Cerebral Microbleeds are Associated with Postural Instability and Gait Disturbance Subtype in People with Parkinson’s Disease

2018 ◽  
Vol 80 (5-6) ◽  
pp. 335-340 ◽  
Author(s):  
Wei Ting Chiu ◽  
Lung Chan ◽  
Dean Wu ◽  
Tzu Hsiang Ko ◽  
David Yen-Ting Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Brain Magnetic Resonance Imaging ◽  
Postural Instability ◽  
Gait Disturbance ◽  
Medical Chart Review ◽  
Taiwanese People ◽  
Magnetic Resonance Imaging Mri ◽  
Student’S T

Objectives: The motor symptoms of Parkinson’s disease (PD) vary among patients and have been categorized into 3 subtypes: tremor dominant, akinetic rigidity, and postural instability and gait disturbance (PIGD). Cerebral microbleed (CMB) is prevalent in people with PD and is associated with some nonmotor symptoms. The present study investigated the association between CMB and the motor subtypes of PD. Materials and Methods: From 2009 to 2017, medical records and brain magnetic resonance imaging (MRI) reports of 134 Taiwanese people with early- and mid-stage PD were reviewed. CMBs were quantified according to the Microbleed Anatomical Rating Scale through susceptibility-weighted MRI. Motor subtypes were determined by medical chart review. Student’s t test and multivariable logistic regression were used to analyze the association between the motor subtypes and CMB. Statistical analyses were performed using SPSS 19.0. Results: Overall, 72 (53.7%) participants were women with a mean age of 69.5 ± 9.8 years. The prevalence of CMB was 33.6%, and lobar, deep, and infratentorial CMBs comprised 21.6, 19.4, and 11.9% of cases, respectively. PIGD subtype PD was associated with a significantly higher prevalence of any CMB as well as deep or lobar CMB. After adjustment for age and sex, the PIGD subtype was significantly positively associated with the presence of any, deep, and white matter (WM) and thalamic CMB. Conclusions: CMB was prevalent in Taiwanese people with early- and mid-stage PD, especially the PIGD subtype. Deep, especially thalamic and WM, CMBs exhibited the highest association with the PIGD subtype.

scholarly journals Plasma Exosomal Brain-Derived Neurotrophic Factor Correlated with the Postural Instability and Gait Disturbance–Related Motor Symptoms in Patients with Parkinson’s Disease

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 684
Author(s):  
Chen Chih Chung ◽  
Pai Hao Huang ◽  
Lung Chan ◽  
Jia-Hung Chen ◽  
Li-Nien Chien ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurotrophic Factor ◽  
Rating Scale ◽  
Brain Derived Neurotrophic Factor ◽  
Postural Instability ◽  
Gait Disturbance ◽  
Enzyme Linked Immunosorbent Assay ◽  
Motor Symptoms ◽  
Bdnf Level

Brain-derived neurotrophic factor (BDNF) is an essential neurotrophin, responsible for neuronal development, function, and survival. Assessments of peripheral blood BDNF in patients with Parkinson’s disease (PD) previously yielded inconsistent results. Plasma exosomes can carry BDNF, so this study investigated the role of plasma exosomal BDNF level as a biomarker of PD. A total of 114 patients with mild to moderate PD and 42 non-PD controls were recruited, and their clinical presentations were evaluated. Plasma exosomes were isolated with exoEasy Maxi Kits, and enzyme-linked immunosorbent assay was used to assess plasma exosomal BDNF levels. Statistical analysis was performed using SPSS version 19.0, and findings were considered significant at p < 0.05. The analysis revealed no significant differences in plasma exosomal BDNF levels between patients with PD and controls. Patients with PD with low plasma exosomal BDNF levels (in the lowest quartile) exhibited a significant association with daily activity dysfunction but not with cognition/mood or overall motor symptoms as assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS). Investigation of UPDRS part III subitems revealed that low plasma exosomal BDNF level was significantly associated with increased motor severity of postural instability and gait disturbance (PIGD)-associated symptoms (rising from a chair, gait, and postural stability) after adjustment for age and sex. In conclusion, although plasma exosomal BDNF level could not distinguish patients with PD from controls, the association with PIGD symptoms in patients with PD may indicate its potential role as a biomarker. Follow-up studies should investigate the association between plasma exosomal BDNF levels and changes in clinical symptoms.

