(MP), a leguminous plant naturally rich in levodopa, has regained attention as both a traditional remedy and a potential therapeutic option for Parkinson's disease (PD). Its appeal is shaped by contrasting contexts: in l...(MP), a leguminous plant naturally rich in levodopa, has regained attention as both a traditional remedy and a potential therapeutic option for Parkinson's disease (PD). Its appeal is shaped by contrasting contexts: in low- and middle-income countries (LMICs), MP may represent a cost-effective, locally cultivable alternative where access to levodopa-based medications is severely limited; in high-income countries, patients are often drawn to its "natural" label, perceiving it as safer or more holistic than synthetic drugs. Evidence from randomised and open-label clinical trials demonstrates that properly processed MP preparations provide symptomatic benefits comparable to commercial levodopa, though long-term safety data are still scarce. However, despite its natural origin, MP is a potent dopaminergic therapy requiring the same caution as commercially available levodopa-based medications. Overuse and unsupervised self-medication have been associated with dyskinesia, dopamine dysregulation syndrome, and psychiatric complications, while cases of toxicity from improper seed preparation underscore its risks. In our view, a balanced perspective is essential: while MP holds promise as a sustainable therapeutic option in LMICs, its use should remain restricted to clinical trials or neurologist-led protocols until more robust evidence of long-term safety and efficacy emerges.
Parkinson's disease (PD) shows pronounced clinical heterogeneity, with individuals presenting differing cognitive and motor trajectories despite similar levels of neurodegeneration, in particular striatal dopamine termin...Parkinson's disease (PD) shows pronounced clinical heterogeneity, with individuals presenting differing cognitive and motor trajectories despite similar levels of neurodegeneration, in particular striatal dopamine terminal loss. This variability underscores the relevance of considering resilience mechanisms, particularly cognitive and motor reserve, that may support preserved function in the face of progressive pathology and neurodegeneration. Building on a previously proposed conceptual framework of resilience in PD, this review provides an updated and integrative synthesis of recent evidence, including longitudinal studies, neuroimaging findings, and emerging insights into lifestyle-related factors. The review further extends the existing framework by addressing current methodological challenges and outlining future directions for incorporating resilience into neuroimaging research, biological staging models, and personalized intervention strategies in PD. Together, this work emphasizes the growing importance of resilience research in PD and its potential to improve prognostic accuracy and inform more precise and individualized therapeutic approaches.
BackgroundCognitive impairment in Parkinson's disease (PD) is often overlooked, despite increased risk of dementia in PD. 'PDCogniCare' is an innovation aiming to improve access to cognitive assessments, for earlier diag...BackgroundCognitive impairment in Parkinson's disease (PD) is often overlooked, despite increased risk of dementia in PD. 'PDCogniCare' is an innovation aiming to improve access to cognitive assessments, for earlier diagnosis and care. This study explored barriers and enablers to cognitive assessment in PD, to inform implementation of 'PDCogniCare'.MethodsParticipants included ten people with PD, one caregiver, and nineteen health professionals within two Australian public health services. Semi-structured interviews were informed by the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR). Deductive and inductive analysis was utilised. Barriers were mapped to the CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool to develop implementation strategies.ResultsSeven themes were identified: 1) lack of discussion about cognitive impairment limits access to cognitive assessments and interventions; 2) clinicians need to 'be on board with cognition'; 3) availability of clinic resources impacts delivery of cognitive screens and assessments; 4) variability of clinician decision-making processes to screen or refer patients for neuropsychological assessment; 5) impact of undergoing neuropsychological assessments on people living with PD; 6) uncertainty over benefits of cognitive assessment in changing clinical management; and 7) perceived advantages of 'PDCogniCare' over current practice. Strategies to address identified barriers included: clinician education and training, additional resource allocation, support and feedback, and involving patient/consumer advocates.ConclusionsSeveral barriers and enablers to cognitive assessment in PD were identified, relating to health professional knowledge, beliefs, context and resources. Strategies that address these may improve clinical practice for more proactive treatment and care.
