Mindfulness Training among Individuals with Parkinson’s Disease: Neurobehavioral Effects

Objective. To investigate possible neurobehavioral changes secondary to a mindfulness based intervention (MBI) training for individuals living with Parkinson’s disease (PD).Background. In the context of complementary medicine, MBIs are increasingly being used for stress reduction and in patient populations coping with chronic illness. The use of alternative and complementary medicine may be higher in patients with chronic conditions such as PD. However, behavioral effects of mindfulness training in PD have not yet been reported in the literature and this points to an unmet need and warrants further examination.Methods. A total of 27 out of 30 PD patients completed a randomized controlled longitudinal trial. Questionnaires and the UPDRS I–IV were obtained at baseline and 8-week follow-up.Results. Significant changes after the MBI were found including a 5.5 point decrease on the UPDRS motor score, an increase of 0.79 points on Parkinson’s disease questionnaire (PDQ-39) pain item, and a 3.15 point increase in the Five Facet Mindfulness Questionnaire observe facet.Conclusions. To the best of our knowledge, this is the first quantitative analysis of neurobehavioral effects of MBI in PD.

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Mindfulness Based Stress Reduction in People with Parkinson’s Disease and their Care Partners

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2021.101377 ◽

2021 ◽

pp. 101377

Author(s):

D. Shah-Zamora ◽

Allen A ◽

Rardin L ◽

Ivancic M ◽

Durham K ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Stress Reduction ◽

Care Partners ◽

Mindfulness Based Stress Reduction

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Social listening – revealing Parkinson’s disease over day and night

BMC Neurology ◽

10.1186/s12883-020-02024-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hui Zhang ◽

Fanwen Meng ◽

Xingyu Li ◽

Yali Ning ◽

Meng Cai

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Unmet Needs ◽

Unmet Need ◽

Motor Symptoms ◽

Motor Complications ◽

Sentiment Score ◽

Negative Sentiment ◽

Non Motor Symptoms ◽

Social Listening

Abstract Background Nocturnal symptoms in Parkinson’s disease are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we analyzed the characteristics and burden of nocturnal symptoms from patients’ perspectives and explored their changes over time. Overall symptoms (occurring at day or night) were collected to compare whether the unmet needs related to nocturnal symptoms and to overall symptoms are different. Methods We used a Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in dialogues available from social media platforms in 2016 to 2018. These symptoms were classified as either overall symptoms or nocturnal symptoms. We used share of voice (SOV) of symptoms as a proportion of total dialogues per year to reflect the characteristics of symptoms. Negative sentiment score of symptoms was analyzed to find out their related burden. Results We found the SOV for overall motor symptoms was 79% and had not increased between 2016 and 2018 (79%, p = 0.5). The SOV for non-motor symptoms was 69% and had grown by 7% in 2018 (p < 0.01). The SOV for motor complications was 9% and had increased by 6% in 2018 (p < 0.01). The SOV of motor symptoms was larger than non-motor symptoms and motor complications (p < 0.01). The SOV of non-motor symptoms was larger than motor complications (p < 0.01). For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% (p < 0.01). The SOV for nocturnal-occurring motor symptoms was higher than most non-motor symptoms. However, non-motor symptoms had the higher increases and evoked higher negative sentiment regardless of whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day. Conclusions The growing SOV and the greater negative sentiment of nocturnal symptoms suggest management of nocturnal symptoms is an unmet need of patients. A greater emphasis on detecting and treating nocturnal symptoms with 24-h care is encouraged.

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Emerging targets for the diagnosis of Parkinson’s disease: examination of systemic biomarkers

Biomarkers in Medicine ◽

10.2217/bmm-2020-0654 ◽

2021 ◽

Author(s):

Lara Cheslow ◽

Adam E Snook ◽

Scott A Waldman

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neurodegenerative Disorder ◽

Neuronal Damage ◽

Unmet Need ◽

Multiple Organ ◽

The Body ◽

Organ Systems ◽

Diagnostic Approaches ◽

New Biomarkers

Parkinson’s disease (PD) is a highly prevalent and irreversible neurodegenerative disorder that is typically diagnosed in an advanced stage. Currently, there are no approved biomarkers that reliably identify PD patients before they have undergone extensive neuronal damage, eliminating the opportunity for future disease-modifying therapies to intervene in disease progression. This unmet need for diagnostic and therapeutic biomarkers has fueled PD research for decades, but these efforts have not yet yielded actionable results. Recently, studies exploring mechanisms underlying PD progression have offered insights into multisystemic contributions to pathology, challenging the classic perspective of PD as a disease isolated to the brain. This shift in understanding has opened the door to potential new biomarkers from multiple sites in the body. This review focuses on emerging candidates for PD biomarkers in the context of current diagnostic approaches and multiple organ systems that contribute to disease.

