Clinical Parkinsonism Related Disorders最新文献_第5页

Cognition is associated with daily-life mobility in people with Parkinson’s disease 帕金森病患者的认知能力与日常生活活动能力有关

IF 1.8 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100393

Pablo I. Burgos , Carla Silva-Batista , Anjanibhargavi Ragothaman , Vrutangkumar V. Shah , Patricia Carlson-Kuhta , Fay B. Horak , Martina Mancini

Introduction

Cognitive impairment is common in people with Parkinson’s disease (PD). Mobility is also impaired in people with PD and functional mobility often requires cognitive dual-tasking to navigate complex environments in daily life. We hypothesized that visuospatial and executive cognitive dysfunction in people with PD will be associated with digital measures of mobility in daily life. Since freezing of gait (FoG) is associated with both cognitive dysfunction and mobility impairments, we also examined the influence of FoG on the cognition-mobility relationship. Here, we investigated, for the first time, the association between cognition and daily-life mobility in PD and the influence of FoG status.

Methods

60 individuals with mild-to-moderate PD (17 with FoG and 43 without FoG) wore 3 inertial sensors (lumbar and feet) for a week of passive monitoring of mobility. Digital visuospatial (Line Orientation task) and executive tasks (Set-Shifting and Flanker task) were assessed in the ON medication state.

Results

Visuospatial function was significantly associated with gait speed (r = -0.46, p = 0.008) and stride length (r = -0.40, p = 0.022). Set Shifting was significantly associated with stance time (r = -0.35, p = 0.046), double support time (r = -0.35, p = 0.046), and the variability of step duration during turning (r = 0.44, p = 0.016). The Flanker test was not associated with any gait variables. FoG status was less important than disease duration or age in the cognitive-mobility associations.

Conclusions

Specific types of cognition were related to specific gait variables in daily life. People with PD with worse visuospatial functions had worse gait pace. In contrast, participants with worse executive function (set-switching) had worse dynamic postural control during gait. FoG status showed minimal influence on these associations.

认知障碍在帕金森病（PD）患者中很常见。帕金森氏症患者的行动能力也受到损害，而且在日常生活中，功能性行动能力往往需要认知双重任务来应对复杂的环境。我们假设PD患者的视觉空间和执行认知功能障碍将与日常生活中移动的数字测量有关。由于步态冻结（FoG）与认知功能障碍和运动障碍都有关，我们也研究了FoG对认知-运动关系的影响。本研究首次探讨了PD患者认知与日常生活活动能力之间的关系以及FoG状态的影响。方法60例轻中度PD患者（17例有FoG， 43例无FoG）佩戴3个惯性传感器（腰椎和足部），进行为期一周的被动活动监测。在开药状态下评估数字视觉空间（线取向任务）和执行任务（Set-Shifting和Flanker任务）。结果视觉空间功能与步速（r = -0.46, p = 0.008）、步长（r = -0.40, p = 0.022）显著相关。Set shift与站立时间（r = -0.35, p = 0.046）、双支撑时间（r = -0.35, p = 0.046）和转弯时步长变异性（r = 0.44, p = 0.016）显著相关。Flanker试验与任何步态变量无关。在认知活动关联中，FoG状态的重要性低于病程或年龄。结论特定的认知类型与日常生活中特定的步态变量有关。视觉空间功能较差的PD患者步态速度较差。相比之下，执行功能较差的参与者在步态过程中动态姿势控制较差。FoG状态对这些关联的影响最小。

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引用次数: 0

Leukoaraiosis does not impact motor outcomes in Parkinson’s patients post deep brain stimulation 脑白质变不影响帕金森病患者脑深部电刺激后的运动结果

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100348

Heather Martin , Rushna Ali , Ashok Sriram , Robert Coleman , Emily Ruether , Hayden Boyce , Morgan L. Maley , Muhib Khan

Objectives

We sought to assess the impact of leukoaraiosis (LA) on motor outcomes in Parkinson disease (PD) patients undergoing DBS. We hypothesized that LA is associated with less improvement in motor function in PD patients post-DBS.