Patients' use of generative AI (GenAI) independently from healthcare is increasing across diseases. Little is known about its use among people with Parkinson's disease (PwP). This exploratory convenience-sample, mixed-me...Patients' use of generative AI (GenAI) independently from healthcare is increasing across diseases. Little is known about its use among people with Parkinson's disease (PwP). This exploratory convenience-sample, mixed-methods online survey (n = 149, 19 countries) explored PwP's use of GenAI. Among our respondents, 65% had used GenAI, of which 40% had used it for disease-specific inquiries. Qualitative analysis identified informational, interpretive, and preparational uses of GenAI. As PwP increasingly bring AI-assisted data to consultations, clinicians must now actively engage in discussions about these tools, to support shared decision-making, safety and transparency.
Despite significant advances in our understanding of Parkinson's disease (PD) over the last three decades, no disease-modifying therapies (DMTs) have been identified. There is considerable effort focused on this goal, bu...Despite significant advances in our understanding of Parkinson's disease (PD) over the last three decades, no disease-modifying therapies (DMTs) have been identified. There is considerable effort focused on this goal, but the challenges in achieving it are illustrated by the limited number of DMTs advancing to late-stage Phase 3 clinical testing (see annual publications). The lack of progress towards slowing the disease is further highlighted by the recent disappointing results from high profile, Phase 2/3 clinical trials for DMTs. In this commentary, we would like to suggest an alternative strategy for identifying DMTs. Specifically, we propose the evaluation of rationally designed combination therapies that target multiple PD etiological factors.
Purpose of researchSMaRT-PD is a clinical decision support system (CDSS) for the home-based management and care of Parkinson's disease. It utilises remote monitoring and artificial intelligence to generate patient and cl...Purpose of researchSMaRT-PD is a clinical decision support system (CDSS) for the home-based management and care of Parkinson's disease. It utilises remote monitoring and artificial intelligence to generate patient and clinician-facing outputs with self-management guidance, care recommendations and triggered follow-up appointments when needed. This study aimed to identify current care pathways for people with Parkinson's (PwP) and elicit healthcare professionals' perspectives on how the introduction of SMaRT-PD would affect current care.MethodsTwelve semi-structured interviews with health care professionals working in the management and care of people with Parkinson's in NHS secondary or tertiary settings informed care pathway analysis and thematic analysis.ResultsParticipants described a care pathway which largely aligned with guidelines. Limitations of the existing care pathway included lengthy time to diagnosis, inconsistent care, staff shortages and challenges of appointment length and frequency. Participants outlined the potential advantages of introducing a home-based pathway including patient empowerment and education, earlier identification of patients who require an in-person review, and efficient use of clinic time. Perceived challenges to implementation of a home-based pathway were clinical and administrative. One concern was that patients and staff would miss regular face-to-face contact. A key evidence requirement for the adoption of SMaRT-PD was identified as demonstrable patient, carer and staff satisfaction.ConclusionsParticipants were generally supportive of introducing a home-based pathway for people with Parkinson's, suggesting that SMaRT-PD could provide an opportunity to direct limited resources to where they are most needed.
Parkinson's disease (PD) is a common neurodegenerative disorder associated with the accumulation of alpha-synuclein in Lewy bodies and Lewy neurites, as well as cell loss, including ventral midbrain dopaminergic (vmDA) n...Parkinson's disease (PD) is a common neurodegenerative disorder associated with the accumulation of alpha-synuclein in Lewy bodies and Lewy neurites, as well as cell loss, including ventral midbrain dopaminergic (vmDA) neurons in the substantia nigra. This degeneration is responsible for some of the characteristic motor features of PD, which, in the early stages of the disease, can be successfully treated pharmacologically. However, in later stages of the disease, the efficacy of these drugs declines, and they can cause side effects. Dopamine cell therapy, which involves replacing lost vmDA neurons by implanting new exogenous ones, is a promising alternative. While research on dopamine cell therapies has made substantial progress over the last few decades, from early foetal transplants to stem cell-derived transplants currently in clinical trials, it is also susceptible to potential misconceptions. This review summarises the past, present, and future of this therapeutic strategy whilst also discussing these potential misconceptions. In doing so, the status of dopamine cell therapy for PD will be critically summarised.
