Introduction:
The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients.
Methods:
PD patients and ...controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson’s disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems.
Results:
The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015–1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009–1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments.
Conclusion:
Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Cognitive symptoms of Parkinson’s disease (PD) have been long underestimated, but are some of the most disabling non-motor features of the disease. In order to establish signs that allow for earlier ...detection of cognitive decline in PD, the concept of `subjective cognitive decline´ (SCD) has gained a growing interest. SCD refers to patients who report a decline in subjective cognitive capacities, while their results on neuropsychological tests are within the normal performance range, indicating adequate cognitive functions. The aim of this review was to evaluate the concept of SCD in PD and give an overview of the current research. A systematic literature search in PubMed was performed to identify articles published before December 2020. We included 18 studies with a total of n = 2,654 patients. While there is currently no consensus on research or clinical criteria for SCD in PD, this review presents the accumulated evidence for SCD in PD patients and supports the importance of early identification of cognitive deficits, due to the relatively high prevalence for SCD in PD and the added risk of future cognitive impairment it entails. The publications included in this review indicate that SCD may be part of the PD spectrum but further research is needed. Expanding research on SCD in PD will allow for earlier detection of cognitive impairment and may foster preventive interventions.
•High prevalence of mild cognitive impairment in the course of Parkinson’s disease.•Subjective cognitive decline marks a growing interest as a preclinical stage.•SCD is a decline in subjective cognitive capacities, while cognitive test results are normal.•SCD is a new concept in persons with Parkinson’s disease.•SCD may allow for earlier detection and may be considered for prevention.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Brain iron homeostasis is increasingly recognized as a potential target for the development of drug therapies for aging‐related disorders. Dysregulation of iron metabolism associated with cellular ...damage and oxidative stress is reported as a common event in several neurodegenerative disorders such as Alzheimer′s, Parkinson′s, and Huntington′s diseases. Indeed, many proteins initially characterized in those diseases such as amyloid‐β protein, α‐synuclein, and huntingtin have been linked to iron neurochemistry. Iron plays a crucial role in maintaining normal physiological functions in the brain through its participation in many cellular functions such as mitochondrial respiration, myelin synthesis, and neurotransmitter synthesis and metabolism. However, excess iron is a potent source of oxidative damage through radical formation and because of the lack of a body‐wide export system, a tight regulation of its uptake, transport and storage is crucial in fulfilling cellular functions while keeping its level below the toxicity threshold. In this review, we discuss the current knowledge on iron homeostasis in the brain and explore how alterations in brain iron metabolism affect neuronal function with emphasis on iron dysregulation in Alzheimer′s and Parkinson′s diseases. Finally, we discuss recent findings implicating iron as a diagnostic and therapeutic target for Alzheimer's and Parkinson's diseases.
Iron plays a fundamental role in maintaining the high metabolic and energetic requirements of the brain. However, iron has to be maintained in a delicate balance as both iron overload and iron deficiency are detrimental to the brain and can trigger neurodegeneration. Here, we discuss the current knowledge on brain iron homeostasis and its involvement in major aging‐related neurodegenerative diseases.
This article is part of a special issue on Parkinson disease.
Iron plays a fundamental role in maintaining the high metabolic and energetic requirements of the brain. However, iron has to be maintained in a delicate balance as both iron overload and iron deficiency are detrimental to the brain and can trigger neurodegeneration. Here, we discuss the current knowledge on brain iron homeostasis and its involvement in major aging‐related neurodegenerative diseases.
This article is part of a special issue on Parkinson disease.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Non-motor symptoms (NMS) are common in Parkinson’s disease (PD), affecting almost all patients during their illness. They may appear in early pre-symptomatic stage as well as throughout the disease ...course. This observational cross sectional study was carried out in the Movement Disorder Clinic, Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka to see the presence of non-motor symptoms in Parkinson’s disease. Seventy-six Parkinson’s Disease patients were recruited during October 2019 to September 2020. Presence of non–motor symptoms (NMSs) was sought by the 30-item Parkinson’s Disease Questionnaire (PDQ-30). All patients (100%) of this study were suffering from one or more non-motor symptoms. Most common non-motor symptoms of Parkinson’s disease were anxiety (78%), fatigue (78%), difficulty in falling or staying sleep (75%), depression (72%), forgetfulness 72%, dizziness (68%), loss of interest in doing activities (66%), flat mood (62%), lack of pleasure (60%), restless leg (59%) & problem in sustaining concentration (50%). Other non-motor symptoms were present in less than 50% patients. Non-motor symptoms are common and often unrecognized in Parkinson`s Disease. Address- ing this issue will help to manage these symptoms and thereby improve quality of life of patients with Parkinson`s Disease.
BSMMU J 2021; 14(4): 121-124
The purpose was to determine the quality of life of Parkinson’s disease patients and their family members and to identify the factors that affect it.
The research sample included 183 patients with ...Parkinson’s disease and 78 family members. Quality of life was assessed using the Czech Quality of Life Questionnaire of Patients with Progressive Neurological Disease.
Patients with a longer duration of the disease had a lower overall quality of life. The connection between higher dependence of patients on daily activities, and higher degree of motor disability was associated with a poorer quality of life in patients. In family members, an association was demonstrated between older age and a lower quality of life in the domain of normal daily activity, social and spiritual area. With older age, the higher burden of symptoms also increased and deteriorated overall quality of life. The connection between higher dependence of patients on daily activities and a worse quality of life of caregivers in the three domain was confirmed.
Regular assessment of the impact of Parkinson’s disease on the quality of life of patients and their family and the identification of factors that affect it can help prioritize the treatment planning phase.
Mutations in Park8, encoding for the multidomain Leucine-rich repeat kinase 2 (LRRK2) protein, comprise the predominant genetic cause of Parkinson's disease (PD). G2019S, the most common amino acid ...substitution activates the kinase two- to threefold. This has motivated the development of LRRK2 kinase inhibitors; however, poor consensus on physiological LRRK2 substrates has hampered clinical development of such therapeutics. We employ a combination of phosphoproteomics, genetics, and pharmacology to unambiguously identify a subset of Rab GTPases as key LRRK2 substrates. LRRK2 directly phosphorylates these both in vivo and in vitro on an evolutionary conserved residue in the switch II domain. Pathogenic LRRK2 variants mapping to different functional domains increase phosphorylation of Rabs and this strongly decreases their affinity to regulatory proteins including Rab GDP dissociation inhibitors (GDIs). Our findings uncover a key class of bona-fide LRRK2 substrates and a novel regulatory mechanism of Rabs that connects them to PD.
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