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Journal of Parkinson's Disease 2020Signs of respiratory dysfunction can be present already early in the course of Parkinson's disease (PD). Respiratory training could alleviate this, but its effectiveness...
BACKGROUND
Signs of respiratory dysfunction can be present already early in the course of Parkinson's disease (PD). Respiratory training could alleviate this, but its effectiveness is not well understood.
OBJECTIVE
The purpose of this systematic review is to review the efficacy of different respiratory training interventions in PD.
METHODS
A search strategy was performed in four databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Methodological quality of original full-text articles was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for the controlled trials (CTs). Levels of evidence were rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach.
RESULTS
Six papers reporting on four randomized controlled trials and another four controlled trials were included. Positive effects were reported for inspiratory muscle strength training (IMST), expiratory muscle strength training (EMST), air stacking, breath-stacking, incentive spirometry and postural training on respiratory muscle strength, swallowing safety, phonatory aspects and chest wall volumes. Best methodological quality was found for breath-stacking and incentive spirometry. Best levels of evidence were found for EMST, IMST and EMST plus air stacking.
CONCLUSION
Respiratory training shows positive effects and should be considered when people with PD experience respiratory dysfunction. Future studies should focus on standardizing both training devices, instruments to measure outcomes and intervention protocols to further increase the level of evidence.
Topics: Breathing Exercises; Humans; Muscle Strength; Outcome Assessment, Health Care; Parkinson Disease; Respiration Disorders; Respiratory Muscles
PubMed: 32986684
DOI: 10.3233/JPD-202223 -
Journal of Parkinson's Disease 2024Several dietary patterns and nutritional supplements have been linked to the development, progression, and symptomatic treatment of Parkinson's disease (PD). Most of the... (Review)
Review
Several dietary patterns and nutritional supplements have been linked to the development, progression, and symptomatic treatment of Parkinson's disease (PD). Most of the evidence, at this point, is preliminary and based largely on observational studies. Interventional studies are scarce, so the evidence on effectiveness remains inconclusive. Dietary interventions could, analogous to exercise, potentially have a beneficial effect on disease symptoms as well as on the progression of the disease and should therefore be researched in high quality studies. Further work is also needed to study whether dietary interventions, when applied to an at-risk population, have any potential to postpone the onset of manifest PD. In this paper, we summarize all ongoing clinical trials on dietary interventions in PD. We found 10 ongoing studies, all aimed at a different intervention. These studies are mostly exploratory in nature or represent phase I or phase II trials focusing on safety, biological responses, and symptomatic effects. Taken together, we conclude that research on dietary interventions in persons with PD is still in its early days. The results of the various ongoing trials are expected to generate new hypotheses and will help to shape the agenda for future research on this important topic.
Topics: Humans; Parkinson Disease
PubMed: 38277304
DOI: 10.3233/JPD-230366 -
Journal of Parkinson's Disease 2018Currently all aspects of Parkinson's disease (PD) treatment are less than ideal and would benefit from new interventions. We focus on problems associated with brain... (Review)
Review
Currently all aspects of Parkinson's disease (PD) treatment are less than ideal and would benefit from new interventions. We focus on problems associated with brain neurotransmitters amenable to more specific subreceptor and temporal manipulation. In addition, we consider potentially treatable CNS non-PD co-pathologies or co-morbidities that may exacerbate progression of various aspects of PD.
Topics: Depressive Disorder; Disease Progression; Gait Disorders, Neurologic; Humans; Parkinson Disease
PubMed: 30584157
DOI: 10.3233/JPD-181472 -
Scandinavian Journal of Immunology May 2021For many years, it was postulated that the brain is the organ behind the barrier with an autonomous need for its maintenance. This view has been changed by the concept... (Review)
Review
For many years, it was postulated that the brain is the organ behind the barrier with an autonomous need for its maintenance. This view has been changed by the concept that the central nervous system is sensitive to the immune processes occurring in the periphery as well as to the infiltration of peripheral immune cells. However, how the immune system might contribute to the development of neurodegenerative diseases, such as Parkinson's disease (PD), remains unclear. PD is a chronic neurodegenerative disorder that affects motor and cognitive functions. Although the precise cause of PD is unknown, studies in both mice and human suggest that alterations in the innate immunity may play a critical role in modulating PD progression. Here, we review recent advancements in our understanding of inflammation and the innate immune mechanisms in PD pathology.