Methods

We reviewed data of adult patients with PD treated with DBS in a single center between 2012 and 2021. Demographics, risk factors, medications, Hoehn and Yahr scale and Unified Parkinson’s Disease Rating Scale (UPDRS) Motor Score before and after DBS and severity of LA were collected. Simple linear regression (SLR) was used to determine variables of interest to include in the multiple linear regression (MLR). MLR was used to determine independent predictors of motor outcomes (UPDRS) post-DBS including LA as a continuous and dichotomized variable of interest.

Results

A total of 90 patients were included in the analysis. Mean age was 65.7 years (±9.7), primarily male (69 %) with a high incidence of young onset PD (29 %), treated with carbidopa/levodopa combination (98 %) and with moderate severity of disease (Hoehn and Yahr Stage 2.0 [2.0, 2.5]). Moderate to severe leukoaraiosis was noted in 26 (32.5 %) patients. SLR revealed age, diabetes and disease severity as predictors of post-DBS motor UPDRS. In adjusted analysis, LA was not an independent predictor of motor outcomes post-DBS either as continuous (β = 0.20, p = 0.77) or dichotomized (β = −0.64; p = 0.77) variable.

Conclusion

In conclusion, our data suggests that motor outcomes in Parkinson’s disease patients undergoing deep brain stimulation (DBS) are not impacted by pre-existing leukoaraiosis. Further studies are needed to validate our findings.

目的：我们试图评估白化病（LA）对帕金森病（PD）患者接受DBS的运动预后的影响。我们假设LA与PD患者dbs后运动功能改善较少相关。方法：我们回顾了2012年至2021年在单一中心接受DBS治疗的成年PD患者的数据。收集DBS前后的人口统计学、危险因素、药物、Hoehn and Yahr量表和统一帕金森病评定量表（UPDRS）运动评分及LA严重程度。使用简单线性回归（SLR）确定感兴趣的变量以纳入多元线性回归（MLR）。MLR用于确定dbs后运动预后（UPDRS）的独立预测因子，包括LA作为连续和二分类的感兴趣变量。结果共纳入90例患者。平均年龄65.7岁（±9.7），主要为男性（69%），年轻发病PD的发病率高（29%），卡比多巴/左旋多巴联合治疗（98%），疾病严重程度中等（Hoehn和Yahr 2.0期[2.0,2.5]）。26例（32.5%）有中度至重度白质变。SLR显示年龄、糖尿病和疾病严重程度是dbs后运动UPDRS的预测因子。在调整分析中，LA不是dbs后运动预后的独立预测因子，无论是连续预测（β = 0.20, p = 0.77）还是二分预测(β = - 0.64；P = 0.77)变量。总之，我们的数据表明，接受深部脑刺激（DBS）的帕金森病患者的运动预后不受先前存在的白质病变的影响。需要进一步的研究来验证我们的发现。

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引用次数: 0

Assessment of social isolation and changes in Parkinson’s disease symptoms during the COVID-19 pandemic: A longitudinal study COVID-19大流行期间社会隔离和帕金森病症状变化的评估：一项纵向研究

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2024.100293

Anish Mehta , Samuel Y.E. Ng , Shermyn X.M. Neo , Nicole S.Y. Chia , Ehsan S. Saffari , Thyagarajan Shivashanmugam , Xinyi Choi , Dede L. Heng , Z.Y. Xu , K.Y. Tay , W.L. Au , E.K. Tan , Louis C.S. Tan

Background

COVID-19-related social restrictions provided an opportunity to evaluate the impact of social isolation on Parkinson’s disease.

Objective

This study aimed to explore changes in social isolation and their associations with PD symptoms using the Lubben Social Network Scale-Revised (LSNS-R).

Methods

Data from 80 participants of the Early Parkinson’s Disease Longitudinal Singapore cohort were collected from April 2019 to April 2023, covering the periods before and after the imposition of COVID-19 restrictions. Individuals with LSNS-R scores ≤ 24 were considered socially isolated. Data were stratified into strata 1 (improved LSNS-R scores) and strata 2 (worsened/unchanged scores). Linear regression was used to identify predictors of LSNS-R change, and MANCOVA was used to examine associations between LSNS-R change and motor/ non-motor symptoms.

