scholarly journals The effects of motor rehabilitation training on clinical symptoms and serum BDNF levels in Parkinson’s disease subjects

2016 ◽  
Vol 94 (4) ◽  
pp. 455-461 ◽  
Author(s):  
Francesco Angelucci ◽  
Jacopo Piermaria ◽  
Francesca Gelfo ◽  
Jacob Shofany ◽  
Marco Tramontano ◽  
...  

Increasing evidence suggests that motor rehabilitation may delay Parkinson’s disease (PD) progression. Moreover, parallel treatments in animals up-regulate brain-derived neurotrophic factor (BDNF). Thus, we investigated the effect of a motor rehabilitation protocol on PD symptoms and BDNF serum levels. Motor rehabilitation training consisted of a cycle of 20 days/month of physiotherapy divided in 3 daily sessions. Clinical data were collected at the beginning, at the end, and at 90 days follow-up. BDNF serum levels were detected by ELISA at 0, 7, 14, 21, 30, and 90 days. The follow-up period had a duration of 60 days (T30–T90). The results showed that at the end of the treatment (day 30), an improvement in extrapyramidal signs (UPDRS III; UPDRS III – Gait and Balance items), motor (6 Minute Walking Test), and daily living activities (UPDRS II; PDQ-39) was observed. BDNF levels were increased at day 7 as compared with baseline. After that, no changes in BDNF were observed during the treatment and in the successive follow-up. This study demonstrates that motor rehabilitation training is able to ameliorate PD symptoms and to increase temporarily BDNF serum levels. The latter effect may potentially contribute to the therapeutic action.

2021 ◽  
Vol 12 ◽  
Author(s):  
Xu Yi ◽  
Yujia Yang ◽  
Zhengfan Zhao ◽  
Manyu Xu ◽  
Yuan Zhang ◽  
...  

Parkinson's disease (PD) is one of the most common chronic, progressive, and neurodegenerative diseases characterized clinically by resting tremor, bradykinesia, rigidity, and postural instability. As this disease is usually detected in the later stages, the cure is often delayed, ultimately leading to disability due to the lack of early diagnostic techniques. Therefore, it is of great importance to identify reliable biomarkers with high sensitivity and specificity for the early diagnosis of PD. In this study, we aimed to investigate whether serum expressions of mature brain-derived neurotrophic factor (mBDNF) and proBDNF can serve as biomarkers for the diagnosis of PD at early stage. One hundred and fifty-six patients with limb tremor and/or bradykinesia meeting the inclusion criteria were assigned to either ex-PD group (PD cases) or ex-NPD group (non-PD cases) and then reassigned to either po-PD group (with PD) or po-NPD group (without PD) at 1-year follow-up based on the results of the rediagnoses as performed in accordance with MDS Parkinson's diagnostic criteria. To improve early diagnostic accuracy, grouping (PD group and non-PD group) at initial visit and follow-up was performed differently and independently. Serum mBDNF and proBDNF levels were measured by enzyme-linked immunosorbent assays. The results demonstrated that serum levels of mBDNF and mBDNF/proBDNF were significantly lower in the ex-PD group (19.73 ± 7.31 and 0.09 ± 0.05 ng/ml) as compared with the ex-NPD group (23.47 ± 8.21 and 0.15 ± 0.12 ng/ml) (p < 0.01 for both) and in the po-PD group (19.24 ± 7.20 and 0.09 ± 0.05 ng/ml) as compared with the po-NPD group (25.05 ± 7.67 and 0.16 ± 0.14 ng/ml) (p < 0.01 for both). However, a significantly higher serum level of proBDNF was noted in the ex-PD group (235.49 ± 60.75 ng/ml) as compared with the ex-NPD group (191.75 ± 66.12 ng/ml) (p < 0.01) and in the po-PD group (235.56 ± 60.80 ng/ml) as compared with the po-NPD group (188.42 ± 65.08 ng/ml) (p < 0.01). In conclusion, mBDNF/proBDNF can be used as biomarkers for early stage Parkinson's disease; in addition, mBDNF plus proBDNF has better diagnostic value than mBDNF alone in the diagnosis of PD.


1997 ◽  
Vol 86 (6) ◽  
pp. 931-942 ◽  
Author(s):  
Juan J. López-Lozano ◽  
Gonzalo Bravo ◽  
Begoña Brera ◽  
Isabel Millán ◽  
Jose Dargallo ◽  
...  

✓ Different groups worldwide have observed in recent years that stereotactic implantation of fetal tissue can ameliorate the clinical symptoms of Parkinson's disease. The authors therefore investigated whether implantation of fetal ventral mesencephalic (FVM) tissue via open surgery is also capable of producing an improvement and whether this improvement is transient or long lasting. The authors report their findings in a 5-year follow-up study in 10 patients with Hoehn and Yahr Grade IV or V Parkinson's disease in whom a single FVM graft was implanted in a cavity created in the right caudate nucleus. The results indicate that the implants improved motor function and that clinical recovery persisted in seven of the 10 patients 5 years after implantation. Amelioration was observed in both the on and off phases and was accompanied by a 64% reduction in the levodopa dose and withdrawal of the dopamine agonist. The on phase was prolonged from 39% of the waking day to 72%, with reduced intensity and duration of dyskinesias. All symptoms that were analyzed showed improvement, although they differed in intensity and time of onset. The course of improvement seemed to be stepwise, with significant improvement between 5 and 7 months postimplantation followed by two waves of progress peaking in Months 15 and 36. Withdrawal of cyclosporine in three patients after more than 2 years of administration produced a decline in the patients' clinical conditions. In conclusion, the results indicate that open surgery implantation of FVM tissue in the caudate nucleus improves the clinical condition of parkinsonian patients and that this improvement can persist for at least 5 years. In comparison with two earlier series reported by the authors, which involved implants of perfused adrenal medulla and coimplantation of adrenal medulla and peripheral nerve, the course and pattern of improvement in these implant recipients suggests that their recovery can be attributed to more than one factor.


