Function In Parkinson's Disease Research Articles

Dietary Caffeine and Brain Dopaminergic Function in Parkinson Disease.

This study was undertaken to investigate the effects of dietary caffeine intake on striatal dopamine function and clinical symptoms in Parkinson disease in a cross-sectional and longitudinal setting. One hundred sixty-three early Parkinson disease patients and 40 healthy controls were investigated with [123I]FP-CIT single photon emission computed tomography, and striatal dopamine transporter binding was evaluated in association with the level of daily coffee consumption and clinical measures. After a median interval of 6.1 years, 44 patients with various caffeine consumption levels underwent clinical and imaging reexamination including blood caffeine metabolite profiling. Unmedicated early Parkinson disease patients with high coffee consumption had 8.3 to 15.4% lower dopamine transporter binding in all studied striatal regions than low consumers, after accounting for age, sex, and motor symptom severity. Higher caffeine consumption was further associated with a progressive decline in striatal binding over time. No significant effects of caffeine on motor function were observed. Blood analyses demonstrated a positive correlation between caffeine metabolites after recent caffeine intake and dopamine transporter binding in the ipsilateral putamen. Chronic caffeine intake prompts compensatory and cumulative dopamine transporter downregulation, consistent with caffeine's reported risk reduction in Parkinson disease. However, this decline does not manifest in symptom changes. Transiently increased dopamine transporter binding after recent caffeine intake has implications for dopaminergic imaging guidelines. ANN NEUROL 2024;96:262-275.

The Relationship Between Psychosis and Cognitive Function in Parkinson Disease (P4-3.015)

The Relationship Between Psychosis and Cognitive Function in Parkinson Disease (P4-3.015)

Sex differences in the association between Body Mass Index and cognitive function in Parkinson disease: a cross-sectional study.

This study utilized a binary logistic regression model to explore the relationship between Body Mass Index (BMI) and cognitive function in Parkinson's disease (PD) patients. In this cross-sectional study, data were obtained from 1,005 Parkinson's patients enrolled in the Parkinson's Progression Markers Initiative (PPMI) from 2010 to 2023, including 378 females and 627 males. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale, and the correlation between BMI and cognitive function was determined using binary logistic regression. The median age of enrollment was 63.6 (56.2, 69.6) years old, including 378 (37.6%) females and 627 (62.4%) males. In the final adjusted model, a significant positive correlation was found between BMI and the prevalence of cognitive impairment in females (OR = 1.06, 95% CI = 1.01 ~ 1.12, p = 0.022), while no correlation was found in males (OR = 1.03, 95% CI = 0.99 ~ 1.08, p = 0.165). The results after categorizing BMI indicate that, among females, the risk of cognitive impairment increases for both groups with BMI ≥ 30 kg/m2 and those with 25 ≤ BMI < 30 kg/m2 compared to the reference group with BMI < 25 kg/m2, with a p for trend <0.001 indicating a stable and strong association between BMI and cognitive impairment in females. In males, the results were not significant. The trend of linear fitting was consistent with the above results. In female Parkinson's patients, there is a positive correlation between BMI and cognitive impairment, while no correlation was found in male patients. This study provides new evidence of sex differences in the correlation between BMI and cognitive impairment among Parkinson's patients. The role of sex differences in the relationship between BMI and cognitive impairment should be considered in future research.

Improvement effect of acupuncture on locomotor function in Parkinson disease via regulating gut microbiota and inhibiting inflammatory factor release

Improvement effect of acupuncture on locomotor function in Parkinson disease via regulating gut microbiota and inhibiting inflammatory factor release

The heartbeat evoked potential as a novel marker of autonomic function in Parkinson disease. (2314)

The heartbeat evoked potential as a novel marker of autonomic function in Parkinson disease. (2314)

Personalized rehabilitation assessment of locomotor functions in Parkinson disease using three-dimensional video analysis of motions

Parkinson disease (PD) is one of the most common neurodegenerative diseases. Its main clinical manifestation is movement disorders. The study of innovative objective methods for the diagnosis and rehabilitation of movement disorders in PD is relevant and in demand taking into account the slowly progressive course of the disease and the complex set of symptoms that subsequently forms a characteristic movement pattern. This article provides an example of a personalized rehabilitation assessment of biomechanical manifestations of the gait function of a patient with exacted diagnosis, stage 3.5 PD according to Hoehn and Yahr, by means of the method of three-dimensional motion video analysis using the Vicon Motion Capture Systems soft-hardware complex. The patient has postural and gait disorders. This method was applied after a rehabilitation course based on the activation of lifting the foot from the support surface (“back push”). Changes in the tempo and rhythm parameters of gait in a patient with PD in comparison to a healthy person were revealed: acceleration of walking pace with shortening of the length of single and double step, a decrease in the time of limb advancement, acceleration of the moment of heel rise and a decrease in walking pace. Analysis of the locomotion also revealed a decrease in the amplitude of flexion-extension in the coxofemoral joint, knee joint and tibio-tarsic on the side with more pronounced Parkinsonism. Insufficient knee flexion and hip extension, excessive dorsal flexion of the foot with insufficient plantar flexion were noted. Revealing the last features of locomotion in a particular case allows one to make a plan for a targeted personalized rehabilitation program for a given patient. Thus, the method of three-dimensional video analysis is a valuable diagnostic tool that makes it possible to objectively assess the existing violations of locomotion and identify the targets of rehabilitation.

