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Brain Sciences
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Advances in Parkinsonian Syndromes
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Advances in Parkinsonian Syndromes

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurodegenerative Diseases".

Deadline for manuscript submissions: closed (15 December 2021) | Viewed by 24308

Special Issue Editors

Dr. Gesine Respondek

E-Mail Website
Guest Editor
Department of Neurology, Hannover Medical School, Hannover, Germany
Interests: parkinsonian syndromes; neurodegenerative diseases
Prof. Dr. Lars Tönges

E-Mail Website
Co-Guest Editor
Department of Neurology, Ruhr-Universität Bochum, Bochum, Germany
Interests: Parkinson’s disease; neuron; neuroprotection; neuroregeneration; neuroinflammation; neurodegeneration; biomarkers; protein aggregation; alpha-synuclein; translational therapies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Parkinsonian syndromes are a heterogeneous group of neurodegenerative diseases that differ significantly from one another in terms of associated pathology and pathogenesis, clinical course, and prognosis. They include Parkinson´s disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), as well as rare genetically determined diseases. We are currently experiencing a high level of clinical scientific progress in this field. Large-scale clinico-pathological examinations have led to a more precise description of the clinical spectrum of these diseases. Imaging and laboratory markers (e.g. structural and functional MRI, FDG- and Tau-PET, CSF and blood biomarkers) are of particular research interest and will enable a more precise and earlier differential diagnosis and progression monitoring of patients with parkinsonian syndromes. The latest genetic, epigenetic and biochemical modalities allow more detailed insights into the etiology and pathogenesis. From a therapeutic point of view, new options for disease-modifying interventions have emerged from neurobiological insights. In light of these developments, this Special Issue aims at presenting the latest advances related to clinical, pathogenetic, diagnostic, and therapeutic aspects of parkinsonian syndromes. We therefore welcome contributions that provide new insights into the above-mentioned topics.

Dr. Gesine Respondek
Prof. Dr. Lars Tönges
Guest Editors

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Keywords

  • parkinsonian syndromes
  • neurodegeneration
  • biomarker
  • natural history
  • differential diagnosis
  • progression trajectories

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Published Papers (7 papers)

