Boala Parkinson și tulburări de mișcare.
64 de articoleCold temperatures are known to increase tremor severity in Parkinson's disease patients, likely due to temperature sensitivity affecting basal ganglia motor control. This seasonal effect is a recognized clinical observation that patients and caregivers should monitor and manage accordingly.
This literature review examines how machine learning techniques, particularly support vector machines and neural networks, can improve early diagnosis and progression prediction in Parkinson's disease by analyzing diverse biomarker data. The analysis demonstrates that more sophisticated machine learning approaches and ensemble models achieve higher diagnostic accuracy than simpler methods, suggesting significant potential for enhancing diagnostic capacity in movement disorders.
This prospective study examined 301 consecutive Parkinson's disease patients and found cervical dystonia (CD) present in 9.3%, substantially higher than in the general population, with most cases developing after PD onset. CD-PD patients differed from idiopathic CD patients by being predominantly male, older, and showing milder severity with less head tremor and pain.
This large population-based cohort study of 355,890 participants followed for 13 years examined whether chronic musculoskeletal pain increases the risk of developing Parkinson's disease and related parkinsonism disorders. Results showed a dose-response relationship: participants with more widespread chronic pain sites had progressively higher risks of incident Parkinson's disease (11-49% increased risk depending on pain extent), though the mechanisms underlying this association remain unclear.
This study examines NT-proBNP levels as a potential biomarker for identifying cardiovascular autonomic dysfunction in Parkinson's disease patients. Elevated NT-proBNP was significantly associated with orthostatic hypotension and abnormal autonomic function tests, suggesting it may serve as an early indicator of cardiac autonomic denervation in PD.
A large Japanese population-based study of 14,280 participants used deep learning to analyze cup-to-disc ratios from fundus photographs as a potential imaging biomarker for Parkinson's disease and drug-induced Parkinsonism. Participants with the highest cup-to-disc ratios showed significantly elevated odds of Parkinson's disease, suggesting optic nerve morphology may aid in identifying neurodegenerative pathology.
Parkinson's disease has a complex genetic architecture including five autosomal dominant forms, three recessive types, and multiple genetic risk factors such as SNCA and GBA1 variants, with approximately 15% of cases attributable to known genetic causes. Recent advances have enabled gene-targeted clinical trials and incorporation of genetic findings into a new biological classification system for Parkinson's disease.
This systematic literature review (1988–2024) evaluated the validity of the 2015 International Parkinson and Movement Disorder Society diagnostic criteria using pathologically-confirmed PD cases, identifying which supportive criteria and red flags best distinguish PD from atypical parkinsonian disorders. The study found that excellent levodopa response and rest tremor were most useful for PD diagnosis, though some red flags (supranuclear gaze palsy, rapid gait progression, bilateral symptoms) occurred in >5% of confirmed PD cases, suggesting potential criteria refinement.
A study of over 18,500 PD patients identified pathogenic or likely pathogenic GRN variants in 24 patients (0.13%), suggesting that GRN-associated frontotemporal dementia can clinically mimic Parkinson's disease. The findings recommend comprehensive genetic testing including GRN analysis for patients with parkinsonism to improve diagnostic accuracy and inform treatment decisions.
This case report documents an unusual parasomnia where a Parkinson's disease patient ingests levodopa medication while asleep, representing a complex interaction between antiparkinsonian therapy and sleep disorders. The phenomenon illustrates how dopaminergic medications can influence sleep-related behaviors in neurological conditions.
This cross-sectional study of 119 Parkinson's disease patients found yawning-triggered tremor (YRT) significantly more prevalent in PD (18.5%) than controls (2.7%), with notably higher rates in patients with concurrent essential tremor (41.2%) or REM sleep behavior disorder (68.2%). In approximately one-third of cases, YRT preceded motor symptom onset by ~21 months, suggesting it may serve as an early neurodegeneration marker reflecting shared brainstem pathophysiology.
This matched case-control study of 116 Parkinson's disease patients with osteoporotic vertebral fractures and 349 matched controls found that PD is associated with a 2.35-fold higher risk of total fractures and nearly threefold higher upper-thoracic vertebral fractures (T1-T10). Non-vertebral fractures were also significantly more common in PD patients, particularly at the hip, distal radius/ulna, and ribs, suggesting increased fall risk and skeletal fragility beyond bone mineral density reduction.
Drug-induced parkinsonism (DIP) is a common adverse effect of dopamine receptor-blocking agents that mimics idiopathic Parkinson's disease but requires prior exposure to triggering medications for diagnosis. Management involves discontinuing or reducing the offending agent, considering alternative medications with lower DIP risk, and using L-dopa when necessary, with ancillary testing like DaT scans helping distinguish DIP from prodromal Parkinson's disease.
This study compared immune cell profiles in individuals with drug-induced Parkinsonism (DIP) and idiopathic Parkinson's disease (PD) using UK Biobank data, finding that both conditions showed elevated neutrophil counts and immune inflammation markers approximately 9 years before diagnosis. However, immune alterations in DIP were attributable to psychiatric comorbidities, while reduced lymphocyte counts appeared to be a distinctive prodromal biomarker specific to PD.
This study examined whether gut bacterial tyrosine decarboxylase (TDC), which metabolizes levodopa, is associated with motor complications in 178 Parkinson's disease patients. While patients with dyskinesia and motor fluctuations showed 2-3 fold higher fecal TDC levels, differences were not statistically significant, suggesting a potential but unproven relationship between microbiota-derived enzymes and treatment response variability.
This systematic review of 93 studies examined whether inertial measurement units (IMUs) can accurately quantify Parkinson's disease motor severity by correlating gait parameters with established clinical scales (MDS-UPDRS III, Hoehn and Yahr). Meta-analysis findings confirm that objective gait metrics including reduced velocity, shorter step length, prolonged stance time, and decreased turning speed reliably reflect disease severity and progression stages.
This cross-sectional study of 1,231 participants from the Fox Insight cohort examined whether repetitive head impacts from soccer and traumatic brain injury (TBI) history independently or cumulatively increase Parkinson's disease (PD) risk. Former soccer players with a history of TBI with loss of consciousness showed significantly elevated odds of PD diagnosis compared to those without such cumulative exposure.
This longitudinal study examined whether amyloid copathology modifies how physical activity influences Parkinson's disease progression in 245 patients followed over 4+ years. Results showed amyloid positivity significantly moderated physical activity's effects on motor severity, with amyloid-negative patients showing slower biomarker increases (neurofilament light chain and tau) associated with higher physical activity levels.