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Parkinson's dementia outcome

Daniel Weintraub, Alexander I Tröster, Connie Marras, Glenn Stebbins
The focus on cognitive impairment in neurodegenerative diseases, including PD, is shifting from the dementia stage to earlier stages of impairment, including mild cognitive impairment. This shift is driven primarily by the desire to improve long-term outcomes by delivering therapeutic interventions earlier in the clinical course, even presymptomatically in those at highest risk, and at the initial stage in the pathophysiological cascade that underpins common dementia syndromes. This article focuses on key findings and challenges in studying earliest stages of cognitive decline in PD, including a detailed examination of neuropsychological testing, cognitive performance in early and prodromal PD, epidemiological research for PD mild cognitive impairment to date, and expert recommendations for assessment...
March 15, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Jaime McDonald, Emmanuelle Pourcher, Alexandra Nadeau, Philippe Corbeil
OBJECTIVES: The objective of this study was to compare the efficacy and safety of oral and transdermal rivastigmine for postural instability in patients with Parkinson disease dementia (PDD) who were candidates for a cholinesterase inhibitor. The primary outcome was the change in mean velocity of the center of pressure (CoP) after 6 months. Secondary outcomes included structural parameters of dynamic posturography, clinical rating scales, and adverse events requiring dose reduction. METHODS: Patients with PDD were randomized in a 1:1 ratio to oral or transdermal rivastigmine with target doses of 6 mg twice daily and 9...
March 13, 2018: Clinical Neuropharmacology
Viorica Chelban, Ekawat Vichayanrat, Lucia Schottlaende, Valeria Iodice, Henry Houlden
The discovery of genetic links between alpha-synuclein and PD has opened unprecedented opportunities for research into a new group of diseases, now collectively known as synucleinopathies. Autonomic dysfunction, including cardiac sympathetic denervation, has been reported in familial forms of synucleinopathies that have Lewy bodies at the core of their pathogenesis. SNCA mutations and multiplications, LRRK2 disease with Lewy bodies as well as other common, sporadic forms of idiopathic PD, MSA, pure autonomic failure, and dementia with Lewy bodies have all been associated with dysautonomia...
March 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Lynne Parkinson, Annie Banbury, Anne Livingstone, Steven Gordon, Biplob Ray, Louise Byrne, Susan Nancarrow, Chris Doran, Margaret McAllister, Carrie Petersen, Sonja Pedell, Denise Wood
In rural Australia, knowledge and utilisation of support by informal carers is lacking. During the caregiving period, socioemotional support from family and friends plays an important role in sustaining caregiving activities. Post-care, these social networks facilitate adjustment to role change and dealing with grief. Developing and improving access to peer support to enable carers to effectively cope with the challenges of caring may positively influence their caring experience. The primary objective of this project is to examine the response of isolated rural carers for older people with dementia to a videoconference (VC) based peer support and information program...
2018: Studies in Health Technology and Informatics
Imke Galazky, Jörn Kaufmann, Stefan Lorenzl, Georg Ebersbach, Florin Gandor, Tino Zaehle, Sylke Specht, Sabine Stallforth, Uwe Sobieray, Edyta Wirkus, Franziska Casjens, Hans-Jochen Heinze, Andreas Kupsch, Jürgen Voges
BACKGROUND: The pedunculopontine nucleus has been suggested as a potential deep brain stimulation target for axial symptoms such as gait and balance impairment in idiopathic Parkinson's disease as well as atypical Parkinsonian disorders. METHODS: Seven consecutive patients with progressive supranuclear palsy received bilateral pedunculopontine nucleus deep brain stimulation. Inclusion criteria comprised of the clinical diagnosis of progressive supranuclear palsy, a levodopa-resistant gait and balance disorder, age <75 years, and absence of dementia or major psychiatric co-morbidities...
February 19, 2018: Parkinsonism & related Disorders
Yu-Hsuan Wu, Yi-Huei Chen, Ming-Hong Chang, Ching-Heng Lin
BACKGROUND: To evaluate the association between Parkinson's disease (PD) prognosis and the patient's onset of depression. METHODS: A total of 353 patients with newly-diagnosed PD and a history of depression were enrolled. On the basis of the onset of depression before or after PD diagnosis, we divided participants into PD patients with pre- or post-diagnostic depression. Cox's regression analysis was used to detect risks between the onset of depression and outcomes (including death, accidental injury, dementia, and aspiration pneumonia)...
