scholarly journals Nonmotor Symptoms of Parkinson’s Disease as Predictors of Dementia

2017 ◽  
Vol 45 (1) ◽  
pp. 97-99 ◽  
Author(s):  
Mohammed Wasif Hussain ◽  
Richard Camicioli
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Nonmotor Symptoms ◽  
Clinical Dementia Rating ◽  
Increased Risk ◽  
Binary Regression Analysis ◽  
State Examination

AbstractSome nonmotor symptoms (NMS) of Parkinson’s disease (PD) have been shown to increase the risk of developing dementia. A total of 52 PD patients without dementia at baseline were examined for NMS over 36 months. Mini-Mental State Examination, Dementia Rating Scale–2, and caregiver-derived (Clinical Dementia Rating) scores were employed to rate patients as having either clear progression or not. Some 20 of 48 participants (41.7%) had clear cognitive decline. Univariate binary regression analysis was statistically significant for age (odds ratio [OR] (CI95%)=1.24, 1.07–1.45, p=0.006) and orthostatic hypotension (OH) (OR (CI95%)=4.91, 1.24–19.5, p=0.024). Multivariate analysis showed that only age (OR (CI95%)=1.19, 1.0–1.41, p=0.05) and OH (OR (CI95%)=5.57, 1.0–30.97, p=0.05) were correlated with an increased risk of cognitive decline. The presence of OH at baseline may be a significant predictor of progression to dementia in PD.

scholarly journals Προσδιορισμός των επιπέδων της α-συνουκλεΐνης στο εγκεφαλονωτιαίο υγρό και το πλάσμα ασθενών με νόσο Parkinson, άνοια της νόσου Parkinson και άνοια με σωμάτια Lewy

2019 ◽  
Author(s):  
Αναστασία Μπουγέα
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Neuropsychiatric Inventory ◽  
Clinical Dementia Rating ◽  
Compulsive Disorder ◽  
Disease Rating ◽  
State Examination

