COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Environmental Neuroscience".

Deadline for manuscript submissions: closed (15 March 2022) | Viewed by 28112

Special Issue Editors

Department of Neurology, Ruhr-Universität Bochum, Bochum, Germany
Interests: Parkinson’s disease; neuron; neuroprotection; neuroregeneration; neuroinflammation; neurodegeneration; biomarkers; protein aggregation; alpha-synuclein; translational therapies
Special Issues, Collections and Topics in MDPI journals
Department for Neurology, University Hospital Essen, Essen, Germany
Interests: movement disorders; neurodegenerative diseases; Parkinson's disease; neurogenetics; spasticity; botulinum toxin

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic is currently affecting almost every area of our daily lives. In addition to the immense societal and economic changes, the medical care of patients is now modified both in the outpatient and in the clinical setting. Neurological patients are experiencing a drastic disruption in the provision of medical care that was not similarly observed in the last few decades.

These strong changes also apply to Parkinson's disease and other neurodegenerative disorders including atypical Parkinson's syndromes, Alzheimer's and other dementias, ataxias, Huntington's disease or dystonia syndromes. The diagnosis, implementation of outpatient or inpatient therapies and the initiation of new pharmacological or non-pharmacological treatment measures have changed considerably. Of note, symptoms of COVID-19 patients and patients with neurodegenerative disease partially overlap, such as olfactory disorders, and similar pathophysiological processes of symptom development are described up to the discussion of an increased neuronal vulnerability induced by COVID-19. How far COVID-19 specifically affects or exposes these patients to an increased risk is not well understood.

However, the need to adapt our services for patients with neurodegenerative disease has also resulted in improvements. Research on the influence of COVID-19 pathomechanisms in neurologic diseases has been accelerated and the delivery of therapies has been optimized with the use of novel technologies including telemedicine. Many of these achievements will remain highly valued even after the COVID-19 pandemic and will improve our practical work and treatment performance.

In this Special Issue, we would like to present important findings on COVID-19, Parkinson's and other neurodegenerative diseases in a series of publications. Thereby, we would like to make a contribution so that we can jointly effectively master the challenges associated with COVID-19.

Prof. Dr. Lars Tönges
Guest Editors

Prof. Dr. Stephan Klebe
Co-Guest Editors

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Keywords

  • Parkinson’s disease
  • neurodegenerative diseases
  • movement disorders
  • COVID-19
  • post-COVID-19
  • SARS-CoV-19
  • provision of care
  • telemedicine

Published Papers (11 papers)

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Editorial

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2 pages, 177 KiB  
Editorial
SARS-CoV-2, COVID-19 and Neurodegeneration
by Lars Tönges and Stephan Klebe
Brain Sci. 2022, 12(7), 897; https://doi.org/10.3390/brainsci12070897 - 08 Jul 2022
Cited by 1 | Viewed by 1275
Abstract
The COVID-19 pandemic continues to affect many areas of our daily life [...] Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)

