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Expert Review of Neurotherapeutics 2023Gait disturbances are a major contributor to the disability associated with Parkinson's disease. Although pharmacologic therapies and deep brain stimulation improve most... (Review)
Review
INTRODUCTION
Gait disturbances are a major contributor to the disability associated with Parkinson's disease. Although pharmacologic therapies and deep brain stimulation improve most motor parkinsonian features, their effects on gait are highly variable. Spinal cord stimulation, typically used for the treatment of chronic pain, has emerged as a potential therapeutic approach to improve gait disturbances in Parkinson's disease.
AREAS COVERED
The authors review the available evidence on the effects of spinal cord stimulation in patients with Parkinson's disease, targeting primarily gait abnormalities. They also discuss possible mechanisms, safety, and methodological implications for future clinical trials. This systematic review of originally published articles in English language was performed using The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
Topics: Humans; Parkinson Disease; Spinal Cord Stimulation; Deep Brain Stimulation; Gait; Gait Disorders, Neurologic
PubMed: 37345383
DOI: 10.1080/14737175.2023.2228492 -
Progress in Neuro-psychopharmacology &... Aug 2017The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD).... (Review)
Review
The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive electronic literature research strategy on ISI Web-of-Science, PsychINFO, PubMed, EBSCO, ScienceDirect, MEDLINE, Scopus, and Google Scholar databases. Out of 2.926 initial records, only a total of 9 studies were identified as clearly relevant and analyzed in this systematic review. The prevalence of somatization in PD has been found to range between 7.0% and 66.7%, with somatoform disorders acting as clinical factor significantly contributing to predict a progressive cognitive impairment. We highlighted that somatization is a highly prevalent comorbidity affecting PD. However, the clinical consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR).
Topics: Comorbidity; Humans; Parkinson Disease; Somatoform Disorders
PubMed: 28522290
DOI: 10.1016/j.pnpbp.2017.05.011 -
Journal of Parkinson's Disease 2022A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD). (Meta-Analysis)
Meta-Analysis
BACKGROUND
A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson's disease (PD).
OBJECTIVE
To provide an updated systematic review and meta-analysis of observational studies examining the relationship between alcohol consumption and risk of PD.
METHODS
Eligible studies comparing PD risk in ever vs. never alcohol drinkers were sourced from six databases. Outcomes were pooled using standard meta-analysis techniques. Separate female and male estimates were generated from studies reporting sex-specific data. Additionally, cohort studies stratifying participants by quantity of alcohol intake were integrated in a dose-response analysis.
RESULTS
52 studies were included, totaling 63,707 PD patients and 9,817,924 controls. Our meta-analysis supported a statistically significant overrepresentation of never drinkers among PD subjects; odds ratio (OR) for ever drinking alcohol 0.84 (95% confidence interval (CI) 0.76 - 0.92). A subgroup analysis revealed similar effect estimates in females and males. A further synthesis of seven cohort studies suggested a negative, dose-dependent association between alcohol and risk of PD.
CONCLUSION
In the absence of a known neuroprotective pathway, there may be reason to doubt a true biological effect. The role of survivor bias, selection and recall bias, misclassification, and residual confounding requires consideration. Alternatively, observations might be attributable to reverse causation if those predestined for PD alter their alcohol habits during the preclinical phase. Major limitations of our study include high between-study heterogeneity (I2 = 93.2%) and lack of adjustment for key confounders, namely smoking status.
Topics: Humans; Male; Female; Alcohol Drinking; Risk Factors; Parkinson Disease; Ethanol; Smoking
PubMed: 36442208
DOI: 10.3233/JPD-223522 -
Age and Ageing Sep 2017cognitive and mobility decline are interrelated processes, whereby mobility decline coincides or precedes the onset of cognitive decline. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
cognitive and mobility decline are interrelated processes, whereby mobility decline coincides or precedes the onset of cognitive decline.
OBJECTIVE
to assess whether there is an association between performance on motor function tests and incident dementia.
METHODS
electronic database, grey literature and hand searching identified studies testing for associations between baseline motor function and incident dementia in older adults.
RESULTS
of 2,540 potentially relevant documents, 37 met the final inclusion criteria and were reviewed qualitatively. Three meta-analyses were conducted using data from 10 studies. Three main motor domains-upper limb motor function, parkinsonism and lower limb motor function-emerged as associated with increased risk of incident dementia. Studies including older adults without neurological overt disease found a higher risk of incident dementia associated with poorer performance on composite motor function scores, balance and gait velocity (meta-analysis pooled HR = 1.94, 95% CI: 1.41, 2.65). Mixed results were found across different study samples for upper limb motor function, overall parkinsonism (meta-analysis pooled OR = 3.05, 95% CI: 1.31, 7.08), bradykinesia and rigidity. Studies restricted to older adults with Parkinson's Disease found weak or no association with incident dementia even for motor domains highly associated in less restrictive samples. Tremor was not associated with an increased risk of dementia in any population (meta-analysis pooled HR = 0.80, 95% CI 0.31, 2.03).