Θεωρητικό υπόβαθρο: Η νόσος του Πάρκινσον(PD), η άνοια στη νόσο του Πάρκινσον (PDD) και η άνοια με τα σώματα Lewy (DLB) αποτελούν κλινικά σύνδρομα γνωστά ως διαταραχές των σωματίων Lewy (LBD) επειδή έχουντα σωμάτια Lewyως κοινό παθολο-ανατομικό χαρακτηριστικό. Δεδομένου ότι η διάγνωσή τους παραμένει κυρίως κλινική, υπάρχει μεγάλο ενδιαφέρον για τη χρήση ενός ή περισσοτέρων βιοδεικτών για την έγκαιρη και έγκυρη διάγνωση και τη διαφορική διάγνωση μεταξύ αυτών των διαφορετικών μορφών παρκινσονισμού. Η α-συνουκλεΐνη (α-Syn) έχει κερδίσει την προσοχή ως εν δυνάμει βιοδείκτηςγια τις συνουκλεϊνοπάθειες. Ωστόσο,ο προσδιορισμός της ολικής α-Syn στο εγκεφαλονωτιαίο υγρό (ΕΝΥ) με τη μέθοδο ELISA και άλλες παρόμοιες τεχνικές απέδωσε αντικρουόμενα αποτελέσματα. Αντίστοιχες μελέτες της α-Syn στο πλάσμα/ορό έχουν επίσης δώσει αβέβαια αποτελέσματα. Τέτοιες αποκλίσεις έχουν συχνά αποδοθεί σε προ-αναλυτικούς και αναλυτικούς συγχυτικούς παράγοντες (ημερήσια διακύμανση, κεφαλοουραία διαβάθμιση της συγκλεντρωσης εντός του κεντρικού νευρικού συστήματος, το φύλο, την ηλικία και, κυρίως, η επιμόλυνση του ΕΝΥ από αίμα), στις διαφορετικές μεθόδους ELISA και στη μέτρηση διαφορετικών τύπων της α-Syn στο ΕΝΥ και το πλάσμα. Σκοπός: Έτσι, λαμβάνοντας υπόψη τις αδυναμίες των προηγούμενων ερευνών, η παρούσα διατριβή στοχεύει να ελέγξει για πιθανή διαφορά των επιπέδων της α-Syn στο ΕΝΥ, τον ορό και το πλάσμα ανάμεσα σε ασθενείς με νόσο PD, PDD, DLB και υγιείς μάρτυρες και τη διαγνωστική της αξία χρησιμοποιώντας βέλτιστες δυνατές μεθόδους και αυστηρή τήρηση των προαναλυτικών και αναλυτικών κατευθυντήριων οδηγιών.Μεθοδολογία: Στη μελέτη συμμετείχαν 77 ασθενείς (30 με PD, 18 με PDD και 29 με DLB) οι οποίοι νοσηλευτηκαν στην Α΄ Νευρολογική κλινική του Αιγινητείου Νοσοκομείου της Ιατρικής Σχολής του Πανεπιστημίου Αθηνών. Η διάγνωση ετέθη βάσει των πλέον πρόσφατων διαγνωστικών κλινικών κριτηρίων. Σε όλους τους ασθενείς ελήφθη πλήρες ιστορικό και διενεργήθηκε ενδελεχής αντικειμενική νευρολογική εξέταση. Επίσης υποβλήθησαν σε πλήρη κλινικοεργαστηριακό και απεικονιστικό έλεγχο, συμπεριλαμβανομένου τομοσπινθηρογραφήματος βασικών γαγγλίων με 123Ι-ioflupane (SPECT). Επίσης διενεργήθηκε νευροψυχολογικός έλεγχος με τις κάτωθι δοκιμασίες: Mini Mental State Examination (MMSE), CLOX 1-2, Frontal Assessment Battery (FAB), Clinical Dementia Rating (CDR), Neuropsychiatric Inventory (NPI),Questionnaire for Impulsive-Compulsive Disorder in Parkinson's Disease-Rating Scale (QUIP) και Instrumental Activities of Daily Living (IADL). Η κινητική αναπηρία των παρκινσονικών ασθενών αξιολογήθηκε με βάση την κλίμακα Unified Parkinson's Disease Rating Scale (UPDRS Ι-ΙV), η σταδιοποίησή τους με τις κλίμακες των Hoehn και Yahrκαι των Schwab και England. Η ομάδα ελέγχου αποτελείται από 30 υγιή άτομα χωρίς ιστορικό νευρολογικής ή ψυχιατρικής νόσου και φυσιολογική βαθμολογία στις ανωτέρω δοκιμασίες και κλίμακες. Όλοι οι συμμετέχοντες υποβλήθηκαν σε οσφυϊκή παρακέντηση μεταξύ 9-12 π.