At present the parkinsonian rigidity assessment depends on subjective judgment of neurologists according to their experience. This study presents a parkinsonian rigidity quantification system based on the electromechanical driving device and mechanical impedance measurement method. The quantification system applies the electromechanical driving device to perform the rigidity clinical assessment tasks (flexion-extension movements) in Parkinson’s disease (PD) patients, which captures their motion and biomechanical information synchronously. Qualified rigidity features were obtained through statistical analysis method such as least-squares parameter estimation. By comparing the judgments from both the parkinsonian rigidity quantification system and neurologists, correlation analysis was performed to find the optimal quantitative feature. Clinical experiments showed that the mechanical impedance has the best correlation (Pearson correlation coefficient r = 0.872, P < 0.001) with the clinical unified Parkinson’s disease rating scale (UPDRS) rigidity score. Results confirmed that this measurement system is capable of quantifying parkinsonian rigidity with advantages of simple operation and effective assessment. In addition, the mechanical impedance can be adopted to help doctors to diagnose and monitor parkinsonian rigidity objectively and accurately.
Age is the main cause of neurodegenerative changes in the central nervous system (CNS), and the loss of neurons would increase with the migration of the disease. The current treatment is also mainly used to relieve symptoms, while the function of CNS is very difficult to recover. The emergence of endogenous stem cells has brought new hope for the treatment of CNS diseases. However, this nerve regeneration is only in some specific areas, and the recovery of neural function remains unknown. More and more experts in the field of neuroscience have carried out various in vivo or in vitro experiments, in order to increase nerve regeneration and nerve function recovery through mechanism research, in the expectation that the results would be applied to the treatment of CNS diseases. This article reviews the recent progress of endogenous neural stem cells in degenerative diseases of CNS.
Objective To assess the efficacy and safety of acupuncture versus western medicine in the treatment of parkinson disease. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicines in the treatment of parkinson disease were identified from CBM (1978 to 2008), VIP (1989 to 2008), Wanfang Database (1998 to 2008), CNKI (1979 to 2008), PubMed (1966 to 2008), EMbase (1980 to 2008), and The Cochrane Library (Issue 4, 2008). And some relevant journals were handsearched. Data were extracted and evaluated by two reviewers independently with a specially-designed extraction form. The Cochrane Collaboration’s RevMan 5.0.20 software was used for meta-analyses. Results A total of 13 trials involving 832 patients were included. The result of meta-analyses showed that the total effective rates of the acupuncture group or of the group of acupuncture plus Madopar were similar when compared with Madopar alone in Webster score. (1) The total effective rate: The total effective rate in acupuncture plus Madopar was similar when compared with Madopar alone in UPDRS score at Day 30 (RR=1.33, 95%CI 0.95 to 1.88) and Day 66 (RR=1.38, 95%CI 0.84 to 2.24), but there were significant differences between acupuncture plus Madopar and Madopar alone (RR=1.61, 95%CI (1.19 to 2.17) at Day 84. The total effective rate in acupuncture plus benserazide-levodopa was higher than benserazide-levodopa alone (RR=1.70, 95%CI 1.08 to 2.68) at Day 66. (2)Webster score: There were no significant differences between acupuncture and Madopar at Day 30 (WMD= –2.51, 95%CI –2.83 to –2.19) and at Day 63 (WMD= –2.48, 95%CI –3.01 to –1.95). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= –13.48, 95%CI –15.35 to –11.61), but not at Day 42 (WMD= 0.50, 95%CI –1.22 to 2.22). (3) UPDRS score: There were no significant differences between acupuncture and Madopar at Day 60 (WMD= –7.19, 95%CI –14.49 to 0.11). There were significant differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07 and 95%CI 2.95 to 11.19) and at Day 84 (WMD= –12.49,95%CI –16.75 to –8.23), but no significant differences were found at Day 66 and Day 33 (WMD= –14.90, 95%CI –31.89 to 2.09; WMD= –8.60, 95%CI –21.51 to 4.31).But there were statistical differences between acupuncture plus Madopar and Madopar alone at Day 30 (WMD= 7.07, 95%CI 2.95 to 11.19). There were no differences between acupuncture plus benserazide-levodopa and benserazide-levodopa alone at Day 66 (WMD=-10.80,95%CI-21.78 to 0.18) and at Day 33 (WMD=-15.60,95%CI-28.38 to -2.82). (4) Adverse reaction: Three trials reported adverse reactions including dizziness, heartbeat acceleration, slight mouth drying and nausea, but all of these were relieved or disappeared in the course of treatment. Conclusion Acupuncture is safe and effective in the treatment of parkinson disease. Acupuncture plus western drugs may be superior to western drugs alone. Because of the defects in the methodological quality of the included trials, the conclusion is to be confirmed by more high-quality RCTs.
Objective To understand the frailty status and main influencing factors of elderly Parkinson’s disease (PD) patients. Methods The elderly PD patients who attended the Department of Neurology of Changshu Hospital of Traditional Chinese Medicine between November 2023 and March 2024 were selected. The patients’ frailty conditions were investigated using general information questionnaire, Chinese version of Tilburg Frailty Indicator, Hoehn-Yahr Rating Scale, Mini-Nutritional Assessment Short Form, Movement Disorder Society-Unified PD Rating Scale Part Ⅲ, PD Sleep Scale-2, and Mini-Mental State Examination. Multiple linear regression analysis was used to further determine the influencing factors of the frailty status in elderly PD patients. Results A total of 170 PD patients were included. Among them, 117 cases (68.82%) had frailty, while 53 cases (31.18%) had not frailty. The average score for frailty was (6.48±3.34) points, the average score for nutritional status was (11.89±1.65) points, the average score for motor function was (27.40±13.73) points, the average score for sleep quality was (16.05±7.76) points, and the average score for cognitive status is (26.25±4.51) points. The Pearson correlation analysis results showed that PD patient frailty was positively correlated with motor function and sleep quality (P<0.01), and negatively correlated with nutritional status and cognitive status (P<0.01). The results of multiple linear regression analysis showed that age, education, place of residence, course of disease, Hoehn-Yahr Rating, nutritional status, motor function, cognitive status and sleep quality were the influencing factors of frailty in PD patients (P<0.05). Conclusions Elderly PD patients are prone to frailty. Healthcare professionals should pay attention to early screening for frailty in this population and provide timely and effective interventions to prevent or delay the onset of frailty in patients.
