scholarly journals Khodakarami, H., et al., Prediction of the Levodopa Challenge Test in Parkinson’s Disease Using Data from a Wrist-Worn Sensor. Sensors 2019, 19, 5153

Sensors ◽  
2020 ◽  
Vol 20 (15) ◽  
pp. 4167
Author(s):  
Hamid Khodakarami ◽  
Lucia Ricciardi ◽  
Maria Fiorella Contarino ◽  
Rajesh Pahwa ◽  
Kelly E. Lyons ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Challenge Test ◽  
Using Data

The authors wish to make the following erratum to this paper [...]

scholarly journals Prediction of the Levodopa Challenge Test in Parkinson’s Disease Using Data from a Wrist-Worn Sensor

Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5153 ◽  
Author(s):  
Hamid Khodakarami ◽  
Lucia Ricciardi ◽  
Maria Contarino ◽  
Rajesh Pahwa ◽  
Kelly Lyons ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Challenge Test ◽  
Classification Problem ◽  
Clinical Scales ◽  
Clinically Significant ◽  
Class Labels ◽  
Using Data ◽  
Multi Class Classification ◽  
Operator Curve

The response to levodopa (LR) is important for managing Parkinson’s Disease and is measured with clinical scales prior to (OFF) and after (ON) levodopa. The aim of this study was to ascertain whether an ambulatory wearable device could predict the LR from the response to the first morning dose. The ON and OFF scores were sorted into six categories of severity so that separating Parkinson’s Kinetigraph (PKG) features corresponding to the ON and OFF scores became a multi-class classification problem according to whether they fell below or above the threshold for each class. Candidate features were extracted from the PKG data and matched to the class labels. Several linear and non-linear candidate statistical models were examined and compared to classify the six categories of severity. The resulting model predicted a clinically significant LR with an area under the receiver operator curve of 0.92. This study shows that ambulatory data could be used to identify a clinically significant response to levodopa. This study has also identified practical steps that would enhance the reliability of this test in future studies.

scholarly journals Temporal trajectory of biofluid markers in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Seok Baek ◽  
Myung Jun Lee ◽  
Han-Kyeol Kim ◽  
Chul Hyoung Lyoo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Amyloid Β ◽  
Rapid Progression ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Using Data ◽  
Negative Exponential ◽  
T Tau

AbstractFull dynamics of biofluid biomarkers have been unknown in patients with Parkinson’s disease (PD). Using data from 396 PD patients and 182 controls in the Parkinson's Progression Markers Initiative (PPMI) database, we estimated long-term temporal trajectories of CSF α-synuclein (α-syn), amyloid-β (Aβ), total tau (t-tau), phosphorylated tau (p-tau) and serum neurofilament light chain (NfL) by integrating function between the baseline levels and annual changes. At baseline, PD patients showed lower CSF α-syn, Aβ, t-tau and p-tau levels than those of the controls. In all PD patients, CSF α-syn and Aβ decreased in a negative exponential pattern before the onset of motor symptoms, whereas CSF t-tau and p-tau, and serum NfL increased. Patients with cognitive impairment exhibited faster decline of Aβ and α-syn and faster rise of t-tau, p-tau and NfL, when compared to those without. Similarly, low Aβ group showed earlier decline of α-syn, faster rise of t-tau, p-tau and NfL, and faster decline of cognitive performances, when compared to high Aβ group. Our results suggest that longitudinal changes in biomarkers can be influenced by cognitive impairment and Aβ burden at baseline. PD patients with Aβ pathology may be associated with early appearance of α-synuclein pathology, rapid progression of axonal degeneration and neurodegeneration, and consequently greater cognitive decline.

Apomorphine therapy: alternative initiation for patients with complex Parkinson's disease presentation

2019 ◽  
Vol 15 (6) ◽  
pp. 264-271 ◽  
Author(s):  
Jane Mills
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Infusion Pump ◽  
Challenge Test ◽  
Patient Specific ◽  
Drug Induced ◽  
Subcutaneous Infusion ◽  
Alternative Approach ◽  
User Friendly ◽  
Dose Injection

