Background:Exercise therapy is recognized as a crucial method that can markedly improve outcomes for individuals with Parkinson's Disease. Research on exercise therapy and Parkinson's Disease is steadily increasing; however, a bibliometric analysis in this field is currently lacking. This study applies bibliometric methods to identify trends and hotspots in research related to Parkinson's Disease and exercise therapy. Methods:Data collection comprised articles relevant to Parkinson's Disease and exercise therapy, which were sourced from the Web of Science core collection for the period between January 1, 2004, and December 31, 2024. The collected literature was subsequently analyzed using a suite of bibliometric tools, including Excel, VOSviewer, and CiteSpace. Additionally, text mining was carried out via Coremine to identify significant correlations among key terms within this research domain. Results:The volume of articles on Parkinson's Disease and exercise therapy has increased yearly, with a notable surge after 2019. The top three countries contributing to this volume are the United States, Italy, and China. The leading institutions in publication output are Radboud University Nijmegen, the University of Sydney, and Northwestern University. The 10 most frequent keywords include Parkinson's Disease, exercise, rehabilitation, people, gait, balance, quality of life, physical therapy, therapy, and motor. Keywords such as telemedicine, telehealth, neurodegeneration, telerehabilitation, and wearable sensors represent current hotspots in this area of research. Conclusion:This study utilizes bibliometric techniques to perform an objective, quantitative assessment of the literature pertaining to Parkinson's Disease and exercise therapy. It outlines the current research landscape, pinpoints emerging hotspots, and addresses prevailing challenges, thereby offering valuable insights to guide and improve the focus and efficacy of subsequent studies.
Aerobic exercise programs with proprioceptive sensory feedback elements such as split-belt treadmill training, perturbation treadmill training, and dynamic cycling improve function in people with Parkinson's disease (PwPD). However, these tools are expensive and not highly accessible. Speed-variable (SV) treadmill training utilizes small-amplitude treadmill belt speed fluctuations every 10-60 s, emulating aforementioned paradigms in a more-accessible design targeted toward home or gym settings. Fourteen PwPD (67.6 ± 6.5 years, 6 female) completed one 30-min session of SV training and one 30-min session of normal (N) non-speed-varied treadmill training in a counterbalanced design. Motor function was assessed pre- and postexercise with KinesiaONE inertial measurement unit validated for assessment of symptoms including tremor, bradykinesia, rhythm, and amplitude of movement. Heart rate (HR) did not differ significantly (p = 0.146, t = -1.102) across conditions, with average HR in 60%-65% age-predicted HRmax range. Rating of perceived exertion (RPE) was significantly (p = 0.020, t = 2.274, effect size 0.608) lower in SV condition than N condition by 0.8 points on the 6-20 Borg scale. Generalized linear mixed model analysis revealed significant interaction effects in sum hand motor function, bradykinesia and tremor sum, and resting and postural tremor items (p < 0.05), driven by improvements in symptoms post-SV exercise. No significant interactions were observed for hand amplitude, rhythm of movement, or lower body symptoms. Overall, data support SV treadmill training as an exercise paradigm for PwPD to acutely impact hand motor function utilizing a standard treadmill. Future work should evaluate multiple sessions of training and evaluate dose-response effect of speed variability.
Parkinson's disease (PD) is a neurodegenerative condition, and its rising prevalence necessitates the urgent need to identify modifiable risk factors. Air pollution, a pervasive and also escalating public health problem, has emerged as a potential contributor to the incidence and progression of PD. As urbanization and industrialization continue to exacerbate global air pollution levels, understanding the relationship between airborne toxicants and PD is a pressing scientific and public health priority. In this review, we critically discuss the current epidemiological evidence and the cellular and molecular mechanisms underlying air pollution-induced neurodegeneration in PD. Clinical studies associate long-term interaction with pollutants such as nitrogen oxides, particulate matter, and ozone with increased PD risk. Evidence also suggests that air pollution worsens PD prognosis. Mechanistically, air pollution is hypothesized to contribute to PD pathogenesis through gut microbiome alternations, oxidative stress, and neuroinflammatory pathways, as well as promoting α-synuclein aggregation.
