Changes in Self-Reported Energy Levels in Prodromal Parkinson's Disease.
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ABSTRACT:
SUBMITTER: Chahine LM
PROVIDER: S-EPMC8840801 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
Publications
Changes in Self-Reported Energy Levels in Prodromal Parkinson's Disease.
Chahine Lana M LM Zhu Xiaonan X Ehrenkranz Rebecca R Chen Honglei H Glynn Nancy W NW Rosano Caterina C
Movement disorders : official journal of the Movement Disorder Society 20210226 5
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Project description:ObjectiveImpulsive decision-making is characterized by actions taken without considering consequences. Patients with Parkinson's disease (PD) who receive dopaminergic treatment, especially dopamine agonists, are at risk of developing impulsive-compulsive behaviors (ICBs). We assessed impulse-related changes across a large heterogeneous PD population using the Barratt impulsivity scale (BIS-11) by evaluating BIS-11 first- and second-order factors.MethodsWe assessed a total of 204 subjects: 93 healthy controls (HCs), and 68 ICB- and 43 ICB + PD patients who completed the BIS-11. Using a general linear model and a least absolute shrinkage and selection operation regression, we compared BIS-11 scores between the HC, ICB- PD, and ICB + PD groups.ResultsPatients with PD rated themselves as more impulsive than HCs in the BIS-11 total score, second-order attention domain, and first-order attention and self-control domains. ICB + patients recorded higher total scores as well as higher scores in the second-order non-planning domain and in self-control and cognitive complexity than ICB- patients.InterpretationThese results indicate that the patients with PD show particular problems with attentional control, whereas ICB + patients show a distinct problem in cognitive control and complexity. Additionally, it appears that all patients with PD are more impulsive than their age- and sex-matched healthy peers. Increased impulsivity may be a result of the disease course, or attributed to dopaminergic medication use, but these results emphasize the importance of the cognitive components of impulsivity in patients with PD.
| S-EPMC7187703 | biostudies-literature
Project description:Parkinson's disease (PD) is a growing public health challenge associated with the aging population. Current diagnostic methods rely on motor symptoms and invasive procedures, making early detection difficult. This study established a transferable artificial intelligence (AI) model, Quest2Dx, to analyze health questionnaires to enable low-cost and non-invasive PD diagnosis. Quest2Dx tackles the common challenges of missing responses and required specific modeling for each questionnaire by developing a novel language modeling approach to allow the model transfer across different questionnaires and to enhance the interpretability. Evaluated on the PPMI and Fox Insight datasets, Quest2Dx achieved AUROCs of 0.977 and 0.974, respectively, significantly outperforming existing methods. Additionally, cross-questionnaire validation achieved AUROCs of 0.920 and 0.952, respectively, from PPMI to Fox Insight and vice versa. Quest2Dx also identified key predictors from the list of questions to provide further insights. The validated technology elucidates a promising path for PD screening in primary-care settings.
| S-EPMC11469361 | biostudies-literature
Project description:Large-scale population screening and in-home monitoring for patients with Parkinson's disease (PD) has so far been mainly carried out by traditional healthcare methods and systems. Development of mobile health may provide an independent, future method to detect PD. Current PD detection algorithms will benefit from better generalizability with data collected in real-world situations. In this paper, we report the top-performing smartphone-based method in the recent DREAM Parkinson's Disease Digital Biomarker Challenge for digital diagnosis of PD. Utilizing real-world accelerometer records, this approach differentiated PD from control subjects with an area under the receiver-operating characteristic curve of 0.87 by 3D augmentation of accelerometer records, a significant improvement over other state-of-the-art methods. This study paves the way for future at-home screening of PD and other neurodegenerative conditions affecting movement.
| S-EPMC7375444 | biostudies-literature
Project description:BackgroundProspective data on cognition in prodromal Parkinson's disease are limited. The objectives of this study were to assess in prodromal PD (1) if baseline cognition predicts conversion to clinical PD, (2) if baseline dopamine transporter binding predicts longitudinal changes in cognition, and (3) if impaired olfaction predicts future cognitive decline.MethodsProdromal participants were 136 hyposmic individuals enrolled in the Parkinson Associated Risk Study. We examined baseline neuropsychological test performance in PD converters versus nonconverters and the association between baseline dopamine transporter binding and change in cognition. An additional 73 normosmic individuals were included in analyses of the relationship between hyposmia and cognitive decline.ResultsIn prodromal participants, baseline cognitive scores did not significantly predict conversion, but converters performed numerically worse on 5 of the 6 cognitive domains assessed, with the greatest differences in executive function/working memory (0.68 standard deviation lower) and global cognition (0.64 standard deviation lower). Lower baseline dopamine transporter binding predicted greater future decline in processing speed/attention (P = 0.02). Hyposmia predicted greater future decline in language (P = 0.005) and memory (P = 0.01) abilities.ConclusionsGiven hyposmia in the general population predicts cognitive decline, the role of cognition in predicting conversion in prodromal PD needs to be assessed in large cohorts followed long-term. The dopamine system may be associated with changes in processing speed/attention in individuals at risk for PD. © 2017 International Parkinson and Movement Disorder Society.
