Article
Clinical Neurology
Katherine Longardner, Aristide Merola, Irene Litvan, Alberto Maria De Stefano, Simona Maule, Fabrizio Vallelonga, Leonardo Lopiano, Alberto Romagnolo
Summary: Cardiovascular dysautonomia was associated with a sevenfold higher risk of developing dementia and a fivefold higher risk of falls in PD patients, as well as significantly higher impairment in ADLs and HRQoL. No relevant associations were found between the other autonomic domains and these outcomes.
JOURNAL OF NEUROLOGY
(2022)
Review
Geriatrics & Gerontology
Shuzhen Zhu, Hualing Li, Xiaoyan Xu, Yuqi Luo, Bin Deng, Xingfang Guo, Yang Guo, Wucheng Yang, Xiaobo Wei, Qing Wang
Summary: Cardiovascular autonomic dysfunctions are common in Parkinson's disease, leading to cognitive dysfunction, falls, and mortality. Both neurogenic and non-neurogenic mechanisms are involved, with baroreflex circulate failure being an important pathogenesis. Treatment options include both pharmacological and non-pharmacological approaches, although drugs that can enhance baroreflex sensitivity, especially by acting on central components, are urgently needed for improved outcomes in scientific research and clinical practice.
Article
Health Care Sciences & Services
Chathurini Fernando, Sarah Osborn, Malcolm Horne
Summary: Orthostatic hypotension is common but often unrecognized in Parkinson's Disease (PD). This study found that multiple home blood pressure measurements are more sensitive in detecting orthostatic hypotension, blood pressure variability, and hypertension than a single in clinic measurement.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Clinical Neurology
Ahmet Turan Isik, Neziha Erken, Idil Yavuz, Derya Kaya, Mehmet Selman Ontan, Esra Ates Bulut, Fatma Sena Dost
Summary: The meta-analysis reveals a higher prevalence of orthostatic hypotension in Alzheimer's disease patients, with a risk approximately 2.5 times higher compared to healthy controls. Therefore, evaluating postural blood pressure changes should be a crucial follow-up and treatment goal for individuals with AD.
NEUROLOGICAL SCIENCES
(2022)
Article
Peripheral Vascular Disease
Andreea Slavescu, Lisa Byrne, Amanda Lavan, Robert Briggs
Summary: This case illustrates the contribution of orthostatic hypotension without typical symptoms to falls in Parkinson's disease. A significant proportion of individuals with severe orthostatic hypotension do not exhibit typical symptoms, and this is even more prevalent in patients with Parkinson's disease. Clinically, this is important as it complicates the attribution of falls to orthostatic hypotension, which can act as a prompt for fall prevention. Therefore, screening and management of orthostatic hypotension in Parkinson's disease patients, regardless of reported symptoms, is crucial to prevent falls.
JOURNAL OF HYPERTENSION
(2023)
Article
Clinical Neurology
Francesca Baschieri, Luisa Sambati, Pietro Guaraldi, Giorgio Barletta, Pietro Cortelli, Giovanna Calandra-Buonaura
Summary: Neurogenic orthostatic hypotension (NOH) is not common in early stage Parkinson's disease (PD). A prospective study showed that PD patients had mild sympathetic impairment at first evaluation, which worsened with disease progression. Some patients with orthostatic symptoms did not have low blood pressure during testing.
PARKINSONISM & RELATED DISORDERS
(2021)
Review
Cell Biology
Aziz Debain, Fien Ann Loosveldt, Veerle Knoop, Axelle Costenoble, Siddhartha Lieten, Mirko Petrovic, Ivan Bautmans, Gerontopole Brussels Study Grp
Summary: Autonomic dysfunction and frailty are common geriatric syndromes that increase with age and have similar negative health outcomes. Frailty is associated with an increased risk of orthostatic hypotension (OH) in older adults, particularly initial OH (IOH). Frail older adults also exhibit other autonomic function alterations such as reduced orthostatic heart rate increase, systolic blood pressure recovery, and heart rate variability.
