Retrograde Procedural Memory in Parkinson's Disease

Poster (2022, March)

Smart Scheduling (SMASCH): multi-appointment scheduling system for longitudinal clinical research studies.

in JAMIA open (2022), 5(2), 038

OBJECTIVE: Facilitate the multi-appointment scheduling problems (MASPs) characteristic of longitudinal clinical research studies. Additional goals include: reducing management time, optimizing clinical ... [more ▼]

OBJECTIVE: Facilitate the multi-appointment scheduling problems (MASPs) characteristic of longitudinal clinical research studies. Additional goals include: reducing management time, optimizing clinical resources, and securing personally identifiable information. MATERIALS AND METHODS: Following a model view controller architecture, we developed a web-based tool written in Python 3. RESULTS: Smart Scheduling (SMASCH) system facilitates clinical research and integrated care programs in Luxembourg, providing features to better manage MASPs and speed up management tasks. It is available both as a Linux package and Docker image (https://smasch.pages.uni.lu). DISCUSSION: The long-term requirements of longitudinal clinical research studies justify the employment of flexible and well-maintained frameworks and libraries through an iterative software life-cycle suited to respond to rapidly changing scenarios. CONCLUSIONS: SMASCH is a free and open-source scheduling system for clinical studies able to satisfy recent data regulations providing features for better data accountability. Better scheduling systems can help optimize several metrics that ultimately affect the success of clinical studies. [less ▲]

The retrograde procedural memory in people with Parkinson’s disease with or without freezing of gait – a cross-sectional study

Poster (2021, September 17)

Objective: To investigate the retrograde procedural memory in people with typical Parkinson’s disease (PwP) with or without freezing of gait (FOG). We hypothesized that the retrograde procedural memory is ... [more ▼]

Objective: To investigate the retrograde procedural memory in people with typical Parkinson’s disease (PwP) with or without freezing of gait (FOG). We hypothesized that the retrograde procedural memory is more strongly impaired in patients with FOG (FOG+) than in patients without FOG (FOG-). Background: Given that cognitive functions, like executive control and automaticity, are crucial for mobility, it is of great importance to get a deeper knowledge of the cognitive impairment that may interfere with walking and causing gait disturbances in PwP, i.e. FOG. The integrity of retrograde procedural memory, the ability to execute skills that have been learned in earlier life stages, is essential for a person’s ability to complete routine, procedural activities like walking. As FOG is characterized as a de-automatization disorder, we hypothesized an impairment of the retrograde procedural memory in patients with FOG. Methods: A total of 194 patients from the Luxembourg Parkinson’s study were included into the cross-sectional study. All patients were assigned to the FOG+ / FOG- groups based on a semi-structured interview conducted by a study physician. The extended evaluation system of the cube copying test was applied to evaluate both the cube-drawing procedure, representing the retrograde procedural memory, and the final result, representing the visuo-constructive abilities (Pauly et al., 2020, MDS abstract). We compared the cube copying performance of n=97 FOG+ with n=97 age-, gender- and education-matched FOG-. Results: FOG+ scored lower on the cube copying procedure compared to the FOG- (p=0.027), which is suggestive of an impaired retrograde procedural memory in FOG+. No significant differences in the visuo-constructional abilities were detected (p=0.945). Conclusion: In line with FOG being considered a de-automatization of walking, a skill acquired in earlier life stages, the present results suggest that PwP with FOG have an impaired retrograde procedural memory in comparison to PwP without FOG. The results lend support to the ability of the extended evaluation system of the cube copying test to assess impaired retrograde procedural memory and help improve our understanding of behavioral symptoms in PwP. [less ▲]

Quantifying activities of daily living impairment in Parkinson’s disease using the Functional Activities Questionnaire

in Neurological Sciences (2021)

Objective Cognitive-driven activity of daily living (ADL) impairment in Parkinson’s disease (PD) is increasingly discussed as prodromal marker for dementia. Diagnostic properties of assessments for this ... [more ▼]

Objective Cognitive-driven activity of daily living (ADL) impairment in Parkinson’s disease (PD) is increasingly discussed as prodromal marker for dementia. Diagnostic properties of assessments for this specifc ADL impairment are sparsely investigated in PD. The ability of the Functional Activities Questionnaire (FAQ) for diferentiating between PD patients with normal cognition and with mild cognitive impairment (PD-MCI), according to informant and self-reports, was examined. Global cognitive function in groups with and without mild ADL impairment was compared according to diferent cut-ofs. Methods Multicenter data of 589 patients of an international cohort (CENTRE-PD) were analyzed. Analyses were run separately for informant-rated and self-rated FAQ. Receiver operating characteristic (ROC) analysis was conducted to defne the optimal FAQ cut-of for PD-MCI (≥1), and groups were additionally split according to reported FAQ cut-ofs for PD-MCI in the literature (≥3,≥5). Binary logistic regressions examined the efect of the Montreal Cognitive Assessment (MoCA) score in PD patients with and without mild ADL impairment. Results Two hundred and twenty-fve (38.2%) patients were classifed as PD-MCI. For all three cut-of values, sensitivity was moderate to low (<0.55), but specifcity was moderately high (>0.54) with a tendency of higher values for self-reported defcits. For the self-report, the cut-of≥3 showed a signifcant efect of the MoCA (B= −0.31, p=0.003), where FAQ≥3 patients had worse cognition. No efect for group diferences based on informant ratings was detected. Conclusion Our data argue that self-reported ADL impairments assessed by the FAQ show a relation to the severity of cognitive impairment in PD. [less ▲]

