non-PD Participants Research Articles

The association between brominated flame retardants exposure with Parkinson's disease in US adults: a cross-sectional study of the National Health and Nutrition Examination Survey 2009-2016.

Increasing evidence suggests that environmental factors play a crucial role in the pathogenesis of Parkinson's disease (PD). Humans are simultaneously exposed to multiple brominated flame retardants (BFRs) in the environment. However, the relationship between BFRs and PD remains unclear. This study was designed to investigate the overall association between BFRs and PD in a nationally representative US population and to further identify significant chemicals. This study used data from 7,161 NHANES participants from 2009 through 2016. The serum BFRs registry included PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-100, PBDE-153, PBDE-154, PBDE-183, PBDE-209, and PBB-153. A survey-weighted generalized logistic regression model with restricted cubic splines (RCS) was used to evaluate the association between single BFRs exposure and periodontitis. Meanwhile, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to evaluate the overall association of mixed frankincense powder with periodontitis and to identify significant chemicals. Sensitivity analysis was performed to evaluate the robustness of the results. Among the 7,161 participants, 65 had PD. PD patients were older (mean age 57.79 vs. 46.57 years) and had a higher proportion of females (70.86%) compared to non-PD participants. Serum levels of PBB-153 were significantly higher in those with PD. Logistic regression analyses revealed a non-linear, inverted U-shaped relationship between serum PBB-153 and PD risk. The risk of PD increased with higher PBB-153 levels up to the 3rd quartile (Q3), beyond which the risk declined (Q3 vs. Q1: OR = 4.98, 95% CI = 1.79-13.86; Q4 vs. Q1: OR = 3.23, 95% CI = 1.03-10.08). PBB-153 (43.40%), PBDE-153 (24.75%), and PBDE-85 (19.51%) contributed most to the weighted quantile sum index associated with PD risk. Bayesian kernel machine regression confirmed the inverted U-shaped dose-response pattern for PBB-153 and the overall BFR mixture. Restricted cubic spline analyses corroborated the non-linear relationship between PBB-153 and PD, which was more pronounced among women and those aged 37-58 years. Sensitivity analyses substantiated these findings. This nationally representative cross-sectional study revealed a novel non-linear, inverted U-shaped relationship between serum levels of the brominated flame retardant PBB-153 and Parkinson's disease risk in U.S. adults. The risk increased with higher PBB-153 exposure up to a point, beyond which it declined. This complex dose-response pattern highlights the importance of considering potential hormetic mechanisms and effect modifiers when evaluating environmental exposures and neurodegenerative diseases. Further research is warranted to elucidate the underlying biological pathways and inform risk mitigation strategies.

Model Touch Pointing and Detect Parkinson's Disease via a Mobile Game

Touch pointing is one of the primary interaction actions on mobile devices. In this research, we aim to (1) model touch pointing for people with Parkinson's Disease (PD), and (2) detect PD via touch pointing. We created a mobile game called MoleBuster in which a user performs a sequence of pointing actions. Our study with 40 participants shows that PD participants exhibited distinct pointing behavior. PD participants were much slower and had greater variances in movement time (MT), while their error rate was slightly lower than age-matched non-PD participants, indicating PD participants traded speed for accuracy. The nominal width Finger-Fitts law showed greater fitness than Fitts' law, suggesting this model should be adopted in lieu of Fitts' law to guide mobile interface design for PD users. We also proposed a CNN-Transformer-based neural network model to detect PD. Taking touch pointing data and comfort rating of finger movement as input, this model achieved an AUC of 0.97 and sensitivity of 0.95 in leave-one-user-out cross-validation. Overall, our research contributes models that reveal the temporal and spatial characteristics of touch pointing for PD users, and provide a new method (CNN-Transformer model) and a mobile game (MoleBuster) for convenient PD detection.

Untargeted serum metabolic profiling of diabetes mellitus among Parkinson’s disease patients

Type 2 diabetes mellitus (T2DM) is a common comorbidity among Parkinson’s disease (PD) patients. Yet, little is known about dysregulated pathways that are unique in PD patients with T2DM. We applied high-resolution metabolomic profiling in serum samples of 636 PD and 253 non-PD participants recruited from Central California. We conducted an initial discovery metabolome-wide association and pathway enrichment analysis. After adjusting for multiple testing, in positive (or negative) ion mode, 30 (25) metabolic features were associated with T2DM in both PD and non-PD participants, 162 (108) only in PD participants, and 32 (7) only in non-PD participants. Pathway enrichment analysis identified 17 enriched pathways associated with T2DM in both the PD and non-PD participants, 26 pathways only in PD participants, and 5 pathways only in non-PD participants. Several amino acid, nucleic acids, and fatty acid metabolisms were associated with T2DM only in the PD patient group suggesting a possible link between PD and T2DM.

