Search Results And Characteristics Of The Included Studies
The details of study selection processes were shown in . Through the computerised databases search, 102 potentially relevant papers were identified and screened for retrieval. After reviewing the title and abstract, 83 studies, which included non-original or non-human studies, or those not investigating the uric acid levels in patients with PD, were excluded. Of the remaining 19 studies, 13 were then excluded for not satisfying the inclusion criteria based on full-text review. Finally, there were six studies in total that met the eligibility criteria and were included in the meta-analysis.,, Among the six studies, two were conducted in Finland,, two in China,, one in Greece and one in Spain. The participants included in each of the six studies included both male and female patients.
Selection of studies for inclusion in the present meta-analysis.
Who Does It Affect
The risk of developing Parkinsons disease naturally increases with age, and the average age at which it starts is 60 years old. Its slightly more common in men or people designated male at birth than in women or people designated female at birth .
While Parkinsons disease is usually age-related, it can happen in adults as young as 20 .
What You Can Do
As of 2021, there is no definite cure for Parkinsons disease. There is also no definite known cause. Its likely due to a combination of an individuals susceptibility and environmental factors. Most cases of Parkinsons disease happen without a genetic link.
According to research published in 2012, only report having a family member with the disease. Many toxins are suspected and have been studied, but no single substance can be reliably linked to Parkinsons.
However, research is ongoing. Its estimated that
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Magnetic Resonance Data Acquisition
The MRI data of all subjects were collected with a 3T Skyra MRI scanner with a standard operation guideline. The subjects were asked to close their eyes and keep silent during scanning, but not fall asleep. The resting state scan procedure lasted for 508 s. The subjects resting-state function and T1-weighted structural image data were collected. Resting-state data were acquired using echoplanar imaging sequences with the following specific parameters: repetition time = 2,500 ms, echo time = 25 ms, numbers of slices = 39, slice thickness = 3.5 mm, gap = 0 mm, voxel size = 3.75 mm × 3.75 mm × 3.75 mm, flip angle = 90°, field of view = 240 mm, matrix = 64 × 64, and image data of 200 time points were acquired by scanning.
T1-weighted structural image data were acquired using magnetization-prepared rapid gradient echo sequence acquisition. The specific parameters were as follows: TR = 1900 ms, TE = 2.01 ms, number of slices = 176, slice thickness = 1.0 mm, voxel size = 1.0 mm × 1.0 mm × 1.0 mm, Flip Angle = 9°, Field of View = 256 mm, and Matrix = 256 × 256. The T1-weighted structural scan procedure lasted for 488 s.
Drugs And Medication Used To Treat Parkinsons Disease
A number of different drugs can be used to treat Parkinsons.
Levodopa
Levodopa is the most common treatment for Parkinsons. It helps to replenish dopamine.
About 75 percent of cases respond to levodopa, but not all symptoms are improved. Levodopa is generally given with carbidopa.
Carbidopa delays the breakdown of levodopa which in turn increases the availability of levodopa at the blood-brain barrier.
Dopamine agonists
Dopamine agonists can imitate the action of dopamine in the brain. Theyre less effective than levodopa, but they can be useful as bridge medications when levodopa is less effective.
Drugs in this class include bromocriptine, pramipexole, and ropinirole.
Anticholinergics
Anticholinergics are used to block the parasympathetic nervous system. They can help with rigidity.
Benztropine and trihexyphenidyl are anticholinergics used to treat Parkinsons.
Amantadine
Amantadine can be used along with carbidopa-levodopa. Its a glutamate-blocking drug . It offers short-term relief for the involuntary movements that can be a side effect of levodopa.
COMT inhibitors
Catechol O-methyltransferase inhibitors prolong the effect of levodopa. Entacapone and tolcapone are examples of COMT inhibitors.
Tolcapone can cause liver damage. Its usually saved for people who do not respond to other therapies.
Ectacapone does not cause liver damage.
Stalevo is a drug that combines ectacapone and carbidopa-levodopa in one pill.
MAO-B inhibitors
- antidepressants
- St. Johns wort
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How Is It Diagnosed
Diagnosing Parkinson’s disease is mostly a clinical process, meaning it relies heavily on a healthcare provider examining your symptoms, asking you questions and reviewing your medical history. Some diagnostic and lab tests are possible, but these are usually needed to rule out other conditions or certain causes. However, most lab tests aren’t necessary unless you don’t respond to treatment for Parkinson’s disease, which can indicate you have another condition.
How Do I Take Care Of Myself
If you have Parkinsons disease, the best thing you can do is follow the guidance of your healthcare provider on how to take care of yourself.
- Take your medication as prescribed. Taking your medications can make a huge difference in the symptoms of Parkinson’s disease. You should take your medications as prescribed and talk to your provider if you notice side effects or start to feel like your medications aren’t as effective.
