Journal of Parkinson's Disease - Volume 12, issue 1

Authors: Okunoye, Olaitan | Horsfall, Laura | Marston, Louise | Walters, Kate | Schrag, Anette

Article Type: Research Article

Abstract: Background: Hospitalization in Parkinson’s disease (PD) is associated with reduced quality of life, caregiver burden and high costs. However, no large-scale studies of rate and causes of hospitalizations in patients with PD have been published. Objective: To investigate the rate and reasons for hospitalization and factors associated with hospitalization among people with PD compared to the general population. Methods: We examined rate and causes of admission in PD patients and matched controls in The Health Improvement Network from 2006 to 2016. Multivariable Poisson regression was used to explore the effects of age, gender, social deprivation, urbanicity …and practice geographic location on hospitalization. Results: In the longitudinal data from 9,998 newly diagnosed individuals with PD and 55,554 controls without PD aged ≥50 years, 39% of PD patients and 28% of controls were hospitalised over a median follow-up of 5.1 years. The adjusted incidence rate ratio (IRR) of hospitalization in PD compared to controls was 1.33 (95% CI:1.29–1.37) and rose with increased follow-up duration. Hospitalization rate was overall higher in the older age groups, but the adjusted IRR of hospitalization compared to controls was highest in the youngest age group. PD patients were more often admitted with falls/fractures, infections, gastrointestinal complications, PD, dementia, psychosis/hallucinations, postural hypotension, electrolyte disturbances, stroke and surgical procedures and slightly less often due to hypertension. Conclusion: People with PD have an increased hospitalization rate compared to controls, particularly in the younger age groups, and it increases with longer disease duration. The complications of motor and non-motor features of PD are amongst the main reasons for admission, some of which could be managed preventatively to avoid admissions. Show more

Keywords: Parkinson’s disease, hospitalization, incidence, reasons, primary care

DOI: 10.3233/JPD-212874

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 411-420, 2022

Authors: Picillo, Marina | LaFontant, David-Erick | Bressman, Susan | Caspell-Garcia, Chelsea | Coffey, Christopher | Cho, Hyunkeun Ryan | Burghardt, Elliot L. | Dahodwala, Nabila | Saunders-Pullman, Rachel | Tanner, Caroline M. | Amara, Amy W. | for the Parkinson’s Progression Markers Initiative

Article Type: Research Article

Abstract: Background: Investigation of sex-related motor and non-motor differences and biological markers in Parkinson’s disease (PD) may improve precision medicine approach. Objective: To examine sex-related longitudinal changes in motor and non-motor features and biologic biomarkers in early PD. Methods: We compared 5-year longitudinal changes in de novo, untreated PD men and women (at baseline N  = 423; 65.5%male) of the Parkinson’s Progression Markers Initiative (PPMI), assessing motor and non-motor manifestations of disease; and biologic measures in cerebrospinal fluid (CSF) and dopamine transporter deficit on DaTscanTM uptake. Results: Men experienced greater longitudinal decline in self-reported motor …(p  < 0.001) and non-motor (p  = 0.009) aspects of experiences of daily living, such that men had a yearly increase in MDS-UPDRS part II by a multiplicative factor of 1.27 compared to women at 0.7, while men had a yearly increase in MDS-UPDRS part I by a multiplicative factor of 0.98, compared to women at 0.67. Compared to women, men had more longitudinal progression in clinician-assessed motor features in the ON medication state (p  = 0.010) and required higher dopaminergic medication dosages over time (p  = 0.014). Time to reach specific disease milestones and longitudinal changes in CSF biomarkers and DaTscanTM uptake were not different by sex. Conclusion: Men showed higher self-assessed motor and non-motor burden of disease, with possible contributions from suboptimal dopaminergic therapeutic response in men. However, motor features of disease evaluated with clinician-based scales in the OFF medication state, as well as biological biomarkers do not show specific sex-related progression patterns. Show more

Keywords: DaTScan, motor, non-motor, Parkinson’s disease, sex

DOI: 10.3233/JPD-212892

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 421-436, 2022

Authors: Bartl, Michael | Dakna, Mohammed | Schade, Sebastian | Wicke, Tamara | Lang, Elisabeth | Ebentheuer, Jens | Weber, Sandrina | Trenkwalder, Claudia | Mollenhauer, Brit

Article Type: Research Article

Abstract: Background: The MDS-Unified Parkinson’s disease (PD) Rating Scale (MDS-UPDRS) is the most used scale in clinical trials. Little is known about the predictive potential of its single items. Objective: To systematically dissect MDS-UPDRS to predict PD progression. Methods: 574 de novo PD patients and 305 healthy controls were investigated at baseline (BL) in the single-center DeNoPa (6-year follow-up) and multi-center PPMI (8-year follow-up) cohorts. We calculated cumulative link mixed models of single MDS-UPDRS items for odds ratios (OR) for class change within the scale. Models were adjusted for age, sex, time, and levodopa equivalent daily dose. …Annual change and progression of the square roots of the MDS-UDPRS subscores and Total Score were estimated by linear mixed modeling. Results: Baseline demographics revealed more common tremor dominant subtype in DeNoPa and postural instability and gait disorders-subtype and multiethnicity in PPMI. Subscore progression estimates were higher in PPMI but showed similar slopes and progression in both cohorts. Increased ORs for faster progression were found from BL subscores I and II (activities of daily living; ADL) most marked for subscore III (rigidity of neck/lower extremities, agility of the legs, gait, hands, and global spontaneity of movements). Tremor items showed low ORs/negative values. Conclusion: Higher scores at baseline for ADL, freezing, and rigidity were predictors of faster deterioration in both cohorts. Precision and predictability of the MDS-UPDRS were higher in the single-center setting, indicating the need for rigorous training and/or video documentation to improve its use in multi-center cohorts, for example, clinical trials. Show more

