Laryngeal and phonatory dysfunction in Parkinson's disease

Objectives: To investigate whether the fecal microbiome of Parkinson's disease patients differs from that of healthy population and explore the pathogenesis and new treatment of idiopathic Parkinson's disease. Methods: A total of 30 patients diagnosed as idiopathic Parkinson disease (PD group) in Beijing Friendship Hospital between April 2017 and June 2018 were enrolled and 30 healthy controls (NC group) were recruited at the same time.Medical records and score of unified Parkinson's disease rating scale (UPDRS) were collected and fresh fecal samples were obtained and stored in refrigerator (-80℃). The microbial compositions of fecal samples were investigated by 16S rRNA gene sequencing targeting the V3-V4 region. The taxa abundance and microbial composition were tested. Results: There was no difference of age and sex in PD and NC groups. Chao1 and Shannon indexes tended to be higher in PD group, yet failed to reach statistic significance (P=0.115 and 0.052). Relative abundance of gut microbiota differed in each taxonomic category. The relative abundance of Firmicutes in PD group was 53.6%(41.7%-64.8%), while that of Bacteroidetes in NC group was 51.7%(31.7%-65.3%). The ratios of Firmicutes to Bacteroidetes were significantly different between the two groups (1.6(0.9-3.4) vs 0.7(0.5-1.4), P=0.001). In Clostridia, Bacilli and Erysipelotrichia of Firmicutes, the relative abundances of Clostridiales, Christensenellaceae, Peptoclostridium, Lactobacillus and Erysipelatoclostridium were higher in PD group (P=0.024, 0.046, 0.036, 0.022 and 0.037). The relative abundance of Prevotella of Bacteroidales, was lower in PD group, yet failed to reach statistic significance (P=0.121). The relative abundances of Alistipes of Rikenellaceae and Butyricimonas of Marinilabiliales in PD group were significantly higher than those in NC group (P=0.047 and 0.033). The relative abundance of Bifidobacterium of Actinobacteria was significanly higher in PD group when compared with NC group (P=0.009). Despite the relatively low abundance, Akkermansia of Verrucomicrobia was significantly higher in PD group than in NC group (P=0.025). Conclusion: The structures of the fecal microbiota differ significantly between PD patients and healthy controls.

To investigate the relevance of ABCA1 R219K polymorphisms and serum ABCA1 protein concentration to Parkinson’s disease (PD) pathogenesis and classification in Chinese population. Between June 2013 to January 2014, 108 patients diagnosed with PD at Department of Neurology, Tangshan People’s Hospital, Tangshan were enrolled in the PD group, and 123 healthy individuals, from Health Screening Center of the same hospital, with matched age, gender, and education were enrolled in the control group. Polymerase chain reaction–restriction fragment length polymorphism method was used to detect ABCA1 R219K polymorphisms and enzyme-linked immunosorbent assay used to measure serum ABCA1 concentrations. Frequencies of R/K and K/K genotypes, and K allele of ABCA1 R219K polymorphisms were significantly lower in the PD group than the control group (all P < 0.05). Significant differences existed in distributions of genotype frequencies, including R/R, R/K and K/K, between PD and control group of each classification (all P < 0.05). ABCA1 concentrations were significantly different in the PD and control group (P < 0.05); also ABCA1 concentrations were very different among PD patients with different genotypes (all P < 0.05). Serum concentrations of ABCA1were significantly different among PD patients in different classifications (all P < 0.05), suggesting the negative correlation between ABCA1 serum concentration and PD classification (r = −0.776, P < 0.05). And serum concentrations of ABCA1 showed obvious differences among cases with three different genotypes in each classification (all P < 0.05). ABCA1 R219K polymorphisms and serum concentration were associated with pathogenesis and classification of PD, and K allele may be a protective genetic factor.

The laryngeal function of 19 severely closed head-injured subjects with a perceptible dysarthria was assessed using electrolaryngography and a computerized airflow/air pressure analysis system (Aerophone II). Variables measured included parameters of the Lx waveform (Fo, duty cycle and closing time) as well as aerodynamic parameters such as subglottal pressure, glottal resistance, average phonatory sound pressure level, phonatory flow rate and ad/abduction rate. Values were compared to those recorded from a non-neurologically impaired control group matched for age and sex, and correlated with the findings of a perceptual speech analysis. The findings are discussed in relation to the effects of a severe closed-head injury on laryngeal function. The clinical implications of the findings for the assessment and treatment of vocal dysfunction in head-injured subjects are also discussed.

