scholarly journals Introducing the Parkinson’s KinetiGraph into Routine Parkinson’s Disease Care: A 3-Year Single Centre Experience

2020 ◽  
Vol 10 (4) ◽  
pp. 1827-1832
Author(s):  
Thea Dominey ◽  
Angie A. Kehagia ◽  
Terry Gorst ◽  
Emma Pearson ◽  
Fiona Murphy ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Unmet Need ◽  
Resource Limitation ◽  
Digital Data ◽  
Continuous Measure ◽  
Remote Management ◽  
Single Centre Experience ◽  
The Face ◽  
Increasing Demand

In an effort to provide timely clinical input for people with Parkinson’s disease (PD) in the face of increasing demand and resource limitation in our UK based service, we introduced remote management in place of clinic appointment, including the use of the Parkinson’s KinetiGraph (PKG™), a wrist-worn device that provides a continuous measure of movement. We evaluated our reporting methods and findings, the nature of unmet need we identified, our treatment recommendations and the degree of their implementation in our patients whose feedback guided our service developments. Our evaluation highlighted opportunities and challenges associated with incorporating digital data into care traditionally delivered via in-person contact.

scholarly journals Social listening – revealing Parkinson’s disease over day and night

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Zhang ◽  
Fanwen Meng ◽  
Xingyu Li ◽  
Yali Ning ◽  
Meng Cai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Unmet Needs ◽  
Unmet Need ◽  
Motor Symptoms ◽  
Motor Complications ◽  
Sentiment Score ◽  
Negative Sentiment ◽  
Non Motor Symptoms ◽  
Social Listening

Abstract Background Nocturnal symptoms in Parkinson’s disease are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we analyzed the characteristics and burden of nocturnal symptoms from patients’ perspectives and explored their changes over time. Overall symptoms (occurring at day or night) were collected to compare whether the unmet needs related to nocturnal symptoms and to overall symptoms are different. Methods We used a Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in dialogues available from social media platforms in 2016 to 2018. These symptoms were classified as either overall symptoms or nocturnal symptoms. We used share of voice (SOV) of symptoms as a proportion of total dialogues per year to reflect the characteristics of symptoms. Negative sentiment score of symptoms was analyzed to find out their related burden. Results We found the SOV for overall motor symptoms was 79% and had not increased between 2016 and 2018 (79%, p = 0.5). The SOV for non-motor symptoms was 69% and had grown by 7% in 2018 (p <  0.01). The SOV for motor complications was 9% and had increased by 6% in 2018 (p <  0.01). The SOV of motor symptoms was larger than non-motor symptoms and motor complications (p <  0.01). The SOV of non-motor symptoms was larger than motor complications (p <  0.01). For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% (p <  0.01). The SOV for nocturnal-occurring motor symptoms was higher than most non-motor symptoms. However, non-motor symptoms had the higher increases and evoked higher negative sentiment regardless of whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day. Conclusions The growing SOV and the greater negative sentiment of nocturnal symptoms suggest management of nocturnal symptoms is an unmet need of patients. A greater emphasis on detecting and treating nocturnal symptoms with 24-h care is encouraged.

scholarly journals WED 131 Evaluating the clinical utility of the parkinson’s kinetigraph (PKG)

2018 ◽  
Vol 89 (10) ◽  
pp. A15.1-A15 ◽  
Author(s):  
Lewis Hutchinson ◽  
Thea Dominey ◽  
Emma Pearson ◽  
Fiona Murphy ◽  
Lucy Bell ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Recommendations ◽  
Healthcare Sector ◽  
Patient Questionnaire ◽  
List Type ◽  
Patient Acceptability ◽  
P4 Medicine ◽  
Remote Management ◽  
Centered Care