Background:Clinical rating scales for Parkinson's disease (PD) have limitations in the accurate assessment of disease severity, which may obscure treatment effects in clinical management and trials. Body-worn sensors can provide data for continuous and more precise monitoring of motor features of PD in patients' daily lives. However, little information exists on the clinical validity of sensor-derived data. Objectives:We assessed the clinical validity of outputs from three different machine learning models using trunk- or wrist-worn sensors in patients with PD, assessing their correlations with scores on clinical scales assessing motor severity and impact on function. Methods:Wrist- and/or trunk-worn sensors were worn by patients with PD, who had been assessed using the MDS-UPDRS and the EQ-5D-5L, for up to one week. Output data were analyzed using three different algorithms: One trained on a publicly available dataset using trunk sensor data and two previously derived from wrist sensor data. Clinical validity was examined by examining correlations of sensor-derived outputs with individual items of the MDS-UPDRS and EQ-5D-5L. Results:For the trunk-worn sensor-derived outputs, the strongest positive correlations were found between output data and axial features such as arising from a chair, posture, and body bradykinesia and aspects of daily functioning on the MDS-UPDRS Part II and health-related quality of life (EQ-5D-5L domain) scores. For the wrist-worn sensor-derived outputs, the strongest positive correlations were seen between output data and postural tremor, rest tremor amplitude, and ability to undertake hobbies. Outputs from both body locations were correlated with MDS-UPDRS II and EQ-5D-5L scores (r > 0.7). In participants who wore both trunk and wrist sensors, percentage of time spent in different activities was similar between trunk- and wrist-worn devices, except for time spent "Lying down" derived from the trunk-worn sensor compared to time spent "Sleeping" derived from the wrist-worn sensor algorithm. Conclusion:These data provide preliminary evidence for the clinical validity of single sensor assessments as measures of severity of motor features and motor functioning in patients with PD for use in clinical trials and practice. The results should be confirmed in large and more diverse populations and expanded to include other assessment methods such as laboratory-based motor measurements.
Background:Parkinson's disease (PD) patients under medical treatment experience motor complications (MCs), namely, ON/OFF fluctuations (ON/OFF) and dyskinesias. Methods:We assessed 120 newly diagnosed PD patients after the initiation of medical treatment who were followed up for at least 24 months. We reviewed the latency of ON/OFF or dyskinesias by months and calculated the levodopa dose (LD), levodopa dose divided by daily intake (LDdiv), and levodopa equivalent dose (LED). We estimated cumulative incidence and median latency by Kaplan-Meier survival analysis. We classified patients with MCs into four groups and patients with ON/OFF or dyskinesias into three groups, according to latency. Results:Seventy-six patients experienced MCs with a median latency of 28 months. Fifty-seven patients experienced ON/OFF and 19 experienced dyskinesias with a median latency of 28 and 50 months, respectively. The medication dose at which each patient experienced ON/OFF or dyskinesias varied widely. The median LD, LDdiv, and LED was 300 (237.5-350), 100 (79-111), and 300 (250-450) mg at the onset of MCs; 300 (200-300), 100 (83-125), and 300 (249-400) mg at the onset of ON/OFF; and 400 (375-500), 125 (105-133), and 600 (466-722.75) mg at the onset of dyskinesias, respectively. Consistently, the shortest latency group had the lowest medication dose, while the longest latency group had the highest. Five patients experienced dyskinesias before ON/OFF, with similar medication doses at the onset of ON/OFF and dyskinesias. Some patients experienced ON/OFF but have not yet developed dyskinesias under a comparable medication dose as patients who experienced dyskinesias; the latter had a significantly younger age at onset. Conclusions:The pathophysiological backgrounds and changes causing ON/OFF or dyskinesias are not the same for all patients. The presence of ON/OFF and higher medication doses does not always cause dyskinesias. A younger age at onset may be associated with the occurrence of dyskinesias.