Results

Mean LSNS-R scores decreased (p = 0.014), and proportions of social isolation increased (p < 0. 001) during COVID-19 restrictions. However, 35 % showed improved LSNS-R scores, while 65 % had worsened/unchanged scores. The regression model was significant in strata 1 (R2 = 0.806, p = 0.001), with age, marital status, and social isolation status being significantly associated with change in LSNS-R scores. LSNS-R. Results of MANCOVA indicated that LSNS-R improvements in LSNS-R were significantly associated with outcomes (Roy’s Largest Root statistic = 126.638, p < 0.001), particularly for changes in PDQ8, HADS-Anxiety, and HADS-Depression scores. The regression model was not significant in strata 2 (R2 = 0. 279, p = 0.206), wherein motor and non-motor symptoms worsened.

Conclusion

While worsening LSNS-R scores were associated with poorer outcomes, improvements in social networks were associated with improved non-motor symptoms and quality of life. These findings underscore the complexity of social isolation in PD and the need for targeted interventions.

背景：与covid -19相关的社会限制为评估社会隔离对帕金森病的影响提供了机会。目的：本研究旨在利用Lubben社会网络量表（LSNS-R）探讨社会隔离的变化及其与PD症状的关系。方法：从2019年4月至2023年4月收集了80名早期帕金森病新加坡纵向队列参与者的数据，涵盖了COVID-19限制实施前后的时期。LSNS-R评分≤24的个体被认为是社会孤立的。将数据分为第1层（改善的LSNS-R评分）和第2层（恶化/不变的评分）。使用线性回归来确定LSNS-R变化的预测因子，并使用MANCOVA来检查LSNS-R变化与运动/非运动症状之间的关联。结果：平均LSNS-R评分下降（p = 0.014），社会隔离比例增加(p)。结论：LSNS-R评分恶化与预后较差相关，而社会网络的改善与非运动症状和生活质量的改善相关。这些发现强调了PD中社会隔离的复杂性和有针对性干预的必要性。

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引用次数: 0

Identification of inverted U-shaped curve association between serum potassium and prodromal Parkinson’s disease 血清钾与前驱帕金森病关系的倒u型曲线鉴定

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100323

Wen Zhou, Qingqing Xia, Duan Liu, Jun-ying Li, Liang Gong

Background

The association between serum potassium and prodromal Parkinson’s disease (PPD) remains unclear currently.

Objective

The ultimate goal is to gain a deeper understanding of the implications of this association between serum potassium and PPD.

Methods

We conducted a retrospective cross-sectional study involving 1035 participants in PPMI cohort. Age, sex, education years, race, body mass index (BMI), calcium, alanine aminotransferase, aspartate aminotransferase, lymphocytes, neutrophils, serum uric acid, serum sodium, serum potassium, creatinine, serum glucose were obtained from all participants. Logistic regression, and smooth curve fitting were utilized to substantiate the research objectives.

Results

The overall PPD was 83.4 % (863/1035). Multivariate odds ratio regression adjusted for risk factors demonstrates a 1-unit increment in the serum potassium raises the risk of PPD by 1.82 times, respectively. Smooth splines analysis suggested an inverted U-shaped association between serum potassium and PPD (P nonlinearity < 0.05), with the zenith of risk at 4.479 mmol/L. Further subgroup analysis and sensitivity analyses supported the primary findings and indicated the conclusions are robust.

Conclusions

This study highlights the association between serum potassium levels and the risk of incident PPD, independent of confounders. The association between serum potassium and PPD is inverted U-shaped, the threshold value is 4.479 mmol/l.