ObjectiveTo evaluate the utility of the Parkinson’s Kinetigraph (PKG™) in the remote management of Parkinson’s disease (PD).BackgroundThere is a movement in Parkinson’s care from a clinic-based model1 to P4 medicine, meaning medicine that is predictive, preventive, personalised and participatory.2 The development of wearable technology provides an opportunity to monitor patients remotely, and deliver targeted care. The PKG™ is a wrist-worn device that objectively measures Parkinson’s symptoms.AimTo evaluate the utility of the PKG™ in managing PD patients remotely, and the perception of service users.MethodPKG™ data were collated in real time. Patient acceptability data were collated via a patient questionnaire (n=61).ResultsBetween July 2015 and January 2018, 216 PKGs were performed. A variety of symptoms were identified, including different types of ‘OFF’ times (wearing off (25%), delayed on (6%) no drug response (8%)) and non-motor complications (fragmented sleep (33%) and daytime somnolence (21%)), with subsequent treatment recommendations being made. Patient acceptability of the PKG™ was high, 81% of patients being satisfied not having to travel for clinic appointments.ConclusionsThe PKG™ facilitated remote treatment recommendations. Remote management was acceptable to patients. Future evaluations will evaluate patient outcome.References. van der Eijk M, Nijhuis FAP, Faber MJ, Bloem BR. Moving from physician-centered care towards patient-centered care for Parkinson’s disease patients. Parkinsonism Relat Disord [Internet]. Elsevier; 1 November 2013;19(11):923–7. Available from: https://www.sciencedirect.com/science/article/pii/S1353802013001697?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb [cited 2018 February 6]. P4 medicine: how systems medicine will transform the healthcare sector and society. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204402/pdf/nihms532619.pdf [cited 2018 April 6]

Emerging targets for the diagnosis of Parkinson’s disease: examination of systemic biomarkers

2021 ◽  
Author(s):  
Lara Cheslow ◽  
Adam E Snook ◽  
Scott A Waldman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Neuronal Damage ◽  
Unmet Need ◽  
Multiple Organ ◽  
The Body ◽  
Organ Systems ◽  
Diagnostic Approaches ◽  
New Biomarkers

Parkinson’s disease (PD) is a highly prevalent and irreversible neurodegenerative disorder that is typically diagnosed in an advanced stage. Currently, there are no approved biomarkers that reliably identify PD patients before they have undergone extensive neuronal damage, eliminating the opportunity for future disease-modifying therapies to intervene in disease progression. This unmet need for diagnostic and therapeutic biomarkers has fueled PD research for decades, but these efforts have not yet yielded actionable results. Recently, studies exploring mechanisms underlying PD progression have offered insights into multisystemic contributions to pathology, challenging the classic perspective of PD as a disease isolated to the brain. This shift in understanding has opened the door to potential new biomarkers from multiple sites in the body. This review focuses on emerging candidates for PD biomarkers in the context of current diagnostic approaches and multiple organ systems that contribute to disease.

Complex Parkinson's disease: review and experiences

2019 ◽  
Vol 15 (3) ◽  
pp. 140-145
Author(s):  
Phil Cotterell ◽  
Debbie Weight ◽  
Sharon Joseph ◽  
Paul Joseph
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Progression ◽  
Unmet Need ◽  
Motor Fluctuations ◽  
Financial Problems ◽  
Care Environment ◽  
Psychological Issues ◽  
Palliative Approach ◽  
The Impact

The rate of Parkinson's disease progression is highly individual. It is important to identify those in the complex stage of the disease. Non-oral therapies may be appropriate for those in the complex stage of the disease who experience motor fluctuations, but there can be reasons for a failure to explore these options. Complex Parkinson's disease is a challenging time for the patient, their carer/s and for Parkinson's specialists. Changes to independence can be difficult to deal with, and the disease has an impact both physically and psychologically. For carers, the impact of Parkinson's can also result in physical and psychological issues as well as social and financial problems. Consideration often turns to moving into a care environment, dealing with neuropsychiatric issues and challenging unmet need. Dealing with symptoms and problems using a team and a palliative approach is required.