AGEING RESEARCH REVIEWS
(2023)
Article
Clinical Neurology
Giovanni Palermo, Alessandro Galgani, Gabriele Bellini, Francesco Lombardo, Nicola Martini, Riccardo Morganti, Davide Paoli, Sara De Cori, Francesca Frijia, Gabriele Siciliano, Roberto Ceravolo, Filippo Sean Giorgi
Summary: This study aimed to explore the association between degeneration of the locus coeruleus (LC) and orthostatic hypotension (OH) in Parkinson's disease (PD). Using LC-MRI scans, the study found a marked alteration of LC signal in PD patients, but no link was found between the LC-MRI features and the presence of OH.
JOURNAL OF NEURAL TRANSMISSION
(2023)
Article
Clinical Neurology
F. Vallelonga, G. Sobrero, M. Giudici, M. Valente, V Milazzo, C. Di Stefano, S. Maule
Summary: In patients with orthostatic hypotension, Delta HR/Delta SBP showed the best accuracy with high sensitivity and acceptable specificity. RD and SD-SBP had high specificity but low sensitivity, resulting in moderate accuracy. For patients without orthostatic hypotension, RD and SD-SBP may be useful with high negative predictive value when both are absent. Integration of bedside and ABPM-derived indexes can help screening for autonomic failure in PD patients.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2021)
Review
Biochemistry & Molecular Biology
Anna Pierzchlinska, Magdalena Kwasniak-Butowska, Jaroslaw Slawek, Marek Drozdzik, Monika Bialecka
Summary: This paper reviews possible vascular and metabolic factors contributing to Parkinson's disease dementia, as well as the role of genetic polymorphisms in cognitive decline. Identifying vascular risk factors may lead to screening and preventive measures for cognitive impairment in PD.
Article
Neurosciences
Martin Iniguez, Antonio Jimenez-Marin, Asier Erramuzpe, Marian Acera, Beatriz Tijero, Ane Murueta-Goyena, Rocio Del Pino, Tamara Fernandez, Mar Carmona-Abellan, Alberto Cabrera-Zubizarreta, Juan Carlos Gomez-Esteban, Jesus M. Cortes, Inigo Gabilondo
Summary: Heart rate variability (HRV) abnormalities are potential early biomarkers in Parkinson's disease (PD), and this study analyzed the synchronization between HRV and brain activity in PD patients using resting-state functional brain MRI. The findings suggest a desynchronization between heart and brain in PD, which has an impact on clinically relevant autonomic outcomes.
NPJ PARKINSONS DISEASE
(2022)
Article
Clinical Neurology
Lisanne J. Dommershuijsen, Alis Heshmatollah, Francesco U. S. Mattace Raso, Peter J. Koudstaal, M. Arfan Ikram, M. Kamran Ikram
Summary: Orthostatic hypotension is common in patients with Parkinson's disease (PD), but our study found that it is not significantly associated with an increased risk of PD in the general population.
MOVEMENT DISORDERS
(2021)
Article
Behavioral Sciences
Jia-jing Wu, Hong Jin, Ying-qi Shao, Cheng-jie Mao, Jing Chen, Chun-feng Liu
Summary: Orthostatic hypotension is a common nonmotor symptom in patients with Parkinson's disease, with impacts on cognition and transcranial sonography findings. Older age is an independent risk factor for OH in PD patients, and there are differences in cognitive function and motor symptom scores between PD-OH and PD-NOH patients. The substantia nigra area may indicate different subtypes of PD or a tendency to develop parkinsonism syndrome.
BRAIN AND BEHAVIOR
(2021)
Article
Clinical Neurology
Valeria C. Goncalves, Lorena Cuenca-Bermejo, Emiliano Fernandez-Villalba, Sebastian Martin-Balbuena, Maria Jose da Silva Fernandes, Carla A. Scorza, Maria-Trinidad Herrero
Summary: It has been over 200 years since James Parkinson first described Parkinson's disease. Despite improvements in knowledge, there is currently no way to prevent the progressive nature of the disease. Early diagnosis through recognition of non-motor symptoms is crucial for better understanding and management of the disease, including its relationship to cardiovascular parameters.
Article
Clinical Neurology
Yingqi Xing, Qing Li, Erhe Xu, Jingrong Zeng, Qiuping Li, Shanshan Mei, Yang Hua
Summary: This study investigated the changes in dynamic cerebral autoregulation in patients with Parkinson's disease and orthostatic hypotension. The results showed that the autoregulation ability of the brain was impaired in the orthostatic position in patients with symptomatic orthostatic hypotension, and tended to be impaired in the supine position in the orthostatic hypotension population.