背景目前，血清钾与帕金森病前驱期（PPD）之间的关系仍不清楚。目的我们的最终目标是深入了解血清钾与帕金森病前驱期之间的关系。我们收集了所有参与者的年龄、性别、受教育年限、种族、体重指数（BMI）、血钙、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、淋巴细胞、中性粒细胞、血清尿酸、血清钠、血清钾、肌酐、血清葡萄糖。利用逻辑回归和平滑曲线拟合来证实研究目标。经风险因素调整的多变量几率回归显示，血清钾每增加 1 个单位，患 PPD 的风险就会增加 1.82 倍。平滑样条分析表明，血清钾与 PPD 呈倒 U 型关系（P 非线性 < 0.05），风险顶点为 4.479 mmol/L。进一步的亚组分析和敏感性分析支持了主要研究结果，并表明结论是可靠的。血清钾与 PPD 之间的关系呈倒 U 型，临界值为 4.479 毫摩尔/升。

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引用次数: 0

Bioequivalence of Foslevodopa/Foscarbidopa continuous subcutaneous infusion to arm, thigh, or flank versus abdomen in healthy and advanced Parkinson’s disease individuals 健康和晚期帕金森病患者手臂、大腿或腹部持续皮下输注Foslevodopa/Foscarbidopa与腹部的生物等效性

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100359

Yi Rang Han , Anna Jeong , Kanwal Ayub , Shelly V. Gupta , Lars Bergmann , Drew S. Kern , Fernando Pagan , Matthew Rosebraugh

Background

Foslevodopa/foscarbidopa (LDp/CDp) are soluble prodrugs of levodopa/carbidopa delivered as a continuous subcutaneous infusion (CSCI) via a portable pump to provide continuous levodopa exposures.

Objective

To assess the safety of LDp/CDp and the relative bioavailability of levodopa/carbidopa following LDp/CDp 24-hour CSCI administration to the arm, thigh, and flank versus the abdomen.

Methods

Two open-label, randomized crossover studies (healthy adult volunteers [HV]; adults with advanced Parkinson’s disease [aPD]; NCT05094050) evaluated 24-hr CSCI of LDp/CDp to different infusion sites (abdomen, arm, thigh, flank), each designated as a study regimen. Participants in the aPD study had levodopa-responsive idiopathic Parkinson’s disease with ≥2.5 h of “Off” time/day. In the HV study, each LDp/CDp regimen was administered over 24 h, with 72-hour washout periods between regimens. In the aPD study, LDp/CDp was administered for 2 consecutive days at each infusion site, with no washout between regimens.

Results

For both levodopa and carbidopa, the 90% confidence intervals for both exposure measures (AUC and C_max) were within the 80–125% range for the comparison between the abdomen and each alternate infusion site, meeting the criteria for bioequivalence. The most commonly reported treatment-emergent adverse events (TEAEs) were mild infusion site reactions, which occurred in 3/12 participants (HV study) and 9/16 participants (aPD study). There were no serious TEAEs and no event led to early discontinuation in either study.

Conclusions

The pharmacokinetics of levodopa and carbidopa demonstrated that the abdomen, arm, thigh, and flank are interchangeable sites for CSCI of LDp/CDp. There were no concerning patterns of adverse events.

foslevodopa /foscarbidopa （LDp/CDp）是左旋多巴/卡比多巴的可溶性前药，通过便携式泵持续皮下输注（CSCI）给药，以提供持续的左旋多巴暴露。目的评价左旋多巴/卡比多巴在手臂、大腿、腹部24小时给药后的安全性和左旋多巴/卡比多巴的相对生物利用度。方法两项开放标签、随机交叉研究(健康成人志愿者[HV]；成人晚期帕金森病[aPD]；NCT05094050)评估了不同输注部位（腹部、手臂、大腿、腹部）的24小时LDp/CDp的CSCI，每个部位被指定为一个研究方案。aPD研究的参与者患有左旋多巴反应性特发性帕金森病，“Off”时间≥2.5小时/天。在HV研究中，每个LDp/CDp方案给药超过24小时，方案之间有72小时的洗脱期。在aPD研究中，在每个输注部位连续给予LDp/CDp 2天，在两个方案之间没有洗脱。结果左旋多巴和卡比多巴两种暴露量的90%置信区间（AUC和Cmax）均在80 ~ 125%范围内，符合生物等效性标准。最常见的治疗不良事件（teae）是轻微的输液部位反应，发生在3/12的参与者（HV研究）和9/16的参与者（aPD研究）中。两项研究均未发生严重teae，也未发生导致早期停药的事件。结论左旋多巴和卡比多巴的药代动力学表明，腹部、手臂、大腿和腹部是LDp/CDp CSCI的可互换部位。没有相关的不良事件模式。