Performance on Daily Life Activities and Executive Functioning in Parkinson Disease

Purpose: This study aimed to know the impact of executive functions on the performance of instrumental activities of daily living in Parkinson disease (PD). Methods: A cross-sectional descriptive study was conducted with 94 participants (64 PD and 30 controls). Results: The poor inhibitory control and verbal fluency in PD could be related to their performance on instrumental activities of daily living as poorer executive performance directly influences the motor and process skills needed to perform instrumental activities of daily living. Conclusion: Our results suggest that rehabilitation activities for these executive tasks could be of interest for the performance of PD patients.

Chest PNF on Pulmonary Function in Parkinson Disease

Chest PNF on Pulmonary Function in Parkinson Disease

Parkin Function in Parkinson Disease

In 1886, architect Louis Sullivan wrote “Whether it be the sweeping eagle in his flight, or the open apple-blossom, the toiling work-horse, the blithe swan, the branching oak, the winding stream at its base, the drifting clouds, over all the coursing sun, form ever follows function and this is the law. Where function does not change, form does not change.” (1) Nature at molecular, cellular, and systems levels is perhaps one of the most efficient examples of “form ever follows function.” However, when natural form is beset by aberrantly coded DNA, as in the case of pathologic gene mutations, the principle is turned on its head to “dysfunction ever follows form.” As reviewed by …

Effects of Subthalamic Stimulation on Olfactory Function in Parkinson Disease

Olfactory dysfunction is a nonmotor symptom of Parkinson disease (PD) associated with reduction in quality of life. There is no evidence on whether improvements in olfaction after subthalamic deep brain stimulation (STN-DBS) may be directly attributable to motor improvement or whether this reflects a direct effect of DBS on olfactory brain areas. The aim of the present study was to evaluate the effect of DBS on olfactory function in PD, as well as to explore the correlation between these changes and changes in motor symptoms and brain metabolism. Thirty-two patients with PD were screened for STN-DBS. Patients were evaluated before and 1 year after surgery. Primary outcome was the change in olfactory function (Sniffin' Sticks odor-identification test [SST]) after surgery among the patients with hyposmia at baseline. Secondary outcomes included the relationship between motor outcomes and olfactory changes and [18F]fluorodeoxyglucose-positron emission tomography analysis between subgroups with improvement versus no improvement of smell. STN-DBS improved SST after surgery (preoperative SST, median 7.3 ± 2.4 vs. postoperative SST, median 8.2 ± 2.1; P= 0.045) in a subset of patients among 29 of 32 patients who presented with hyposmia at baseline. The improvement in SST was correlated with DBS response (r= 0.424; P= 0.035). There was also an increase in glucose metabolism in the midbrain, cerebellum, and right frontal lobe in patients with SST improvement (P < 0.001). STN-DBS improves odor identification in a subset of patients with PD. Motor improvement together with changes in the brain metabolism may be linked to this improvement.

Striatal dopamine in Parkinson disease: A meta-analysis of imaging studies.

A meta-analysis of 142 positron emission tomography and single photon emission computed tomography studies that have investigated striatal presynaptic dopamine function in Parkinson disease (PD) was performed. Subregional estimates of striatal dopamine metabolism are presented. The aromatic L-amino-acid decarboxylase (AADC) defect appears to be consistently smaller than the dopamine transporter and vesicular monoamine transporter 2 defects, suggesting upregulation of AADC function in PD. The correlation between disease severity and dopamine loss appears linear, but the majority of longitudinal studies point to a negative exponential progression pattern of dopamine loss in PD. Ann Neurol 2017;82:873-882.

Cerebellar Volume and Executive Function in Parkinson Disease with and without Freezing of Gait.

