131 results on '"Yu, Yan"'
Search Results
2. Links between COVID-19 and Parkinson’s disease/Alzheimer’s disease: reciprocal impacts, medical care strategies and underlying mechanisms
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Huang, Pei, Zhang, Lin-Yuan, Tan, Yu-Yan, and Chen, Sheng-Di
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- 2023
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3. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson’s disease patients
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Li, Gen, Huang, Pei, Cui, Shi-Shuang, Tan, Yu-Yan, He, Ya-Chao, Shen, Xin, Jiang, Qin-Ying, Huang, Ping, He, Gui-Ying, Li, Bin-Yin, Li, Yu-Xin, Xu, Jin, Wang, Zheng, and Chen, Sheng-Di
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- 2022
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4. Prevalence of freezing of gait in Parkinson’s disease: a systematic review and meta-analysis
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Zhang, Wei-Shan, Gao, Chao, Tan, Yu-Yan, and Chen, Sheng-Di
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- 2021
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5. Dyspnea after subthalamic deep brain stimulation in Parkinson’s disease: a case–control study
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Meoni, Sara, Bradi, Ana C., Wadia, Pettarusp, Poon, Yu-Yan, and Moro, Elena
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- 2020
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6. Current approaches for the management of Parkinson’s disease in Chinese hospitals: a cross-sectional survey
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Gang Wang, Hai-Lun Cui, Jun Liu, Qin Xiao, Ying Wang, Jian-Fang Ma, Hai-Yan Zhou, Jing Pan, Yu-Yan Tan, Sheng-Di Chen, and on behalf of the Chinese Movement Disorders Society
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Parkinson’s disease ,Surveys and questionnaires ,Guideline ,Disease management ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background Chinese guidelines for management of Parkinson’s disease (PD) have been issued and updated regularly since 2006. We undertook a cross-sectional survey to evaluate the impact of the latest edition (2014) on current approaches to the management of PD based on previous pilot works. Methods Seven hundred and seventeen participants, divided into 3 groups (GPs, Neurologists, and Specialists), recruited from 138 randomly chosen hospitals from 30 cities across China, participated by completing the questionnaire describing their current approaches before and after the guidelines were issued. Results Considerable discrepancies in management were apparent across the three categories, with different selection of first-choice medication for PD patients. There were also variations in management of concurrent psychiatric symptoms and dementia. Notably, over 50% of participants reported improvements in PD recognition and management by following the guidelines. Conclusions The increasing use of Chinese clinical practice guidelines for PD management is having a positive impact on the optimization of care, which in turn offers important economic benefits.
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- 2018
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7. The role of substantia nigra sonography in the differentiation of Parkinson’s disease and multiple system atrophy
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Hai-Yan Zhou, Pei Huang, Qian Sun, Juan-Juan Du, Shi-Shuang Cui, Yun-Yun Hu, Wei-Wei Zhan, Ying Wang, Qin Xiao, Jun Liu, Yu-Yan Tan, and Sheng-Di Chen
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Parkinson’s disease ,Multiple system atrophy ,Atypical parkinsonian disorders ,Transcranial sonography ,Substantia nigra ,Disease duration ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background The differential diagnosis of Parkinson’s disease (PD) and multiple system atrophy (MSA) remains a challenge, especially in the early stage. Here, we assessed the value of transcranial sonography (TCS) to discriminate non-tremor dominant (non-TD) PD from MSA with predominant parkinsonism (MSA-P). Methods Eighty-six MSA-P patients and 147 age and gender-matched non-TD PD patients who had appropriate temporal acoustic bone windows were included in this study. All the patients were followed up for at least 2 years to confirm the initial diagnosis. Patients with at least one substantia nigra (SN) echogenic size ≥18 mm2 were classified as hyperechogenic, those with at least one SN echogenic size ≥25 mm2 was defined as markedly hyperechogenic. Results The frequency of SN hyperechogenicity in non-TD PD patients was significantly higher than that in MSA-P patients (74.1% vs. 38.4%, p
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- 2018
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8. Axial Impairment Following Deep Brain Stimulation in Parkinson’s Disease: A Surgicogenomic Approach
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Rajasumi Rajalingam, Ziv Gan-Or, Erfan Ghani Kakhki, Melanie Cohn, Mahdi Ghani, Maryam Naghibzadeh, Ekaterina Rogaeva, Yu-Yan Poon, Taline Naranian, Renato P. Munhoz, Jürgen Germann, Eric Yu, Marta Statucka, Suneil K. Kalia, Maryam Abdollahi, Anthony E. Lang, Alexandre Boutet, Mojgan Hodaie, Gavin J B Elias, Alfonso Fasano, Christine Sato, Naomi P. Visanji, Danielle Moreno, and Andres M. Lozano
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Oncology ,medicine.medical_specialty ,Linkage disequilibrium ,Levodopa ,Deep brain stimulation ,Parkinson's disease ,Deep Brain Stimulation ,medicine.medical_treatment ,Disease ,Cellular and Molecular Neuroscience ,Internal medicine ,Humans ,Medicine ,Trypsin ,Genotyping ,Allele frequency ,Retrospective Studies ,business.industry ,Parkinson Disease ,medicine.disease ,Subthalamic nucleus ,Treatment Outcome ,Neurology (clinical) ,business ,medicine.drug - Abstract
Background: Postoperative outcome following deep brain stimulation (DBS) of the subthalamic nucleus is variable, particularly with respect to axial motor improvement. We hypothesized a genetic underpinning to the response to surgical intervention, termed “surgicogenomics”. Objective: We aimed to identify genetic variants associated with clinical heterogeneity in DBS outcome of Parkinson’s disease (PD) patients that could then be applied clinically to target selection leading to improved surgical outcome. Methods: Retrospective clinical data was extracted from 150 patient’s charts. Each individual was genotyped using the genome-wide NeuroX array tailored to study neurologic diseases. Genetic data were clustered based on surgical outcome assessed by comparing pre- and post-operative scores of levodopa equivalent daily dose and axial impairment at one and five years post-surgery. Allele frequencies were compared between patients with excellent vs. moderate/poor outcomes grouped using a priori defined cut-offs. We analyzed common variants, burden of rare coding variants, and PD polygenic risk score. Results: NeuroX identified 2,917 polymorphic markers at 113 genes mapped to known PD loci. The gene-burden analyses of 202 rare nonsynonymous variants suggested a nominal association of axial impairment with 14 genes (most consistent with CRHR1, IP6K2, and PRSS3). The strongest association with surgical outcome was detected between a reduction in levodopa equivalent daily dose and common variations tagging two linkage disequilibrium blocks with SH3GL2. Conclusion: Once validated in independent populations, our findings may be implemented to improve patient selection for DBS in PD.
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- 2022
9. Prevalence of freezing of gait in Parkinson’s disease: a systematic review and meta-analysis
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Chao Gao, Sheng-Di Chen, Wei-Shan Zhang, and Yu-Yan Tan
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medicine.medical_specialty ,education.field_of_study ,Parkinson's disease ,genetic structures ,business.industry ,Advanced stage ,Population ,Prevalence ,medicine.disease ,Gait ,Study Characteristics ,Neurology ,Rating scale ,Meta-analysis ,Physical therapy ,Medicine ,Neurology (clinical) ,business ,education - Abstract
Freezing of gait (FOG) is considered one of the most disturbing and least understood symptoms in Parkinson’s disease (PD). The reported prevalence rates of FOG in PD vary widely, ranging from 5 to 85.9%. We conducted a systematic review and meta-analysis to provide a reliable estimate of the average point prevalence of FOG in PD, and we further investigated the study characteristics that might have influenced the estimate. We searched different databases to identify studies that report the prevalence of FOG in PD or include relevant raw data for further calculation. The last inclusion date was February 20, 2020. The modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was used for the quality assessment, and articles that met the predefined criteria were included in the quantitative analysis. Sixty-six studies were selected from 3392 references. A weighted prevalence of 50.6% in 9072 PD patients experienced FOG based on the special questionnaires (the FOG-Q and NFOG-Q), which was about twice as high as that assessed by the specific items of the clinical rating scales (UPDRS item2.14 and MDS-UPDRS item3.11) (23.2%) or simple clinical questions (25.4%). The weighted prevalence was 37.9% for early stage (≤ 5 years) and 64.6% for advanced stage (≥ 9 years). Moreover, a higher prevalence was calculated from the population-based studies than that in multicenter and single-center studies (47.3% vs. 33.5% and 37.1%, respectively). The result from this systematic review confirms that FOG is very common in PD and its prevalence is usually underestimated in hospital settings. Importantly, a more accurate assessment of FOG in future clinical researches would involve the use of special FOG scale rather than a single item on a scale or a general clinical inquiry.
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- 2021
10. Current approaches for the management of Parkinson’s disease in Chinese hospitals: a cross-sectional survey
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Wang, Gang, Cui, Hai-Lun, Liu, Jun, Xiao, Qin, Wang, Ying, Ma, Jian-Fang, Zhou, Hai-Yan, Pan, Jing, Tan, Yu-Yan, Chen, Sheng-Di, and on behalf of the Chinese Movement Disorders Society
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- 2018
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11. The role of substantia nigra sonography in the differentiation of Parkinson’s disease and multiple system atrophy
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Zhou, Hai-Yan, Huang, Pei, Sun, Qian, Du, Juan-Juan, Cui, Shi-Shuang, Hu, Yun-Yun, Zhan, Wei-Wei, Wang, Ying, Xiao, Qin, Liu, Jun, Tan, Yu-Yan, and Chen, Sheng-Di
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- 2018
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12. Programming Directional Deep Brain Stimulation in Parkinson’s Disease: A Randomized Prospective Trial Comparing Early versus Delayed Stimulation Steering
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Alfonso Fasano, Derrick Soh, Andres M. Lozano, Suneil K. Kalia, Ricardo Maciel, Renato P. Munhoz, Mojgan Hodaie, and Yu-Yan Poon
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medicine.medical_specialty ,Deep brain stimulation ,Parkinson's disease ,business.industry ,Programming algorithm ,Deep Brain Stimulation ,medicine.medical_treatment ,Subthalamic nucleus deep brain stimulation ,Parkinson Disease ,Stimulation ,medicine.disease ,Ring mode ,law.invention ,Physical medicine and rehabilitation ,Randomized controlled trial ,Subthalamic Nucleus ,Prospective trial ,law ,medicine ,Humans ,Surgery ,Prospective Studies ,Neurology (clinical) ,business ,Algorithms - Abstract
Introduction: Programming directional leads poses new challenges as the optimal strategy is yet to be established. We designed a randomized control study to establish an evidence-based programming algorithm for patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation with directional leads. Methods: Fourteen consecutive patients were randomized to programming with either early or delayed (i.e., starting with a “ring mode”) steered stimulation. Motor scores, number of programming visits, calls to the clinic, battery consumption, and stimulation adjustments required were recorded and compared between groups, using the Wilcoxon signed-ranks test, after 3 months of open-label programming. Results: Thirteen patients (25 electrodes) were included, of which 23 were steerable. Nine out of 14 electrodes allocated to delayed steered stimulation were changed to steered mode due to side effects during the course of the study. No patients (11 electrodes) initially allocated to early steered stimulation were converted to ring mode. The 2 study arms did not differ in any of the considered measures at 3 months. Conclusion: Programming with early or delayed steered stimulation is equally effective in the short term. However, delayed steering is less time consuming and is not always needed.