Pathological neural activity in subthalamic nucleus (STN) is closely related to the symptoms of Parkinson's disease. Local field potentials (LFPs) recordings from subthalamic nucleus show that power spectral peaks exist at tremor, double tremor and tripble tremor frequencies, respectively. The interaction between these components in the multi-frequency tremor may be related to the generation of tremor. To study the linear and nonlinear relationship between those components, we analyzed STN LFPs from 9 Parkinson's disease patients using time frequency, cross correlation, Granger casuality and bi-spectral analysis. Results of the time-frequency analysis and cross-frequency correlation analysis demonstrated that the power density of those components significantly decreased as the alleviation of tremor and cross-correlation (0.18~0.50) exists during tremor period. Granger causality of the time-variant amplitude showed stronger contribution from tremor to double tremor components, and contributions from both tremor and double tremor components to triple tremor component. Quadratic phase couplings among these three components were detected by the bispectral approaches. The linear and nonlinear relationships existed among the multi-components and certainly confirmed that the dependence cross those frequencies and neurological mechanism of tremor involved complicate neural processes.
Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness (RNFL) in Parkinson's disease (PD) evaluated by spectral-domain optical coherence tomography (SD-OCT). Methods A total of 37 patients (74 eyes) with PD were in the PD group, 32 age- and sex-matched healthy subjects (64 eyes) in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness (CFT), macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale (UPDRS) Ⅲ in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group (t= −2.546, −3.410;P=0.012, 0.001). There was no difference of CFT (t= −0.463,P=0.644) and the thickness of circumpapillary (t= −1.645,P=0.102), superior (t= −0.775,P=0.439), inferior (t=−1.844,P=0.067), nasal (t= −0.344,P=0.732) and temporal (t= −0.541,P=0.590) of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS Ⅲ in PD patients (P＞0.05). Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.
Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness and its correlation with visual field mean defects（MD）in Parkinsonprime;s disease (PD).Methods Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 normal controls undertook RNFL examination by Stratus OCT3. Circular scans (diameter is 3.46 mm) were taken around the optic nerve head including eight quadrants (superior, inferior, temporal, nasal, temporalsuperior, temporalinferior, nasalsuperior and nasalinferior). The RNFL thickness in different quadrants in the two groups was analyzed. The visual field of PD patients was measured by central 302 program of Humphery750 visual field analyzer, and the MD was recorded. The correlation between RNFL thickness and MD was analyzed by linear correlation and regression analysis.Results RNFL thicknesses of superior, inferior, temporal, nasal, temporalsuperior, temporalinferior, nasalsuperior, nasalinferior and average RNFL thickness in the control group were (132.7plusmn;17.4), (141.5plusmn;15.3) ,（83.2plusmn;17.5）, (83.7plusmn;22.3) ,（120.8plusmn;21.2）, (117.9plusmn;24.5) ,（109.6plusmn;20.6）,（110.2plusmn;27.7）, and（109.9plusmn;8.5）mu;m respectively, while in the PD group they were (128.1plusmn;25.3) , (128.6plusmn;13.2) , (68.7plusmn;13.5) , (76.5plusmn;17.8) ,（102.6plusmn;23.7）, (103.3plusmn;14.1) ,（101.2plusmn;20.9）,（96.6plusmn;15.0）,（102.3plusmn;11.9） mu;m. Compared with each other, the differences of RNFL thickness of inferior, temporal, temporalsuperior, temporalinferior and average RNFL thickness were statistically significant（t=2.595，2.700，2.330，2.153，2.131；P=0.014，0.011，0.026，0.040，0.041）. There was a close negative relationship between average RNFL thickness and MD in PD patients (r=-0.933，P＜0.0001). Conclusions RNFL thickness was significantly thinner in PD patients than that in the normal controls. There was a negative relationship between RNFL thickness and MD in PD patients.
PTEN-induced putative kinase 1 (PINK1), a Parkinson's disease (PD)-related protein, has two isoforms, the mitochondria-localized full-length isoform PINK1FL and the cytoplasm-localized short isoform PINK1-cyto. Studies have suggested that PINK1FL can selectively accumulate at the surface of damaged mitochondria and cooperate with another Parkinson's Disease-related protein PARKIN to trigger the degradation of MIRO1, a mitochondria trafficking regulator. The functions of PINK1-cyto are, however, not yet clear. To investigate the functions of PINK1-cyto, we expressed different proteins in cultured HEK293 cells by transfecting it with different plasmids, and detected the protein levels by Western blot after expressing for 24 h. We found that in cultured HEK293 cells, PINK1-cyto could also cooperate with PARKIN degrade MIRO1 in the presence of CK2β, and the regulatory subunit of Casein Kinase Ⅱ. Interestingly, this function of CK2β was not dependent on CK2α, the catalytic subunit of Casein Kinase II. We also found that CK2β could promote the direct interaction between PINK1-cyto and MIRO1 by immunocoprecipitation analysis. This result suggested that in addition to CK2α, CK2β could also form a kinase complex with PINK1-cyto with important physiological functions.