- See your provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your conditions and finding the right medications and dosages.
- Dont ignore or avoid symptoms. Parkinsons disease can cause a wide range of symptoms, many of which are treatable by treating the condition or the symptoms themselves. Treatment can make a major difference in keeping symptoms from having worse effects.
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Challenges To Classify Disease Stages At The Boundary Of Advpd And Atypical Parkinsonism
During disease progression and based on the predominant motor and non-motor features associated with advPD, the separation from atypical parkinsonism may be difficult and overlap syndromes like minimal change multiple system atrophy or progressive supranuclear palsy with predominant parkinsonism have been described . AP includes a heterogeneous bunch of syndromes, all characterized by clinically manifest parkinsonism in combination with other clinical features and a poor therapeutic response to dopaminergic medication. Only post-mortem analyses can clearly differentiate from advPD, as their neuropathology is characteristically different: in MSA, alpha-synuclein accumulation is found and defines an alpha-syncleinopathy as PD, but mainly in glial cells as cytoplasmic inclusions . In contrast, PSP and corticobasal degeneration are referred to as tauopathies due to characteristic intraneuronal tau aggregation and some TDP-43 proteinopathies might also develop clinical parkinsonism .
In this context, technical tests might further improve the quality of differential diagnosis. Autonomous tests, such as tests for cardiovascular, urinary, thermoregulatory or gastrointestinal dysfunction can be helpful for the diagnostic differentiation PD versus AP. Due to a marked overlap, the combination of several tests such as urodynamic investigation, tests for orthostatic dysregulation, RR-intervals and sympathetic skin response can contribute to support the correct diagnosis.
Parkinson’s Disease Diet And Nutrition
Maintaining Your Weight With Parkinson’s Disease
Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.
- Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
- If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
- Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.
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What Are The Stages Of Parkinsons
Doctors sometimes use five stages to describe the progress of Parkinsons disease. Each stage presents new or changing symptoms that a person is likely to encounter.
It is worth noting that not everyone will reach the advanced stages. Some people find that the symptoms remain mild and that they can continue to live independently and be mobile.
Dividing the condition into stages helps doctors and caregivers understand and address some of the challenges a person is experiencing as it progresses.
The 5 Stages Of Parkinsons Disease
Getting older is underrated by most. Its a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinsons Disease.
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Diagnosis Of Parkinsons Disease
There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.
A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.
Unified Parkinsons Disease Rating Scale
The Unified Parkinsons Disease Rating Scale has four parts. Each part has multiple points that are individually scored, using zero for normal or no problems, 1 for minimal problems, 2 for mild problems, 3 for moderate problems, and 4 for severe problems.
These scores are tallied to indicate the severity of the disease, with 199 points being the worst and total disability and 0 meaning no disability.3
In 2001, the Movement Disorder Society updated the rating scale with involvement from patients and caregivers. The updated scale is referred to as the UPDRS-MDS, and it was published in 2008. It now includes the following sections:3
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Signs Of Parkinsons Disease
In 1817, Dr. James Parkinson published An Essay on the Shaking Palsy describing non-motor, as well as, motor symptoms of the illness that bears his name. Parkinsons is not just a movement disorder, explained Dr. Shprecher. Constipation, impaired sense of smell, and dream enactment can occur years before motor symptoms of Parkinsons. The latter, caused by a condition called REM sleep behavior disorder, is a very strong risk factor for both Parkinsons and dementia . This has prompted us to join a consortium of centers studying REM sleep behavior disorder.
When Should I See My Healthcare Provider Or When Should I Seek Care
You should see your healthcare provider as recommended, or if you notice changes in your symptoms or the effectiveness of your medication. Adjustments to medications and dosages can make a huge difference in how Parkinsons affects your life.
When should I go to ER?
Your healthcare provider can give you guidance and information on signs or symptoms that mean you should go to the hospital or seek medical care. In general, you should seek care if you fall, especially when you lose consciousness or might have an injury to your head, neck, chest, back or abdomen.
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Surgery For People With Parkinsons Disease
Deep brain stimulation surgery is an option to treat Parkinsons disease symptoms, but it is not suitable for everyone. There are strict criteria and guidelines on who can be a candidate for surgery, and this is something that only your doctor and you can decide. Surgery may be considered early or late in the progression of Parkinsons. When performing deep-brain stimulation surgery, the surgeon places an electrode in the part of the brain most effected by Parkinsons disease. Electrical impulses are introduced to the brain, which has the effect of normalising the brains electrical activity reducing the symptoms of Parkinsons disease. The electrical impulse is introduced using a pacemaker-like device called a stimulator. Thalamotomy and pallidotomy are operations where the surgeon makes an incision on part of the brain. These surgeries aim to alleviate some forms of tremor or unusual movement, but they are rarely performed now.