Background:Parkinson's disease is a progressive neurodegenerative disorder with no currently approved disease-modifying therapies. Alpha-synuclein targeting monoclonal antibodies provide a potential therapeutic strategy. Objectives:To evaluate published studies of the efficacy and/or safety of monoclonal antibodies that target alpha-synuclein in human subjects. Methods:A systematic review of peer-reviewed journal articles was conducted. PubMed, Embase and Scopus were searched up to March 2, 2025. Results were synthesised narratively. Risk of bias was assessed, and sensitivity analysis excluding studies with high risk was performed. Results:After screening 1509 papers, 10 publications incorporating a total of 13 studies were included. These assessed Prasinezumab, Cinpanemab, Exidavnemab and Lu-AF82422 with heterogeneity amongst studies. Tolerability was generally favourable across all studies. Cinpanemab showed almost no efficacy, whilst Prasinezumab demonstrated mixed motor symptom improvements. Safety profiles for all monoclonal antibodies reflected mostly consistent rates of adverse events. Six studies were removed in the sensitivity analysis due to high risks of bias, which reduced Prasinezumab's apparent efficacy findings. Conclusions:The efficacy of monoclonal antibodies in Parkinson's disease remains uncertain with most positive results coming from the studies with high risks of bias. Prasinezumab demonstrated an efficacy profile with the potential of significance, warranting further research. This lack of efficacy reported with Cinpanemab is consistent with the manufacturer's decision to discontinue it. Safety data on Exidavnemab and Lu-AF82422 in healthy volunteers support further investigation in Parkinson's disease patients. Future trials may benefit from the inclusion of subjects at earlier disease stages, diagnosed before clinical features have emerged. Trial Registration: ClinicalTrials.gov identifier: NCT03100149.
Freezing of gait (FOG) is a highly disabling, poorly dopa-responsive symptom of Parkinson's disease (PD) that becomes increasingly prevalent with disease progression and is one of the main contributors to falls and loss of independence. Although FOG has long been viewed as a motor phenomenon, converging evidence shows that executive impairment-particularly deficits in attention, task-switching, inhibition, and visuospatial processing-is strongly implicated in its pathophysiology. Yet the field lacks a coherent framework explaining how these cognitive processes contribute to FOG and how they should be targeted in therapy. This narrative review synthesizes current evidence on the neural mechanisms linking cognitive dysfunction and FOG. Literature was identified through targeted searches of neuroimaging, behavioral, and rehabilitation studies in PD with and without FOG. Findings consistently demonstrate altered activity and connectivity within corticostriatal and corticolimbic circuits in freezers, including inefficient hyperactivation of the frontal, prefrontal, and posterior parietal cortices, and abnormal coupling between the ventral striatum, precuneus, and amygdala. These patterns suggest that cognitive networks become overrecruited yet insufficient to compensate for impaired motor automaticity, especially under dual-task demands or emotional load. Robust cognitive reserve can serve as compensation, whereas cognitive impairment can contribute to FOG in situations with high cognitive load. Freezers show disproportionate deficits in inhibitory control, visuospatial processing, and task-switching, which correlate with gait initiation failures and FOG severity. Cognitive training, particularly dual-task and other motor-cognitive interventions, shows promising yet variable effects on gait, executive performance, and FOG; however, the field lacks clarity about which cognitive and executive domains are causally involved and which merely reflect compensatory strain. FOG-specific mechanistic models integrating motor, executive, and limbic dysfunction are needed to guide individualized cognitive training and optimize therapeutic outcomes for people with PD.
