scholarly journals Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

2016 ◽  
Vol 2016 ◽  
pp. 1-23 ◽  
Author(s):  
Andrée-Anne Poirier ◽  
Benoit Aubé ◽  
Mélissa Côté ◽  
Nicolas Morin ◽  
Thérèse Di Paolo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gastrointestinal Symptoms ◽  
Motor Symptoms ◽  
Therapeutic Approaches ◽  
Medical Treatments ◽  
Disease Symptoms ◽  
Comprehensive Picture ◽  
Neuronal Types ◽  
The Central Nervous System

A diagnosis of Parkinson’s disease is classically established after the manifestation of motor symptoms such as rigidity, bradykinesia, and tremor. However, a growing body of evidence supports the hypothesis that nonmotor symptoms, especially gastrointestinal dysfunctions, could be considered as early biomarkers since they are ubiquitously found among confirmed patients and occur much earlier than their motor manifestations. According to Braak’s hypothesis, the disease is postulated to originate in the intestine and then spread to the brain via the vagus nerve, a phenomenon that would involve other neuronal types than the well-established dopaminergic population. It has therefore been proposed that peripheral nondopaminergic impairments might precede the alteration of dopaminergic neurons in the central nervous system and, ultimately, the emergence of motor symptoms. Considering the growing interest in the gut-brain axis in Parkinson’s disease, this review aims at providing a comprehensive picture of the multiple gastrointestinal features of the disease, along with the therapeutic approaches used to reduce their burden. Moreover, we highlight the importance of gastrointestinal symptoms with respect to the patients’ responses towards medical treatments and discuss the various possible adverse interactions that can potentially occur, which are still poorly understood.

The role of gut dysbiosis in Parkinson's disease: mechanistic insights andtherapeutic options

Brain ◽  
2021 ◽  
Author(s):  
Qing Wang ◽  
Yuqi Luo ◽  
K Ray Chaudhuri ◽  
Richard Reynolds ◽  
Eng-King Tan ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Gut Microbiota ◽  
Fecal Microbiota Transplantation ◽  
Gastrointestinal Symptoms ◽  
Fecal Microbiota ◽  
Motor Symptoms ◽  
Treatment Paradigm ◽  
New Treatment

Abstract Parkinson's disease is a common neurodegenerative disease in which gastrointestinal symptoms may appear prior to motor symptoms. The gut microbiota of patients with Parkinson's disease shows unique changes, which may be used as early biomarkers of disease. Alteration in gut microbiota composition may be related to the cause or effect of motor or non-motor symptoms, but the specific pathogenic mechanisms are unclear. The gut microbiota and its metabolites have been suggested to be involved in the pathogenesis of Parkinson's disease by regulating neuroinflammation, barrier function and neurotransmitter activity. There is bidirectional communication between the enteric nervous system and the central nervous system, and the microbiota-gut-brain axis may provide a pathway for the transmission of α-synuclein. We highlight recent discoveries and alterations of the gut microbiota in Parkinson's disease, and highlight current mechanistic insights on the microbiota-gut-brain axis in disease pathophysiology. We discuss the interactions between production and transmission of α-synuclein and gut inflammation and neuroinflammation. In addition, we also draw attention to diet modification, use of probiotics and prebiotics and fecal microbiota transplantation as potential therapeutic approaches that may lead to a new treatment paradigm for Parkinson's disease.

scholarly journals Pilot Study of Mindfulness Training on the Self-Awareness of Motor Symptoms in Parkinson’s Disease – A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Timo Marcel Buchwitz ◽  
Franziska Maier ◽  
Andrea Greuel ◽  
Franziska Thieken ◽  
Kenan Steidel ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Control Group ◽  
Motor Symptoms ◽  
Self Awareness ◽  
Disease Symptoms ◽  
Waitlist Control ◽  
Sleeping Problems ◽  
Waitlist Control Group ◽  
Insight Into

