We read with great interest the commentary by Helmich and Bloem [1] in which the authors suggested that patients with Parkinson's disease (PD) may not only face a greater risk of developing worse coronavirus disease 2019 (COVID-19)-related respiratory outcomes, but also a variety of "hidden sorrows" of the pandemic. The authors argue that PD patients may suffer from chronic stress and lack of physical activity associated with social isolation. As the COVID-19 continues snaking its way around the world (as of April 29, 2020, global cases topped 3 million), we would like to further highlight several impacts that the ongoing COVID-19 pandemic may induce on the global burden of PD. Preliminary studies suggested that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the etiologic agent of the COVID-19, may have a potential neurotropism in humans though such feature has not been conclusively demonstrated yet [2, 3]. Similar to other respiratory viruses, the SARS-CoV-2 may gain access to the Central Nervous System (CNS) by the hematogenous route or axonal transport along with the olfactory neuroepithelium [4, 5]. The olfactory pathway hypothesis for SARS-CoV-2 neuroinvasion is supported by the fact
To the Editor: We read with great interest the study by Gulunay and colleagues. 1 Their findings contributed to the evidence that Parkinson's disease (PD) is not simply a motor disorder, but also a complex multisystem disorder that may have major impacts on the quality of life (QOL) of PD patients. 1 Considering that the scientific community still lacks a complete picture of how PD affects QOL, we congratulate the authors for pursuing this topic. In addition, there is a palpable sense of optimism among neuroscientists about the prospects for the discovery of more meaningful therapies for PD and the animal-assisted therapy comes into this scenario. PD is one of the most common age-related neurodegenerative disorders, which affects 2% to 3% of the global population by the age of 65 and up to 5% of the population aged >85 years. 2 Its prevalence is expected to double by 2030 due to the ageing of the population. 2 Despite a growing body of research paving the way for new therapeutic avenues for PD, little effort has been expended in studying animal-assisted therapy. Zakeri and Bain described the case of an early-onset PD patient who benefited from the arrival of a dog at home. 3 They reported that caring for the pet helped the patient to improve major symptoms of PD as well as to reduce anti-PD medication. 3 The authors also suggest that dogs may help people with PD by increasing their daily exercise, which in turn may help to decrease resting tremors and propulsive gait. 3 In fact, different mechanisms have been proposed to explain animalassisted therapy benefits such as positive changes in several physiological parameters (e.g., heart rate, blood pressure, and hormone levels). 4,5 In summary, dog-assisted therapy can make a big difference in the daily life of one with PD and, therefore, it should be considered as a promising complementary therapy for improving the QOL of PD patients.
In the absence of efficient disease-modifying treatments for Parkinson’s disease (PD), research has focused on identifying potential environmental factors whose modulation may prevent or slow the progression of this neurodegenerative disorder. Compelling epidemiological evidence suggests that caffeine consumption is inversely associated with the risk of developing PD. Further experimental findings demonstrated that caffeine, by particularly targeting adenosine A2A (A2AR) receptors, protected PD animal models against the loss of dopaminergic neurons. The antagonistic action of caffeine on adenosine receptors not only slowed PD-related neurodegeneration, but also improved motor and nonmotor symptoms of PD in animal models. Here, we review the potential action mechanisms by which caffeine might play a role in reducing the risk of PD. We also review current evidence of the benefits of caffeine consumption in motor and nonmotor symptoms of PD. Finally, we point out how these promising findings could lead to the identification of new approaches for effective treatment of PD.
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