At the Frontiers in Movement Disorders: In Romania

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuromuscular and Movement Disorders".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 18969

Special Issue Editor


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Guest Editor
1. Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
2. Department of Neurology, Clinical Emergency County Hospital Timisoara, Bd. Iosif Bulbuca No. 10, 300736 Timisoara, Romania
Interests: Parkinson's Disease; multiple sclerosis; stroke; evidence based medicine; myasthenia gravis

Special Issue Information

Dear Colleagues,

Movement Disorders, including Parkinson’s disease (PD), tremor, tics and dystonia, are common conditions. In recent years, there has been a tremendous growth in new diagnostic information, pharmacological and neurosurgical treatments for movement disorders, as well as a greater understanding of impaired motor control function.

Recent data demonstrated that movement disorders are an important cause of disability. For example, among neurological disorders, PD was reported to be the fastest growing in prevalence, disability, and deaths. The latest research estimates that approximately 6 million people are diagnosed with PD worldwide. In Europe, there are an estimated 1.2 million PD patients, the disease affecting 1% of the population over the age of 60.

The latest European Commission report estimates that Romania has a population size of 19.587 million, with 17.8% being over 65 years old. The data of the Romanian Antiparkinson Association (the main Romanian patients’ association) estimates that in Romania, there are over 72,000 patients. Although in the recent years the research and care of patients with movement disorders, including PD, has made considerable progress, data from this Eastern European country is still not fully uncovered.

Therefore, the aim of the present Special Issue is to encourage publication of research regarding movement disorders in this area, bringing it into the attention of the interested medical community.

We will be accepting basic science and clinical research papers as well as reviews.

Prof. Dr. Mihaela Simu
Guest Editor

Manuscript Submission Information

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Keywords

  • Movement Disorders
  • Parkinson disease
  • Eastern Europe
  • Romania

Published Papers (6 papers)

