The late stage of Parkinson's –results of a large multinational study on motor and non-motor complications

Schrag, Anette; Hommel, Adrianus L.A.J.; Lorenzl, Stefan; Meissner, Wassilios G.; Odin, Per; Coelho, Miguel; Bloem, Bastiaan R.; Dodel, Richard; Ferreira, Joaquim J.; Fabbri, Margherita; Tison, François; Foubert‐Samier, Alexandra; Read, Joy; Meinders, Marjan J.; Koopmans, Raymond T.C.M.; Richinger, Carmen; Rosqvist, Kristina; Wittenberg, Michael; Neuser, Petra

doi:10.1016/j.parkreldis.2020.05.016

Cited by 32 publications

(51 citation statements)

References 31 publications

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“…Late stage PD may be complicated by psychotic symptoms, in particular hallucinations and delusions, which are associated with reduced quality of life, increased rates of institutionalization and increased mortality [63]. A prevalence of hallucinations and delusions of 44% and 25%, respectively, has been observed in a recent longitudinal multicenter study conducted on a cohort of patients with advanced PD with a mean disease duration of 15.4 years [64]. In an acute setting, delirium may also occur in hospitalized patients, as evident in PwP affected by COVID-19 [55].…”

Section: Psychosismentioning

confidence: 99%

Non-motor complications in late stage Parkinson’s disease: recognition, management and unmet needs

Rukavina

Batzu

Boogers

et al. 2021

Expert Review of Neurotherapeutics

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Introduction:The burden of non-motor symptoms (NMS) is a major determinant of health-related quality of life in Parkinson's disease (PD), particularly at its late stage. Areas covered: The late stage is usually defined as the period from unstable advanced to the palliative stage, characterized by a combination of emerging treatment-resistant axial motor symptoms (freezing of gait, postural instability, falls and dysphagia), as well as both non-dopaminergic and dopaminergic NMS: cognitive decline, neuropsychiatric symptoms, aspects of dysautonomia, pain and sleep disturbances (insomnia and excessive day-time sleepiness). Here, the authors summarize the current knowledge on NMS dominating the late stage of PD and propose a pragmatic and clinically focused approach for their recognition and treatment. Expert opinion: The NMS progression pattern is complex and remains under-researched. While dopamine-dependent NMS may improve with dopamine replacement therapy, non-dopamine dependent NMS worsen progressively and culminate at the late stages of PD. Furthermore, some PD specific features could interact negatively with other comorbidities, multiple medication use and frailty -the evaluation of these aspects is important in the creation of personalized management plans in the late stage of PD.

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Section: Psychosismentioning

confidence: 99%

Non-motor complications in late stage Parkinson’s disease: recognition, management and unmet needs

Rukavina

Batzu

Boogers

et al. 2021

Expert Review of Neurotherapeutics

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“…Bear in mind that these phenotypes of SARS-CoV-2 infection might be frequent complications of other diseases and treatments. For example, dyspnea is a frequent complication of chronic respiratory diseases [46], lung cancer [47], and hepatopulmonary syndrome [48]; septic shock is a complication of pneumococcal pneumonia, chronic corticosteroid treatment, and current tobacco smoking [49]; fatigue is a complication of multi-type cancers [50,51] and Parkinson's disease [52]; and lymphopenia is a complication of human immunodeficiency viral infection [53].…”

Section: Database Contentmentioning

confidence: 99%

MicroPhenoDB Associates Metagenomic Data with Pathogenic Microbes, Microbial Core Genes, and Human Disease Phenotypes

GuoCai

Zhang

Yang

et al. 2020

Preprint

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Microbes play important roles in human health and disease. The interaction between microbes and hosts is a reciprocal relationship, which remains largely under-explored. Current computational resources lack manually and consistently curated data to connect metagenomic data to pathogenic microbes, microbial core genes, and disease phenotypes. We developed the MicroPhenoDB database by manually curating and consistently integrating microbe-disease association data. MicroPhenoDB provides 5677 non-redundant associations between 1781 microbes and 542 human disease phenotypes across more than 22 human body sites. MicroPhenoDB also provides 696,934 relationships between 27,277 unique clade-specific core genes and 685 microbes. Disease phenotypes are classified and described using the Experimental Factor Ontology (EFO). A refined score model was developed to prioritize the associations based on evidential metrics. The sequence search option in MicroPhenoDB enables rapid identification of existing pathogenic microbes in samples without running the usual metagenomic data processing and assembly. MicroPhenoDB offers data browsing, searching and visualization through user-friendly web interfaces and web service application programming interfaces. MicroPhenoDB is the first database platform to detail the relationships between pathogenic microbes, core genes, and disease phenotypes. It will accelerate metagenomic data analysis and assist studies in decoding microbes related to human diseases. MicroPhenoDB is available through http://www.liwzlab.cn/microphenodb and http://lilab2.sysu.edu.cn/microphenodb.

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“…Parkinson's disease (PD) is a progressive neurodegenerative disease. In severe stages, PD is associated with severe disability, and in some cases a complete inability to perform activities of daily living without assistance 1 . There are approximately 18,000–20,000 individuals with a PD diagnosis in Sweden 2 .…”

Section: Introductionmentioning

confidence: 99%

Swedish guidelines for device‐aided therapies in Parkinson's disease —Economic evaluation and implementation

et al. 2021

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Objectives The National Board of Health and Welfare in Sweden published the national guidelines for Parkinson's Disease 2016. The aim of this study was to summarize this evidence review and development of the guidelines, focusing on the economic evaluation of device‐aided therapies (deep brain stimulation, pump‐based infusion of levodopa‐carbidopa intestinal gel or apomorphine) for Parkinson's disease, and the rate of implementation after 3 years in Sweden. Material and methods The evidence review underlying the guidelines—including systematic literature searches of clinical and economic evidence, model‐based economic evaluation, and formal analysis and guideline development—was examined, condensed, and translated. The impact of the guidelines was assessed with treatment use statistics from 2009 to 2019. Results All device‐aided therapies were assigned high priority. Based on a relatively low proportion of device‐aided therapies (30%) in Parkinson's disease, a 5‐year increase of 500 patients was recommended. This was estimated to reduce total costs by SEK 14 million (€1.7 million). Follow‐up data found an increase of 217 patients between 2017 and 2019, following the same trend as before the guidelines. Conclusion Three years after the guidelines were published, the use of device‐aided therapies has increased in Sweden, albeit not in pace with recommendations. One reason for slow implementation may be poor incentivization related to budget silos in which the costs for device‐aided therapies are borne by the regions but the cost offsets (eg, reduced need for home care) are reaped by local stakeholders.

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The late stage of Parkinson's –results of a large multinational study on motor and non-motor complications

Abstract: Declaration of interest:The CLaSP study is funded by the European Commission (Joint Programme -Neurodegenerative Disease Research "European research projects for the evaluation of health care policies, strategies and interventions for Neurodegenerative Diseases").

Cited by 32 publications

References 31 publications

Non-motor complications in late stage Parkinson’s disease: recognition, management and unmet needs

Non-motor complications in late stage Parkinson’s disease: recognition, management and unmet needs

MicroPhenoDB Associates Metagenomic Data with Pathogenic Microbes, Microbial Core Genes, and Human Disease Phenotypes

Swedish guidelines for device‐aided therapies in Parkinson's disease —Economic evaluation and implementation

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