Journal of Parkinson's Disease - Volume 11, issue 2

Authors: Braczynski, Anne K. | Ganse, Bergita | Ridwan, Stephanie | Schlenstedt, Christian | Schulz, Jörg B. | Hoog Antink, Christoph

Article Type: Research Article

Abstract: Background: Parkinson’s disease (PD) is the most frequent movement disorder. Patients access YouTube, one of the largest video databases in the world, to retrieve health-related information increasingly often. Objective: We aimed to identify high-quality publishers, so-called “channels” that can be recommended to patients. We hypothesized that the number of views and the number of uploaded videos were indicators for the quality of the information given by a video on PD. Methods: YouTube was searched for 8 combinations of search terms that included “Parkinson” in German. For each term, the first 100 search results were analyzed for …source, date of upload, number of views, numbers of likes and dislikes, and comments. The view ratio (views / day) and the likes ratio (likes * 100 / [likes + dislikes]) were determined to calculate the video popularity index (VPI). The global quality score (GQS) and title - content consistency index (TCCI) were assessed in a subset of videos. Results: Of 800 search results, 251 videos met the inclusion criteria. The number of views or the publisher category were not indicative of higher quality video content. The number of videos uploaded by a channel was the best indicator for the quality of video content. Conclusion: The quality of YouTube videos relevant for PD patients is increased in channels with a high number of videos on the topic. We identified three German channels that can be recommended to PD patients who prefer video over written content. Show more

Keywords: Chronic disease, health information, information retrieval, movement disorder, neurology, social media, video database

DOI: 10.3233/JPD-202513

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 833-842, 2021

Authors: Rodríguez, Miguel Ángel | Crespo, Irene | del Valle, Miguel | Olmedillas, Hugo

Article Type: Article Commentary

DOI: 10.3233/JPD-212541

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 843-845, 2021

Authors: Camarda, Cecilia | Torelli, Paola | Pipia, Carmela | Battaglini, Iacopo | Sottile, Gianluca | Cilluffo, Giovanna | Camarda, Rosolino

Article Type: Research Article

Abstract: Background: Rigidity is a key clinical feature of Parkinson’s disease (PD), but in a very early phase of the disease it may be absent and can be enhanced through active movements of the arm contralateral to the one being tested. Objective: To evaluate in a large cohort of neurologically and cognitively healthy (NCH) subjects aged 18–90 years if activation-induced rigidity (AR) is present in all age classes, and if there are biological differences between subjects showing AR (AR+) and not showing AR (AR-). Methods: 2,228 NCH subjects categorized as young adult (18–44 years), adult (45–64 years), …elderly (65–74 years), and old/oldest-old (75–90 years) were included in the analysis, and underwent brain MRI. White matter hyperintensities were assessed through two visual rating scales. Lacunes were also rated. Atrophy of the caudate nuclei and ventricular enlargement were assessed through the bicaudate ratio and the lateral ventricles to brain ratio. To elicit AR, the Froment’s maneuver (FM) and the instructions of the UPDRS-ME were used. Results: Among the sample, 1,689 (75.81%) subjects showed AR, of which 1,270 (57.00%) subjects showed AR by using FM, and 419 (18.81%) showed AR by using UPDRS-ME instructions. The latter subjects also showed AR by using FM. The number of AR+ subjects significantly increased with increasing age, regardless of the activation maneuver used. In each age class, the number of AR+ subjects was significantly higher by using the FM than the UPDRS-ME instructions. Conclusion: Our findings suggest that AR is likely to be one of the signs of the prodromal phase of PD. Show more

Keywords: Activation-induced rigidity, healthy aging subjects, white matter hyperintensities, lacunes, caudate atrophy, global cerebral atrophy

DOI: 10.3233/JPD-202488

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 847-856, 2021

Authors: Gupta, Ankita | LaFaver, Kathrin | Duque, Kevin R. | Lingaiah, Anushree | Meriwether, Kate V. | Gaskins, Jeremy | Gomes, Josephine | Espay, Alberto J. | Mahajan, Abhimanyu

Article Type: Research Article

Abstract: Background: Urinary dysfunction and constipation, manifestations of pelvic floor dysfunction are common sources of disability and impaired quality of life in women with Parkinson’s disease (PD). Objective: We sought to evaluate the pelvic floor health amongst women with PD and their reporting of bladder and bowel symptoms. Methods: We surveyed women with PD and age-matched controls about pelvic floor health using validated questionnaires. All participants completed the Pelvic Floor Disability Index (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS) short form version 2.0 Cognitive Function 8a. Additionally, PD patients …underwent the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) scale and the Montreal Cognition Assessment (MoCA). Results: Women with PD (n  = 59; age, 70.4±8.6 years, PROMIS cognitive score, 52.0±7.8) self-reported urinary symptoms to a greater extent than controls (n  = 59; age, 70.2±8.7 years, PROMIS cognitive score, 51.0±10) (68% vs 43%, p  < 0.01). The difference was mirrored by higher (worse) scores on both PFDI-20 (35.4 vs 15.6; p  = 0.01) and PFIQ-7 (4.8 vs 0; p  < 0.01) for PD women compared to controls. Only 63% of all participants with self-reported pelvic floor symptoms had previously reported these symptoms to a health care provider. There was no difference in utilization of specialty care between the two groups (30% vs 46%, p  = 0.2). Conclusion: Pelvic floor dysfunction, more common amongst women with PD, is underreported and undertreated. Our study identifies a key gap in care of women with PD. Show more

Keywords: Parkinson’s disease, pelvic floor disease, urinary incontinence, urinary dysfunction, prolapse, health care utilization, women’s health