Background:Ground reaction force (GRF) alterations are reported in Parkinson's disease (PD), but most kinetic measures depend on walking speed. Since individuals with PD walk more slowly, apparent differences may reflect speed rather than disease-specific biomechanics. Virtual reality (VR) may further modify gait kinetics beyond speed effects. Objective:To determine whether between-group differences in GRF waveforms during overground walking persist after accounting for walking speed and whether VR induces speed-independent kinetic modulation in individuals with PD. Methods:14 adults with mild-to-moderate PD (Hoehn and Yahr stage II-III) and seventeen age-matched controls performed overground walking under normal and immersive VR conditions. Three-dimensional kinematics (100 Hz) and GRFs (1000 Hz) were recorded. Discrete spatiotemporal and kinetic variables were analyzed using mixed-design repeated-measures ANOVA. Time-continuous GRF waveforms were examined using mixed-model statistical parametric mapping (SPM) ANCOVA with walking speed entered as a covariate. Results:Individuals with PD walked significantly slower than controls in both conditions. VR increased stride length and modulated several discrete GRF variables, including anterior-posterior and mediolateral components. However, waveform-level SPM analyses revealed no persistent group or group × task effects once walking speed was included as a covariate. In contrast, walking speed demonstrated widespread and robust associations with vertical and mediolateral GRF trajectories across multiple stance-phase intervals. Conclusion:During comfortable overground walking in mild-to-moderate PD, many apparent kinetic differences are largely speed-coupled rather than clearly speed-independent. These findings underscore the necessity of speed-aware modeling when interpreting gait kinetics and evaluating VR-based paradigms in Parkinson's disease.
Background There is limited literature describing rehabilitation utilization among the Parkinson's disease (PD) population across the world and especially in Africa, despite ample evidence and clinical guidelines in support of rehabilitation for persons with PD (PwPD). Objectives To describe the characteristics of PwPD, the types of rehabilitation services and treatment parameters used, and the factors associated with rehabilitation utilization in southern Ghana. Methods A descriptive cross-sectional survey was conducted among PwPD receiving care at one primary and two tertiary hospitals selected from southern Ghana. The MDS-UPDRS Part III, PDQ-8, and modified ICF Checklist Clinician Form were used to assess motor function, health-related quality of life, and rehabilitation use. Descriptive and inferential statistics were conducted with significance set at p < 0.05. Results Seventy-five PwPD were included, with 61.3% being males. Engagement in physiotherapy and/or gymnasium activities was reported by 40.0% of participants. The most common indication for physiotherapy was gait difficulties. No participant had used occupational therapy or speech therapy. Nonreferral by neurologists and participants' poor knowledge of rehabilitation benefits and needs were the main reasons for nonuse of rehabilitation. Gait retraining and strengthening exercises were the most common physiotherapy interventions received by 73.7% of the participants. Longer PD duration was associated with physiotherapy utilization. A total of 42.4% of participants discontinued physiotherapy services, primarily due to transportation challenges and high treatment cost. Conclusion Rehabilitation services are underutilized by PwPD in southern Ghana due to limited referrals, poor awareness of benefits, and related barriers. This highlights the need for more accessible and integrated services.
Background:The neurobiological pathology of levodopa-induced dyskinesia (LID) remains unclear despite its prevalence. Emerging evidence suggests a critical interplay between dopaminergic and serotonergic systems in the development of LID. Objective:This study aimed to investigate longitudinal changes in striatal and midbrain SBRs and their association with LID development, with exploratory evaluation of midbrain-striatal monoaminergic coupling. Methods:A total of 169 drug-naïve PD patients from the PPMI database were followed over four years. I-123 FP-CIT SPECT imaging was used to measure specific binding ratios (SBRs) in the caudate, putamen, and midbrain. Patients were categorized into LID and non-LID groups at follow-up. Interregional correlation analysis assessed the correlation between midbrain and striatal subregions. The impact of levodopa-equivalent daily dose (LEDD) on correlation was also evaluated. Results:The LID group exhibited significantly lower striatal SBRs at baseline and follow-up compared to the non-LID group. Midbrain SBRs declined more steeply in the LID group over time. In multivariable regression models adjusting for baseline clinical differences, the interaction between midbrain SBR and LID status for the 4-year putamen SBR showed a trend-level association (p = 0.09, q = 0.15). The regression slope for the midbrain-putamen association was numerically higher in the LID group (β = 1.1571) compared to the non-LID group (β = 0.5201) at 4 years. The midbrain-to-putamen ratio was higher in the LID group at baseline, indicating relatively preserved nonstriatal monoaminergic signal early in the disease course. After adjustment, LEDD and the midbrain × LEDD interaction were not independently associated with midbrain-putamen coupling. Conclusion:Our findings suggest a dynamic pattern in which early relative preservation of nonstriatal monoaminergic signals, reflected by midbrain SBR changes, may accompany dopaminergic loss in patients who develop LID. Midbrain SBR should be interpreted as a proxy of monoaminergic integrity rather than a direct serotonergic biomarker. LID appears to mark a phenotype of accelerated nigrostriatal degeneration characterized by lower baseline and faster longitudinal decline of putaminal SBR. Midbrain-striatal coupling patterns may reflect secondary monoaminergic network changes associated with disease progression rather than a causal serotonergic mechanism.