Social deprivation and exclusion in Parkinson’s disease: a cross-sectional and longitudinal study

ObjectiveTo describe prevalence and associated factors of social deprivation in people with Parkinson’s disease (PwPD).DesignCross-sectional and longitudinal cohort study.SettingData were taken from the Survey of Health, Ageing and Retirement in...

Semantic fluency deficits and associated brain activity in Parkinson’s disease with mild cognitive impairment

People living with Parkinson’s disease (PD) with poor verbal fluency have an increased risk of developing dementia. This study examines the neural mechanisms underpinning semantic fluency deficits in patients with PD with mild cognitive impairment (PD-MCI) compared to those without MCI (PD-NC) and control participants without PD (non-PD). Thirty-seven (37) participants with PD completed a cognitive assessment battery to identify MCI (13 PD-MCI). Twenty sex- and age-matched non-PD patients also participated. Participants were scanned (3T Siemens PRISMA) while performing semantic fluency, semantic switching, and automatic speech tasks. The number of responses and fMRI data for semantic generation and semantic switching were analyzed. Participants also completed a series of verbal fluency tests outside the scanner, including letter fluency. Participants with PD-MCI performed significantly worse than PD-NC and non-PD participants during semantic fluency and semantic switching tasks. PD-MCI patients showed greater activity in the right angular gyrus than PD-NC and non-PD patients during semantic switching. Increased right angular activity correlated with worse verbal fluency performance outside the scanner. Our study showed that the PD-MCI group performed worse on semantic fluency than either the PD-NC or non-PD groups. Increased right angular gyrus activity in participants with PD-MCI during semantic switching suggests early compensatory mechanisms, predicting the risk of future dementia in PD.

Retinal Diseases and Parkinson Disease: A Population-Based Study.

IntroductionPatients with Parkinson disease (PD) tend to have ophthalmic symptoms. Retinal diseases are associated with central nervous system diseases, especially neurodegenerative diseases. Here, we investigated the association of retinal diseases with PD, especially the temporal relationship before and after PD diagnosis.MethodsData were obtained from the National Health Insurance Research Database of Taiwan. In total, 21,845 patients with newly diagnosed PD were matched with four controls each on the basis of propensity score. This study was bidirectional. A case–control study evaluated the adjusted odds ratio (aOR) of retinal disease before PD diagnosis by using conditional logistic regression. Furthermore, a cohort study evaluated the adjusted subdistribution hazard ratio (aSHR) for new-onset retinal and optic nerve diseases after PD diagnosis by using competing risk analysis. The association between PD with optic nerve diseases and glaucoma (another common ophthalmic diseases with the consequence of retinal dysfunction) were also analyzed as reference.ResultsIn the case–control study, PD was found to be significantly comorbid with recent and remote retinal disease [recent: ≤ 5 years, aOR: 1.12, 95% confidence interval (CI): 1.03–1.23; remote: > 5 years, aOR: 1.18, 95% CI: 1.04–1.34]. No similar association was identified between optic nerve disease or glaucoma with PD. In the cohort study, patients with PD were found to have a low risk of retinal disease in short-term (≤ 5 years, aSHR: 0.81, 95% CI: 0.71–0.93) and long-term (> 5 years, aSHR: 0.82, 95% CI: 0.72–0.93) follow-up.ConclusionThe study findings demonstrated that patients with prediagnostic PD were at greater risk of retinal disease than non-PD participants, but the risk reversed afterward. Thus, retinal disease may be a premotor manifestation of PD, and there may be some possible effect of dopamine supplements on retina.

Differences in the Presentation and Progression of Parkinson's Disease by Sex.

