scholarly journals Abnormal Olfaction in Parkinson’s Disease Is Related to Faster Disease Progression

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Sara Cavaco ◽  
Alexandra Gonçalves ◽  
Alexandre Mendes ◽  
Nuno Vila-Chã ◽  
Inês Moreira ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Identification Test ◽  
Disease Rating ◽  
Abnormal Performance ◽  
Smell Identification

Introduction. A possible association between olfactory dysfunction and Parkinson’s disease (PD) severity has been a topic of contention for the past 40 years. Conflicting reports may be partially explained by procedural differences in olfactory assessment and motor symptom evaluation.Methods. One hundred and sixty-six nondemented PD patients performed the Brief-Smell Identification Test and test scores below the estimated 20th percentile as a function of sex, age, and education (i.e., 80% specificity) were considered demographically abnormal. Patients underwent motor examination after 12 h without antiparkinsonian medication.Results. Eighty-two percent of PD patients had abnormal olfaction. Abnormal performance on the Brief-Smell Identification Test was associated with higher disease severity (i.e., Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III, Freezing of Gait questionnaire, and levodopa equivalent dose), even when disease duration was taken into account.Conclusions. Abnormal olfaction in PD is associated with increased severity and faster disease progression.

scholarly journals Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson’s Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Belén González-Herrero ◽  
Serge Jauma-Classen ◽  
Roser Gómez-Llopico ◽  
Gerard Plans ◽  
Matilde Calopa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Therapeutic Option ◽  
Freezing Of Gait ◽  
Disease Rating ◽  
Deep Brain

Background. Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson’s disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms. Objective. To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation. Methods. We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson’s Disease Rating Scale before and after intestinal levodopa infusion. Results. Administration of intestinal levodopa caused improvement of FOG in the “ON” state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson’s Disease Rating Scale. The improvement was maintained for at least 12 months. Conclusions. Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

scholarly journals Relation of Subjective Quality of Life to Motor Symptom Profile in Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Erica R. Appleman ◽  
Karina Stavitsky ◽  
Alice Cronin-Golomb
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Motor Symptom ◽  
Subjective Quality Of Life ◽  
Treatment Optimization ◽  
Symptom Profile ◽  
Disease Rating

Parkinson's disease (PD) presents with extensive heterogeneity in symptomatology, inviting examination of disease subtypes. One significant categorization is by whether patients present at onset with tremor as the dominant symptom (TD) or with nontremor symptoms (NTD). We examined differences in quality of life between TD and NTD patients using the Parkinson's Disease Questionnaire-39 (PDQ-39), correlating performance with aspects of motor function as indexed by the Unified Parkinson's Disease Rating Scale (UPDRS). Participants included 35 nondemented individuals (19 TD, 16 NTD) matched on clinical and demographic characteristics. NTD had significantly lower overall PDQ-39 scores, particularly for the mobility subscale. Several UPDRS subscale scores significantly correlated with quality of life, especially for NTD. Further, the correlations were driven by nontremor type symptoms, even in TD patients. Determining reliable subtypes of PD may aid in prognosis and treatment optimization, thereby enhancing quality of life in afflicted individuals.

Hand Function as Predictor of Motor Symptom Severity in Individuals with Parkinson’s Disease

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Thiago da Silva Rocha Paz ◽  
Vera Lúcia Santos de Britto ◽  
Bruna Yamaguchi ◽  
Vera Lúcia Israel ◽  
Alessandra Swarowsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Symptom Severity ◽  
Rating Scale ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Hand Function ◽  
Freezing Of Gait ◽  
Motor Symptom ◽  
Cross Sectional