Background:There is increasing demand for an effective adjuvant therapies for Parkinson's disease (PD) patients to minimize side effects and improve quality of life, due to unmet needs not fully addressed by conventional treatments. Objectives:To examine the long-term effects of adjuvant acupuncture-related therapies on medication use and mortality in patients with PD using the National Health Insurance Service (NHIS) database in Korea. Methods:NHIS records from 2010 to 2011 were searched to extract the study population. The medical records of patients with PD were followed from the initial diagnosis to August 2018. Propensity score matching was performed using covariates, including age group, sex, and duration of levodopa therapy. Odds ratios (ORs) of levodopa therapy and nonmotor symptom medication use were examined. Cox proportional hazards modeling and Kaplan-Meier analysis were performed to determine differences between acupuncture-related therapy users (ACU group) and nonusers (non-ACU group). Results:The ACU group (n = 23,454) used less levodopa therapy compared to non-ACU group (n = 23,454) but showed higher use of nonmotor symptom medications including those for sleep disorders, anxiety, and depression. In the Cox proportional hazards model, the ACU group was associated with a slightly lower long-term risk of all-cause mortality. Conclusion:Acupuncture-related therapies-defined here as one or more treatments delivered at Korean medicine clinics, including acupuncture, electroacupuncture, moxibustion, cupping, and herbal formulations-were more frequently received by patients with nonmotor symptoms. The use of levodopa therapy and all-cause mortality was lower in the ACU group than in the non-ACU group. Given the observational design, heterogeneity of the exposure, and potential residual confounding, these associations should not be interpreted as causal evidence of therapeutic benefit. Prospective, randomized, sham-controlled trials are required to determine whether acupuncture-related therapies confer specific clinical benefit in patients with PD.
Protein aggregation is a hallmark of several neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies. A common feature of these disorders is the misfolding and aggregation of α-synuclein (α-syn) and amyloid-β (Aβ) proteins into amyloid structures, which disrupt cellular homoeostasis and drive disease progression. While Aβ typically forms extracellular deposits and α-syn accumulates in intracellular inclusions, both ultimately contribute to neuronal damage and neurodegeneration. Increasing in vitro evidence suggests that these proteins can interact, altering their structural properties and, in turn, their biological effects; however, the consequences of their co-occurrence in vivo remain unclear. To address this gap, we examined whether α-syn modulates Aβ deposition and associated neuroinflammation at early stages using a physiologically relevant bigenic mouse model coexpressing human α-syn and APP knock-in Aβ. Using combined histological and biochemical analysis, we characterised Aβ load and microglial responses at early time points. Our results indicate that α-syn expression is associated with altered early Aβ deposition and microglial morphology in vivo. Specifically, while early Aβ deposits were detected in both Aβ/α-syn and Aβ-control mice from 2 months of age, at 4 and 6 months, reduced number and size of Aβ microdeposits was observed in the Aβ/α-syn model. The reduction in Aβ load was accompanied by a more ramified microglial morphology consistent with a less activated microglial state. Whether this delayed response reflects protection or impaired immune surveillance remains unclear. Our findings highlight the complexity of indirect Aβ and α-syn interactions and the need for further studies to clarify their functional impact. The newly generated bigenic mice provide a relevant platform to investigate early co-pathology and its role in disease progression.
