Clinically meaningful parameters of progression and long-term outcome of Parkinson disease: An international consensus statement

Puschmann, Andreas; Brighina, Laura; Μarkopoulou, Κaterina; Aasly, Jan; Chung, Sun Ju; Frigerio, Roberta; Hadjigeorgiou, Georgios M.; Kõks, Sulev; Krüger, Rejko; Siuda, Joanna; Wider, Christian; Zesiewicz, Theresa; Maraganore, Demetrius M.

doi:10.1016/j.parkreldis.2015.04.029

Cited by 20 publications

(15 citation statements)

References 100 publications

(84 reference statements)

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“…Recent data showed that the main motor symptoms impacting the health-related QoL of patients with PD include dyskinesia, motor fluctuations, axial impairment, and freezing of gait [ 2 ]. Regarding non-motor symptoms (NMS), depression, dementia, psychosis, cognitive impairment, apathy, and sleep disorders were found to be the most common determinants in reducing QoL and increasing disability [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Caregiver burden and its related factors in advanced Parkinson’s disease: data from the PREDICT study

Tessitore

Marano²,

Modugno

et al. 2018

J Neurol

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IntroductionCaring for a person with Parkinson’s disease (PD) is associated with an increased risk of psychiatric morbidity and persistent distress. The objective of this study was to describe the burden and the related factors of caregivers of advanced PD (APD) patients either treated with continuous dopaminergic delivery systems or standard therapy.MethodsThis cross-sectional, epidemiologic study conducted in 13 Italian sites enrolled PD patients treated with continuous dopaminergic delivering systems [either levodopa/carbidopa intestinal gel (LCIG) infusion or continuous subcutaneous apomorphine infusion (CSAI)] or continuation of standard of care (SOC) with a caregiver. Patient quality of life (QoL) and caregiver burden were assessed using the Parkinson’s Disease Questionnaire (PDQ-8) and Zarit Burden Inventory (ZBI), respectively.Results126 patients (mean age 69.3 ± 8 years) and their caregivers (mean age 57.9 ± 12.9) were enrolled. Most caregivers were spouses. Fifty-three patients were treated with LCIG, 19 with CSAI, and 54 with SOC. Mean ZBI scores were 29.6 ± 14.4 for LCIG, 35.8 ± 20.2 for CSAI, and 31.4 ± 16.0 for SOC. Caregivers of LCIG, CSAI, and SOC patients showed no burden or mild/moderate burden in 74, 53, and 63% of the cases, respectively. Mean PDQ-8 scores were 11.25 ± 5.67, 11.26 ± 5.55, and 14.22 ± 6.51 in LCIG, CSAI, and SOC patients. Neurologists considered patients “very much or much improved” in 89, 58, and 13% of the LCIG, CSAI, and SOC groups using the Clinical Global Impression–Global Improvement Scale. Predictors significantly associated with caregiver burden were patients and caregivers’ judgment of QoL and caregivers’ need to change work.ConclusionsCaregiver burden showed a tendency to be lower when patients are treated with LCIG than with CSAI or SOC.

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Section: Introductionmentioning

confidence: 99%

Caregiver burden and its related factors in advanced Parkinson’s disease: data from the PREDICT study

Tessitore

Marano²,

Modugno

et al. 2018

J Neurol

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“…Our results highlight the importance of jointly measuring the complex interplay between motor and cognitive skills in PD [4,5], not only in multitask settings but also in single condition performance. Only tasks that impose motor-cognitive hybrid demands seem to be able to detect disability levels in single condition and performance worsening in concurrent condition (i. e., dual or triple), even when cognitive decline is controlled.…”

Section: Discussionmentioning

confidence: 73%

“…However, cognitive decline usually coexists with motor impairment as a consequence of the neurodegenerative progression [2]. Despite the relationship between cognitive and motor impairments in PD [3], cognitive performance is usually measured regardless of the motor impairment or as with other nonmotor features of the illness, does not receive adequate attention [4]. e interaction between the motor and cognitive components seems to determine the functional capacity and should be considered simultaneously in the evaluation of the progression of PD [5].…”

Section: Introductionmentioning

confidence: 99%

Combining a Cognitive Concurrent Task with a Motor or Motor-Cognitive Task: Which Is Better to Differentiate Levels of Affectation in Parkinson’s Disease?