IntroductionParkinson's disease is associated with increased mortality and hospitalisations are common at the end of life. However, limited evidence exists regarding the place of death and its influencing factors in peop...IntroductionParkinson's disease is associated with increased mortality and hospitalisations are common at the end of life. However, limited evidence exists regarding the place of death and its influencing factors in people with Parkinson's disease (PwPD).ObjectivesTo identify and analyse factors associated with place of death in PwPD.MethodsWe systematically searched three electronic databases (MEDLINE, EMBASE, PsycINFO) for studies reporting on the place of death of PwPD. No restrictions on time or language were applied. Where possible, meta-analyses were conducted using random-effects meta-regression adjusted for country-level long-term care and hospital bed availability. Results are presented as odds ratios (OR) for place of death with 95% confidence intervals. Sensitivity analyses were performed to explore heterogeneity.Results33 studies were analysed, including over 1,200,000 individuals across five continents and reporting on individual, illness-level, service-level, and environmental factors. Hospital death was more likely among men (OR = 1.34; 95% CI: 1.21-1.49), married individuals (OR = 1.16; 95% CI: 1.07-1.26), and those under 85 years (OR = 1.29; 95% CI: 1.20-1.39). Lower-quality evidence suggested a higher likelihood of hospital death among non-white individuals, while receipt of palliative care was associated with reduced odds.ConclusionsThis systematic review and meta-analysis identify key factors associated with hospital death in PwPD that can inform clinical decision-making and policy planning. Our findings may support the development of targeted screening interventions and help clinicians and policymakers allocate resources effectively. Further research is needed to address gaps in evidence across different care settings.Plain language titlePlace of death in Parkinson's disease and related factors.
Varlow C, Pees A, Stehouwer JS
… +20 more, Grotegerd AK, Bleher D, Guarino DS, Lindberg A, Tong J, Lopresti BJ, Knight AC, Zabrocki M, Nasser A, Shalgunov V, Ferri E, Cannazza G, McQuade P, Mathis CA, Mach RH, Battisti UM, Herfert K, Herth MM, Knudsen GM, Vasdev N
J Parkinsons Dis
· 2026 Jun · PMID 41995458
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BackgroundParkinson's disease (PD) and multiple system atrophy (MSA) are considered α-synucleinopathies, characterized by the presence of pathological α-synuclein (α-syn) aggregates. A positron emission tomography (PET)...BackgroundParkinson's disease (PD) and multiple system atrophy (MSA) are considered α-synucleinopathies, characterized by the presence of pathological α-synuclein (α-syn) aggregates. A positron emission tomography (PET) tracer for imaging α-syn aggregates is highly sought after, as disease progression correlates with the accumulation of aggregated α-syn. We recently reported [F]asyn-44 as a radiotracer for α-syn, worthy of evaluation in higher species, based on binding data from human brain tissues and PET imaging studies in rodents.Objective[H]ACI-12589 is a promising α-syn PET tracer which recently showed binding in MSA patients but appears to have limited utility in other α-synucleinopathies. Objective 1) compare the binding properties of our lead, [H]asyn-44, to [H]ACI-12589; Objective 2) evaluate [F]asyn-44 and [F]ACI-12589 kinetics by PET imaging in normal rodents; Objective 3) assess pharmacokinetic properties and metabolism of [F]asyn-44 in normal pig and non-human primate (NHP).Methods autoradiography with [H]asyn-44 and [H]ACI-12589 was performed to compare radiotracer binding in PD, MSA, Alzheimer's disease and healthy control post-mortem brain tissue. Additionally, preclinical PET imaging was performed in rats with [F]ACI-12589 to compare with our previously reported [F]asyn-44 data. Further evaluation of [F]asyn-44 in higher species