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Symptoms and Treatment of Parkinson’s Disease
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Symptoms and Treatment of Parkinson’s Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 24 June 2025 | Viewed by 4433

Special Issue Editors

Dr. Christos Koros

E-Mail Website
Guest Editor
1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: Parkinson’s disease; movement disorders; cognitive assessment; genetic; frontotemporal dementia; alpha-synuclein; device-aided therapy
Dr. Nikolaos Papagiannakis

E-Mail Website
Guest Editor
1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
Interests: Parkinson’s disease; movement disorders; alpha-synuclein; bioinformatics; device-aided monitoring; device-aided therapy; biostatistics

Special Issue Information

Dear Colleagues,

Parkinson’s disease represents a major cause of neurodegeneration with an everincreasing worldwide prevalence. Recent research has focused on the individualized assessment of motor and non-motor symptoms. Device-aided remote monitoring has facilitated the in-depth evaluation of Parkinson’s disease symptomatology and distinct phenotypes. Moreover, the new developments witihn the field of genetics have increased our understanding on Parkinson’s disease pathogenesis. Underrepresented populations are in the spotlight of Parkinson’s disease research, so as to expand our knowledge of this complex disorder. On the other hand, new biomarkers including alpha-synuclein seeding assays and innovative imaging techniques have revolutionized Parkinson’s disease diagnosis.

Additionally, novel therapies, both symptomatic and disease modifying, are being developed and implemented. Device-aided treatments play a crucial role in the current therapeutics of this disorder. In this Special Issue, we welcome authors to submit papers concerning the clinical advancement of Parkinson’s disease in terms of both diagnosis and treatment.

Dr. Christos Koros
Dr. Nikolaos Papagiannakis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Parkinson’s disease
  • non-motor symptoms
  • clinical progression
  • cognitive assessment
  • genetics
  • remote monitoring
  • biomarkers
  • personalized medicine
  • device-aided treatments
  • disease-modifying therapies

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Published Papers (4 papers)

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Research

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22 pages, 503 KiB  
Article
Cardiovascular Dysautonomia in Patients with Parkinson’s Disease and Hypertension: A Cross-Sectional Pilot Study
by Delia Tulbă, Aida Cristina Tănăsoiu, Ana-Maria Constantinescu, Natalia Blidaru, Adrian Buzea, Cristian Băicuș, Laura Dumitrescu, Eugenia Irene Davidescu and Bogdan Ovidiu Popescu
J. Clin. Med. 2025, 14(7), 2225; https://doi.org/10.3390/jcm14072225 - 25 Mar 2025
Viewed by 967
Abstract
Background/Objectives: Parkinson’s disease (PD) and hypertension are often coexistent conditions that interact in entwined ways at various levels. Cardiovascular autonomic dysfunction (CAD), a non-motor feature of PD occurring across all stages, alters blood pressure (BP) regulation. Methods: We conducted a cross-sectional [...] Read more.
Background/Objectives: Parkinson’s disease (PD) and hypertension are often coexistent conditions that interact in entwined ways at various levels. Cardiovascular autonomic dysfunction (CAD), a non-motor feature of PD occurring across all stages, alters blood pressure (BP) regulation. Methods: We conducted a cross-sectional study enrolling patients with PD and primary hypertension, without diabetes mellitus or other causes of secondary CAD, aiming to characterize BP profiles/patterns by ambulatory BP monitoring. We also sought associations between different CAD phenotypes and PD characteristics, disability, and cardiovascular comorbidities. Results: We included 47 patients with a median age of 71 years, PD duration of 9 years, and Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III score of 40. Diurnal and nocturnal BP values were within the reference range, but BP load was excessive. Almost one-third had neurogenic orthostatic hypotension (OH) and 80% were non-dippers. The overall burden of non-motor symptoms was significant in these phenotypes. Patients with neurogenic OH were more prone to constipation, anxiety, and urinary problems, whereas gustatory dysfunction, loss of libido, and erectile dysfunction were more frequently reported by non-dippers. No significant differences with regard to cognitive decline were identified in subjects with and without neurogenic OH. Neurogenic OH was symptomatic in 78% of the cases, whereas 56% of those with orthostatic symptoms did not have OH at repeated measurements. Conclusions: Neurogenic OH is an independent predictor of disability in patients with PD and hypertension, after adjusting for PD duration, Hoehn and Yahr stage, levodopa equivalent daily dose (LEDD), and Montreal Cognitive Assessment (MoCA) score. Full article
(This article belongs to the Special Issue Symptoms and Treatment of Parkinson’s Disease)
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10 pages, 480 KiB  
Article
Amplitude of Lower Limb Muscle Activation in Different Phases of the Illinois Test in Parkinson’s Disease Patients: A Pilot Study
by Carlos Villarón-Casales, Nieves de Bernardo, Jorge Alarcón-Jiménez, Daniel López-Malo, Belén Proaño, Julio Martín-Ruiz and José Enrique de la Rubia Ortí
J. Clin. Med. 2024, 13(19), 5792; https://doi.org/10.3390/jcm13195792 - 28 Sep 2024
Viewed by 1113
Abstract
Background: Parkinson’s disease (PD) is a neurodegenerative disorder with high prevalence in men and is characterized by symptoms such as tremors and gait difficulties. This study aimed to determine muscle activation in patients with PD by considering sex differences. Methods: This pilot study [...] Read more.
Background: Parkinson’s disease (PD) is a neurodegenerative disorder with high prevalence in men and is characterized by symptoms such as tremors and gait difficulties. This study aimed to determine muscle activation in patients with PD by considering sex differences. Methods: This pilot study used analytical, quantitative, observational, and case-control methods. Surface electromyography was used to assess muscle activity during a variant of the Illinois agility test. The study population comprised an experimental group of patients with PD (N = 30) and a control group of healthy individuals without the disease (N = 10). Results: The Illinois agility test revealed significant differences in completion times between the groups. The Parkinson’s disease group took longer overall (p = 0.004), especially for standing up (p < 0.001) and sitting down (p = 0.002), than the control group. In the control group, sex influenced gastrocnemius muscle activation, with women showing higher activation (rs = −0.87). Women also had greater rectus femoris activation during standing and sitting, with higher activation on the right side when standing (rs = −0.66) and the left side when sitting (rs = −0.87). In the control group, men exhibited greater activation of the right biceps femoris (rs = 0.87). However, in the Parkinson’s disease group, sex did not affect muscle activation. Conclusions: Patients with Parkinson’s showed lower muscle activation than healthy individuals while standing up, sitting down, and walking. Full article
(This article belongs to the Special Issue Symptoms and Treatment of Parkinson’s Disease)
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Review

