People with Parkinson’s disease (PD) exhibit multi-system damaged. Medication mainly targets impairments related to dopaminergic lesions. Moreover, in later stages of the disease, medication becomes less effective. Rehabilitation therapy is believed that it can improve multiple functional disorders, including myotonia, bradykinesia, and postural gait abnormalities. It not only reduces the severity of non-motor symptoms and improves the quality of life in PD patients, but also delays the development of PD and improves the activity of daily life of patients. This article summarizes the progress of rehabilitation assessment and the therapy of PD.
Objective
To systematically review the efficacy and safety of CoenzymeQ10 for Parkinson’s disease.
Methods
Databases including PubMed, The Cochrane Library (Issue 1, 2015), EMbase, CBM, CNKI, WanFang Data and VIP were searched from inception to August 2015, to collect randomized controlled trials (RCTs) about CoenzymeQ10 for Parkinson’s disease. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software.
Results A total of 5 RCTs involving 981 patients were included. The results of meta-analysis showed that, a) As for recently effectiveness, CoenzymeQ10 2 400 mg group was superior to the placebo group in total UPDRS score change (MD=1.09, 95%CI 0.94 to 1.24, P < 0.000?01), UPDRS-I score change (MD=0.19, 95%CI 0.17 to 0.21, P < 0.000?01), UPDRS-II score change (MD=0.27, 95%CI 0.21 to 0.32, P < 0.000?01), UPDRS-III score change (MD=0.65, 95%CI 0.54 to 0.76, P < 0.000?01), Hoehn & Yahr score change (MD=0.05, 95%CI 0.04 to 0.06, P < 0.000?01), and Schwab England score change (MD= –0.87, 95%CI –1.02 to –0.72, P < 0.000?01). b) As for long-term effectiveness, there were no differences between two groups, except that the UPDRS-II score change of CoenzymeQ10 1 200 mg group was superior to the placebo group. c) As for adverse reactions, there were no statistical differences between two groups except that the incidence of cholesterol of the CoenzymeQ10 600 mg group and incidence of diarrhea of the CoenzymeQ10 2?400 mg group were lower than that of the placebo group.
Conclusion
Current evidence shows that, the dosage of 2?400 mg/d CoenzymeQ10 is effective and safe for early Parkinson’s disease. Due to the limited quality and quantity of included studies, more higher quality studies are needed to verify the above conclusion.
ObjectiveThis study aims to analyze the trends in Parkinson’s disease incidence rates among the elderly population in China from 1990 to 2021 and to forecast incidence growth over the next 20 years, providing. MethodsJoinpoint regression and age-period-cohort models were employed to analyze temporal trends in Parkinson’s disease incidence, and the Nordpred model was used to predict case numbers and incidence rates among the elderly in China from 2022 to 2044. ResultsFindings indicated a significant increase in Parkinson’s disease incidence among China’s elderly population from 1990 to 2021, with crude and age-standardized incidence rates rising from 95.37 per 100 000 and 111.05 per 100 000 to 170.52 per 100 000 and 183.91 per 100 000, respectively. Predictions suggested that by 2044, the number of cases will rise to approximately 878 264, with the age-standardized incidence rate reaching 223.4 per 100 000, and men showing significantly higher incidence rates than women. The rapid increase in both cases and incidence rates indicated that Parkinson’s disease will continue to impose a heavy disease burden on China’s elderly population. ConclusionThe burden of Parkinson’s disease in China’s elderly population has grown significantly and is expected to worsen. To address the rising incidence rates effectively, it is recommended to enhance early screening and health education for high-risk groups, improve diagnostic and treatment protocols, and prioritize resource allocation to Parkinson’s disease prevention and care services to reduce future public health burdens.