was carried out by preclinical PET imaging in pig and NHP with metabolite analysis. Liver microsome assays and mass spectrometry were performed to identify the metabolites formed in NHP.Results[H]Asyn-44 and [H]ACI-12589 displayed different binding properties in both PD and MSA tissue, suggesting that the tracers target different binding sites and asyn-44 might therefore be more suited for PD imaging. In the pig, [F]asyn-44 readily entered the brain and no brain penetrant metabolites were observed in arterial blood samples. In the NHP, [F]asyn-44 readily entered the brain but was rapidly metabolized. Radiolabeled metabolites of asyn-44 were proposed and will be considered in the design of future derivatives.ConclusionsSpecies differences in metabolism of [F]asyn-44 are observed between pig and NHP, and do not support the further translation of [F]asyn-44. Additionally, autoradiography with [H]asyn-44 revealed low signal specificity and high non-displaceable binding. We report evidence for off-target binding of [H]ACI-12589 to amyloid-β plaques. The limitations of both [H]asyn-44 and [H]ACI-12589 reported here support the development of additional derivatives and structural scaffolds of asyn-44 with the potential to improve radiotracer specificity and selectivity towards α-syn.
Chaparro-Solano HM, Teixeira-Dos-Santos D, Waldo E
… +47 more, Leal TP, Inca-Martinez M, Alcauter S, Medina-Rivera A, Ruiz-Contreras AE, Cornejo-Olivas M, Mejia-Rojas K, Armas C, Chana-Cuevas P, Rojas N, Orozco JL, Ospina BM, Aguillon D, Buritica O, Masmela SM, Tumas V, Schuh AF, Rieder CR, Santos-Lobato BL, Duarte JS, Peña Martínez SL, Rodríguez-Violante M, Hernández-Medrano AJ, Gatto EM, Da Prat De Magalhaes GA, Arboleda G, Kauffman MA, Rodriguez-Quiroga SA, Vinuela A, Espinal Martinez AO, Braga-Neto P, Camargos S, Fernandez-Toledo E, Avila CL, Cardoso FE, Olguin P, Borges V, Müller MV, Merello M, Rosso A, Martinez-Ramirez D, Adamec DS, Tela MS, Letro GH, Nicaretta DH, Mata IF, Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD)
BackgroundAlthough levodopa is the gold standard treatment for Parkinson's disease (PD), its chronic use is associated with levodopa-induced dyskinesia (LID), a motor complication that impacts prognosis, quality of life,...BackgroundAlthough levodopa is the gold standard treatment for Parkinson's disease (PD), its chronic use is associated with levodopa-induced dyskinesia (LID), a motor complication that impacts prognosis, quality of life, and treatment costs. Most known LID-associated factors have been identified in European-descendant populations.ObjectivesTo describe the epidemiology of LID in Latin American and Caribbean (LATAM) countries and assess the relevance of known and novel LID-associated factors in this population.MethodsWe conducted a cross-sectional study using data from the Latin American Research consortium on the Genetics of Parkinson's Disease (LARGE-PD). We included PD patients with information on LID status and levodopa use from eight LATAM countries. LID prevalence was calculated overall and by country. Countries were compared on demographic and clinical variables. Logistic regression was used to identify associations with LID.ResultsA total of 3695 PD patients (58.8% male) were included. Overall LID prevalence was 25.4% [95% CI: 24.06-26.87], ranging from 9.3% in Colombia to 45.1% in Puerto Rico. Prevalence increased progressively with longer disease duration. Country comparisons showed that not all known LID-associated factors explained prevalence differences. In logistic regression, fast disease progression was significantly associated with LID (OR: 1.55, 95%CI: 1.16-2.07), while sex was not (OR: 1.02, 95%CI: 0.87-1.18).ConclusionsThis is the largest study on LID epidemiology in LATAM. While some known risk factors remain relevant, others, like sex, do not, underscoring the need for population-specific studies. Future work should integrate environmental, clinical, and genetic data to better understand LID mechanisms.
