1. Predictors of loneliness in Parkinson's disease and craniocervical dystoniaSuzette Shahmoon, Dejan Georgiev, Paul Jarman, Kailash P. Bhatia, Patricia Limousin, Marjan Jahanshahi, 2025, izvirni znanstveni članek Povzetek: Background Loneliness is a state in which an individual feels socially isolated due to deficiencies in the quantity or quality of social relationships and interaction. To date very little is known about loneliness in Parkinson's disease (PD) and focal/segmental craniocervical dystonia (FSCD). Objectives To explore whether level of loneliness is disease-specific by comparing PD, FCSD and healthy controls (HCs), and to define predictors of loneliness in both PD and FSCD. Methods Eighty-two people with PD, 63 people with FSCD and 50 HC were surveyed. The UCLA Loneliness Scale was used to assess loneliness. Various non-motor symptoms, psychosocial variables and measures of subjective well-being were assessed and used as potential predictors of loneliness. Results There was no significant difference in reported levels of loneliness between people with PD and matched HCs, and between people with PD and people with FSCD, but people with FSCD reported higher levels of loneliness than HCs (p = 0.018). Perceived stigma predicted loneliness in both disease groups (p < 0.001). Additionally, non-motor symptoms (p = 0.006), lack of optimism (p = 0.015) and practical social support (p = 0.006) predicted loneliness in people with PD. Patients with PD and FSCD with higher perceived stigma levels felt lonelier (p < 0.001), as did female patients with PD (p = 0.004), younger patients with FSCD (p = 0.007) and older patients with PD (p = 0.023). Conclusions We identified important predictors of loneliness in PD and FSCD. The identified age- and gender-specific differences in loneliness in people with PD and FSCD contribute to our better understanding of this complex and not yet fully understood concept.
Ključne besede: loneliness, Parkinson's disease, focal/segmental craniocervical dystonia, optimism and stigma
Objavljeno v DiRROS: 04.12.2025; Ogledov: 18; Prenosov: 9
 Celotno besedilo (281,64 KB)
Gradivo ima več datotek! Več... |
2. Long-term effect and reasons for switching and combining device-aided therapies in Parkinson’s DiseaseDejan Georgiev, Maja Trošt, 2025, pregledni znanstveni članek Povzetek: Introduction. In the advanced stages of Parkinson’s disease (PD), when standard drug adjustments fail to sufficiently improve patients’ quality of life, device-aided therapies (DATs) such as deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel infusion (LCIG), levodopa-carbidopa-entacapone intestinal gel infusion, or continuous subcutaneous foslevodoa-foscarbidopa infusion are beneficial in the long run. However, sometimes patients need to switch or combine DATs due to either adverse events or loss of efficacy. Aim of study. The aim of this article was to summarise the existing data on the long-term efficacy and adverse events of DATs, and to review the data on the rationale and efficacy for switching or combining DATs in advanced PD. State of the art. A total of 50 studies on the long-term efficacy of DBS (N = 28), LCIG (N = 12), CSAI (N = 10) and 13 studies on switching and combining DATs were included in this review. Although the DATs show a favourable long-term effect on the main motor and non-motor symptoms of PD they all feature specific adverse events that need to be considered when deciding which DAT to offer to a particular patient. Occasionally, switching or combining DATs is recommended, e.g. if the first DAT shows inadequate symptom control, or due to adverse events. The choice of the second DAT depends above all on the main problems of the first DAT being correctly recognised. Clinical implications. DATs are a safe and long-term effective option for the treatment of advanced PD. Switching and/or combining DATs is recommended for patients in whom the first treatment option is not optimal. Future directions. Future studies are warranted to address the unresolved issues related to long-term efficacy, side effect profile and switching and combination of DATs in multicentric studies and using advanced analytical approaches such as machine learning.