The apomorphine challenge test can be a distressing experience for some patients and, if they are not experienced, a discouraging option for some healthcare professionals (HCPs). The test is repeated exposure to bolus-dose injection of the medication to assess response and patient-specific dose before embarking on apomorphine therapy. Recent changes in prescribing of the anti-emetic domperidone (limited use because of QT prolongation), a drug which is a prerequisite for most patients embarking on therapy, has also added a possible complication. While recognising the value of the apomorphine challenge test, the author suggests an alternative approach of establishing apomorphine by subcutaneous infusion pump (SCAI) without the challenge test. This approach makes it more ‘user friendly’ for people with complex Parkinson's disease (PwPd) and their HCPs, and can eliminate the need for preloading with domperidone or other anti-emetic (if one is available in the country of practice). It is a viable option in acute situations, such as nil by mouth, surgery and oral dopamine agonist withdrawal, because of the associated harmful impulsive behaviour. Starting immediately with SCAI without the challenge test has proven both helpful and beneficial in clinical practice, especially in PwPd who have potential to abuse the intermittent injection, have complicated regimens and are vulnerable to drug-induced adverse effects. Some patients only need nocturnal infusions; injections during the night are difficult to administer and miss the objective of better sleep. Facilitating the process of initiation with the SCAI could improve uptake of this underused treatment through easier use and positive experience, and overcome the need for short- and longer-term domperidone use.

scholarly journals Deep Brain Stimulation Selection Criteria for Parkinson’s Disease: Time to Go beyond CAPSIT-PD

2020 ◽  
Vol 9 (12) ◽  
pp. 3931
Author(s):  
Carlo Alberto Artusi ◽  
Leonardo Lopiano ◽  
Francesca Morgante
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Selection Criteria ◽  
Challenge Test ◽  
Phenotypic Characterization ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Deep Brain

Despite being introduced in clinical practice more than 20 years ago, selection criteria for deep brain stimulation (DBS) in Parkinson’s disease (PD) rely on a document published in 1999 called ‘Core Assessment Program for Surgical Interventional Therapies in Parkinson’s Disease’. These criteria are useful in supporting the selection of candidates. However, they are both restrictive and out-of-date, because the knowledge on PD progression and phenotyping has massively evolved. Advances in understanding the heterogeneity of PD presentation, courses, phenotypes, and genotypes, render a better identification of good DBS outcome predictors a research priority. Additionally, DBS invasiveness, cost, and the possibility of serious adverse events make it mandatory to predict as accurately as possible the clinical outcome when informing the patients about their suitability for surgery. In this viewpoint, we analyzed the pre-surgical assessment according to the following topics: early versus delayed DBS; the evolution of the levodopa challenge test; and the relevance of axial symptoms; patient-centered outcome measures; non-motor symptoms; and genetics. Based on the literature, we encourage rethinking of the selection process for DBS in PD, which should move toward a broad clinical and instrumental assessment of non-motor symptoms, quantitative measurement of gait, posture, and balance, and in-depth genotypic and phenotypic characterization.

scholarly journals Positive association of Parkinson’s disease with ankylosing spondylitis: a nationwide population-based study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Fu-Chiang Yeh ◽  
Hsiang-Cheng Chen ◽  
Yu-Ching Chou ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ankylosing Spondylitis ◽  
Cox Model ◽  
Positive Association ◽  
Underlying Mechanism ◽  
Population Based ◽  
Neurodegenerative Process ◽  
Increased Risk ◽  
Using Data

Abstract Background Ankylosing spondylitis (AS) is characterized by excessive production of inflammatory cytokines. Recent evidence suggests that inflammation underlies the neurodegenerative process of Parkinson’s disease (PD). Whether AS has an influence on the development of PD is unclear. We aimed to examine a relationship, if any exists between AS and PD. Methods A population-based matched cohort study was performed using data from the 2000–2010 Taiwan National Health Insurance database. 6440 patients with AS and 25,760 randomly selected, age- and sex-matched controls were included in this study. The risk of PD in the AS cohort was evaluated by using a Cox model. Results This study revealed a positive association between AS and the risk of PD regardless of sex and age (aHR 1.75, p < .001). Particularly, AS cohort to non-AS cohort relative risk of PD significantly increased for the patients aged below 49 and above 65 years (aHR 4.70, p < .001; aHR 1.69, p < .001, respectively) and the patients with and without comorbidities (aHR 1.61, p < .001; aHR 2.71, p < .001, respectively). Furthermore, NSAID use was associated with lower risk of PD (aHR 0.69, p < .05). However, the risk of PD was higher (aHR 2.40, p < .01) in patients with AS receiving immunosuppressants than in those not receiving (aHR 1.70, p < .001). Conclusions Patients with AS had an increased risk of PD which might be related to underlying chronic inflammation. Further research is required to elucidate the underlying mechanism.

scholarly journals Parkinson’s disease hospital admissions in the last decade: a parallel between ages in the Southeast of Brazil