Background: Most assessment tools may not be comprehensive enough to measure all relevant problems associated with Parkinson's disease (PD) and may focus only on activity. While specific performance-based outcome assessments are crucial for intervention design, it is important to establish the epidemiology of functioning problems, to understand the broad range of disability associated with a disease. Objectives: This study aimed to describe the prevalence and nature of functional problems and the contextual factors experienced by persons with PD (PwPD) using the International Classification of Functioning, Disability and Health (ICF) framework. The distribution of substantial functioning problems across selected demographic and clinical variables was also assessed. Methods: A cross-sectional survey was conducted among PwPD attending one primary and two tertiary hospitals in southern Ghana. The ICF Checklist (Clinician Form) was adapted to record impairments, activity limitations, participation restrictions, and environmental facilitators and barriers. Descriptive and inferential analyses were performed, with significance set at p < 0.001 for multiple comparisons using the Hochberg correction. Results: The study included 75 PwPD (61.3% male) with a mean (SD) age of 66.8 (9.6) years. The most frequently reported issues were impairments in body functions and participation restrictions, with the top 10 problems reported by 68%-91% and 67%-88% of participants, respectively. Participants reported more facilitators, while challenges with general social support were the most frequently reported barrier among 60% of participants. Women and individuals with advanced PD were significantly more likely (p < 0.001) to report substantial functioning problems. Conclusion: This study highlights critical functioning problems faced by PwPD in a resource-limited setting and underscores the value of using the ICF framework in rehabilitation assessment and planning. The findings may inform gender- and disease-stage-sensitive interventions for PwPD across diverse healthcare contexts.
BackgroundParkinson's disease (PD) is a prevalent neurodegenerative disease, whereas nonalcoholic fatty liver disease (NAFLD) is a common metabolic liver disorder. Growing evidence suggests that NAFLD may affect the central nervous system through the liver-brain axis, potentially contributing to PD, although the underlying molecular mechanisms remain unclear.MethodsTo identify differentially expressed genes (DEGs), transcriptomic data for NAFLD and PD were sourced from the GEO database. Key common candidate genes were screened using protein-protein interaction (PPI) networks, machine learning approaches (LASSO, neural networks, and random forest), and functional enrichment analyses, including GO, KEGG, GSEA, and GSVA. Immune infiltration, TF-miRNA regulatory networks, and single-cell RNA sequencing analyses were applied to investigate gene function, immune regulation, and cellular distribution. Candidate drugs were predicted using bioinformatic approaches and validated through molecular docking.ResultsCASP1, CCNA2, and INHBE were identified as three core common candidate genes that may be associated with NAFLD and PD. Involvement of these genes includes inflammatory responses, regulation of the cell cycle, metabolic pathways, and immune microenvironment remodeling. The analysis of the TF-miRNA network suggested possible regulation by transcription factors CEBPB, BRD4, FOS, and miRNAs such as hsa-miR-29b-1-5p and hsa-miR-128-3p. Drug prediction and molecular docking identified ethinyl estradiol, mesalamine, and seliciclib as candidate therapeutics, showing strong binding affinity to the core targets.ConclusionThis study offers a comprehensive elucidation of the molecular ties between NAFLD and PD. The identified core genes and candidate drugs offer theoretical support for potential candidate biomarkers and therapeutic targets in comorbid NAFLD and PD.