Freezing of gait (FOG) affects approximately 50% of people with Parkinson Disease (PD), impacting quality of life and placing financial and emotional strain on the individual and caregivers. People with PD and FOG have similar deficits in motor adaptation and cognition as individuals with cerebellar lesions, indicating the cerebellum may play a role in FOG. To examine potential differences in cerebellar volumes and their relationships with cognition between PD with (FOG+) and without FOG (FOG-). Sixty-three participants were divided into two groups, FOG+ (n = 25) and FOG- (n = 38), based on the New Freezing of Gait Questionnaire. Cognitive assessment included Trail Making, Stroop, Verbal Fluency, and Go-NoGo executive function tasks. All participants completed structural T1- and T2-weighted MRI scans. Imaging data were processed with FreeSurfer and the Spatially Unbiased Infratentorial toolbox to segment the cerebellum into individual lobules. FOG+ performed significantly worse on phonemic verbal fluency (F(1, 22) = 7.06, p = 0.01) as well as the Go-NoGo task (F(1, 22) = 9.00, p = 0.004). We found no differences in cerebellar volumes between groups (F(4, 55) = 1.42, p = 0.24), but there were significant relationships between verbal fluency measures and lobule volumes in FOG-. These findings underscore the need for longitudinal studies to better characterize potential changes in cerebellar volume, cognitive function, and functional connectivity between people with PD with and without FOG.

The Effect of Core Muscle Training on Cardiopulmonary Function in Parkinson disease

Core Muscle mainly including the rectus abdominis, the oblique muscle, the lower back muscle and shaft sma, which located around the abdomen. It is an important muscle group responsible for protecting the stability of the spine. At present, core muscle group training is mainly aimed at Athletes, Stroke, Lumbar disc herniation and Parkinson’s Disease. However, quite few people did the research about the effects of exercise training on cardiopulmonary function in Parkinson’s patients. Therefore, this review summarized the effects of Core Muscle Training on cardiopulmonary function from its evaluating the parameters.

Increased Motor Activity During REM Sleep Is Linked with Dopamine Function in Idiopathic REM Sleep Behavior Disorder and Parkinson Disease.

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by impaired motor inhibition during REM sleep, and dream-enacting behavior. RBD is especially associated with α-synucleinopathies, such as Parkinson disease (PD). Follow-up studies have shown that patients with idiopathic RBD (iRBD) have an increased risk of developing an α-synucleinopathy in later life. Although abundant studies have shown that degeneration of the nigrostriatal dopaminergic system is associated with daytime motor function in Parkinson disease, only few studies have investigated the relation between this system and electromyographic (EMG) activity during sleep. The objective of this study was to investigate the relationship between the nigrostriatal dopamine system and muscle activity during sleep in iRBD and PD. 10 iRBD patients, 10 PD patients with PD, 10 PD patients without RBD, and 10 healthy controls were included and assessed with (123)I-N-omega-fluoropropyl-2-beta-carboxymethoxy-3beta-(4-iodophenyl) nortropane ((123)I-FP-CIT) Single-photon emission computed tomography (SPECT) scanning ((123)I-FP-CIT SPECT), neurological examination, and polysomnography. iRBD patients and PD patients with RBD had increased EMG-activity compared to healthy controls. (123)I-FP-CIT uptake in the putamen-region was highest in controls, followed by iRBD patients, and lowest in PD patients. In iRBD patients, EMG-activity in the mentalis muscle was correlated to (123)I-FP-CIT uptake in the putamen. In PD patients, EMG-activity was correlated to anti-Parkinson medication. Our results support the hypothesis that increased EMG-activity during REM sleep is at least partly linked to the nigrostriatal dopamine system in iRBD, and with dopamine function in PD.

Trajectories of Prediagnostic Motor and Non-Motor Functioning in Parkinson Disease (S5.005)

Trajectories of Prediagnostic Motor and Non-Motor Functioning in Parkinson Disease (S5.005)

Trajectories of Prediagnostic Motor and Non-Motor Functioning in Parkinson Disease (I1.004)

Trajectories of Prediagnostic Motor and Non-Motor Functioning in Parkinson Disease (I1.004)

Non-exercise physical activity attenuates motor symptoms in Parkinson disease independent from nigrostriatal degeneration.