Objective: This study aims to evaluate feasibility and effects of a newly developed mindfulness intervention tailored to specific needs of patients with Parkinson’s disease (PD).Background: The phenomenon of impaired self-awareness of motor symptoms (ISAm) in PD might be reduced by increasing patients’ mindfulness. A PD-specific mindfulness intervention has been developed and evaluated as a potential treatment option: IPSUM (“Insight into Parkinson’s Disease Symptoms by using Mindfulness”).Methods: IPSUM’s effectiveness is evaluated by comparing an intervention with a waitlist-control group. Applying a pre-post design, patients were assessed before, directly after and 8weeks after treatment. The primary outcome was the change in a quantitative ISAm score from baseline to post-assessment. Secondary outcome measures were PD-related affective changes and neuropsychological test performance. Feasibility was evaluated via feedback forms.Results: In total, 30 non-depressed and non-demented PD patients were included (intervention: n=14, waitlist-control: n=16). ISAm score did not change significantly, but the training group showed greater performance in sustained attention and language tasks over time. Additional changes included greater mindfulness as well as less sleeping problems and anxiety. Cognitive disturbances, apathy, and sleeping problems worsened only in the waitlist-control group. Patients’ feedback regarding the training concept and material was excellent.Conclusion: Insight into Parkinson’s Disease Symptoms by using Mindfulness has not been capable of reducing ISAm in PD patients but appears to be a feasible and effective concept to, among others, support mental health in the mid-term. It has to be noted though that the study was stopped beforehand because of the SARS CoV-2 pandemic. The lack of findings might therefore be caused by a lack of statistical power. The need for further research to better understand the mechanisms of ISAm and its connection to mindfulness in PD is highlighted.

scholarly journals Dynamics of levodopa-therapy in patients with Parkinson’s disease afterunilateral pallidotomy

2018 ◽  
Vol 24 (2) ◽  
pp. 30-36
Author(s):  
V.I. Tsymbaliuk ◽  
A.O. Popov
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Contralateral Side ◽  
Levodopa Therapy ◽  
Motor Symptoms ◽  
Disease Symptoms ◽  
Positive Effects ◽  
Primary Reduction ◽  
One Year

Objective — to investigate the dynamics of levodopa-therapy in patients with Parkinson's disease (PD) after unilateral stereotactic radiofrequency pallidotomy (USRP). Materials and methods. From 2008 to 2016 USRP was performed in 16 patients (7 men and 9 women from 48 to 73 years old, average — 56 years) with PD complicated by levodopa-induced dyskinesias and motor fluctuations (MF). The dynamics of the disease symptoms was interpreted on the basis of separate sections and points of the UPDRS. The levodopa-equivalent dose (LED) was calculated using standard conventers. Patients were evaluated before, one week and then one year after surgery. Results. One week after the USRP 43.2 % reduction of average daily LED was noted. The decrease of severity of MF and motor symptoms of the OFF-period on the contralateral side was traced. After 1 year of follow up the rate of reduction decline of the average daily LED compared to its preoperative level was 22.3 %. The recurrence of the MF and the steady positive effects on the motor symptoms of the OFF-period on the contralateral side were observed. Conclusions. Primary reduction of the daily LED effects of USRP decrease during one year of observation in the background of the MF recurrence, despite the steady positive effects on the motor symptoms of the OFF-period on the contralateral side.

scholarly journals Genetic Imaging of Neuroinflammation in Parkinson’s Disease: Recent Advancements

2021 ◽  
Vol 9 ◽  
Author(s):  
Longping Yao ◽  
Jiayu Wu ◽  
Sumeyye Koc ◽  
Guohui Lu
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Genetic Factors ◽  
Clinical Symptoms ◽  
Neuroprotective Effect ◽  
Pathological Process ◽  
Motor Symptoms ◽  
Surgical Interventions ◽  
The Central Nervous System ◽  
Non Motor Symptoms

