Parkinson's and Movement Disorder Institute

BackgroundData-driven approaches identified Mild Motor Predominant (MMP), Intermediate (IM), and Diffuse Malignant (DM) as Parkinson's Disease (PD) subtypes with different motor and non-motor impairment at diagnosis. It remains unclear whether these subtypes remain stable over time or whether they represent distinct biological substrates. The alpha-synuclein seed amplification assay in CSF (CSF-αSyn-SAA) might provide further insights.Objectiveto evaluate the association between baseline CSF-αSyn-SAA parameters and 10-year clinical evolution of PD subtypes.Methods323 sporadic PD patients from PPMI dataset were classified as MMP, IM, or DM at baseline and 10-year follow-up based on motor, cognitive, sleep and dysautonomia features. CSF-αSyn-SAA parameters were collected at baseline using 150-h protocol. CSF Aβ1-42, tTau and pTau181, CSF and serum NfL were also considered at baseline.ResultsReaction times (T50, TTT) and area under the curve (AUC) respectively were shorter and larger in DM compared to IM/MMP. The difference in baseline amplification parameters was more evident when comparing subtypes based on 10-year clinical features (T50, η2 = 0.036; TTT, η2 = 0.031; AUC, η2 = 0.033; all p-values < 0.05) than when comparing subtypes based on baseline clinical features (T50, η2 = 0.012; TTT, η2 = 0.012; AUC, η2 = 0.013; all p < 0.05). Shorter T50 and TTT at baseline, or larger AUC, were associated with greater risk of DM versus MMP at 10-year follow-up (T50, OR = 4.1, p = 0.004; TTT, OR = 5.5, p < 0.001; AUC, OR = 3.5, p = 0.010). Aβ, Tau and NfL were similar between groups.ConclusionsBaseline CSF-αSyn-SAA parameters predicted long-term PD progression. Faster reactions were associated with a more severe 10-year PD phenotype considering motor and non-motor features.

BackgroundReal‐world evidence on treatment practices in Parkinson's disease (PD) has been limited due to the difficulty in collecting comprehensive and generalizable clinical data.ObjectivesWe sought to identify treatment patterns and test how treatment changed in response to (1) falling, (2) worsening disease, and (3) worsening quality of life across PD specialized centers.MethodsWe used the Parkinson Outcomes Project data collected from 2010 to 2023 across 31 international PD specialized centers. Demographic and clinical characteristics were collected annually and included medication use, physical therapy referral, psychologist or psychiatrist care, and deep brain stimulation (DBS) surgery. Treatment practice variation was described by center and in response to outcomes (self‐reported falls, higher Hoehn and Yahr stage, worse emotional and mobility subscale scores on quality‐of‐life scale).ResultsA total of 12,664 participants were analyzed. Treatment practices varied substantially across centers with the use of levodopa in the first 5 years of disease ranging from 59.3% to 94.6% and physical therapy referral ranging from 13% to 71%. At ≥ 5 years of disease, DBS rates varied from 2% to 41%. After a fall, individuals were more likely to be referred for physical therapy (β: 0.44, 95% confidence interval [CI]: 0.36, 0.52), and mental health services were recommended after a decline in emotional subscores (β: 1.74, 95% CI: 1.50, 1.98). However, there was no change in levodopa‐equivalent daily dose after worsening mobility subscores (β: −29.97, 95% CI: −76.67, 16.73).ConclusionsThese results highlight the large variability in PD practice across specialty centers and the importance of establishing best practice guidelines. Understanding the drivers of this variability is an essential next step.

To determine the level of burnout amongst adult and pediatric neurology residency program directors (PDs), and to determine whether a positive perception of value by one's institution is associated with lower-level burnout.

Media pembelajaran merupakan sarana komunikasi antara guru dengan peserta didik untuk menyampaikan materi. Melalui penggunaan media pembelajaran yang interaktif dapat membuat peserta didik memperoleh proses pembelajaran yang menyenangkan dan membuat mereka terlibat secara aktif dalam setiap proses pembelajaran. Media pembelajaran disesuaikan dengan tujuan dari kurikulum merdeka yang berfokus pada materi esensial, pengembangan karakter, dan kompetensi peserta didik Tujuan dari Program Pengabdian Masyarakat (PPM) ini untuk melakukan sosialisasi pada Guru SMP Negeri 2 Jetis, Mojokerto mengenai pemanfaatan media pembelajaran berbasis kurikulum merdeka. Dari diskusi analitis yang sudah dipaparkan di atas, maka dapat disimpulkan bahwa Dilihat dari keantusiasan guru-guru mengikuti kegiatan PPM oleh tim dosen Program Studi Pendidikan Matematika ini dapat disimpulkan bahawa meningkatkan kemampuan guru dalam merancang dan menggunakan media pembelajaran di SMP Negeri 2 Jetis Kabupaten Mojokerto. Namun mereka memiliki banyak masalah dan masalah mereka adalah terkait dengan waktu, kurang motivasi, kurang informasi, dan beban kerja yang cukup berat. Para peserta berharap jika nantinya kegiatan ini selalu berkesinambungan, karena kegiatan yang dilakukan oleh Tim Dosen Program Studi Pendidikan Matematika Universitas PGRI Adi Buana Surabaya adalah salah satu kegiatan yang menunjang kegiatan pembelajaran dan membantu para guru untuk mengembangkan potensi baik berbasis pembelajaran maupun penelitian yang nantinya bisa juga membantu akreditasi sekolah.

To compare efficacy and safety of two injection schedules of incobotulinumtoxinA for treating cervical dystonia (CD).

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To report ≥24 week outcomes of an open-label trial of DaxibotulinumtoxinA for Injection (RT002) in isolated cervical dystonia (CD).