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Complex Parkinson's disease: review and experiences

British Journal of Neuroscience Nursing ◽

10.12968/bjnn.2019.15.3.140 ◽

2019 ◽

Vol 15 (3) ◽

pp. 140-145

Author(s):

Phil Cotterell ◽

Debbie Weight ◽

Sharon Joseph ◽

Paul Joseph

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Progression ◽

Unmet Need ◽

Motor Fluctuations ◽

Financial Problems ◽

Care Environment ◽

Psychological Issues ◽

Palliative Approach ◽

The Impact

The rate of Parkinson's disease progression is highly individual. It is important to identify those in the complex stage of the disease. Non-oral therapies may be appropriate for those in the complex stage of the disease who experience motor fluctuations, but there can be reasons for a failure to explore these options. Complex Parkinson's disease is a challenging time for the patient, their carer/s and for Parkinson's specialists. Changes to independence can be difficult to deal with, and the disease has an impact both physically and psychologically. For carers, the impact of Parkinson's can also result in physical and psychological issues as well as social and financial problems. Consideration often turns to moving into a care environment, dealing with neuropsychiatric issues and challenging unmet need. Dealing with symptoms and problems using a team and a palliative approach is required.

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A New Perspective in the Treatment of Parkinson’s Disease Psychosis

US Neurology ◽

10.17925/usn.2016.12.02.93 ◽

2016 ◽

Vol 12 (02) ◽

pp. 93

Author(s):

Rajesh Pahwa ◽

Kelly E Lyons ◽

◽

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Neuropsychiatric Symptoms ◽

Unmet Need ◽

Controlled Study ◽

Psychotic Symptoms ◽

Dopamine Antagonists ◽

Motor Symptoms ◽

Double Blind ◽

Good Tolerability

Neuropsychiatric symptoms, such as psychosis, are well described in Parkinson’s disease (PD); most appear to be due to disease pathology with exacerbation caused by dopaminergic treatment. More than 50% of patients with PD develop psychosis at some point throughout their disease course. Clinicians need to routinely assess patients with PD for psychotic symptoms, particularly hallucinations. Treatment of psychotic symptoms in PD is an unmet need as there are currently no US Food and Drug Administration (FDA) approved medications specifically for PD psychosis (PDP). Current treatments for PDP have been adapted from dopamine antagonists used to treat psychosis in other conditions, such as schizophrenia. Typical antipsychotics, as well as some atypical antipsychotics, worsen PD motor symptoms due to blockade of dopamine D2 receptors. Quetiapine and clozapine have been studied in PDP and are the most commonly used treatments for PDP. Clozapine has been shown to be effective; however, regular bloodwork is required, while data for quetiapine are inconsistent. Pimavanserin, a highly selective serotonin (5HT2A subtype) receptor inverse agonist, is not associated with motor worsening in PDP patients due to the absence of dopamine blockade. In a double-blind, placebo-controlled study, pimavanserin showed significant improvement in moderate to severe psychosis compared to placebo, with good tolerability and without worsening of PD motor symptoms. These data suggest that pimavanserin is a safe and efficacious treatment for PDP psychosis and could be a potential new treatment option for PDP.

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The Neuroprotective Effects of Cannabis-Derived Phytocannabinoids and Resveratrol in Parkinson’s Disease: A Systematic Literature Review of Pre-Clinical Studies

Brain Sciences ◽

10.3390/brainsci11121573 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1573

Author(s):

Samay Prakash ◽

Wayne G. Carter

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Unmet Need ◽

Neuroprotective Agents ◽

Eligibility Criteria ◽

Neuroprotective Effects ◽

In Vivo Models ◽

Anti Inflammatory ◽

Nigral Degeneration

Currently, there are no pharmacological treatments able to reverse nigral degeneration in Parkinson’s disease (PD), hence the unmet need for the provision of neuroprotective agents. Cannabis-derived phytocannabinoids (CDCs) and resveratrol (RSV) may be useful neuroprotective agents for PD due to their anti-oxidative and anti-inflammatory properties. To evaluate this, we undertook a systematic review of the scientific literature to assess the neuroprotective effects of CDCs and RSV treatments in pre-clinical in vivo animal models of PD. The literature databases MEDLINE, EMBASE, PsychINFO, PubMed, and Web of Science core collection were systematically searched to cover relevant studies. A total of 1034 publications were analyzed, of which 18 met the eligibility criteria for this review. Collectively, the majority of PD rodent studies demonstrated that treatment with CDCs or RSV produced a significant improvement in motor function and mitigated the loss of dopaminergic neurons. Biochemical analysis of rodent brain tissue suggested that neuroprotection was mediated by anti-oxidative, anti-inflammatory, and anti-apoptotic mechanisms. This review highlights the neuroprotective potential of CDCs and RSV for in vivo models of PD and therefore suggests their potential translation to human clinical trials to either ameliorate PD progression and/or be implemented as a prophylactic means to reduce the risk of development of PD.