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- 2021
13. Levodopa Versus Dopamine Agonist after Subthalamic Stimulation in Parkinson's Disease
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Mojgan Hodaie, Andres M. Lozano, Renato P. Munhoz, Suneil K. Kalia, Cameron C. McIntyre, Alfonso Fasano, Marina Picillo, Sinem Balta Beylergil, Yu-Yan Poon, and Onanong Phokaewvarangkul
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0301 basic medicine ,Levodopa ,Parkinson's disease ,deep brain stimulation ,antiparkinsonian medications ,levodopa ,dopamine agonist ,Deep brain stimulation ,Movement disorders ,Randomization ,medicine.medical_treatment ,Population ,Regular Issue Articles ,Dopamine agonist ,Antiparkinson Agents ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Single-Blind Method ,education ,Research Articles ,education.field_of_study ,business.industry ,Parkinson Disease ,medicine.disease ,Treatment Outcome ,030104 developmental biology ,Neurology ,Dopamine receptor ,Anesthesia ,Dopamine Agonists ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Research Article ,medicine.drug - Abstract
Background No clinical trials have been specifically designed to compare medical treatments after surgery in Parkinson's disease (PD). Objective Study's objective was to compare the efficacy and safety of levodopa versus dopamine agonist monotherapy after deep brain stimulation (DBS) in PD. Methods Thirty-five surgical candidates were randomly assigned to receive postoperative monotherapy with either levodopa or dopamine agonist in a randomized, single-blind study. All patients were reevaluated in short- (3 months), mid- (6 months), and long-term (2.5 years) follow-up after surgery. The primary outcome measure was the change in the Non-Motor Symptoms Scale (NMSS) 3 months after surgery. Secondary outcome measures were the percentage of patients maintaining monotherapy, change in motor symptoms, and specific non-motor symptoms (NMS). Analysis was performed primarily in the intention-to-treat population. Results Randomization did not significantly affect the primary outcome (difference in NMSS between treatment groups was 4.88 [95% confidence interval: -11.78-21.53, P = 0.566]). In short- and mid-term follow-up, monotherapy was safe and feasible in more than half of patients (60% in short- and 51.5% in mid-term follow-up), but it was more often possible for patients on levodopa. The ability to maintain dopamine agonist monotherapy was related to optimal contact location. In the long term, levodopa monotherapy was feasible only in a minority of patients (34.2%), whereas dopamine agonist monotherapy was not tolerated due to worsening of motor conditions or occurrence of impulse control disorders. Conclusions This trial provides evidence for simplifying pharmacological treatment after functional neurosurgery for PD. The reduction in dopamine receptor agonists should be attempted while monitoring for occurrence of NMSs, such as apathy and sleep disturbances. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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- 2020
14. Dyspnea after subthalamic deep brain stimulation in Parkinson’s disease: a case–control study
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Sara Meoni, Elena Moro, Pettarusp M. Wadia, Ana C Bradi, and Yu-Yan Poon
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Male ,Spirometry ,medicine.medical_specialty ,Neurology ,Deep brain stimulation ,Parkinson's disease ,Deep Brain Stimulation ,medicine.medical_treatment ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Neuroradiology ,medicine.diagnostic_test ,business.industry ,Case-control study ,Parkinson Disease ,medicine.disease ,respiratory tract diseases ,nervous system diseases ,Subthalamic nucleus ,Dyspnea ,Treatment Outcome ,surgical procedures, operative ,nervous system ,Case-Control Studies ,Anesthesia ,Neurology (clinical) ,business ,therapeutics ,030217 neurology & neurosurgery - Abstract
Dyspnea can be present as non-motor symptom in patients with Parkinson’s disease (PD). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor and non-motor symptoms in PD. However, new-onset dyspnea has been reported after DBS surgery. We have studied respiratory characteristics of PD patients with bilateral STN-DBS to assess the impact of DBS on pulmonary function. STN-DBS PD patients with dyspnea after surgery (cases) were matched with STN-DBS PD patients without dyspnea (controls). Motor and pulmonary function were assessed with stimulation and without medication (on stim/off med), and without stimulation and medication (off stim/off med). Pulmonary function was investigated with spirometry and dyspnea with the Medical Research Council Dyspnea Scale (MRCDS) and the Borg Scale (BS). Seven cases (five men, 58.30 ± 6.70 years of age) and seven controls (six men, 61.10 ± 6.30 years of age) were enrolled. MRCDS and BS revealed the presence of dyspnea in both groups. No significant changes in pulmonary function were found in both cases and controls in on stim/off med vs. off stim/off med condition (p
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- 2020
15. Freezing of gait in Parkinson’s disease: pathophysiology, risk factors and treatments
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Yu-Yan Tan, Chao Gao, Jun Liu, and Sheng-Di Chen
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0301 basic medicine ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Neurology ,genetic structures ,Deep Brain Stimulation ,Cognitive Neuroscience ,medicine.medical_treatment ,Electric Stimulation Therapy ,Review ,Transcranial Direct Current Stimulation ,Pathophysiology ,lcsh:RC346-429 ,Antiparkinson Agents ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,0302 clinical medicine ,Physical medicine and rehabilitation ,Risk Factors ,medicine ,Humans ,Gait Disorders, Neurologic ,lcsh:Neurology. Diseases of the nervous system ,Transcranial direct-current stimulation ,Freezing of gait ,business.industry ,Parkinson Disease ,Istradefylline ,medicine.disease ,Transcranial Magnetic Stimulation ,Non-pharmacological treatment ,Transcranial magnetic stimulation ,Clinical trial ,030104 developmental biology ,chemistry ,Parkinson’s disease ,Neurology (clinical) ,Risk factor ,business ,Pharmacological treatment ,030217 neurology & neurosurgery ,Vagus nerve stimulation ,medicine.drug - Abstract
Background Freezing of gait (FOG) is a common, disabling symptom of Parkinson’s disease (PD), but the mechanisms and treatments of FOG remain great challenges for clinicians and researchers. The main focus of this review is to summarize the possible mechanisms underlying FOG, the risk factors for screening and predicting the onset of FOG, and the clinical trials involving various therapeutic strategies. In addition, the limitations and recommendations for future research design are also discussed. Main body In the mechanism section, we briefly introduced the physiological process of gait control and hypotheses about the mechanism of FOG. In the risk factor section, gait disorders, PIGD phenotype, lower striatal DAT uptake were found to be independent risk factors of FOG with consistent evidence. In the treatment section, we summarized the clinical trials of pharmacological and non-pharmacological treatments. Despite the limited effectiveness of current medications for FOG, especially levodopa resistant FOG, there were some drugs that showed promise such as istradefylline and rasagiline. Non-pharmacological treatments encompass invasive brain and spinal cord stimulation, noninvasive repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) and vagus nerve stimulation (VNS), and physiotherapeutic approaches including cues and other training strategies. Several novel therapeutic strategies seem to be effective, such as rTMS over supplementary motor area (SMA), dual-site DBS, spinal cord stimulation (SCS) and VNS. Of physiotherapy, wearable cueing devices seem to be generally effective and promising. Conclusion FOG model hypotheses are helpful for better understanding and characterizing FOG and they provide clues for further research exploration. Several risk factors of FOG have been identified, but need combinatorial optimization for predicting FOG more precisely. Although firm conclusions cannot be drawn on therapeutic efficacy, the literature suggested that some therapeutic strategies showed promise.
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- 2020
16. Complex dyskinesias in Parkinson patients on levodopa/carbidopa intestinal gel
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Yu-Yan Poon, Lazzaro di Biase, Vincenzo Di Lazzaro, Pietro Marano, Giovanni Cossu, Roberta Arca, Taline Naranian, Alfonso Fasano, Massimo Marano, and Alessandro Di Santo
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Male ,0301 basic medicine ,Dyskinesia, Drug-Induced ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Gastroenterology ,Antiparkinson Agents ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Effective treatment ,Longitudinal Studies ,Control sample ,Oral therapy ,Aged ,Retrospective Studies ,business.industry ,Dopaminergic ,Carbidopa ,Parkinson Disease ,Middle Aged ,medicine.disease ,nervous system diseases ,Intestines ,Drug Combinations ,Cross-Sectional Studies ,030104 developmental biology ,Neurology ,Dyskinesia ,Case-Control Studies ,Levodopa carbidopa ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,medicine.symptom ,business ,Gels ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background Levodopa-carbidopa intestinal infusion is an effective treatment for motor fluctuations in Parkinson's disease. However, it has been recently associated with emergent complex/atypical dyskinesias. We sought to characterize patients who developed these dyskinesias after levodopa infusion initiation, and to compare these patients to a control population with conventional motor fluctuations. Methods 208 Parkinson's disease patients, treated with levodopa intestinal infusion due to motor fluctuations, were screened for onset and/or worsening of dyskinesias after initiation of levodopa infusion, resistant to the routine titration, and presenting with atypical or unexpected patterns. Patients with extensive follow-up data were enrolled for a longitudinal analysis. Cases were compared to a control sample with conventional motor fluctuations in order to investigate predisposing factors, difference in dyskinesia phenotype, management strategies and dropouts. Results Thirty patients out of 208 (14.4%) reported atypical (i.e. long-lasting) biphasic, biphasic-like (i.e. continuous) or mixed (peak-dose and continuous biphasic) dyskinesias after levodopa infusion. They were compared at baseline and follow-up to a sample of 49 patients with conventional motor fluctuations on levodopa infusion. Both groups had similar demographic and clinical features, except the former having higher prevalence of biphasic dyskinesias while on oral therapy. Biphasic-like dyskinesias in nearly half the number of cases improved with increasing the dopaminergic load, while mixed dyskinesias had the worst outcome and highest dropout rate (58%). Conclusions Atypical biphasic, biphasic-like and complex dyskinesias could hinder the course of patients treated with levodopa infusion. This study further informs the selection process of advanced therapies, particularly in dyskinetic patients.