Objective To investigate the correlation between late-onset sporadic parkinson's disease(PD)and single nucleotide polymorphism(SNP)of autophagy-related genes 7(Atg7)rs2606757(6+ 1196A/T)in Han Chinese population. Methods Totally 124 patients with late-onset sporadic PD(the PD group)and 105 age- and sex-matched healthy individuals(the control group)were enrolled in this study.The SNP of Atg7 rs2606757 was detected by the polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP). After gene sequencing for the detection of allele and genotype frequencies distribution and testing Hardy-Weinberg equilibrium, the differences in Atg7 rs2606757 genotype and allele frequency were compared between PD group and control group and between males and females. Results The frequency of AA genotype was statistically significantly lower in the PD group[34.7%(43/124)]than in the control group[53.3%(56/105)](χ2=8.063, P=0.005, OR=0.465, 95%CI: 0.273-0.791). In men's PD group versus men's control group, AA genotype of the Atg7 rs2606757 showed a lower frequency for late-onset sporadic PD[33.3%(23/69)vs.53.2%(33/62), χ2=5.280, P=0.022, OR=0.439, 95%CI: 0.217-0.891]. Logistic regression analysis indicated that the AA genotype frequency distribution of Atg7 rs2606757 showed a significant difference between PD and control groups(OR=2.210, 95%CI: 1.289-3.789, P=0.004). Conclusions The higher frequence of AA genotype at Atg7 rs2606757 only in males might be associated with the decreased risk of late-onset sporadic PD. Key words: Autophagy; Atg7; Polymorphism single nucleotide; Parkinson's disease

To clarify a characteristic of dynamic stability during gait in idiopathic normal pressure hydrocephalus (iNPH) and Parkinson's disease (PD), and to explore the association between dynamic stability and disease severity in each disease. The 5-m gait of 36 iNPH (precerebrospinal fluid drainage), 20 PD (medicated state), and 25 healthy controls (HC) were evaluated using three-dimensional motion analysis. Ambulatory dynamic stability was defined as the ability to maintain the extrapolated center of mass within the base of support at heel contact, with the distance between the two referred to as the margin of stability (MOS). Anteroposterior direction (AP) MOS was significantly larger in the iNPH and PD groups than in the HC group; no significant difference was found between the iNPH and PD groups. Mediolateral direction (ML) MOS was significantly larger in the iNPH and PD groups than in the HC group and significantly larger in the iNPH group than in the PD group. In the iNPH group, the disease severity was positively correlated with only ML MOS. In the PD group, the disease severity was positively correlated with the AP MOS and ML MOS. Dynamic stability in iNPH increases in AP and ML, and it may be associated with not only iNPH-associated gait disturbance but also with a voluntarily cautious gait strategy. Dynamic stability in PD only increased in AP, and this may be associated with PD symptoms. These findings will help physicians understand the difference in pathological gait including dynamic stability between patients with iNPH and PD.

Neuropsychiatric symptoms are common in patients with Parkinson's disease (PD) and they are likely to outweigh the motor symptoms and become a major factor affecting the quality of life of PD patients. However, the studies focusing on the non-motor symptoms in Chinese PD patients from different ethnicity are scarce. The aim of this retrospective study was to investigate neuropsychiatric symptoms and cognitive impairment in Chinese PD patients from Han and Hui populations from central China. Seventy-two Han Chinese PD patients (Han PD group) and 71 age-and sex-matched Hui Chinese PD patients (Hui PD group) were enrolled from Zhongnan Hospital of Wuhan University between Sept. 2011 and Aug. 2014 in the study. The neuropsychiatric symptoms and cognitive impairment were assessed using Neuropsychiatric Inventory (NPI) and Mini Mental State Examination (MMSE). We found that the proportion of depression, anxiety, apathy, irritability, euphoria and night time behavior disturbances were higher in the Han PD group than in the Hui PD group (P<0.05 or P<0.01). But the proportion of delusion, hallucination, agitation, disinhibition, aberrant motor behavior and change in appetite were not significantly different between the Han PD group and the Hui PD group (P>0.05). The total mean scores of the MMSE from patients in the Han PD group were similar to those in the Hui PD group (P>0.05). However, the subscale scores of recall domain and language domain in the Han PD group were significantly different from those in the Hui PD group (P<0.05). No significant difference was noted in the orientation, memory and calculation domains between the two PD groups (P>0.05). This study first showed the recall domain and language domain were different between the Han PD patients and the Hui PD patients. Depression, anxiety, apathy, irritability, euphoria and night time behavior disturbances were less presented in the Hui PD patients. All these differences may be related to the different ethnicity, which would be helpful for clinical physicians to recognize the different non-motor symptoms in Chinese PD patients with different ethnicity.