2018: PloS One
John V Hindle, Tamlyn J Watermeyer, Julie Roberts, Andrew Brand, Zoe Hoare, Anthony Martyr, Linda Clare
OBJECTIVE: To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study. METHODS: This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9)...
January 4, 2018: International Journal of Geriatric Psychiatry
Hideki Mochizuki, Chi-Jing Choong, Eliezer Masliah
α-synuclein (αSyn) still remains a mysterious protein even two decades after SNCA encoding it was identified as the first causative gene of familial Parkinson's disease (PD). Accumulation of αSyn causes α-synucleinopathies including PD, dementia with Lewy bodies (DLB) and multiple system atrophy (MSA). Recent advances in therapeutic approaches offer new antibody-, vaccine-, antisense-oligonucleotide- and small molecule-based options to reduce αSyn protein levels and aggregates in patient's brain. Gathering research information of other neurological disease particularly Alzheimer's disease, recent disappointment of an experimental amyloid plaques busting antibody in clinical trials underscores the difficulty of treating people who show even mild dementia as damage in their brain may already be too extensive...
January 2, 2018: Neurochemistry International
Joseph R Winer, Anne Maass, Peter Pressman, Jordan Stiver, Daniel R Schonhaut, Suzanne L Baker, Joel Kramer, Gil D Rabinovici, William J Jagust
Importance: Multiple disease processes are associated with cognitive impairment in Parkinson disease (PD), including Lewy bodies, cerebrovascular disease, and Alzheimer disease. It remains unknown whether tau pathology relates to cognition in patients with PD without dementia. Objective: To compare tau aggregation in patients with PD who are cognitively normal (PD-CN), patients with PD with mild cognitive impairment (PD-MCI), and healthy control participants, and evaluate the relationships between β-amyloid (Aβ), tau, and cognition in patients with PD who did not have dementia...
February 1, 2018: JAMA Neurology
Lorena Broseghini Barcelos, Flávia Saad, Carla Giacominelli, Roberta Arb Saba, Patrícia Maria de Carvalho Aguiar, Sonia Maria Azevedo Silva, Vanderci Borges, Paulo Henrique Ferreira Bertolucci, Henrique Ballalai Ferraz
OBJECTIVE: We evaluated neuropsychological tests to compare cognitive impairment between two types of multiple system atrophy: predominant parkinsonism (MSA-P) and predominant cerebellar ataxia (MSA-C). PATIENTS AND METHODS: This cross-sectional study included 14 patients diagnosed with MSA: four with MSA-C and ten with MSA-P. Presence of motor symptoms was determined by using the Unified Rating MSA Scale (URMSAS). Non-motor symptoms were evaluated by the Short Form Health Survey (SF-36), Scales for Outcomes in Parkinson's disease Autonomic (SCOPA-AUT), Hospital Anxiety and Depression Scale (HADS), and Beck Depression Inventory (BDI)...
January 2018: Clinical Neurology and Neurosurgery
Thomas F Tropea, Sharon X Xie, Jacqueline Rick, Lana M Chahine, Nabila Dahodwala, Jimit Doshi, Christos Davatzikos, Leslie M Shaw, Vivianna Van Deerlin, John Q Trojanowski, Daniel Weintraub, Alice S Chen-Plotkin
BACKGROUND: People with PD are at high risk of developing cognitive impairment and dementia. Cross-sectional studies have identified candidate biomarkers associated with cognitive decline. However, longitudinal studies on this topic are rarer, and few have investigated the use of biomarker panels encompassing multiple modalities. The objective of this study was to find baseline predictors of cognitive decline in longitudinally followed, nondemented Parkinson's disease patients. METHODS: We performed a prospective cohort study of 100 PD patients with a median disease duration of 6...
February 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Matej Skorvanek, Jennifer G Goldman, Marjan Jahanshahi, Connie Marras, Irena Rektorova, Ben Schmand, Erik van Duijn, Christopher G Goetz, Daniel Weintraub, Glenn T Stebbins, Pablo Martinez-Martin
BACKGROUND: Cognitive impairment is a common nonmotor manifestation of Parkinson's disease, with deficits ranging from mild cognitive difficulties in 1 or more of the cognitive domains to severe dementia. The International Parkinson and Movement Disorder Society commissioned the assessment of the clinimetric properties of cognitive rating scales measuring global cognitive performance in PD to make recommendations regarding their use. METHODS: A systematic literature search was conducted to identify the scales used to assess global cognitive performance in PD, and the identified scales were reviewed and rated as "recommended," "recommended with caveats," "suggested," or "listed" by the panel using previously established criteria...