Research

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9 pages, 824 KiB  
Communication
Impact of the COVID-19 Pandemic on Patients with Parkinson’s Disease from the Perspective of Treating Physicians—A Nationwide Cross-Sectional Study
by Andreas Wolfgang Wolff, Bernhard Haller, Antonia Franziska Demleitner, Erica Westenberg and Paul Lingor
Brain Sci. 2022, 12(3), 353; https://doi.org/10.3390/brainsci12030353 - 05 Mar 2022
Cited by 8 | Viewed by 2193
Abstract
The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson’s disease (PD). The Parkinson’s Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess [...] Read more.
The COVID-19 pandemic has posed challenges to maintaining medical care for patients with Parkinson’s disease (PD). The Parkinson’s Disease during the COVID-19 Pandemic (ParCoPa) survey was conducted as an online, nationwide, cross-sectional survey from December 2020 to March 2021 and aimed to assess the impact of the pandemic on the medical care of PD patients from the physicians’ perspective. Invitations containing a randomly generated registration code were mailed to healthcare professionals from sixty-seven specialty centers in Germany. Confounders for the worsening of subjective treatment quality, perceived health risk due to the profession, and adequate protective measures against SARS-CoV-2 were assessed using logistic regression analysis. Of all forty physicians who responded, 87.5% reported a worsening of motor and nonmotor symptoms in their patients, 97.5% experienced cancellation of appointments, and difficulties in organizing advanced and supplementary therapies were reported by over 95%. Participants offered alternative consultation options, mostly in the form of telephone (77.5%) or online (64.1%) consultations, but telephone consultations were the most accepted by patients (“broadly accepted”, 40.0%). We identified pandemic-related deficits in providing care for patients with PD and areas of improvement to ensure continued care for this vulnerable patient population. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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9 pages, 258 KiB  
Article
Effects of Phone-Based Psychological Intervention on Caregivers of Patients with Early-Onset Alzheimer’s Disease: A Six-Months Study during the COVID-19 Emergency in Italy
by Manuela De Stefano, Sabrina Esposito, Alessandro Iavarone, Michele Carpinelli Mazzi, Mattia Siciliano, Daniela Buonanno, Danilo Atripaldi, Francesca Trojsi and Gioacchino Tedeschi
Brain Sci. 2022, 12(3), 310; https://doi.org/10.3390/brainsci12030310 - 24 Feb 2022
Cited by 6 | Viewed by 1688
Abstract
Caregivers of patients with early-onset Alzheimer’s disease (EOAD) experience higher level of burden, stress, and depression, due to premature role changes and social isolation. Moreover, the SARS-CoV-2 pandemic compelled restrictions regarding social interactions and mobility in Italy from March 2020, prompting telemedicine approaches [...] Read more.
Caregivers of patients with early-onset Alzheimer’s disease (EOAD) experience higher level of burden, stress, and depression, due to premature role changes and social isolation. Moreover, the SARS-CoV-2 pandemic compelled restrictions regarding social interactions and mobility in Italy from March 2020, prompting telemedicine approaches for supporting patients and their families confined at home. We reported our experience regarding the effects of psychological phone-intervention (phone-I) on EOAD caregivers during pandemic. Twenty caregivers of EOAD patients were randomly assigned to treatment (TG) or control (CG) group. TG weekly underwent a phone-I for one month. All participants were assessed for caregiver burden and needs, anxiety and depression levels, and subjective impact of traumatic events at baseline (T0), at the fifth week (T1) and after 6 months (T2) from phone-I. We observed higher vulnerability to post-traumatic stress in TG compared to CG in all timepoints (p ≤ 0.05). Decreased stress effects and caregiver burden were revealed in TG at T1 compared to T0 (p ≤ 0.05), although showing an increase of these measures at T2 in the treated caregivers. Our findings suggest that although TG showed a peculiar vulnerability to post-traumatic stress, they showed increased wellbeing immediately after phone-I. However, this benefit disappeared six months later, along with the second infection wave, probably due to “exhaustion stage” achievement in “General Adaptation Syndrome”. This trend may suggest a beneficial but not solving role of a prompt phone-I on burden of caregivers of EOAD patients during the SARS-CoV-2 emergency. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
17 pages, 2232 KiB  
Article
Secondary Impact of COVID-19 Pandemic on People with Parkinson’s Disease—Results of a Polish Online Survey
by Karolina Krzysztoń, Beata Mielańczuk-Lubecka, Jakub Stolarski, Anna Poznańska, Katarzyna Kępczyńska, Agata Zdrowowicz, Izabela Domitrz and Jan Kochanowski
Brain Sci. 2022, 12(1), 26; https://doi.org/10.3390/brainsci12010026 - 26 Dec 2021
Cited by 12 | Viewed by 2364
Abstract
The COVID-19 pandemic causes increased mental stress and decreased mobility, which may affect people with Parkinson’s disease (PD). The study aimed to investigate the secondary impact of the COVID-19 pandemic on the level of activity, quality of life (QoL) and PD-related symptoms. The [...] Read more.