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引用次数: 0

The impact of mild-to-moderate cortical cognitive deficits on post-operative outcomes in deep brain stimulation for Parkinson’s disease: Considerations for patient selection 轻度至中度皮质认知缺陷对帕金森病深部脑刺激术后预后的影响：患者选择的考虑

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100361

Marina Sarno, Scott Harcourt, Annelly Bure-Reyes, Jonathan Jagid, Corneliu Luca, Bonnie Levin, Ihtsham Haq

Introduction

Subcortical deficits in Parkinson’s disease (PD) are well studied; however, deep brain stimulation (DBS) risks posed by mild-moderate deficits in semantic fluency, verbal memory storage, and confrontation naming are not as well understood. This study aims to better define DBS risk stratification criteria by evaluating whether pre-DBS cortical domain deficits predict surgical outcomes, including cognition, mood, quality of life, medication and motor function in patients with PD.

Methods

A retrospective study was conducted with 50 PD patients who underwent pre- and post-surgical neurological and neuropsychological evaluations between 2015 and 2023. Patients were categorized into normal, mildly impaired, and moderately impaired cognitive groups based on pre-surgical neuropsychological testing. Bayesian paired-sample t-tests compared pre- and post-surgery outcomes in motor function, medication use, quality of life, mood, and cognition.

Results

No significant differences were found in demographic or clinical variables across cognitive groups. In the normal cognition group, there was a credible decline in memory and anxiety. The mildly impaired group showed a weak decline in delayed word list memory. The moderately impaired group had no significant changes in cognitive or mood variables. Medication use reliably decreased post-surgically across all groups. There was no significant change in motor function or quality of life post-DBS.

Conclusion

Mild to moderate cognitive impairments in memory and language do not significantly affect post-surgical outcomes. Our preliminary findings warrant further confirmation with larger sample sizes and long-term follow-up when assessing DBS candidacy in those with pre-surgical cognitive deficits. Comprehensive neuropsychological evaluations can assist in proper risk stratification and informed patient selection.

帕金森病（PD）的皮质下缺陷得到了很好的研究；然而，脑深部刺激（DBS）对语义流畅性、言语记忆存储和对抗命名方面的轻度-中度缺陷所造成的风险尚未得到很好的理解。本研究旨在通过评估DBS前皮质结构域缺陷是否能预测PD患者的手术结果，包括认知、情绪、生活质量、药物和运动功能，从而更好地定义DBS风险分层标准。方法对2015年至2023年间接受术前和术后神经学和神经心理学评估的50例PD患者进行回顾性研究。根据术前神经心理测试，将患者分为正常、轻度和中度认知受损组。贝叶斯配对样本t检验比较了手术前后运动功能、药物使用、生活质量、情绪和认知方面的结果。结果不同认知组在人口学和临床变量上无显著差异。在正常认知组，记忆力和焦虑有明显下降。轻度受损组在延迟单词表记忆方面表现出轻微下降。中度损伤组在认知和情绪变量方面没有显著变化。所有组的术后用药均明显减少。dbs后运动功能和生活质量没有明显变化。结论轻至中度记忆和语言认知障碍对术后预后无显著影响。在评估术前认知缺陷患者的DBS候选性时，我们的初步研究结果需要更大的样本量和长期随访来进一步证实。全面的神经心理学评估可以帮助适当的风险分层和知情的患者选择。

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引用次数: 0

Functional outcomes in older patients after Parkinson’s disease diagnosis in Japan: The LIFE study 日本老年帕金森病患者诊断后的功能结局：LIFE研究

IF 1.8 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100375

Masayo Komatsu , Sanyu Ge , Yasuyoshi Kimura , Ling Zha , Nobuhiro Narii , Yuki Okita , Yoshimitsu Shimomura , Yasufumi Gon , Fumiko Murata , Megumi Maeda , Sho Komukai , Kosuke Kiyohara , Tetsuhisa Kitamura , Hideki Mochizuki , Haruhisa Fukuda

Background

The association between care needs level (CNL) and functional outcomes after diagnosis in older patients with Parkinson’s disease (PD) is unclear.

