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Parkinson's dementia outcome

Tamara Shiner, Anat Mirelman, Mali Gana Weisz, Anat Bar-Shira, Elissa Ash, Ron Cialic, Naomi Nevler, Tanya Gurevich, Noa Bregman, Avi Orr-Urtreger, Nir Giladi
Importance: Mutations in the glucocerebrosidase (GBA) gene are a risk factor for the development of dementia with Lewy bodies (DLB). These mutations are common among Ashkenazi Jews (AJ) and appear to have an effect on the natural history of the disease. Objectives: To evaluate the clinical and genetic characteristics of an AJ cohort of patients diagnosed with DLB, assess the association of phenotype of DLB with GBA mutations, and explore the effects of these mutations on the clinical course of the disease...
October 10, 2016: JAMA Neurology
George A Heckman, Alexander M Crizzle, Jonathen Chen, Tamara Pringsheim, Nathalie Jette, Marie-Jeanne Kergoat, Leslie Eckel, John P Hirdes
BACKGROUND: Patients with Parkinson's disease (PD) and/or Parkinsonism are affected by a complex burden of comorbidity. Many ultimately require institutional care, where they may be subject to the application of physical restraints or the prescription of antipsychotic medications, making them more vulnerable to adverse outcomes. OBJECTIVES: The objectives of this paper are to: 1) describe the clinical complexity of older institutionalized persons with PD; and 2) examine patterns and predictors of restraint use and prescription of antipsychotics in this population...
September 29, 2016: Journal of Parkinson's Disease
Judith A Boel, Vincent J J Odekerken, Ben A Schmand, Gert J Geurtsen, Danielle C Cath, Martijn Figee, Pepijn van den Munckhof, Rob J de Haan, P Richard Schuurman, Rob M A de Bie
BACKGROUND: Effects on non-motor symptoms, mainly cognitive and psychiatric side effects, could influence the decision for either globus pallidus pars interna (GPi) or subthalamic nucleus (STN) deep brain stimulation (DBS) for patients with Parkinson's disease (PD). OBJECTIVE: 1) To compare cognitive and psychiatric outcomes 3 years after GPi DBS versus STN DBS, and 2) to report on occurrence of suicidal ideation, psychiatric diagnoses, social functioning, and marital satisfaction 3 years after DBS...
September 19, 2016: Parkinsonism & related Disorders
Sean J Udow, Andrew D Robertson, Bradley J MacIntosh, Alberto J Espay, James B Rowe, Anthony E Lang, Mario Masellis
Parkinson's disease, dementia with Lewy bodies and multiple system atrophy are characterised by abnormal neuroglial α-synuclein accumulation. These α-synucleinopathies have in common parkinsonism and non-motor features including orthostatic hypotension (OH) and cognitive impairment. However, the nature of the relationship between OH and cognitive impairment is unclear. We therefore systematically reviewed the literature for evidence of an association between OH and cognitive impairment in α-synucleinopathies and discuss possible mechanisms and implications of this relationship...
September 9, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
Marie Y Davis, Catherine O Johnson, James B Leverenz, Daniel Weintraub, John Q Trojanowski, Alice Chen-Plotkin, Vivianna M Van Deerlin, Joseph F Quinn, Kathryn A Chung, Amie L Peterson-Hiller, Liana S Rosenthal, Ted M Dawson, Marilyn S Albert, Jennifer G Goldman, Glenn T Stebbins, Bryan Bernard, Zbigniew K Wszolek, Owen A Ross, Dennis W Dickson, David Eidelberg, Paul J Mattis, Martin Niethammer, Dora Yearout, Shu-Ching Hu, Brenna A Cholerton, Megan Smith, Ignacio F Mata, Thomas J Montine, Karen L Edwards, Cyrus P Zabetian
Importance: Parkinson disease (PD) is heterogeneous in symptom manifestation and rate of progression. Identifying factors that influence disease progression could provide mechanistic insight, improve prognostic accuracy, and elucidate novel therapeutic targets. Objective: To determine whether GBA mutations and the E326K polymorphism modify PD symptom progression. Design, Setting, and Participants: The entire GBA coding region was screened for mutations and E326K in 740 patients with PD enrolled at 7 sites from the PD Cognitive Genetics Consortium...
October 1, 2016: JAMA Neurology
Gustavo Christofoletti, Marie E McNeely, Meghan C Campbell, Ryan P Duncan, Gammon M Earhart
Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n=114) were tested in one session 'off' medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking...
