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Brain Sciences
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Clinical Research on Parkinson’s Disease: Opportunities and Challenges
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Clinical Research on Parkinson’s Disease: Opportunities and Challenges

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

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 6926

Special Issue Editors

Dr. Santiago Perez-Lloret

E-Mail Website
Guest Editor
1. Psychology and Pedagogy Research Center, Pontifical Catholic University of Argentina, Buenos Aires C1107AFD, Argentina
2. Department of Physiology, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires C1121ABG, Argentina
Interests: Parkinson’s disease; neuropsychological disorders; disease-modifying therapies; clinical research; epidemiology; non-motor symptoms; quality of life; technology
Dr. Matilde Otero-Losada

E-Mail Website
Guest Editor
Center for Advanced Studies in Human and Health Sciences, Inter-American Open University, National Council for Scientific and Technical Research, CAECIHS, UAICONICET, Av. Montes de Oca 745, Buenos Aires C1147AAU, Argentina
Interests: neurodegeneration; metabolic syndrome; diabetes; oxidative stress; inflammation
Dr. Francisco Capani

E-Mail Website1 Website2
Guest Editor
1. Center for Advanced Studies in Human and Health Sciences, Inter-American Open University, National Council for Scientific and Technical Research, CAECIHS, UAI-CONICET, Av. Montes de Oca 745, Buenos Aires C1147AAU, Argentina
2. Institute of Biomedical Sciences, Faculty of Health Sciences, Autonomous University of Chile, 7500912 Santiago, Chile
Interests: neurodegeneration-neuroprotection; cell biology-synapses; 3D reconstructions; electron tomography

Special Issue Information

Dear Colleagues,

There are no adequate animal or cellular models of the chronic, insidious development of Parkinson’s Disease (PD) and most non-motor symptoms that affect patients. Therefore, clinical research is essential to better understanding the genesis, progression, and treatment of PD. Furthermore, genetic influences can only be studied using clinical studies. Quality of life is one of the most important aspects for patients; thus, more research about its determinants using observational studies is required. Finally, new treatments for non-motor features and improved therapies for motor symptoms are urgently needed.

This Special Issue includes the most recent and cutting-edge research on clinical aspects of PD, including diagnosis, the assessment of motor and non-motor symptoms, biochemical testing, the evaluation of prognostic factors, the development of machine learning/artificial intelligence algorithms, and the evaluation of treatments’ efficacy and safety. All kinds of papers, including original articles, brief reports, opinion articles, systematic reviews, and meta-analysis papers, are welcome. Authors from all around the world are encouraged to submit high-quality research articles to this Special Issue.

Dr. Santiago Perez-Lloret
Dr. Matilde Otero-Losada
Dr. Francisco Capani
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. Brain Sciences is an international peer-reviewed open access monthly 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 2200 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
  • disease-modifying therapies
  • clinical research
  • epidemiology
  • non-motor symptoms
  • quality of life
  • technology
  • observational studies
  • randomized controlled trials

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Published Papers (5 papers)