To investigate the relationship between time spent in non-exercise and exercise physical activity and severity of motor functions in Parkinson disease (PD). Increasing motor impairments of PD incline many patients to a sedentary lifestyle. We investigated the relationship between duration of both non-exercise and exercise physical activity over a 4-week period using the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire and severity of clinical motor symptoms in PD. We accounted for the magnitude of nigrostriatal degeneration. Cross-sectional study. PD subjects, n = 48 (40 M); 69.4 ± 7.4 (56-84) years old; 8.4 ± 4.2 (2.5-20) years motor disease duration, mean UPDRS motor score 27.5 ± 10.3 (7-53) and mean MMSE score 28.4 ± 1.9 (22-30) underwent [(11)C]dihydrotetrabenazine (DTBZ) PET imaging to assess nigrostriatal denervation and completed the CHAMPS questionnaire and clinical assessment. Bivariate correlations showed an inverse relationship between motor UPDRS severity scores and duration of non-exercise physical activity (R = -0.37, P = 0.0099) but not with duration of exercise physical activity (R = -0.05, P = 0.76) over 4 weeks. Multiple regression analysis using UPDRS motor score as outcome variable demonstrated a significant regressor effect for duration of non-exercise physical activity (F = 6.15, P = 0.017) while accounting for effects of nigrostriatal degeneration (F = 4.93, P = 0.032), levodopa-equivalent dose (LED; F = 1.07, P = 0.31), age (F = 4.37, P = 0.043) and duration of disease (F = 1.46, P = 0.23; total model (F = 5.76, P = 0.0004). Non-exercise physical activity is a correlate of motor symptom severity in PD independent of the magnitude of nigrostriatal degeneration. Non-exercise physical activity may have positive effects on functional performance in PD.

New ways to assess brain function in Parkinson disease.

Over the past 40 years, our understanding of the brain and its function has dramatically changed. Much of this has been due to new ways of looking at the living brain. It was in the 1970s that computed tomography scans (CT or CAT scans) were first used. By the 1980s CAT scans were commonplace. Magnetic resonance imaging (MRI) was developed in the 1980s. It became widely available thereafter and is now a standard way of looking at the brain and other parts of the nervous system. CAT and MRI have allowed scientists to study the structure of the living brain in detail. In addition, doctors and scientists have been able to study neurologic disease in ways that previously were not possible.

Structural Changes on the Brain MRI and Cognitive Function in Parkinson Disease

Purpose: Cognitive impairment in Parkinson disease (PD) related with the fronto-striatal dysfunction as one cause of subcortical dementia. However, cognitive impairment in PD might be associated with medial temporal lobe atrophy in recent studies. We carried out this study to know whether structural changes on brain MRI are responsible for cognitive dysfunction in PD. Materials and Methods: We recruited 183 patients who were newly diagnosed with PD from January, 2007 to February, 2012. All patients were undertaken brain MRI and neuropsychological assessment. Structural changes of the brain images were evaluated with visual rating scales. We analyzed clinical and neuro-imaging data to assess a relation between cognitive function and brain structural changes in the total patients and did subanalysis with PD-cognitively declined (PD-CD) and PD-cognitively preserved (PD-CP) subgroup. Results: Total scores of the MMSE and 3MS was worsened as havingsevere white matter change (WMC), ventricular enlargement (VE), medial temporal lobe atrophy (MTA), and cortical atrophy in PD patients. PD-CD showed more severe WMC, VE and MTA than those in PD-CP patients even after adjustment of age and durations of education. Degree of the MTA among the brain structural changes was the most relevant factor for cognitive dysfunction in PD patients. Conclusions: Although cognitive dysfunction in PD is suggestive of subcortical origin, medial temporal structure also may have an important role for cognition in PD. Therefore, clinicians need thorough evaluation of the structural changes in the brain MRI as well as neuropsychological assessment to define cognitive function in PD. Keywords: Parkinson disease, dementia, cognitive function, brain magnetic resonance imaging, atrophy. Read more →

Aerobic Exercise to Improve Executive Function in Parkinson Disease

Parkinson disease (PD) affects cognition, specifically executive function. In people with PD, impaired executive function has been identified as an indicator of fall risk and decreased quality of life. Therefore, it is important to consider impaired executive function in the physical therapy management of PD. It has been established that exercise improves cognition in older adults and emerging evidence suggests a similar effect in people with neurological conditions. We assessed changes in executive function in an aerobic exercise intervention in 2 people with cognitive impairments due to PD. Two individuals with PD participated in this case series. Participant 1 was a 61-year-old woman with PD dementia, who had PD for 14 years. Participant 2 was a 72-year-old man with mild cognitive impairments, who had PD for 7 years. The participants completed an 8-week program of aerobic exercise training on a stationary bicycle. Primary outcome measures examined executive function, and secondary measures examined disease severity, quality of life, and walking function. Both participants demonstrated improvements in all measures of executive function and quality of life. Participant 1 also made improvements in walking function. Our outcomes provide preliminary evidence of improved executive function following aerobic exercise in people with PD with cognitive impairments. Larger studies are needed to confirm these findings and investigate whether a causal relationship exists between exercise and improved executive function in persons with PD, and how these impact motor performance and quality of life measures.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A43) for more insights from the authors.