FRONTIERS IN NEUROLOGY
(2022)
Review
Medicine, General & Internal
Tjalf Ziemssen, Jo Vandercappellen, Valeria Jordan Mondragon, Gavin Giovannoni
Summary: This article introduces the development and benefits of the MSProDiscuss clinical decision support tool for neurologists to improve care for MS patients. MS is a progressive disease with heterogeneous symptoms, and early intervention is crucial. MSProDiscuss facilitates structured patient consultations, analyzes multidimensional data, and provides personalized treatment and disease management plans.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Clinical Neurology
Tjalf Ziemssen, Virender Bhan, Jeremy Chataway, Tanuja Chitnis, Bruce Anthony Campbell Cree, Eva Kubala Havrdova, Ludwig Kappos, Pierre Labauge, Aaron Miller, Jin Nakahara, Celia Oreja-Guevara, Jacqueline Palace, Barry Singer, Maria Trojano, Ashwini Patil, Benedict Rauser, Thomas Hach
Summary: There are many challenges in accurately diagnosing and managing SPMS due to the lack of definitive criteria for the transition from RRMS to SPMS. This review discusses the diagnostic criteria/definition and the heterogeneity of SPMS patient populations, and emphasizes the importance of early identification through prospective/retrospective tools to improve outcomes with approved treatments. Effective interventions require ongoing patient-clinician dialogue within a multidisciplinary team.
NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION
(2023)
Article
Clinical Neurology
Colin M. Dayan, Beatriz Lecumberri, Ilaria Muller, Sashiananthan Ganesananthan, Samuel F. Hunter, Krzysztof W. Selmaj, Hans-Peter Hartung, Eva K. Havrdova, Christopher C. LaGanke, Tjalf Ziemssen, Bart Van Wijmeersch, Sven G. Meuth, David H. Margolin, Elizabeth M. Poole, Darren P. Baker, Peter A. Senior
Summary: This study aimed to describe the endocrine and multiple sclerosis outcomes over 6 years for alemtuzumab-treated relapsing multiple sclerosis patients. The results showed that the common adverse event of this treatment was autoimmune thyroid events, but it did not affect the disease course.
MULTIPLE SCLEROSIS JOURNAL-EXPERIMENTAL TRANSLATIONAL AND CLINICAL
(2023)
Article
Clinical Neurology
Tammy Jiang, Tjalf Ziemssen, Sibyl Wray, Changyu Shen, Karin Soderbarg, James B. Lewin, Ivan Bozin, Mark S. Freedman
Summary: This study compared the differences between Diroximel fumarate (DRF) and ponesimod (PON) as well as DRF and teriflunomide (TERI) in terms of clinical and radiological outcomes. The study found that there was no strong evidence of differences between DRF and PON in the treatment of relapsing multiple sclerosis, but DRF showed improved efficacy compared to TERI.
Article
Medicine, General & Internal
Marco Ghiani, Evi Zhuleku, Anja Dillenseger, Ulf Maywald, Andreas Fuchs, Thomas Wilke, Tjalf Ziemssen
Summary: This study introduces a novel database that links administrative claims and medical records, allowing for a complete capture of patient profiles. Currently including 500 patients, this database has the potential to enhance the quality and scope of real-world studies in multiple sclerosis.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Immunology
Tjalf Ziemssen, Eugen Schlegel, Marie Groth, Benjamin Ettle, Tobias Bopp
Summary: Booster vaccinations increase neutralizing antibody titers in ofatumumab-treated patients. A booster is recommended in ofatumumab-treated patients.
Article
Biochemistry & Molecular Biology
Anne Gessner, Heidi Stoelzer-Hutsch, Katrin Trentzsch, Dirk Schriefer, Tjalf Ziemssen
Summary: In the early stages of multiple sclerosis (MS), there are currently no sensitive assessments to evaluate complex motor functions. The countermovement jump (CMJ) has been investigated as a reliable assessment for lower extremity motor function in healthy subjects. This study aimed to determine if CMJ could identify motor deficits in individuals with MS below the clinical threshold. The results showed that individuals with MS demonstrated significantly decreased CMJ performance compared to healthy controls, indicating that CMJ could detect motor deficits in MS patients.