μ. μετά από ολονύκτια νηστεία. Δείγματα ΕΝΥ και πλάσματος/ ορού ελήφθησαν σε σωληνάρια από πολυπροπυλένιο, φυγοκεντρήθηκαν σε 2000xg για 10 λεπτά και αποθηκεύτηκαν στους -80 ° C μέχρι την ανάλυση. Δείγματα ΕΝΥ με περισσότερα από 50 ερυθρά αιμοσφαίρια απορρίφθηκαν. Αποτελέσματα: Η ηλικία κατά την έναρξη της νόσου ήταν μεγαλύτερη στους ασθενείς με DLB και οι βαθμολογίες MMSE ήταν υψηλότερες σε ασθενείς με PD. Μεγαλύτερες μέσες τιμές UPDRS-III καταγράφηκαν στους PDD και χαμηλότερες σε ασθενείς με PD. Μετά τη διόρθωση του Bonferroni διαπιστώθηκαν σημαντικά χαμηλότερες τιμές του Αβ42 σε ασθενείς με DLB σε σύγκριση με μάρτυρες (p = 0,002), ασθενείς με PD (p <0,001) και ασθενείς με PDD (p = 0,021). Επιπλέον, ηΤΡ-181 είχε σημαντικά χαμηλότερες τιμές σε ασθενείς με PD σε σύγκριση με ασθενείς με DLB (p = 0,028). Μεγαλύτερες τιμές α-Syn στο ΕΝΥ βρέθηκαν σε ασθενείς με DLB σε σύγκριση με τους μάρτυρες (p <0,001), ασθενείς με PD (p <0,001) και με PDD (p <0,001). Η ομάδα έλεγχου είχε σημαντικά χαμηλότερες τιμές α-Syn ορού σε σύγκριση με τους ασθενείς με PD (p <0,001), με PDD (p <0,001) και με DLB (p <0,001). Επιπλέον, οι ασθενείς με PDD είχαν σημαντικά υψηλότερες τιμές του πλάσματος α-Syn σε σύγκριση με τους μάρτυρες (p= 0,023). Ανεξαρτήτως ομάδας ασθενών, τα επίπεδα της α-Syn στο ΕΝΥ συσχετίζονταν σημαντικά με την Aβ42, ενώ τα επίπεδα της α-Syn στο πλάσμα συσχετίζονταν με την Τp-181. Αφαιρώντας τους 7 ασθενείς με DLB με προφιλ ΕΝΥ παθολογίας τύπου Alzheimer (Τt≥ 376, Aβ42≤580 and ΤP-181≥ 62.5 pg/ml) ανεύρεθηκαν σημαντικά υψηλότερες τιμές για την α-Syn ορού και πλάσματος αλλά οριακά για την πρωτεϊνη ΤP-181 στην ομάδα των LBDs συγκριτικά με την ομάδα ελέγχου. Η ανάλυση ROC έδειξε ότι οι α-Syn και Αβ42 στο ΕΝΥ είχαν την καλύτερη διακριτική ικανότητα μεταξύ PD και DLB. Επιπλέον, η διακριτική ικανότητα μεταξύ PDD και DLB ήταν παρόμοια για τις α-Syn και Αβ42 στο ΕΝΥ. Η α-Syn στον ορό έδειξε την καλύτερη διακριτική ικανότητα μεταξύ των PD και μαρτύρων ή μεταξύ PDD και μαρτύρων. Προέκυψαν τέλος οριακές συσχετίσεις μεταξύ βιοδεικτών της α-Syn και της Τp-181 και συγκεκριμένων νευροψυχολογικών/συμπεριφορικών κλιμάκων. Συμπεράσματα: Η α-Syn και η Αβ42 στο ΕΝΥ και τον ορο θα μπορούσαν να θεωρηθουν εν δυναμει βιοδεικτες για την διαφοροδιαγνωση των ασθενών στο φάσμα της LBD αφού έδειξαν την καλύτερη διακριτική ικανότητα μεταξύ των ομάδων PD- PDD και DLB. Εφ’ όσον επιβεβαιωθούν τα αποτελέσματα, η α-Syn του ορού, και, σε μικρότερο βαθμό, του πλάσματος, θα μπορούσαν να θεωρηθούν βιοδείκτες διάγνωσης των LBDs, καθώς εμφανίζουν υψηλότερες τιμές σε σχέση με άτομα ελέγχου.