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- 2019
17. Mechanisms of motor symptom improvement by long-term Tai Chi training in Parkinson's disease patients
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Bin-Yin Li, Gen Li, Xin Shen, Pei Huang, Ping Huang, Ya-Chao He, Yu-Xin Li, Sheng-Di Chen, Shi-Shuang Cui, Zheng Wang, Jin Xu, Yu-Yan Tan, Qin-Ying Jiang, and Guiying He
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medicine.medical_specialty ,Parkinson's disease ,Motor symptoms ,business.industry ,Cognitive Neuroscience ,Parkinson Disease ,medicine.disease ,Brain network ,Tai Chi ,Term (time) ,Cellular and Molecular Neuroscience ,Physical medicine and rehabilitation ,Treatment Outcome ,Time and Motion Studies ,medicine ,Parkinson’s disease ,Humans ,Tai Ji ,Neurology (clinical) ,Mechanism ,Neurology. Diseases of the nervous system ,business ,RC346-429 ,Postural Balance - Abstract
Background Tai Chi has been shown to improve motor symptoms in Parkinson’s disease (PD), but its long-term effects and the related mechanisms remain to be elucidated. In this study, we investigated the effects of long-term Tai Chi training on motor symptoms in PD and the underlying mechanisms. Methods Ninety-five early-stage PD patients were enrolled and randomly divided into Tai Chi (n = 32), brisk walking (n = 31) and no-exercise (n = 32) groups. At baseline, 6 months and 12 months during one-year intervention, all participants underwent motor symptom evaluation by Berg balance scale (BBS), Unified PD rating-scale (UPDRS), Timed Up and Go test (TUG) and 3D gait analysis, functional magnetic resonance imaging (fMRI), plasma cytokine and metabolomics analysis, and blood Huntingtin interaction protein 2 (HIP2) mRNA level analysis. Longitudinal self-changes were calculated using repeated measures ANOVA. GEE (generalized estimating equations) was used to assess factors associated with the longitudinal data of rating scales. Switch rates were used for fMRI analysis. False discovery rate correction was used for multiple correction. Results Participants in the Tai Chi group had better performance in BBS, UPDRS, TUG and step width. Besides, Tai Chi was advantageous over brisk walking in improving BBS and step width. The improved BBS was correlated with enhanced visual network function and downregulation of interleukin-1β. The improvements in UPDRS were associated with enhanced default mode network function, decreased L-malic acid and 3-phosphoglyceric acid, and increased adenosine and HIP2 mRNA levels. In addition, arginine biosynthesis, urea cycle, tricarboxylic acid cycle and beta oxidation of very-long-chain fatty acids were also improved by Tai Chi training. Conclusions Long-term Tai Chi training improves motor function, especially gait and balance, in PD. The underlying mechanisms may include enhanced brain network function, reduced inflammation, improved amino acid metabolism, energy metabolism and neurotransmitter metabolism, and decreased vulnerability to dopaminergic degeneration. Trial registration This study has been registered at Chinese Clinical Trial Registry (Registration number: ChiCTR2000036036; Registration date: August 22, 2020).
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- 2021
18. Vitamins and Infusion of Levodopa-Carbidopa Intestinal Gel
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Aristide Merola, Alfonso Fasano, Yu-Yan Poon, Vathany Kulasingam, Taline Naranian, Oksana Suchowersky, Jennifer Taher, and Tiago A. Mestre
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Vitamin ,medicine.medical_specialty ,Levodopa ,Parkinson's disease ,Homocysteine ,Methylmalonic acid ,Context (language use) ,Gastroenterology ,Antiparkinson Agents ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Quality of life ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Vitamin B12 ,business.industry ,Carbidopa ,General Medicine ,Vitamins ,medicine.disease ,Neurology ,chemistry ,Quality of Life ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Levodopa-carbidopa intestinal gel infusion (LCIG) is an established therapy for advanced Parkinson disease (PD), resulting in a significant improvement of quality of life. With increased LCIG adoption worldwide, potential complications due to abnormal vitamin absorption or metabolism have been reported in these patients. Neurologists are unfamiliar with vitamins physiology and pathophysiological mechanisms in case of their deficiency. Unfortunately, clinical and laboratory guidelines related to vitamin monitoring and supplementation in the context of treatment with LCIG are not available. We herein summarize the current knowledge on three vitamins that are reduced with LCIG therapy reporting on their physiology, laboratory testing, and clinical impact of their deficiency/excess. In addition, we proposed an opinion-based recommendation for clinicians treating LCIG patients. Patients and caregivers should be informed about the risk of vitamin deficiency. Vitamin B12, homocysteine, and methylmalonic acid (MMA) should be tested before starting LCIG, six months after and once/year thereafter. Vitamin B6 and folate testing is not universally available but it should be considered if homocysteine is elevated but MMA and/or total vitamin B12 are normal. Prophylaxis of vitamin deficiency should be started as soon as LCIG is implemented, possibly even before. Dietary recommendations are enough in most patients although a subgroup of patients is at higher risk and should receive Vitamin B12 regularly and cycles of B6. Finally, once diagnosed a vitamin deficiency should be readily treated and accompanied by clinical and laboratory monitoring. Resistant cases should receive non-oral routes of administration and possibly discontinue LCIG, even temporarily.
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- 2021
19. Clinical correlates of decreased plasma coenzyme Q10 levels in patients with multiple system atrophy
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Tian Wang, Juan-Juan Du, Chao Gao, Shi-Shuang Cui, Sheng-Di Chen, Ya-Chao He, Pei Huang, Jun-Yi Shen, Yu-Yan Tan, Rao Fu, and Yi-Qi Lin
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Male ,0301 basic medicine ,medicine.medical_specialty ,Parkinson's disease ,Ubiquinone ,Disease ,Sensitivity and Specificity ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Atrophy ,stomatognathic system ,Internal medicine ,mental disorders ,parasitic diseases ,Humans ,Medicine ,In patient ,Aged ,Coenzyme Q10 ,Receiver operating characteristic ,business.industry ,Middle Aged ,Multiple System Atrophy ,medicine.disease ,nervous system diseases ,030104 developmental biology ,nervous system ,Neurology ,chemistry ,Biomarker (medicine) ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,Differential diagnosis ,business ,Biomarkers ,030217 neurology & neurosurgery - Abstract
Introduction Multiple system atrophy (MSA) is a progressive neurodegenerative disease. Recent studies revealed decreased coenzyme Q10 (COQ10) levels in the cerebellum and blood samples of MSA patients. But few studies focused on the associations of COQ10 with the clinical symptoms of MSA. In this study, we aimed to quantify plasma COQ10 and characterize its association with clinical features. Methods We recruited 40 patients with MSA, 30 patients with Parkinson's disease (PD), and 30 healthy participants. Plasma COQ10 was quantified by UPLC-MS. The basic demographic data, motor symptoms, and non-motor symptoms were also assessed. Results Plasma COQ10 levels were significantly different in MSA, PD, and controls (P = 0.001). Post-hoc analysis revealed plasma COQ10 levels in MSA patients were lower than that in controls after adjusting for age, gender, and total cholesterol (P = 0.001). COQ10 levels differentiated MSA patients from controls with modest accuracy (P = 0.001). A sensitivity of 40% and a specificity of 97.5% was calculated with the receiver operating characteristic curve. However, COQ 10 levels did not discriminate between the MSA and PD groups (P = 0.07). Plasma COQ10 levels were correlated with the severity of motor symptoms only in MSA-C patients (b = −0.025, P = 0.009). Conclusion The association between decreased COQ10 levels and the severity of motor symptoms in MSA-C patients promotes further research. Plasma COQ10 levels alone may not be a reliable MSA diagnostic biomarker, and cannot be considered a useful biomarker in the differential diagnosis of MSA vs PD.
- Published
- 2018
20. Mortality from Parkinson's disease in China: Findings from a ten-year follow up study in Shanghai
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Gang Wang, Jian-Fang Ma, Sheng-Di Chen, Yu-Yan Tan, Jun Liu, Chun-Fang Wang, Hai-Yan Zhou, Qin Xiao, Ying Wang, Jing Pan, Yue-Qi Zhang, and Gang Xu
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0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Parkinson's disease ,business.industry ,Respiratory disease ,Follow up studies ,Disease ,medicine.disease ,Gait ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Standardized mortality ratio ,Neurology ,Cohort ,medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Cause of death - Abstract
Background Standardized mortality ratio (SMR) is the most frequently used index in Parkinson's disease (PD) survival survey. However, there is little SMR data in PD from China. Objective To examine the outcome, including overall and cause-specific mortality, of PD patients subsequent to 10 years of surveillance in Shanghai, China. This is an extension study of our previous investigation on mortality. Methods One hundred fifty-seven PD patients recruited from the movement disorder clinic of Rui Jin Hospital in 2006 were followed up until December 31, 2016 or death, representing a follow-up period of up to 10 years. Overall and cause-specific standardized mortality ratios (SMR) were calculated, and predictors for survival at disease onset were estimated. Results Thirty one patients had died by December 31, 2016, and the SMR at 10 years of follow-up was 0.87 (0.59–1.25). The primary direct cause of death was respiratory disease (SMR = 3.52, 95% CI 1.98–5.78). Employing Cox's proportional hazard modeling, postural instability gait disorder (PIGD) type and older age at onset predicted poor survival in this cohort. Conclusions This finding confirms the similar survival of patients with PD to the control population in the post-levodopa era. PIGD type and older age at onset had a negative impact on survival.