The COVID-19 pandemic causes increased mental stress and decreased mobility, which may affect people with Parkinson’s disease (PD). The study aimed to investigate the secondary impact of the COVID-19 pandemic on the level of activity, quality of life (QoL) and PD-related symptoms. The respondents completed an online survey in Polish in the period from December, 2020 to June, 2021. The questionnaire was completed by 47 participants aged 43 to 90 years (mean 72.1 ± 1.3 years). A total of 94% reported reduced contact with family and friends. Over 90% remained active during the pandemic. However, 55% of people with PD showed subjectively lower level of activity then before the pandemic. Moreover, 36% of the respondents felt afraid to visit a doctor and reported problems with access to medication. Subjective QoL reduction was reported by 80%, and 83% declared worsening of PD symptoms. The post pandemic deterioration of motor symptoms in people with PD did not affect their QoL. However, the deterioration of contacts and feelings of isolation had a significant impact on the decline in quality of life (p = 0.022 and p = 0.009, respectively) and the presence of anxiety (p = 0.035 and p = 0.007, respectively). These results may indicate than greater importance of social and mental factors than fitness and health-related factors in the QoL self-assessment of the people with PD. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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9 pages, 936 KiB  
Article
Accelerated Early Progression of Amyotrophic Lateral Sclerosis over the COVID-19 Pandemic
by Fabiola De Marchi, Chiara Gallo, Maria Francesca Sarnelli, Ilaria De Marchi, Massimo Saraceno, Roberto Cantello and Letizia Mazzini
Brain Sci. 2021, 11(10), 1291; https://doi.org/10.3390/brainsci11101291 - 29 Sep 2021
Cited by 14 | Viewed by 2161
Abstract
During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to [...] Read more.
During the COVID-19 pandemic and the related lockdowns, outpatient follow-up visits for patients with chronic neurological diseases have been suspended. Managing people affected by amyotrophic lateral sclerosis (ALS) has become highly complicated, leaving patients without the standard multidisciplinary follow-up. This study aimed to analyze the impact of the COVID-19 lockdown on ALS disease progression. We compared the clinical data and progression in the first year following diagnosis for patients who received ALS diagnosis during 2020 (G20, N = 34), comparing it with a group of diagnosed in 2018 (G18, N = 31). Both groups received a comparable multidisciplinary model of care in our Tertiary Expert ALS Centre, Novara, Italy. The monthly rate of ALSFRS-R decline during the lockdown was significantly increased in G20 compared to G18 (1.52 ± 2.69 vs. 0.76 ± 0.56; p-value: 0.005). In G20, 47% required non-invasive ventilation (vs. 32% of G18). Similarly, in G20, 35% of patients died vs. 19% of patients in G18 (p-value: 0.01). All results were corrected for gender, age, site of onset, and diagnostic delay. Several factors can be implicated in making ALS more severe, with a faster progression, such as reduced medical evaluations and the possibility of therapeutic changes, social isolation, and rehabilitation therapy suspension. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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6 pages, 579 KiB  
Communication
Hospital Admissions for Neurodegenerative Diseases during the First Wave of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study from Germany
by Raphael Scherbaum, Eun-Hae Kwon, Daniel Richter, Dirk Bartig, Ralf Gold, Christos Krogias and Lars Tönges
Brain Sci. 2021, 11(9), 1219; https://doi.org/10.3390/brainsci11091219 - 15 Sep 2021
Cited by 4 | Viewed by 1799
Abstract
(1) Background: The COVID-19 pandemic impacts healthcare utilization across all care settings and health conditions. The objective of this study was to determine changes in hospital admissions for neurodegenerative diseases (NDD) during the first COVID-19 wave in Germany; (2) Methods: This cross-sectional study [...] Read more.
(1) Background: The COVID-19 pandemic impacts healthcare utilization across all care settings and health conditions. The objective of this study was to determine changes in hospital admissions for neurodegenerative diseases (NDD) during the first COVID-19 wave in Germany; (2) Methods: This cross-sectional study used nationwide administrative claims data covering 1468 hospitals. The primary outcome was the year-to-year relative change in case numbers during a four-month study period (16 January–15 May 2020 vs. 2019) during the first pandemic wave. Secondary outcomes included year-to-year relative changes during a four-week peak phase (16 March–15 April) and changes between differential phases of the wave. The analyzed NDD comprised progressive supranuclear palsy (PSP), multiple system atrophy (MSA), Parkinson’s disease, amyotrophic lateral sclerosis (ALS) and Huntington’s disease; (3) Results: Hospital admissions for any reason decreased by 16.7% in 2020 during the study period and by 36.6% during the peak phase, whereas admissions for NDD decreased by 27.6% and 65.0%, respectively. PSP cases decreased during the study period (−34.7%) and the peak phase (−68.1%) and stayed reduced in a late phase with falling COVID-19 numbers. MSA and ALS cases increased strongest after the peak, with ALS cases being comparatively weakly reduced during the study period (−17.3%) and peak phase (−51.7%); (4) Conclusions: Inpatient care utilization for NDD changed differentially during the first wave of the COVID-19 pandemic in Germany and showed a greater reduction than overall and general neurological admissions. Mitigating long-term health deterioration of this vulnerable subgroup is important to reduce morbidity and mortality in the future. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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Review

