低剂量（MD -1.36；95 % IC -2.78 至 -0.47；I2 = 38 %）和最高剂量（MD -1.58；95 % IC -3.07 至 -0.09；I2 = 50 %）时，关机状态下的 MDS-UPDRS III 部分评分有所改善。接受任何剂量降糖药物治疗的 ON 状态患者的 MDS-UPDRS III 部分评分变化显著（MD -3.32；95 % IC -5.28 至 -1.36；I2 = 0 %）。MDS-UPDRS第一、二、四部分和PDQ-39组间无明显差异：结论：在帕金森病患者中，使用降糖药对症治疗帕金森病具有疗效，可改善 MDS-UPDRS 第三部分。
{"title":"The use of hypoglycemic drugs in Parkinson's disease: An updated meta-analysis of randomized controlled trials","authors":"Milene Vitória Sampaio Sobral , Victor Gonçalves Soares , João Lucas de Magalhães Leal Moreira , Livia Kneipp Rodrigues , Paula Rocha , Lucas Cael Azevedo Ramos Bendaham , Ocílio Ribeiro Gonçalves , Rafaela da Cunha Pirolla , Lucas Veronezi Vilela , Victoria Städler de Abreu , Kelson James Almeida","doi":"10.1016/j.parkreldis.2024.107210","DOIUrl":"10.1016/j.parkreldis.2024.107210","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent studies have demonstrated an association between hypoglycemic medications and neuroprotective action in neurodegenerative diseases, such as Parkinson's disease (PD). Therefore, in this meta-analysis, our objective was to evaluate the efficacy of these medications, compared to placebo, as disease-modifying therapy in patients with PD.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Cochrane for studies comparing the use of hypoglycemic drugs and placebo in patients with PD. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) with 95 % confidence intervals (CI) were pooled across trials. Outcomes of interest were change in Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I, II, III, IV, and Parkinson's Disease Questionnaire 39 (PDQ-39).</div></div><div><h3>Results</h3><div>This meta-analysis included six randomized controlled trials (RCT) reporting data on 787 patients. Among them, 480 (61 %) received hypoglycemic drugs. Follow-up ranged from 36 to 61 weeks. At the end of follow-up, improvement in MDS-UPDRS part III score during OFF state occurred when subjects received any hypoglycemic agents at their lowest dose (MD -1.36; 95 % IC -2.78 to −0.47; I2 = 38 %), as well as highest doses (MD -1.58; 95 % IC -3.07 to −0.09; I2 = 50 %). Changes in MDS-UPDRS part III score in patients examined in the ON state who received any dose of any hypoglycemic agents (MD -3.32; 95 % IC -5.28 to −1.36; I2 = 0 %) were significant. There was no significant difference between groups MDS-UPDRS parts I, II, IV, and PDQ-39.</div></div><div><h3>Conclusion</h3><div>In patients with PD, the use of hypoglycemic agents showed efficacy on symptomatic PD treatment with an improvement in MDS-UPDRS part III.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"130 ","pages":"Article 107210"},"PeriodicalIF":3.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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