<b><i>Introduction:</i></b> Parkinson’s disease (PD) leads to deficits in upper limb strength and manual dexterity and consequently resulting in functional impairment. Handgrip strength is correlated with the motor symptom severity of the disease, but there is a gap in the literature about the influence of freezing in PD patients. <b><i>Objective:</i></b> The objective is to study the correlation between handgrip strength and motor symptom severity considering the freezing phenomenon and to verify variables that can predict Unified Parkinson’s Disease Rating Scale (UPDRS) III. <b><i>Methods:</i></b> This is a multicenter cross-sectional study in PD. 101 patients were divided into 2 groups: freezing of gait (FOG) (<i>n</i> = 51) and nonfreezing (nFOG) (<i>n</i> = 52). Freezing of Gait Questionnaire (FOGQ); UPDRS II and III sections; Hoehn and Yahr (HY) scale; handgrip dynamometry (HD); 9 Hole Peg Test (9-HPT) were assessed. <b><i>Results:</i></b> In both groups, HD was correlated to UPDRS III (nFOG: −0.308; FOG: −0.301), UPDRS total (nFOG: −0.379; FOG: −0.368), UPDRS item 23 (nFOG: −0.404; FOG: −0.605), and UPDRS item 24 (nFOG: −0.405; FOG: −0.515). For the correlation to UPDRS II (0.320) and 9-HPT (−0.323), only nFOG group presented significance. For the UPDRS 25 (−0.437), only FOG group presented statistical significance. The UPDRS III can be predicted by 9-HPT, age, and HY in nFOG patients (Adjusted <i>R</i><sup>2</sup> = 0.416). In FOG group, UPDRS III can be predicted by HD, 9-HPT, age, and HY (Adjusted <i>R</i><sup>2</sup> = 0.491). <b><i>Conclusion:</i></b> Handgrip strength showed to be predictive of motor impairment only in the FOG group. Our results showed clinical profile differences of motor symptoms considering freezers and nonfreezers with PD.

scholarly journals Olfactory Dysfunction Predicts Disease Progression in Parkinson’s Disease: A Longitudinal Study

2020 ◽  
Vol 14 ◽  
Author(s):  
Runcheng He ◽  
Yuwen Zhao ◽  
Yan He ◽  
Yangjie Zhou ◽  
Jinxia Yang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scale ◽  
Mmse Score ◽  
Clinical Manifestations ◽  
Olfactory Dysfunction ◽  
Olfactory Function ◽  
Motor Symptom

Background and Objective:Olfactory dysfunction (hyposmia) is an important non-motor symptom of Parkinson’s disease (PD). To investigate the potential prognostic value of hyposmia as a marker for disease progression, we prospectively assessed clinical manifestations and longitudinal changes of hyposmic PD patients and normosmic ones.MethodsOlfactory function was evaluated with the Sniffin’ Sticks in PD patients at baseline. One hundred five hyposmic PD patients and 59 normosmic PD patients were enrolled and followed up for 2 years. They were subsequently evaluated at baseline and during follow-up periods with neurological and neuropsychological assessments. Clinical manifestations and disease progressions were compared between hyposmic and normosmic patients. In addition, the relationship between disease progressions and olfactory function was analyzed.ResultsOur study suggested that hyposmic PD patients and normosmic ones were similar in gender, age, education levels, age of onset, disease duration, and clinical features at baseline. Hyposmic PD patients exhibited more severe Unified Parkinson’s Disease Rating Scale Part II–III (UPDRS II-III) scores, higher levodopa equivalent dose (LED) needs, and poorer Mini-Mental State Examination (MMSE) score at follow-up visits compared to those in normosmic PD patients. Hyposmia also showed greater rates in the increase of LED needs, improvement of UPDRS III score, and deterioration of MMSE score. Both improvement of UPDRS III score and decline of MMSE score were associated with poorer odor identification.ConclusionOur prospective study demonstrated that hyposmic PD patients showed a relatively worse clinical course compared with normosmic patients. Olfactory dysfunction is a useful predictor of disease progression.

scholarly journals The Methods of Detection of Gait Disturbance and Postural Instability in Case of Parkinson’s Disease

