scholarly journals CLOCK 3111T/C Variant Correlates with Motor Fluctuation and Sleep Disorders in Chinese Patients with Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Fan Lou ◽  
Ming Li ◽  
Xiaoguang Luo ◽  
Yan Ren
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Rating Scale ◽  
Clock Genes ◽  
Motor Fluctuation ◽  
Binary Logistic Regression ◽  
Chinese Patients ◽  
Binary Logistic Regression Analysis

Background. The clock genes controlling biological rhythm play an important role in the pathophysiology of aging. The purpose of this study was to determine whether there is an association between a variant of the circadian locomotor output cycles kaput (CLOCK) gene and circadian dysfunction of Parkinson’s disease (PD). Methods. Six hundred and forty-six cases of Parkinson’s disease from consecutive outpatients and inpatients ward from our hospital were included in this study. Kompetitive allele-specific PCR was used to determine the frequency distribution of genotypes and alleles. The examinations for the PD group were assessed in person in order to evaluate motor symptoms, cognitive function, sleep, and depression, including the Unified Parkinson’s Disease Rating Scale (UPDRS), Mini-Mental State Examination (MMSE), Pittsburgh Sleep Quality Index (PSQI), and 17-item Hamilton Rating Scale for Depression (HAMD-17). Results. Motor fluctuation (P<0.001) and sleep disorders (P=0.007) were significantly different between the two groups. These correlations persisted after adjusting for confounding risk factors by further binary logistic regression analysis, suggesting that the CLOCK 3111T/C variant was associated with motor fluctuation (OR = 1.080, P<0.001) and a subjective sleep disorder (OR = 1.130, P=0.037). Conclusion. The CLOCK 3111T/C variant can be an independent risk factor for motor fluctuation and sleep disorder in Parkinson’s disease.

scholarly journals Clinical Markers May Identify Patients at Risk for Early Parkinson’s Disease Dementia: A Prospective Study

2021 ◽  
Vol 36 ◽  
pp. 153331752110213
Author(s):  
Anamaria Jurcau ◽  
Vharoon Sharma Nunkoo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Clinical Markers ◽  
Pearson Coefficient ◽  
Autonomic Dysfunctions ◽  
Patients At Risk ◽  
A Prospective Study ◽  
State Examination

Background: The study aims at identifying features predictive of early onset of dementia in Parkinson’s disease (PD). Methods: 103 non-demented PD patients were evaluated on various scales at baseline and 89 patients at 3-year follow-up. Results: By the end of the study 43.8% of patients developed dementia. The development of dementia was linked to the baseline Mini Mental State Examination score (Pearson coefficient r = .404, p = 0.013), the presence of autonomic dysfunctions (r = −.621, p < 0.001) and insomnia (r = −.526, p = 0.001). A binary logistic regression analysis showed that the development of dementia was correlated strongly with the presence of autonomic dysfunctions (95% CI 2.60 to 52.83, p < 0.001), and insomnia (95% CI 0.60 to 0.95, p = 0.017). Conclusion: Patients with signs of autonomic dysfunction and insomnia are at higher risk for developing dementia and deserve closer monitoring of cognitive symptoms.

Predictors of Pharyngeal Dysphagia in Patients with Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1727-1735
Author(s):  
Inga Claus ◽  
Paul Muhle ◽  
Judith Suttrup ◽  
Bendix Labeit ◽  
Sonja Suntrup-Krueger ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Logistic Regression ◽  
Rating Scale ◽  
Equivalent Dose ◽  
Binary Logistic Regression Analysis ◽  
Screening Methods ◽  
Clinical Predictors ◽  
Pharyngeal Dysphagia ◽  
Increased Risk