Primary results from the 24-week EPSILON study (NCT04978597) showed that adding opicapone to levodopa in non-fluctuating Parkinson's patients significantly improved motor impairment without increasing the development of...Primary results from the 24-week EPSILON study (NCT04978597) showed that adding opicapone to levodopa in non-fluctuating Parkinson's patients significantly improved motor impairment without increasing the development of motor complications versus placebo. All participants finishing the double-blind phase became eligible for open-label treatment with opicapone. Symptomatic efficacy of opicapone was maintained with 1-year open-label treatment (adjusted-mean ± SE change in MDS-UPDRS motor score from double-blind baseline to Week 76: -7.4 ± 0.81); participants who switched from placebo to opicapone had a motor improvement of -6.1 ± 0.79. At Week 76, 80.2% of opicapone-opicapone-treated participants remained motor complication-free versus 69.7% in the placebo-opicapone group (p = 0.1).
Multiple system atrophy (MSA) includes parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes. This study characterizes the spatial pattern of brain metabolic PET for MSA subtypes and assesses their relationship to striata...Multiple system atrophy (MSA) includes parkinsonian (MSA-P) and cerebellar (MSA-C) subtypes. This study characterizes the spatial pattern of brain metabolic PET for MSA subtypes and assesses their relationship to striatal dopamine transporter (DAT) loss, considering sex, age and disease duration. We studied 270 MSA patients using F-flurodeoxyglucose-PET and scaled subprofile modeling (SSM) to characterize subtype-specific disease-related metabolic patterns and F-fluoro-propyl-β-CIT-PET to quantify striatal DAT loss. SSM analysis characterized an MSA-P-related metabolic pattern (MSAPRP-Combined), which was created by linear combination of two principal components (PC) that differentiated MSA-P from 16 age-matched controls subsequently named as MSAPRP-PC1 and MSAPRP-PC2. For MSA-C-related pattern (MSACRP), only one PC (MSACRP-PC1) differentiated the MSA-C patients from the same healthy controls, therefore MSACRP-PC1 equaled to MSACRP. MSAPRP-Combined showed hypermetabolism in the pons, the posterior lobe of the cerebellum, the pallidum and in the sensorimotor cortex, and hypometabolism in the putamen, the vermis of the cerebellum, the lateral premotor cortex and the parieto-occipital association regions. MSACRP showed hypometabolism in the cerebellum and putamen. MSAPRP-PC1 was topographically more similar to MSAPRP-Combined while MSAPRP-PC2 was more similar to MSACRP. MSA-P had greater DAT loss than MSA-C and controls. In MSA-P, age correlated with MSAPRP-Combined and DAT binding, while disease duration correlated with DAT. For MSA-P females, MSAPRP-PC2 correlated with disease duration. In MSA-C, MSACRP correlated with disease duration and, in females, with age. These findings suggest that metabolic and dopaminergic relationships with disease progression may differ by sex and age in MSA subtypes.
Calculli A, Di Martino D, Grillo P
… +14 more, Bellini G, Gagliardi S, Capriglia E, Fazio C, Comolli D, Malomo G, Regalbuto S, Maestri M, Hoxhaj D, Bonanni E, Ceravolo R, Cerri S, Pisani A, Terzaghi M
BackgroundIsolated REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Evaluating trajec...BackgroundIsolated REM sleep behavior disorder (iRBD) is a prodromal stage of α-synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). Evaluating trajectories of phenoconversion is crucial in this population. Plasma neurofilament light chain (NfL), a marker of axonal injury, has emerged as a promising candidate for tracking disease progression.ObjectivesTo assess plasma NfL levels in iRBD patients, examine their associations with clinical features, particularly neurogenic orthostatic hypotension (nOH), and explore their potential role in predicting phenoconversion.MethodsPlasma NfL was measured in 54 iRBD subjects, 54 PD, 54 healthy controls and 16 MSA. Participants underwent motor, cognitive, and non-motor symptoms assessments. Longitudinal follow-up data have been collected for iRBD subjects. NfL was quantified using the Ella platform; analyses were performed with Prism 9.ResultsNfL levels were significantly higher in iRBD compared to controls and similar to PD. iRBD-nOH patients had significantly higher NfL than nOH counterparts, with values overlapping PD and MSA. nOH was inversely associated with hyposmia, supporting phenotypic divergence. NfL correlated positively with SCOPA-AUT and BDI scores. At follow-up, all four MSA converters had nOH at baseline.ConclusionsPlasma NfL elevation in iRBD supports its role as a marker of early neurodegeneration. Its association with nOH suggests that this autonomic feature may identify a biologically more severe iRBD phenotype, possibly on a trajectory toward MSA. These findings warrant extended longitudinal validation and support the integration of clinical and biological markers, including NfL, for stratifying conversion risk.