Objective To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for treating dysfunction in patients with Parkinson’s disease (PD). Methods We searched the Cochrane Library (Issue 1, 2010), MEDLINE, EMbase, CBMdisc, and CNKI from the date of the database establishment to April 2010. Randomized controlled trials (RCTs) of rTMS for patients with PD were collected. The quality of the included RCTs was critically appraised and data were extracted by two reviewers independently. Meta-analyses were conducted for the eligible RCTs. Results Eight RCTs were included. The pooled results of the first 2 RCTs showed that, there was no significant difference compared with control group about treating PD patients with clinical motor dysfunction by high-frequency rTMS 10 days later (WMD= –4.75, 95%CI –13.73 to 4.23). The pooled analysis of another 3 studies showed that, no significant difference were found about improving symptoms with treatment of low-frequency rTMS for 1 month compared with control group (WDM= –8.51, 95%CI –18.48 to 1.46). The pooled analysis of last 3 studies showed that, patient with treatment of low-frequency rTMS for 3 months, had been significantly improved in clinical symptoms such as neurological, behavior and emotional state, clinical motor function, and activities of daily living (WDM= –5.79, 95%CI –8.44 to –1.13). The frontal or motor cortex rTMS manifested as low frequency (≤1Hz), high intensity (≥90% RMT), multi-frequency (≥3 times) and long time (≥3 months) had a positive effect on the clinical symptoms of patients with PD and also had a long-term effect. Conclusions rTMS can improve clinical symptoms and dysfunction of the patients with PD.
The application of dopamine agonists in Parkinson’s disease has been a hot topic in recent years. Can dopamine receptor agonists serve as the initial drugs for Parkinson’s disease? Does it improve the natural history of patients? Has it neuroprotective role? When and how to use dopamine receptor agonists? This article provides evidence on the pros and cons of dopamine receptor agonists in the treatment of Parkinson’s disease for helping clinical decision making.
1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (Sal) is a kind of catechol isoquinoline compound, which mainly exists in mammalian brain and performs a variety of biological functions. Through in vivo metabolism, Sal can be transformed into endogenous neurotoxins and can participate the occurrence of Parkinson’s disease (PD). This has attracted widespread concern of researchers. Recently, many research works have shown that Sal may lead to alcohol addiction and regulate hormone release of the neuroendocrine system, which indicated that it is a potential regulator of dopaminergic neurons. In this paper, we discuss the neural functions of Sal on the above aspects, and wish to provide some theoretical supports for further research on its mechanism.
Objective To assess the changes in depression symptoms in patients with Parkinson’s disease (PD) receiving combined treatment of deep brain stimulation (DBS) and antiparkinsonian drug therapy (DT) compared with under DT alone. Methods Related literature was retrieved from electronic databases, including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP databases. Stata 14.0 software was used for statistical analysis. Network meta-analysis was performed using frequentist model to compare different interventions with each other. Results Five cohort studies and seven randomized controlled trials (RCTs) were included. The total number of participants was 1241. Assessed by the Beck Depression Inventory (BDI) score as the primary outcome, patients who received DT alone showed worse outcome in depression as compared to those who received subthalamic nucleus (STN)-DBS plus DT [standardized mean difference (SMD)=0.30, 95% confidence interval (CI) (0.01, 0.59), P<0.05], and there was no significant difference between the patients receiving globus pallidus interna (GPi)-DBS plus DT and those receiving STN-DBS plus DT [SMD=–0.12, 95%CI (–0.41, 0.16), P>0.05] or those receiving DT alone [SMD=–0.42, 95%CI (–0.84, 0.00), P>0.05]. Assessed by BDI-Ⅱ as the primary outcome, patients who received DT alone showed worse outcome in depression than those who received STN-DBS plus DT [SMD=0.29, 95%CI (0.05, 0.54), P<0.05]; compared with STN-DBS plus DT and DT alone, GPi-DBS plus DT was associated with better improvement in depression [SMD=–0.26, 95%CI (–0.46, –0.06), P<0.05; SMD=–0.55, 95%CI (–0.88, –0.23), P<0.05]. The ranking results of surface under the cumulative ranking curves showed that DBS plus DT had a better superiority in depression symptoms, and GPi-DBS was better than STN-DBS. Conclusion Compared with DT, STN-DBS plus DT is more likely to improve the depressive symptoms of PD patients, and GPi-DBS may be better than STN-DBS.