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Social Listening – Revealing Parkinson’s Disease over Day and Night

10.21203/rs.3.rs-55799/v1 ◽

2020 ◽

Author(s):

Hui Zhang ◽

Fanwen Meng ◽

Xingyu Li ◽

Yali Ning ◽

Meng Cai

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Unmet Need ◽

Motor Complication ◽

Motor Symptoms ◽

Social Media Platforms ◽

Sentiment Score ◽

Negative Sentiment ◽

Non Motor Symptoms ◽

Social Listening

Abstract Background: Nocturnal symptoms in Parkinson’s disease and their related burdens on patients are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we sought to analyze the characteristics of nocturnal symptoms and the burden of nocturnal-occurring motor and non-motor symptoms from patients’ perspectives.Methods: We used a contemporary Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in patient-doctor and patient-patient dialogues available from social media platforms in China. Frequency of nocturnal symptoms as a proportion of total dialogues per year and their relative negative sentiment were analyzed. As a contrast, overall symptoms (occurring at day or night) were also analyzed. Results: We found that share of voice for overall motor symptoms did not increase from 2016 to 2018 (79%, p = 0.5), but share of voice for non-motor symptoms was 69% in 2018, growing by 7% (p < 0.01), and motor complications was 9%, growing by 6% (p < 0.01), respectively. For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% from 2016 (p < 0.01). Share of voice for nocturnal-occurring motor symptoms was higher than non-motor symptoms. Non-motor symptoms evoked higher negative sentiment no matter whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day, regardless of the type of symptom (motor, non-motor, or motor complication).Conclusions: The growing share of voice and the greater negative sentiment of nocturnal symptoms from patients’ perspectives suggest that management of nocturnal symptoms is an unmet need of patients with Parkinson’s disease. A greater emphasis on detecting nocturnal symptoms and treating them with 24-hour care is encouraged.

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Introducing the Parkinson’s KinetiGraph into Routine Parkinson’s Disease Care: A 3-Year Single Centre Experience

Journal of Parkinson s Disease ◽

10.3233/jpd-202101 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1827-1832

Author(s):

Thea Dominey ◽

Angie A. Kehagia ◽

Terry Gorst ◽

Emma Pearson ◽

Fiona Murphy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Unmet Need ◽

Resource Limitation ◽

Digital Data ◽

Continuous Measure ◽

Remote Management ◽

Single Centre Experience ◽

The Face ◽

Increasing Demand

In an effort to provide timely clinical input for people with Parkinson’s disease (PD) in the face of increasing demand and resource limitation in our UK based service, we introduced remote management in place of clinic appointment, including the use of the Parkinson’s KinetiGraph (PKG™), a wrist-worn device that provides a continuous measure of movement. We evaluated our reporting methods and findings, the nature of unmet need we identified, our treatment recommendations and the degree of their implementation in our patients whose feedback guided our service developments. Our evaluation highlighted opportunities and challenges associated with incorporating digital data into care traditionally delivered via in-person contact.

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Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2015/124214 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 22

Author(s):

Giovanni Abbruzzese ◽

Laura Avanzino ◽

Roberta Marchese ◽

Elisa Pelosin

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Imagery ◽

Muscle Activation ◽

Mirror Neuron System ◽

Action Observation ◽

Unmet Need ◽

Mirror Neuron ◽

Physiological Basis ◽

Actual Performance

Parkinson’s disease (PD) is characterized by a progressive impairment of motor skills with deterioration of autonomy in daily living activities. Physiotherapy is regarded as an adjuvant to pharmacological and neurosurgical treatment and may provide small and short-lasting clinical benefits in PD patients. However, the development of innovative rehabilitation approaches with greater long-term efficacy is a major unmet need. Motor imagery (MI) and action observation (AO) have been recently proposed as a promising rehabilitation tool. MI is the ability to imagine a movement without actual performance (or muscle activation). The same cortical-subcortical network active during motor execution is engaged in MI. The physiological basis of AO is represented by the activation of the “mirror neuron system.” Both MI and AO are involved in motor learning and can induce improvements of motor performance, possibly mediated by the development of plastic changes in the motor cortex. The review of available evidences indicated that MI ability and AO feasibility are substantially preserved in PD subjects. A few preliminary studies suggested the possibility of using MI and AO as parts of rehabilitation protocols for PD patients.

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