Topics: Animals; Central Nervous System; Humans; Immunity, Innate; Inflammation; Mice; Microglia; Neuroimmunomodulation; Parkinson Disease; alpha-Synuclein
PubMed: 33471378
DOI: 10.1111/sji.13022 -
Communications Biology Jan 2024The subthalamic nucleus (STN) is a major neuromodulation target for the alleviation of neurological and neuropsychiatric symptoms using deep brain stimulation (DBS).... (Review)
Review
The subthalamic nucleus (STN) is a major neuromodulation target for the alleviation of neurological and neuropsychiatric symptoms using deep brain stimulation (DBS). STN-DBS is today applied as treatment in Parkinson´s disease, dystonia, essential tremor, and obsessive-compulsive disorder (OCD). STN-DBS also shows promise as a treatment for refractory Tourette syndrome. However, the internal organization of the STN has remained elusive and challenges researchers and clinicians: How can this small brain structure engage in the multitude of functions that renders it a key hub for therapeutic intervention of a variety of brain disorders ranging from motor to affective to cognitive? Based on recent gene expression studies of the STN, a comprehensive view of the anatomical and cellular organization, including revelations of spatio-molecular heterogeneity, is now possible to outline. In this review, we focus attention to the neurobiological architecture of the STN with specific emphasis on molecular patterns discovered within this complex brain area. Studies from human, non-human primate, and rodent brains now reveal anatomically defined distribution of specific molecular markers. Together their spatial patterns indicate a heterogeneous molecular architecture within the STN. Considering the translational capacity of targeting the STN in severe brain disorders, the addition of molecular profiling of the STN will allow for advancement in precision of clinical STN-based interventions.
Topics: Animals; Humans; Subthalamic Nucleus; Brain; Parkinson Disease; Research Personnel
PubMed: 38200143
DOI: 10.1038/s42003-023-05691-4 -
Current Neuropharmacology 2021
Topics: Alzheimer Disease; Biological Products; Humans; Parkinson Disease
PubMed: 33423641
DOI: 10.2174/1570159X1902201231153120 -
Journal of Parkinson's Disease 2022People with Parkinson's disease (PD) benefit from boxing exercise. Adding kicking variations to the boxing may provide additional benefit to improve balance. However,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
People with Parkinson's disease (PD) benefit from boxing exercise. Adding kicking variations to the boxing may provide additional benefit to improve balance. However, the benefits and adherence to such trainings is unknown.
OBJECTIVE
To explore the feasibility, safety, and benefits on balance of boxing training combined with kicking techniques in comparison to boxing without kicking in PD.
METHODS
Participants were randomized to group-based boxing training with kicking techniques (BK) or to group-based boxing alone training (BO). Both groups trained for one hour, once a week, for a period of 10 weeks. Participants were assessed at baseline and ten weeks post-intervention for difference in balance, fear of falling, balance confidence, walking ability, and quality of life.
RESULTS
Twenty-nine people with PD (median age 64 years; median disease duration 5 years) participated. Both interventions were feasible and acceptable for all participants. No adverse events occurred. Most participants (BK 80%; BO 75%) were satisfied with the training. We found no significant between group difference on either the primary (Mini-BEST) or secondary outcomes. The within group comparison showed that balance improved in both groups after the intervention (BK 22.60 (2.7) to 25.33 (2.64) p = 0.02; BO 23.09 (3.44) to 25.80 (2.39); p = 0.01 on the Mini BEST test).
CONCLUSION
Both types of boxing seem to be feasible and safe. Adding kicking techniques to boxing does not improve balance significantly more than boxing alone. Incorporation of kicking may be a valuable addition to the exercise therapy repertoire.