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Research

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11 pages, 490 KiB  
Article
The Impact of Probiotics on Clinical Symptoms and Peripheral Cytokines Levels in Parkinson’s Disease: Preliminary In Vivo Data
by Luca Magistrelli, Elena Contaldi, Annalisa Visciglia, Giovanni Deusebio, Marco Pane and Angela Amoruso
Brain Sci. 2024, 14(11), 1147; https://doi.org/10.3390/brainsci14111147 - 15 Nov 2024
Viewed by 375
Abstract
Introduction. Previous studies have shown that probiotics have positive effects on both motor and non-motor symptoms in Parkinson’s disease (PD). Additionally, in preclinical settings, probiotics have demonstrated the ability to counteract neuronal loss and alpha-synuclein aggregation, important pathological hallmarks of PD. Notably, preliminary [...] Read more.
Introduction. Previous studies have shown that probiotics have positive effects on both motor and non-motor symptoms in Parkinson’s disease (PD). Additionally, in preclinical settings, probiotics have demonstrated the ability to counteract neuronal loss and alpha-synuclein aggregation, important pathological hallmarks of PD. Notably, preliminary in vitro studies have revealed the immunomodulatory properties of probiotics. This study aims to evaluate the impact of probiotics on symptoms and peripheral cytokines levels in PD patients compared to placebo. Methods. Patients were enrolled and blindly randomized to receive either active probiotics (comprising Bifidobacterium animalis subsp. lactis BS01 LMG P-21384, Bifidobacterium longum BL03 DSM 16603, Bifidobacterium adolescentis BA02 DSM 18351, Fructo-oligosaccharides and Maltodextrin-Group A) or placebo (Maltodextrin-Group B). Clinical evaluations and plasma levels cytokines (TNF-α, IFN-γ, IL-6, and TGF-β) were also assessed at enrollment and after 12 weeks. Anti-parkinsonian therapy remained stable throughout the study. Results. Forty PD patients were recruited. After 12 weeks, Group A showed significant improvement in motor symptoms (UPDRS III: 13.89 ± 4.08 vs. 12.74 ± 4.57, p = 0.028) and non-motor symptoms (NMSS: 34.32 ± 21.41 vs. 30.11 ± 19.89, p = 0.041), with notable improvement in the gastrointestinal sub-item (3.79 ± 4.14 vs. 1.89 ± 2.54, p = 0.021). A reduction of IFN-γ levels was observed in both groups, but group A also showed a significant decrease in IL-6 and a slight increase in the anti-inflammatory cytokine TGF-β. Conclusions. Our data suggest that probiotics may modulate peripheral cytokines levels and improve clinical symptoms in PD patients. Probiotics may, therefore, represent a valuable adjunctive therapy to conventional anti-parkinsonian drugs. Full article
(This article belongs to the Special Issue Clinical Research on Parkinson’s Disease: Opportunities and Challenges)
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11 pages, 3896 KiB  
Article
Utilization of MANAGE-PD Tool in a Real-World Setting in Germany: A Cross-Sectional Study
by Martin Südmeyer, David J. Pedrosa, Frank Siebecker, Carolin Arlt, Jaakko J. Kopra and Wolfgang H. Jost
Brain Sci. 2024, 14(7), 630; https://doi.org/10.3390/brainsci14070630 - 24 Jun 2024
Viewed by 1004
Abstract
MANAGE-PD is a validated, web-based tool to assist physicians in identifying patients with Parkinson’s disease (PD) whose symptoms are inadequately controlled by oral medication. Also, a modified patient version of MANAGE-PD (Parkinson Check) is available in Germany. However, prospective research into the clinical [...] Read more.
MANAGE-PD is a validated, web-based tool to assist physicians in identifying patients with Parkinson’s disease (PD) whose symptoms are inadequately controlled by oral medication. Also, a modified patient version of MANAGE-PD (Parkinson Check) is available in Germany. However, prospective research into the clinical utility of MANAGE-PD is lacking. This non-interventional study aimed to assess the real-world clinical utility of the MANAGE-PD and Parkinson Check in PD patients attending a single visit at specialist clinics and neurologist practices in Germany in 2022. Participants’ disease control was rated by the physicians using their own judgment, and by completing the MANAGE-PD, and by the patients completing the Parkinson Check. Concordance was calculated between the unassisted physician’s assessment and the outcome of MANAGE-PD, as well as the Parkinson Check. A total of 278 patients from 19 sites were included in the analyses, of whom 160 patients (57.6%) were assigned to the same category of disease control by physicians’ judgment and the MANAGE-PD. Concordance was higher in patients treated in specialist clinics (63.9%) than in neurologist practices (43.7%). Concordance between physicians’ and patients’ responses was high (>80%) for each question in the Parkinson Check. MANAGE-PD proved to be especially valuable for general neurologists in identifying patients who should be referred to specialist clinics. The Parkinson Check self-assessment generated promising outcomes that merit its more widespread use. Full article
(This article belongs to the Special Issue Clinical Research on Parkinson’s Disease: Opportunities and Challenges)
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16 pages, 899 KiB  
Article
The Impact of Fatigue on Sleep and Other Non-Motor Symptoms in Parkinson’s Disease
by Stefania Diaconu, Vlad Monescu, Rafaela Filip, Laura Marian, Cristian Kakucs, Iulia Murasan, K. Ray Chaudhuri, Dragos Catalin Jianu, Cristian Falup-Pecurariu and Bianca Opritoiu
Brain Sci. 2024, 14(4), 397; https://doi.org/10.3390/brainsci14040397 - 19 Apr 2024
Cited by 4 | Viewed by 1527
Abstract
Fatigue is a common non-motor symptom in Parkinson’s disease (PD), but even so, it may still be underdiagnosed or misdiagnosed in current practice due to its non-specific manifestations. The aims of this study were to investigate the prevalence of fatigue in PD patients [...] Read more.
Fatigue is a common non-motor symptom in Parkinson’s disease (PD), but even so, it may still be underdiagnosed or misdiagnosed in current practice due to its non-specific manifestations. The aims of this study were to investigate the prevalence of fatigue in PD patients compared to healthy controls and to identify the main characteristics and associations of fatigue with other non-motor symptoms and the impact of fatigue on sleep disturbances in Parkinson’s disease. Materials and methods: case–control study in which 131 PD patients and 131 age- and sex-matched controls were enrolled. Main characteristics of fatigue, sleep, and other non-motor symptoms were assessed using specific validated questionnaires. Results: According to the Chalder fatigue scale, fatigue is more prevalent in PD patients (38.16%) compared to healthy controls (26.71%). Fatigue was identified in 46.54% of the PD patients using the Parkinson’s Fatigue Scale (PFS-16). PD patients with fatigue presented a worse motor status, more sleep disturbances (insomnia, daytime sleepiness), a broader spectrum of non-motor symptoms (pain, anxiety, urinary disturbances), worse cognitive performances, a lower level of happiness, and worse quality of life compared to PD patients without fatigue. Conclusion: Fatigue is a common symptom of PD and needs to be assessed, considering its consequences on quality of life. Sleep disturbances have a great influence over fatigue in PD patients. Full article
(This article belongs to the Special Issue Clinical Research on Parkinson’s Disease: Opportunities and Challenges)
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Review