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- 2018
21. The iPS Technique Provides Hope for Parkinson’s Disease Treatment
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Xu, Liang, Tan, Yu-Yan, Ding, Jian-Qing, and Chen, Sheng-Di
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- 2010
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22. Endoplasmic reticulum stress contributes to the cell death induced by UCH-L1 inhibitor
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Tan, Yu-Yan, Zhou, Hai-Yan, Wang, Zhi-Quan, and Chen, Sheng-Di
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- 2008
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23. Monoamine Oxidase-B Inhibitors for the Treatment of Parkinson's Disease: Past, Present, and Future.
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Tan, Yu-Yan, Jenner, Peter, and Chen, Sheng-Di
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- *
PARKINSON'S disease , *DISEASE progression - Abstract
Monoamine oxidase-B (MAO-B) inhibitors are commonly used for the symptomatic treatment of Parkinson's disease (PD). MAO-B inhibitor monotherapy has been shown to be effective and safe for the treatment of early-stage PD, while MAO-B inhibitors as adjuvant drugs have been widely applied for the treatment of the advanced stages of the illness. MAO-B inhibitors can effectively improve patients' motor and non-motor symptoms, reduce "OFF" time, and may potentially prevent/delay disease progression. In this review, we discuss the effects of MAO-B inhibitors on motor and non-motor symptoms in PD patients, their mechanism of action, and the future development of MAO-B inhibitor therapy. [ABSTRACT FROM AUTHOR]
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- 2022
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24. The Association Analysis of GPNMB rs156429 With Clinical Manifestations in Chinese Population With Parkinson's Disease
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Gen Li, Pingchen Zhang, Wei-Shan Zhang, Sheng-Di Chen, Yixi He, Jin Liu, Yu-Yan Tan, Xin Shen, Shi-Shuang Cui, and Guiying He
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Parkinson's disease ,lcsh:QH426-470 ,Single-nucleotide polymorphism ,Disease ,Logistic regression ,GPNMB ,single nucleotide polymorphisms ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Genetics ,medicine ,Genetics (clinical) ,Original Research ,Genetic association ,business.industry ,clinical manifestation ,Montreal Cognitive Assessment ,medicine.disease ,Chinese people ,lcsh:Genetics ,030104 developmental biology ,030220 oncology & carcinogenesis ,Molecular Medicine ,business - Abstract
Background: The mechanisms of Parkinson's disease (PD) include complicated genetic factors. The roles of newly found risk genes need to be further verified among different ethnicities. In a two-stage meta-analysis, single nucleotide polymorphism (SNP) of rs156429 in glycoprotein non-metastatic melanoma protein B (GPNMB) was reported to be associated with PD. So far clinical studies have focused on association between rs156429 and PD onset, however there is little evidence linking rs156429 with PD symptoms. Objective: This study aimed to investigate the possible association of GPNMB rs156429 with PD manifestations among southeastern Chinese people. Methods: Demographic variables, disease-related factors, and motor and non-motor assessments of 511 PD patients were collected. Polymerase chain reaction (PCR) and SNaPshot technique were used to detect GPNMB rs156429. The associations of rs156429 with PD rating scales and clinical manifestations were analyzed by Kruskal-Wallis test and logistic regression model separately. Results: Kruskal-Wallis test and logistic regression model failed to reveal an association between GPNMB rs156429 and scores from Montreal Cognitive Assessment (MoCA) (p = 0.037; p = 1.000 after correction), and pain symptoms of 511 PD patients (p = 0.008, OR = 0.59, 95% CI = 0.40–0.87, overdominant model after adjustment; p = 0.168 after correction, overdominant model after adjustment). However, further analysis based on genders showed that GPNMB rs156429 might have a trend for being associated with cognitive dysfunction (Mini-Mental State Examination (MMSE), p = 0.064 after correction; MoCA, p = 0.064 after correction) and pain symptoms (p = 0.063 after correction, overdominant model after adjustment) in female PD patients but not male patients. Conclusions: This study revealed that GPNMB rs156429 might have a trend for being associated with cognitive dysfunction and pain symptoms of female PD patients in the southeastern Chinese population. Further studies from a larger sample size are needed to confirm these findings.
- Published
- 2020
25. Advanced Therapies for the Management of Dopamine Dysregulation Syndrome in Parkinson's Disease
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Suneil K. Kalia, Mateusz Zurowski, Andres M. Lozano, Alfonso Fasano, Renato P. Munhoz, Mojgan Hodaie, Roberto Matta, Yu-Yan Poon, and Sanskriti Sasikumar
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Levodopa ,Deep brain stimulation ,Parkinson's disease ,business.industry ,medicine.medical_treatment ,Disease ,030105 genetics & heredity ,medicine.disease ,Substance abuse ,03 medical and health sciences ,Subthalamic nucleus ,0302 clinical medicine ,Neurology ,Internal medicine ,medicine ,Neurology (clinical) ,business ,Complication ,030217 neurology & neurosurgery ,Research Articles ,medicine.drug ,Dopamine dysregulation syndrome - Abstract
Background Dopamine Dysregulation Syndrome (DDS) is an adverse non-motor complication of dopamine replacement therapy in Parkinson's disease. The current literature on this syndrome is limited, and it remains underdiagnosed and challenging to manage. Objective To assess the role of advanced therapies in the management of DDS. Methods We performed a retrospective chart review and identified patients who fit the inclusion criteria for DDS. They were classified according to risk factors that have been identified in the literature, motor and complication scores, intervention (medical or surgical) and outcome. Multivariate analyses were performed to analyze these characteristics. Results Twenty-seven patients were identified (23 males, mean age of onset: 49 ± 8.8 years). Average levodopa equivalent daily dose was 1916.7 ± 804 mg and a history of impulse control disorders, psychiatric illness, and substance abuse was present in 89%, 70% and 3.7% of the patients, respectively. Overall 81.5% of patients had symptom resolution at follow up, on average 4.8 ± 3.5 years after management, with medication only (7/9), levodopa-carbidopa intestinal gel (1/3), deep brain stimulation of subthalamic nucleus (10/13), or globus pallidus pars interna (2/2). Reduction of medications occurred with deep brain stimulation of subthalamic nucleus (P = 0.01) but was associated with a relapse in two patients. Conclusion Although the small sample size of some subgroups limits our ability to draw meaningful conclusions, our results did not suggest superiority of a single treatment option. Advanced therapies including deep brain stimulation can be considered in patients with DDS refractory to conservative measures, but outcome is variable and relapse is possible.
- Published
- 2020
26. Validation of Revised Chinese Version of PD-CRS in Parkinson’s Disease Patients
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Sheng-Di Chen, Xiaoguang Luo, Shi-Shuang Cui, Cui-Yu Yu, Shengyu Zha, Juan-Juan Du, Hui-Dong Tang, Lei Yan, Yi-Zhou Lu, Hong Lv, Xi Wang, Yu-Yan Tan, Yang Liu, Lijun Han, Miao-Miao Hou, and Weiguo Liu
- Subjects
medicine.medical_specialty ,Parkinson's disease ,Article Subject ,business.industry ,Intraclass correlation ,Concurrent validity ,Neuroscience (miscellaneous) ,Cognition ,Audiology ,medicine.disease ,behavioral disciplines and activities ,Chinese people ,nervous system diseases ,Psychiatry and Mental health ,Cronbach's alpha ,Rating scale ,mental disorders ,medicine ,Dementia ,Neurology (clinical) ,Neurology. Diseases of the nervous system ,business ,RC346-429 ,Research Article - Abstract
There is a high prevalence of mild cognitive impairment (MCI) and dementia in Parkinson’s disease (PD) patients, but a Chinese version of cognitive rating scale that is specific and sensitive to PD patients is still lacking. The aims of this study are to test the reliability and validity of a Chinese version of Parkinson’s disease-cognitive rating scale (PD-CRS), establish cutoff scores for diagnosis of Parkinson’s disease dementia (PDD) and PD with mild cognitive impairment (PD-MCI), explore cognitive profiles of PD-MCI and PDD, and find cognitive deficits suggesting a transition from PD-MCI to PDD. PD-CRS was revised based on the culture background of Chinese people. Ninety-two PD patients were recruited in three PD centers and were classified into PD with normal cognitive function (PD-NC), PD-MCI, and PDD subgroups according to the cognitive rating scale (CDR). Those PD patients underwent PD-CRS blind assessment by a separate neurologist. The PD-CRS showed a high internal consistency (Cronbach’s Alpha = 0.840). Intraclass Correlation coefficient (ICC) of test-retest reliability reached 0.906 (95% CI 0.860–0.935, p<0.001). ICC of inter-rater reliability was 0.899 (95% CI 0.848–0.933, p<0.001). PD-CRS had fair concurrent validity with MDRS (ICC = 0.731, 95% CI 0.602–0.816). All the frontal-subcortical items showed significant decrease in PD-MCI compared with the PD-NC group (p≤0.001), but the instrument cortical items did not (confrontation naming p=0.717, copying a clock p=0.620). All the frontal-subcortical and instrumental-cortical functions showed significant decline in PDD compared with the PD-NC group (p≤0.001). The cutoff value for diagnosis of PD-MCI is 80.5 with the sensitivity of 75.7% and the specificity of 75.0%, and for diagnosis of PDD is 73.5 with the sensitivity of 89.2% and the specificity of 98.9%. Revised Chinese version of PD-CRS is a reliable, acceptable, valid, and useful neuropsychological battery for assessing cognition in PD patients.