Previous studies reported various symptoms of Parkinson's disease (PD) associated with sex. Some were conflicting or confirmed in only one study. We examined sex associations to PD phenotypes cross-sectionally and longitudinally in large-scale data. We tested 40 clinical phenotypes, using longitudinal, clinic-based patient cohorts, consisting of 5946 patients, with a median follow-up of 3.1 years. For continuous outcomes, we used linear regressions at baseline to test sex-associated differences in presentation, and linear mixed-effects models to test sex-associated differences in progression. For binomial outcomes, we used logistic regression models at baseline and Cox regression models for survival analyses. We adjusted for age, disease duration, and medication use. In the secondary analyses, data from 17 719 PD patients and 7588 non-PD participants from an online-only, self-assessment PD cohort were cross-sectionally evaluated to determine whether the sex-associated differences identified in the primary analyses were consistent and unique to PD. Female PD patients had a higher risk of developing dyskinesia early during the follow-up period, with a slower progression in activities of daily living difficulties, and a lower risk of developing cognitive impairments compared with male patients. The findings in the longitudinal, clinic-based cohorts were mostly consistent with the results of the online-only cohort. We observed sex-associated contributions to PD heterogeneity. These results highlight the necessity of future research to determine the underlying mechanisms and importance of personalized clinical management. © 2020 International Parkinson and Movement Disorder Society.

Cognitive Performance in Parkinson's Disease in the Brain Health Registry.

The study of cognition in Parkinson's disease (PD) traditionally requires exhaustive recruitment strategies. The current study examines data collected by the Brain Health Registry (BHR) to determine whether ongoing efforts to improve the recruitment base for therapeutic trials in Alzheimer's disease may be similarly effective for PD research, and whether online cognitive measurements can discriminate between participants who do and do not report a PD diagnosis. Participants enrolled in the BHR (age ≥50) with self-reported PD data and online cognitive testing available were included (n = 11,813). Associations between baseline cognitive variables and diagnostic group were analyzed using logistic regression. Linear mixed effects models were used to analyze longitudinal data. A total of 634 participants reported PD diagnosis at baseline with no self-reported cognitive impairment and completed cognitive testing. Measures of visual learning and memory, processing speed, attention, and working memory discriminated between self-reported PD and non-PD participants after correcting for multiple comparisons (p values < 0.006). Scores on all cognitive tests improved over time in PD and controls with the exception of processing speed, which remained stable in participants with PD while improving in those without. We demonstrate that a novel online approach to recruitment and longitudinal follow-up of study participants is effective for those with self-reported PD, and that significant differences exist between those with and without a reported diagnosis of PD on computerized cognitive measures. These results have important implications for recruitment of participants with PD into targeted therapeutic trials or large-scale genetic and cognitive studies.

Time Perception of an Artwork's Manipulation Is Distorted by Patients With Parkinson's Disease.

Objectives: In artwork appreciation situations, individuals often show altered time perception. We tested the hypothesis that Parkinson’s disease (PD) patients present movement patterns that have an impact on the time perception of artwork manipulation time. We predicted that, compared to healthy controls (non-PD), differences in the exploratory behavior of patients would evoke alteration of artwork manipulation time perception.Methods: Ten PD patients and 10 non-PD participants manipulated two reproductions of artwork with different complexity levels from the series “Bichos” by Lygia Clark. Subsequently, participants performed a verbal estimation regarding the temporal duration of their manipulations. The exploratory behavior was analyzed.Results: All participants overestimated the artwork manipulation time. However, PD patients, regardless of the artwork’s level of complexity, showed shorter manipulation time and minor time overestimation compared to the non-PD participants. PD patients touched the artworks more often, especially the more complex artworks, than the non-PD participants; in contrast, PD patients moved the artworks less often, particularly the less complex artwork.Conclusion: PD patients showed an altered perception of artwork manipulation time. This suggests that exploratory behavior influenced temporal estimation. Besides, it is likely that PD patients had presented a decreased ability to manage attention during the task, which interfered in the cognitive reconstruction of its duration. Considered altogether, these appointments indicate that, as a result of cognitive and motor deficits, PD patients showed impairment in temporal information processing. The exploratory behavior facilitated the understanding of these results and processes in terms of motor-timing operations of the basal ganglia-thalamocortical system.