scholarly journals Association of SNCA Parkinson's Disease Risk Polymorphisms With Disease Progression in Newly Diagnosed Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Aleksandra A. Szwedo ◽  
Camilla Christina Pedersen ◽  
Anastasia Ushakova ◽  
Lars Forsgren ◽  
Ole-Bjørn Tysnes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Confidence Interval ◽  
Disease Progression ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Minor Effect ◽  
The Impact ◽  
State Examination

Objectives: To evaluate the impact of SNCA polymorphisms originally identified as risk factors for Parkinson's disease (PD) on the clinical presentation and progression of the disease in a large cohort of population-based patients with incident PD.Methods: Four hundred thirty-three patients and 417 controls from three longitudinal cohorts were included in the study. Disease progression was recorded annually for up to 9 years using the Unified Parkinson's Disease Rating Scale (UPDRS) or Mini-Mental State Examination. Genotypes for five variants within the SNCA locus (rs2870004, rs356182, rs5019538, rs356219, and rs763443) were determined. We studied the association between each variant and disease progression using linear mixed-effects regression models.Results: The clinical profile of the patients with PD at the point of diagnosis was highly uniform between genotype groups. The rs356219-GG genotype was associated with a higher UPDRS II score than A-allele carriers (β = 1.52; 95% confidence interval 0.10–2.95; p = 0.036), but no differences were observed in the rate of progression of the UPDRS II scores. rs356219-GG was also associated with a faster annual change in Mini-Mental State Examination score compared with A-carriers (β = 0.03; 95% confidence interval 0.00–0.06; p = 0.043).Conclusions: We show that the known PD-risk variant rs356219 has a minor effect on modifying disease progression, whereas no differences were associated with rs2870004, rs356182, rs5019538, and rs763443. These findings suggest that SNCA variants associated with PD risk may not be major driving factors to the clinical heterogeneity observed for PD.

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.

scholarly journals Cluster analysis of cognitive performance in a sample of patients with Parkinson's disease

2016 ◽  
Vol 10 (4) ◽  
pp. 315-319 ◽  
Author(s):  
Carolina Pinto Souza ◽  
Guiomar Nascimento Oliveira ◽  
Maria Paula Foss ◽  
Vitor Tumas
Keyword(s):  
Parkinson’S Disease ◽  
Cluster Analysis ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Rating Scale ◽  
Digit Span ◽  
Depression Scale ◽  
Cognitive Profiles ◽  
Clinical Dementia Rating ◽  
Increased Risk

ABSTRACT Background: Cognitive impairment is a common feature of Parkinson's disease (PD). The diagnoses of mild cognitive impairment (MCI) in patients with PD implies an increased risk for later development of dementia, however, it is unclear whether a specific type of cognitive loss confers increased risk for faster cognitive decline. Objective: Determine whether it was possible to identify distinct cognitive phenotypes in a sample of patients with PD. Methods: A cross-sectional evaluation of 100 patients with PD recruited from a movement disorders clinic was conducted. The patients were evaluated using the simplified motor score of the UPDRS, the Hoehn and Yahr, Schwab and England, Geriatric Depression Scale, Pfeffer Functional Activities Questionnaire, Clinical Dementia Rating Scale, Mini-Mental State Examination, clock drawing test, digit span, word list battery of CERAD, Frontal Assessment Battery and verbal fluency test. We classified the patients as having normal cognition (PDNC), MCI (PDMCI) or dementia (PDD). Data were analyzed using the chi-square test, non-parametric statistics and cluster analysis. Results: There were 40 patients with PDD, 39 with PDMCI and 21 with PDNC. Patients with PDD were older, had longer disease duration, lower education and lower MMSE scores. Cluster analysis showed 3 general distinct cognitive profiles that represented a continuum from mild to severe impairment of cognition, without distinguishing specific cognitive profiles. Conclusion: Cognitive impairment in PD occurs progressively and heterogeneously in most patients. It is unclear whether the definition of the initial phenotype of cognitive loss can be used to establish the cognitive prognosis of patients.

scholarly journals Frailty and cognitive impairment among community-dwelling elderly

2013 ◽  
Vol 71 (6) ◽  
pp. 362-367 ◽  
Author(s):  
Mariana Asmar Alencar ◽  
Joao Marcos Domingues Dias ◽  
Luisa Costa Figueiredo ◽  
Rosangela Correa Dias
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Community Dwelling ◽  
Clinical Dementia Rating ◽  
Frailty Status ◽  
Level Of Activity ◽  
Short Period ◽  
State Examination