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9 pages, 1409 KiB  
Article
Short- and Long-Term Effect of Parkinson’s Disease Multimodal Complex Treatment
by Konstantin G. Heimrich and Tino Prell
Brain Sci. 2021, 11(11), 1460; https://doi.org/10.3390/brainsci11111460 - 3 Nov 2021
Cited by 12 | Viewed by 2592
Abstract
Parkinson´s disease multimodal complex treatment (PD-MCT) is a multidisciplinary inpatient treatment option increasingly applied in Germany. However, data on its effectiveness are rare. Data were collected at the Department of Neurology of the University Hospital Jena, Germany. In 2019, 159 patients were admitted [...] Read more.
Parkinson´s disease multimodal complex treatment (PD-MCT) is a multidisciplinary inpatient treatment option increasingly applied in Germany. However, data on its effectiveness are rare. Data were collected at the Department of Neurology of the University Hospital Jena, Germany. In 2019, 159 patients were admitted to our neurology ward for PD-MCT. Patients were followed for up to 12 months, and their data were retrospectively analyzed to assess the short- and long-term treatment effects. The treatment led to an improvement in motor function assessed by Movement Disorder Society sponsored revision of the unified Parkinson´s disease rating scale part III (MDS-UPDRS III) and motor performance (Tinetti test). Improvement of MDS-UPDRS III was associated with lower age, higher MDS-UPDRS III at admission, and less depression (assessed by Hospital Anxiety and Depression Scale and Beck-Depression Inventory II). One month after the hospital stay, 36.8% of the patients reported feeling better, while 32.6% reported feeling worse. If the patients were not depressed, they were more likely to have reported feeling better. PD-MCT is an effective inpatient treatment option. However, to improve patients’ satisfaction, screening and treatment for depression is essential. The effectiveness of different treatment durations has to be elucidated in further studies. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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11 pages, 1266 KiB  
Article
Cluster Analysis of Categorical Variables of Parkinson’s Disease Patients
by Renee Hendricks and Mohammad Khasawneh
Brain Sci. 2021, 11(10), 1290; https://doi.org/10.3390/brainsci11101290 - 29 Sep 2021
Cited by 2 | Viewed by 2641
Abstract
Parkinson’s disease (PD) is a chronic disease. No treatment stops its progression, and it presents symptoms in multiple areas. One way to understand the PD population is to investigate the clustering of patients by demographic and clinical similarities. Previous PD cluster studies included [...] Read more.
Parkinson’s disease (PD) is a chronic disease. No treatment stops its progression, and it presents symptoms in multiple areas. One way to understand the PD population is to investigate the clustering of patients by demographic and clinical similarities. Previous PD cluster studies included scores from clinical surveys, which provide a numerical but ordinal, non-linear value. In addition, these studies did not include categorical variables, as the clustering method utilized was not applicable to categorical variables. It was discovered that the numerical values of patient age and disease duration were similar among past cluster results, pointing to the need to exclude these values. This paper proposes a novel and automatic discovery method to cluster PD patients by incorporating categorical variables. No estimate of the number of clusters is required as input, whereas the previous cluster methods require a guess from the end user in order for the method to be initiated. Using a patient dataset from the Parkinson’s Progression Markers Initiative (PPMI) website to demonstrate the new clustering technique, our results showed that this method provided an accurate separation of the patients. In addition, this method provides an explainable process and an easy way to interpret clusters and describe patient subtypes. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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15 pages, 1825 KiB  
Article
The Anterior Attentional–Intentional System in Patients with Parkinson’s Disease—A Pilot and Feasibility Study
by Paulina Beata Golińska, Artur Józef Sawicki, Łucja Bieleninik and Mariola Bidzan
Brain Sci. 2021, 11(8), 1013; https://doi.org/10.3390/brainsci11081013 - 30 Jul 2021
Viewed by 2135
Abstract
(1) Background: This study compared anterior attentional–intentional system performance between three groups: Parkinson’s disease (PD) patients with normal cognition (PD-NC), with mild cognitive impairment (PD-MCI), and a comparison group (CG). It also evaluated the feasibility of the recruitment and study procedures; (2) Methods: [...] Read more.
(1) Background: This study compared anterior attentional–intentional system performance between three groups: Parkinson’s disease (PD) patients with normal cognition (PD-NC), with mild cognitive impairment (PD-MCI), and a comparison group (CG). It also evaluated the feasibility of the recruitment and study procedures; (2) Methods: From 45 participants recruited, 39 were allocated (mean age 65.31; 43.59% men) to PD-NC, PD-MCI and CG (13 per group). To assess attention, we used three tasks from the ROtman–Baycrest Battery for Investigating Attention: Simple Reaction time (RT), Choice RT, and Prepare RT. We conducted a mixed-model analysis of variance with a 3 (groups) × 4 (tasks) design to compare reaction times; (3) Results: PD-MCI had slower reaction times than PD-NC (p = 0.028) and the CG (p = 0.052); there was no difference between PD-NC and CG. PD-MCI might perform worse on monitoring tasks than PD-NC, Z = −1.68, p = 0.092. Nearly half the volunteers from the CG and 87% of all eligible patients were enrolled in the study and completed all neuropsychological procedures; (4) Conclusions: General cognitive decline appears related to partial deficits in energization and tends to impair attentional monitoring. Furthermore, PD-NC exhibited similar reaction times to the CG. Results from the feasibility study contributed to the definitive study. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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13 pages, 1539 KiB  
Article
Prevalence and Characteristics of Polyneuropathy in Atypical Parkinsonian Syndromes: An Explorative Study
by Rachel Rohmann, Eva Kühn, Raphael Scherbaum, Lovis Hilker, Saskia Kools, Leonard Scholz, Katharina Müller, Sophie Huckemann, Christiane Schneider-Gold, Ralf Gold, Kalliopi Pitarokoili, Lars Tönges and Eun Hae Kwon
Brain Sci. 2021, 11(7), 879; https://doi.org/10.3390/brainsci11070879 - 30 Jun 2021
Cited by 7 | Viewed by 3518
Abstract