Background: Diagnosis of pharyngeal dysphagia in patients with Parkinson’s disease is often difficult as reliable screening methods are lacking so far and clinical examination fails to adequately assess the pharyngeal phase of swallowing. Objective: To identify clinical predictors indicating the presence of pharyngeal dysphagia in patients at risk. Methods: We examined pharyngeal dysphagia in a large cohort of patients with Parkinson’s disease (n = 200) divided in three clinical subtypes (tremor-dominant (TD), mainly bradykinetic (BK) and early postural instability and gait difficulty PIGD)) by using flexible endoscopic evaluation of swallowing. ANOVA-multivariance analysis and following t-tests as well as binary logistic regression analysis were performed to detect group differences and to identify clinical predictors for dysphagia. Results: Statistically significant differences were found in the dysphagic group: age, male gender, disease duration, stage of the disease, Levodopa equivalent dose and higher scores on the Unified Parkinson’s disease rating scale III and II, item 7. The PIGD subtype was affected more frequently than the TD and BK subtype. In a logistic regression model higher age (>63.5 years p < 0.05) and Levodopa equivalent dose (>475 mg, p < 0.01) were identified to be independent predictors for the presence of pharyngeal dysphagia. Conclusion: Particularly patients with an age > 63.5 years and a daily Levodopa equivalent dose >475 mg show an increased risk for pharyngeal dysphagia. These findings may partly be influenced by presbyphagia but are likely to represent disease progression. The PIGD subtype seems to be a risk factor due to more pronounced dyscoordination of oropharyngeal muscle movements.

scholarly journals Automated Stage Discrimination of Parkinson’s Disease

2020 ◽  
Vol 1 (2) ◽  
pp. 55-63
Author(s):  
Vered Aharonson ◽  
Nabeel Seedat ◽  
Simon Israeli-Korn ◽  
Sharon Hassin-Baer ◽  
Michiel Postema ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Motor Fluctuation ◽  
Step Length ◽  
Disease Stage ◽  
Physical Parameters ◽  
Timed Up And Go ◽  
Step Velocity ◽  
Treatment Plans

Abstract Background: Treatment plans for Parkinson’s disease (PD) are based on a disease stage scale, which is generally determined using a manual, observational procedure. Automated, sensor-based discrimination saves labor and costs in clinical settings and may offer augmented stage determination accuracy. Previous automated devices were either cumbersome or costly and were not suitable for individuals who cannot walk without support.Methods: Since 2017, a device has been available that successfully detects PD and operates for people who cannot walk without support. In the present study, the suitability of this device for automated discrimination of PD stages was tested. The device consists of a walking frame fitted with sensors to simultaneously support walking and monitor patient gait. Sixty-five PD patients in Hoehn and Yahr (HY) stages 1 to 4 and 24 healthy controls were subjected to supported Timed Up and Go (TUG) tests, while using the walking frame. The walking trajectory, velocity, acceleration and force were recorded by the device throughout the tests. These physical parameters were converted into symptomatic spatiotemporal quantities that are conventionally used in PD gait assessment.Results: An analysis of variance (ANOVA) test extended by a confidence interval (CI) analysis indicated statistically significant separability between HY stages for the following spatiotemporal quantities: TUG time (p < 0.001), straight line walking time (p < 0.001), turning time (p < 0.001), and step count (p < 0.001). A negative correlation was obtained for mean step velocity (p < 0.001) and mean step length (p < 0.001). Moreover, correlations were established between these, as well as additional spatiotemporal quantities, and disease duration, L-dihydroxyphenylalanine-(L-DOPA) dose, motor fluctuation, dyskinesia and the mobile part of the Unified Parkinson Disease Rating Scale (UPDRS).Conclusions: We have proven that stage discrimination of PD can be automated, even to patients who cannot support themselves. A similar method might be successfully applied to other gait disorders.

scholarly journals Efficacy and safety of rasagiline as an adjunct to levodopa treatment in Chinese patients with Parkinson's disease: a randomized, double-blind, parallel-controlled, multi-centre trial

2013 ◽  
Vol 16 (7) ◽  
pp. 1529-1537 ◽  
Author(s):  
Lina Zhang ◽  
Zhiqin Zhang ◽  
Yangmei Chen ◽  
Xinyue Qin ◽  
Huadong Zhou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Chinese Patients ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Levodopa Treatment ◽  
Parallel Group ◽  
Disease Rating ◽  
Rasagiline Mesylate

Abstract Rasagiline mesylate is a highly potent, selective and irreversible monoamine oxidase type B (MAOB) inhibitor and is effective as monotherapy or adjunct to levodopa for patients with Parkinson's disease (PD). However, few studies have evaluated the efficacy and safety of rasagiline in the Chinese population. This study was designed to investigate the safety and efficacy of rasagiline as adjunctive therapy to levodopa treatment in Chinese PD patients. This was a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial conducted over a 12-wk period that enrolled 244 PD patients with motor fluctuations. Participants were randomly assigned to oral rasagiline mesylate (1 mg) or placebo, once daily. Altogether, 219 patients completed the trial. Rasagiline showed significantly greater efficacy compared with placebo. During the treatment period, the primary efficacy variable – mean adjusted total daily off time – decreased from baseline by 1.7 h in patients treated with 1.0 mg/d rasagiline compared to placebo (p < 0.05). Scores using the Unified Parkinson's Disease Rating Scale also improved during rasagiline treatment. Rasagiline was well tolerated. This study demonstrated that rasagiline mesylate is effective and well tolerated as an adjunct to levodopa treatment in Chinese PD patients with fluctuations.