| S-EPMC5722226 | biostudies-literature
Project description:BackgroundOrthostatic hypotension is common in patients with Parkinson's disease (PD). However, it remains unknown whether orthostatic hypotension is a marker of prodromal PD or more advanced disease. The objectives of this study were to assess whether orthostatic hypotension is a prodromal marker of PD in the general population.MethodsThis study was embedded in the Rotterdam Study, a large prospective population-based cohort in the Netherlands. We measured orthostatic hypotension in 6910 participants. First, we determined the relation between prevalent PD and orthostatic hypotension using logistic regression. Second, we followed PD-free participants for the occurrence of PD until 2016 and studied the association between orthostatic hypotension and the risk of PD using Cox proportional hazards models. All models were adjusted for age and sex.ResultsAt baseline, the mean age ± standard deviation of the study population was 69.0 ± 8.8 years, and 59.1% were women. Orthostatic hypotension was present in 1245 participants (19.8%), and 62 participants (1.0%) had PD at the time of orthostatic hypotension measurement. Participants with PD were significantly more likely to have orthostatic hypotension (odds ratio, 1.88; 95% confidence interval, 1.09-3.24). During a median (interquartile range) follow-up of 16.1 years (8.5-22.7 years), 122 participants were diagnosed with incident PD. Orthostatic hypotension at baseline was not associated with an increased risk of PD (hazard ratio, 0.97; 95% confidence interval, 0.59-1.58).ConclusionsOur study suggests that orthostatic hypotension is common in patients with PD, but that orthostatic hypotension is not associated with an increased risk of PD and thus is not a prodromal marker of PD in the general population. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
| S-EPMC7891584 | biostudies-literature
Project description:IntroductionTo test drugs with the potential to prevent the onset of Parkinson's disease (PD), it is key to identify individuals in the general population at high risk of developing PD. This is often difficult because most of the clinical markers are non-specific, common in PD but also common in older adults (e.g., sleep problems).ObjectiveWe aimed to identify the clinical markers at high specificity for developing PD by comparing individuals with PD or prodromal PD to healthy controls.MethodsWe investigated motor and non-motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale Part 1 and 2 items) in 64 prodromal PD and 422 PD individuals calculating the odds ratios, adjusting for age and gender, for PD and prodromal PD versus 195 healthy controls. Symptoms at high specificity were defined as having an adjusted odds ratio ≥ 6.ResultsConstipation had an adjusted odds ratio, 6.14 [95% CI: 2.94-12.80] showing high specificity for prodromal PD, and speech difficulties had an adjusted odds ratio, 9.61 [95% CI: 7.88-48.81] showing high specificity for PD. The proportion of participants showing these specific markers was moderate (e.g., prevalence of constipation was 43.75% in prodromal PD, and speech difficulties was 33.89% in PD), suggesting these symptoms may make robust predictors of prodromal PD and PD, respectively.DiscussionClinical markers at high specificity for developing PD could be used as tools in the screening of general populations to identify individuals at higher risk of developing PD.
| S-EPMC10556459 | biostudies-literature
Project description:BackgroundA 3-step clinical prediction tool including falling in the previous year, freezing of gait in the past month and self-selected gait speed <1.1 m/s has shown high accuracy in predicting falls in people with Parkinson's disease (PD). The accuracy of this tool when including only self-report measures is yet to be determined.ObjectivesTo validate the 3-step prediction tool using only self-report measures (3-step self-reported prediction tool), and to externally validate the 3-step clinical prediction tool.MethodsThe clinical tool was used with 137 individuals with PD. Participants also answered a question about self-reported gait speed, enabling scoring of the self-reported tool, and were followed-up for 6 months. An intraclass correlation coefficient (ICC2,1) was calculated to evaluate test-retest reliability of the 3-step self-reported prediction tool. Multivariate logistic regression models were used to evaluate the performance of both tools and their discriminative ability was determined using the area under the curve (AUC).ResultsForty-two participants (31%) reported ≥1 fall during follow-up. The 3-step self-reported tool had an ICC2,1 of 0.991 (95% CI 0.971-0.997; P < 0.001) and AUC = 0.68; 95% CI 0.59-0.77, while the 3-step clinical tool had an AUC = 0.69; 95% CI 0.60-0.78.ConclusionsThe 3-step self-reported prediction tool showed excellent test-retest reliability and was validated with acceptable accuracy in predicting falls in the next 6 months. The 3-step clinical prediction tool was externally validated with similar accuracy. The 3-step self-reported prediction tool may be useful to identify people with PD at risk of falls in e/tele-health settings.