Ključne besede: advanced Parkinson’s Disease, device-aided therapies, long-term effect of device-aided therapies
Objavljeno v DiRROS: 02.12.2025; Ogledov: 53; Prenosov: 24
Celotno besedilo (310,56 KB)
Gradivo ima več datotek! Več... |
3. The effect of serotonin reuptake and serotonin-noradrenaline reuptake inhibitors on motor symptoms in Parkinson’s disease : a PPMI-based matched-subject studyTeodora Matić, Martijn Hendriks, Ruben Saman Vinke, Aleksander Sadikov, Dejan Georgiev, 2024, izvirni znanstveni članek Povzetek: Background: Depression often co-occurs with Parkinson’s disease (PD) and is effectively treated with selective serotonin reuptake inhibitors (SSRI) and serotonin and noradrenaline reuptake inhibitors (SNRI), but their effect on motor symptoms has not yet been conclusively demonstrated. Objective: To assess the impact of the SSRI/SNRI on the motor symptoms of PD. Methods: We used data from the Parkinson’s Progression Markers Initiative database, in a matched subject design with a target group (N =47) which had been taking SSRI/SNRI medication and a control group (N =90) which had not. Matching criteria included Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRS-III) total score and its subscales’ scores, and levodopa equivalent daily dose (LEDD) at the time of the first examination (initial LEDD). For the target group, we compared the MDS-UPDRS-III score before and after taking the SSRI/SNRI medication, while for the control group we compared two equally spaced examinations. Results: In the target group, we found a greater worsening of motor scores, which was associated with lower values of initial LEDD. In addition, apathy was an independent predictor of motor worsening. Conclusions: SSRI/SNRI-use seems to be characterized by a steeper worsening of motor symptoms, which can be predicted by a lower initial LEDD. Further research should continue to investigate the effect of SSRI/SNRI-use on motor symptoms in PD.
Ključne besede: Parkinson’s disease, serotonin/noradrenaline reuptake inhibitors, depression
Objavljeno v DiRROS: 28.11.2025; Ogledov: 85; Prenosov: 44
Celotno besedilo (851,08 KB)
Gradivo ima več datotek! Več... |
4. The usefulness of wearable sensors for detecting freezing of gait in Parkinson’s disease : a systematic reviewMatic Gregorčič, Dejan Georgiev, 2025, pregledni znanstveni članek Povzetek: Background: Freezing of gait (FoG) is one of the most debilitating motor symptoms in Parkinson’s disease (PD). It often leads to falls and reduces quality of life due to the risk of injury and loss of independence. Several types of wearable sensors have emerged as promising tools for the detection of FoG in clinical and real-life settings. Objective: The main objective of this systematic review was to critically evaluate the current usability of wearable sensor technologies for FoG detection in PD patients. The focus of the study is on sensor types, sensor combinations, placement on the body and the applications of such detection systems in a naturalistic environment. Methods: PubMed, IEEE Explore and ACM digital library were searched using a search string of Boolean operators that yielded 328 results, which were screened by title and abstract. After the screening process, 43 articles were included in the review. In addition to the year of publication, authorship and demographic data, sensor types and combinations, sensor locations, ON/OFF medication states of patients, gait tasks, performance metrics and algorithms used to process the data were extracted and analyzed. Results: The number of patients in the reviewed studies ranged from a single PD patient to 205 PD patients, and just over 65% of studies have solely focused on FoG + PD patients. The accelerometer was identified as the most frequently utilized wearable sensor, appearing in more than 90% of studies, often in combination with gyroscopes (25.5%) or gyroscopes and magnetometers (20.9%). The best overall sensor configuration reported was the accelerometer and gyroscope setup, achieving nearly 100% sensitivity and specificity for FoG detection. The most common sensor placement sites on the body were the waist, ankles, shanks and feet, but the current literature lacks the overall standardization of optimum sensor locations. Real-life context for FoG detection was the focus of only nine studies that reported promising results but much less consistent performance due to increased signal noise and unexpected patient activity. Conclusions: Current accelerometer-based FoG detection systems along with adaptive machine learning algorithms can reliably and consistently detect FoG in PD patients in controlled laboratory environments. The transition of detection systems towards a natural environment, however, remains a challenge to be explored. The development of standardized sensor placement guidelines along with robust and adaptive FoG detection systems that can maintain accuracy in a real-life environment would significantly improve the usefulness of these systems.