Methods

Using health insurance claims and the Japanese Long-Term Care (LTC) data from 12 municipalities in Japan, PD patients aged ≥ 65 years old were identified between April 2014 and March 2022. CNL was classified as no care needed (NCN), support level (SL), CNL1 (low level), CNL2-3, and CNL4-5 (fully dependent) based on the total estimated daily care hours as defined by the national standard criteria. The primary outcomes were changes in CNL and all-cause death one year after PD diagnosis by baseline CNL at diagnosis.

Results

Of the 11,270 PD patients, 39.8% had NCN, 27.6% SL&CNL1, 18.8% CNL2-3, and13.9% CNL4-5 at PD diagnosis. One-year after diagnosis, there were NCN 28.2%, SL&CNL1 24.9%, CNL2-3 19.2%, CNL4-5 17.6% (i.e., 61.7% required care need), and all-cause death 10.1%. Compared with NCN patients at diagnosis, patients with SL&CNL1, CNL2-3, and CNL4-5 had an increased risk of all-cause death one-year after diagnosis (adjusted hazard ratio [95% confidence interval]: 1.58 [1.29–1.93], 2.83 [2.32–3.46], and 5.80 [4.76–7.06]), assessed by using Cox proportional hazard models.

Conclusions

Baseline CNL in older Japanese patients was associated with all-cause death even one-year after PD diagnosis, and high CNL was associated with a high risk of all-cause death.

背景：老年帕金森病（PD）患者诊断后的护理需求水平（CNL）与功能结局之间的关系尚不清楚。方法使用来自日本12个直辖市的健康保险索赔和日本长期护理（LTC）数据，在2014年4月至2022年3月期间确定年龄≥65岁的PD患者。根据国家标准定义的每日估计护理总时间，将CNL分为无需护理（NCN）、支持水平（SL）、CNL1（低水平）、CNL2-3和CNL4-5（完全依赖）。主要结局是PD诊断后一年CNL和全因死亡的变化，以诊断时的基线CNL为标准。结果在11,270例PD患者中，39.8%的PD诊断为NCN， 27.6%为sl&cnl1, 18.8%为CNL2-3, 13.9%为CNL4-5。诊断一年后，NCN 28.2%, SL&CNL1 24.9%, CNL2-3 19.2%, CNL4-5 17.6%（即需要护理的61.7%），全因死亡10.1%。与诊断时的NCN患者相比，SL&；CNL1、CNL2-3和CNL4-5患者在诊断后一年的全因死亡风险增加（校正风险比[95%置信区间]:1.58[1.29-1.93]、2.83[2.32-3.46]和5.80[4.76-7.06]）。结论日本老年患者的基线CNL与PD诊断后一年的全因死亡相关，且高CNL与全因死亡的高风险相关。

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引用次数: 0

Nonmotor symptoms in Parkinson’s disease patients in South Asia: A systematic review and meta-analysis 南亚帕金森病患者的非运动症状：系统回顾和荟萃分析

IF 1.8 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100374

Prayash Paudel, Asutosh Sah

Background

The most common movement disorder and neurodegenerative disorder that progresses over time, Parkinson’s disease, has both motor and nonmotor symptoms. Asia is home to half of the world’s elderly population, and Parkinson’s disease is a common condition in this demographic.

Objectives

We aimed to estimate the pooled prevalence of nonmotor symptoms among Parkinson’s disease patients in South Asia based on the available literature.

Methods

The study protocol was registered on PROSPERO with reference number CRD42024579956. Databases were searched for observational studies from 2000 to 2024 in English that have assessed the prevalence of nonmotor symptoms among Parkinson’s disease patients in South Asia via validated tools. High-quality studies were included after quality assessment. A random-effects model was used to calculate the pooled prevalence with a 95 % confidence interval.

Results

Among the 50 articles (4931 participants) included in the review, 9 (862 participants) used the Nonmotor Symptoms Questionnaire, 9 (803 participants) used the Nonmotor Symptoms Scale, 2 (171 participants) used both, and the remaining 30 (3095 participants) used other validated tools to assess nonmotor symptoms in South Asian patients with Parkinson’s disease. The prevalence of nonmotor symptoms was high, with nocturia being the most prevalent. Psychological symptoms were frequently explained via other tools.