(1) Background: Peripheral nerve involvement is increasingly recognized in Parkinson’s disease (PD). Although non-motor symptoms and postural instability are early features of atypical parkinsonian syndromes (APS), peripheral neuropathies in APS have not been addressed in detail thus far. Therefore, the aim of this [...] Read more.
(1) Background: Peripheral nerve involvement is increasingly recognized in Parkinson’s disease (PD). Although non-motor symptoms and postural instability are early features of atypical parkinsonian syndromes (APS), peripheral neuropathies in APS have not been addressed in detail thus far. Therefore, the aim of this study was to investigate the prevalence and characteristics of polyneuropathies (PNP) in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), as representative syndromes of APS. (2) Methods: In total, 8 MSA and 6 PSP patients were comprehensively analyzed regarding subjective, clinical (motor and non-motor) and paraclinical PNP features using nerve conduction studies and high resolution nerve ultrasounds (HRUS). (3) Results: A total of 87.5% of MSA and 66.7% of PSP patients complained of at least one neuropathic symptom, with electrophysiological confirmation of PNP in 50.0% of both, MSA and PSP patients. PNP symptom severity in PSP and motor nerve amplitude in MSA were associated with compromised motor function. Morphologic nerve examination by HRUS showed few alterations according to the axonal type of PNP. (4) Conclusions: The overall high PNP symptom burden may be partially credited to the significant prevalence of electrophysiologically diagnosed PNP, and impact motor aspects of APS. The findings of this exploratory study reinforce further investigations on a larger scale, in order to elucidate peripheral nerve involvement and the underlying pathophysiological mechanisms of APS. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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12 pages, 993 KiB  
Article
Association between Temporomandibular Joint Disorder and Parkinson’s Disease
by Hyo-Geun Choi, Joo-Heung Yoon, Tae-Hwan Chung, Chanyang Min, Dae-Myoung Yoo, Jee-Hye Wee, Suk-Yun Kang, Yeso Choi, Seok-Jin Hong and Soo-Hwan Byun
Brain Sci. 2021, 11(6), 747; https://doi.org/10.3390/brainsci11060747 - 4 Jun 2021
Cited by 8 | Viewed by 3354
Abstract
This study performed two different analyses using a large set of population data from the Korean National Health Insurance Service Health Screening Cohort to evaluate the interactional association between temporomandibular disorder (TMD) and Parkinson’s disease (PD). Two nested case–control population-based studies were conducted [...] Read more.
This study performed two different analyses using a large set of population data from the Korean National Health Insurance Service Health Screening Cohort to evaluate the interactional association between temporomandibular disorder (TMD) and Parkinson’s disease (PD). Two nested case–control population-based studies were conducted on 514,866 participants. In Study I, 4455 participants with TMD were matched with 17,820 control participants, with a ratio of 1:4. In Study II, 6076 participants with PD were matched with 24,304 control participants, with a ratio of 1:4. Obesity, smoking, alcohol consumption, systolic, diastolic blood pressure, fasting blood glucose level, and total cholesterol were adjusted. The adjusted odds ratio (OR) for TMD was 1.43 (95% confidence interval (CI) = 1.02–2.00) in PD patients compared to non-PD patients in Study I (p < 0.001). The adjusted OR for PD was 1.56 (95% CI = 1.13–2.15) in TMD patients compared to non-TMD patients in Study II (p = 0.007). This study demonstrated that patients with TMD have a significantly higher risk of developing PD and, conversely, those with PD have a significantly higher risk of developing TMD. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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7 pages, 596 KiB  
Article
Self-Reported Nonadherence to Medication Is Not Associated with Health-Related Quality of Life in Parkinson’s Disease
by Hannah M. Zipprich, Sarah Mendorf, Thomas Lehmann and Tino Prell
Brain Sci. 2021, 11(2), 273; https://doi.org/10.3390/brainsci11020273 - 22 Feb 2021
Cited by 5 | Viewed by 3032
Abstract
Nonadherence is a growing issue in the treatment of Parkinson’s disease (PD). Many factors are known to influence nonadherence, but little is known about the influence of quality of life (QoL). Detailed clinical data were obtained from 164 patients with PD using the [...] Read more.
Nonadherence is a growing issue in the treatment of Parkinson’s disease (PD). Many factors are known to influence nonadherence, but little is known about the influence of quality of life (QoL). Detailed clinical data were obtained from 164 patients with PD using the Parkinson’s Disease Questionnaire-39 (PDQ-39) and the German Stendal Adherence with Medication Score (SAMS). Descriptive statistics were used to identify reasons for nonadherence, and multivariable linear models were used to study associations between QoL and clinical parameters as well as nonadherence. Multivariate analysis of variance (MANOVA) and multivariate analysis of covariance (MANCOVA) were used to study the effect of the SAMS on PDQ domains and other medical covariates. The results showed that 10.4% (n = 17) of patients were fully adherent, 66.4% (n = 109) were moderately nonadherent, and 23.2% (n = 38) were nonadherent. Nonadherence was associated with male gender, lower Montreal Cognitive Assessment (MoCA) score, higher non-motor symptoms questionnaire (NMS-Quest) score, greater number of medications per day (an indicator of comorbidity), and higher Beck Depression Inventory (BDI) score. QoL was correlated with male gender, lower MoCA score, higher NMS-Quest score, more comorbidities, and higher BDI score, but was not correlated with nonadherence. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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19 pages, 3553 KiB  
Systematic Review
Heart Rate Variability Analyses in Parkinson’s Disease: A Systematic Review and Meta-Analysis
by Konstantin G. Heimrich, Thomas Lehmann, Peter Schlattmann and Tino Prell
Brain Sci. 2021, 11(8), 959; https://doi.org/10.3390/brainsci11080959 - 21 Jul 2021
Cited by 39 | Viewed by 5622
Abstract
Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart [...] Read more.
Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson’s disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson’s disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson’s disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate. Full article
(This article belongs to the Special Issue Advances in Parkinsonian Syndromes)
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