ObjectiveTo summarize and evaluate the quality of methodology, report and evidence of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture and moxibustion interventions for Parkinson's disease. MethodsEight databases including CNKI, WanFang Data, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were searched from inception to May 1, 2023. The quality of methodology, report and evidence involved in these studies were evaluated by AMSTAR 2, PRISMA and GRADE tool. ResultsA total of 28 SRs/MAs were included, and the findings of included studies showed that acupuncture and moxibustion had a clinical advantage for Parkinson's disease. The methodological quality of all studies was extremely low. Thirteen reports were relatively complete, 14 reports had certain flaws, and 1 report had relatively serious flaws. And of the 126 reports for seven outcomes, 1 was graded as high, 12 as moderate, 57 as low, and 56 as critically low. ConclusionThe current evidence shows that acupuncture and moxibustion have a certain clinical effect for Parkinson's disease, but the methodological quality and evidence quality of related SRs/MAs are low, and the standardization still needs to be improved. The efficacy of acupuncture and moxibustion in Parkinson's disease still needs to be verified by high-quality clinical studies in the future.
Methods for achieving diagnosis of Parkinson’s disease (PD) based on speech data mining have been proven effective in recent years. However, due to factors such as the degree of disease of the data collection subjects and the collection equipment and environment, there are different categories of sample aliasing in the sample space of the acquired data set. Samples in the aliased area are difficult to be identified effectively, which seriously affects the classification accuracy of the algorithm. In order to solve this problem, a partition bagging ensemble learning is proposed in this article, which measures the aliasing degree of the sample by designing the the ratio of sample centroid distance metrics and divides the training set into multiple subsets. And then the method of transfer training of misclassified samples is used to adjust the results of subset partitioning. Finally, the optimized weights of each sub-classifier are used to integrate the test results. The experimental results show that the classification accuracy of the proposed method is significantly improved on two public datasets and the increasement of mean accuracy is up to 25.44%. This method not only effectively improves the classification accuracy of PD speech dataset, but also increases the sample utilization rate, providing a new idea for the diagnosis of PD.
Objective To investigate the association between parkin gene S/N167 polymorphism and the risk for Parkinson’s Disease (PD) using the methods of meta-analysis. Method References were retrieved through the computerized Medline, Cochrane Library and CBM search from 1998 to 2003. Similar search strategies were applied to each of these databases. The unpublished data of our study were also included.Studies eligible for this meta-analysis should meet the following inclusion criterias: ① presentation of original data and a cross-sectional design. ② PD as the outcome of interest. ③ an odds ratio (or enough information to calculate it) reported to quantify the association between the frequencies of genotypes and alleles of parkin gene S/N167 polymorphism and the risk for PD. All analyses were conducted with ’Review Manager’ Version 4.2 software. Results A total of 1 239 PD patients and 1 168 control studies were studied. The combined data statistics revealed the frequencies of the genotypes and alleles were higher, but showed no statistically difference, for the total PD group from that ofthe control group (Z=1.57, P=0.12). After stratification according to eastern or western origin, the frequencies of G/A+A/A genotype and a allele of eastern origin were significantly higher [test for overall effect: P=0.01, OR=1.41, 95%CI= (1.08 to1.83); P=0.01, OR=1.25, 95%CI= (1.08 to1.44), respectively] in the PD group than that in the control group. After including our unpublished data, the results remained constant, and the trend was much more pronounced. Conversely, there was no difference [test for overall effect: P=0.08, OR=0.55, 95%CI= (0.30 to1.02); P=0.08, OR=0.55, 95%CI= (0.28 to1.08)] in the frequencies of allele and genotype of western origin between the PD patients and the controls. Conclusions The meta-analysis suggests that the parkin gene S/N167 polymorphism might be a genetic risk factor for PD of eastern origin, but not a definite risk for PD of western origin.