Unmet Needs of People With Parkinson's Disease and Their Caregivers During COVID-19-Related Confinement: An Explorative Secondary Data Analysis.

in Frontiers in neurology (2020), 11

Self-perceived unmet needs in people with typical and atypical parkinsonism (PwP) and their caregivers, support network, personalized ways to address self-perceived unmet needs during confinement, as well ... [more ▼]

Self-perceived unmet needs in people with typical and atypical parkinsonism (PwP) and their caregivers, support network, personalized ways to address self-perceived unmet needs during confinement, as well as the prevalence of self-reported COVID-19 related symptoms, confirmed SARS-CoV-2 infection, and self-reported COVID-19 related hospitalization in Luxembourg and the Greater Region were assessed. From 18th March to 10th April 2020, 679 PwP were contacted by phone. Data was collected in the form of a semi-structured interview. The thematic synthesis identified 25 themes where PwP need to be supported in order to cope with consequences of the pandemic, and to adapt their daily and health-related activities. The present work highlights that in the context of personalized medicine, depending on the individual needs of support of the patient the identified self-perceived unmet needs were addressed in various ways ranging from one-directed information over interaction up to proactive counseling and monitoring. Family and health professionals, but also other support systems were taking care of the unmet needs of PwP (e.g., shopping, picking-up medication, etc.) during the pandemic. 7/606 PwP (1.15%) reported COVID-19 related symptoms, 4/606 (0.66%) underwent a rRT-PCR-based diagnostic test and 2/606 (0.33%) were confirmed as SARS-CoV-2 positive. None of these PwP reported being hospitalized due to COVID-19. Our results will allow health professionals to expand their services in a meaningful way i.e., personalize their support in the identified themes and thus improve the healthcare of PwP in times of crisis. [less ▲]

Contributing Factors and Evolution of Impulse Control Disorder in the Luxembourg Parkinson Cohort.

in Frontiers in neurology (2020), 11

Background: To establish the frequency of impulse control disorder (ICD) in Parkinson's disease (PD). Methods: Within the Luxembourg Parkinson's Study, PD patients were evaluated for ICD presence (score ≥ ... [more ▼]

Background: To establish the frequency of impulse control disorder (ICD) in Parkinson's disease (PD). Methods: Within the Luxembourg Parkinson's Study, PD patients were evaluated for ICD presence (score ≥ 1 on MDS-UPDRS I item 1.6), use of dopamine agonists (DA) and other medications. Results: 470 patients were enrolled. Among 217 patients without DA use, 6.9% scored positive for ICD, vs. 15.4% among 253 patients with DA use (p = 0.005). The regression analysis showed that age at PD diagnosis had only a minor impact on ICD occurrence, while there was no influence by gender or co-medications. The longitudinal study over 2 years in 156 patients demonstrated increasing ICD frequency in DA users (p = 0.005). Conclusion: This large and non-interventional study confirms that PD patients with DA treatment show higher frequency of ICD than patients without DA use. It newly demonstrates that ICD can develop independently from age, gender, or co-medications. [less ▲]

The Luxembourg Parkinson’s Study: A Comprehensive Approach for Stratification and Early Diagnosis

in Frontiers in Aging Neuroscience (2018), 10

While genetic advances have successfully defined part of the complexity in Parkinson’s disease (PD), the clinical characterization of phenotypes remains challenging. Therapeutic trials and cohort studies ... [more ▼]

While genetic advances have successfully defined part of the complexity in Parkinson’s disease (PD), the clinical characterization of phenotypes remains challenging. Therapeutic trials and cohort studies typically include patients with earlier disease stages and exclude comorbidities, thus ignoring a substantial part of the real-world PD population. To account for these limitations, we implemented the Luxembourg PD study as a comprehensive clinical, molecular and device-based approach including patients with typical PD and atypical parkinsonism, irrespective of their disease stage, age, comorbidities, or linguistic background. To provide a large, longitudinally followed, and deeply phenotyped set of patients and controls for clinical and fundamental research on PD, we implemented an open-source digital platform that can be harmonized with international PD cohort studies. Our interests also reflect Luxembourg-specific areas of PD research, including vision, gait, and cognition. This effort is flanked by comprehensive biosampling efforts assuring high quality and sustained availability of body liquids and tissue biopsies. We provide evidence for the feasibility of such a cohort program with deep phenotyping and high quality biosampling on parkinsonism in an environment with structural specificities and alert the international research community to our willingness to collaborate with other centers. The combination of advanced clinical phenotyping approaches including device-based assessment will create a comprehensive assessment of the disease and its variants, its interaction with comorbidities and its progression. We envision the Luxembourg Parkinson’s study as an important research platform for defining early diagnosis and progression markers that translate into stratified treatment approaches. [less ▲]