We examined two-wave longitudinal changes in two indicators of neurocognitive speed (i.e., mean rate, intraindividual variability) using one simple and three complex reaction time tasks. Participants included idiopathic Parkinson's disease (PD) patients, with and without incipient dementia, and normal controls. At baseline, there were 45 patients (26 men, 19 women) with idiopathic PD who ranged from 65 to 84 years (M = 71.3; SD = 4.5) and 47 matched controls (27 men, 20 women) who ranged from 65 to 84 years (M = 71.4; SD = 4.9). The 18-month longitudinal sample comprised of 74 returning participants (43 controls; 31 PD patients) who had no cognitive impairment or dementia at both waves. Ten of the 31 PD patients returning for Time 3 had dementia or cognitive impairment. These constituted the PD with incipient dementia (PDID) group. Repeated measures analyses of variance showed that the PD and PDID groups were slower over time on the reaction time tasks, whereas the controls improved their performance over time on all tasks. Inconsistency distinguished the two clinical groups (i.e., the PDID group but not the PD group became more inconsistent over time). Changes in neurocognitive speed and inconsistency may be valid clinical markers of PDID.

OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV) dos pacientes com doença de Parkinson (DP) idiopática e com disfonia espasmódica adutora (DEA). MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV) validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância &lt;0,05. RESULTADOS: as médias de idade dos grupos foram 66,18 para o grupo controle, 67,21 DP e 59,7 DEA, não havendo diferença estatística entre as médias. No protocolo QVV as médias dos domínios sócio-emocional, físico e escore total foram maiores para o grupo controle, seguido pelo grupo de DP idiopática e por fim o grupo da DEA, sendo a diferença entre elas estatisticamente significante. Além disso, houve diferença estatística para cada par de grupos, referente aos domínios do protocolo QVV, exceto no que se refere ao par controle e DP idiopática, no domínio sócio emocional (p=0,076). CONCLUSÃO: o maior impacto negativo na QV relacionado à voz está nos indivíduos com DEA, seguido por aqueles com DP idiopática e por fim os indivíduos do grupo controle.

Introduction Up to now, limited and contradictory results have been published on the role of prognostic values of lipid profile molecules including: HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), TG (Triglyceride), Total Cholesterol and PCSK9 (Proprotein Convertase SubtilisinKexin type 9) molecule in occurrence and development of Parkinson’s disease (PD). The aim of this study was to investigate the role of lipid profile and PCSK9 in patients with PD and to compar it with healthy individuals. Methods and Results In the present case-evidence study, 32 individuals diagnosed with PD were compared with 32 healthy individuals. After receiving the participant's consent forms, 5 ml blood was taken from vein and the level of HDL(High -Density Lipoprotein), LDL (Low-Density Lipoprotein), TG (Triglyceride),Total Cholesterol and PCSK9 in the blood samples were measured. The Elisa method was used for measuring PCSK9 level in blood serum. Data were analyzed using SPSS17 software. The P values smaller than 0.05 were considered significant. The mean age of participants in the PD and control group was 56.9±8.8 and 53.7±10.1 years respectively (P>0.05). Twenty seven individuals (87.1%) and 13 individuals (41.9%) in the PD group and control group were men, respectively. The remaining participants were women (P=0.000). LDL level (84.2±24.9 ml/dl vs. 105.5±16.8, P=0.000), HDL (45.5±8.7 ml/dl vs. 51.1±9.5 ml/dl, P=0.000), total cholesterol (155.3±31.2 ml/dl vs. 192.8±32.5 ml/dl P=0.000) were lower and TG level was higher in the PD group (133.3±79.3 ml/dl vs. 131.2±58.6 ml/dl, P=0.9) compared with the control group. PCSK9 level was higher in the PDgroup, but no significant difference was found (141.6±70 vs. 129.7±51 ng/ml, P=0.5). Conclusions Our findings showed that individuals with PD have lower level of HDL, LDL and total cholesterol compared with the control group, but PCSK9 levels were same in both groups. Key words TG (Triglyceride), LDL (Low Density Lipoprotein), HDL (High Density Lipoprotein), PCSK9 (Proprotein Convertase SubtilisinKexin type 9, Total Cholesterol, Parkinson’s disease.

