Background Inflammation is suggested to play a role in the development of non-motor Parkinson’s disease (PD) symptoms. We aimed to investigate the association between serum tumor necrosis factor-alpha (TNF-α) levels and cognition in PD patients. Thirty patients with PD and 30 healthy controls were included. Evaluation and staging of PD were done using Unified PD Rating Scale. Cognitive assessment was done using Addenbrooke’s Cognitive Examination (ACE-III) and trail making B tests. Measurement of serum levels of TNF-α was done. Results Patients had significantly worser cognitive scores than controls except for language subclass of ACE score. Mean serum TNF-α level was significantly greater in PD patients as compared to controls. TNF-α serum level was significantly negatively correlated with ACE visuospatial function. Sensitivity and specificity of TNF-α to detect cognitive dysfunction in PD using ACE III and trail making B tests were (73.1, 75%), (57.1, 56.2%), respectively, whereas sensitivity and specificity of TNF-α to detect severity of PD using H&Y staging in PD were 50%. Conclusion Patients with PD frequently have cognitive impairment. Elevated serum TNF-α levels in patients with PD, and association of this cytokine to visuospatial impairment, implicate this pro-inflammatory cytokine in the neurobiology of cognitive impairment in PD.

Background The changes in the different retinal layers in Parkinson’s disease (PD) patients can be easily assessed using optical coherence tomography (OCT). Our aim was to evaluate retinal structural changes in patients with PD using OCT. Structural measurements of the retinal nerve fiber layer (RNFL), macular and ganglion cell complex (GCC) thicknesses were obtained using spectral domain optical coherence tomography. Disease severity was assessed using Unified Parkinson Disease Rating Scale (UPDRS). Results Retinal nerve fiber layer parameters, except for the superonasal and inferonasal quadrants, were significantly reduced in PD patients compared to controls. All macular parameters and GCC thickness were also reduced in PD patients compared to controls. Hoehn and Yahr (HY) staging was inversely correlated with all macular parameters, GCC and temporal RNFL thicknesses. UPDRS score showed a significant negative correlation with macular volume, inferior and nasal parafoveal thicknesses, nasal and temporal RNFL thicknesses and GCC thickness. The disease duration was inversely correlated with macular volume, inferior and temporal parafoveal thicknesses and GCC thickness. Using the multivariate linear regression analysis, the HY scale was a significant predictor for both the average GCC thickness and the macular volume. The sensitivity and specificity of average GCC thickness and macular volume to detect disease severity were 58.8%, 86.7%, 64.7% and 86.7%, respectively. Conclusion Parkinson’s disease causes axonal damage in the RNFL along with retinal thinning that can be detected using SD-OCT. Patients with greater axonal damage tend to have longer duration of the disease and more severe PD symptoms.

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Background: Chronic sciatica due to lumbar disc lesion is an important medical and socioeconomic problem that affects the quality of life. The most important symptom is radiating leg pain. Objective: This study was conducted to determine the effect of adding monochromatic infrared energy to selected physical therapy program in the treatment of chronic sciatic pain. Methods: Thirty patients with chronic sciatica due to posterior lumbar disc prolapse L4-5/L5-S1 participated in this study. The patients were assigned into two equal groups (fifteen patients each): Group A (study group) received monochromatic infrared energy along the distribution of sciatic pain, ultrasound therapy on lower back area and Exercise program in the form of (static abdominal, bridging, pelvic rocking and stretching exercise). Group B (control group) received ultrasound therapy on lower back area and the same Exercise program. The treatment sessions were conducted three times per week (every other day) for four successive weeks. Assessment of pain, functional level and back range of motion were done using visual analogue scale, Arabic translated form Oswestry disability index and back range of motion device (BROM) respectively before and after four weeks of treatment. Results: post treatment results revealed that there was a significant improvement in pain intensity in favor to group (A),It was also observed that there was significant improvement in functional abilities in group (A) Back range of motion showed significant improvement of extension and rotation in both groups with no significant improvement in flexion, side bending and rotation to non affected side.Conclusion: Adding monochromatic infrared energy to selected physical therapy program is effective in improving pain, functional abilities and lumbar range of motion (extension and rotation to affected side).