scholarly journals Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

2015 ◽  
Vol 21 (7) ◽  
pp. 692-697 ◽  
Author(s):  
V.E. Kelly ◽  
C.O. Johnson ◽  
E.L. McGough ◽  
A. Shumway-Cook ◽  
F.B. Horak ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Instability ◽  
Gait Disturbance ◽  
Cognitive Domains

scholarly journals Evaluation of Knee Proprioception and Factors Related to Parkinson’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Nathalie Ribeiro Artigas ◽  
Giovana Duarte Eltz ◽  
Alexandre Severo do Pinho ◽  
Vanessa Bielefeldt Leotti Torman ◽  
Arlete Hilbig ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Ability ◽  
Rating Scale ◽  
Center Of Pressure ◽  
Postural Instability ◽  
Lower Limbs ◽  
Controlled Study ◽  
Motor Symptoms ◽  
Cross Sectional

Background. Changes in proprioception may contribute to postural instability in individuals with neurological disorders. Objectives. Evaluate proprioception in the lower limbs of patients with Parkinson’s disease (PD) and the association between proprioception and cognitive ability, motor symptoms, postural instability, and disease severity. Methods. This is a cross-sectional, controlled study that evaluated proprioception in PD patients and healthy age- and sex-matched individuals. Kinetic postural proprioception of the knee was evaluated using an isokinetic dynamometer (Biodex® Multi-Joint System 4 Pro). Participants were evaluated using the Montreal Cognitive Assessment (MoCA), the Hoehn and Yahr rating scale and postural instability (pull test and stabilometric analysis), and motor function (UPDRS-III) tests. Results. A total of 40 individuals were enrolled in the study: 20 PD patients and 20 healthy controls (CG). The PD patients had higher angular errors on the proprioceptive ratings than the CG participants (p=0.002). Oscillations of the center of pressure (p=0.002) were higher in individuals with PD than in the controls. Proprioceptive errors in the PD patients were associated with the presence of tremors as the dominant symptom and more impaired motor performance. Conclusion. These findings show that individuals with PD have proprioceptive deficits, which are related to decreased cognitive ability and impaired motor symptoms.

scholarly journals Predictive Value of Verbatim Parkinson’s Disease Patient-Reported Symptoms of Postural Instability and Falling

2021 ◽  
pp. 1-8
Author(s):  
Monica Javidnia ◽  
Lakshmi Arbatti ◽  
Abhishek Hosamath ◽  
Shirley W. Eberly ◽  
David Oakes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Natural Language Processing ◽  
Natural Language ◽  
Parkinson Disease ◽  
Language Processing ◽  
Rating Scale ◽  
Disease Patient ◽  
Postural Instability ◽  
Patient Reported

Background: Postural instability is an intractable sign of Parkinson’s disease, associated with poor disease prognosis, fall risk, and decreased quality of life. Objective: 1) Characterize verbatim reports of postural instability and associated symptoms (gait disorder, balance, falling, freezing, and posture), 2) compare reports with responses to three pre-specified questions from Part II of the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS), and 3) examine postural instability symptoms and MDS-UPDRS responses as predictors of future falls. Methods: Fox Insight research participants reported their problems attributed to PD in their own words using the Parkinson Disease Patient Reports of Problems (PD-PROP). Natural language processing, clinical curation, and data mining techniques were applied to classify text into problem domains and clinically-curated symptoms. Baseline postural instability symptoms were mapped to MDS-UPDRS questions 2.11–2.13. T-tests and chi-square tests were used to compare postural instability reporters and non-reporters, and Cochran-Armitage trend tests were used to evaluate associations between PD-PROP and MDS-UPDRS responses; survival methods were utilized to evaluate the predictive utility of PD-PROP and MDS-UPDRS responses in time-to-fall analyses. Results: Of participants within 10 years of PD diagnosis, 9,692 (56.0%) reported postural instability symptoms referable to gait unsteadiness, balance, falling, freezing, or posture at baseline. Postural instability symptoms were significantly associated with patient-reported measures from the MDS-UPDRS questions. Balance problems reported on PD-PROP and MDS-UPDRS 2.11–2.13 measures were predictive of future falls. Conclusion: Verbatim-reported problems captured by the PD-PROP and categorized by natural language processing and clinical curation and MDS-UPDRS responses predicted falls. The PD-PROP output was more granular than, and as informative as, the categorical responses.

