Journal of Parkinson's Disease - Volume 12, issue 4

Authors: Béreau, Matthieu | Castrioto, Anna | Lhommée, Eugénie | Maillet, Audrey | Gérazime, Aurélie | Bichon, Amélie | Pélissier, Pierre | Schmitt, Emmanuelle | Klinger, Hélène | Longato, Nadine | Fraix, Valérie | Benatru, Isabelle | Durif, Franck | Azulay, Jean-Philippe | Moro, Elena | Broussolle, Emmanuel | Tranchant, Christine | Anheim, Mathieu | Thobois, Stéphane | Krack, Paul

Article Type: Research Article

Abstract: Background: Fatigue is a frequent and troublesome symptom present from the early stages of Parkinson’s disease (PD). Objective: To examine the relationship between fatigue and the neuropsychiatric triad, which includes apathy, depression, and anxiety, in de novo PD. Methods: We performed a cross-sectional study including 197 patients with de novo PD and assessed fatigue using the Parkinson’s Disease Fatigue Scale (PDFS-16). We evaluated motor status using the Unified Parkinson’s Disease Rating Scale (UPDRS) part III score and evaluated neuropsychiatric status using the Ardouin Scale of Behavior in Parkinson’s Disease (ASBPD). We carried out univariate …and multivariate analyses to model association between motor signs, non-motor signs, and fatigue risk. Results: Frequency of fatigue (28.9%) was of the same order of magnitude as that of apathy. PD patients with fatigue reported a lower quality of life than patients without fatigue (p  < 0.0001). The ASBPD showed that patients with fatigue had higher scores for depressed mood (p  < 0.0001), anxiety (p  < 0.0001), and apathy (p  < 0.0001). In the univariate analysis, fatigue score was positively correlated with apathy, depression, anxiety, and the neuropsychiatric triad as a whole, and to a lesser extent with female sex, hyperemotivity, and the UPDRS part III score. In the multivariate analysis, after adjusting for sex and motor status, the fatigue score remained significantly correlated with apathy (OR = 11.17 [4.33–28.78], p  < 0.0001) and depression (OR = 4.28 [1.39–13.12], p  = 0.01), but not with anxiety (OR = 0.94 [0.34–2.58], p  = 0.9). Conclusion: We propose that the neuropsychiatric triad could be expanded to include fatigue. Show more

Keywords: Parkinson’s disease, fatigue, apathy, depression, motivation

DOI: 10.3233/JPD-213116

Citation: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1329-1337, 2022

Authors: Bliwise, Donald L. | Karroum, Elias G. | Greer, Sophia A. | Factor, Stewart A. | Trotti, Lynn Marie

Article Type: Research Article

Abstract: Background: The association between restless legs syndrome (RLS) and Parkinson’s disease (PD) remains controversial, with epidemiologic and descriptive evidence suggesting some potential overlap while mechanistic/genetic studies suggesting relative independence of the conditions. Objective: To examine a known, objectively measured endophenotype for RLS, periodic leg movements (PLMS) in sleep, in patients with PD and relate that objective finding to restless legs symptoms. Methods: We performed polysomnography for one (n  = 8) or two (n  = 67) consecutive nights in 75 PD patients and examined the association of PLMS with restless legs symptoms. Results: We found no association …between restless legs symptoms and PLMS in PD. Prevalence of both was similar to data reported previously in other PD samples. Conclusion: We interpret these results as suggesting that restless legs symptoms in PD patients may represent a different phenomenon and pathophysiology than RLS in the non-PD population. Show more

Keywords: Restless legs, periodic leg movements in sleep, Parkinson’s disease

DOI: 10.3233/JPD-213100

Citation: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1339-1344, 2022

Authors: Tosin, Michelle H.S. | Simuni, Tanya | Stebbins, Glenn T. | Cedarbaum, Jesse M.

Article Type: Research Article

Abstract: Background: Summary scores of current clinical rating scales do not appear sensitive enough to quantify changes in disease progression in early Parkinson’s disease (PD) clinical trials. An alternate approach might be to track the appearance of new or emergent symptoms (ES) over time as a measure of disease progression. Objective: Explore the potential utility of patient reported ES as an outcome measure during the early phase of PD. Methods: We analyzed data from the MDS-UPDRS Parts IB (non-motor) and II (motor) Experiences of Daily Living scales over two years in the STEADY-PD3 study. We assessed the …number of ES reported in each part of the scale in both participants who started symptomatic treatment and those who did not (STx-yes/no) in two periods: between 0 and 12-months (Year 1), and 13 and 24-months (Year 2). Results: Of 331 participants, 87% developed ES, and 55% started STx in Year 1. The median number of Part IB ES did not significantly differ between STx groups, but ES in Part II were significantly more frequent in the STx-yes group. Of 148 participants who remained STx-no into Year 2, 77% developed ES, and 42% started STx. Again, Part II, but not Part IB ES were more frequent the STx-yes group. Using these results, a sample size of ∼90 per group would be required to detect a 30% reduction in combined Part IB and II ES over 12 months. Conclusion: Assessing ES of patient-reported experiences of daily living may provide a useful marker for tracking PD progression. Show more

Keywords: Parkinson’s disease, clinimetrics, activities of daily living, patient outcome assessment, severity of illness index

DOI: 10.3233/JPD-223170

Citation: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1345-1351, 2022

Authors: Kal, Elmar C. | Ellmers, Toby J. | Fielding, Anna E. | Hardeman, Lotte | Coito, Juliana | Joyce, Lauren | Young, William R.

Article Type: Short Communication

Abstract: Freezing of gait (FOG) can severely compromise daily functioning in people with Parkinson’s disease. Inability to initiate a step from FOG is likely underpinned, at least in part, by a deficient preparatory weight-shift. Conscious attempts to weight-shift in preparation to step can improve success of initiating forward steps following FOG. However, FOG often occurs during turning, where weight-shifting is more complex and risk of falling is higher. We explored the effectiveness of a dance-based (‘cha-cha’) weight-shifting strategy to re-initiate stepping following FOG during turning. Results suggest that this simple movement strategy can enhance turning steps following FOG, without compromising safety.

Keywords: Parkinson’s disease, freezing of gait, cueing, step initiation, anticipatory postural adjustment, weight-shifting, festination

DOI: 10.3233/JPD-213125

Citation: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1353-1358, 2022

Authors: Meinders, Marjan J. | Donnelly, Anne C. | Sheehan, Margaret | Bloem, Bastiaan R.

Article Type: Short Communication

Abstract: The proactive inclusion of patients in the design and execution of clinical studies has been an emerging focus for decades. Such participatory research helps to design studies better, by addressing relevant research questions and defining outcomes that matter to patients. Yet, much remains to be learned about the best methods and exact impacts of patient engagement in research in general, and more specifically, about the specific challenges that come with Parkinson’s disease. Here we present the lived experiences of patient researchers living with Parkinson’s disease, as a motivation for the value of their perspectives in research and as a call …to action for empirical research on how to successfully include patient researchers. Show more

Keywords: Patient participation, patient advocacy, patient preference, Parkinson’s disease

DOI: 10.3233/JPD-223190

Citation: Journal of Parkinson's Disease, vol. 12, no. 4, pp. 1359-1363, 2022