Parkinson’s disease (PD) is one of the most prevalent neurodegenerative aging disorders characterized by motor and non-motor symptoms due to the selective loss of midbrain dopaminergic (DA) neurons. The decreased viability of DA neurons slowly results in the appearance of motor symptoms such as rigidity, bradykinesia, resting tremor, and postural instability. These symptoms largely depend on DA nigrostriatal denervation. Pharmacological and surgical interventions are the main treatment for improving clinical symptoms, but it has not been possible to cure PD. Furthermore, the cause of neurodegeneration remains unclear. One of the possible neurodegeneration mechanisms is a chronic inflammation of the central nervous system, which is mediated by microglial cells. Impaired or dead DA neurons can directly lead to microglia activation, producing a large number of reactive oxygen species and pro-inflammatory cytokines. These cytotoxic factors contribute to the apoptosis and death of DA neurons, and the pathological process of neuroinflammation aggravates the primary morbid process and exacerbates ongoing neurodegeneration. Therefore, anti-inflammatory treatment exerts a robust neuroprotective effect in a mouse model of PD. Since discovering the first mutation in the α-synuclein gene (SNCA), which can cause disease-causing, PD has involved many genes and loci such as LRRK2, Parkin, SNCA, and PINK1. In this article, we summarize the critical descriptions of the genetic factors involved in PD’s occurrence and development (such as LRRK2, SNCA, Parkin, PINK1, and inflammasome), and these factors play a crucial role in neuroinflammation. Regulation of these signaling pathways and molecular factors related to these genetic factors can vastly improve the neuroinflammation of PD.

scholarly journals The gut-brain axis in the pathogenesis of Parkinson’s disease

2019 ◽  
Vol 5 (2) ◽  
pp. 73-81 ◽  
Author(s):  
Lanxia Meng ◽  
Xin Yuan ◽  
Xuebing Cao ◽  
Zhentao Zhang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Substantia Nigra ◽  
Enteric Nervous System ◽  
Lewy Bodies ◽  
Motor Symptoms ◽  
Gastrointestinal Dysfunction ◽  
Neurodegenerative Process ◽  
The Central Nervous System

Parkinson’s disease (PD) is the second most common neurodegenerative disease. Its pathological markers include Lewy bodies and Lewy neuritis, which primarily affect the substantia nigra. However, in recent years, mounting evidence suggests that PD is a multifocal neurodegenerative process that influences several neuronal structures aside from the substantia nigra, one of which is the enteric nervous system. Many clinical studies have reported that patients with PD experience gastrointestinal dysfunction for many years before the onset of motor symptoms. Emerging evidence indicates that α-synuclein deposition may start in the enteric nervous system and then propagate to the central nervous system. The gut-brain axis plays an important role in PD pathogenesis. Recent evidence suggests that these interactions may be primarily affected by the intestinal microbiota. In this review, the authors discuss recent research, and illustrate how changes in the composition of the gut microbiota may trigger inflammation, thus contributing to neurodegeneration in PD.

NON MOTOR SYMPTOMS IN PARKINSON’S DISEASE PATIENTS: A HOSPITAL BASED PROSPECTIVE STUDY.

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Atul Baid ◽  
Dr. Chhavi Raman Baid
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neuropsychiatric Symptoms ◽  
Gastrointestinal Symptoms ◽  
Motor Symptoms ◽  
Yahr Stage ◽  
Brain Bank ◽  
Unexplained Pain ◽  
Office Software ◽  
Non Motor Symptoms

Objectives: This present study was to evaluate the clinical profile and prevalence of non motor symptoms in Parkinson’s disease patients on the basis of various system involvements. Methods: Detail history, clinical examination and relevant investigations were performed to all cases of Parkinson’s disease patients. The diagnosis of Parkinson’s disease was confirmed by UKPDS Brain Bank Criteria. Neurological examination was conducted for MMSE scores and H and Y staging. Results: Data was analyzed by using simple statistical methods with help of Ms-Office software. Data was tabulated and percentages were calculated. Conclusions: Parkinson’s disease was commonly occurred in old age male populations. Most of the cases had H & Y stage 2. Non motor symptoms were progressed as the stage of Parkinson’s disease progressed. Nausea, unsatisfactory bowel voiding and constipation were common gastrointestinal symptoms. Decreased libido, orthostatic hypotension, nocturia and hypo/hyper Sexuality were common autonomic dysfunction. Insomnia, Restless Leg and Behavioural limb movements were common sleep disorders. Dementia, attention deficit, anhedonia and apathy were common neuropsychiatric symptoms seen in patients with Parkinson’s disease. Common sensory symptoms were unexplained Pain (Paraesthesia) and hyposmia. Other common symptoms of Parkinson’s disease patients had swelling of leg, falls and weight gain. Hence early diagnosis, management and awareness are essential for improvement of quality of life of patients with Parkinson’s disease. Keywords:  Parkinson’s disease, non motor symptoms, Hoehn & Yahr stage, UKPDS Brain Bank Criteria