Pereiro

Resúa

Facal

et al. 2020

Parkinson's Disease

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Introduction. Cognitive decline usually coexists with motor impairment in PD. Multitask settings provide appropriate measures to evaluate the complex interaction between motor and cognitive impairments. The main objective was to analyze which concurrent task, i. e., motor or hybrid motor-cognitive, in combination with a cognitive task better differentiates between PD patients with mild and moderate levels of disease. Methods. Thirty-seven individuals (19 male and 18 female) with idiopathic PD performed dual and triple tasks combining a cognitive task (phonemic fluency) with motor (pedaling) and/or cognitive-motor hybrid (tracking) tasks. Mild and moderate disability PD groups were specified considering the Hoehn and Yahr scale. Mixed ANOVA analyses for each of the concurrent task were carried out to test differences between the single and dual or triple condition performances comparing the low and high PD disability groups. Supplementary mixed ANCOVA analysis was performed considering the cognitive status as the covariate. Results. The only significant differences between disability PD groups were found for performances in the cognitive-motor hybrid (tracking) task, both in dual and triple conditions. Our results showed a better performance for the mild rather than for the moderate disability group in the single condition task and a significant decline of the mild disability group in the dual and triple condition when compared to the levels of those shown by the moderate disability group. The group-condition interaction remained significant when the cognitive status was statistically controlled. Conclusion. The hybrid of motor-cognitive task combining with a cognitive task (i. e., fluency) successfully differentiated between mild and moderate PD patients in the context of dual and triple multitask sets even when the cognitive status was statistically controlled. Our results highlight the importance of jointly measuring the complex interplay between motor and cognitive skills in PD.

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“…Emphasis was put on harmonization of the datasets with ongoing international cohort studies for comparability and cross validation, thereby increasing statistical power of the planned analyses. Therefore, the diagnostic criteria and scales applied in our study, have been aligned with already existing international cohort programs, e.g., DeNoPa ( Mollenhauer et al, 2013 ), Oxford PD Centre (OPDC) ( Lawton et al, 2015 ); PPMI ( Marek et al, 2011 ), GEoPD ( Puschmann et al, 2015 ), as described previously ( Lerche et al, 2015 ). Harmonization rates are shown in Table 2 .…”

Section: Methodsmentioning

confidence: 99%

The Luxembourg Parkinson’s Study: A Comprehensive Approach for Stratification and Early Diagnosis

Hipp

Vaillant

Diederich

et al. 2018

Front. Aging Neurosci.

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While genetic advances have successfully defined part of the complexity in Parkinson’s disease (PD), the clinical characterization of phenotypes remains challenging. Therapeutic trials and cohort studies typically include patients with earlier disease stages and exclude comorbidities, thus ignoring a substantial part of the real-world PD population. To account for these limitations, we implemented the Luxembourg PD study as a comprehensive clinical, molecular and device-based approach including patients with typical PD and atypical parkinsonism, irrespective of their disease stage, age, comorbidities, or linguistic background. To provide a large, longitudinally followed, and deeply phenotyped set of patients and controls for clinical and fundamental research on PD, we implemented an open-source digital platform that can be harmonized with international PD cohort studies. Our interests also reflect Luxembourg-specific areas of PD research, including vision, gait, and cognition. This effort is flanked by comprehensive biosampling efforts assuring high quality and sustained availability of body liquids and tissue biopsies. We provide evidence for the feasibility of such a cohort program with deep phenotyping and high quality biosampling on parkinsonism in an environment with structural specificities and alert the international research community to our willingness to collaborate with other centers. The combination of advanced clinical phenotyping approaches including device-based assessment will create a comprehensive assessment of the disease and its variants, its interaction with comorbidities and its progression. We envision the Luxembourg Parkinson’s study as an important research platform for defining early diagnosis and progression markers that translate into stratified treatment approaches.

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Clinically meaningful parameters of progression and long-term outcome of Parkinson disease: An international consensus statement

Cited by 20 publications

References 100 publications

Caregiver burden and its related factors in advanced Parkinson’s disease: data from the PREDICT study

Caregiver burden and its related factors in advanced Parkinson’s disease: data from the PREDICT study

Combining a Cognitive Concurrent Task with a Motor or Motor-Cognitive Task: Which Is Better to Differentiate Levels of Affectation in Parkinson’s Disease?

The Luxembourg Parkinson’s Study: A Comprehensive Approach for Stratification and Early Diagnosis

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