scholarly journals INFLUENCE OF SLEEP DISTURBANCES ON COGNITIVE DECLINE IN PATIENTS WITH PARKINSON’S DISEASE

2020 ◽  
Vol 117 (3) ◽  
pp. 58-67
Author(s):  
Anastasiia Shkodina ◽  
Kateryna Tarianyk ◽  
Dmytro Boiko
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Early Stages ◽  
The Impact

The article summarizes the arguments and counter-arguments within the scientific discussion on the impact of sleep disorders on the development of cognitive decline in patients with Parkinson's disease. The main purpose of the study is to study the possibility of predicting the development of cognitive decline by assessing the severity of sleep disorders and their differences in the presence of cognitive impairment. Systematization of literature sources and approaches to solving the problem showed that sleep disorders develop in the early stages of Parkinson's disease and are often accompanied by cognitive impairment. Cognitive decline is manifested throughout Parkinson's disease and ranges from moderate in the early stages to dementia in the late stages. The relevance of the study of the relationship between sleep disorders and cognitive functions lies in the possibility of further improving the prediction of the development of cognitive decline in order to effectively correct it. Treatment of sleep disorders can be accompanied by improved memory and even morphological changes in the brain. Therefore, the question arises about the possibility of correcting cognitive decline by influencing sleep disorders. The methodology of the study included assessment of the overall status of patients on a unified scale of Parkinson's disease, Montreal cognitive rating scale and sleep scale in Parkinson's disease. The duration of the study was 8 months. Patients with Parkinson's disease were selected as the study. The article presents the results of a survey of patients who show that patients with Parkinson's disease and cognitive decline showed a predominance of motor disorders, sleep disorders and the overall score on the sleep scale in Parkinson's disease. In the presence of cognitive decline more pronounced disorders of motor functions in everyday life, which can lead to sleep disorders and its quality. The study empirically confirms and theoretically proves that the assessment of sleep disorders can be used to predict the risk of developing cognitive impairment in patients with Parkinson's disease. The results of this study may be useful for improving the early diagnosis and prevention of cognitive impairment in patients with Parkinson's disease, which, in turn, leads to improved quality of treatment of these patients. Such changes can directly affect the choice of therapeutic tactics and improve the quality of life of patients with Parkinson's disease. The question of the features of various sleep disorders and their prognostic value in relation to cognitive decline in patients with various forms of Parkinson's disease remains open.

Association among fatigue, sleep disorders and other clinical parameters in Parkinson’s disease

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A Asano ◽  
N Asano ◽  
D Mota ◽  
I Gondim ◽  
F Aroxa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Clinical Parameters ◽  
Motor Symptoms ◽  
Nocturnal Sleep ◽  
Advanced Stages

Abstract Introduction Fatigue and sleep disorders are common in Parkinson disease (PD) patients. Fatigue is not always clinically recognized because of its subjective character manifested by feelings of extreme tiredness. These non-motor symptoms can occur from the early stages of the disease and tend to persist. Objectives To evaluate fatigue in patients with PD and the possible association with sleep disorders and other clinical parameters of the PD; and to evaluate the impact of fatigue on quality of life Methodology A cross-sectional study with 123 patients with PD was implemented. The following instruments were used: Mini Mental State Examination, the Hoehn-Yarh Scale, Beck Depression Inventory, Parkinson’s Disease Quality of Life Questionnaire, Parkinson’s Disease Sleep Scale, Epworth Sleepiness Scale, and Parkinson’s Disease Fatigue Scale. Results Fatigue was found in 48% of patients. Patients with fatigue presented longer duration of illness, depressive symptoms, cognitive impairment, severity of motor symptoms, excessive daytime sleepiness and nocturnal sleep disorder. Fatigue combined with sleep disorder occurred in 21% of the total sample, being more frequent in females (32% vs 15%) and in patients at more advanced stages of the disease (52% in HY3). The multiple logistic regression analysis indicated that the significant independent variables for the presence of fatigue were: cognition (OR = 1.19 P = 0.02), nocturnal sleep disorder (OR = 1.03 P = 0.0001); among PDSS domains, nocturnal motor symptoms (OR = 1.09 P = 0.0005) and sleep refreshment (OR = 1.11 P = 0.02); among PDQ-39 domains, mobility (OR = 0.9323 P &lt; 0.0001) and body discomfort (OR = 0.9767 P = 0.0428). Conclusion Fatigue is common in PD, especially in the more advanced stages, and it seems to be associated with the female gender, nocturnal sleep disorder and cognition, having thus a negative impact on the quality of life.