The Role of Exercise in Parkinson’s Disease

2021 ◽  
Vol 34 (4) ◽  
pp. 321-330
Author(s):  
Mallory Emig ◽  
Tikku George ◽  
Justin K. Zhang ◽  
Momina Soudagar-Turkey
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Neurodegenerative Disorder ◽  
Surgical Techniques ◽  
Motor Symptoms ◽  
Sleep Habits ◽  
The Central Nervous System

Parkinson’s disease (PD) is a progressive, neurodegenerative disorder of the central nervous system. While it primarily affects motor function, patients eventually develop non-motor symptoms including depression, anxiety, and eventually dementia. Although there is currently no cure, treatment is aimed largely at improving quality of life though medication or surgical techniques to reduce motor symptoms. However, there is vast evidence of the benefits of physical activity as adjunct therapy for Parkinson’s disease. In this review, we analyze 31 studies or reviews and highlight the role of exercise and rehabilitation in PD treatment. This study serves to provide clinicians with a comprehensive resource of the wide variety of exercises with proven benefit for patients affected by Parkinson’s disease. Specifically, patients report significant improvements in motor function, cognition, mood and sleep habits.

scholarly journals Safinamide Improves Non-Motor Symptoms Burden in Parkinson’s Disease: An Open-Label Prospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 316
Author(s):  
Diego Santos García ◽  
Carmen Labandeira Guerra ◽  
Rosa Yáñez Baña ◽  
Maria Icíar Cimas Hernando ◽  
Iria Cabo López ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gastrointestinal Symptoms ◽  
Motor Symptoms ◽  
Open Label ◽  
Open Label Study ◽  
Efficacy Outcome ◽  
Non Motor Symptoms

Some studies observed a benefit of Parkinson’s disease (PD) patients after treatment with safinamide in some non-motor symptoms (NMSs). The aim of this study was to analyze the effectiveness of safinamide on NMS burden in PD. SAFINONMOTOR (an open-label study of the effectiveness of safinamide on non-motor symptoms in Parkinson’s disease patients) is a prospective open-label single-arm study conducted in five centers from Spain. The primary efficacy outcome was the change from baseline (V1) to the end of the observational period (6 months) (V4) in the non-motor symptoms scale (NMSS) total score. Between May/2019 and February/2020 50 patients were included (age 68.5 ± 9.12 years; 58% females; 6.4 ± 5.1 years from diagnosis). At 6 months, 44 patients completed the follow-up (88%). The NMSS total score was reduced by 38.5% (from 97.5 ± 43.7 in V1 to 59.9 ± 35.5 in V4; p < 0.0001). By domains, improvement was observed in sleep/fatigue (−35.8%; p = 0.002), mood/apathy (−57.9%; p < 0.0001), attention/memory (−23.9%; p = 0.026), gastrointestinal symptoms (−33%; p = 0.010), urinary symptoms (−28.3%; p = 0.003), and pain/miscellaneous (−43%; p < 0.0001). Quality of life (QoL) also improved with a 29.4% reduction in the PDQ-39SI (from 30.1 ± 17.6 in V1 to 21.2 ± 13.5 in V4; p < 0.0001). A total of 21 adverse events in 16 patients (32%) were reported, 5 of which were severe (not related to safinamide). Dyskinesias and nausea were the most frequent (6%). Safinamide is well tolerated and improves NMS burden and QoL in PD patients with severe or very severe NMS burden at 6 months.

scholarly journals The Parkinson’s Real-World Impact Assessment (PRISM) Study: A European Survey of the Burden of Parkinson’s Disease in Patients and their Carers

2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Impact Assessment ◽  
Real World ◽  
European Countries ◽  
Life Questionnaire ◽  
Motor Symptoms ◽  
Non Motor Symptoms

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.

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