Longitudinal course of mild parkinsonian signs in elderly people: A population-based study in Japan

Wada‐Isoe, Kenji; Tanaka, Kenichiro; Uemura, Yoshiko; Nakashita, Satoko; Tajiri, Yuki; Tagashira, Shugo; Yamamoto, Masaichi; Yamawaki, Mika; Kishi, Masafumi; Nakashima, Kenichiro

doi:10.1016/j.jns.2016.01.016

Cited by 12 publications

(28 citation statements)

References 30 publications

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“…9 In a recent longitudinal study, 8.5% of elderly individuals with MPS developed PD within the course of 3 years. 30 This high conversion rate clearly exceeds the overall PD risk of individuals >60 years of 2%, supporting the concept of prodromal PD in a subset of individuals with MPS. 31 In particular, rigidity is a risk factor for the development of subsequent PD, 30 and rigidity and axial symptoms are associated with a higher degree of functional disability than tremor.…”

Section: Discussionmentioning

confidence: 69%

“…30 This high conversion rate clearly exceeds the overall PD risk of individuals >60 years of 2%, supporting the concept of prodromal PD in a subset of individuals with MPS. 31 In particular, rigidity is a risk factor for the development of subsequent PD, 30 and rigidity and axial symptoms are associated with a higher degree of functional disability than tremor. 32 Most importantly, progression of MPS over time supports the concept of ongoing degeneration.…”

Section: Discussionmentioning

confidence: 69%

“…26 In contrast, cortical 30 This high conversion rate clearly exceeds the overall PD risk of individuals >60 years of 2%, supporting the concept of prodromal PD in a subset of individuals with MPS. 30,33 These observations indicate the limitations of MPS as a feature of prodromal PD and highlight the necessity of other or additional sensitive and specific PD risk markers. 32 Most importantly, progression of MPS over time supports the concept of ongoing degeneration.…”

Section: Discussionmentioning

confidence: 69%

“…26 In contrast, cortical 30 This high conversion rate clearly exceeds the overall PD risk of individuals >60 years of 2%, supporting the concept of prodromal PD in a subset of individuals with MPS. "Brainstem" symptoms, ie, impairment of sleep and mood, are thought to result, at least in part, from degeneration of serotonergic and noradrenergic brainstem nuclei.…”

Section: Discussionmentioning

confidence: 79%

“…Depression, for example, is an independent risk factor for future PD in healthy subjects. 30,33 Interestingly, MPS subjects of higher age and with sleep problems were, however, less likely to revert. 31 In particular, rigidity is a risk factor for the development of subsequent PD, 30 and rigidity and axial symptoms are associated with a higher degree of functional disability than tremor.…”

Section: Discussionmentioning

confidence: 99%

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Non-motor symptoms and quality of life in subjects with mild parkinsonian signs

et al. 2017

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 69%

“…26 In contrast, cortical 30 This high conversion rate clearly exceeds the overall PD risk of individuals >60 years of 2%, supporting the concept of prodromal PD in a subset of individuals with MPS. "Brainstem" symptoms, ie, impairment of sleep and mood, are thought to result, at least in part, from degeneration of serotonergic and noradrenergic brainstem nuclei.…”

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Non-motor symptoms and quality of life in subjects with mild parkinsonian signs

et al. 2017

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Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations

et al. 2021

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A BS TRACT: Mild parkinsonian signs (MPS) have been widely studied during the past 3 decades and proposed as a risk marker for neurodegenerative disease. This systematic review explores the epidemiology, clinical and prognostic associations, radiological features, and pathological findings associated with MPS in older adults free from neurodegenerative disease. We find that MPS as currently defined are strongly associated with increasing age and increased risk of development of Parkinson's disease (PD), all-cause dementia, disability, and death. Positive associations with later PD are found mainly in younger populations and those with other features of prodromal PD. There are currently no consistent radiological findings for MPS, and pathological studies have shown that MPS, at least in the oldest old, are often underpinned by mixed neuropathologies, including those associated with Alzheimer's disease, cerebrovascular disease, nigral neuronal loss, and Lewy bodies. Different subcategories of MPS appear to convey varying risk and specificity for PD and other outcomes. MPS overall are not specific for parkinsonian disorders and, although associated with increased risk of PD, can reflect multiple pathologies, particularly in older individuals. "Mild motor signs" appears a more appropriate term to avoid prognostic and pathological implications, and larger future studies to prospectively examine outcomes and associations of specific MPS subcategories are required.

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Frailty phenotype and the role of levodopa challenge test in geriatric inpatients with mild parkinsonian signs

et al. 2017

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Deficiency in dopaminergic system function may be one of the hypothetical reasons of the frailty syndrome but its role still remains unclear. The aim of our study was to assess the frailty phenotype prevalence in geriatric inpatients with mild parkinsonian signs (MPS) and to investigate levodopa test in the frail patients with MPS. We examined 118 participants: 90 with MPS and 28 in control group (without MPS). The frailty syndrome presence was evaluated by the Fried criteria. Deficiency in dopaminergic system function was assessed by one of the modifications of an acute levodopa challenge test (LCT): in MPS group every patient was examined by performing Up and Go Test and also Step Test before and 3 h after taking 125 mg of Madopar (levodopa + benserazide). Sixty-nine study subjects (58%) met criteria for frailty. Fifty-five participants in MPS group (61.1% of MPS group) and fourteen (50%) in control group. All of the patients that scored positive in walk speed criterion of frailty were frail. When all MPS patients were considered, the number of components scored positive for frailty was directly related to the walk speed (r = -0.70, p < 0.0001). In MPS group LCT scores were significantly higher for frailty patients compared to non-frailty (p = 0.0027). When all MPS patients were considered, the number of components scored positive for frailty was directly related LCT score (r = 0.37, p = 0.0004). There was a relationship between LCT and walk speed (r = -0.31, p = 0.0032). Our observations provide new information about the relationship between frailty and MPS, suggest the need for increased awareness of frailty in MPS patients and conversely. Our study provides data for a discussion on pathophysiological background of the frailty syndrome (FS), emphasizing the theories of the important impact of dopaminergic system deficit and encourages further research on the role of LCT in measuring it.

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Longitudinal course of mild parkinsonian signs in elderly people: A population-based study in Japan

Cited by 12 publications

References 30 publications

Non-motor symptoms and quality of life in subjects with mild parkinsonian signs

Non-motor symptoms and quality of life in subjects with mild parkinsonian signs

Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations

Frailty phenotype and the role of levodopa challenge test in geriatric inpatients with mild parkinsonian signs

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