scholarly journals Automated Assessment of the Substantia Nigra Pars Compacta in Parkinson’s Disease: A Diffusion Tensor Imaging Study

2021 ◽  
Vol 11 (11) ◽  
pp. 1235
Author(s):  
Niels Bergsland ◽  
Laura Pelizzari ◽  
Maria Marcella Laganá ◽  
Sonia Di Tella ◽  
Federica Rossetto ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Diffusion Tensor Imaging ◽  
Substantia Nigra ◽  
Rating Scale ◽  
Diffusion Tensor ◽  
Imaging Study ◽  
Substantia Nigra Pars Compacta ◽  
Disease Rating ◽  
Magnetic Resonance Imaging Mri

The substantia nigra (SN) pars compacta (SNpc) and pars reticulata (SNpr) are differentially affected in Parkinson’s disease (PD). Separating the SNpc and SNpr is challenging with standard magnetic resonance imaging (MRI). Diffusion tensor imaging (DTI) allows for the characterization of SN microstructure in a non-invasive manner. In this study, 29 PD patients and 28 healthy controls (HCs) were imaged with 1.5T MRI for DTI. Images were nonlinearly registered to standard space and SNpc and SNpr DTI parameters were measured. ANCOVA and receiver operator characteristic (ROC) analyses were performed. Clinical associations were assessed with Spearman correlations. Multiple corrections were controlled for false discovery rate. PD patients presented with significantly increased SNpc axial diffusivity (AD) (1.207 ± 0.068 versus 1.156 ± 0.045, p = 0.024), with ROC analysis yielding an under the curve of 0.736. Trends with Unified Parkinson’s Disease Rating Scale (UPDRS) III scores were identified for SNpc MD (rs = 0.449), AD (rs = 0.388), and radial diffusivity (rs = 0.391) (all p < 0.1). A trend between baseline SNpr MD and H&Y change (rs = 0.563, p = 0.081) over 2.9 years of follow-up was identified (n = 14). In conclusion, SN microstructure shows robust, clinically meaningful associations in PD.

scholarly journals Noninvasive and quantitative evaluation of movement disorder disability using an infrared depth sensor

2019 ◽  
Author(s):  
Setsuki Tsukagoshi ◽  
Minori Furuta ◽  
Kimitoshi Hirayanagi ◽  
Natsumi Furuta ◽  
Shogo Nakazato ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Stride Length ◽  
Rating Scale ◽  
Gait Disturbance ◽  
Depth Sensor ◽  
Control Subjects ◽  
Scale Scores ◽  
Positive Correlations