- Published
- 2020
27. The role of substantia nigra sonography in the differentiation of Parkinson’s disease and multiple system atrophy
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Juan-Juan Du, Ying Wang, Yun-Yun Hu, Shi-Shuang Cui, Pei Huang, Wei-Wei Zhan, Sheng-Di Chen, Jun Liu, Yu-Yan Tan, Qin Xiao, Hai-Yan Zhou, and Qian Sun
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Neurology ,Parkinson's disease ,Cognitive Neuroscience ,Context (language use) ,Substantia nigra ,Gastroenterology ,lcsh:RC346-429 ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Atypical parkinsonian disorders ,0302 clinical medicine ,Atrophy ,Internal medicine ,medicine ,lcsh:Neurology. Diseases of the nervous system ,Disease duration ,business.industry ,Parkinsonism ,Research ,Echogenicity ,Multiple system atrophy ,medicine.disease ,030104 developmental biology ,Transcranial sonography ,Parkinson’s disease ,Neurology (clinical) ,Differential diagnosis ,business ,030217 neurology & neurosurgery - Abstract
Background The differential diagnosis of Parkinson’s disease (PD) and multiple system atrophy (MSA) remains a challenge, especially in the early stage. Here, we assessed the value of transcranial sonography (TCS) to discriminate non-tremor dominant (non-TD) PD from MSA with predominant parkinsonism (MSA-P). Methods Eighty-six MSA-P patients and 147 age and gender-matched non-TD PD patients who had appropriate temporal acoustic bone windows were included in this study. All the patients were followed up for at least 2 years to confirm the initial diagnosis. Patients with at least one substantia nigra (SN) echogenic size ≥18 mm2 were classified as hyperechogenic, those with at least one SN echogenic size ≥25 mm2 was defined as markedly hyperechogenic. Results The frequency of SN hyperechogenicity in non-TD PD patients was significantly higher than that in MSA-P patients (74.1% vs. 38.4%, p
- Published
- 2018
28. Correction to: Prevalence of freezing of gait in Parkinson’s disease: a systematic review and meta-analysis
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Yu-Yan Tan, Wei-Shan Zhang, Sheng-Di Chen, and Chao Gao
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medicine.medical_specialty ,Parkinson's disease ,Neurology ,business.industry ,MEDLINE ,medicine.disease ,Gait (human) ,Physical medicine and rehabilitation ,Meta-analysis ,medicine ,Neurology (clinical) ,business ,Neuroradiology - Published
- 2021
29. Axial Impairment Following Deep Brain Stimulation in Parkinson's Disease: A Surgicogenomic Approach.
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Visanji, Naomi P., Ghani, Mahdi, Yu, Eric, Kakhki, Erfan Ghani, Sato, Christine, Moreno, Danielle, Naranian, Taline, Poon, Yu-Yan, Abdollahi, Maryam, Naghibzadeh, Maryam, Rajalingam, Rajasumi, Lozano, Andres M., Kalia, Suneil K., Hodaie, Mojgan, Cohn, Melanie, Statucka, Marta, Boutet, Alexandre, Elias, Gavin J.B., Germann, Jürgen, and Munhoz, Renato
- Subjects
DEEP brain stimulation ,BRAIN stimulation ,PARKINSON'S disease ,DISEASE risk factors ,GENETIC variation ,NEUROLOGICAL disorders - Abstract
Background: Postoperative outcome following deep brain stimulation (DBS) of the subthalamic nucleus is variable, particularly with respect to axial motor improvement. We hypothesized a genetic underpinning to the response to surgical intervention, termed "surgicogenomics". Objective: We aimed to identify genetic variants associated with clinical heterogeneity in DBS outcome of Parkinson's disease (PD) patients that could then be applied clinically to target selection leading to improved surgical outcome. Methods: Retrospective clinical data was extracted from 150 patient's charts. Each individual was genotyped using the genome-wide NeuroX array tailored to study neurologic diseases. Genetic data were clustered based on surgical outcome assessed by comparing pre- and post-operative scores of levodopa equivalent daily dose and axial impairment at one and five years post-surgery. Allele frequencies were compared between patients with excellent vs. moderate/poor outcomes grouped using a priori defined cut-offs. We analyzed common variants, burden of rare coding variants, and PD polygenic risk score. Results: NeuroX identified 2,917 polymorphic markers at 113 genes mapped to known PD loci. The gene-burden analyses of 202 rare nonsynonymous variants suggested a nominal association of axial impairment with 14 genes (most consistent with CRHR1, IP6K2, and PRSS3). The strongest association with surgical outcome was detected between a reduction in levodopa equivalent daily dose and common variations tagging two linkage disequilibrium blocks with SH3GL2. Conclusion: Once validated in independent populations, our findings may be implemented to improve patient selection for DBS in PD. [ABSTRACT FROM AUTHOR]
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- 2022
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30. Non-Motor Fluctuations in Parkinson's Disease (PD): Development and Validation of the Non-Motor Fluctuation Assessment Instrument (NoMoFA)
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Kevin R Duque, Alberto J. Espay, A. Law, Adam Margolius, M. Saenz-Farret, Joaquin A. Vizcarra, Galit Kleiner, Glenn T. Stebbins, Kelvin L. Chou, Hubert H. Fernandez, Yu-Yan Poon, D. Hengartner, and Alfonso Fasano
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,Parkinson's disease ,Neurology ,business.industry ,Assessment instrument ,Medicine ,Non motor ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,medicine.disease - Published
- 2020
31. Motor-symptom laterality affects acquisition in Parkinson's disease: A cognitive and functional magnetic resonance imaging study
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Dong-Qiang Liu, Yu-Yan Tan, Mohammad M. Herzallah, Mark A. Gluck, Pei Huang, Sheng-Di Chen, Yu-Feng Zang, Ying Wang, and Elizabeth Lapidow
- Subjects
medicine.medical_specialty ,Parkinson's disease ,medicine.diagnostic_test ,Putamen ,05 social sciences ,Cognition ,Striatum ,Audiology ,medicine.disease ,050105 experimental psychology ,Lateralization of brain function ,Associative learning ,03 medical and health sciences ,0302 clinical medicine ,Neurology ,Laterality ,medicine ,0501 psychology and cognitive sciences ,Neurology (clinical) ,Psychology ,Functional magnetic resonance imaging ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Background and Objectives: Asymmetric onset of motor symptoms in PD can affect cognitive function. We examined whether motor-symptom laterality could affect feedback-based associative learning and explored its underlying neural mechanism by functional magnetic resonance imaging in PD patients. Methods: We recruited 63 early-stage medication-naive PD patients (29 left-onset medication-naive patients, 34 right-onset medication-naive patients) and 38 matched normal controls. Subjects completed an acquired equivalence task (including acquisition, retention, and generalization) and resting-state functional magnetic resonance imaging scans. Learning accuracy and response time in each phase of the task were recorded for behavioral measures. Regional homogeneity was used to analyze resting-state functional magnetic resonance imaging data, with regional homogeneity lateralization to evaluate hemispheric functional asymmetry in the striatum. Results: Left-onset patients made significantly more errors in acquisition (feedback-based associative learning) than right-onset patients and normal controls, whereas right-onset patients performed as well as normal controls. There was no significant difference among these three groups in the accuracy of either retention or generalization phase. The three groups did not show significant differences in response time. In the left-onset group, there was an inverse relationship between acquisition errors and regional homogeneity in the right dorsal rostral putamen. There were no significant regional homogeneity changes in either the left or the right dorsal rostral putamen in right-onset patients when compared to controls. Conclusions: Motor-symptom laterality could affect feedback-based associative learning in PD, with left-onset medication-naive patients being selectively impaired. Dysfunction in the right dorsal rostral putamen may underlie the observed deficit in associative learning in patients with left-sided onset.© 2016 International Parkinson and Movement Disorder Society
- Published
- 2017
32. Programming Directional Deep Brain Stimulation in Parkinson's Disease: A Randomized Prospective Trial Comparing Early versus Delayed Stimulation Steering.
- Author
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Maciel, Ricardo, Soh, Derrick, Munhoz, Renato P., Poon, Yu-Yan, Kalia, Suneil K., Hodaie, Mojgan, Lozano, Andres M., and Fasano, Alfonso
- Abstract
Introduction: Programming directional leads poses new challenges as the optimal strategy is yet to be established. We designed a randomized control study to establish an evidence-based programming algorithm for patients with Parkinson's disease undergoing subthalamic nucleus deep brain stimulation with directional leads. Methods: Fourteen consecutive patients were randomized to programming with either early or delayed (i.e., starting with a "ring mode") steered stimulation. Motor scores, number of programming visits, calls to the clinic, battery consumption, and stimulation adjustments required were recorded and compared between groups, using the Wilcoxon signed-ranks test, after 3 months of open-label programming. Results: Thirteen patients (25 electrodes) were included, of which 23 were steerable. Nine out of 14 electrodes allocated to delayed steered stimulation were changed to steered mode due to side effects during the course of the study. No patients (11 electrodes) initially allocated to early steered stimulation were converted to ring mode. The 2 study arms did not differ in any of the considered measures at 3 months. Conclusion: Programming with early or delayed steered stimulation is equally effective in the short term. However, delayed steering is less time consuming and is not always needed. [ABSTRACT FROM AUTHOR]
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- 2021
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33. Substantia nigra echogenicity correlated with clinical features of Parkinson's disease
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Dunhui Li, Wei-Wei Zhan, Ying Wang, Qin Xiao, Qian Sun, Hai-Yan Zhou, Jun Liu, Yu-Yan Tan, Sheng-Di Chen, and Yun-Yun Hu
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Pathology ,Parkinson's disease ,Ultrasonography, Doppler, Transcranial ,Severe disease ,Substantia nigra ,Disease ,Severity of Illness Index ,Gastroenterology ,Statistics, Nonparametric ,03 medical and health sciences ,0302 clinical medicine ,Disease severity ,Residence Characteristics ,Rating scale ,Internal medicine ,medicine ,Humans ,Aged ,business.industry ,Echogenicity ,Parkinson Disease ,Middle Aged ,medicine.disease ,Substantia Nigra ,030104 developmental biology ,Neurology ,Autonomic symptoms ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
Transcranial sonography can display structural alterations in the substantia nigra (SN) of patients with Parkinson's disease (PD), and is considered to be a potential useful tool for the diagnosis of PD. The aim of this study was to assess the correlation between SN echogenicity and clinical features in Chinese patients with PD.A total of 420 subjects including 290 patients with PD and 130 controls were recruited from the neurological clinic or the community. Transcranial sonographic evaluations of the SN were performed in all subjects, and motor and non-motor symptoms were thoroughly assessed by a series of rating scales in PD patients.Two hundred and one patients were successfully assessed by transcranial sonography. SN hyperechogenicity was found to be associated with male sex (p = 0.004), higher scores on the Unified Parkinson's Disease Rating Scale (UPDRS) part II (p = 0.001) and autonomic symptoms scores (p = 0.003). Moreover, regression analysis revealed that UPDRS part II scores (odds ratio = 1.141, p0.001) and gender (odds ratio = 2.409, p = 0.007) could be the independent predictors for SN hyperechogenicity; in addition, among all items of UPDRS part II, speech, dressing, hygiene, and turning in bed and adjusting bed clothes significantly correlated with SN hyperechogenicity.This is the first report suggesting the correlation between SN echogenicity and UPDRS part II, and we conclude that increased SN echogenicity might reflect more severe disease disability or poorer medical response.