A New Perspective in the Treatment of Parkinson’s Disease Psychosis

US Neurology ◽  
2016 ◽  
Vol 12 (02) ◽  
pp. 93
Author(s):  
Rajesh Pahwa ◽  
Kelly E Lyons ◽  
◽  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neuropsychiatric Symptoms ◽  
Unmet Need ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Dopamine Antagonists ◽  
Motor Symptoms ◽  
Double Blind ◽  
Good Tolerability

Neuropsychiatric symptoms, such as psychosis, are well described in Parkinson’s disease (PD); most appear to be due to disease pathology with exacerbation caused by dopaminergic treatment. More than 50% of patients with PD develop psychosis at some point throughout their disease course. Clinicians need to routinely assess patients with PD for psychotic symptoms, particularly hallucinations. Treatment of psychotic symptoms in PD is an unmet need as there are currently no US Food and Drug Administration (FDA) approved medications specifically for PD psychosis (PDP). Current treatments for PDP have been adapted from dopamine antagonists used to treat psychosis in other conditions, such as schizophrenia. Typical antipsychotics, as well as some atypical antipsychotics, worsen PD motor symptoms due to blockade of dopamine D2 receptors. Quetiapine and clozapine have been studied in PDP and are the most commonly used treatments for PDP. Clozapine has been shown to be effective; however, regular bloodwork is required, while data for quetiapine are inconsistent. Pimavanserin, a highly selective serotonin (5HT2A subtype) receptor inverse agonist, is not associated with motor worsening in PDP patients due to the absence of dopamine blockade. In a double-blind, placebo-controlled study, pimavanserin showed significant improvement in moderate to severe psychosis compared to placebo, with good tolerability and without worsening of PD motor symptoms. These data suggest that pimavanserin is a safe and efficacious treatment for PDP psychosis and could be a potential new treatment option for PDP.

scholarly journals Mindfulness Training among Individuals with Parkinson’s Disease: Neurobehavioral Effects

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Barbara Pickut ◽  
Sven Vanneste ◽  
Mark A. Hirsch ◽  
Wim Van Hecke ◽  
Eric Kerckhofs ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Complementary Medicine ◽  
Stress Reduction ◽  
Unmet Need ◽  
Mindfulness Training ◽  
Five Facet Mindfulness Questionnaire ◽  
Alternative And Complementary Medicine ◽  
Point Increase ◽  
Neurobehavioral Effects

Objective. To investigate possible neurobehavioral changes secondary to a mindfulness based intervention (MBI) training for individuals living with Parkinson’s disease (PD).Background. In the context of complementary medicine, MBIs are increasingly being used for stress reduction and in patient populations coping with chronic illness. The use of alternative and complementary medicine may be higher in patients with chronic conditions such as PD. However, behavioral effects of mindfulness training in PD have not yet been reported in the literature and this points to an unmet need and warrants further examination.Methods. A total of 27 out of 30 PD patients completed a randomized controlled longitudinal trial. Questionnaires and the UPDRS I–IV were obtained at baseline and 8-week follow-up.Results. Significant changes after the MBI were found including a 5.5 point decrease on the UPDRS motor score, an increase of 0.79 points on Parkinson’s disease questionnaire (PDQ-39) pain item, and a 3.15 point increase in the Five Facet Mindfulness Questionnaire observe facet.Conclusions. To the best of our knowledge, this is the first quantitative analysis of neurobehavioral effects of MBI in PD.

scholarly journals Continuous force measurements reveal no inhibitory control deficits in Parkinson’s disease

2019 ◽  
Author(s):  
Jade S. Pickering ◽  
Jennifer McBride ◽  
Iracema Leroi ◽  
Ellen Poliakoff
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Inhibitory Control ◽  
Response Inhibition ◽  
Force Measurement ◽  
Button Press ◽  
Continuous Measure ◽  
Response Force ◽  
Link Type ◽  
And Control

AbstractSuppression of unwanted motor responses can be disrupted by Parkinson’s disease. People with Parkinson’s (PwP) can show maladaptive reward-driven behaviours in the form of impulse control behaviours, which are associated with use of the dopaminergic treatments used to alleviate the motor symptoms of the disease. However, the effects of Parkinson’s itself on impulsive behaviour and control are unclear – empirical studies have yielded mixed findings, and some imaging studies have shown a functional deficit in the absence of a measurable change in behaviour. Here, we investigated the effects of Parkinson’s on response activation and control by studying the dynamics of response in standard inhibitory control tasks – the Stop Signal and Simon tasks – using a continuous measure of response force. Our results are largely in favour of the conclusion that response inhibition appears to be intact in PwP, even when using a more sensitive measure of behavioural control relative to traditional button-press measures. Our findings provide some clarity as to the effects of Parkinson’s on response inhibition and show continuous response force measurement can provide a sensitive means of detecting erroneous response activity in PwP, which could also be generalised to studying related processes in other populations.Open dataData and analysis can be found on the Open Science Framework (osf.io/kx6h3/)Pre-print templateWiernik, B.M. (2019, October 11). Preprint templates. osf.io/hsv6a/