November 23, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
Helena M Blumen, Joe Verghese
Over a third of community-residing elderly have clinical gait abnormalities, and gait impairment is associated with morbidity, mortality and dementia. Motor imagery - envisioning motor actions without actual execution - has been used to improve gait in Parkinson's disease and poststroke, but the efficacy of motor imagery in healthy elderly is unknown. This single-blind pilot randomized-controlled trial aims to establish feasibility and explore the efficacy of a 3-month, telephone-based motor imagery intervention - that involves imagined walking, imagined talking and imagined walking while talking for improving gait in 48 healthy elderly...
December 2017: Neurodegenerative Disease Management
Peter B Nunn
The isolation of α-amino-β-methylaminopropionic acid from seeds of Cycas circinalis (now C. micronesica Hill) resulted from a purposeful attempt to establish the cause of the profound neurological disease, amyotrophic lateral sclerosis/parkinsonism/dementia, that existed in high frequency amongst the inhabitants of the western Pacific island of Guam (Guam ALS/PD). In the 50 years since its discovery the amino acid has been a stimulus, and sometimes a subject of mockery, for generations of scientists in a remarkably diverse range of subject areas...
December 2017: Phytochemistry
Erik K St Louis, Bradley F Boeve
Rapid eye movement sleep behavior disorder (RBD) is diagnosed by a clinical history of dream enactment accompanied by polysomnographic rapid eye movement sleep atonia loss (rapid eye movement sleep without atonia). Rapid eye movement sleep behavior disorder is strongly associated with neurodegenerative disease, especially synucleinopathies such as Parkinson disease, dementia with Lewy bodies, and multiple system atrophy. A history of RBD may begin several years to decades before onset of any clear daytime symptoms of motor, cognitive, or autonomic impairments, suggesting that RBD is the presenting manifestation of a neurodegenerative process...
November 2017: Mayo Clinic Proceedings
Kirstie L McDermott, Nancy Fisher, Sandra Bradford, Richard Camicioli
BACKGROUND: We apply recently recommended Parkinson's disease mild cognitive impairment (PD-MCI) classification criteria from the movement disorders society (MDS) to PD patients and controls and compare diagnoses to that of short global cognitive scales at baseline and over time. We also examine baseline prevalence of neuropsychiatric symptoms across different definitions of MCI. METHODS: 51 PD patients and 50 controls were classified as cognitively normal, MCI, or demented using MDS criteria (1...
November 2, 2017: International Psychogeriatrics
Kirsten Cumming, Angus D Macleod, Phyo K Myint, Carl E Counsell
OBJECTIVE: To compare weight change over time in patients with Parkinson disease (PD), those with atypical parkinsonism, and matched controls; to identify baseline factors that influence weight loss in parkinsonism; and to examine whether it predicts poor outcome. METHODS: We analyzed data from the Parkinsonism Incidence in North-East Scotland (PINE) study, an incident, population-based prospective cohort of parkinsonian patients and age- and sex-matched controls with annual follow-up...
November 28, 2017: Neurology
Gioia Mura, Mauro G Carta, Federica Sancassiani, Sergio Machado, Luca Prosperini
INTRODUCTION: Exergames represent a way to perform physical activity through active video games, serving as potentially useful tool in the field of neurorehabilitation. However, little is known regarding the possible role of exergames in improving cognitive functions in persons suffering from neurological disabilities. EVIDENCE ACQUISITION: A search for relevant articles was carried out on PubMed/Medline, Scopus, PEDro, and Google Scholar. Only randomized controlled studies and non-randomized but controlled studies were retained...
October 25, 2017: European Journal of Physical and Rehabilitation Medicine
David Bäckström, Magdalena Eriksson Domellöf, Gabriel Granåsen, Jan Linder, Sofia Mayans, Eva Elgh, Susanna Jakobson Mo, Lars Forsgren
Dementia is a devastating manifestation of Parkinson's disease (PD). This study investigates whether a common polymorphism in the PITX3 gene (rs2281983), which is of importance for the function of dopaminergic neurons, affects the risk of developing dementia in PD and whether it affects dopamine transporter (DAT) uptake. We PITX3 genotyped 133 patients with new-onset, idiopathic PD, participating in a population-based study in Sweden. Patients were followed prospectively during 6-11years with extensive investigations, including neuropsychology and DAT-imaging with (123)I FP-CIT...
October 15, 2017: Journal of the Neurological Sciences
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
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