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Research

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13 pages, 1332 KiB  
Article
Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
by József Attila Szász, Viorelia Adelina Constantin, Károly Orbán-Kis, Ligia Ariana Bancu, Marius Ciorba, István Mihály, Előd Ernő Nagy, Róbert Máté Szász, Krisztina Kelemen, Mihaela Adriana Simu and Szabolcs Szatmári
Brain Sci. 2021, 11(7), 826; https://doi.org/10.3390/brainsci11070826 - 22 Jun 2021
Cited by 10 | Viewed by 2215
Abstract
Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex [...] Read more.
Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskinesias, including diphasic dyskinesia. Methods: In this retrospective study, we analyzed the characteristics of patients with APD who had at least 30 min of diphasic dyskinesia (DID) in 3 consecutive days, were considered responders and were treated with LCIG in our clinic. Patients were evaluated before and after PEG and at 6, 12 and 18 months, when the changes in the therapy were recorded, and they completed a 7-point Global Patient Impression of Improvement (PGI-I) scale. Results: Forty patients fulfilled the inclusion criteria—out of which, 34 performed all visits. There was a substantial difference between the calculated and real LCIG (1232 ± 337 mg vs. 1823 ± 728 mg). The motor fluctuations and most dyskinesias improved significantly after starting LCIG, but an increasing number of patients needed longer daily administrations of LCIG (24 instead of 16 h). Conclusions: Patients with APD with complex dyskinesias must be tested in dedicated hospitals, and they need a special therapeutic approach. The properly adapted LCIG treatment regarding the dose and time of administration completed with well-selected add-on medication should offer improvement for patients who want to or can only choose this DAT vs. others. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)
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9 pages, 258 KiB  
Article
Apathy and Anhedonia: Clinical and Neurophysiological Assessment of a Romanian Cohort
by Diana Sipos-Lascu, Ștefan-Cristian Vesa and Lăcrămioara Perju-Dumbravă
Brain Sci. 2021, 11(6), 729; https://doi.org/10.3390/brainsci11060729 - 31 May 2021
Cited by 1 | Viewed by 3038
Abstract
Background: Patients with Parkinson’s disease (PD) often have, besides the characteristic motor manifestations, a wide variety of non-motor symptoms. These include apathy and anhedonia, common issues in PD, which can be quantified with the help of evaluation scales recommended by the literature. There [...] Read more.
Background: Patients with Parkinson’s disease (PD) often have, besides the characteristic motor manifestations, a wide variety of non-motor symptoms. These include apathy and anhedonia, common issues in PD, which can be quantified with the help of evaluation scales recommended by the literature. There are sensory non-motor manifestations of PD, some of which are easy to detect through electrophysiological studies. Our aim was to investigate the possible association of apathy and anhedonia with the severity of the motor status in a sample of PD patients in Romania. We also examined the prevalence of latency changes in the P100 wave of visual evoked potentials (VEPs) and how they correlated with motor status, apathy, and anhedonia in PD patients. Methods: Thirty-four patients with PD participated in this study. All were assessed for motor status using the Unified Parkinson’s Disease Rating Scale (UPDRS) and were rated on the Hoehn and Yahr scales. The presence and severity of apathy and anhedonia were assessed using the Apathy Evaluation Scale (AES), the Dimensional Apathy Scale (DAS), the Lille Apathy Rating Scale (LARS), and the Snaith–Hamilton Pleasure Scale (SHAPS). The latency of the P100 wave of the VEP was measured in all the patients. Results: Apathy and anhedonia were common among the patients with PD (35% and 58.8%, respectively). The presence of apathy/anhedonia was correlated with the severity of motor symptoms, as assessed using the UPDRS scale (p < 0.001), and with the stage of the disease according to the Hoehn and Yahr scale (p < 0.001). A prolonged latency of the P100 wave of the VEP was observed among apathetic (p < 0.001)/anhedonic (p < 0.01) patients and those with increased disease severity (p < 0.001). Conclusion: Apathy and anhedonia are common in PD and may correlate with the severity of motor symptoms. There may be visual impairment in these patients, evidenced by a prolonged P100 latency, which correlates with the severity of disease. Significance: Scales for assessing apathy and anhedonia, as well as measuring VEP latency, could be useful in assessing the severity of disease. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)
14 pages, 3373 KiB  
Article
Of Criteria and Men—Diagnosing Atypical Parkinsonism: Towards an Algorithmic Approach
by Liviu Cozma, Mioara Avasilichioaei, Natalia Dima and Bogdan Ovidiu Popescu
Brain Sci. 2021, 11(6), 695; https://doi.org/10.3390/brainsci11060695 - 25 May 2021
Cited by 2 | Viewed by 2945
Abstract
Diagnosing atypical parkinsonism can be an error-exposed undertaking in the context of elaborate criteria coupled with time restraints on their comprehensive application. We conducted a retrospective, descriptive study of diagnostic accuracy among physicians at two tertiary neurology centers in Romania and developed an [...] Read more.
Diagnosing atypical parkinsonism can be an error-exposed undertaking in the context of elaborate criteria coupled with time restraints on their comprehensive application. We conducted a retrospective, descriptive study of diagnostic accuracy among physicians at two tertiary neurology centers in Romania and developed an algorithmic tool for comparison purposes. As many as 90 patients qualified for inclusion in the study, with 77 patients actually complying with atypical parkinsonism criteria. Overall, physician-established diagnoses may be incorrect in about one-fourth of cases. The reasons for this finding span a wide range of possibilities, from terminology-related inaccuracies to criteria sophistication. A Boolean-logic algorithmic approach to diagnosis might decrease misdiagnosis rates. These findings prepare the ground for the future refinement of an algorithmic application to be fully validated in a prospective study for the benefit of patients and health professionals alike. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)
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9 pages, 246 KiB  
Article
Music as Add-On Therapy in the Rehabilitation Program of Parkinson’s Disease Patients—A Romanian Pilot Study
by Dana Marieta Fodor, Xenia-Melania Breda, Dan Valean, Monica Mihaela Marta and Lacramioara Perju-Dumbrava
Brain Sci. 2021, 11(5), 569; https://doi.org/10.3390/brainsci11050569 - 29 Apr 2021
Cited by 6 | Viewed by 3185
Abstract
Music has been proven to have therapeutic potential in neurological disorders, especially Parkinson’s disease (PD), since rhythmic auditory cueing can partially replace the progressive loss of rhythmicity and automaticity. Several reports have highlighted improvements in motor outcomes in PD patients undergoing music therapy, [...] Read more.
Music has been proven to have therapeutic potential in neurological disorders, especially Parkinson’s disease (PD), since rhythmic auditory cueing can partially replace the progressive loss of rhythmicity and automaticity. Several reports have highlighted improvements in motor outcomes in PD patients undergoing music therapy, but only a few studies have evaluated non-motor outcomes, such as quality of life (QoL), which deteriorates with disease progression. The current pilot study aims to examine the effects of a multimodal rehabilitation program centered on physical therapy combined with listening to music on self-reported QoL in people with PD, compared to the same rehabilitation program alone. The study was conducted on patients with idiopathic PD who attended a specific rehabilitation program with a duration of 2.5 h daily for 14 days. The patients were divided into the study group (16 patients), who listened to background music during the rehabilitation program sessions, and the control group who did not listen to music during sessions. The patients were assessed using the self-report Parkinson’s Disease Questionnaire (PDQ-39) at the beginning of the program and 1 month after its initiation. The patients in the study group registered greater improvements in five of the eight areas of life assessed by PDQ-39 compared to the control group. In conclusion, listening to music combined with a multimodal rehabilitation program centered on physical therapy may be beneficial for the patients’ quality of life. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)