2021 ◽  
Author(s):  
Júlia Estrazulas Falcetta ◽  
Laura Toffoli ◽  
Ana Laura Terra Affonso ◽  
Gabriela Kreutz Ferrari ◽  
Victoria Bento Alves Paglioli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Hospital Admissions ◽  
Epidemiologic Study ◽  
Unknown Origin ◽  
Average Growth ◽  
Age Gap ◽  
Disease Hospital ◽  
Using Data ◽  
Brazilian Health System

Background: Parkinson’s is a neurodegenerative and progressive disease, with an unknown origin that can lead to functional incapacity and decreased quality of life. Objectives: Analyze the number of hospital admissions for Parkinson’s Disease in the Southeast of Brazil. Design and setting: Transversal, descriptive Epidemiologic study between the years of 2011 and 2020 in the Southeast of Brazil. Methods: Study realized using data from the Department of Information of the Brazilian Health System (DATASUS). The variables researched were hospital admissions, age, and year. Results: In the Southeast region, in the determined period, there was an average of 405 hospital admissions per year, an average growth of 4% between the years of 2011 and 2019. However, in 2020, there was a 30% decrease compared to the previous year. It was also observed that in the gap ages between 40 to 49 and 50 to 59 years old, there was a significant increase in the number of hospital admissions. In addition, the age gap between 50 to 80 or more represents an average of 90.88% of all the hospital admissions of the last decade. Conclusion: In the Southeast of Brazil, Parkinson’s Disease had a noticeable absolute reduction of the total admissions analyzed in the last year and a deviation in the average growth of the other years, meaning a possible relation with the COVID-19 pandemic.

scholarly journals Dopamine Neuron Challenge Test for early detection of Parkinson’s disease

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jingheng Zhou ◽  
Jicheng Li ◽  
Amy B. Papaneri ◽  
Nicholas P. Kobzar ◽  
Guohong Cui
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cerebrospinal Fluid ◽  
Diagnostic Tests ◽  
Dopamine Release ◽  
Challenge Test ◽  
Dopamine Neurons ◽  
Substantia Nigra Pars Compacta ◽  
High Risk Population ◽  
Clinical Onset

AbstractDiagnosing Parkinson’s disease (PD) before the clinical onset proves difficult because the hallmark PD symptoms do not manifest until more than 60% of dopamine neurons in the substantia nigra pars compacta have been lost. Here we show that, by evoking a transient dopamine release and subsequently measuring the levels of dopamine metabolites in the cerebrospinal fluid and plasma, a hypodopaminergic state can be revealed when less than 30% of dopamine neurons are lost in mouse PD models. These findings may lead to sensitive and practical screening and diagnostic tests for detecting early PD in the high-risk population.

scholarly journals Effect of Acute Levodopa Up-Titration on Blood Pressure in Patients With Early Stage Parkinson’s Disease: Results of a Levodopa Challenge Test

2022 ◽  
Vol 13 ◽  
Author(s):  
Xiaoqin He ◽  
Chengjun Mo ◽  
Yi Zhang ◽  
Ying Cai ◽  
Xiaodong Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Challenge Test ◽  
Drug Uptake ◽  
Induced Hypotension ◽  
Before And After ◽  
Standing Up ◽  
At Home

Objective: Levodopa up-titration is the primary therapeutic strategy as the Parkinson’s disease (PD) progresses. However, the effects of levodopa up-titration on blood pressure (BP) are inconclusive. This study aimed to investigate the effect of acute levodopa up-titration simulated by levodopa challenge test (LCT) on BP in patients with early stage PD.Methods: We monitored BP in 52 patients with early stage PD using a standardized standing test. BP was assessed in supine position after 10 min of rest and at 1 and 3 min after standing up. BP was measured in the “off-state” and the best “on-state” during LCT in the morning at hospital. In another day, “off-state” and the best “on-state” BP was measured before and after anti-PD drug uptake in the morning at home. Demographic and clinical features of the patients were evaluated and analyzed.Results: In the LCT, the prevalence of OH in the “off-state” and the best “on-state” was 11.5 and 13.5%, respectively. Additionally, the OH in the best “on-state” was associated with OH in the “off-state” and monoamine oxidase B inhibitor use. Although 38 (73.1%) patients experienced levodopa-induced hypotension during the LCT, no risk factors were identified. While BP reductions were observed after taking anti-PD drugs at home, no further reduction was seen during acute levodopa up-titration simulated by the LCT.Conclusion: Our results demonstrate that acute levodopa up-titration does not exacerbate BP reduction induced by anti-PD drugs at home. BP monitoring is critical for the management of patients with PD.

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