Dementia in Parkinson's disease challenges the “gold standard”

2005 ◽  
Vol 58 (5) ◽  
pp. 663-665 ◽  
Author(s):  
Gilberto Levy
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard

scholarly journals Postmortem studies in Parkinson's disease

2004 ◽  
Vol 6 (3) ◽  
pp. 281-293 ◽  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard ◽  
Dopaminergic Neurons ◽  
Nigrostriatal System ◽  
Regional Vulnerability ◽  
Environmental Agents ◽  
Postmortem Studies

No animal model to date perfectly replicates Parkinson's disease (PD) etiopathogenesis, and the anatomical organization of the nigrostriatal system differs considerably between species. Human postmortem material therefore remains the gold standard for both formulating hypotheses for subsequent testing in in vitro and in vivo PD models and verifying hypotheses derived from experimental PD models with regard to their validity in the human disease. This article focuses on recent and relevant fields in which human postmortem work has generated significant impact in our understanding of PD. These fields include Lewy body formation, regional vulnerability of dopaminergic neurons, oxidative/nitrative cellular stress, inflammation, apoptosis, infectious and environmental agents, and nondopaminergic lesions.

scholarly journals Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire – Current Short (QUIP-CS) – Translation and validation of content of Portuguese Version

2017 ◽  
Vol 66 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Débora Mascella Krieger ◽  
Sabrina Vilanova Cardoso ◽  
Wolnei Caumo ◽  
Guilherme Valença ◽  
Daniel Weintraub ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard ◽  
Impulse Control ◽  
Neuropsychiatric Symptoms ◽  
Compulsive Buying ◽  
Portuguese Version ◽  
Back Translation ◽  
Compulsive Disorders ◽  
Translation And Validation

ABSTRACT Objective Parkinson’s disease (PD) management is usually successfully reached with proper pharmacological treatment. However, PD patients can manifest neuropsychiatric symptoms secondary to medical therapy, including impulse control disorders (ICD), presenting as pathological gambling, hypersexuality, compulsive buying, drinking or eating disorders. We translated and validated the Portuguese version of the gold-standard questionnaire Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire, or (QUIP) for identifying ICDs in PD patients. Methods Translation, back translation and submission to instrument developer was performed, that approved its new version comparing it to his original, validated version, with no loss of it’s original properties. Then, the Portuguese version was administered to 30 PD patients. They also were asked to rate from 1 to 5 the level of comprehensibility of the questions. Results The average level of comprehension was 4.06 ± 0.69 DP, considering 3 or more as acceptable. No patient has answered 1 or 2. Conclusion Our results on Portuguese version of QUIP-CS show that QUIP-CS translated and corrected version was easily understood and easily self-applied.

scholarly journals Gold Standard of Symptomatic treatment in Parkinson disease: Carbidopa / Levodopa

2018 ◽  
pp. 63-68 ◽  
Author(s):  
Aslam Pathan ◽  
Abdulrahman Alshahrani
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Adverse Effects ◽  
Gold Standard ◽  
Signs And Symptoms ◽  
Symptomatic Treatment ◽  
Short Term ◽  
Neurologic Disorders ◽  
Pharmacological Data

Parkinson's disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed but not halted, by treatment. The goal of the medical management of Parkinson's disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Levodopa coupled with a peripheral decarboxylase inhibitor (PDI), such as carbidopa, remains the gold standard of symptomatic treatment of motor features of Parkinson's disease. It provides the greatest antiparkinsonian benefit with the fewest adverse effects in the short term. However, its long-term use is associated with the development of fluctuations and dyskinesias. This review article is written to summarize the clinical and pharmacological data of carbidopa and levodopa which will be helpful to neurologists and physicians.

scholarly journals Responsiveness to Change of the Montreal Cognitive Assessment, Mini-Mental State Examination, and SCOPA-Cog in Non-Demented Patients with Parkinson’s Disease

2019 ◽  
Vol 47 (4-6) ◽  
pp. 187-197 ◽  
Author(s):  
Achinoam Faust-Socher ◽  
Sarah Duff-Canning ◽  
Arthur Grabovsky ◽  
Melissa J. Armstrong ◽  
Brandon Rothberg ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
Mental State ◽  
Gold Standard ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Neuropsychological Testing ◽  
Montreal Cognitive Assessment ◽  
State Examination