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17 pages, 2674 KiB  
Systematic Review
Parkinson’s Disease in Romania: A Scoping Review
by Elena Cecilia Rosca, Raluca Tudor, Amalia Cornea and Mihaela Simu
Brain Sci. 2021, 11(6), 709; https://doi.org/10.3390/brainsci11060709 - 27 May 2021
Cited by 6 | Viewed by 3200
Abstract
Parkinson’s disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review summarizes the epidemiological and clinical data, research on the diagnostic approaches and the interventions available in the Eastern European country of Romania. This scoping review follows the recommendations [...] Read more.
Parkinson’s disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review summarizes the epidemiological and clinical data, research on the diagnostic approaches and the interventions available in the Eastern European country of Romania. This scoping review follows the recommendations on the scoping review methodology by Joanna Briggs Institute. We searched four databases (up to 27 January 2021). The data of eligible studies were extracted in standardized forms. We identified 149 unique studies from 1133 records, with 11 epidemiological studies, 52 studies investigating clinical aspects of PD, 35 studies on diagnostic tools, and 51 intervention studies. A narrative synthesis is provided and placed in a historical context. Our review revealed a considerable increase in the Romanian research on PD in the latest 15 years, which largely follows international trends. However, we also identified several research gaps that provide useful information for policymakers, public health specialists, and clinicians. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)
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5 pages, 195 KiB  
Systematic Review
Parkinson’s Disease in Romania: A Scoping Review Protocol
by Elena Cecilia Rosca, Raluca Tudor, Amalia Cornea and Mihaela Simu
Brain Sci. 2021, 11(2), 251; https://doi.org/10.3390/brainsci11020251 - 17 Feb 2021
Cited by 10 | Viewed by 3205
Abstract
Parkinson’s disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review will summarize the epidemiological and clinical data in Romania and the interventions and diagnostic approaches used in this Eastern European country. This scoping review will primarily follow the [...] Read more.
Parkinson’s disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review will summarize the epidemiological and clinical data in Romania and the interventions and diagnostic approaches used in this Eastern European country. This scoping review will primarily follow the recommendations on the scoping review methodology made by the Joanna Briggs Institute. In order to answer our research questions, we will search four databases using appropriate search terms. We will use pre-defined inclusion criteria and the data of eligible studies will be extracted in a standardized form. Results will be reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The proposed scoping review will map the evidence on PD in Romania through a literature review, focusing on epidemiology, clinical characteristics, interventions, and diagnosis, contributing to PD research advancement. We will provide information for policy-makers, public health specialists, and clinicians. Full article
(This article belongs to the Special Issue At the Frontiers in Movement Disorders: In Romania)
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