DOI: 10.3233/JPD-202491

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 857-864, 2021

Authors: Tsitsi, Panagiota | Benfatto, Mattias Nilsson | Seimyr, Gustaf Öqvist | Larsson, Olof | Svenningsson, Per | Markaki, Ioanna

Article Type: Research Article

Abstract: Background: Visual and oculomotor problems are very common in Parkinson’s disease (PD) and by using eye-tracking such problems could be characterized in more detail. However, eye-tracking is not part of the routine clinical investigation of parkinsonism. Objective: To evaluate gaze stability and pupil size in stable light conditions, as well as eye movements during sustained fixation in a population of PD patients and healthy controls (HC). Methods: In total, 50 PD patients (66% males) with unilateral to mild-to-moderate disease (Hoehn & Yahr 1–3, Schwab and England 70–90%) and 43 HC (37% males) were included in the …study. Eye movements were recorded with Tobii Pro Spectrum, a screen-based eye tracker with a sampling rate of 1200 Hz. Logistic regression analysis was applied to investigate the strength of association of eye-movement measures with diagnosis. Results: Median pupil size (OR 0.811; 95% CI 0.666–0.987; p  = 0.037) and longest fixation period (OR 0.798; 95% CI 0.691-0.921; p  = 0.002), were the eye-movement parameters that were independently associated with diagnosis, after adjustment for sex (OR 4.35; 95% CI 1.516–12.483; p  = 0.006) and visuospatial/executive score in Montreal Cognitive Assessment (OR 0.422; 95% CI 0.233–0.764; p  = 0.004). The area under the ROC curve was determined to 0.817; 95% (CI) 0.732–0.901. Conclusion: Eye-tracking based measurements of gaze fixation and pupil reaction may be useful biomarkers of PD diagnosis. However, larger studies of eye-tracking parameters integrated into the screening of patients with suspected PD are necessary, to further investigate and confirm their diagnostic value. Show more

Keywords: Parkinson’s disease, eye-tracking, fixation, pupil size, eye movements

DOI: 10.3233/JPD-202427

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 865-875, 2021

Authors: Jones, Jolynn | Nielson, Spencer A. | Trout, Jonathan | Swenson, Mckaella | Reiley, Joseph | Tanner, Jared | Bowers, Dawn | Kay, Daniel B.

Article Type: Research Article

Abstract: Background: Parkinson’s disease (PD) is associated with sleep disturbance (SD) and sleep-related impairment (SRI). Validation of self-report measures of these problems is needed in PD. The Patient-Reported Outcomes Measurement Information System (PROMIS) includes tools that assess these problems (PROMIS-SD and PROMIS-SRI, respectively). Objective: This study aimed to further validate these measures in individuals with PD and matched controls. Methods: Individuals with early-stage PD (n =50) and matched controls (n =48) completed measures of SD including the PROMIS-SD, Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI). They also completed measures of daytime impairment including the …PROMIS-SRI, Epworth Sleepiness Scale, State-Trait Anxiety Inventory, Beck Depression Inventory 2nd edition, and Parkinson’s Disease Questionnaire-39. Internal consistency for the PROMIS measures were assessed using Cronbach’s α coefficient and item-total correlations in the total sample. Convergent and divergent validity of the PROMIS item banks were assessed using Spearman correlations. Results: The PROMIS item banks had excellent internal consistency (α >0.94). Supporting convergent validity, the PROMIS-SD had strong correlations with other measures of SD (ρ >0.68, for PSQI and ISI) and the PROMIS-SRI had moderate to strong correlations with all measures of daytime impairment (ρ =0.41–0.72). Supporting divergent validity within the PD group, the PROMIS-SD correlated more strongly with SRI than with the Parkinson’s Disease Questionnaire total score, a metric of PD related impairment. Conclusion: In middle-aged and older adults, with and without early-stage PD, the PROMIS-SD and PROMIS-SRI are reliable and valid measures of SD and SRI, respectively. Show more

Keywords: Parkinson’s disease, sleep, validation study, patient-reported outcome measures

DOI: 10.3233/JPD-202429

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 877-883, 2021

Authors: Isaacson, Jonathan R. | Brillman, Salima | Chhabria, Nisha | Isaacson, Stuart H.

Article Type: Other

Abstract: Background: The diagnosis of Parkinson’s disease (PD) is primarily clinical, but in cases of diagnostic uncertainty, evaluation of nigrostriatal dopaminergic degeneration (NSDD) by imaging of the dopamine transporter using DaTscan with single-photon emission computed tomography (SPECT) brain imaging may be helpful. Objective/Methods: In the current paper, we describe clinical scenarios for which DaTscan imaging was used in a prospective case series of 201 consecutive patients in whom a movement disorder specialist ordered DaTscan imaging to clarify NSDD. We describe the impact of DaTscan results on changing or confirming pre-DaTscan clinical diagnosis and on post-DaTscan treatment changes. …Results/Conclusion: DaTscan imaging can be useful in several clinical scenarios to determine if NSDD is present. These include in patients with early subtle symptoms, suboptimal response to levodopa, prominent action tremor, drug-induced parkinsonism, and in patients with lower extremity or other less common parkinsonism clinical presentations. We also found DaTscan imaging to be useful to determine underlying NSDD in patients with PD diagnosis for 3-5 years but without apparent clinical progression or development of motor fluctuations. Overall, in 201 consecutive patients with clinically questionable NSDD, DaTscan was abnormal in 58.7% of patients, normal in 37.8%, and inconclusive in 3.5%. DaTscan imaging changed clinical diagnosis in 39.8% of patients and led to medication therapy changes in 70.1% of patients. Show more

DOI: 10.3233/JPD-202506

Citation: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 885-889, 2021