Ključne besede: Parkinson’s disease, wearable sensors, freezing of gait, symptoms
Objavljeno v DiRROS: 24.11.2025; Ogledov: 100; Prenosov: 54
Celotno besedilo (1,05 MB)
Gradivo ima več datotek! Več... |
5. |
6. Neurophysiological underpinnings of balance control and cognitive-motor interaction in early Parkinson’s diseaseManca Peskar, Paolo Manganotti, Uroš Marušič, Klaus Gramann, 2025, izvirni znanstveni članek Povzetek: People with Parkinson’s Disease (PD) often compensate for impaired automatic balance control by engaging additional attentional resources for motor tasks. With disease progression, their cognitive system too becomes increasingly affected, further impairing postural stability. The interaction between cognitive and motor systems in the early disease stages, however, remains poorly investigated. The present study aimed to elucidate behavioral and neurophysiological changes in early-stage PD to identify with greater accuracy the specific disease-related discrepancies from healthy functioning on both cognitive and motor systems. Eighteen participants with PD (aged 62.9±6.6 years) and 18 healthy matched controls (aged 62.9±6.4 years) performed (i) a balancing single task in a semi-tandem stance (ST-sts), (ii) a single visual oddball task with conflicting Stroop color-word stimuli (ST-Stroop), and (iii) a dual-task (DT) combining the two single tasks. Centre of pressure displacement using a force plate and 128-channel electroencephalography (EEG) were recorded. Participants with PD exhibited reduced postural sway compared to controls, and postural sway was lower in DT as opposed to ST. Reduced sway in PD might be attributed to postural rigidity and tonic muscle activation, while in the DT, it might reflect resource conflicts. EEG analyses indicated distinct spectral activity patterns: the central midline low-frequency (δ, θ) power increased with cognitive load, centroparietal β desynchronization intensified with motor load, and parietal α desynchronization heightened during DT in both PD and control groups, underscoring specific frequency bands’ governing roles in cognitivemotor processing. Furthermore, PD participants exhibited heightened or prolonged responses in ERP components related to working memory (frontocentral P2) and conflict resolution (P300), possibly reflecting compensatory neural strategies. Overall, these findings suggest that cognitive capacities, particularly selective attention, might be more affected than sensory acuity in early PD, highlighting areas for targeted interventions.
Ključne besede: EEG, semi-tandem stance, COP (Center of pressure), Parkinson's disease, cognitive-motor dual-tasking
Objavljeno v DiRROS: 08.09.2025; Ogledov: 275; Prenosov: 123
Celotno besedilo (4,02 MB)
Gradivo ima več datotek! Več... |
7. Exploring the impact of electroencephalography-based neurofeedback (EEG NFB) on motor deficits in Parkinson’s disease : a targeted literature reviewLaura Blaznik, Uroš Marušič, 2025, pregledni znanstveni članek Povzetek: Parkinson’s disease (PD) is a progressive neurodegenerative disorder, with pharmacological treatments predominantly focusing on dopaminergic therapies. In the early stages of PD, symptoms may also be alleviated through non-pharmacological interventions. One such non-invasive technique is electroencephalogram neurofeedback (EEG NFB), which has shown promising results in improving the cognitive and motor functions of PD patients. The aim of our study was to assess the existing evidence, identify key trends and determine potential opportunities for future research in the field of EEG NFB for PD. This analysis explores the impact of EEG NFB on motor deficits in PD and identifies key factors for the successful implementation of EEG NFB as evidenced in the literature. The synthesis includes findings from five relevant studies, including one case study, one pilot study and three randomized controlled trials. Study selection followed the PICO framework to ensure relevance and rigor. The results suggest a correlation between sensorimotor rhythm (SMR) and beta rhythms, with increases in SMR (13–15 Hz) and beta (12–15 Hz) rhythms linked to improvements in balance, mobility and stability in PD patients. However, limitations such as small sample sizes, brief intervention durations and lack of follow-up warrant a cautious interpretation. Future research should prioritize robust protocols, larger samples and extended neurofeedback training to fully assess EEG NFB’s potential for PD management.