- Published
- 2016
34. Combination of olfactory test and substantia nigra transcranial sonopraphy in the differential diagnosis of Parkinson’s disease: a pilot study from China
- Author
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Chen Wei, Tan Yu-Yan, Hu Yun-Yun, Zhan Wei-Wei, Wu Li, Lou Yue, Wang Xi, Zhou Yi, Huang Pei, Gao Yuan, Xiao Qin, and Chen Sheng-Di
- Subjects
Parkinson’s disease ,Hyposmia ,Transcranial sonography ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Objectives Both hyposmia and substania nigra (SN) hyperechogenicity on trascranial sonography (TCS) were risk markers for idiopathic Parkinson’s disease (PD), which was beneficial to the differential diagnosis of the disease. However, each of their single diagnostic value is often limited. The purpose of present study was to explore whether the combination of olfactory test and TCS of SN could enhance the differential diagnostic power in Chinese patients with PD. Methods Thirty-seven patients with PD and twenty-six patients with essential tremor (ET) were evaluated on 16-item odor identification test from extended version of sniffin’ sticks and TCS of SN. The frequency of hyposmia and SN hyperechogenicity in each group was compared. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two clinical biomarkers were analyzed. Results The frequency of hyposmia in patients with PD was significantly higher than in patients with ET (62.2% VS. 3.8%, P = 0.000). The frequency of SN hyperechogenicity in patients with PD was significantly higher than in ET subjects (48.6% VS. 15.4%, P = 0.006). The combination of hyposmia and SN hyperechogenicity (if either one or both present) discriminated patients with PD from ET with a sensitivity of 78.4% and 29.7%, specificity of 80.8% and 100%, PPV of 85.3% and 100%, and NPV of 72.4% and 50.0%, respectively. Conclusions Our preliminary data suggested that the combination of hyposmia and SN hyperechogenicity could improve the diagnostic potential for discriminating Chinese patients with PD from ET.
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- 2012
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35. Non‐Motor Fluctuations in Parkinson's Disease: Validation of the Non‐Motor Fluctuation Assessment Questionnaire.
- Author
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Kleiner, Galit, Fernandez, Hubert H., Chou, Kelvin L., Fasano, Alfonso, Duque, Kevin R., Hengartner, Diana, Law, Albie, Margolius, Adam, Poon, Yu‐Yan, Sáenz Farret, Michel, Saleh, Philip, Vizcarra, Joaquin A., Stebbins, Glenn T., and Espay, Alberto J.
- Abstract
Background: In patients with Parkinson's disease (PD), sleep, mood, cognitive, autonomic, and other non‐motor symptoms may fluctuate in a manner similar to motor symptoms. Objectives: To validate a final version of a patient‐rated questionnaire that captures the presence and severity of non‐motor fluctuations in levodopa‐treated PD patients (NoMoFA). Methods: We recruited PD subjects from five movement disorders centers across the US and Canada. We assessed the internal consistency, floor and ceiling effects, test–retest reliability, and concurrent validity of NoMoFA. Classical test theory and item response theory methods informed item reduction and Delphi process yielded a final questionnaire. Results: Two hundred subjects and their care‐partners participated in the study (age: 66.4 ± 9.6 years; disease duration: 9 ± 5.5 years; median Hoehn and Yahr [H&Y] OFF: 3 [range 1−5]; mean Unified Parkinson's Disease Rating Scale (UPDRS) III ON score: 27.4 ± 14.9). Acceptability of the scale was adequate. There were floor effects in 8/28 items. Cronbach's alpha was 0.894. While eight items had "item‐to‐total" correlations below the cutoff of 0.4, removing these items did not improve Cronbach's alpha. Test–retest reliability was acceptable (intraclass correlation coefficient [ICC] 0.73; 95% confidence interval, 0.64−0.80). Concurrent validity was adequate with all Spearman's rho values comparing NoMoFA score to other measures of parkinsonian severity showing significance and in the expected direction. A final Delphi panel eliminated one item to avoid redundancy. Conclusions: The final 27‐item self‐administered NoMoFA is a valid and reliable questionnaire, capturing both static and fluctuating non‐motor symptoms in PD. © 2021 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
36. Advanced Therapies for the Management of Dopamine Dysregulation Syndrome in Parkinson's Disease.
- Author
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Sasikumar, Sanskriti, Matta, Roberto, Munhoz, Renato P., Zurowski, Mateusz, Poon, Yu‐Yan, Hodaie, Mojgan, Kalia, Suneil K., Lozano, Andres M., and Fasano, Alfonso
- Subjects
PARKINSON'S disease ,DEEP brain stimulation ,DOPAMINE ,IMPULSE control disorders ,SUBSTANCE abuse - Abstract
Background: Dopamine Dysregulation Syndrome (DDS) is an adverse non‐motor complication of dopamine replacement therapy in Parkinson's disease. The current literature on this syndrome is limited, and it remains underdiagnosed and challenging to manage. Objective: To assess the role of advanced therapies in the management of DDS. Methods: We performed a retrospective chart review and identified patients who fit the inclusion criteria for DDS. They were classified according to risk factors that have been identified in the literature, motor and complication scores, intervention (medical or surgical) and outcome. Multivariate analyses were performed to analyze these characteristics. Results: Twenty‐seven patients were identified (23 males, mean age of onset: 49 ± 8.8 years). Average levodopa equivalent daily dose was 1916.7 ± 804 mg and a history of impulse control disorders, psychiatric illness, and substance abuse was present in 89%, 70% and 3.7% of the patients, respectively. Overall 81.5% of patients had symptom resolution at follow up, on average 4.8 ± 3.5 years after management, with medication only (7/9), levodopa‐carbidopa intestinal gel (1/3), deep brain stimulation of subthalamic nucleus (10/13), or globus pallidus pars interna (2/2). Reduction of medications occurred with deep brain stimulation of subthalamic nucleus (P = 0.01) but was associated with a relapse in two patients. Conclusion: Although the small sample size of some subgroups limits our ability to draw meaningful conclusions, our results did not suggest superiority of a single treatment option. Advanced therapies including deep brain stimulation can be considered in patients with DDS refractory to conservative measures, but outcome is variable and relapse is possible. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
37. Gait Characteristics and Brain Activity in Parkinson’s Disease with Concomitant Postural Abnormalities
- Author
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Hong Jiang, Liche Zhou, Jun Liu, Yu-Yan Tan, Ningdi Luo, Quan-Zhou Wu, Lin Zhu, Wenyan Kang, Mengsha Yao, and Zhichun Chen
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Parkinson's disease ,camptocormia ,Timed Up and Go test ,gait ,Orginal Article ,Pathology and Forensic Medicine ,03 medical and health sciences ,Camptocormia ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,Outpatient clinic ,Middle frontal gyrus ,Supplementary motor area ,business.industry ,Cell Biology ,medicine.disease ,Gait ,Pisa syndrome ,030104 developmental biology ,medicine.anatomical_structure ,Parkinson’s disease ,postural abnormality ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,Insula ,030217 neurology & neurosurgery - Abstract
To explore the underlying pathogenic mechanism of Parkinson’s disease (PD) with concomitant postural abnormalities (PDPA) through the relationship between its gait and brain function characteristics. PD patients from the neurology outpatient clinic at Ruijin Hospital were recruited and grouped according to whether postural abnormalities (including camptocormia and Pisa syndrome) were present. PD-related scale assessments, three-dimensional gait tests and brain resting-state functional magnetic imaging were performed and analyzed. The gait characteristics independently associated with PDPA were decreased pelvic obliquity angle and progressive downward movement of the center of mass during walking. PDPA features included decreased functional connectivity between the left insula and bilateral supplementary motor area, which was significantly correlated with reduced Berg Balance Scale scores. Functional connectivity between the right insula and bilateral middle frontal gyrus was decreased and significantly correlated with a decreased pelvic obliquity angle and poor performance on the Timed Up and Go test. Moreover, through diffusion tensor imaging analysis, the average fractional anisotropy value of the fibers connecting the left insula and left supplementary motor area was shown to be decreased in PDPA. There is decreased functional connectivity among the insula, supplementary motor area and middle frontal gyrus with structural abnormalities between the left insula and the left supplementary motor area; these changes in brain connectivity are probably among the causes of gait dysfunction in PDPA and provide some clues regarding the pathogenic mechanisms of PDPA.
- Published
- 2020
38. Substantia Nigra Echogenicity Associated with Clinical Subtypes of Parkinson's Disease
- Author
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Shi-Shuang Cui, Qin Xiao, Jun Liu, Pei Huang, Hai-Yan Zhou, Yun-Yun Hu, Qian Sun, Wei-Wei Zhan, Ying Wang, Yu-Yan Tan, Sheng-Di Chen, and Juan-Juan Du
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,Ultrasonography, Doppler, Transcranial ,Substantia nigra ,Disease ,Gastroenterology ,Severity of Illness Index ,Correlation ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Internal medicine ,Tremor ,medicine ,Humans ,Stage (cooking) ,Age of Onset ,Aged ,business.industry ,Disease progression ,Echogenicity ,Parkinson Disease ,Middle Aged ,medicine.disease ,Substantia Nigra ,030104 developmental biology ,Disease Progression ,Biomarker (medicine) ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background It is debatable whether transcranial sonography (TCS) could be a biomarker for monitoring disease progression. Various phenotypes of Parkinson's disease (PD) may be a major reason contributing to the inconsistency. Objective We classified PD patients into different subtypes and evaluated the correlation between SN echogenicity and disease progression. Methods A total of 411 PD patients were included in this study. TCS evaluations of the substantia nigra (SN) were performed, and motor and non-motor symptoms were assessed by a series of rating scales in all PD patients. Results Three hundred and thirteen patients had appropriate temporal acoustic bone windows, and they were divided into three subgroups according to disease onset age. SN hyperechogenicity (SN+) was found to be associated with age, gender, disease duration, H-Y stage and UPDRS-II scores in 220 middle-age onset patients. Regression analysis identified both disease duration and gender as independent predictors for SN+. When this distinct group was separated into male and female subgroups, the correlation between larger SN echogenicity (SNL) and disease duration was positive in males rather than females. When these middle-age onset male patients were classified as tremor dominant (TD) and non-TD subtypes, it turned out that correlation between disease duration and SNL only existed in male non-TD PD patients. Conclusions Our study demonstrated correlation between the size of SN echogenicity and disease duration in Chinese patients with PD who were male non-TD subtypes with middle-age onset, suggesting the formation of SN echogenicity might be a dynamic process following disease progression in this distinct subtype.