scholarly journals The Neuroprotective Effects of Cannabis-Derived Phytocannabinoids and Resveratrol in Parkinson’s Disease: A Systematic Literature Review of Pre-Clinical Studies

2021 ◽  
Vol 11 (12) ◽  
pp. 1573
Author(s):  
Samay Prakash ◽  
Wayne G. Carter
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Unmet Need ◽  
Neuroprotective Agents ◽  
Eligibility Criteria ◽  
Neuroprotective Effects ◽  
In Vivo Models ◽  
Anti Inflammatory ◽  
Nigral Degeneration

Currently, there are no pharmacological treatments able to reverse nigral degeneration in Parkinson’s disease (PD), hence the unmet need for the provision of neuroprotective agents. Cannabis-derived phytocannabinoids (CDCs) and resveratrol (RSV) may be useful neuroprotective agents for PD due to their anti-oxidative and anti-inflammatory properties. To evaluate this, we undertook a systematic review of the scientific literature to assess the neuroprotective effects of CDCs and RSV treatments in pre-clinical in vivo animal models of PD. The literature databases MEDLINE, EMBASE, PsychINFO, PubMed, and Web of Science core collection were systematically searched to cover relevant studies. A total of 1034 publications were analyzed, of which 18 met the eligibility criteria for this review. Collectively, the majority of PD rodent studies demonstrated that treatment with CDCs or RSV produced a significant improvement in motor function and mitigated the loss of dopaminergic neurons. Biochemical analysis of rodent brain tissue suggested that neuroprotection was mediated by anti-oxidative, anti-inflammatory, and anti-apoptotic mechanisms. This review highlights the neuroprotective potential of CDCs and RSV for in vivo models of PD and therefore suggests their potential translation to human clinical trials to either ameliorate PD progression and/or be implemented as a prophylactic means to reduce the risk of development of PD.

scholarly journals Social Listening – Revealing Parkinson’s Disease over Day and Night

2020 ◽  
Author(s):  
Hui Zhang ◽  
Fanwen Meng ◽  
Xingyu Li ◽  
Yali Ning ◽  
Meng Cai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Unmet Need ◽  
Motor Complication ◽  
Motor Symptoms ◽  
Social Media Platforms ◽  
Sentiment Score ◽  
Negative Sentiment ◽  
Non Motor Symptoms ◽  
Social Listening

Abstract Background: Nocturnal symptoms in Parkinson’s disease and their related burdens on patients are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we sought to analyze the characteristics of nocturnal symptoms and the burden of nocturnal-occurring motor and non-motor symptoms from patients’ perspectives.Methods: We used a contemporary Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in patient-doctor and patient-patient dialogues available from social media platforms in China. Frequency of nocturnal symptoms as a proportion of total dialogues per year and their relative negative sentiment were analyzed. As a contrast, overall symptoms (occurring at day or night) were also analyzed. Results: We found that share of voice for overall motor symptoms did not increase from 2016 to 2018 (79%, p = 0.5), but share of voice for non-motor symptoms was 69% in 2018, growing by 7% (p < 0.01), and motor complications was 9%, growing by 6% (p < 0.01), respectively. For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% from 2016 (p < 0.01). Share of voice for nocturnal-occurring motor symptoms was higher than non-motor symptoms. Non-motor symptoms evoked higher negative sentiment no matter whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day, regardless of the type of symptom (motor, non-motor, or motor complication).Conclusions: The growing share of voice and the greater negative sentiment of nocturnal symptoms from patients’ perspectives suggest that management of nocturnal symptoms is an unmet need of patients with Parkinson’s disease. A greater emphasis on detecting nocturnal symptoms and treating them with 24-hour care is encouraged.

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