2021 ◽  
Author(s):  
Akiko Chukyo ◽  
Motoki Fujimaki ◽  
Naoko Kaga ◽  
Hikari Taka ◽  
Yuanzhe Li ◽  
...  

Abstract No methods to assess efficacy of levodopa-associated therapy by blood sampling in Parkinson’s disease (PD) have been established. In this study, we investigated levodopa associated metabolites to characterize their associations with medication and clinical symptoms in PD patients. Comprehensive metabolome analysis using plasma from PD and controls was performed in two independent cohorts (PD: 109, controls: 32; PD: 145, controls: 45). In another validation cohort [251 PD patients (16 de novo, 17 receiving only dopamine-receptor agonists, 218 receiving levodopa/benserazide or levodopa/carbidopa with/without other parkinsonian drugs) and 40 age-matched controls], serum levels of levodopa and its six metabolites were examined by liquid chromatography-mass spectrometry. The association of each metabolite with clinical parameters, medication, and enzymic genotypes was investigated. Significant increases in 3-methoxytyrosine and homovanillic acid were observed in PD patients administered levodopa/benserazide or levodopa/carbidopa. Serum levels of levodopa and five of its metabolites were significantly increased in PD patients administered levodopa and were related to the levodopa or entacapone dose but not to disease severity. Levodopa levels were more effectively preserved in PD patients given levodopa/benserazide than in those given levodopa/carbidopa, especially when taken with entacapone. Each dopamine or 3-methoxytyramine level was efficiently expressed with a numerical model using levodopa, entacapone, and selegiline doses as variables, indicative of its application for drug efficacy monitoring. Benserazide (25 mg) blocked AADC and preserved levodopa levels more effectively than carbidopa (10 mg), and entacapone provided a concomitant effect on levodopa level preservation. The drug efficacy of levodopa-associated medication could be monitored by dopamine or 3-methoxytyramine levels.


2020 ◽  
Author(s):  
Shi Rong Wen ◽  
Guang Yang ◽  
Si Jia Xu ◽  
Yan Liu ◽  
Yu Jun Pan

Abstract Background: The predictive value of subjective cognitive decline in Parkinson's disease (PD-SCD) remains controversial. However, there is growing evidence that individuals with subjective cognitive decline (SCD) are associated with Alzheimer's disease pathology and are a higher risk for cognitive decline. The aim of the present study is to characterize PD-SCD and its progression, assess the effects of rehabilitation training programs on cognitive function in PD patients.Methods: Forty-two PD patients were evaluated with a neuropsychological protocol, and classified depending on the presence (PD-SCD+, n=22) or absence of SCD (PD-SCD-,n=20). After a mean follow-up of 3.0 years (2.0-4.0 years), we repeated the cognitive assessments with the same subjects. The rehabilitation training for individuals with PD for six months after the re-assessment.Results: The clinical characteristics and overall cognitive performance of the 2 groups did not differ from baseline. During the follow-up assessment, patients with PD-SCD exhibited a more significant annual decline in Chinese-Beijing version of Montreal Cognitive Assessment-Test (BJ-MoCA) and semantic fluency than patients without PD-SCD. Stepwise logistic regression analysis showed that the MMSE Scores(P=0.000), HAMD Scores (P=0.008), male (P=0.026), and the presence of SCD (P=0.022) were risk factors for language and related functions domain. There are significant improvements detected in 2 groups after rehabilitation training in terms of BJ-MoCA. Pairwise comparisons showed that language at post-intervention in the PD-SCD+ groups were significantly higher than at pre-intervention in the PD-SCD-.Conclusion: With the progression of the disease, the cognitive performance of patients with PD-SCD+ was worse than PD-SCD-. Meanwhile, the present data indicate that semantic fluency might be a key component to evaluate the cognitive subset of PD. Rehabilitation training is a viable intervention for PD that can improve several non-motor domains, produced larger improvements in cognition.


2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.


2012 ◽  
Vol 153 (52) ◽  
pp. 2060-2069 ◽  
Author(s):  
András Guseo

Parkinson’s disease is one of the most frequent progressive degenerative disorders with unknown origin of the nervous system. The commutation of the disease on Guam led to the discovery of a neurotoxin which was also found in other continents. This neurotoxin was identified in the common cyanobacteria (blue-green algae). Early clinical observations suggested some loose correlations with gastric and duodenal ulcer and Parkinson’s disease, while recent studies revealed a toxin, almost identical to that found in cyanobacteria in one strain of Helicobacter pylori, which proved to cause Parkinson like symptoms in animals. Therefore, it cannot be ruled out that there is a slowly progressive poisoning in Parkinson’s disease. The disease specific alpha-sinuclein inclusions can be found in nerve cells of the intestinal mucosa far before the appearance of clinical symptoms indicating that the disease may start in the intestines. These results are strengthened by the results of Borody’s fecal transplants, after which in Parkinson patients showed a symptomatic improvement. Based on these observations the Parkinson puzzle is getting complete. Although these observations are not evidence based, they may indicate a new way for basic clinical research, as well as a new way of thinking for clinicians. These new observations in psycho-neuro-immunology strengthen the fact that immunological factors may also play a critical factor facilitating local cell necrosis which may be influenced easily. Orv. Hetil., 2012, 153, 2060–2069.


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