Ključne besede: Parkinson's disease, motor deficits, biofeedback, neurofeedback, electroencephalography
Objavljeno v DiRROS: 27.02.2025; Ogledov: 689; Prenosov: 359
Celotno besedilo (371,13 KB)
Gradivo ima več datotek! Več... |
8. Post-physical therapy 4-month in-home dynamic standing protocol maintains physical therapy gains and improves mobility, balance confidence, fear of falling and quality of life in Parkinson’s disease : a randomized controlled examiner-blinded feasibility clinical trialMiriam van Emde Boas, Chatkaew Pongmala, Abigail M. Biddix, Alexis Griggs, Austin T. Luker, Giulia Carli, Uroš Marušič, Nicolaas I. Bohnen, 2024, izvirni znanstveni članek Povzetek: Objective: Parkinson’s patients will experience mobility disturbances with disease progression. Beneficial effects of physical therapy are short-lasting. Novel interventions are needed to maintain these benefits. Methods: Fourteen Parkinson’s patients (71±4.08 years) participated in a randomized controlled examiner-blinded feasibility clinical trial. After 12 physical therapy sessions, the intervention group received a height-adjustable desk that facilitates stepping while standing, for 4 months. Explorative outcome measures included MDS-UPDRS II, III, TUG, 8.5m walking test, PDQ-39, sABC, sFES, DEXA scans, and lower extremity strength. Results: Post-physical-therapy, everyone significantly improved on the MDS-UPDRS II, III, TUG, and 8.5m walking test, and PDQ-39. (p<0.05) After 4 months, the control group regressed towards pre-physical-therapy values. In the intervention group, sedentary behavior decreased beyond desk use, indicating a carry-over effect. MDS-UPDRS II, PDQ-39, sFES, sABC, TUG, 8.5m walking test, activity time, sitting time, hip strength all improved with clinically relevant effect sizes. Conclusion: Postphysical therapy in-home reduction of sedentary behavior was associated with maintenance of physical benefits and additional improvements in mobility, activity time, balance and quality of life
Ključne besede: Parkinson’s disease, physical therapy, sedentarism, sarcopenia, quality of life
Objavljeno v DiRROS: 05.12.2024; Ogledov: 667; Prenosov: 382
Celotno besedilo (1,04 MB)
Gradivo ima več datotek! Več... |
9. Dynamic balance and gait impairments in Parkinson’s disease : novel cholinergic patternsNicolaas I. Bohnen, Uroš Marušič, Stiven Roytman, Rebecca Paalanen, Fotini Michalakis, Taylor Brown, Peter J. H. Scott, Giulia Carli, Roger Albin, Prabesh Kanel, 2024, izvirni znanstveni članek Povzetek: The cholinergic system has been implicated in postural deficits, in particular falls, in Parkinson’s disease.
Falls and freezing of gait typically occur during dynamic and challenging balance and gait conditions,
such as when initiating gait, experiencing postural perturbations, or making turns. However, the precise
cholinergic neural substrate underlying dynamic postural and gait changes remains poorly understood.