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29 pages, 2482 KiB  
Review
Role of SARS-CoV-2 in Modifying Neurodegenerative Processes in Parkinson’s Disease: A Narrative Review
by Jeremy M. Morowitz, Kaylyn B. Pogson, Daniel A. Roque and Frank C. Church
Brain Sci. 2022, 12(5), 536; https://doi.org/10.3390/brainsci12050536 - 22 Apr 2022
Cited by 5 | Viewed by 3163
Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, continues to impact global health regarding both morbidity and mortality. Although SARS-CoV-2 primarily causes acute respiratory distress syndrome (ARDS), the virus interacts with and influences other organs and tissues, including blood vessel endothelium, heart, gastrointestinal tract, and [...] Read more.
The COVID-19 pandemic, caused by SARS-CoV-2, continues to impact global health regarding both morbidity and mortality. Although SARS-CoV-2 primarily causes acute respiratory distress syndrome (ARDS), the virus interacts with and influences other organs and tissues, including blood vessel endothelium, heart, gastrointestinal tract, and brain. We are learning much about the pathophysiology of SARS-CoV-2 infection; however, we are just beginning to study and understand the long-term and chronic health consequences. Since the pandemic’s beginning in late 2019, older adults, those with pre-existing illnesses, or both, have an increased risk of contracting COVID-19 and developing severe COVID-19. Furthermore, older adults are also more likely to develop the neurodegenerative disorder Parkinson’s disease (PD), with advanced age as the most significant risk factor. Thus, does SARS-CoV-2 potentially influence, promote, or accelerate the development of PD in older adults? Our initial focus was aimed at understanding SARS-CoV-2 pathophysiology and the connection to neurodegenerative disorders. We then completed a literature review to assess the relationship between PD and COVID-19. We described potential molecular and cellular pathways that indicate dopaminergic neurons are susceptible, both directly and indirectly, to SARS-CoV-2 infection. We concluded that under certain pathological circumstances, in vulnerable persons-with-Parkinson’s disease (PwP), SARS-CoV-2 acts as a neurodegenerative enhancer to potentially support the development or progression of PD and its related motor and non-motor symptoms. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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11 pages, 522 KiB  
Review
SARS-CoV-2, COVID-19 and Parkinson’s Disease—Many Issues Need to Be Clarified—A Critical Review
by Tsepo Goerttler, Eun-Hae Kwon, Michael Fleischer, Mark Stettner, Lars Tönges and Stephan Klebe
Brain Sci. 2022, 12(4), 456; https://doi.org/10.3390/brainsci12040456 - 28 Mar 2022
Cited by 7 | Viewed by 2506
Abstract
Neurological manifestations during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are of interest, regarding acute treatment and the so-called post-COVID-19 syndrome. Parkinson’s disease (PD) is one of the most common neurodegenerative movement disorders worldwide. Hence, the influence of SARS-CoV-2 and the [...] Read more.
Neurological manifestations during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are of interest, regarding acute treatment and the so-called post-COVID-19 syndrome. Parkinson’s disease (PD) is one of the most common neurodegenerative movement disorders worldwide. Hence, the influence of SARS-CoV-2 and the COVID-19 syndrome on PD patients has raised many questions and produced various publications with conflicting results. We reviewed the literature, with respect to symptoms, treatment, and whether the virus itself might cause PD during the SARS-CoV-2 pandemic in SARS-CoV-2-affected symptomatic PD patients (COVID-19 syndrome). In addition, we comment on the consequences in non-symptomatic and non-affected PD patients, as well as post-COVID syndrome and its potential linkage to PD, presenting our own data from our out-patient clinic. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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9 pages, 282 KiB  
Review
Parkinson’s Disease in Light of the COVID-19 Pandemic
by Anna Drelich-Zbroja, Mateusz Cheda, Maryla Kuczyńska, Izabela Dąbrowska, Ewa Kopyto and Izabela Halczuk
Brain Sci. 2022, 12(2), 143; https://doi.org/10.3390/brainsci12020143 - 21 Jan 2022
Cited by 7 | Viewed by 2469
Abstract
In this review we attempt to collate the existing scientific evidence regarding the possible role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pathophysiology of Parkinson’s disease (PD), as well as to investigate the impact of PD/parkinsonism on the clinical course [...] Read more.
In this review we attempt to collate the existing scientific evidence regarding the possible role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pathophysiology of Parkinson’s disease (PD), as well as to investigate the impact of PD/parkinsonism on the clinical course of the viral infection itself. Since etiology of PD is not completely understood, various studies suggest different potential links between coronavirus disease 2019 (COVID-19) and PD. Suggested connections include, among others, similar prodromal symptoms, renin–angiotensin–aldosterone system involvement, or gut microbiome dysbiosis participation. Despite the initial assumptions that, as a mainly elderly population suffering from rigidity of respiratory muscles, impairment of cough reflex, and dyspnea, PD patients would be more susceptible to viral infection, and would experience a more aggressive course of COVID-19, the published scientific reports contain mutually exclusive data that require further investigation and meta-analysis. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
20 pages, 399 KiB  
Review
Can SARS-CoV-2 Infection Lead to Neurodegeneration and Parkinson’s Disease?
by Lea Krey, Meret Koroni Huber, Günter U. Höglinger and Florian Wegner
Brain Sci. 2021, 11(12), 1654; https://doi.org/10.3390/brainsci11121654 - 18 Dec 2021
Cited by 23 | Viewed by 3894
Abstract
The SARS-CoV-2 pandemic has affected the daily life of the worldwide population since 2020. Links between the newly discovered viral infection and the pathogenesis of neurodegenerative diseases have been investigated in different studies. This review aims to summarize the literature concerning COVID-19 and [...] Read more.
The SARS-CoV-2 pandemic has affected the daily life of the worldwide population since 2020. Links between the newly discovered viral infection and the pathogenesis of neurodegenerative diseases have been investigated in different studies. This review aims to summarize the literature concerning COVID-19 and Parkinson’s disease (PD) to give an overview on the interface between viral infection and neurodegeneration with regard to this current topic. We will highlight SARS-CoV-2 neurotropism, neuropathology and the suspected pathophysiological links between the infection and neurodegeneration as well as the psychosocial impact of the pandemic on patients with PD. Some evidence discussed in this review suggests that the SARS-CoV-2 pandemic might be followed by a higher incidence of neurodegenerative diseases in the future. However, the data generated so far are not sufficient to confirm that COVID-19 can trigger or accelerate neurodegenerative diseases. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)