- Published
- 2018
39. Establishing a Standard of Care for Deep Brain Stimulation Centers in Canada
- Author
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Alejandro Valencia-Mizrachi, Christopher R. Honey, Nicolas Jodoin, Yu-Yan Poon, Marina Picillo, Michel Panisset, Alfonso Fasano, and Renato P. Munhoz
- Subjects
medicine.medical_specialty ,Canada ,Deep brain stimulation ,Movement disorders ,Parkinson's disease ,medicine.medical_treatment ,Deep Brain Stimulation ,programming ,03 medical and health sciences ,Outcome Assessment (Health Care) ,0302 clinical medicine ,Physical medicine and rehabilitation ,Outcome Assessment, Health Care ,medicine ,Humans ,030212 general & internal medicine ,essential tremor ,Thalamic stimulator ,Dystonia ,Protocol (science) ,Essential tremor ,business.industry ,Parkinson Disease ,Standard of Care ,General Medicine ,medicine.disease ,tremor ,dystonia ,deep brain stimulation ,Neurology ,Neurology (clinical) ,Physical therapy ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
During the “DBS Canada Day” symposium held in Toronto July 4-5, 2014, the scientific committee invited experts to share their knowledge regarding deep brain stimulation (DBS) management of movement disorders in three domains: (1) the programming algorithms, (2) the necessary team to run a neurosurgery program, and (3) the appropriate scales to better define in a more comprehensive fashion the effect of the brain surgery. Each presentation was followed by an open discussion, and this article reports on the conclusions of this meeting on these three questions. Concerning programming, the role of the pulse width and the switching off of the stimulation at night for thalamic stimulation for the control of tremor have been discussed. The algorithms proposed in the literature for programming in Parkinson’s disease (PD) need validation. In dystonia, the use of monopolar vs bipolar parameters, the use of low vs high frequencies and the use of smaller versus larger pulse widths all need to be examined properly. Concerning the necessary team to run a neurosurgical program, recommendations will follow the suggestions for standardized outcome measures. Regarding the outcome measures for DBS in PD, investigations need to focus on the non-motor aspects of PD. Identifying which nonmotor symptoms respond to DBS would allow a better screening before and satisfaction postoperatively. There is an important need for more data to determine the optimal programming protocol and the standard measures that should be performed routinely by all centers.
- Published
- 2017
40. Correction: Links between COVID-19 and Parkinson's disease/Alzheimer's disease: reciprocal impacts, medical care strategies and underlying mechanisms.
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Huang, Pei, Zhang, Lin-Yuan, Tan, Yu-Yan, and Chen, Sheng-Di
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PARKINSON'S disease ,MEDICAL care ,COVID-19 ,SARS-CoV-2 Delta variant ,INDUCED pluripotent stem cells - Abstract
Pei Huang and Lin-Yuan Zhang contributed equally to this work B Correction to: Translational Neurodegeneration (2023) 12:5 b https://doi.org/10.1186/s40035-023-00337-1 Following publication of this article [[1]], three errors were identified about the reference. Links between COVID-19 and Parkinson's disease/Alzheimer's disease: reciprocal impacts, medical care strategies and underlying mechanisms. [Extracted from the article]
- Published
- 2023
- Full Text
- View/download PDF
41. Analysis of genome-wide association study-linked loci in Parkinson's disease of Mainland China
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Gang Wang, Jun Liu, Yu-Yan Tan, Zhi-Min Xu, Ying Wang, Qin Xiao, Wei Huang, Jian-Fang Ma, Qiong Yang, Jin Zhang, and Sheng-Di Chen
- Subjects
Genetics ,Parkinson's disease ,Genome-wide association study ,Single-nucleotide polymorphism ,Disease ,Biology ,medicine.disease ,Minor allele frequency ,Neurology ,Genotype ,medicine ,SNP ,Neurology (clinical) ,Genetic association - Abstract
Background Genome-wide association studies (GWAS) have identified numerous single-nucleotide polymorphisms (SNPs) that can modulate the risk of developing Parkinson's disease (PD). Methods We investigated the association of previously identified loci in a Mainland Chinese population to identify a possible ethnic-specific effect with GWAS analysis. Seventeen SNPs were genotyped from those loci using case–control methodology to analyze a total of 1,737 individuals. Results Strong evidence of an association for reference SNP 894278 (rs894278) and rs11931074 on 4q22 throughout the α synuclein (SNCA) region was observed in our study. The SNP rs894278 confers risk via a dominant model and an additive model, whereas the minor allele G of rs11931074 reduces the risk of PD progression. The minor allele frequency of rs11724635 produced weaker signals for PD, but this was not replicated in the genotype after adjusting for age and sex. Conclusions This study yields new clues about GWAS-linked data in patients with PD from Mainland China. © 2013 International Parkinson and Movement Disorder Society
- Published
- 2013
42. Motor-symptom laterality affects acquisition in Parkinson's disease: A cognitive and functional magnetic resonance imaging study
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Ying Wang, Mohammad M. Herzallah, Elizabeth Lapidow, Mark A. Gluck, Pei Huang, Yu-Feng Zang, Sheng-Di Chen, Dong-Qiang Liu, and Yu-Yan Tan
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Male ,medicine.medical_specialty ,Parkinson's disease ,Feedback, Psychological ,Striatum ,Audiology ,Lateralization of brain function ,Functional Laterality ,medicine ,Humans ,Cognitive Dysfunction ,Aged ,medicine.diagnostic_test ,business.industry ,Putamen ,Functional Neuroimaging ,Association Learning ,Cognition ,Parkinson Disease ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Associative learning ,Neurology ,Laterality ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,Functional magnetic resonance imaging ,business - Abstract
Background and Objectives: Asymmetric onset of motor symptoms in PD can affect cognitive function. We examined whether motor-symptom laterality could affect feedback-based associative learning and explored its underlying neural mechanism by functional magnetic resonance imaging in PD patients. Methods: We recruited 63 early-stage medication-naive PD patients (29 left-onset medication-naive patients, 34 right-onset medication-naive patients) and 38 matched normal controls. Subjects completed an acquired equivalence task (including acquisition, retention, and generalization) and resting-state functional magnetic resonance imaging scans. Learning accuracy and response time in each phase of the task were recorded for behavioral measures. Regional homogeneity was used to analyze resting-state functional magnetic resonance imaging data, with regional homogeneity lateralization to evaluate hemispheric functional asymmetry in the striatum. Results: Left-onset patients made significantly more errors in acquisition (feedback-based associative learning) than right-onset patients and normal controls, whereas right-onset patients performed as well as normal controls. There was no significant difference among these three groups in the accuracy of either retention or generalization phase. The three groups did not show significant differences in response time. In the left-onset group, there was an inverse relationship between acquisition errors and regional homogeneity in the right dorsal rostral putamen. There were no significant regional homogeneity changes in either the left or the right dorsal rostral putamen in right-onset patients when compared to controls. Conclusions: Motor-symptom laterality could affect feedback-based associative learning in PD, with left-onset medication-naive patients being selectively impaired. Dysfunction in the right dorsal rostral putamen may underlie the observed deficit in associative learning in patients with left-sided onset.© 2016 International Parkinson and Movement Disorder Society
- Published
- 2016
43. SCL20A2 mutation mimicking fluctuating Parkinson's disease
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Alfonso Fasano, Mohammad Rohani, Yu-Yan Poon, and Taline Naranian
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0301 basic medicine ,Genetics ,Fahr disease ,Parkinson's disease ,business.industry ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Neurology ,Mutation (genetic algorithm) ,Medicine ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,Neuroscience ,030217 neurology & neurosurgery - Published
- 2017
44. Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease
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Jason M. Schwalb, Yu Yan W Poon, Andres M. Lozano, Serena W. Hung, Robert Chen, Clement Hamani, Anthony E. Lang, Elena Moro, Tamara Arenovich, and Panida Piboolnurak
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medicine.medical_specialty ,Parkinson's disease ,Movement disorders ,Essential tremor ,medicine.medical_treatment ,Stimulation ,Neurological disorder ,medicine.disease ,nervous system diseases ,Surgery ,Central nervous system disease ,medicine.anatomical_structure ,Anesthesia ,medicine ,Neurology (clinical) ,medicine.symptom ,Psychology ,Craniotomy ,Motor cortex - Abstract
Epidural motor cortex stimulation has been reported to be effective in treating some movement disorders. Nevertheless, clinical results have been variable and no double-blinded evaluations have been reported. The aim of this study was to investigate efficacy and safety of unilateral subdural motor cortex stimulation in patients with essential tremor and Parkinson’s disease. Six patients with essential tremor and five parkinsonian patients were selected. Craniotomy was performed under local anaesthesia with conscious sedation. A four contact electrode (Resume II model 3587, Medtronic, Inc) was positioned on the motor cortex, after identification of the area with direct monopolar cortical stimulation. Soon after surgery, a variety of different settings of stimulation were assessed using standard rating scales to select the optimal stimulation parameters. The effects of chronic stimulation were evaluated in both groups of patients after 3 months (double-blinded fashion) and 1 year (open fashion). In essential tremor, contralateral hand tremor scores significantly improved ( P = 0.04) with stimulation during the double-blinded study, whereas in Parkinson’s disease, there were no changes in the OFF medication/on stimulation motor scores compared with off stimulation. At 1 year, tremor was improved by stimulation in two out of three patients with essential tremor available at follow-up, whereas no improvement was observed in the five parkinsonian patients. One parkinsonian patient had a cortical venous infarct. Three other patients had self-limiting seizures with aggressive trials of stimulation in the period of dosage selection. These findings suggest that unilateral subdural motor cortex stimulation may be useful for contralateral hand tremor in selected patients with essential tremor but was not effective in improving parkinsonian signs in our series. * Abbreviations : OFF : OFF medication ON : ON medication UPDRS : Unified Parkinson’s Disease Rating Scale
- Published
- 2011
45. The Dominant-STN phenomenon in bilateral STN DBS for Parkinson's disease
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Anna Castrioto, Christopher Meaney, Yu-Yan Poon, Elena Moro, Filomena Mazzella, Andres M. Lozano, Clement Hamani, and Mojgan Hodaie
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Male ,medicine.medical_specialty ,Parkinson's disease ,Deep brain stimulation ,medicine.medical_treatment ,Stimulation ,Subthalamic nucleus ,Functional Laterality ,law.invention ,lcsh:RC321-571 ,Unilateral right ,Double-Blind Method ,Randomized controlled trial ,law ,Neural Pathways ,Outcome Assessment, Health Care ,Basal ganglia ,medicine ,Humans ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Aged ,Parkinson Disease ,Recovery of Function ,Middle Aged ,medicine.disease ,Surgery ,nervous system diseases ,Treatment Outcome ,Bilateral stimulation ,surgical procedures, operative ,Neurology ,nervous system ,Anesthesia ,Unilateral STN stimulation ,Female ,Psychology ,therapeutics - Abstract
In some patients with Parkinson's disease (PD) and bilateral STN-DBS the motor benefit from one STN alone appears similar to the improvement obtained with bilateral STN-DBS. Thus, we hypothesized that some patients have a "dominant-STN," whose stimulation achieves similar results than bilateral stimulation. Twenty-two consecutive PD patients with bilateral STN-DBS were assessed in 4 randomized conditions: bilateral off-stimulation, bilateral on-stimulation, unilateral right- and unilateral left-stimulation. A hierarchical agglomerative cluster analysis of the motor UPDRS scores in these 4 conditions showed that 11 patients (50%) presented with a "dominant-STN." Interestingly, in 3 of these patients the dominant-STN was ipsilateral to the most affected side of the body. Our results support the presence of different phenotypes of response to bilateral STN stimulation. In our sample 50% of the patients presented with a dominant-STN, suggesting that a non-negligible part of PD patients might not need bilateral STN-DBS surgery.