Background: Clinical monitoring of patients with Parkinson’s disease (PD) for cognitive decline is an important element of care. The Montreal Cognitive Assessment (MoCA) has been proposed to be a sensitive tool for assessing cognitive impairment in PD. The aim of our study was to compare the responsiveness of the MoCA to decline in cognition to the responsiveness of the Mini Mental State Examination (MMSE) and the Scales for Outcomes of Parkinson’s disease-cognition (SCOPA-Cog). Methods: PD patients without dementia were enrolled at 6 North American movement disorders centers between 2008 and 2011. Participants received annual evaluations including the MoCA, MMSE, and SCOPA-Cog followed by formal neuropsychological testing. The gold standard for change in cognition was defined as the change on the neuropsychological test scores over the annual assessments. The Reliable Change Method was used to provide an estimate of the probability that a given difference score would be obtained by chance. The sensitivity of the MoCA, MMSE, and SCOPA-Cog to change was quantified using receiver operating characteristics (ROC) curves. Results: One hundred seventeen patients were included in the analysis. Participants were followed at mean intervals of 11 ± 2 months for a median of 2 (maximum 5) visits. According to the reliable change index, 56 intervals of cognitive testing showed a decline in global cognition. ROC analysis of change in MoCA, MMSE, and SCOPA-Cog global scores compared to gold standard testing found an area under the curve (AUC) of 0.55 (95% CI 0.48–0.62), 0.56 (0.48–0.63), and 0.63 (0.55–0.70) respectively. There were no significant differences in the AUCs across the tests. The sensitivity of the MoCA, MMSE, and SCOPA-Cog to change at various thresholds for decline in scores reached a maximum of 71% for a cut-off of 1 point change on the SCOPA-Cog. Conclusion: Using neuropsychological testing as a gold standard comparator, the performance of the MoCA, MMSE, and SCOPA-Cog for detecting decline in non-demented PD patients over a 1-year interval is poor. This has implications for clinical practice; stable scores may not be taken as reassurance of the absence of cognitive decline.

Domperidone in Parkinson’s Disease: A Perilous Arrhythmogenic or the Gold Standard?

2013 ◽  
Vol 8 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Unax Lertxundi ◽  
Saioa Domingo- Echaburu ◽  
Amaia Soraluce ◽  
Montserrat Garcia ◽  
Borja Ruiz- Osante ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard

scholarly journals Reliability of Three Disability Scales for Detection of Independence Loss in Parkinson’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anders Bjornestad ◽  
Ole-Bjorn Tysnes ◽  
Jan Petter Larsen ◽  
Guido Alves
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Diagnostic Accuracy ◽  
Activities Of Daily Living ◽  
Gold Standard ◽  
Daily Living ◽  
Outcome Measure ◽  
Clinical Interview ◽  
Disease Specific ◽  
Important Outcome Measure

Background.Loss of independence is considered an important outcome measure in Parkinson’s disease (PD), but tools to assess dependency have not been tested in PD.Methods.In this study of 158 PD patients, we examined the two most widely used scales and cut-offs for dependency evaluation in PD, the Hoehn and Yahr (HY) stage > 3 and the Schwab and England (SE) scale score < 80%, against a standardized clinical interview assessing dependency in activities of daily living (ADL). We also examined the performance of the generic Barthel ADL index. In addition, we determined whether alternative cut-offs improved the utility of these tools.Results.Compared to clinical interview as gold standard, HY stage > 3 had 21% sensitivity and 98% specificity in detecting dependency in ADL. Corresponding figures for SE score < 80% were 55% and 92%, respectively. Using alternative cut-off values improved the overall diagnostic accuracy only slightly. Barthel ADL index had 67% sensitivity and 78% specificity in detecting dependency at its optimal cut-off value.Conclusion.Both the disease-specific HY staging and SE scale and the generic Barthel ADL index are suboptimal tools for assessing independence loss in PD. Clinical interview should be the assessment of choice in studies of dependency.

scholarly journals A Novel Easy-of-Use Smartphone-Based Assessment of Gait Characteristics in Parkinson’s Disease (Preprint)

2020 ◽  
Author(s):  
Dongning Su ◽  
Zhu Liu ◽  
Xin Jiang ◽  
Fangzhao Zhang ◽  
Wanting Yu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Gold Standard ◽  
Rating Scale ◽  
Standard System ◽  
Functional Characteristics ◽  
Velocity Signal ◽  
Single Task ◽  
Gait Assessment