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Project description:BackgroundScientific research increasingly focuses on visual symptoms of people with Parkinson's disease (PD). However, this mostly involves functional measures, whereas self-reported data are equally important for guiding clinical care.ObjectiveThis review provides an overview of the nature and prevalence of self-reported visual complaints by people with PD, compared to healthy controls.MethodsA systematic literature search was performed. Studies from three databases (PubMed, PsycInfo, and Web of Science) were screened for eligibility. Only studies that reported results of visual self-reports in people with idiopathic PD were included.ResultsOne hundred and thirty-nine eligible articles were analyzed. Visual complaints ranged from function-related complaints (e.g., blurred vision, double vision, increased sensitivity to light or changes in contrast sensitivity) to activity-related complaints (e.g., difficulty reading, reaching, or driving). Visual complaints were more prevalent in people with PD compared to healthy controls. The presence of visual complaints leads to a reduced quality of life (QoL). Increased prevalence and severity of visual complaints in people with PD are related to longer disease duration, higher disease severity, and off-state.ConclusionA large proportion of people with PD have visual complaints, which negatively affect QoL. Complaints are diverse in nature, and specific and active questioning by clinicians is advised to foster timely recognition, acknowledgement, and management of these complaints.
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Project description:ObjectiveThis study aimed to compare self-reported with objective measurements of energy intake changes (∆EI) during a 1-year weight-loss intervention with subjects randomized to low-carbohydrate versus low-fat diets.MethodsRepeated body weight measurements were used as inputs to an objective mathematical model to calculate ∆EIModel and to compare with self-reported energy intake changes assessed by repeated 24-hour recalls (∆EIRecall ).Results∆EIRecall indicated a relatively persistent state of calorie restriction of ~500 to 600 kcal/d at 3, 6, and 12 months with no significant differences between the diets. ∆EIModel demonstrated large early decreases in calorie intake > 800 kcal/d followed by an exponential return to ~100 kcal/d below baseline at the end of the year. Accounting for self-reported physical activities did not materially affect the results. Discrepancies between ∆EIModel and ∆EIRecall became progressively greater over time. The low-carbohydrate diet resulted in ∆EIModel that was 162 ± 53 kcal/d lower than the low-fat diet over the first 3 months (P = 0.002), but no significant diet differences were found thereafter.ConclusionsSelf-reported ∆EI measurements were inaccurate. Model-based calculations of ∆EI found that instructions to follow the low-carbohydrate diet resulted in greater calorie restriction than the low-fat diet in the early phases of the intervention, but these diet differences were not sustained.
| S-EPMC6392435 | biostudies-literature
Project description:The search for experimental models mimicking an early stage of Parkinson's disease (PD) before motor manifestations is fundamental in order to explore early signs and get a better prognosis. Interestingly, our previous studies have indicated that 6-hydroxydopamine (6-OHDA) is a suitable model to induce an early degeneration of the nigrostriatal system without any gross motor impairment. Considering our previous findings, we aim to implement a novel system to monitor rats after intrastriatal injection of 6-OHDA to detect and analyze physiological changes underlying prodromal PD. Twenty male Sprague-Dawley rats were unilaterally injected with 6-OHDA (n = 10) or saline solution (n = 10) into the right striatum and placed in enriched environment cages where the activity was monitored. After 2 weeks, the amphetamine test was performed before the sacrifice. Immunohistochemistry was developed for the morphological evaluation and western blot analysis to assess molecular changes. Home-cage monitoring revealed behavioral changes in response to 6-OHDA administration including significant hyperactivity and hypoactivity during the light and dark phase, respectively, turning out in a change of the circadian timing. A preclinical stage of PD was functionally confirmed with the amphetamine test. Moreover, the loss of tyrosine hydroxylase expression was significantly correlated with the motor results, and 6-OHDA induced early proapoptotic events. Our findings provide evidence for a novel prodromal 6-OHDA model following a customized monitoring system that could give insights to detect non-motor deficits and molecular targets to test neuroprotective/neurorestorative agents.
| S-EPMC7591774 | biostudies-literature