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See detailPrimary vision and facial emotion recognition in early Parkinson's disease
Hipp, Géraldine; Diederich, Nico UL; Pieria, Viannina et al

in Journal of the Neurological Sciences (2014), 338

Background: In early stages of idiopathic Parkinson's disease (IPD), lower order vision (LOV) deficits including reduced colour and contrast discrimination have been consistently reported. Data are less ... [more ▼]

Background: In early stages of idiopathic Parkinson's disease (IPD), lower order vision (LOV) deficits including reduced colour and contrast discrimination have been consistently reported. Data are less conclusive concerning higher order vision (HOV) deficits, especially for facial emotion recognition (FER). However, a link between both visual levels has been hypothesized. Objective: To screen for both levels of visual impairment in early IPD. Methods: We prospectively recruited 28 IPD patients with disease duration of 1.4 +/− 0.8 years and 25 healthy controls. LOV was evaluated by Farnsworth-Munsell 100 Hue Test, Vis-Tech and Pelli-Robson test. HOV was examined by the Ekman 60 Faces Test and part A of the Visual Object and Space recognition test. Results: IPD patients performed worse than controls on almost all LOV tests. The most prominent difference was seen for contrast perception at the lowest spatial frequency (p = 0.0002). Concerning FER IPD patients showed reduced recognition of “sadness” (p = 0.01). “Fear” perception was correlated with perception of low contrast sensitivity in IPD patients within the lowest performance quartile. Controls showed a much stronger link between “fear” perception” and low contrast detection. Conclusion: At the early IPD stage there are marked deficits of LOV performances, while HOV performances are still intact, with the exception of reduced recognition of “sadness”. At this stage, IPD patients seem still to compensate the deficient input of low contrast sensitivity, known to be pivotal for appreciation of negative facial emotions and confirmed as such for healthy controls in this study. [less ▲]

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See detailLack of Polysomnographic Non-REM Sleep Changes in Early Parkinson’s Disease
Diederich, Nico UL; Rufra, Olivier; Pieri, Vannina et al

in Movement Disorders : Official Journal of the Movement Disorder Society (2013)

Background: Polysomnography (PSG) data are rare in patients who have early stage idiopathic Parkinson’s disease (IPD). Methods: Thirty-three patients who had IPD with a disease duration 3 years and 37 age ... [more ▼]

Background: Polysomnography (PSG) data are rare in patients who have early stage idiopathic Parkinson’s disease (IPD). Methods: Thirty-three patients who had IPD with a disease duration 3 years and 37 age-matched controls were recruited. PSG analysis was performed on current medication. Results: Patients with IPD had a reduced mean percentage of muscle atonia during rapid eye movement (REM) sleep (80% vs 93%; P < 0.05). Total sleep time, sleep efficiency, indices/hour of arousals, awakenings, apnea/hypopnea, and periodic leg movements were similar in both groups. Age, but not dopaminergic medication, had a negative impact on sleep architecture in patients with IPD. There was no correlation between sleep efficiency assessed by PSG and sleep quality assessed by questionnaire. Conclusions: The results confirmed a reduction in muscle atonia during REM sleep as a characteristic finding in early IPD. However, there were no further disease-inherent or medication-induced changes in sleep architecture. Although sleep disturbances are considered to be an integral part of IPD, PSG cannot yet identify them objectively at an early stage. VC 2013 International Parkinson and Movement Disorder Society [less ▲]

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See detailDiscriminative power of different nonmotor signs in early Parkinson's disease. A case-control study
Diederich, Nico UL; Pieri, Vannina; Hipp, Geraldine et al

in Movement Disorders : Official Journal of the Movement Disorder Society (2010), 25(7), 882-887

The objective of this study was to evaluate the discriminative power of different nonmotor signs for early diagnosis of Parkinson's disease (PD). Thirty patients with PD with <or=3 years of disease ... [more ▼]

The objective of this study was to evaluate the discriminative power of different nonmotor signs for early diagnosis of Parkinson's disease (PD). Thirty patients with PD with <or=3 years of disease duration were compared with 30 healthy controls. Six deficit domains (DD) were defined: hyposmia, sleep abnormalities, dysautonomia, visual deficits, executive dysfunction, and depression. Plotting of Receiver operating characteristic (ROC) curves and exact conditional logistic modeling, followed by manual stepwise descending procedure were used to identify a model for nonmotor signs that detects early PD. Patients with PD and controls did not differ in terms of age, gender, and educational level. Several DD discriminated patients with PD from healthy controls. Visual deficits showed the largest area under the ROC curve (0.83), followed by hyposmia (0.81) and dysautonomia (0.80). When combining the DD visual deficits and dysautonomia, the best residual model was obtained; it maximized both sensitivity and specificity for PD at a level of 0.77. At an early disease stage, several nonmotor domains were already able to discriminate patients with PD from healthy controls. Visual deficits had the best discriminatory power. Being brief and inexpensive, visual tests should be further investigated in larger cohorts as potential screening tool for early PD. [less ▲]

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