CONCLUSION
lower limb motor function was associated with increased risk of developing dementia, while tremor and hand grip strength were not. Our results support future research investigating the inclusion of quantitative motor assessment, specifically gait velocity tests, for clinical dementia risk evaluation.
Topics: Age Factors; Aged; Aged, 80 and over; Cognition; Cognitive Aging; Dementia; Female; Gait; Hand Strength; Humans; Incidence; Lower Extremity; Male; Motor Activity; Odds Ratio; Parkinson Disease; Postural Balance; Prognosis; Risk Factors; Upper Extremity
PubMed: 28541374
DOI: 10.1093/ageing/afx084 -
Molecular Medicine Reports May 2017A possible association between iron serum levels and Parkinson's disease (PD) using a meta‑analytic approach was evaluated. A systematic MEDLINE search was conducted... (Meta-Analysis)
Meta-Analysis Review
A possible association between iron serum levels and Parkinson's disease (PD) using a meta‑analytic approach was evaluated. A systematic MEDLINE search was conducted to identify published observational, case‑control studies dealing with the association between iron blood levels and PD. In both groups, iron blood levels were extracted as means and standard deviations to calculate the standardized mean differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity of selected studies was investigated. Then, a meta-analysis was performed applying a random effects model. Possible causes of bias were also examined. A meta-regression analysis was finally conducted to investigate whether associations varied according to specified confounding factors. Of 155 studies detected by the research strategy, a total of 23 case‑control studies with full available data were selected based on the adopted criteria. A small, around zero, overall SMD of -0.052 (95% CI, -0.303-0.2) was estimated, indicating no substantial differences between groups among selected studies. High heterogeneity among studies was detected (I2=91.42%; p<0.001). By performing a meta-regression analysis considering single available demographic, geographical and clinical covariates, no significant association was detected. Based on our systematic revision and meta-analysis of available case‑control studies, there was not sufficient evidence supporting a possible significant association between iron serum levels and PD as compared to controls. Principal reasons should be sought in the elevated methodological heterogeneity we found among available studies. A particular attention should be paid on bias and confounding effects to limit heterogeneity among studies and to facilitate the summary of results.
Topics: Age Factors; Case-Control Studies; Databases, Factual; Humans; Iron; Parkinson Disease; Spectrophotometry, Atomic
PubMed: 28339068
DOI: 10.3892/mmr.2017.6386 -
Ageing Research Reviews Dec 2022Neurodegenerative diseases have become an important concern with the accelerated aging process. Tai Chi Quan (TCQ) has positive benefits for brain health and chronic... (Review)
Review
BACKGROUND
Neurodegenerative diseases have become an important concern with the accelerated aging process. Tai Chi Quan (TCQ) has positive benefits for brain health and chronic diseases. The aim of this study was to summarize the protective effects of TCQ for motor function, cognition, quality of life, and mood in patients with neurodegenerative diseases.
METHODS
A systematic search was conducted via PubMed database and the Web of Science core collection database until August 20, 2021. The available English systematic reviews, meta-analyses, and clinical trials were included. Two reviewers completed the screening and assessment process independently.
RESULTS
A total of 28 studies on Parkinson's disease, 21 on cognitive impairment, and 9 on multiple sclerosis met the included criteria. The study found that TCQ remarkably improved general motor function and balance, and prevented falls for Parkinson's disease. TCQ significantly improved global cognitive function for cognitive impairment. TCQ was likely safe and beneficial for multiple sclerosis as result of heterogeneous outcomes and small samples.
CONCLUSION
TCQ exercise can effectively improve the motor function, global cognitive function, and falls in patients with neurodegenerative diseases. However, the positive effects of TCQ on the quality of life and mood of patients with neurodegenerative diseases need further evidence.
Topics: Humans; Tai Ji; Parkinson Disease; Quality of Life; Neurodegenerative Diseases; Multiple Sclerosis
PubMed: 36220604
DOI: 10.1016/j.arr.2022.101741 -
Parkinsonism & Related Disorders Sep 2023The human immunodeficiency virus (HIV) causes movement disorders in persons living with HIV (PLH). (Review)
Review
BACKGROUND
The human immunodeficiency virus (HIV) causes movement disorders in persons living with HIV (PLH).
OBJECTIVES AND METHODS
We conducted a systematic review on the spectrum of movement disorders in PLH using standard terms for each of the phenomenologies and HIV.