Parkinsons Disease At A Glance
Parkinsonâs disease is a movement disorder that affects at least 500,000 people in the United States. It occurs when brain cells fail to produce enough dopamine, a chemical that helps to control movements, motivation, emotions, and sensations like pleasure. Symptoms of Parkinsonâs begin gradually and become worse over time. They include trembling, stiffness, and poor balance and coordination. As Parkinsonâs progresses, daily tasks like walking, talking, and chewing may become difficult. Depression and sleep problems are common. Itâs unclear why some people develop Parkinsonâs genes may play a role, as well as exposure to chemicals in the environment.
Researchers have studied the following complementary health approaches for Parkinsonâs:
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Stratification For Therapeutic Outcomes
Based on the increasingly recognized heterogeneity of PDnot only in terms of underlying genetic and/or environmental causes, but also in terms of clinical presentationsthere is an emerging need for better definitions of subtypes of PD that allow to assign treatments and shape therapeutic approaches according to the best response. As there is still no established neuroprotective treatment option that is able to intervene with the chronic neurodegenerative process, most benefit for the patients in terms of quality of life can be currently achieved by providing access to best symptomatic treatment. This is also reflected by the fact that clinical trials focus on more meaningful parameters in terms of primary and secondary outcomes . Complications of symptomatic pharmacological treatment of PD like dyskinesia remain a significant problem and several recent trials failed to efficiently target dyskinesia at phase III level . Therefore, the translation of novel drugs into successful trials requires the definition of clinically important change that goes beyond the application of clinical rating scales and aligns with the patients observation, e.g., of remission and perception of dyskinesia.
Psychological And Physical Approaches
- Tai Chi. Thereâs limited evidence that tai chi may help to improve balance in some people with Parkinsonâs disease, but studies have had mixed results. In a 2012 study of people with mild-to-moderate Parkinsonâs, the group assigned to do tai chi twice a week for 24 weeks had greater improvements in their balance, stability, and walking speed compared to the groups who did resistance training or stretching. The tai chi group was also more likely to continue exercising after the 24 weeks, a follow-up study showed. However, two or three tai chi classes a week over 16 weeks wasnât associated with improvements in walking, a smaller, 2013 study funded by NCCIH showed.
- Massage and Acupuncture. The research on massage and acupuncture for people with Parkinsonâs is limited. Thereâs no strong evidence that either helps to reduce symptoms.
- Dance. Compared to other forms of exercise, taking dance lessons, particularly Argentine tango, appears to help with some symptoms of Parkinsonâs for at least the short term, research reviews of multiple, small studies show. In general, participantsâ balance, mobility, and quality of life improved. The studies didnât include participants with advanced Parkinsonâs.
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Neurotransmitter And Metabolite Levels Determination
Specimen Collection
Plasma and urine were obtained to determine the neurotransmitter and metabolite concentrations, respectively. Blood samples were collected from a cubital vein, drawn into an EDTA tube, immediately centrifuged to separate plasma at 3,000 ×g for 10 min, and stored at 80°C until analyzed. Plasma DA, NE, EPI, and 5-HT were measured by HPLC with an electrochemical detector. At the same time, a single urine sample was collected in a container with 10 ml hydrochloric acid per liter of urine and pH was adjusted to 12. In these urine samples, the levels of homovanillic acid , vanillylmandelic acid , and 5-hydroxyindoleacetic acid , metabolites of DA, NE/EPI, and 5-HT, respectively, were quantified.
HPLC Analysis
Is There A Cure For Parkinsons
Theres currently no cure for Parkinsons, a disease that is chronic and worsens over time. More than 50,000 new cases are reported in the United States each year. But there may be even more, since Parkinsons is often misdiagnosed.
Its reported that Parkinsons complications was the
Complications from Parkinsons can greatly reduce quality of life and prognosis. For example, individuals with Parkinsons can experience dangerous falls, as well as blood clots in the lungs and legs. These complications can be fatal.
Proper treatment improves your prognosis, and it increases life expectancy.
It may not be possible to slow the progression of Parkinsons, but you can work to overcome the obstacles and complications to have a better quality of life for as long as possible.
Parkinsons disease is not fatal. However, Parkinsons-related complications can shorten the lifespan of people diagnosed with the disease.
Having Parkinsons increases a persons risk for potentially life threatening complications, like experiencing:
Parkinsons often causes problems with daily activities. But very simple exercises and stretches may help you move around and walk more safely.
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Standard Protocol Approvals Registrations And Patient Consents
Each PPMI participating site received approval from the local ethics committee before study initiation, and written informed consent was obtained from all participants before participation. Our study strictly adheres to the publication policy in the PPMI study, and we have obtained permission for publishing our research by the Data & Publication Committee of the PPMI study.