2018 ◽  
Vol 3 (2) ◽  
pp. 37-40
Author(s):  
IE E Poverennova ◽  
VA A Kalinin ◽  
SA A Shpileva
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scales ◽  
Rating Scale ◽  
Neurological Diseases ◽  
Freezing Of Gait ◽  
Postural Instability ◽  
Motor Disorders ◽  
Medication Therapy ◽  
Disease Rating

Parkinson’s disease takes first place among neurological diseases of senior persons and its prevalence consists of 2% among people elderly than 65 years old. Disturbance of gait and postural instability are the most important motor disorders in case of Parkinson’s disease. Aim - to reveal factors which influence on the falling down of patients with Parkinson’s disease. Materials and methods. The use of unified Parkinson’s disease rating scale for examination of patients with Parkinson’s disease was performed. Results of rating scales were analyzed due to regression analysis. Results. It was revealed that the most important factor of falling down is the disturbance of gait. Freezing of gait has little influence on falling. Conclusion. The use of such diagnostic tests in the routine neurological examination allows to optimize medication therapy and to use modern non- medication methods of correction of gait.

scholarly journals German Translation and Validation of the “Freezing of Gait Questionnaire” in Patients with Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Anina Vogler ◽  
Jorina Janssens ◽  
Thomas Nyffeler ◽  
Stephan Bohlhalter ◽  
Tim Vanbellingen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Convergent Validity ◽  
Rating Scale ◽  
Freezing Of Gait ◽  
Divergent Validity ◽  
Timed Up And Go ◽  
Disease Rating ◽  
Disease Questionnaire ◽  
Movement Disorder Society

Background. Freezing of Gait (FOG) is a disabling parkinsonian symptom. The Freezing of Gait Questionnaire (FOG-Q) reliably detects FOG in patients with Parkinson’s disease (PD).Objectives. The aim of this study was to develop a German translated version of the FOG-Q and to assess its validity.Methods. The translation was accomplished using forward-backward-translation. The construct validity of the FOG-Q was examined in twenty-seven German native speaking PD patients. Convergent validity was assessed by correlating the FOG-Q with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) II-III, the Parkinson Disease Questionnaire 39 (PDQ-39), and the Timed Up and Go Test (TUG). Divergent validity was assessed by correlating the FOG-Q with the MDS-UPDRS I. The internal consistency was measured using Cronbach’s alpha (Cα).Results. A good internal structure of the FOG-Q was found (Cα=0.83). Significant moderate correlations between the FOG-Q and the MDS-UPDRS item 2.13 (freezing) (rs=0.568,P=0.002) and between the FOG-Q and the PDQ-39 subscale mobility (rs=0.516,P=0.006) were found. The lack of correlation with the MDS-UPDRS I demonstrated good divergent validity.Conclusion. The German FOG-Q is a valid tool to assess FOG in German native speaking PD patients.

Use of the Unified Parkinson’s Disease Rating Scale Activities of Daily Living Subscale to Assess Response to Rasagiline in Early Parkinson’s Disease

US Neurology ◽  
2011 ◽  
Vol 07 (02) ◽  
pp. 91
Author(s):  
Daniel E Kremens ◽  
James Gilbart ◽  
◽  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Disease Progression ◽  
Daily Living ◽  
Rating Scale ◽  
Response To Treatment ◽  
Early Start ◽  
Secondary Analyses ◽  
Disease Rating