October 2016: Human Movement Science
Yu-Hsuan Wu, Wei-Ju Lee, Yi-Huei Chen, Ming-Hong Chang, Ching-Heng Lin
BACKGROUND: To evaluate the association between the premotor symptoms and the prognosis of PD. METHODS: A total of 1213 patients who were diagnosed of PD from January 2001 to December 2008 were selected from the Taiwan's National Health Insurance Research Database. Patients were traced back to determine the presence of premotor symptoms, including rapid eye movement sleep behavior disorder (RBD), depression, and constipation. Cox's regression analysis was used to detect the risks between the occurrence of premotor symptoms and the outcome (including death, psychosis, accidental injury, dementia and aspiration pneumonia)...
2016: PloS One
Elizabeth Casiano Evans, Kristen A Matteson, Francisco J Orejuela, Marianna Alperin, Ethan M Balk, Sherif El-Nashar, Jonathan L Gleason, Cara Grimes, Peter Jeppson, Cara Mathews, Thomas L Wheeler, Miles Murphy
OBJECTIVE: To compare the long-term risks associated with salpingo-oophorectomy with ovarian conservation at the time of benign hysterectomy. DATA SOURCES: MEDLINE,, and the Cochrane Central Register of Controlled Trials were searched from inception to January 30, 2015. We included prospective and retrospective comparative studies of women with benign hysterectomy who had either bilateral salpingo-oophorectomy (BSO) or conservation of one or both ovaries...
September 2016: Obstetrics and Gynecology
Jennifer L Whitwell
BACKGROUND: It is essential that randomized clinical trials (RCTs) incorporate biomarkers of disease progression that would be sensitive to the effects of disease-modifying treatments. Magnetic resonance imaging (MRI) can be safely repeated over time, and is routinely performed in clinical centers, making it an ideal modality to be incorporated into RCTs. SUMMARY: This chapter discusses potential structural MRI biomarkers that have been proposed for a number of different neurodegenerative disorders, including Alzheimer's disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), progressive supranuclear palsy syndrome (PSPS), and Parkinson's disease (PD)...
2016: Frontiers of Neurology and Neuroscience
David Ireland, Christina Atay, Jacki Liddle, Dana Bradford, Helen Lee, Olivia Rushin, Thomas Mullins, Dan Angus, Janet Wiles, Simon McBride, Adam Vogel
People with neurological conditions such as Parkinson's disease and dementia are known to have difficulties in language and communication. This paper presents initial testing of an artificial conversational agent, called Harlie. Harlie runs on a smartphone and is able to converse with the user on a variety of topics. A description of the application and a sample dialog are provided to illustrate the various roles chat-bots can play in the management of neurological conditions. Harlie can be used for measuring voice and communication outcomes during the daily life of the user, and for gaining information about challenges encountered...
2016: Studies in Health Technology and Informatics
Richard K Wyse, Patrik Brundin, Todd B Sherer
We discuss a report in the current issue on clinical and biochemical findings from a safety trial using the cAbl tyrosine kinase inhibitor Nilotinib (150 mg or 300 mg given daily for 24 weeks) in a small group of patients with either advanced Parkinson's disease or Dementia with Lewy Bodies. Despite some side effects (one serious), the authors claim that Nilotinib, which is normally used at much higher doses for treating leukemia, is safe and tolerated. Furthermore, they report a possible benefit on motor and cognitive outcomes...
July 12, 2016: Journal of Parkinson's Disease
Fernando Pagan, Michaeline Hebron, Ellen H Valadez, Yasar Torres-Yaghi, Xu Huang, Reversa R Mills, Barbara M Wilmarth, Hellen Howard, Connell Dunn, Alexis Carlson, Abigail Lawler, Sean L Rogers, Ramsey A Falconer, Jaeil Ahn, Zhaoxia Li, Charbel Moussa
BACKGROUND: We evaluated the effects of low doses of the tyrosine kinase Abelson (Abl) inhibitor Nilotinib, on safety and pharmacokinetics in Parkinson's disease dementia or dementia with Lewy bodies. OBJECTIVES: The primary outcomes of this study were safety and tolerability; pharmacokinetics and target engagement were secondary, while clinical outcomes were exploratory. METHODS: Twelve subjects were randomized into 150 mg (n = 5) or 300 mg (n = 7) groups and received Nilotinib orally every day for 24 weeks...
July 11, 2016: Journal of Parkinson's Disease
Symron Bansal, John P Hirdes, Colleen J Maxwell, Alexandra Papaioannou, Lora M Giangregorio
Few studies have focused on falls among home care (HC) clients with neurological conditions. This study identified factors that increase risk of falling among HC clients with no recent history of falls, and explored whether risk profiles varied among those with dementia or parkinsonism compared to those without selected neurological conditions. A retrospective cohort design was used and analysis of data from community-based HC clients across Ontario was conducted on a sample of ambulatory clients with dementia, parkinsonism, or none of the selected neurological conditions...