Abstract Background: Cerebellar ataxia including spinocerebellar ataxia and Parkinson’s disease are neurodegenerative disorders clinically characterized by motor disabilities including gait disturbance. This study aimed to investigate the usefulness of an infrared depth sensor device to quantitatively evaluate gait disturbances and assess its cost effectiveness in patients with movement disorders. Methods: Twenty five ataxic, twenty five Parkinson’s disease, and twenty five control subjects were enrolled and evaluated their walk over a short distance. Stride length, feet interval, gait rhythm, and a ratio of the actual walking route length to the linear distance between the start and goal points (A/L ratio) were assessed and compared between ataxic or Parkinson’s disease subjects and control subjects. Outcome correlations with clinical scales were also analyzed in the disease groups. Results: The average stride length was shorter in ataxic subjects or Parkinson’s disease subjects than in control subjects. The average feet interval was larger in ataxic subjects than in control subjects. The stride length coefficient of variation (CV), gait rhythm CV, and average and standard deviations of the A/L ratio were larger in ataxic or Parkinson’s disease subjects than in control subjects. Ataxic subjects exhibited significant positive correlations between the CV of stride length or average feet interval and scale for the assessment and rating of ataxia scores or international cooperative ataxia rating scale scores. Parkinson’s disease subjects exhibited a significant correlation between the average stride length, CV of stride length, or standard deviation of A/L ratio and unified Parkinson's disease rating scale score. Conclusion: The device used in this study differentiated the characteristics of gait disturbance in each movement disorder and quantitatively evaluated ataxia or Parkinson’s disease severity, indicating its potential clinical utility across applications.

scholarly journals Impact of Sex on the Nonmotor Symptoms and the Health-Related Quality of Life in Parkinson’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Márton Kovács ◽  
Attila Makkos ◽  
Zsuzsanna Aschermann ◽  
József Janszky ◽  
Sámuel Komoly ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Independent Predictor ◽  
Postural Instability ◽  
Cross Sectional

Background. Female Parkinson’s disease (PD) patients seem to experience not only more severe motor complications and postural instability but also more pronounced depression, anxiety, pain, and sleep disturbances.Objective. The aim of the present study was to evaluate the role of sex as a possible independent predictor of HRQoL in PD.Methods. In this cross-sectional study, 621 consecutive patients treated at the University of Pécs were enrolled. Severity of PD symptoms was assessed by MDS-UPDRS, UDysRS, Non-Motor Symptoms Scale, PDSS-2, Hamilton Anxiety Scale, Montgomery-Asberg Depression Rating Scale, Lille Apathy Rating Scale, and Addenbrooke Cognitive Examination. HRQoL was assessed by PDQ-39 and EQ-5D. Multiple regression analysis was performed to estimate the PDQ-39 and EQ-5D index values based on various clinical factors.Results. Although females received significantly lower dosage of levodopa, they had significantly more disabling dyskinesia and worse postural instability. Anxiety, pain, sleep disturbances, and orthostatic symptoms were more frequent among females while sexual dysfunction, apathy, and daytime sleepiness were more severe among males. Women had worse HRQoL than men (EQ-5D index value:0.620±0.240versus0.663±0.229,p=0.025, and PDQ-39 SI:27.1±17.0versus23.5±15.9,p=0.010). Based on multiple regression analysis, sex was an independent predictor for HRQoL in PD.Conclusions. Based on our results, female sex is an independent predictor for having worse HRQoL in PD.

scholarly journals Feasibility of Home-Based Automated Assessment of Postural Instability and Lower Limb Impairments in Parkinson’s Disease

Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 1129 ◽  
Author(s):  
Claudia Ferraris ◽  
Roberto Nerino ◽  
Antonio Chimienti ◽  
Giuseppe Pettiti ◽  
Nicola Cau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Limb ◽  
Rating Scale ◽  
Postural Instability ◽  
Motor Tasks ◽  
Automated Assessment ◽  
Home Based ◽  
Supervised Classifiers ◽  
Disease Rating

A self-managed, home-based system for the automated assessment of a selected set of Parkinson’s disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson’s Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson’s disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects’ performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson’s disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework.

scholarly journals Postural instability/gait disturbance in Parkinson's disease has distinct subtypes: an exploratory analysis

2010 ◽  
Vol 82 (5) ◽  
pp. 564-568 ◽  
Author(s):  
S. A. Factor ◽  
N. K. Steenland ◽  
D. S. Higgins ◽  
E. S. Molho ◽  
D. M. Kay ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Instability ◽  
Exploratory Analysis ◽  
Gait Disturbance
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