Article
Biochemistry & Molecular Biology
Undine Proschmann, Puya Shalchi Amirkhiz, Pauline Andres, Rocco Haase, Hernan Inojosa, Tjalf Ziemssen, Katja Akgun
Summary: This study aims to evaluate the impact of various pre-analytic conditions on immune cell counts and draw conclusions for clinical implications. The results suggest that storage temperature significantly affects immune cell counts, while tourniquet application duration, body position, and aspiration speed during blood draws do not have significant impacts. Pre-analytic conditions should be carefully considered when interpreting laboratory values of immune cell subpopulations.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Clinical Neurology
Undine Proschmann, Magdalena Mueller-Enz, Christina Woopen, Georges Katoul Al Rahbani, Rocco Haase, Anja Dillenseger, Marie Dunsche, Yassin Atta, Tjalf Ziemssen, Katja Akguen
Summary: The study found differential effects of selective versus unselective S1PRMs on the immune response to SARS-CoV-2 vaccination, with patients on selective S1PRMs exhibiting lower antibody levels and diminished T-cell response.
MULTIPLE SCLEROSIS JOURNAL
(2023)
Article
Immunology
Tjalf Ziemssen, Marie Groth, Veronika Eva Winkelmann, Tobias Bopp
Summary: This study examines the effect of SARS-CoV-2 mRNA vaccination in patients receiving siponimod treatment. The results demonstrate favorable antibody and T-cell responses in patients at six months and after the booster dose.
Article
Immunology
Christina Woopen, Marie Dunsche, Georges Katoul Al Rahbani, Anja Dillenseger, Yassin Atta, Rocco Haase, Catarina Raposo, Rosetta Pedotti, Tjalf Ziemssen, Katja Akgun
Summary: The objective of this study was to compare cellular and humoral immune responses to SARS-CoV-2 vaccination between multiple sclerosis (pwMS) patients on B-cell depleting treatment (BCDT) and those without immunotherapy. The results showed that BCDT patients had lower humoral responses but higher cellular responses. The immune responses decreased over time after primary vaccination and increased again after booster vaccination. Untreated and B-cell-depleted pwMS patients had higher antibody titers after booster vaccination. COVID-19 infection led to a significant increase in SARS-CoV-2-specific responses. A third vaccination for BCDT patients is recommended, and assessing T-cell responses may be helpful in evaluating the efficacy of SARS-CoV-2 vaccination.
Letter
Clinical Neurology
Hernan Inojosa, Stephen Gilbert, Jakob Nikolas Kather, Undine Proschmann, Katja Akgun, Tjalf Ziemssen
NEUROLOGICAL RESEARCH AND PRACTICE
(2023)
Article
Behavioral Sciences
Leone Malan, Roelof van Wyk, Roland von Kanel, Tjalf Ziemssen, Walthard Vilser, Peter M. Nilsson, Martin Magnusson, Amra Jujic, Daniel W. Mak, Faans Steyn, Nico T. Malan
Summary: The brain is the key organ that orchestrates the stress response which translates to the retina. The retina is an extension of the brain and retinal symptoms in subjects with neurodegenerative diseases substantiated the eye as a window to the brain. The retina is used in this study to determine whether chronic stress reflects neurodegenerative signs indicative of neurodegenerative conditions.
STRESS-THE INTERNATIONAL JOURNAL ON THE BIOLOGY OF STRESS
(2023)
Article
Health Care Sciences & Services
Steffeni Mountford, Maria Kahn, Preetha Balakrishnan, Elizabeth Jacyshyn-Owen, Markus Eberl, Benjamin Friedrich, Natalie Joschko, Tjalf Ziemssen
Summary: BRISA is a digital app designed to help MS patients monitor their disease by tracking symptoms. Simplified versions of questionnaires can provide comparable information regarding individual symptom presentations. However, traditional questionnaires are still needed for a more objective assessment.
Article
Clinical Neurology
Alasdair J. Coles, Anat Achiron, Anthony Traboulsee, Barry A. Singer, Carlo Pozzilli, Celia Oreja-Guevara, Gavin Giovannoni, Giancarlo Comi, Mark S. Freedman, Tjalf Ziemssen, Debora Shiota, Andreea M. Rawlings, Alana T. Wong, Magdalena Chirieac, Xavier Montalban
Summary: The safety risks associated with alemtuzumab treatment decreased over time, and the clinical benefits were maintained for 11-13 years, with most patients not requiring additional courses.
THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS
(2023)