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- 2011
46. The iPS Technique Provides Hope for Parkinson’s Disease Treatment
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Liang Xu, Jianqing Ding, Sheng-Di Chen, and Yu-Yan Tan
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Cancer Research ,Pathology ,medicine.medical_specialty ,Cell type ,Parkinson's disease ,Somatic cell ,Induced Pluripotent Stem Cells ,Cell Differentiation ,Parkinson Disease ,Cell Biology ,Disease ,Biology ,Cellular Reprogramming ,medicine.disease ,Models, Biological ,Embryonic stem cell ,medicine ,Humans ,Stem cell ,Induced pluripotent stem cell ,Reprogramming ,Neuroscience ,Embryonic Stem Cells - Abstract
More recently, reprogramming of somatic cells to an embryonic stem cell-like state presents a milestone in the realm of stem cells, making it possible to derive all cell types from any patients bearing specific genetic mutations. With the development of induced pluripotent stem (iPS) cells, we are now able to use the derivatives of iPS cells to study the mechanisms of disease and to perform drug screening and toxicology testing. In addition, differentiated iPS cells are now close to be used in clinical practice. Here we review the progress of iPS technique and the possible application in the area of Parkinson's disease treatment.
- Published
- 2010
47. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease
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Kathy Dujardin, Andres M. Lozano, Jan Herzog, Johannes D. Speelman, James M. Dambrosia, Cynthia S. Kubu, Valerie Voon, Johan Samanta, Claire Ardouin, Stéphane Thobois, Filippo Tamma, Jean A. Saint-Cyr, Helene Rossignol, Michael Schüpbach, Yu-Yan Poon, Elena Moro, Anthony E. Lang, Paul Krack, and Neurology
- Subjects
Male ,medicine.medical_specialty ,Parkinson's disease ,Deep brain stimulation ,Deep Brain Stimulation ,medicine.medical_treatment ,Subthalamic Nucleus/*physiopathology ,Poison control ,Suicide, Attempted ,Suicide ,Neuropsychological Tests ,Suicide prevention ,Deep Brain Stimulation/*adverse effects ,Central nervous system disease ,Subthalamic Nucleus ,Internal medicine ,medicine ,Humans ,Postoperative Period ,Parkinson Disease/physiopathology/psychology/*therapy ,Depression (differential diagnoses) ,Psychiatric Status Rating Scales ,Movement Disorders ,Suicide attempt ,Depression ,Movement Disorders/surgery ,Parkinson Disease ,Original Articles ,Middle Aged ,medicine.disease ,Standardized mortality ratio ,Physical therapy ,Female ,Neurology (clinical) ,Epidemiologic Methods ,Psychology ,Depression/psychology - Abstract
Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. As after other life-altering surgeries, suicides have been reported following deep brain stimulation for movement disorders. We sought to determine the suicide rate following subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres. We further sought to determine factors associated with suicide attempts through a nested case-control study. In the survey of suicide rate, 55/75 centres participated. The completed suicide percentage was 0.45% (24/5311) and attempted suicide percentage was 0.90% (48/5311). Observed suicide rates in the first postoperative year (263/100 000/year) (0.26%) were higher than the lowest and the highest expected age-, gender- and country-adjusted World Health Organization suicide rates (Standardized Mortality Ratio for suicide: SMR 12.63–15.64; P < 0.001) and remained elevated at the fourth postoperative year (38/100 000/year) (0.04%) (SMR 1.81–2.31; P < 0.05). The excess number of deaths was 13 for the first postoperative year and one for the fourth postoperative year. In the case-control study of associated factors, 10 centres participated. Twenty-seven attempted suicides and nine completed suicides were compared with 70 controls. Postoperative depression (P < 0.001), being single (P = 0.007) and a previous history of impulse control disorders or compulsive medication use (P = 0.005) were independent associated factors accounting for 51% of the variance for attempted suicide risk. Attempted suicides were also associated (P < 0.05) with being younger, younger Parkinson's disease onset and a previous suicide attempt. Completed suicides were associated with postoperative depression (P < 0.001). Postoperative depression remained a significant factor associated with attempted and completed suicides after correction for multiple comparisons using the stringent Bonferroni correction. Mortality in the first year following subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following subthalamic nucleus deep brain stimulation for Parkinson's disease. Postoperative depression should be carefully assessed and treated. A multidisciplinary assessment and follow-up is recommended.
- Published
- 2008
48. Sleep disorders in Chinese patients with Parkinson's disease: validation study of a Chinese version of Parkinson's disease sleep scale
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Qi Cheng, Sheng-Di Chen, Gui-Dong Liu, Jing Pan, Jie Zeng, Gang Wang, Zhen Hong, Ying Wang, Li Bai, Yu-Yan Tan, and Yu Zhang
- Subjects
Male ,Sleep Wake Disorders ,China ,medicine.medical_specialty ,Parkinson's disease ,Neurological disorder ,Severity of Illness Index ,Central nervous system disease ,Pittsburgh Sleep Quality Index ,Surveys and Questionnaires ,Severity of illness ,medicine ,Humans ,Geriatric Assessment ,Aged ,Retrospective Studies ,Sleep disorder ,Epworth Sleepiness Scale ,Reproducibility of Results ,Parkinson Disease ,Middle Aged ,Translating ,medicine.disease ,Neurology ,Physical therapy ,Female ,Geriatric Depression Scale ,Neurology (clinical) ,Psychology - Abstract
To evaluate the Chinese version of the Parkinson's disease sleep scale (PDSS) as an instrument for measuring sleep disorders in Chinese patients with Parkinson's disease (PD). The objective of the present study was to carry out a metric analysis of a Chinese version of PDSS using a cross-sectional study of 126 patients with PD who participated in the study. Usual measures for PD patients including the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Geriatric Depression Scale (GDS), and the Hamilton Anxiety Scale (HAMA) were applied by neurologists. The intra-class correlation coefficient was 0.880, and test-retest reliability for total PDSS score was 0.914. The Mean total PDSS score was 118.38+/-26.07. There was a significant correlation between the PDSS and PSQI, between the PDSS and ESS, between the PDSS and GDS, between the PDSS and HAMA, between the PDSS and the disease durations, and between the PDSS and the LDE, respectively. The Chinese version of PDSS met some basic standards required for sleep disorders measures. It could lead to better understanding the sleep disorders of PD of China in future studies.
- Published
- 2008
49. Levodopa response in long-term bilateral subthalamic stimulation for Parkinson's disease
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William D. Hutchison, Panida Piboolnurak, Jonathan O. Dostrovsky, Janis M. Miyasaki, Anthony E. Lang, Elena Moro, Jean A. Saint-Cyr, Yu-Yan W. Poon, and Andres M. Lozano
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Male ,medicine.medical_specialty ,Levodopa ,Time Factors ,Deep brain stimulation ,Parkinson's disease ,Deep Brain Stimulation ,medicine.medical_treatment ,Stimulation ,Statistics, Nonparametric ,Antiparkinson Agents ,Central nervous system disease ,Degenerative disease ,Subthalamic Nucleus ,medicine ,Humans ,Retrospective Studies ,business.industry ,Parkinson Disease ,Retrospective cohort study ,Middle Aged ,medicine.disease ,nervous system diseases ,Surgery ,Subthalamic nucleus ,Treatment Outcome ,surgical procedures, operative ,nervous system ,Neurology ,Anesthesia ,Female ,Neurology (clinical) ,business ,therapeutics ,Follow-Up Studies ,medicine.drug - Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long-term STN-DBS, STN-DBS efficacy and predictive value of preoperative levodopa response to long-term DBS benefit in 33 PD patients with bilateral STN-DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN-DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti-PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years.
- Published
- 2007
50. 24-Hour infusion of levodopa/carbidopa intestinal gel for nocturnal akinesia in advanced Parkinson's disease
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Ricciardi, Lucia, Bove, Francesco, Espay, Kristy J., Lena, Francesco, Modugno, Nicola, Poon, Yu Yan, Krikorian, Robert, Espay, Alberto J., and Fasano, Alfonso
- Subjects
Male ,Sleep Wake Disorders ,Infusions ,Nonmotor symptoms ,Parkinson's disease ,Antiparkinson Agents ,Levodopa ,Outcome Assessment (Health Care) ,Parenteral ,Outcome Assessment, Health Care ,Humans ,Infusions, Parenteral ,Aged ,Carbidopa ,Parkinson Disease ,Intrajejunal levodopa ,Sleep ,Drug Combinations ,Female ,Follow-Up Studies ,Gels ,Middle Aged ,Muscle Rigidity ,Neurology ,Neurology (clinical) - Published
- 2015
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