BackgroundParkinson's disease (PD) is the most common movement disorder, and patients increasingly use YouTube to obtain health-related information.ObjectiveThis study aimed to assess the content quality and informationa...BackgroundParkinson's disease (PD) is the most common movement disorder, and patients increasingly use YouTube to obtain health-related information.ObjectiveThis study aimed to assess the content quality and informational reliability of YouTube videos on PD exercises.MethodsA total of 150 English-language YouTube videos were screened using the search terms "Parkinson exercises", "Parkinson physiotherapy exercises", and "Parkinson home exercise program". For each video, the source, upload date, number of views, likes, dislikes, and comments were recorded. The Video Power Index (VPI) was assessed using the view ratio (views/day) and like ratio (likes × 100 / [likes + dislikes]). The clinical quality, reliability, and educational value of PD-specific exercise videos were assessed using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and guideline-based criteria derived from the European Physiotherapy Guideline for Parkinson's Disease (PD-GEC).ResultsA total of 29 videos met the inclusion criteria and were analyzed. Videos explaining how and why exercises were performed demonstrated higher mDiscern and GQS scores, while providing repetition, duration, and intensity information was associated with higher GQS scores but not mDiscern (p = 0.080); no differences were observed for disease specificity, functional linkage, or safety warnings (all p > 0.05). PD-GEC scores were not significantly related to video engagement metrics.ConclusionHigher-quality videos tended to provide clear explanations of exercise rationale and dosage, while guideline-based clinical features, including PD-GEC criteria, were not associated with viewer engagement.
We examined pupil-light reflex in 25 drug-naïve patients with newly diagnosed Parkinson's disease and compared them to 29 healthy controls. We also evaluated effects of symptomatic treatment and correlations with clinica...We examined pupil-light reflex in 25 drug-naïve patients with newly diagnosed Parkinson's disease and compared them to 29 healthy controls. We also evaluated effects of symptomatic treatment and correlations with clinical scores. Besides a smaller pupil diameter at maximum constriction, no pupil parameter robustly distinguished patients from controls. Following initiation of symptomatic therapy, baseline pupil diameter and constriction amplitude increased, whereas peak constriction velocity remained unchanged and correlated with patient-reported autonomic symptoms. These findings suggest peak constriction velocity may reflect autonomic dysfunction less influenced by medication. Further studies should clarify the pupil-light reflex's clinical utility in Parkinson's disease.Plain Language Summary TitlePupil response to light in newly diagnosed Parkinson's patients.