Background: Neuroinflammation is increasingly recognized as an important contributor to Parkinson's disease (PD), yet perioperative immune responses in this population remain incompletely characterized. This study investigated perioperative cytokine dynamics in patients with PD compared with healthy controls (HCs) undergoing orthopedic surgery under general anesthesia. Methods: In this prospective pilot observational study, 50 patients scheduled for lower limb orthopedic surgery were enrolled (25 PD patients, 25 HCs). Serum cytokines (IL-6, IL-8, VEGF, MCP-1, HMGB1, S100B, and PARK7) were measured immediately after anesthesia induction (PRE) and 24 h postoperatively (POST). Between-group comparisons were performed using independent t-tests, and within-group perioperative changes were assessed using paired t-tests. Absolute (Δ = POST - PRE) and relative perioperative changes were analyzed. Results: IL-6 increased significantly after surgery in both groups, with no significant differences in absolute or relative perioperative changes between the PD and HC group. IL-8 concentrations were numerically higher in PD patients at both time points, but perioperative changes did not differ significantly between groups. VEGF decreased modestly within the PD group, whereas no significant change was observed in HCs; however, between-group differences in perioperative VEGF changes were not significant. S100B and PARK7 increased postoperatively in HCs but not in PD patients, while MCP-1 and HMGB1 showed no significant perioperative changes. Conclusions: In this pilot study, perioperative cytokine responses in patients with PD were largely comparable to those in HCs. Despite evidence of chronic low-grade inflammation in the PD group, no disease-specific amplification of acute perioperative inflammatory responses was observed. These findings suggest that perioperative immune activation in PD may be selective rather than global.

Recent evidence suggests a link between glycoprotein non-metastatic melanoma protein B (GPNMB) and Parkinson's disease (PD) pathogenesis. Although elevated plasma GPNMB levels associated with disease severity have been reported in PD, cerebrospinal fluid (CSF) alterations remain elusive. To explore CSF GPNMB alterations and its clinical significance in PD. This study enrolled 118 sporadic PD patients and 40 controls. We examined the potential associations between CSF GPNMB levels and the clinical characteristics or biomarkers of neurodegenerative pathogenesis. PD patients had higher CSF GPNMB levels than controls (p = 0.0159). In the PD group, CSF GPNMB levels correlated with age (age at examination: rs = 0.2511, p = 0.0061; age at onset: rs = 0.2800, p = 0.0021) and the severity of motor and cognitive dysfunction (MDS-UPDRS III score: rs = 0.1998, p = 0.0347; Mini-Mental State Examination score: rs = -0.1922, p = 0.0370). After correcting for multiple comparisons, the correlation with age at onset remained significant. CSF GPNMB levels were also positively correlated with CSF soluble triggering receptor expressed on myeloid cells 2 (sTREM2) levels in both the PD (rs = 0.3582, p < 0.0001) and control (rs = 0.4743, p = 0.0023) groups. Furthermore, multiple regression analysis revealed CSF sTREM2 level as the strongest determinant of CSF GPNMB levels in the PD group (t-value = 3.49, p = 0.0007). Elevated CSF GPNMB levels, linked with age and microglial activation, may be a valuable marker for understanding the interplay between aging, neuroinflammation, and PD pathology.