Other

12 pages, 1232 KiB  
Brief Report
Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson’s Disease in Germany (Care4PD)
by Odette Fründt, Anne-Marie Hanff, Tobias Mai, Christiane Kirchner, Emma Bouzanne des Mazery, Ali Amouzandeh, Carsten Buhmann, Rejko Krüger and Martin Südmeyer
Brain Sci. 2022, 12(1), 62; https://doi.org/10.3390/brainsci12010062 - 31 Dec 2021
Cited by 7 | Viewed by 2711
Abstract
The Care4PD study examined the impact of the COVID-19 pandemic on the care situation of people (PwP) with Parkinson’s disease in Germany. A comprehensive, nationwide, anonymous questionnaire for PwP was distributed by the members’ journal of the German Parkinson’s Disease Association and in [...] Read more.
The Care4PD study examined the impact of the COVID-19 pandemic on the care situation of people (PwP) with Parkinson’s disease in Germany. A comprehensive, nationwide, anonymous questionnaire for PwP was distributed by the members’ journal of the German Parkinson’s Disease Association and in several PD specialized in- and outpatient institutions. PwP subjectively evaluated their general care situation and individual impairments during the pandemic. We analyzed 1269 eligible out of 1437 returned questionnaires (88.3%) and compared PwP with (p-LTC) and without (np-LTC) professional long-term care. Both groups rated the general pandemic-related consequences as being rather mild to moderate (e.g., worsening of symptom or concerns). However, familial/social contact restrictions were indicated as most compromising, whereas access to outpatient professional health care providers was less affected. PwP with professional LTC reported more impairment than those without. COVID-19 vaccination rates and acceptance were generally high (p-LTC: 64.3%, np-LTC: 52.3%) at the time of the study, but realization of sanitary measures—especially wearing masks as a patient during care sessions—still needs to be improved. Technical options for telemedicine were principally available but only rarely used. Altogether, during the COVID-19 pandemic, PwP in Germany seemed to have a relatively stable health care access, at least in outpatient settings, while mainly social isolation compromised them. The p-LTC group was more impaired in everyday live compared with the np-LTC group. Full article
(This article belongs to the Special Issue COVID-19, Parkinson’s Disease and Other Neurodegenerative Disorders)
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