Non‐motor symptoms in postural instability/gait difficulty subtype in the early stage of Parkinson's disease

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
K. Suzuki ◽  
H. Fujita ◽  
T. Matsubara ◽  
K. Hirata
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Postural Instability ◽  
Motor Symptoms ◽  
Postural Instability Gait Difficulty ◽  
Non Motor Symptoms

Effects of deep brain stimulation on sleep-wake disturbances in patients with Parkinson's disease: A narrative review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yu Jin Jung ◽  
Han-Joon Kim ◽  
Sun Ha Paek ◽  
Beomseok Jeon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Early Stage ◽  
Motor Symptoms ◽  
Specific Effects ◽  
The Impact ◽  
Non Motor Symptoms ◽  
Deep Brain

: Sleep-wake disturbances (SWD) are one of the most common non-motor symptoms in Parkinson's disease (PD) and can appear in the early stage even before the onset of motor symptoms. Deep brain stimulation (DBS) is an established treatment for the motor symptoms in patients with advanced PD. However, the effect of DBS on SWD and its specific mechanisms are not widely understood and remain controversial. In addition to the circuit-mediated direct effect, DBS may improve SWD by an indirect effect such as the resolution of nocturnal motor complications and a reduction of dopaminergic medication. Here, the authors review the recent literatures regarding the impact of DBS on SWD in patients with PD. Furthermore, the selection of the DBS targets and the specific effects of applying DBS to each target on SWD in PD are also discussed.

scholarly journals Screening Patients with Early Stage Parkinson’s Disease Using a Machine Learning Technique: Measuring the Amount of Iron in the Basal Ganglia

2020 ◽  
Vol 10 (23) ◽  
pp. 8732
Author(s):  
Seon Lee ◽  
Se-Hong Oh ◽  
Sun-Won Park ◽  
Chaewon Shin ◽  
Jeehun Kim ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Grey Matter ◽  
Early Stage ◽  
Support Vector ◽  
Motor Symptoms ◽  
Model Based ◽  
Svm Model ◽  
Deep Grey Matter ◽  
Non Motor Symptoms

The purpose of this study was to determine whether a support vector machine (SVM) model based on quantitative susceptibility mapping (QSM) can be used to differentiate iron accumulation in the deep grey matter of early Parkinson’s disease (PD) patients from healthy controls (HC) and Non-Motor Symptoms Scale (NMSS) scores in early PD patients. QSM values on magnetic resonance imaging (MRI) were obtained for 24 early PD patients and 27 age-matched HCs. The mean QSM values in deep grey matter areas were used to construct SVM and logistic regression (LR) models to differentiate between early PD patients and HCs. Additional SVM and LR models were constructed to differentiate between low and high NMSS scores groups. A paired t-test was used to assess the classification results. For the differentiation between early PD patients and HCs, SVM had an accuracy of 0.79 ± 0.07, and LR had an accuracy of 0.73 ± 0.03 (p = 0.027). SVM for NMSS classification had a fairly high accuracy of 0.79 ± 0.03, while LR had 0.76 ± 0.04. An SVM model based on QSM offers competitive accuracy for screening early PD patients and evaluates non-motor symptoms, which may offer clinicians the ability to assess the progression of motor symptoms in the patient population.

scholarly journals Longitudinal evolution of non-motor symptoms in early Parkinson’s disease: a 3-year prospective cohort study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruwei Ou ◽  
Yanbing Hou ◽  
Qianqian Wei ◽  
Junyu Lin ◽  
Kuncheng Liu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Effect Size ◽  
Rating Scale ◽  
Early Stage ◽  
Chinese Patients ◽  
Sexual Dysfunctions ◽  
Motor Symptoms ◽  
Small Effect Size ◽  
Non Motor Symptoms