BackgroundFamily members of people with Parkinson's disease (PwP) often experience significant burden and poor quality of life (QoL). However, existing research predominantly centres on caregiver burden, with limited exp...BackgroundFamily members of people with Parkinson's disease (PwP) often experience significant burden and poor quality of life (QoL). However, existing research predominantly centres on caregiver burden, with limited exploration of the broader impact of Parkinson's disease (PD) on family QoL.AimTo measure the impact of a person's PD on the QoL of their family members and partners using the validated generic Family Reported Outcome Measure-16 (FROM-16).MethodsA cross-sectional study recruited online UK family members/partners of PwP through patient support groups to complete the FROM-16.Results152 family members/partners (mean age=67 years, median=70, SD = 10.9; females=106) of patients (mean age=72.3, median=74, SD = 8.5; females=55) with PD completed the FROM-16. The FROM-16 mean total score was 15.3 (SD = 7.9), with 45% of family members/partners having a score ≥17, meaning "a very large effect" on QoL of family members. A significant predictor of family impact was if the patient was male. The most impacted areas were feeling worried, sad, and frustrated, and the impact on holiday, family activities, sleep and sex life.ConclusionsA person's PD greatly impacts the QoL of their family members/partners. Their well-being has important implications for supporting PwP and nursing home placement, hence the need to measure this impact to provide tailored support to these family members/partners. FROM-16 could be used to measure the family impact of PD in the routine practice of different settings.
BackgroundLewy Body pathology can be detected by alpha-synuclein-Seed Amplification Assay (αSyn-SAA) in cerebrospinal fluid (CSF) with high sensitivity and specificity in cohort studies. Yet, little is known about the re...BackgroundLewy Body pathology can be detected by alpha-synuclein-Seed Amplification Assay (αSyn-SAA) in cerebrospinal fluid (CSF) with high sensitivity and specificity in cohort studies. Yet, little is known about the results that can be expected from αSyn-SAA in CSF in samples outside cohort studies as obtained in clinical routine.ObjectiveThis study analyzed the concordance of αSyn-SAA findings in CSF with clinical diagnosis in patients from clinical routine with diverse neurologic and psychiatric conditions.MethodsIn this cross-sectional study, CSF from patients who underwent lumbar puncture for therapeutic or diagnostic purposes were tested in αSyn-SAA. Analysis included binary αSyn-SAA findings, data collected during neurological examination, and structured medical history.ResultsAll 356 participants (Mean Age 67.1 years, SD = 16.2; 55.9% male) were included in the primary analysis, including 90 patients with Parkinsonian syndromes, 139 with predominant cognitive disorders, 25 with other movement disorders, 35 with inflammatory or (para)neoplastic syndromes, and 67 with further diseases. αSyn-SAA was positive in all samples from patients with Parkinson's disease (41), dementia with Lewy bodies (30), pure autonomic failure (4), and in a subset of patients with Alzheimer's disease (13/46), normal pressure hydrocephalus (7/14) and others.ConclusionsαSyn-SAA findings show high concordance with a clinical diagnosis of PD and DLB. Findings are comparable to results from well-characterized cohort studies, supporting potential diagnostic value in future clinical routine. Challenges may result from the fact that αSyn-SAA detect LB co-pathology that is known from neuropathological studies for several neurodegenerative diseases.
Not all medications arrive from a disciplined path of translational drug development; sometimes, the route of discovery involves serendipity. A drug developed for controlling urinary urgency, oxybutynin, is reviewed here...Not all medications arrive from a disciplined path of translational drug development; sometimes, the route of discovery involves serendipity. A drug developed for controlling urinary urgency, oxybutynin, is reviewed here as a highly effective treatment for excessive sweating (hyperhidrosis). Its use in Parkinson disease is described in a case report.
As the use of artificial intelligence (AI) in healthcare becomes more pervasive, its application in the clinical care for those with Parkinson's disease (PD) presents exciting opportunities to improve the timeliness and...As the use of artificial intelligence (AI) in healthcare becomes more pervasive, its application in the clinical care for those with Parkinson's disease (PD) presents exciting opportunities to improve the timeliness and accuracy of diagnosis and to optimize treatment. Perhaps more than many other neurological conditions, PD lends itself to the creation of rich data from which AI can surface actionable insights that hold the potential to revolutionize PD care in a personalized manner. For direct clinical care, AI has the potential to contribute to initial diagnosis, disease subtyping, symptom identification and severity assessment, progression monitoring, and treatment management. With patients and clinicians informing AI and contributing to its methods of deployment, an enormous opportunity exists to open up access to expert-level care to many more people.