The aim of this study was to investigate whether brain vesicular acetylcholine transporter binding, as
measured with [18F]-fluoroethoxybenzovesamicolbinding PET, correlates with dynamic gait and balance
impairments in 125 patients with Parkinson’s disease (mean age 66.89±7.71 years) using the abbreviated
Balance Evaluation Systems Test total and its four functional domain sub-scores (anticipatory postural
control, reactive postural control, dynamic gait, and sensory integration). Whole brain false discoverycorrected (P < 0.05) correlations for total abbreviated Balance Evaluation Systems Test scores included
the following bilateral or asymmetric hemispheric regions: gyrus rectus, orbitofrontal cortex, anterior part
of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, cingulum, frontotemporal opercula,
insula, fimbria, right temporal pole, mesiotemporal, parietal and visual cortices, caudate nucleus, lateral
and medial geniculate bodies, thalamus, lingual gyrus, cerebellar hemisphere lobule VI, left cerebellar
crus I, superior cerebellar peduncles, flocculus, and nodulus. No significant correlations were found for
the putamen or anteroventral putamen. The four domain-specific sub-scores demonstrated overlapping
cholinergic topography in the metathalamus, fimbria, thalamus proper, and prefrontal cortices but also
showed distinct topographic variations. For example, reactive postural control functions involved the right
flocculus but not the upper brainstem regions. The anterior cingulum associated with reactive postural
control whereas the posterior cingulum correlated with anticipatory control. The spatial extent of
associated cholinergic system changes were least for dynamic gait and sensory orientation functional
domains compared to the anticipatory and reactive postural control functions. We conclude that specific
aspects of dynamic balance and gait deficits in Parkinson’s disease associate with overlapping but also
distinct patterns of cerebral cholinergic system changes in numerous brain regions. Our study also presents
novel evidence of cholinergic topography involved in dynamic balance and gait in Parkinson’s disease
that have not been typically associated with mobility disturbances, such as the right anterior temporal pole,
right anterior part of the dorsomedial prefrontal cortex, gyrus rectus, fimbria, lingual gyrus, flocculus,
nodulus and right cerebellar hemisphere lobules VI and left crus I.
Ključne besede: Parkinson’s disease, dynamic balance, cholinergic, PET
Objavljeno v DiRROS: 30.08.2024; Ogledov: 944; Prenosov: 935
Celotno besedilo (4,32 MB)
Gradivo ima več datotek! Več... |
10. Enhancing balance in Parkinson’s disease patients : a comprehensive literature review on the efficacy of exercise in an enriched environmentAna Ponebšek, Friderika Kresal, Luka Šlosar, 2023, pregledni znanstveni članek Povzetek: Various physiotherapeutic methods and approaches play a significant role in the
treatment of patients with Parkinson’s disease, including the use of enriched environments. Virtual reality (VR) as a type of enriched environment has the potential to create
multiple sensory experiences and feedback, influencing various aspects of the patient’s
information processing and response. The suitability for home use and the considerable impact on motivation highlight its advantages over alternative approaches. The
objective of this review is to investigate the impact of VR-based exercise on balance
outcomes among individuals with Parkinson’s disease. The inclusion criteria consisted Parkinson’s disease. The comparable improvements in balance observed between the
experimental and control groups signify the potential effectiveness of VR-based exercises. This underscores the encouragement for further development in this technology,
particularly focusing on fully immersive VR environments, which may yield superior
effects in enhancing balance among individuals with Parkinson’s disease.
of randomized controlled trials (RCTs) that examined the effects of exercise in a VR
environment on individuals’ static and dynamic balance outcomes. In order to gather
relevant studies, we conducted a comprehensive search across three databases. From a
dataset of 625 records, we conducted a comprehensive full-text screening based on specific inclusion and exclusion criteria. This process resulted in the inclusion of 14 RCTs
in our review. The emerging evidence regarding exercising in a VR environment does
not definitively prove its superiority over standard exercise routines. However, studies
have demonstrated that both the experimental and control groups showed comparable improvements in enhancing static and dynamic balance among individuals with
Ključne besede: virtual reality, Parkinson's disease, balance, rehabilitation
Objavljeno v DiRROS: 16.04.2024; Ogledov: 977; Prenosov: 568
Celotno besedilo (552,71 KB)
Gradivo ima več datotek! Več... |