Keywords: MDS-UPDRS, Parkinson’s disease, progression, predictors, DeNoPa, PPMI

DOI: 10.3233/JPD-212860

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 437-452, 2022

Authors: Sauerbier, Anna | Bachon, Pia | Ambrosio, Leire | Loehrer, Philipp A. | Rizos, Alexandra | Jost, Stefanie T. | Gronostay, Alexandra | Konitsioti, Agni | Barbe, Michael T. | Fink, Gereon R. | Ashkan, Keyoumars | Nimsky, Christopher | Visser-Vandewalle, Veerle | Chaudhuri, K. Ray | Timmermann, Lars | Martinez-Martin, Pablo | Dafsari, Haidar S. | on behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group

Article Type: Research Article

Abstract: Background: The satisfaction with life and, in particular, with treatment in Parkinson’s disease (PD) is understudied. Objective: To explore a new 7-item rating tool assessing satisfaction with life and treatment (SLTS-7) in PD. Methods: In this cross-sectional, multi-center study, including patients screened for advanced therapies, psychometric characteristics of the SLTS-7 were analyzed. An exploratory factor analysis identified the underlying factorial structure of the SLTS-7. Results: 117 patients were included, and the data quality of the SLTS-7 was excellent (computable data 100%), and acceptability measures satisfied standard criteria. Besides the global assessment (item 1), the …exploratory factor analysis produced item 2 (physical satisfaction) as an independent item and two factors among the remaining items: items 3–5 (psycho-social satisfaction), and items 6 and 7 (treatment satisfaction). Cronbach’s alpha was 0.89, indicative of high internal consistency. The SLTS-7 total score correlated moderately with motor symptoms and weakly with non-motor symptoms total scores. SLTS-7 showed the highest correlations with the European Quality of Life with 5 items (EQ-5D) visual analog scale (0.43–0.58, p  < 0.01), indicating a moderate convergent validity. The SLTS-7 significantly increased with higher non-motor symptoms burden levels (p  = 0.002). Conclusion: Life satisfaction in PD covers three specific aspects, namely physical, psycho-social, and treatment satisfaction. The new SLTS-7 is a valid, reliable, and easy-to-use tool to assess satisfaction with life and treatment in patients with PD screened for advanced therapies. Longitudinal studies analyzing the effect of advanced PD treatment on life and treatment satisfaction are warranted. Show more

Keywords: Non-motor symptoms, patient-reported outcomes, quality of life, satisfaction with life, satisfaction with treatment

DOI: 10.3233/JPD-212823

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 453-464, 2022

Authors: Brock, Peter | Oates, Lloyd L. | Gray, William K. | Henderson, Emily J. | Mann, Helen | Haunton, Victoria J. | Skelly, Rob | Hand, Annette | Davies, Matthew L | Walker, Richard W.

Article Type: Research Article

Abstract: Background: Parkinson’s disease (PD) is a multi-system disorder that can impact on driving ability. Little is known about how these changes in driving ability affect people with PD, making it difficult for clinicians and carers to offer appropriate support. Objective: To assess patient views concerning the effect of PD on their driving ability, the impact of these changes and how they manage them. Method: An online survey was created by a team of clinicians, people with PD, their carers, and representatives from Parkinson’s UK. People with PD throughout the United Kingdom were invited to participate through …Parkinson’s UK’s website, newsletter and Parkinson’s Excellence Network email list. Results: 805 people with PD took part in the survey. We found that the loss of a driving licence had an adverse impact on employment, socialisation, travel costs and spontaneous lifestyle choices. Multiple changes in driving ability related to PD were described, including that impulse control disorders can have an adverse impact on driving. Changes in driving ability caused people to change their driving practices including taking shorter journeys and being less likely to drive at night. Participants advised managing changes in driving ability through planning, vehicle adaptions, maintaining skills and self-assessment. Conclusion: This study demonstrates the impact that changes in driving ability can have on the lifestyle of people with PD and reveals the strategies that individuals adopt to manage these changes. Show more

Keywords: Parkinson’s disease, automobile driving, impulsive behavior, quality of life, survey

DOI: 10.3233/JPD-212686

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 465-471, 2022

Authors: Abbruzzese, Giovanni | Kulisevsky, Jaime | Bergmans, Bruno | Gomez-Esteban, Juan C. | Kägi, Georg | Raw, Jason | Stefani, Alessandro | Warnecke, Tobias | Jost, Wolfgang H. | the SYNAPSES Study Investigators Group

Article Type: Correction

DOI: 10.3233/JPD-219007

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 473-473, 2022

Article Type: Correction

DOI: 10.3233/JPD-219009

Citation: Journal of Parkinson's Disease, vol. 12, no. 1, pp. 475-475, 2022