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Advances in Diagnosis and Treatment of Parkinson's Disease and Other...
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Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 11537

Special Issue Editors

Prof. Dr. Tobias Warnecke

E-Mail Website
Guest Editor
Dept Neurol, Univ Hosp Muenster, Albert Schweitzer Campus 1, D-48149 Munster, Germany
Dr. Florin Gandor

E-Mail Website
Guest Editor
1. Kliniken Beelitz GmbH, Movement Disorders Hospital, Str nach Fichtenwalde 16, D-14547 Beelitz-Heilstätten, Germany
2. Otto-von-Guericke-University Magdeburg, Dept Neurol, Leipziger Str 44, D-39120 Magdeburg, Germany
Interests: laryngology; dysphagia; Parkinson’s disease; multiple system atrophy; 4repeat-tauopathies; movement disorders

Special Issue Information

Dear Colleagues,

Novel therapeutic strategies for the treatment of Parkinson’s disease (PD) and other movement disorders are emerging. While an optimization of dopaminergic stimulation, be it by adaption of pharmacodynamic and galenic properties of medication or by improving deep brain stimulation techniques, targets mainly the improvement of motor fluctuation in PD, therapy strategies for multiple system atrophy (MSA) and 4repeat tauopathies (4RT), it addresses the inhibition of protein aggregation or immunological mechanisms to decelerate disease progression. A development of new therapies for these disorders relies on overly sensitive and specific diagnostic criteria that enable an early identification of patients with MSA and 4RT and their clear delineation from patients with PD. Beyond pharmacological and surgical treatment approaches, care networks focusing on PD and other movement disorders are evolving in many areas of the world and aim to improve patients’ quality of life by integrating different medical and non-medical experts into a multidisciplinary, patient-centered, and coordinated approach to deliver evidence-based and highly individualized treatment options.

This issue focusses on strategies to improve the diagnostic certainty of atypical Parkinsonism such as MSA and 4RT, and addresses new therapeutic approaches for PD and other movement disorders.

Prof. Dr. Tobias Warnecke
Dr. Florin Gandor
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnosis
  • biomarker
  • therapy
  • Parkinson’s disease (PD)
  • multiple system atrophy (MSA)
  • 4repeat tauopathies (4RT)
  • progressive supranuclear palsy (PSP)
  • dysphagia
  • movement disorders
  • care networks

Published Papers (5 papers)