RESULTS
Movement disorders in PLH were commonly attributed to opportunistic infections (OI), dopamine receptor blockade reactions, HIV-associated dementia (HAD), presented during seroconversion, developed due to drug reactions or antiretroviral therapy (ART) itself and lastly, movement disorders occurred as a consequence of the HIV-virus. Parkinsonism in ART naïve PLH was associated with shorter survival, however when Parkinsonism presented in PLH on ART, the syndrome was indistinguishable from Idiopathic Parkinson's disease and responded to therapy. Tremor was often postural due to HAD, drugs or OI. Generalized chorea was most frequent in HIV encephalopathy and toxoplasmosis gondii caused most cases of hemichorea. Ataxia was strongly associated with JCV infection, ART efavirenz toxicity or due to HIV itself. Dystonia was reported in HAD, secondary to drugs and atypical facial dystonias. Both cortical/subcortical and segmental/spinal origin myoclonus were noted mainly associated with HAD. In patients with HIV related opsoclonus-myoclonus-ataxia-syndrome, seroconversion illness was the commonest cause of followed by IRIS and CSF HIV viral escape phenomenon.
CONCLUSIONS
Aetiology of movement disorders in PLH depend on the treatment state. Untreated, PLH are prone to develop OI and HAD and movement disorders. However, as the number of PLH on ART increase and survive longer, the frequency of ART and non-AIDS related complications are likely to increase.
Topics: Humans; HIV; Myoclonus; Movement Disorders; HIV Infections; Parkinson Disease; Parkinsonian Disorders; Ataxia
PubMed: 37532621
DOI: 10.1016/j.parkreldis.2023.105774 -
Frontiers in Endocrinology 2022Studies have suggested that patients with thyroid dysfunction may have an increased risk of developing Parkinson's disease (PD). However, the results from existing... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Studies have suggested that patients with thyroid dysfunction may have an increased risk of developing Parkinson's disease (PD). However, the results from existing studies are inconsistent. Therefore, we aimed to investigate the association of hypothyroidism and hyperthyroidism with risk of PD using the method of systematic review and meta-analysis.
METHODS
Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 2021 using search strategy that comprised of terms for "Thyroid" and "Parkinson's Disease". Eligible cohort study must consist of one cohort of patients with hypothyroidism/hyperthyroidism and another cohort of individuals without hypothyroidism/hyperthyroidism. Then, the study must report effect estimates with 95% confidence intervals (95% CIs) comparing incident PD between the groups. Eligible case-control studies must include cases with PD and controls without PD. Then, the study must explore their history of hypothyroidism/hyperthyroidism. Odds ratio (OR) with 95% CIs of the association between presence of hypothyroidism/hyperthyroidism and PD must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.
RESULTS
A total of 3,147 articles were identified. After two rounds of independent review by three investigators, 3 cohort studies and 6 case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed an increased likelihood of PD in both patients with hypothyroidism (pooled OR 1.56; 95%CI, 1.38 - 1.77; with moderate heterogeneity, I 66.9%) and patients with hyperthyroidism (pooled OR 1.57; 95%CI, 1.40 - 1.77; with insignificant heterogeneity, I 0.0%). Funnel plots for both meta-analyses were fairly symmetric, which did not indicate presence of publication bias.
CONCLUSION
This systematic review and meta-analysis found a significant association of both hypothyroidism and hyperthyroidism with an increased risk of PD.
Topics: Cohort Studies; Humans; Hyperthyroidism; Hypothyroidism; Parkinson Disease
PubMed: 35600588
DOI: 10.3389/fendo.2022.863281 -
BMJ Clinical Evidence Apr 2015The mean age of onset of Parkinson's disease is about 65 years, with a median time of 9 years between diagnosis and death. (Review)
Review
INTRODUCTION
The mean age of onset of Parkinson's disease is about 65 years, with a median time of 9 years between diagnosis and death.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of fetal cell or stem cell-derived therapy in people with Parkinson's disease? We searched: Medline, Embase, The Cochrane Library and other important databases up to September 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found two studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: fetal cell therapy versus deep brain stimulation; fetal cell therapy versus sham surgery; stem cell-derived therapy versus deep brain stimulation; stem cell-derived therapy versus sham surgery.
Topics: Cell- and Tissue-Based Therapy; Deep Brain Stimulation; Humans; Parkinson Disease; Stem Cell Transplantation; Treatment Outcome
PubMed: 25898159
DOI: No ID Found -
Journal of Parkinson's Disease 2021A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent. (Meta-Analysis)
Meta-Analysis
BACKGROUND
A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent.
OBJECTIVE
Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression.
METHODS
MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD.
RESULTS
A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 -12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26-1.43 p < 0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12-0.60; p < 0.001) and higher UPDRS (SMD 0.60 95%CI 0.28-0.92; p < 0.001) compared with PD patients without DM.
CONCLUSION
Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.
Topics: Diabetes Mellitus; Disease Progression; Humans; Incidence; Parkinson Disease; Severity of Illness Index
PubMed: 34486987
DOI: 10.3233/JPD-212725