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13 pages, 2136 KiB  
Review
Imbalance and Falls in Patients with Parkinson’s Disease: Causes and Recent Developments in Training and Sensor-Based Assessment
by Veit Mylius, Elisabeth Zenev, Caroline S. Brook, Florian Brugger, Walter Maetzler, Roman Gonzenbach and Anisoara Paraschiv-Ionescu
Brain Sci. 2024, 14(7), 625; https://doi.org/10.3390/brainsci14070625 - 22 Jun 2024
Viewed by 2080
Abstract
Imbalance and falls in patients with Parkinson’s disease (PD) do not only reduce their quality of life but also their life expectancy. Aging-related symptoms as well as disease-specific motor and non-motor symptoms contribute to these conditions and should be treated when appropriate. In [...] Read more.
Imbalance and falls in patients with Parkinson’s disease (PD) do not only reduce their quality of life but also their life expectancy. Aging-related symptoms as well as disease-specific motor and non-motor symptoms contribute to these conditions and should be treated when appropriate. In addition to an active lifestyle, advanced exercise training is useful and effective, especially for less medically responsive symptoms such as freezing of gait and postural instability at advanced stages. As treadmill training in non-immersive virtual reality, including dual tasks, significantly reduced the number of falls in PD patients, the mechanism(s) explaining this effect should be further investigated. Such research could help to select the most suitable patients and develop the most effective training protocols based on this novel technology. Real-life digital surrogate markers of mobility, such as those describing aspects of endurance, performance, and the complexity of specific movements, can further improve the quality of mobility assessment using wearables. Full article
(This article belongs to the Special Issue Clinical Research on Parkinson’s Disease: Opportunities and Challenges)
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Other

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33 pages, 23252 KiB  
Systematic Review
Non-Ergot Dopamine Agonists and the Risk of Heart Failure and Other Adverse Cardiovascular Reactions in Parkinson’s Disease
by James A. G. Crispo, Nawal Farhat, Yannick Fortin, Santiago Perez-Lloret, Lindsey Sikora, Rebecca L. Morgan, Mara Habash, Priyanka Gogna, Shannon E. Kelly, Jesse Elliott, Dafna E. Kohen, Lise M. Bjerre, Donald R. Mattison, Renée C. Hessian, Allison W. Willis and Daniel Krewski
Brain Sci. 2024, 14(8), 776; https://doi.org/10.3390/brainsci14080776 - 31 Jul 2024
Viewed by 1304
Abstract
Reports suggest possible risks of adverse cardiovascular reactions, including heart failure, associated with non-ergot dopamine agonist (DA) use in Parkinson’s disease (PD). The objectives of our review were to evaluate the risk of heart failure and other adverse cardiovascular reactions in PD patients [...] Read more.
Reports suggest possible risks of adverse cardiovascular reactions, including heart failure, associated with non-ergot dopamine agonist (DA) use in Parkinson’s disease (PD). The objectives of our review were to evaluate the risk of heart failure and other adverse cardiovascular reactions in PD patients who received a non-ergot DA compared with other anti-PD pharmacological interventions, placebo, or no intervention. Studies were identified via searches of six bibliographic databases. Randomized controlled trials (RCTs) and non-randomized studies (NRS) were eligible for study inclusion. Random-effect meta-analyses were performed to estimate adverse cardiovascular reaction risks. Quality of evidence was assessed using GRADE. In total, forty-four studies (thirty-six RCTs and eight NRS) satisfied our inclusion criteria. A single RCT found no significant difference in the risk of heart failure with ropinirole compared with bromocriptine (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.07 to 2.04; low certainty). Conversely, three case–control studies reported a risk of heart failure with non-ergot DA treatment. The quality of evidence for the risk of heart failure was judged as low or very low. Findings suggest that non-ergot DA use may be associated with adverse cardiovascular outcomes, including heart failure. Studies are needed to better understand cardiovascular risks associated with PD treatment. Full article
(This article belongs to the Special Issue Clinical Research on Parkinson’s Disease: Opportunities and Challenges)
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