Introduction:The purpose of this trial was to evaluate preliminary efficacy and safety of multiple intravenous infusions of autologous, Hope Biosciences adipose-derived mesenchymal stem cells (HB-adMSCs) for the treatment of patients with Parkinson's disease (PD). Methods:A total of N = 24 patients with PD were randomized 5:3 into HB-adMSC (200 million) or Placebo. Six intravenous infusions of HB-adMSCs or saline were administered at Weeks 0, 4, 8, 16, 24, and 32 with a follow-up at Week 42 and the end of study (EOS) at Week 52. The primary efficacy endpoint was to investigate change from baseline to Week 52 in Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II. Primary safety endpoints included the incidence of adverse and serious adverse events (AE/SAEs) and clinically significant changes in laboratory assessments. Results:HB-adMSC treatment was well tolerated and safe, with only one SAE reported, which was deemed unrelated to the investigational product. In total, 81 AEs were recorded, 79 of which were mild, one moderate, and one severe. Neurological disorders were the most commonly reported AEs, with a higher incidence in the placebo group (66.7%) compared with the HB-adMSC group (46.7%). No deaths occurred, and no clinically meaningful changes were observed in laboratory parameters from baseline to the EOS for either group. Efficacy analyses revealed no clear treatment effect in MDS-UPDRS II scores between the HB-adMSC and Placebo groups. Conclusion:Multiple intravenous infusions of autologous HB-adMSCs were found to be safe and feasible in the patients with PD. Efficacy outcomes should be interpreted with caution, as this small, early-phase study was not designed or powered to demonstrate definitive efficacy. Trial Registration: ClinicalTrials.gov identifier: NCT04928287.
ObjectiveGrowth differentiation factor 15 (GDF-15) has emerged as a potential biomarker for neurodegenerative diseases. Although elevated serum GDF-15 levels have been reported in Parkinson's disease (PD), their association with clinical features has not been fully characterized.MethodsWe evaluated serum GDF-15 concentrations in 40 patients with PD and analyzed their relationships with clinical measures, including motor severity (MDS-UPDRS), quality of life (PDQ-39), sleep disturbances (PDSS-2), autonomic symptoms (SCOPA-AUT), and cognitive function (MoCA-J).ResultsHigher serum GDF-15 levels were associated with older age and greater symptom burden across multiple domains. Significant relationships were observed with MDS-UPDRS Parts I-III and total scores, PDQ-39 summary index and bodily discomfort index, two different PDSS-2 domains (motor symptoms at night and PD symptoms at night), and SCOPA-AUT total and gastrointestinal dysfunction scores. After adjusting for age, the associations between serum GDF-15 levels and MDS-UPDRS Part II, Part III, and total scores remained significant. No sex-related differences were detected. A trend toward lower MoCA-J scores with increasing GDF-15 levels was observed but did not reach statistical significance.ConclusionSerum GDF-15 levels are linked to both motor and nonmotor aspects of PD and may reflect overall disease burden. Further longitudinal studies are needed to determine their value for disease monitoring and prognosis.
Background:Bilateral motor asymmetry is a hallmark feature of Parkinson's disease (PD). However, few studies have quantitatively examined this feature in patients with scans without evidence of dopaminergic deficit (SWEDD). This study aimed to investigate upper limb asymmetry in bradykinesia among PD and SWEDD patients using gyro sensors, focusing on finger tapping and forearm rotation task. Methods:We recruited 23 early-stage, drug-naïve PD patients, 23 SWEDD patients, and 20 age-matched healthy controls. We recorded gyro sensor signals during 15-s finger tapping and forearm rotation tasks. Bilateral asymmetry indices were calculated and compared among groups. In addition, repeated measure analysis of variance (ANOVA) was used to examine the interaction of task and group, and Spearman correlation analysis was conducted with clinical motor scores. Results:No significant group differences were found during finger tapping. However, during forearm rotation, PD patients exhibited significantly greater asymmetry than SWEDD patients in several indices, including RMS angular velocity, peak angular displacement, peak power, and total power. Task × group interaction effects were significant only in forearm rotation, and asymmetry indices from forearm rotation showed significant correlations with clinical motor scores. Conclusions:Forearm rotation is a sensitive task for detecting motor asymmetry in PD and for differentiating PD from SWEDD. These results suggest that quantitative motor asymmetry indices using wearable sensors could aid clinicians in the identification of potential SWEDD.