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17 pages, 665 KiB  
Review
Neurogenic Orthostatic Hypotension in Parkinson Disease—A Narrative Review of Diagnosis and Management
by Cristina Grosu, Otilia Noea, Alexandra Maștaleru, Emilian Bogdan Ignat and Maria Magdalena Leon
J. Clin. Med. 2025, 14(2), 630; https://doi.org/10.3390/jcm14020630 - 19 Jan 2025
Cited by 1 | Viewed by 1347
Abstract
Background: Neurogenic orthostatic hypotension (NOH) is a significant non-motor manifestation of Parkinson’s disease (PD), that substantially affects patient disability and has a powerful impact on the quality of life of PD patients, while also contributing to increased healthcare costs. This narrative review aims [...] Read more.
Background: Neurogenic orthostatic hypotension (NOH) is a significant non-motor manifestation of Parkinson’s disease (PD), that substantially affects patient disability and has a powerful impact on the quality of life of PD patients, while also contributing to increased healthcare costs. This narrative review aims to summarize key insights into the diagnosis and management of NOH in individuals with PD. Methods: For diagnosing NOH, a recently introduced and valuable metric is the ΔHr/ΔSBP index. Additional tools, such as autonomic reflex testing and various blood tests, also can be used to help distinguish orthostatic hypotension (OH) from NOH. Results: Treatment strategies for NOH involve both non-pharmacological and pharmacological approaches. As NOH frequently coexists with other abnormal blood pressure patterns (supine hypertension, nocturnal hypertension, and non-dipping hypertension), its treatment can be a challenge for the clinician. Droxidopa and midodrine are the primary pharmacological agents for NOH, though emerging therapies, such as norepinephrine transporter inhibitors, are being investigated. Conclusions: Despite these advancements, further research is needed to better understand the underlying pathophysiology of NOH, enabling more tailored and effective treatment options for individuals with PD. Full article
(This article belongs to the Special Issue Symptoms and Treatment of Parkinson’s Disease)
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Other

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15 pages, 779 KiB  
Systematic Review
Evaluation of Computer-Based Cognitive Training on Mild Cognitive Impairment in Parkinson’s Disease (PD-MCI): Α Review
by Stamatia Kotsimpou, Ioannis Liampas, Metaxia Dastamani, Chrysa Marogianni, Polyxeni Stamati, Antonia Tsika, Lampros Messinis, Grigorios Nasios, Efthimios Dardiotis and Vasileios Siokas
J. Clin. Med. 2025, 14(9), 3001; https://doi.org/10.3390/jcm14093001 - 26 Apr 2025
Viewed by 123
Abstract
Background/Objectives: Mild cognitive impairment in Parkinson’s disease (PD-MCI) affects approximately 20–50% of patients, and it is associated with an increased risk of dementia. Computer-assisted cognitive interventions (CCTs) have been proposed as a promising method of improving cognitive function in these patients. This review [...] Read more.
Background/Objectives: Mild cognitive impairment in Parkinson’s disease (PD-MCI) affects approximately 20–50% of patients, and it is associated with an increased risk of dementia. Computer-assisted cognitive interventions (CCTs) have been proposed as a promising method of improving cognitive function in these patients. This review aims to (1) demonstrate the effectiveness of computer-based intervention in PD-MCI, and (2) determine the most effective iteration. Methods: A review was performed using PubMed, Google Scholar, and ScienceDirect. Full texts of randomized clinical trials (RCTs) involving CCT intervention in PD-MCI and published in English language journals between 2014 and 2024 were included. Results: Of the 747 studies identified, 6 studies fulfilled the eligibility criterion for this review. Patients receiving CCTs showed significant improvements in global cognition and executive function, while mood was not significantly affected in most studies. Conclusions: CCT improves cognitive functions, particularly memory and executive abilities, but has little effect on mood. Although the results are encouraging, there are potential methodological biases that need to be considered. Full article
(This article belongs to the Special Issue Symptoms and Treatment of Parkinson’s Disease)
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