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Research

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15 pages, 2016 KiB  
Article
Feasibility of a Multimodal Telemedical Intervention for Patients with Parkinson’s Disease—A Pilot Study
by Jonas Bendig, Anna-Sophie Wolf, Tony Mark, Anika Frank, Josephine Mathiebe, Madlen Scheibe, Gabriele Müller, Marcus Stahr, Jochen Schmitt, Heinz Reichmann, Kai F. Loewenbrück and Björn H. Falkenburger
J. Clin. Med. 2022, 11(4), 1074; https://doi.org/10.3390/jcm11041074 - 18 Feb 2022
Cited by 13 | Viewed by 2570
Abstract
Symptoms of Parkinson’s disease (PD) can be controlled well, but treatment often requires expert judgment. Telemedicine and sensor-based assessments can allow physicians to better observe the evolvement of symptoms over time, in particular with motor fluctuations. In addition, they potentially allow less frequent [...] Read more.
Symptoms of Parkinson’s disease (PD) can be controlled well, but treatment often requires expert judgment. Telemedicine and sensor-based assessments can allow physicians to better observe the evolvement of symptoms over time, in particular with motor fluctuations. In addition, they potentially allow less frequent visits to the expert’s office and facilitate care in rural areas. A variety of systems with different strengths and shortcomings has been investigated in recent years. We designed a multimodal telehealth intervention (TelePark) to mitigate the shortcomings of individual systems and assessed the feasibility of our approach in 12 patients with PD over 12 weeks in preparation for a larger randomized controlled trial. TelePark uses video visits, a smartphone app, a camera system, and wearable sensors. Structured training included setting up the equipment in patients’ homes and group-based online training. Usability was assessed by questionnaires and semi-standardized telephone interviews. Overall, 11 out of 12 patients completed the trial (5 female, 6 male). Mean age was 65 years, mean disease duration 7 years, mean MoCA score 27. Adherence was stable throughout the study and 79% for a short questionnaire administered every second day, 62% for medication confirmation, and 33% for an electronic Hauser diary. Quality of life did not change in the course of the study, and a larger cohort will be required to determine the effect on motor symptoms. Interviews with trial participants identified motivations to use such systems and areas for improvements. These insights can be helpful in designing similar trials. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders)
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12 pages, 299 KiB  
Article
Relevance of Sociodemographics and Clinical Tests in Single- and Dual-Task Conditions as Gait Speed Predictors of Parkinson’s Disease
by Constanza San Martín Valenzuela, Lirios Dueñas, José M. Tomás, Patricia Correa-Ghisays and Pilar Serra-Añó
J. Clin. Med. 2022, 11(3), 757; https://doi.org/10.3390/jcm11030757 - 30 Jan 2022
Viewed by 1937
Abstract
This cross-sectional study aimed to identify the patient characteristics and clinical test results that predict the functional gait speed of people with Parkinson’s disease (PD). The impact of dual tasks on gait in Parkinson’s disease (PD) reveals a lack of automaticity and increased [...] Read more.
This cross-sectional study aimed to identify the patient characteristics and clinical test results that predict the functional gait speed of people with Parkinson’s disease (PD). The impact of dual tasks on gait in Parkinson’s disease (PD) reveals a lack of automaticity and increased cognitive demands. We explored which characteristics explained walking speed with and without dual-task interference and if they reflected the cognitive demands of the task. The preferred gait speed, stride length, and cadence were measured in individuals with PD through five conditions: single-task (ST) and visual, verbal, auditory, and motor dual-tasks (DTs). Sociodemographic and disease characteristics and the results from clinical tests such as the Dynamic Parkinson’s Disease Gait Scale (DYPAGS), Frontal Assessment Battery (FAB), and Parkinson’s Disease Questionnaire-39 (PDQ-39), among others, were also recorded. Two models of multiple regression analysis were used to explore the predictive value of outcomes concerning speed. In Model I, clinical results were included, and in Model II, spatiotemporal variables were added to the significant predictors of Model I. Forty PD patients (aged 66.72 (7.5) years) completed the assessments. All the models generated were significant (p < 0.01). Models I and II accounted for 47% and 93% of the variance, respectively, in the single-task condition. A patient’s gender, prescribed medication (drugs), academic level, and Hoehn and Yahr (H&Y) stage, along with the FAB, DYPAGS, and PDQ-39 scores, were significant predictors of gait speed in Model I for the ST and DT conditions. In Model II, the H&Y stage and prescribed medication (drugs), along with the FAB and DYPAGS scores, remained significant predictors. This research found that sociodemographics, the patient’s stage disease, and their clinical test results contribute to their walking speed, highlighting the multifactorial nature of gait in demanding environments. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders)
10 pages, 1650 KiB  
Article
Blood Neurofilament Light Chain in Parkinson’s Disease: Comparability between Parkinson’s Progression Markers Initiative (PPMI) and Asian Cohorts
by Jia-Hung Chen, Lung Chan, Chen-Chih Chung, Oluwaseun Adebayo Bamodu and Chien-Tai Hong
J. Clin. Med. 2021, 10(21), 5085; https://doi.org/10.3390/jcm10215085 - 29 Oct 2021
Cited by 7 | Viewed by 1845
Abstract
Elevated blood neurofilament light chain (NfL), which indicates the loss of neuronal integrity, is increasingly implicated as a diagnostic and outcome-predicting biomarker for neurological diseases. However, its diagnostic implication for Parkinson’s disease (PD) remains unclear, with conflicting data reported by several studies. This [...] Read more.
Elevated blood neurofilament light chain (NfL), which indicates the loss of neuronal integrity, is increasingly implicated as a diagnostic and outcome-predicting biomarker for neurological diseases. However, its diagnostic implication for Parkinson’s disease (PD) remains unclear, with conflicting data reported by several studies. This may result from the demographic heterogeneity of the studied cohorts. The present study investigated the comparability of blood NfL between a domestic, single-centered PD cohort from Shuang Ho Hospital (SHH) in Taiwan, with the large international, multi-center cohort, Parkinson’s Progression Markers Initiative (PPMI). In the SHH PD cohort, with 61 people with PD (PwP) and 25 healthy non-PD controls, plasma NfL unexpectedly was significantly higher in the control group than PwP (14.42 ± 13.84 vs. 9.39 ± 6.91 pg/mL, p = 0.05). Interestingly, subgroup analysis revealed a non-significant difference of plasma NfL levels in male PwP compared with controls (8.58 ± 6.21 vs. 7.25 ± 4.43 pg/mL, p =0.575), whereas NfL levels were significantly lower in the female PwP group than in their healthy control peers (10.29 ± 7.62 vs. 17.79 ± 15.52 pg/mL, p = 0.033). Comparative analysis of the SHH and PPMI cohorts revealed a comparable gender-stratified distribution of blood NfL based on approximate theoretical quantiles. After adjusting for age and gender, no apparent difference in NfL value distribution was observed between the SHH and PPMI cohorts’ control or PD groups. Significant downregulation of blood NfL levels were positively correlated with a reduced probability of having a PD diagnosis in both cohorts. These results demonstrated that the adjustment for demographic background enhances comparability between cohorts, and may be required to eliminate covariate/confounder-associated conflict in blood NfL results between different PD studies. This experience may be beneficial to other researchers around the world who are saddled with limited study participants, especially as data from small cohort sizes are often at greater risk of being skewed by specific variables. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders)
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11 pages, 279 KiB  
Article
Evolution of Quality of Life in Persons with Parkinson’s Disease: A Prospective Cohort Study
by Eduardo Candel-Parra, María Pilar Córcoles-Jiménez, Victoria Delicado-Useros, Antonio Hernández-Martínez and Milagros Molina-Alarcón
J. Clin. Med. 2021, 10(9), 1824; https://doi.org/10.3390/jcm10091824 - 22 Apr 2021
Cited by 4 | Viewed by 1808
Abstract
Parkinson’s disease (PD) is a chronic neurodegenerative disorder that results in important functional symptoms, altered mood, and deterioration in quality of life (QoL). This study aimed to determine the evolution of the QoL in persons with PD in the Albacete health district over [...] Read more.
Parkinson’s disease (PD) is a chronic neurodegenerative disorder that results in important functional symptoms, altered mood, and deterioration in quality of life (QoL). This study aimed to determine the evolution of the QoL in persons with PD in the Albacete health district over a two-year period and identify associated sociodemographic, clinical, and socio-health characteristics. A cohort study was conducted of patients at different stages of PD in the Albacete health district. Calculated sample size: 155 patients. Instruments: A purpose-designed questionnaire for data collection and the “Parkinson Disease Questionnaire” (PDQ-39), which measures 8 dimensions and a global index where a higher score indicates worse quality of life. Three measurements were made: baseline, one year, two years. A descriptive and bivariate analysis was conducted. Ethical aspects: informed consent, anonymized data. Results: Mean age 69.51 (standard deviation, SD 8.73) years, 60% male, 75.5% married, and 85.5% lived with family. The most frequent motor symptoms were slow movement (86.23%), postural instability (55.5%), tremor (45.5%), and dyskinesia (24.6%). Among the non-motor symptoms were fatigue (66.2%), pain, daytime somnolence, constipation, and apathy, with approximately 50% each. The mean QoL score at baseline was 27.47 (SD 16.14); 95% CI (confidence interval) 24.91–30.03. At two years, global QoL had slightly worsened (28.3; SD 17.26; 95% CI 25.41–31.18), with a statistically significant worsening in mobility, activities of daily living, and communication, whereas social support improved. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders)