scholarly journals Tremor and clinical fluctuation are related to sleep disorders in Chinese patients with Parkinson’s disease

2014 ◽  
Vol 3 (1) ◽  
pp. 21
Author(s):  
Hongyan Zhou ◽  
Cunzhou Shen ◽  
Jie Chen ◽  
Hao Qian ◽  
Yifan Zheng ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Chinese Patients

The Relationships Between the Unified Parkinson’s Disease Rating Scale and Lower Extremity Functional Performance in Persons With Early-Stage Parkinson’s Disease

2009 ◽  
Vol 23 (7) ◽  
pp. 657-661 ◽  
Author(s):  
Jooeun Song ◽  
Beth E. Fisher ◽  
Giselle Petzinger ◽  
Allan Wu ◽  
James Gordon ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Extremity ◽  
Rating Scale ◽  
Functional Performance ◽  
Early Stage ◽  
Motor Fluctuation ◽  
Stair Climbing ◽  
Functional Capabilities ◽  
Disease Rating

Background. The Unified Parkinson’s Disease Rating Scale (UPDRS) is the “gold standard” assessment tool for characterizing impairments in persons with Parkinson’s disease (PD); however, this scale’s ability to predict functional capabilities across different functional tasks has not been adequately assessed in persons with early-stage PD. Methods. Thirty persons with PD within 3 years of diagnosis and without motor fluctuation performed self-selected walking, fast walking, and sit-to-stand and stair-climbing tasks. Pearson’s correlation coefficients were used to calculate correlations with a standard UPDRS examination ( P < .05). Simple linear regression models were used to fit each functional performance outcome measure with the UPDRS total predictor scores. Results. The correlations between the UPDRS motor (section III), UPDRS total scores, and all timed functional performance measures were fair to good (range, 0.45-0.57). Conversely, only greater self-selected time to walk 50 ft correlated with a higher UPDRS activities of daily living (II) score ( r = .386; P < .05). Conclusions. The UPDRS motor (III) and total scores may be good predictors of overall lower extremity function in persons with early-stage PD. Understanding the relationships between UPDRS scores and functional capabilities may allow clinicians to better quantify early physical functioning, longitudinally assess disease progression, and assess the efficacy of interventions.

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 Cognitive Function Characteristics of Parkinson’s Disease with Sleep Disorders

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jing Huang ◽  
Wenyan Zhuo ◽  
Yuhu Zhang ◽  
Hongchun Sun ◽  
Huan Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Control Group ◽  
Different Types ◽  
Healthy Control ◽  
State Examination ◽  
Primary Sleep Disorder

Objective. The aim of this study was to investigate the cognitive function characteristics of Parkinson’s disease (PD) with sleep disorders. Methods. Consecutive patients with PD (n=96), patients with primary sleep disorders (n=76), and healthy control subjects (n=66) were assessed. The patients with PD were classified into sleep disorder (PD-SD) and non-sleep disorder (PD-NSD) groups. Results. Among 96 patients with PD, 69 were diagnosed with a sleep disorder. There were 38 sleep disorder cases, 31 RBD cases, and 27 NSD cases. On the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and MoCA subtests, patients in the PD-SD, primary sleep disorder, and PD-NSD groups exhibited lower scores than those in the control group. Moreover, the PD-SD patients exhibited more significant cognitive impairment than was observed in the primary sleep disorder patients. In the PD-SD subgroup, the attention scores on the MoCA and on MoCA subtests were lower in the PD with RBD group than in the PD with insomnia group. Conclusion. PD with sleep disorders may exacerbate cognitive dysfunction in patients. PD associated with different types of sleep disorders differentially affects cognitive functions, and patients with PD with RBD exhibited poorer cognitive function than was seen in patients with PD with insomnia.

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