Topics: Humans; Middle Aged; Parkinson Disease; Boxing; Quality of Life; Pilot Projects; Fear; Exercise Therapy; Postural Balance
PubMed: 36245387
DOI: 10.3233/JPD-223447 -
Journal of Parkinson's Disease 2021Technology has an increasing presence and role in the management of Parkinson's disease. Whether embraced or rebuffed by patients and clinicians, this is an undoubtedly... (Review)
Review
Technology has an increasing presence and role in the management of Parkinson's disease. Whether embraced or rebuffed by patients and clinicians, this is an undoubtedly growing area. Wearable sensors have received most of the attention so far. This review will focus on technology integrated into the home setting; from fixed sensors to automated appliances, which are able to capture information and have the potential to respond in an unsupervised manner. Domotics also have the potential to provide 'real world' context to kinematic data and therapeutic opportunities to tackle challenging motor and non-motor symptoms. Together with wearable technology, domotics have the ability to gather long-term data and record discrete events, changing the model of the cross-sectional outpatient assessment. As clinicians, our ultimate goal is to maximise quality of life, promote autonomy, and personalise care. In these respects, domotics may play an essential role in the coming years.
Topics: Housing; Humans; Parkinson Disease; Technology
PubMed: 33612494
DOI: 10.3233/JPD-202398 -
Nutrients Feb 2021Methylxanthines (MTX) are purine derived xanthine derivatives. Whereas naturally occurring methylxanthines like caffeine, theophylline or theobromine are widely consumed... (Review)
Review
Methylxanthines (MTX) are purine derived xanthine derivatives. Whereas naturally occurring methylxanthines like caffeine, theophylline or theobromine are widely consumed in food, several synthetic but also non-synthetic methylxanthines are used as pharmaceuticals, in particular in treating airway constrictions. Besides the well-established bronchoprotective effects, methylxanthines are also known to have anti-inflammatory and anti-oxidative properties, mediate changes in lipid homeostasis and have neuroprotective effects. Known molecular mechanisms include adenosine receptor antagonism, phosphodiesterase inhibition, effects on the cholinergic system, wnt signaling, histone deacetylase activation and gene regulation. By affecting several pathways associated with neurodegenerative diseases via different pleiotropic mechanisms and due to its moderate side effects, intake of methylxanthines have been suggested to be an interesting approach in dealing with neurodegeneration. Especially in the past years, the impact of methylxanthines in neurodegenerative diseases has been extensively studied and several new aspects have been elucidated. In this review we summarize the findings of methylxanthines linked to Alzheimer´s disease, Parkinson's disease and Multiple Sclerosis since 2017, focusing on epidemiological and clinical studies and addressing the underlying molecular mechanisms in cell culture experiments and animal studies in order to assess the neuroprotective potential of methylxanthines in these diseases.
Topics: Alzheimer Disease; Animals; Caffeine; Coffee; Humans; Multiple Sclerosis; Neurodegenerative Diseases; Neuroprotective Agents; Parkinson Disease; Theobromine; Theophylline; Xanthines
PubMed: 33671099
DOI: 10.3390/nu13030803 -
CPT: Pharmacometrics & Systems... Feb 2019Parkinsons disease (PD) is a progressive neurodegenerative disease with substantial and growing socio-economic burden. In this multifactorial disease, aging,... (Review)
Review
Parkinsons disease (PD) is a progressive neurodegenerative disease with substantial and growing socio-economic burden. In this multifactorial disease, aging, environmental, and genetic factors contribute to neurodegeneration and dopamine (DA) deficiency in the brain. Treatments aimed at DA restoration provide symptomatic relief, however, no disease modifying treatments are available, and PD remains incurable to date. Mathematical modeling can help understand such complex multifactorial neurological diseases. We review mathematical modeling efforts in PD with a focus on mechanistic models of pathogenic processes. We consider models of α-synuclein (Asyn) aggregation, feedbacks among Asyn, DA, and mitochondria and proteolytic systems, as well as pathology propagation through the brain. We hope that critical understanding of existing literature will pave the way to the development of quantitative systems pharmacology models to aid PD drug discovery and development.
Topics: Brain; Dopamine; Humans; Mitochondria; Models, Biological; Parkinson Disease; alpha-Synuclein
PubMed: 30358157
DOI: 10.1002/psp4.12362