scholarly journals Association between Parkinson’s Disease subtypes and tests of physical function: the 360-degree turn test is most predictive

2018 ◽  
Author(s):  
Morgane Prime ◽  
J. Lucas McKay ◽  
Allison Bay ◽  
Ariel Hart ◽  
Chaejin Kim ◽  
...  

ABSTRACTBACKGROUND AND PURPOSEPeople with Parkinson’s disease (PD) present phenotypes that can be characterized as tremor-dominant (TD) or postural instability / gait difficulty (PIGD) subtypes. Differentiation of subtypes allows clinicians to predict the disease course and adjust treatment accordingly. We examined whether brief mobility and balance measures can discriminate PIGD from TD phenotypes.METHODSWe performed a cross-sectional study with individuals with PD (N=104). Blinded raters assessed participants with the UPDRS or MDS-UPDRS, and potential predictor variables: 360-degree turn test, one-leg stance, backward perturbation test and tandem walk. Participant were classified as PIGD or TD based on the Unified Parkinson’s Disease Rating Scale or the Movement Disorder Society revision (UPDRS or MDS-UPDRS) assessment results. Differences in study variables between subtype groups were assessed with univariate analyses. Receiver operating characteristic (ROC) curve analyses were performed to investigate the ability of candidate predictor variables to differentiate PD subtypes.RESULTSMean age and disease duration were 68±9 and 7±5 years, respectively, and Hoehn & Yahr Stages I-IV median (1st,3rd quartile) = II (II, III). No differences between subtypes were observed for tandem walk or reactive postural control. PIGD participants performed worse on number of steps (p<0.001) and time to complete (p=0.003) the 360-degree turn test and one-leg stance (p=0.006). ROC curves showed only the 360-degree turn test could discriminate PIGD from TD with high sensitivity.CONCLUSIONSThe 360-degree turn test requires minimal time to administer and may be useful in mild-moderate PD for distinguishing PIGD from TD subtypes.

2020 ◽  
Vol 10 (9) ◽  
pp. 588
Author(s):  
Elena Cecilia Rosca ◽  
Mihaela Simu

The aim of the present systematic review was to examine the evidence on the accuracy and psychometric properties of the Parkinson’s Disease-Cognitive Rating Scale (PD-CRS) for evaluating the presence of cognitive impairment in patients with Parkinson’s disease (PD) as well as to highlight the quality and quantity of research available on the use of the PD-CRS in this population. We searched four databases from inception until July 2020. Eight studies, published between 2008 and 2020, met the inclusion criteria: One cross-sectional study in which participants were assessed with the index test (PD-CRS) and a reference standard diagnostic assessment, in accordance with the Level II criteria of the International Parkinson and Movement Disorder Society (MDS); one case-control study comparing the PD-CRS to an extensive battery of tests (i.e., MDS Level II diagnosis); and six studies comparing the PD-CRS to other short cognitive batteries. In patients with Parkinson’s disease, the PD-CRS test provides information about cortical and sub-cortical cognitive functions. Even if it demonstrated good psychometric properties, the results regarding the optimal threshold for detecting mild cognitive impairment and dementia in PD are somewhat inconsistent. Further cross-sectional studies are necessary to examine the optimum cut-off score for detecting cognitive dysfunction in PD patients.


2006 ◽  
Vol 21 (8) ◽  
pp. 516-520 ◽  
Author(s):  
Hubert M. Wichowicz ◽  
Jarosław Sławek ◽  
Mirosława Derejko ◽  
Wiesław Jerzy Cubała

AbstractObjectiveThe aim of this study was to assess the prevalence and factors influencing depression in PD patients in a cross-sectional outpatient clinic - based Polish patients sample.Materials and methodsOne hundred consecutive PD patients were included in this study; 35 of them fulfilled DSM-IV criteria for Major Depression and its severity was assessed with Montgomery–Asberg Depression Rating Scale (MADRS). A structured interview and a neurological examination, including Hoehn and Yahr scale (H–Y), Schwab–England disability scale, II, III, IV parts of Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Examination (MMSE) were performed. The parameters obtained were analysed between the depressed and non-depressed PD patients.ResultsThe prevalence of depression in PD in Polish population was established at the level of 35%. PD patients with depression scored significantly higher in all UPDRS scales (except for the subscale of clinical fluctuation) and in H–Y scale. PD with depression was also associated with longer PD duration, higher doses of L-dopa equivalents, patients' age, general impairment of daily living in Schwab and England disability scale, lower MMSE and higher clinical fluctuations. However, those six differences were insignificant.ConclusionsDepression prevalence rate among PD patients in Polish population is slightly lower than in most of other published studies. This may result from strict selection criteria, use of specific outcome measures and restricted criteria for depression that were applied.


Author(s):  
Wildja de Lima Gomes ◽  
Laize Gabriele Castro Silva ◽  
Neildja Maria da Silva ◽  
Robison Carlos Silva Costa ◽  
Roberta de Oliveira Cacho ◽  
...  