Parkinson's disease (PD) is a clinically heterogeneous disorder, which mainly affects patients' motor and non-motor function. Functional connectivity was preliminary explored and studied through resting state functional magnetic resonance imaging (rsfMRI). Through the topological analysis of 54 PD scans and 31 age-matched normal controls (NC) in the Neurocon dataset, leveraging on rsfMRI data, the brain functional connection and the Vietoris-Rips (VR) complex were constructed. The barcodes of the complex were calculated to reflect the changes of functional connectivity neural circuits (FCNC) in brain network. The 0-dimensional Betti number β0 means the number of connected branches in VR complex. The average number of connected branches in PD group was greater than that in NC group when the threshold δ ≤ 0.7. Two-sample Mann-Whitney U test and false discovery rate (FDR) correction were used for statistical analysis to investigate the FCNC changes between PD and NC groups. In PD group, under threshold of 0.7, the number of FCNC involved was significantly differences and these brain regions include the Cuneus_R, Lingual_R, Fusiform_R and Heschl_R. There are also significant differences in brain regions in the Frontal_Inf_Orb_R and Pallidum_R, when the threshold increased to 0.8 and 0.9 (p < 0.05). In addition, when the length of FCNC was medium, there was a significant statistical difference between the PD group and the NC group in the Neurocon dataset and the Parkinson's Progression Markers Initiative (PPMI) dataset. Topological analysis based on rsfMRI data may provide comprehensive information about the changes of FCNC and may provide an alternative for clinical differential diagnosis.

PurposeIn this study, we used arterial spin labeling (ASL) to explore altered cerebral blood flow perfusion in Parkinson's disease (PD) patients with anxiety and assessed the relationship between anxiety and perfusion in various brain regions to determine the pathophysiologic basis for the occurrence of anxiety in patients with PD.Materials and methodsSeventy-three patients with PD who were treated at China-Japan Friendship Hospital from September 2023 to November 2024 were enrolled: 36 PD patients with anxiety (PD-A) and 37 PD patients without anxiety (PD-NA); in addition, 37 healthy volunteers were recruited as healthy controls (HCs). All the subjects underwent three-dimensional T1-weighted imaging (3D-T1WI) and pseudo-continuous arterial spin labeling (pCASL) sequential scans via 3.0-T MRI, and cerebral blood flow (CBF) values were obtained from the whole brain. Independent samples t tests and non-parametric Mann–Whitney U tests were applied to test the differences in the CBF values of each brain region between the PD and HC groups, and between the PD-A and PD-NA groups. The relationships between CBF values and anxiety scores in the PD group were also investigated.ResultsCBF values in the bilateral frontal lobes, parietal lobes, temporal lobes, occipital lobes, substantia nigra, striatum, caudate nuclei, left pallidum, and bilateral cerebellum were lower in the PD group than in the HC group (P &amp;lt; 0.05). Compared with those in the PD-NA group, the CBF values of the bilateral frontal lobes, temporal lobes, left putamen and left pallidum were lower in the PD-A group (P &amp;lt; 0.05). CBF values in the left frontal lobe (r = −0.265, P = 0.024), right frontal lobe (r = −0.283, P = 0.015), left temporal lobe (r = −0.287, P = 0.014), and right temporal lobe (r = −0.275, P = 0.019) were negatively correlated with Hamilton Anxiety Scale (HAMA) scores in PD patients.ConclusionThe development of PD-A may be associated with dysfunctional brain perfusion in multiple brain regions, notably the bilateral frontal lobes, temporal lobes, left putamen, and left pallidum. Abnormal CBF in these brain regions may serve as a neuroimaging marker for early PD-A diagnosis. Using ASL to identify perfusion changes in core regions may advance our understanding of the pathophysiological mechanisms underlying PD-A.

Usefulness of 5 Minutes 123I-mIBG Scan in Parkinson's Disease and Heart Failure.

Purpose: Chewing problems are a major and prevalent issue in populations with neurological pathologies including cerebrovascular accident (CVA) and Parkinson’s disease (PD). We measured habitual solid chewing performance in patients with CVA or PD and compared it to that of normal older adults to identify differences in chewing ability between groups.Methods: Measures of habitual solid chewing in 32 patients with CVA, in 35 patients with PD, and in 217 normal older adults were compared. Data on the chewing duration, frequency, and rate were collected using a solid chewing task (SCT). We also analyzed the relationships between dentures, number of teeth, and SCT outcomes.Results: The chewing duration in the PD group was significantly longer than the normal group (p&lt;0.05). Chewing frequency and rate were not significantly different among the three groups. Results can be explained by rigidity and bradykinesia in orofacial structures in the PD group. No significant differences between the PD and CVA groups may be partly explained by the diverse location and size of the CVA lesion compared to the PD. Dentures and the number of teeth were not significantly correlated with SCT outcomes.Conclusions: Chewing impairment remains the area of development for research and rehabilitation, and SCT may help to assess oropharyngeal dysphagia and to identify therapeutic interventions.