Occurrence of spleen qi deficiency as defined by Chinese medicine in Parkinson disease

ObjectiveTo investigate the frequency of deficiency of spleen qi (DSQ) in persons with Parkinson disease (PD) as well as the correlation between DSQ and PD. MethodsThis study comprised three parts: determining the frequency of DSQ in participants with PD; comparing the frequency of DSQ in PD and non-PD participants; and monitoring DSQ in participants with PD for 24 weeks. Outcome measurements were a modified DSQ scale and the Chinese version of the Parkinson Disease Questionnaire 39 (C-PDQ39). ResultsA total of 187 participants with PD (mean ages 69.9 ± 9.6 years) completed the assessment in Part 1. Of these, 170 (90.9%) were diagnosed as having DSQ. Thirty non-PD participants (mean ages 66.6 ± 10.2 years) completed the assessment in Part 2. Of these 11 (36.7%) were diagnosed as having DSQ. Positive correlations between total DSQ score and Hoehn-and-Yahr (H&Y) stage (correlation 0.316; P < .001), as well as between DSQ and total C-PDQ39 score (correlation 0.572; P < .001), were observed. For Part 3, 47 participants from Part 1 were observed for 24 weeks. Variation in DSQ symptoms was noted, but all participants developed DSQ by the end of the study. ConclusionsDSQ is 2.5 times higher in PD participants than in the non-PD participants. More PD participants had DSQ in the advanced H&Y stages. A larger study is needed to validate these results on the prevalence of DSQ in persons with PD.

Effects of aging and idiopathic Parkinson's disease on tactile temporal order judgment.

It is generally accepted that the basal ganglia play an important role in interval timing that requires the measurement of temporal durations. By contrast, it remains controversial whether the basal ganglia play an essential role in temporal order judgment (TOJ) of successive stimuli, a behavior that does not necessarily require the measurement of durations in time. To address this issue, we compared the effects of idiopathic Parkinson’s disease (PD) on the TOJ of two successive taps delivered to each hand, with the arms uncrossed in one condition and crossed in another. In addition to age-matched elderly participants without PD (non-PD), we examined young healthy participants so that the effect of aging could serve as a control for evaluating the effects of PD. There was no significant difference between PD and non-PD participants in any parameter of TOJ under either arm posture, although reaction time was significantly longer in PD compared with non-PD participants. By contrast, the effect of aging was apparent in both conditions. With their arms uncrossed, the temporal resolution (the interstimulus interval that yielded 84% correct responses) in elderly participants was significantly worse compared with young participants. With their arms crossed, elderly participants made more errors at longer intervals (~1 s) than young participants, although both age groups showed similar judgment reversal at moderately short intervals (~200 ms). These results indicate that the basal ganglia and dopaminergic systems do not play essential roles in tactile TOJ involving both hands and that the effect of aging on TOJ is mostly independent of the dopaminergic systems.

An Experimental Examination of the Interaction between Mood Induction Task and Personality Psychopathology on State Emotion Dysregulation.

While emotion dysregulation has been investigated as a key variable in the development and persistence of personality psychopathology, few studies have explored state emotion dysregulation among individuals with personality disorders (PDs). The current study addresses this void in the literature through a laboratory investigation of state emotion dysregulation among participants with and without PDs. To facilitate this goal, participants were matched to pairs based on similar personality features and were randomized to one of two behavioral analogues; either the Paced Auditory Serial Addition Task-Computerized (PASAT-C) or an interpersonally based mood induction. As hypothesized, PD participants in the PASAT-C reported significantly more difficulty with impulsivity and emotion regulation strategies. Contrary to expectations, the PD group in the interpersonal task demonstrated significantly less difficulty with non-acceptance of emotion and emotional clarity and significantly greater positive affect compared to non-PD participants. Implications for these findings and directions for future research are discussed.

Sonography for diagnosis of Parkinson disease-from theory to practice: a study on 300 participants.