September 2016: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
Sheung-Tak Cheng, Helene H Fung, Wai Chi Chan, Linda C W Lam
OBJECTIVE: To examine the effects of a benefit-finding intervention, the key feature being the use of gain-focused reappraisal strategies to find positive meanings and benefits in caring for someone with dementia. METHODS: In a cluster-randomized, double-blind, controlled trial conducted in social centers and clinics, 129 caregivers aged 18 + and without cognitive impairment, providing at least 14 care hours per week to a relative with mild-to-moderate Alzheimer disease, and scoring ≥ 3 on the Hamilton Depression Rating Scale were studied...
September 2016: American Journal of Geriatric Psychiatry
Paul K Crane, Laura E Gibbons, Kristen Dams-O'Connor, Emily Trittschuh, James B Leverenz, C Dirk Keene, Joshua Sonnen, Thomas J Montine, David A Bennett, Sue Leurgans, Julie A Schneider, Eric B Larson
IMPORTANCE: The late effects of traumatic brain injury (TBI) are of great interest, but studies characterizing these effects are limited. OBJECTIVE: To determine whether TBI with loss of consciousness (LOC) is associated with an increased risk for clinical and neuropathologic findings of Alzheimer disease (AD), Parkinson disease (PD), and other dementias. DESIGN, SETTING, AND PARTICIPANTS: This study analyzed data from the Religious Orders Study (ROS), Memory and Aging Project (MAP), and Adult Changes in Thought study (ACT)...
September 1, 2016: JAMA Neurology
Esther S Oh, Frederick E Sieber, Jeannie-Marie Leoutsakos, Sharon K Inouye, Hochang B Lee
OBJECTIVES: To describe the differences observed in risk factors for delirium and outcomes between men and women undergoing hip fracture repair surgery. DESIGN: Prospective cohort study. SETTING: Academic medical center. PARTICIPANTS: Individuals with acute hip fracture admitted to an academic medical center (N = 431). MEASUREMENTS: Information on preoperative demographic characteristics, medical history, laboratory results, and postoperative outcomes was obtained according to history and chart review...
August 2016: Journal of the American Geriatrics Society
Gustaf Edgren, Henrik Hjalgrim, Klaus Rostgaard, Paul Lambert, Agneta Wikman, Rut Norda, Kjell-Einar Titlestad, Christian Erikstrup, Henrik Ullum, Mads Melbye, Michael P Busch, Olof Nyrén
BACKGROUND: The aggregation of misfolded proteins in the brain occurs in several neurodegenerative disorders. Aberrant protein aggregation is inducible in rodents and primates by intracerebral inoculation. Possible transfusion transmission of neurodegenerative diseases has important public health implications. OBJECTIVE: To investigate possible transfusion transmission of neurodegenerative disorders. DESIGN: Retrospective cohort study. SETTING: Nationwide registers of transfusions in Sweden and Denmark...
September 6, 2016: Annals of Internal Medicine
Delaram Safarpour, Allison W Willis
The prevalence of neurodegenerative diseases such as Parkinson disease (PD) will increase substantially, due to the aging of the population and improved treatments leading to better disease-related outcomes. Dementia is the most common nonmotor symptom in PD, and most patients with PD will have cognitive dysfunction and cognitive decline in the course of their disease. The development of cognitive dysfunction in PD greatly limits the ability to participate in activities of daily living and can be a tipping point for nursing home placement or major caregiver stress...
June 13, 2016: American Journal of Alzheimer's Disease and Other Dementias
Prasanna R Karunanayaka, Eun-Young Lee, Mechelle M Lewis, Suman Sen, Paul J Eslinger, Qing X Yang, Xuemei Huang
BACKGROUND: Parkinson's disease (PD) traditionally is characterized by tremor, rigidity, and bradykinesia, although cognitive impairment also is a common symptom. The clinical presentation of PD is heterogeneous and associated with different risk factors for developing cognitive impairment. PD patients with primary akinetic/rigidity (PDAR) are more likely to develop cognitive deficits compared to those with tremor-predominant symptoms (PDT). Because cognitive impairment in PD appears to be related to changes in the default mode network (DMN), this study tested the hypothesis that DMN integrity is different between PDAR and PDT subtypes...
August 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Michael Inskip, Yorgi Mavros, Perminder S Sachdev, Maria A Fiatarone Singh
BACKGROUND: Individuals with Lewy body Dementia (LBD), which encompasses both Parkinson disease dementia (PDD) and Dementia with Lewy Bodies (DLB) experience functional decline through Parkinsonism and sedentariness exacerbated by motor, psychiatric and cognitive symptoms. Exercise may improve functional outcomes in Parkinson's disease (PD), and Alzheimer's disease (AD). However, the multi-domain nature of the LBD cluster of symptoms (physical, cognitive, psychiatric, autonomic) results in vulnerable individuals often being excluded from exercise studies evaluating physical function in PD or cognitive function in dementia to avoid confounding results...
2016: PloS One
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