AbstractThe progression of global non-motor symptoms (NMS) in Chinese patients with Parkinson’s disease (PD) has not been explored. We aimed to examine the longitudinal evolution of overall NMS in a 3-year prospective Chinese cohort with early-stage PD. We included 224 patients with early PD who underwent annual evaluation of motor and non-motor symptoms. NMS was assessed using the non-motor symptoms scale (NMSS). We observed an increased number of NMS in the majority of the NMSS domains except mood/apathy and sexual dysfunctions. Significant deterioration was observed in the sleep/fatigue, perceptual problems/hallucinations, attention/memory, gastrointestinal, urinary, and miscellaneous domains during the follow-up (P < 0.05). Notably, the number and the score of sexual dysfunctions decreased with the progression of the disease. All NMSS domains showed a small effect size from baseline to 1-, 2-, and 3-year follow-ups (effect size < 0.5). The generalized estimating equations model indicated that the total number of NMS was significantly associated with age and the Unified Parkinson’s Disease Rating Scale (UPDRS) III score (P < 0.05). Multiple logistic regression indicated that a high number of NMS at baseline was associated with a 3-point, a 6-point, and a 9-point increase in the UPDRS III score from baseline to 1-year (odds ratio [OR] 1.074, P = 0.017), 2-year (OR 1.113, P = 0.001), and 3-year (OR 1.117, P < 0.001), respectively. Our study indicated that overall NMS evolution in early PD is mild and multidimensional; a high NMS burden in early PD predicts the faster motor progression of PD. Our study is helpful for understanding the longitudinal evolution of NMS in PD.

scholarly journals Unusual motor and non-motor symptoms and signs in the early stage of Parkinson’s disease

2016 ◽  
Vol 74 (10) ◽  
pp. 781-784 ◽  
Author(s):  
Hélio A. G. Teive ◽  
Délcio C. Bertucci Filho ◽  
Renato P. Munhoz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Shoulder Pain ◽  
Movement Disorders ◽  
Early Stage ◽  
Color Discrimination ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Symptoms And Signs

ABSTRACT Objective Patients with Parkinson’s disease (PD) may present with unusual motor and non-motor symptoms and signs in the early stage of the disease. Methods Cases were collected over a five-year period at two tertiary movement disorders clinics. All had a diagnosis of PD with unusual presentations defined retrospectively as the presence of complaints not objectively related to any of the classic cardinal signs of parkinsonism or the typical early non-motor features of PD. Results A total of 15 early PD patients fulfilled the proposed criteria, presenting with symptoms such as atypical tremors, shoulder pain, signs related to the rigid akinetic syndrome, as well as cases of asthenia, rhinorrhea, parosmia, dysgeusia, nocturnal sialorrhea, and color discrimination disorders. Conclusions Unusual motor and non-motor symptoms and signs in the early stage of PD can be difficult to interpret. Specialists should be aware of these conditions as clues to a potential diagnosis.

scholarly journals Motor and Non-motor Symptoms Associated With Exercise Behavior in Parkinson's Disease Patients: Factors Differ Between Patients With and Without Postural Instability

2021 ◽  
Vol 12 ◽  
Author(s):  
Joomee Song ◽  
Jinyoung Youn ◽  
Young Eun Huh ◽  
Jun Kyu Mun ◽  
Jong Hyeon Ahn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Instability ◽  
Exercise Behavior ◽  
Motor Symptom ◽  
Disease Stage ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Positive Determinant ◽  
Updrs Part

Background: Exercise is an important treatment for Parkinson's disease (PD). Therefore, recognizing determinants of exercise behavior for PD based on disease stage is essential. We sought to find whether the determinants differ based on presence of postural instability (PI), which is indicative of disease stage in PD.Methods: We enrolled patients at Samsung Medical Center from September 2019 to November 2020, who had the ability to perform exercise [modified Hoehn and Yahr (HY) stage ≤ 3]. All the motor and non-motor symptoms were investigated. The exercise of the PD patients was evaluated using the Physical Activity Scale of the Elderly (PASE)-leisure score. We classified patients into PD without PI (HY stage 1 – 2) and PD with PI (HY stage 2.5 – 3) groups. Multivariate linear regression was performed using backward elimination in each group to determine factors associated with PASE-leisure score.Results: A total of 233 patients were enrolled. In the PD without PI group (n = 177), the positive determinant of exercise was Activities-Specific Balance Confidence (ABC) score (β = 0.142, p = 0.032), and the negative determinants were fatigue score (β = −0.228, p = 0.018), female (β = −6.900, p = 0.016) and currently employed status (β = −6.072, p = 0.046). In the PD with PI group (n = 56), the positive determinant was non-motor symptom scale (NMSS) score (β = 0.221, p = 0.017) and disease duration (β = 1.001, p = 0.036), while the negative determinants were UPDRS part 3 score (β = −0.974, p &lt; 0.001), UPDRS part 4 score (β = −2.192, p = 0.002), and age (β = −1.052, p &lt; 0.001).Conclusion: Different motor and non-motor symptoms were associated with the exercise in PD patients with and without PI. When encouraging PD patients to exercise, personalized and different strategies should be applied based on the presence of PI.