BACKGROUND Parkinson’s disease (PD) is common movement disorder and patients with PD had multiple gait impairments, leading to increased risk of falls, and diminished quality of life. The gait measurement in patients with Parkinson’s disease (PD) is thus important for the management of PD. OBJECTIVE We have developed and validated a smartphone-based assessment of gait, allowing the remote gait assessment in healthy cohorts. We here aimed to test the validity of this App-based gait measurement in people with PD and explore the association between the gait metrics measured by App and the clinical and functional characteristics in PD. METHODS Fifty-two participants with clinically-diagnosed PD completed assessments of walking, MDS-Unified Parkinson's Disease Rating Scale III (UPDRS III), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety (HAM-A) and Depression (HAM-D) rating scale tests. Participants followed multi-media instructions provided by the App to complete two 20-meter trials each of walking normally (single-task) and walking while performing a serial subtraction dual task (dual-task). The locomotion data were simultaneously collected with the App and a gold-standard system. The gait stride times (ST) and stride time variability (STV) were derived from the acceleration and angular velocity signal acquired from the internal motion sensor of the phone, and from the wearable sensor system. RESULTS High correlations between the ST and STV derived from the App and those from gold-standard system were observed (r=0.98~0.99, p<.0001), revealing excellent validity of the App-based gait assessment in PD. Compared to single-task, the ST (F=13.1, p=.0005) and STV (F=6.3, p=.01) in dual-task condition were significantly greater. Participants with greater STV in both conditions had greater total score of UPDRS III (r=0.37~0.39, p=.0007~.01), HAM-A (single-task: r=0.49, p=.007; dual-task: r=0.48, p=.009) and HAM-D (single-task: r=0.44, p=.01; dual-task: r=0.49, p=.009); and those with greater dual-task STV (r=0.48, p=.001) and/or dual-task cost to STV (r=0.44, p=.004) had lower MoCA score. CONCLUSIONS These results demonstrated that this ease-of-its-use smartphone-based gait measurement is validated and provides meaningful metrics that are associated with clinical and functional characteristics in PD.

scholarly journals Validation of a Sensor-Based Gait Analysis System with a Gold-Standard Motion Capture System in Patients with Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7680
Author(s):  
Verena Jakob ◽  
Arne Küderle ◽  
Felix Kluge ◽  
Jochen Klucken ◽  
Bjoern M. Eskofier ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Motion Capture ◽  
Gold Standard ◽  
Wearable Sensors ◽  
Heel Strike ◽  
Motion Capture System ◽  
Gait Parameters ◽  
Analysis System

Digital technologies provide the opportunity to analyze gait patterns in patients with Parkinson’s Disease using wearable sensors in clinical settings and a home environment. Confirming the technical validity of inertial sensors with a 3D motion capture system is a necessary step for the clinical application of sensor-based gait analysis. Therefore, the objective of this study was to compare gait parameters measured by a mobile sensor-based gait analysis system and a motion capture system as the gold standard. Gait parameters of 37 patients were compared between both systems after performing a standardized 5 × 10 m walking test by reliability analysis using intra-class correlation and Bland–Altman plots. Additionally, gait parameters of an age-matched healthy control group (n = 14) were compared to the Parkinson cohort. Gait parameters representing bradykinesia and short steps showed excellent reliability (ICC > 0.96). Shuffling gait parameters reached ICC > 0.82. In a stridewise synchronization, no differences were observed for gait speed, stride length, stride time, relative stance and swing time (p > 0.05). In contrast, heel strike, toe off and toe clearance significantly differed between both systems (p < 0.01). Both gait analysis systems distinguish Parkinson patients from controls. Our results indicate that wearable sensors generate valid gait parameters compared to the motion capture system and can consequently be used for clinically relevant gait recordings in flexible environments.

scholarly journals An attempt to dissect a peripheral marker based on cell pathology in Parkinson's disease

2021 ◽  
Author(s):  
Francesca Biagioni ◽  
Rosangela Ferese ◽  
Filippo Sean Giorgi ◽  
Nicola Modugno ◽  
Enrica Olivola ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gold Standard ◽  
Mononuclear Cells ◽  
De Novo ◽  
Disease Marker ◽  
Large Populations ◽  
Associated Proteins ◽  
Reliable Marker ◽  
And Control

AbstractPeripheral markers in Parkinson’s disease (PD) represent a hot issue to provide early diagnosis and assess disease progression. The gold standard marker of PD should feature the same reliability as the pathogenic alteration, which produces the disease itself. PD is foremost a movement disorder produced by a loss of nigrostriatal dopamine innervation, in which striatal dopamine terminals are always markedly reduced in PD patients to an extent, which never overlaps with controls. Similarly, a reliable marker of PD should possess such a non-overlapping feature when compared with controls. In the present study, we provide a novel pathological hallmark, the autophagosome, which in each PD patient was always suppressed compared with each control subject. Autophagosomes were counted as microtubule-associated proteins 1A/1B light chain 3B (LC3)-positive vacuoles at ultrastructural morphometry within peripheral (blood) blood mononuclear cells (PBMC). This also provides the gold standard to assess the autophagy status. Since autophagy may play a role in the pathogenesis of PD, autophagosomes may be a disease marker, while participating in the biology of the disease. Stoichiometric measurement of α-synuclein despite significantly increased in PD patients, overlapped between PD and control patients. Although the study need to be validated in large populations, the number of autophagy vacuoles is neither related with therapy (the amount was similarly suppressed in a few de novo patients), nor the age in PD or controls.

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