The aim was to evaluate associations between frailty status and cognitive decline and the incidence of cognitive impairment over 12-month period. Two hundred seven older adults were assessed. Frailty was defined as having at least three of the following criteria: weight loss, weakness, exhaustion, slowness, and low level of activity. Cognitive decline was assessed using the Mini Mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR). Relative risk (RR) was calculated with a 95% confidence interval (CI). Frailty was associated with subsequent cognitive decline in 12-month when assessed using the MMSE (p=;0.005; RR=;4.6; 95%CI 1.93–11.2). No association was found between frailty and cognitive decline measured by the CDR (p=;0.393; RR=;2.1; 95%CI 0.68–6.7) or between frailty and the incidence of cognitive impairment (p=;0.675; RR=;1.2; 95%CI 0.18–8.3). These findings reveal an association between frailty and subsequent cognitive decline when measured by the MMSE, even within a short period of time.

scholarly journals Neurokognitív zavarok diagnosztizálási és kezelési lehetőségei Parkinson-kórban

2015 ◽  
Vol 156 (23) ◽  
pp. 915-926 ◽  
Author(s):  
Tivadar Lucza ◽  
Kázmér Karádi ◽  
Sámuel Komoly ◽  
József Janszky ◽  
János Kállai ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Neurocognitive Disorders ◽  
Dsm 5 ◽  
Mattis Dementia Rating Scale ◽  
State Examination ◽  
Addenbrooke’S Cognitive Examination

In the present review the recent developments in the definitions of neurocognitive disorders associated with Parkinson’s disease are summarized including the possibilities for screening and treating. For a long time, the recognition of neurocognitive disorders associated in patients with Parkinson’s disease was unsatisfactory due to the heterogeneity of definitions. The recently developed Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) introduced the definitions of mild and major neurocognitive disorders instead of mild cognitive impairment and dementia. The new DSM-5 definitions are clinically well applicable; therefore, the validation of the most frequent screening tests (Mini-Mental State Examination; Addenbrooke’s Cognitive Examination; Montreal Cognitive Assessment; Mattis Dementia Rating Scale) is warranted. Based on a Hungarian sample of 295 patients with Parkinson’s disease, the cut-off scores having the best discriminative values are highly dependent on education years (Addenbrooke’s Cognitive Examination: 0–8 years of education: 82.5 points, 9–12 years of education: 83.5 points, and ≥13 years of education: 84.5 points; Mini-Mental State Examination: 26.5–27.5–28.5 points, Montreal Cognitive Assessment: 23.5–24.5–24.5 points, Mattis Dementia Rating Scale: 138.5–139.5–139.5 points, respectively). Orv. Hetil., 2015, 156(23), 915–926.

scholarly journals A-079 Hand Preference in Men and Women with Parkinson’s Disease: A Preliminary Investigation

2020 ◽  
Vol 35 (6) ◽  
pp. 871-871
Author(s):  
Ryan J ◽  
Kreiner D ◽  
Gontkovsky S ◽  
Paolo A
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurological Disorders ◽  
Rating Scale ◽  
Preliminary Investigation ◽  
Hand Preference ◽  
Dominant Hand ◽  
Healthy Individuals ◽  
Left Handed ◽  
Increased Risk

Abstract Objective Research has identified common genetic influences on handedness and neurological/mental health phenotypes. It also has been shown there may be increased risk for development of neurological disorders/diseases among individuals naturally left-handed or demonstrating non-right-hand preference. This investigation examined prevalence of right-handed versus non-right-handed individuals with Parkinson’s disease (PD) compared to controls. Method Participants were 264 patients with PD (mean age = 69.83 years) and 256 control volunteers (mean age = 71.42 years). Mean Dementia Rating Scale composites for the groups were 123.68 and 136.00, respectively. Participants self-identified their dominant hand for writing and usage was confirmed during the session. Results Proportions of non-right- and right-handed controls (7.0% and 93.0%) versus individuals with PD (6.8% and 93.2%) did not differ. Changes in proportions of non-right- and right-handedness across age ranges were not significant for controls or patients. There was a trend for a larger proportion of women (55.9%) versus men among controls (44.1%), □ 2 (1) = 3.29, p &lt; .10; whereas, the proportion of men (64.4%) with PD was larger than that of women. (35.6%), □ 2 (1) = 21.31, p &lt; .001. For controls and patients, non-right and right handedness gender proportions were similar. Conclusions This study is the first to assess handedness prevalence rates in PD. Results suggest prevalence of non-right handedness is similar in PD and healthy individuals and does not appear to differ markedly by gender or with advancing age. The occurrence of a trend for a larger proportion of women than men among controls is consistent with census-based statistics.

