Epidemiologie und Ursachen der Parkinson-Erkrankung

Lill, Christina M.; Klein, Christine

doi:10.1007/s00115-017-0288-0

Cited by 37 publications

(20 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Parkinson disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease ( 1 , 2 ). The disease is accompanied by an array of disabling motor and non-motor symptoms.…”

Section: Introductionmentioning

confidence: 99%

Method of Levodopa Response Calculation Determines Strength of Association With Clinical Factors in Parkinson Disease

2018

View full text Add to dashboard Cite

BackgroundThe levodopa challenge test is routinely used in Parkinson disease (PD) to determine a patient’s motor improvement following levodopa administration [levodopa response (LR)]. LR is most commonly reported as a percent OFF to ON change in the Unified Parkinson Disease Rating Scale (UPDRS) part III score, and occasionally as an absolute difference in score. This inconsistency in LR determination alters how clinical factors such as patient age and disease duration are understood in relation to LR in PD.ObjectiveThe aim of this study was to compare the calculation of the LR as either a percent change or difference in UPDRS-III motor score between OFF and ON medication. These two scores were then used to correlate to disease duration, patient age, levodopa duration, levodopa equivalent dose (LED), OFF score, cognition, mood, gait, and quality of life (QOL).Methods70 PD patients underwent the levodopa challenge test. The UPDRS-III motor examination was performed in the defined OFF and ON medication states to determine LR. Each patient was assessed after 12–14 h without anti-parkinsonian medication and then given three 100/25 mg levodopa/carbidopa tablets. LR was reported as both a difference in score [OFF − ON; absolute LR (aLR)] and as a percent change in score [(OFF − ON)/OFF*100%; %LR]. Patients completed the following non-motor symptom assessment scales: Montreal Cognitive Assessment, Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Parkinson’s Disease Questionnaire, and Geriatric Depression Scale. The effect of the LR calculation method was correlated to the clinical measures.ResultsThe aLR was significantly associated with disease duration (r = 0.40), levodopa duration (r = 0.47), OFF motor score (r = 0.58), and LED (r = 0.31), but not age. The aLR was also found to have a significant relationship with clinical scales assessing cognition (r = 0.41), freezing of gait (r = 0.35), QOL (r = 0.40), and depression (r = 0.30). By contrast, the more commonly used %LR demonstrated no significant relationships with any of the variables tested.ConclusionAlthough the %LR is more commonly employed in clinical protocols and research studies, the aLR is the superior method for reporting motor response to levodopa in PD given its significant associations with the clinical factors evaluated.

show abstract

Section: Introductionmentioning

confidence: 99%

Method of Levodopa Response Calculation Determines Strength of Association With Clinical Factors in Parkinson Disease

2018

View full text Add to dashboard Cite

show abstract

“…The ultimate cause of chronic peripheral inflammation in PD patients is not entirely understood and may be multifactorial. However, it seems reasonable to conclude that pesticide exposure and perhaps a history of head trauma may be involved, as both factors appear to play as a causative role in the development of the illness [391, 392].…”

Section: Other Neurodegenerative Disordersmentioning

confidence: 99%

Could Alzheimer’s Disease Originate in the Periphery and If So How So?

et al. 2018

View full text Add to dashboard Cite

The classical amyloid cascade model for Alzheimer's disease (AD) has been challenged by several findings. Here, an alternative molecular neurobiological model is proposed. It is shown that the presence of the APOE ε4 allele, altered miRNA expression and epigenetic dysregulation in the promoter region and exon 1 of TREM2, as well as ANK1 hypermethylation and altered levels of histone post-translational methylation leading to increased transcription of TNFA, could variously explain increased levels of peripheral and central inflammation found in AD. In particular, as a result of increased activity of triggering receptor expressed on myeloid cells 2 (TREM-2), the presence of the apolipoprotein E4 (ApoE4) isoform, and changes in ANK1 expression, with subsequent changes in miR-486 leading to altered levels of protein kinase B (Akt), mechanistic (previously mammalian) target of rapamycin (mTOR) and signal transducer and activator of transcription 3 (STAT3), all of which play major roles in microglial activation, proliferation and survival, there is activation of microglia, leading to the subsequent (further) production of cytokines, chemokines, nitric oxide, prostaglandins, reactive oxygen species, inducible nitric oxide synthase and cyclooxygenase-2, and other mediators of inflammation and neurotoxicity. These changes are associated with the development of amyloid and tau pathology, mitochondrial dysfunction (including impaired activity of the electron transport chain, depleted basal mitochondrial potential and oxidative damage to key tricarboxylic acid enzymes), synaptic dysfunction, altered glycogen synthase kinase-3 (GSK-3) activity, mTOR activation, impairment of autophagy, compromised ubiquitin-proteasome system, iron dyshomeostasis, changes in APP translation, amyloid plaque formation, tau hyperphosphorylation and neurofibrillary tangle formation.

show abstract

“…Parkinson's disease (PD) is one of the most common neurodegenerative disorders. Neural degeneration and loss of dopaminergic cells in the substantia nigra cause a lack of dopamine which ultimately leads to impaired motor functioning (Lill and Klein, 2017). Cardinal motor symptoms of PD include bradykinesia, rigidity and resting tremor (Postuma et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Improving Self-Awareness of Motor Symptoms in Patients With Parkinson’s Disease by Using Mindfulness – A Study Protocol for a Randomized Controlled Trial

et al. 2020

View full text Add to dashboard Cite

Objective: This study aims to increase self-awareness in patients with Parkinson's disease (PD) using a newly developed mindfulness-based intervention, tailored for the specific needs of PD patients. Its impact on self-awareness and patients' daily lives is currently being evaluated. Background: Recently, the phenomenon of impaired self-awareness for motor symptoms (ISAm) and some non-motor symptoms has been described in PD. ISAm can negatively influence patients' daily lives, e.g., by affecting therapy adherence, and is therefore the main focus of this study. The main goal is the development of IPSUM ("Insight into Parkinson's Disease Symptoms by using Mindfulness"), a PD-specific intervention for increasing patients' mindfulness and thereby reducing ISAm. Methods: The effectiveness of IPSUM is evaluated by comparison of an intervention group with a waitlist-control group. A pre-post design with an additional 8-week followup measurement is applied, resulting in three measurement points: before, directly after and 8 weeks after completing the intervention protocol. In total, up to 180 nondepressed PD patients without severe cognitive impairment (non-demented) will be included. The primary outcome is a quantitative score for measuring ISAm. Secondary outcome measures are affective changes, neuropsychological performance and selfawareness of cognition. At pre-and post-measurement an fMRI scan is performed to connect behavioral and neurobiological findings. At post-and follow-up-measurement each patient will take part in a semi-structured interview to explore IPSUM's impact on self-awareness and patients' everyday lives. Results: The conception of the intervention protocol is finished, the resulting 8-week program is presented in detail. It has successfully been tested in the first group of patients, their feedback so far was quite promising. Recruitment is ongoing and a first interim analysis will be performed once 30 patients have completed IPSUM.

show abstract

Epidemiologie und Ursachen der Parkinson-Erkrankung

Cited by 37 publications

References 52 publications

Method of Levodopa Response Calculation Determines Strength of Association With Clinical Factors in Parkinson Disease

Method of Levodopa Response Calculation Determines Strength of Association With Clinical Factors in Parkinson Disease

Could Alzheimer’s Disease Originate in the Periphery and If So How So?

Improving Self-Awareness of Motor Symptoms in Patients With Parkinson’s Disease by Using Mindfulness – A Study Protocol for a Randomized Controlled Trial

Contact Info

Product

Resources

About