Conclusions

Our research is among the few clinical accounts in the literature of the prevalence of nonmotor stmptoms in South Asian Parkinson’s disease patients. Although the heterogeneity of the results could not be fully explained, our study could significantly enhance the understanding of symptoms, leading to more tailored therapeutic and diagnostic strategies.

帕金森氏病是最常见的运动障碍和神经退行性疾病，随着时间的推移而发展，同时具有运动和非运动症状。亚洲拥有世界上一半的老年人口，帕金森病是这一人群的常见病。目的基于现有文献，估计南亚帕金森病患者非运动症状的总患病率。方法研究方案在PROSPERO上注册，参考号为CRD42024579956。数据库检索了2000年至2024年的英语观察性研究，这些研究通过经过验证的工具评估了南亚帕金森病患者非运动症状的患病率。质量评估后纳入高质量研究。采用随机效应模型计算合并患病率，置信区间为95%。在纳入本综述的50篇文章（4931名受试者）中，9篇（862名受试者）使用非运动症状问卷，9篇（803名受试者）使用非运动症状量表，2篇（171名受试者）两者都使用，其余30篇（3095名受试者）使用其他有效工具来评估南亚帕金森病患者的非运动症状。非运动症状的发生率较高，夜尿最为常见。心理症状经常通过其他工具来解释。结论sour研究是文献中少数关于南亚帕金森病患者非运动症状患病率的临床研究之一。虽然结果的异质性不能完全解释，但我们的研究可以显著提高对症状的理解，从而导致更有针对性的治疗和诊断策略。

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引用次数: 0

Corrigendum to “Spatial variability and directional shifts in postural control in Parkinson’s disease” [Clin. Parkinsonism Relat. Disord. (2024) 10, 100249] “帕金森病中姿势控制的空间变异性和方向变化”的更正[临床]。帕金森症遗传代数。Disord。（2024） 10, 100249]

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100308

Damian G. Kelty Stephen , Ken Kiyono , Nick Stergiou , Madhur Mangalam

引用次数: 0

Distinctive cognitive phenotypes in Parkinson’s disease patients with GBA mutations and without dementia: a multicentre cross-sectional retrospective study 具有GBA突变且无痴呆的帕金森病患者的独特认知表型：一项多中心横断面回顾性研究

IF 1.9 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders

Pub Date : 2025-01-01 DOI: 10.1016/j.prdoa.2025.100365

Chiara Longo , Marco Liccari , Ruggero Bacchin , Costanza Papagno , Donatella Ottaviani , Raffaella Di Giacopo , Mauro Catalan , Alina Menichelli , Massimo Marano , Alessio Di Fonzo , Giovanni Duro , Carmela Zizzo , Paolo Manganotti , Bruno Giometto , Maria Chiara Malaguti

Background

Cognitive impairment is a major non-motor complication of Parkinson’s disease (PD). GBA mutations are associated with an increased risk, with PD-GBA+ patients typically showing earlier disease onset and faster cognitive decline. However, the specific cognitive phenotype of these patients remains unclear.

Aim

To provide a detailed neuropsychological profile of PD-GBA+ patients compared to PD-GBA− patients.

Methods

Data from 18 PD-GBA+ and 68 PD-GBA− patients were retrospectively analyzed. All participants underwent comprehensive neurological evaluations of motor and non-motor symptoms, along with a Level II neuropsychological assessment based on the MDS criteria for mild cognitive impairment (MCI). Patients with dementia were excluded.

Results

PD-GBA+ patients showed significantly lower cognitive performance, particularly on the RAVLT immediate recall (RAVLT-IR, p < 0.001) and delayed recall (RAVLT-DR, p = 0.002). All PD-GBA+ patients exhibited an amnestic multi-domain MCI phenotype. In contrast, the PD-GBA− group predominantly showed a non-amnestic single-domain MCI, characterized by a dysexecutive profile. Additionally, PD-GBA+ patients had a higher prevalence of freezing of gait (p < 0.001), right-sided motor symptom lateralization (p = 0.011), and REM sleep behavior disorder (p = 0.006).