Hyperechogenicity of the substantia nigra on transcranial sonography is used for diagnosing Parkinson disease (PD). Cutoff values for the substantia nigra echogenic area, defining substantia nigra hyperechogenicity, vary among ultrasound systems from different manufacturers. In this study we wanted to determine the cutoff criterion for a Toshiba (Tokyo, Japan) system and to assess its diagnostic value. Three hundred participants (controls, n = 138; patients with PD, n = 105; and patients with essential tremor, n = 57) underwent transcranial sonography following a standardized protocol. The substantia nigra was assessable in 92.7% of all participants. The substantia nigra echogenic area (larger of bilateral measurements) was larger in patients with PD (mean ± SD, 0.24 ± 0.05 cm(2)) than controls (0.14 ± 0.05 cm(2); P < .001) and patients with essential tremor (0.14 ± 0.04 cm(2); P < .001). Substantia nigra echogenicity was larger in male participants (0.20 ± 0.07 cm(2)) than female participants (0.15 ± 0.06 cm(2); P< .001). Age did not correlate with substantia nigra echogenicity in any group. Frontal horn width was larger and lenticular nucleus hyperechogenicity and a discontinuous raphe were more frequent in the PD group than the other groups. On multivariate analysis, only substantia nigra hyperechogenicity was associated with the diagnosis of PD. The 90th-percentile substantia nigra echogenic area in the control group, which defined marked substantia nigra hyperechogenicity, also represented the optimum cutoff value for discrimination of PD from non-PD participants on receiver operating characteristic curve analysis (area under the curve, 0.913; Youden index, 0.73). This cutoff value (≥0.21 cm(2), larger of bilateral measurements) yielded sensitivity of 83% and specificity of 90% for the diagnosis of PD. Transcranial sonography shows good diagnostic validity for diagnosis of PD when implemented according to a strictly standardized protocol.

Pragmatic language production deficits in Parkinson’s disease

This study examines pragmatic language production deficits in people with Parkinson’s disease (PD). Participants (PD and non-PD) were interviewed and their responses coded for degree of informativeness. PD participants weremore under-informative than non-PD participants. Response underinformativeness was associated with decreased executive control, mental status, and speech act comprehension measures. However, both speech act priming and utterance informativeness were strongly related to a measure of executive control, and when this variable (i.e., Stroop performance) was controlled, the correlation between speech act priming and utterance underinformativeness was no longer significant. It appears, then, that executive control deficits are related to the ability to comprehend and produce conversational utterances.

An experimental investigation of emotional reactivity and delayed emotional recovery in borderline personality disorder: the role of shame

Despite the emphasis on emotional reactivity and delayed emotional recovery in prominent theoretical accounts of borderline personality disorder (BPD), research in this area remains limited. This study sought to extend extant research by examining emotional reactivity (and recovery following emotional arousal) to 2 laboratory stressors (one general, and the other involving negative evaluation) and exploring the impact of these stressors on subjective responding across the specific emotions of anxiety, irritability, hostility, and shame. We hypothesized that outpatients with BPD (compared to outpatients without a personality disorder; non-PD) would demonstrate heightened subjective emotional reactivity to both stressors, as well as a delayed return to baseline levels of emotional arousal. Results provide evidence for context- and emotion-specific reactivity in BPD. Specifically, BPD participants (compared to non-PD participants) evidenced heightened reactivity to the negative evaluation but not the general stressor. Furthermore, results provide support for shame-specific reactivity in BPD, with BPD participants (vs non-PD participants) evidencing a significantly different pattern of change in shame (but not in reported anxiety, irritability, or hostility) across the course of the study. Specifically, not only did BPD participants report higher levels of shame in response to the negative evaluation, their levels of shame remained elevated following this stressor (through the post-recovery period at the end of the study). Findings suggest the importance of continuing to examine emotional reactivity in BPD within specific contexts and across distinct emotions, rather than at the general trait level.

Prospective memory in Parkinson disease across laboratory and self-reported everyday performance.

Prospective memory is a complex cognitive construct ubiquitous in everyday life that is thought to sometimes rely on executive skills commonly affected by Parkinson's disease (PD). The present study investigated the effect of PD on prospective memory tasks with varying demand on executive control processes, namely on the amount of strategic attentional monitoring required for intention retrieval. Individuals with PD but without dementia and healthy adults performed laboratory event-based prospective memory tasks that varied in whether strategic attentional monitoring (nonfocal condition) or spontaneous processes (focal condition) were primarily involved in intention retrieval. Participants also completed a questionnaire rating their frequency of prospective memory failures in everyday life for both self-cued and environment-cued tasks. PD participants performed worse than non-PD participants in the nonfocal, but not focal, condition of the laboratory task. They also reported more everyday failures than non-PD participants for self-cued, but not environment-cued, prospective memory tasks. Thus, nondemented individuals with PD are preferentially impaired on prospective memory tasks for which higher levels of executive control are needed to support intention retrieval. This pattern is consistent across laboratory and reported real-world performance.