Background: Fatigue corresponds to a non-motor symptom of high prevalence in Parkinson’s disease (PD) affecting about one thirdof patients with the disease. This symptom negatively affects daily activities, contributing to the deterioration of the quality of life ofthese subjects. Objectives: To estimate fatigue in PD and to correlate with demographic characteristics, sleep, disease stage, motorfunction and daily activities. Methods: The sample consisted of patients with PD. The following measuring instruments were used for thestudy:Hoehn and Yahr scale, Fatigue Rating Scale, Unified Parkinson’s Disease Rating Scale, Parkinson’s Disease Sleep Scale. Results: Thisstudy highlights the high prevalence of fatigue in subjects with PD, and the screening and treatment of this symptom is extremelyrelevant in clinical practice. There were no significant correlations between fatigue and other variables analyzed. Conclusions: Mostparticipants reported fatigue as a relevant problem, so it is important the use of instruments for fatigue screening in clinical practiceand the need to develop therapies related to this symptom in the PD.


Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 383
Author(s):  
Patrícia Lyra ◽  
Vanessa Machado ◽  
Luís Proença ◽  
Josefa Domingos ◽  
Catarina Godinho ◽  
...  

Background and objectives: People with Parkinson’s disease (PD) may be at risk of having bad periodontal status. A consistent periodontal examination is critical to investigate how it impacts on PD quality of life. We aimed to assess the periodontal status of people with PD, and its association with quality of life and self-perceived xerostomia. Materials and Methods: To this end, from February to March 2020, we consecutively enrolled 28 PD individuals, and motor and non-motor symptoms of PD were assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). We performed full-mouth periodontal examination and gathered information on self-perceived quality of life in PD, oral health impact profile (OHIP-14) and xerostomia. Results: The prevalence of periodontitis was 75.0% and most cases were identified as severe (46.4%). Upper extremity rigidity, hand posture and kinetic tremors were significantly correlated with worse periodontal status. PDQ-8 showed to be correlated with self-perceived oral health-related quality of life and xerostomia levels. Conclusions: This group of people with PD had a high prevalence of periodontitis. Deteriorated levels of the upper extremities in advanced stages of PD were associated with worse periodontal status and hygiene habits. Quality of life in PD appears to be associated with self-perceived OHRQoL and xerostomia.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ting-Ya Chang ◽  
Yi-Huei Chen ◽  
Ming-Hong Chang ◽  
Ching-Heng Lin

Abstract A possible association between depression and either the severity of constipation or dysosmia in Parkinson’s disease (PD) patients was investigated in this cross-sectional study. One-hundred six patients who had the history of PD for less than 5 years were recruited. Depression was measured using the Beck Depression Inventory-II (BDI-II), and our patients were divided into depressive and non-depressive groups (DP: BDI-II ≥ 14; n = 22 and NDP: BDI-II < 14; n = 84). Olfactory dysfunction was assessed by the University of Pennsylvania Smell Identification Test (UPSIT). Constipation severity was defined by stool softener dosage and amount. Statistical analyses with one-tailed T- or chi-squared test, odds ratios (OR), and beta-coefficient were used to determine significant differences. Total scores based on the Unified Parkinson’s Disease Rating Scale (UPDRS) were significantly higher in the DP group. A significant relationship was observed between PD patients with depression and severe constipation; PD patients with depression were more likely to present with severe constipation (OR 5.81; 95% CI 1.24–27.29, p = 0.026, adjusted for age and gender); but the significance became marginal after adjusted for age, gender and UPDRS part 3 (OR 4.46, 95% CI 0.93–21.33; p = 0.061). However, no association between olfactory dysfunction and depression was detected. There were significant positive correlations between BDI-II scores and severe constipation (β ± SE 7.65 ± 2.02; p =  < 0.001, adjusted for age and gender; β ± SE 7.06 ± 2.04; p = 0.001, adjusted for age, gender, and UPDRS-3). Besides, we detected a marginally significant correlation that PD patients with higher BDI-II scores tended to present more severe motor symptoms. Olfactory dysfunction seemed to be less relevant to BDI-II scores. Based on our findings, we speculate that depression may be more closely related to brainstem nuclei than to the limbic pathway.