Conclusions

PD-GBA+ patients exhibit a distinctive cognitive phenotype, already evident in the early stages of the disease. These results highlight the added value of Level II neuropsychological assessment in accurately characterizing the clinical phenotype and identifying patients at higher risk of developing dementia. Early cognitive profiling may thus contribute to more targeted monitoring and personalized therapeutic strategies.

认知障碍是帕金森病（PD）的主要非运动并发症。GBA突变与风险增加有关，PD-GBA+患者通常表现出更早的疾病发作和更快的认知能力下降。然而，这些患者的具体认知表型尚不清楚。目的提供PD-GBA+患者与PD-GBA -患者的详细神经心理学资料。方法回顾性分析18例PD-GBA+和68例PD-GBA -患者的资料。所有参与者都接受了运动和非运动症状的综合神经学评估，以及基于MDS轻度认知障碍（MCI）标准的II级神经心理学评估。痴呆患者排除在外。结果spd - gba +患者的认知表现明显下降，尤其是在RAVLT即时回忆(RAVLT- ir, p <；延迟回忆（RAVLT-DR, p = 0.002）。所有PD-GBA+患者均表现为遗忘型多域MCI表型。相比之下，PD-GBA组主要表现为非遗忘的单域MCI，其特征是执行障碍。此外，PD-GBA+患者步态冻结的发生率更高(p <；0.001)、右侧运动症状偏侧化（p = 0.011）和REM睡眠行为障碍（p = 0.006）。结论spd - gba +患者表现出独特的认知表型，在疾病的早期阶段已经很明显。这些结果突出了二级神经心理学评估在准确表征临床表型和识别痴呆高风险患者方面的附加价值。因此，早期认知分析可能有助于更有针对性的监测和个性化的治疗策略。

{"title":"Distinctive cognitive phenotypes in Parkinson’s disease patients with GBA mutations and without dementia: a multicentre cross-sectional retrospective study","authors":"Chiara Longo , Marco Liccari , Ruggero Bacchin , Costanza Papagno , Donatella Ottaviani , Raffaella Di Giacopo , Mauro Catalan , Alina Menichelli , Massimo Marano , Alessio Di Fonzo , Giovanni Duro , Carmela Zizzo , Paolo Manganotti , Bruno Giometto , Maria Chiara Malaguti","doi":"10.1016/j.prdoa.2025.100365","DOIUrl":"10.1016/j.prdoa.2025.100365","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment is a major non-motor complication of Parkinson’s disease (PD). GBA mutations are associated with an increased risk, with PD-GBA+ patients typically showing earlier disease onset and faster cognitive decline. However, the specific cognitive phenotype of these patients remains unclear.</div></div><div><h3>Aim</h3><div>To provide a detailed neuropsychological profile of PD-GBA+ patients compared to PD-GBA− patients.</div></div><div><h3>Methods</h3><div>Data from 18 PD-GBA+ and 68 PD-GBA− patients were retrospectively analyzed. All participants underwent comprehensive neurological evaluations of motor and non-motor symptoms, along with a Level II neuropsychological assessment based on the MDS criteria for mild cognitive impairment (MCI). Patients with dementia were excluded.</div></div><div><h3>Results</h3><div>PD-GBA+ patients showed significantly lower cognitive performance, particularly on the RAVLT immediate recall (RAVLT-IR, p < 0.001) and delayed recall (RAVLT-DR, p = 0.002). All PD-GBA+ patients exhibited an amnestic multi-domain MCI phenotype. In contrast, the PD-GBA− group predominantly showed a non-amnestic single-domain MCI, characterized by a dysexecutive profile. Additionally, PD-GBA+ patients had a higher prevalence of freezing of gait (p < 0.001), right-sided motor symptom lateralization (p = 0.011), and REM sleep behavior disorder (p = 0.006).</div></div><div><h3>Conclusions</h3><div>PD-GBA+ patients exhibit a distinctive cognitive phenotype, already evident in the early stages of the disease. These results highlight the added value of Level II neuropsychological assessment in accurately characterizing the clinical phenotype and identifying patients at higher risk of developing dementia. Early cognitive profiling may thus contribute to more targeted monitoring and personalized therapeutic strategies.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"13 ","pages":"Article 100365"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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