Objectives:The Constipation Scoring System (CSS) is a validated tool for assessing constipation severity and has been previously applied in Parkinson's disease (PD) populations. However, comparative data on post-treatment CSS outcomes between individuals with and without PD remain lacking. This study aimed to compare post-treatment constipation severity between PD and non-PD patients in real-world clinical settings, with particular focus on neurology and gastroenterology outpatient clinics. Methods:This retrospective chart review included 67 patients with PD from a neurology clinic and 50 non-PD patients with constipation from a gastroenterology clinic. Baseline characteristics were retrieved from electronic medical records. Follow-up assessments were conducted through direct or telephone interviews to evaluate constipation severity using the CSS. Additional data were collected on patients' self-reported intake of water, coffee, carbohydrates, and fiber, as well as exercise habits. Results:Post-treatment CSS scores did not differ significantly between groups (PD: 6.07 ± 3.57 vs. non-PD: 5.24 ± 2.84; p = 0.172), with most participants classified as having mild constipation. No significant differences were observed in daily water, coffee, or fiber intake, or in exercise habits. However, non-PD patients reported significantly higher carbohydrate intake compared to PD patients (p = 0.003). PD patients more frequently reported long-standing constipation symptoms (≥ 6 years) than non-PD patients (p < 0.001). Patterns of laxative use also differed: while sennosides were most commonly used in both groups, non-PD patients more frequently used lactulose and mucilin, whereas PD patients more commonly used Unison enemas (p = 0.020) and milk of magnesia (p = 0.070). Conclusion:Although constipation severity and treatment outcomes were comparable between PD and non-PD patients, PD patients more often experienced long-standing symptoms and demonstrated distinct patterns of laxative use. Prospective studies are warranted to evaluate standardized treatment protocols to better clarify treatment outcomes and inform clinical practice.
This study explores the healthcare experiences of Australians with Parkinson's disease, focusing on healthcare access, symptom management and support networks. Despite the body of research on the experiences of PwPD, there is limited understanding of the specific challenges faced by Australians in accessing and navigating healthcare services. A national survey was conducted, and free-text responses to an optional open-ended question were analysed using thematic analysis to identify key themes in healthcare experiences and barriers. Seven themes were identified: Navigating Healthcare, Diagnostic Experiences, Symptom Experience and Management, Optimism and Resilience, Knowledge and Understanding of Parkinson's Disease, Necessitated Self-Advocacy, and Community-Driven Support. Participants reported difficulties in obtaining timely diagnoses, navigating healthcare services and accessing specialised care. Information gaps and inadequate patient-provider communication were also noted. Peer support networks were highlighted as crucial for coping and resilience, with a notable shift away from traditional familial support structures. Findings underscore systemic challenges in healthcare access and communication for Australian PwPD and suggest that enhancing peer support networks and improving care pathways could strengthen disease management and support.
Background:Reduced social engagement is associated with increased risk of incident Parkinson's disease (PD). Online peer support provides opportunities to develop new social connections. A digital social forum was recently embedded within PREDICT-PD, an online UK cohort study that stratifies participants for risk of future PD, to explore the feasibility of digital social engagement as an intervention to modify PD risk. Objective:This study reports on the content of messages exchanged on the forum to better understand how this was used and experienced. Methods:364 public posts from 218 distinct users were analysed using thematic analysis. Results:Members created a sense of community through disclosing personal information and reaching out to others. Experiences were shared in relation to symptom appraisal, emotional impacts and routes to diagnosis. Practical advice, resources and information were exchanged to aid symptom management and proactive lifestyle changes. Users discussed their aspirations for timely diagnosis and treatment within healthcare, further research funding to aid prevention and treatment, and greater awareness of PD within society. Technical issues with the forum were reported, and accessibility was viewed as a potential barrier. Conclusions:The online forum provided a peer support environment for people with similar health experiences to connect, exchange information and emotional support, and engage in discussions around political and social issues unique to PD. This highlights the potential of leveraging online peer support to promote social engagement in prodromal PD. Further research is needed to examine the effect on PD risk and develop accessible technologies.