Predictors of Pharyngeal Dysphagia in Patients with Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1727-1735
Author(s):  
Inga Claus ◽  
Paul Muhle ◽  
Judith Suttrup ◽  
Bendix Labeit ◽  
Sonja Suntrup-Krueger ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Logistic Regression ◽  
Rating Scale ◽  
Equivalent Dose ◽  
Binary Logistic Regression Analysis ◽  
Screening Methods ◽  
Clinical Predictors ◽  
Pharyngeal Dysphagia ◽  
Increased Risk

Background: Diagnosis of pharyngeal dysphagia in patients with Parkinson’s disease is often difficult as reliable screening methods are lacking so far and clinical examination fails to adequately assess the pharyngeal phase of swallowing. Objective: To identify clinical predictors indicating the presence of pharyngeal dysphagia in patients at risk. Methods: We examined pharyngeal dysphagia in a large cohort of patients with Parkinson’s disease (n = 200) divided in three clinical subtypes (tremor-dominant (TD), mainly bradykinetic (BK) and early postural instability and gait difficulty PIGD)) by using flexible endoscopic evaluation of swallowing. ANOVA-multivariance analysis and following t-tests as well as binary logistic regression analysis were performed to detect group differences and to identify clinical predictors for dysphagia. Results: Statistically significant differences were found in the dysphagic group: age, male gender, disease duration, stage of the disease, Levodopa equivalent dose and higher scores on the Unified Parkinson’s disease rating scale III and II, item 7. The PIGD subtype was affected more frequently than the TD and BK subtype. In a logistic regression model higher age (>63.5 years p < 0.05) and Levodopa equivalent dose (>475 mg, p < 0.01) were identified to be independent predictors for the presence of pharyngeal dysphagia. Conclusion: Particularly patients with an age > 63.5 years and a daily Levodopa equivalent dose >475 mg show an increased risk for pharyngeal dysphagia. These findings may partly be influenced by presbyphagia but are likely to represent disease progression. The PIGD subtype seems to be a risk factor due to more pronounced dyscoordination of oropharyngeal muscle movements.

scholarly journals Genetic Impact on Clinical Features in Parkinson’s Disease: A Study on SNCA-rs11931074

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Li Shu ◽  
Dongxiao Liang ◽  
Hongxu Pan ◽  
Qian Xu ◽  
Jifeng Guo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Features ◽  
Rating Scale ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Association Analyses ◽  
Comorbidity Burden ◽  
Severe Motor ◽  
Genetic Impact

SNCA-rs11931074 had been demonstrated to be strongly correlated with PD risk. However, there was lack of comprehensive analysis of SNCA-rs11931074-related clinical features which may help explain clinical heterogeneity of PD. In our study, we performed association analyses on the relationship between SNCA-rs11931074 and motor symptoms, nonmotor symptoms, and comorbidities in PD. 611 rs11931074 carriers and 113 rs11931074 noncarriers were enrolled. In the clinical phenotype analyses, the Unified Parkinson’s Disease Rating Scale part II (UPDRS II) and part III (UPDRS III) scores of rs11931074 carriers were lower than those of noncarriers (SC: −0.083, p=0.035; SC: −0.140, p≤0.001). The Charlson Comorbidity Index (CCI) score of carriers was lower than that of noncarriers (SC: −0.097, p=0.009). No significant statistical differences were found between the variant and other clinical features such as motor complications and nonmotor symptoms. The SNCA-rs11931074 carriers may present with more benign clinical profiles than noncarriers with less severe motor symptoms and comorbidity burden.

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