scholarly journals Monoamine Oxidase-B Inhibitors for the Treatment of Parkinson’s Disease: Past, Present, and Future

2021 ◽  
pp. 1-17
Author(s):  
Yu-Yan Tan ◽  
Peter Jenner ◽  
Sheng-Di Chen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Monoamine Oxidase ◽  
Early Stage ◽  
Symptomatic Treatment ◽  
Monoamine Oxidase B ◽  
Motor Symptoms ◽  
Mao B ◽  
Advanced Stages ◽  
Non Motor Symptoms

Monoamine oxidase-B (MAO-B) inhibitors are commonly used for the symptomatic treatment of Parkinson’s disease (PD). MAO-B inhibitor monotherapy has been shown to be effective and safe for the treatment of early-stage PD, while MAO-B inhibitors as adjuvant drugs have been widely applied for the treatment of the advanced stages of the illness. MAO-B inhibitors can effectively improve patients’ motor and non-motor symptoms, reduce “OFF” time, and may potentially prevent/delay disease progression. In this review, we discuss the effects of MAO-B inhibitors on motor and non-motor symptoms in PD patients, their mechanism of action, and the future development of MAO-B inhibitor therapy.

scholarly journals 37 Postural Instability in Parkinson’s Disease: The Association of Cognitive Impairment and Non-Motor Symptoms

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Tien K Khoo ◽  
Melanie Cusso ◽  
Allka Sewram ◽  
Dean Pountney ◽  
Kenneth Donald
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Rating Scale ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Postural Instability ◽  
Motor Symptoms ◽  
Yahr Scale ◽  
Non Motor Symptoms

Abstract Introduction Parkinson’s disease (PD) is the second most common neurodegenerative condition after Alzheimer’s. Historically considered as a movement disorder, the multitude of non-motor symptoms (NMS) are now a recognised cause of significant disease burden. This study aimed to explore the relationship between postural instability and NMS in PD. Methodology We recruited individuals (n=100) in South East Queensland with a pre-existing diagnosis of idiopathic PD into this prospective observational study. Motor assessment was performed via the Movement Disorders Society-revised Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Assessment of postural instability was based on the Hoehn & Yahr Scale (H&Y) with a score of ≥3 considered indicative of postural instability. NMS were assessed via the Non-Motor Symptoms Scale (NMSS). Further neuropsychiatric and affective assessment was evaluated with the Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI), Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI) and Montreal Cognitive Assessment (MoCA). Results Cohort demographics comprised of 62% male and 38% female with a mean age of 69.1 years (SD 7.35) and mean H&Y 2.34 (SD 0.59). Sixty four participants were H&Y 1 & 2 whilst 36 participants were H&Y ≥3. Participants with postural instability were significantly older (p = 0.033) and had lower MoCA scores (p=0.039). Among the MoCA domains, only the Visuospatial / Executive domain was associated with postural instability (p= 0.005). Among the NMSS domains, only the sexual function domain was significantly associated with the latter group (p=0.029). GDS scores tended to be higher in the postural instability group (p=0.054) but there was no significance in major depressive disorder (p=0.436). Conclusion Postural instability in PD is significantly associated with age and cognitive impairment, in-particular frontal lobe function. The association of sexual dysfunction is supportive of the notion that disorders in dopaminergic and non-dopaminergic systems underpin the pathophysiology substrate of postural instability.

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