Various assessment scales are used to measure the severity and rate of progression of Parkinson’s disease (PD)—for example, the Unified Parkinson's Disease Rating Scale (UPDRS) and its Activities of Daily Living (ADL) subscale. The relative merits of these scales for accurately determining the degree of disease progression have recently come under scrutiny. Analyses of data from the recent Attenuation of disease progression with Azilect given once daily (ADAGIO) trial demonstrated that patients receiving early-start rasagiline (Azilect®, Teva Neuroscience, North Wales, PA) 1 mg/day experienced slower disease progression, as assessed by their mean total UPDRS score, than patients receiving placebo followed by delayed-start rasagiline treatment. Subsequent secondary analyses showed that 1 and 2 mg/day doses of early-start rasagiline delayed the need for antiparkinsonian drugs and improved other parameters, including ADL scores and fatigue, when compared with placebo followed by delayed-start rasagiline. Furthermore, the analyses highlighted that, over time, the motor and mentation sections of the UPDRS-ADL subscale increasingly reflect the response to treatment of the early- and delayed-start rasagiline 1 mg/day patient groups. The results from the ADAGIO trial suggest that rasagiline has potential disease-modifying effects, but more clinical data are required to confirm their effect on PD progression.

scholarly journals An Investigation into the Use and Meaning of Parkinson’s Disease Clinical Scale Scores

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Renee M. Hendricks ◽  
Mohammad T. Khasawneh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Rating Scales ◽  
Rating Scale ◽  
Neurodegenerative Disorder ◽  
Analytical Investigation ◽  
Clinical Scale ◽  
Scale Scores ◽  
Disease Rating

Parkinson’s disease (PD) is the second most common, neurodegenerative disorder. It is a chronic, disabling, and progressive disease, and no treatment stops its progression. Rating scales are utilized to quantify PD progression and severity. The most conventional scale is the Unified Parkinson’s Disease Rating Scale (UPDRS) and its modified version, Movement Disorder Society- (MDS-) UPDRS. An analytical investigation into the use and meaning of these clinical scale scores was conducted to determine if gaps exist in quantifying disease progression and severity. A series of discrepancies were identified including confusion among patients regarding the score meaning and misuse of the scores among clinicians and researchers to define disease progression. The scales are of an ordinal type and hence the resulting scores are ordinal, not providing a quantifiable progression nor severity level, but a categorical value and survey total. The knowledge that the scores are ordinal and the scales are subjective is mentioned in very limited publications, not the focus of these papers, but a brief introduction and a thoroughly researched, analytical investigation into the scales and scores have not been found. Therefore, the continuous misunderstanding and misuse of these scales and resulting scores warrant a comprehensive assessment and evaluation of these scales and scores to identify the gaps.

scholarly journals Linking Profiles of Pathway Activation with Clinical Motor Improvements – a Retrospective Computational Study

2021 ◽  
Author(s):  
Konstantin Butenko ◽  
Ningfei Li ◽  
Clemens Neudorfer ◽  
Jan Roediger ◽  
Andreas Horn ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Computational Study ◽  
Motor Symptom ◽  
External Modulation ◽  
Profile Matching ◽  
Pathway Activation ◽  
Disease Rating ◽  
Activation Rates

AbstractDeep brain stimulation (DBS) is an established therapy for patients with Parkinson’s disease. In silico computer models for DBS allow to pre-select a set of potentially optimal stimulation parameters. If efficacious, they could further carry insight into the mechanism of action of DBS and foster the development of more efficient stimulation approaches. In recent years, the focus has shifted towards DBS-induced firing in myelinated axons, deemed particularly relevant for the external modulation of neural activity. We use the concept of pathway activation modeling, which incorporates advanced volume conductor models and anatomically authentic fiber trajectories to estimate DBS-induced action potential initiation in anatomically plausible pathways that traverse in close proximity to targeted nuclei. We apply the method on a retrospective dataset with the aim of providing a model-based prediction of clinical improvement following DBS (as measured by the motor part of the Unified Parkinson’s Disease Rating Scale). Based on differences in outcome and activation rates for two DBS protocols in a training cohort, we compute a theoretical 100% improvement profile and enhance it by analyzing the importance of profile matching for individual pathways. Finally, we validate the performance of our profile-based predictive model in a test cohort. As a result, we demonstrate the clinical utility of pathway activation modeling in the context of motor symptom alleviation in Parkinson’s patients treated with DBS.

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