2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Trine Hørmann Thomsen ◽  
Troels Wesenberg Kjær ◽  
Lene Bastrup Jørgensen ◽  
Anita Haahr ◽  
Kristian Winge

Background. Individuals with Parkinson’s Disease (PD) have bradykinesia during mobility tasks in the morning before intake of dopaminergic treatment and have difficulties managing Activities of Daily Living (ADLs). Early morning off (EMO) refers to off-states in the morning where the severity of bradykinesia is increased and causes a decrease in mobility related to wearing off of effects of medication. Measurements from devices capable of continuously recording motor symptoms may provide insight into the patient’s response to medication and possible impact on ADLs. Objectives. To test whether poor or slow response to medication in the morning predicts the overall ADL-level and to assess the association between change in bradykinesia score (BKS) and the risk of having disabilities within three selected ADL-items. Methods. In this cross-sectional study, the sample consists of 34 patients with light to moderate PD. Data collection encompasses measurements from the Parkinson KinetiGraph, and the ADL-limitations are assessed by the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part II. Results. The association between UPDRS- II and BKS from the algorithm was −0.082 (p<0.01), 95% CL:−0.113; −0.042). The individuals experienced disabilities in performing “Speech” (p=0.004) and “Doing hobbies” (p=0.038) when being slow or poor responders to dopaminergic therapy. The PD patients’ L-dopa equivalent dose seems to be a strong predictor of the ADL-level in the morning. Conclusion. Slow response to the medication dosages in the morning is correlated with disabilities in the overall ADL-level in PD. The combination of PD-drugs and precise, timely dosages must be considered in the improvement of the ADL-level in PD patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yewei Qu ◽  
Lu Zhang ◽  
Dongfang Shen ◽  
Wangzikang Zhang ◽  
Mingsha Zhang ◽  
...  

Objectives. We aimed to investigate the prevalence of restless leg syndrome (RLS) and exploring the contributing factors that affect the development of RLS in Parkinson’s disease (PD) patients. Methods. A cross-sectional study was conducted consisting of 178 consecutive PD patients from our hospital between October 2015 and August 2016. We divided the participants into two groups, which were PD with RLS and PD with non-RLS. Then, we recorded their demographics and clinical data to draw a comparison between PD with RLS and PD with non-RLS. Results. 23 (12.92%) were diagnosed with RLS among all the enrolled PD patients. Unified Parkinson’s Disease Rating Scale III (UPDRS III) and Hamilton Depression Scale (HAMD) scores, probable rapid eye movement sleep behavior disorder (PRBD), and daily levodopa equivalent dose (LED) in the PD with the RLS group were significantly different from those in the PD with the non-RLS group. Daily LED and the scores of UPDRS III and HAMD in PD patients with RLS were all higher than those in PD patients with non-RLS. PRBD, daily LED, and HAMD scores were significantly independent factors contributing to the development of RLS (OR=4.678, 95% CI 1.372~15.944, P=0.014; OR=1.003, 95% CI 1.001~1.005, P=0.019; OR=1.094, 95% CI 1.002~1.193, P=0.045). The severity of RLS was positively correlated with the duration of PD and daily LED (r=0.438, P=0.036; r=0.637, P=0.001). Conclusion. PRBD existence, daily LED, and HAMD scores are independent factors for developing RLS in PD patients. PRBD existence is firstly proposed as an independent factor in developing RLS among PD patients. RLS severity in PD patients are positively associated with the duration of PD and daily LED.


2016 ◽  
Vol 74 (7) ◽  
pp. 519-523 ◽  
Author(s):  
Nathalie Ribeiro Artigas ◽  
Clarissa Franco ◽  
Paula Leão ◽  
Carlos R. M. Rieder

ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.


2019 ◽  
Author(s):  
Shuqi Huang ◽  
Nannan Li ◽  
Shuangyan Tu ◽  
Xiaoyi Sun ◽  
Pingqiao Yuan ◽  
...  

Abstract Background Falling is a common and devastating problem in Parkinson’s disease (PD) patients. However, the factors associated with fall among Chinese PD population remain unclear. Aim The aim of this study was to explore the prevalence and potential factors independently contribute to falls in patients with PD. Methods This cross-sectional study recruited one hundred and ninety-seven PD patients from West China Hospital. According to patients or their caregivers’ memory divided them into two different groups: fallers and non-fallers. Demographical information, clinical features and pharmacological conditions of patients were all collected. Results Out of 197 patients (mean age 63.2±9.0 years) 55.3% (110/197) patients had at least one fall in the half of year. Factors associated with falls in PD including: sex, age, co-disease condition, clinical symptoms, the severity of disease, doing activities, the function of balance, cognition, and the emotional conditions. Furthermore, statistically significant differences were found by binary regression in Hoehn and Yahr (H-Y) stage (OR = 11.500, 95% CI = 2.801-47.214, P = 0.001), the Hamilton Depression (HAMD-24) Rating Scale (OR = 1.296, 95% CI = 1.034-1.296, P = 0.011) and the Falls Efficacy (FES) Scale (OR = 1.028, 95% CI = 1.004-1.053, P = 0.021). However, doing exercise (OR = 0.159, 95% CI = 0.046-0.555, P = 0.004) is a protective factor for PD patients. Conclusions Patients with severe disease, bad psychological condition will increase the risk of falling. Monitoring disease progress and pay more attention on non-motor symptoms are needed while patients in the mild stage.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
He-Yang You ◽  
Lei Wu ◽  
Hai-Ting Yang ◽  
Chen Yang ◽  
Xiao-Ling Ding

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.


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