Review

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28 pages, 466 KiB  
Review
Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review
by Michał Hutny, Jagoda Hofman, Aleksandra Klimkowicz-Mrowiec and Agnieszka Gorzkowska
J. Clin. Med. 2021, 10(19), 4377; https://doi.org/10.3390/jcm10194377 - 25 Sep 2021
Cited by 6 | Viewed by 2503
Abstract
Levodopa remains the primary drug for controlling motor symptoms in Parkinson’s disease through the whole course, but over time, complications develop in the form of dyskinesias, which gradually become more frequent and severe. These abnormal, involuntary, hyperkinetic movements are mainly characteristic of the [...] Read more.
Levodopa remains the primary drug for controlling motor symptoms in Parkinson’s disease through the whole course, but over time, complications develop in the form of dyskinesias, which gradually become more frequent and severe. These abnormal, involuntary, hyperkinetic movements are mainly characteristic of the ON phase and are triggered by excess exogenous levodopa. They may also occur during the OFF phase, or in both phases. Over the past 10 years, the issue of levodopa-induced dyskinesia has been the subject of research into both the substrate of this pathology and potential remedial strategies. The purpose of the present study was to review the results of recent research on the background and treatment of dyskinesia. To this end, databases were reviewed using a search strategy that included both relevant keywords related to the topic and appropriate filters to limit results to English language literature published since 2010. Based on the selected papers, the current state of knowledge on the morphological, functional, genetic and clinical features of levodopa-induced dyskinesia, as well as pharmacological, genetic treatment and other therapies such as deep brain stimulation, are described. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Parkinson's Disease and Other Movement Disorders)
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