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Abstract: Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease caused by degeneration of dopaminergic neurons in substantia nigra pars compacta (SNc). One of the most prevalent symptoms is eye movement impairment, presenting in 75% of PD patients, which have fragmented and hypometric smooth pursuit movements with prolonged latency. We aimed to investigate differences in smooth pursuit, reflexive, and memory-guided saccades and antisaccades between patients with early-stage PD and healthy controls.Methods: We conducted a cross-sectional study with idiopathic PD patients in early stage of disease (Hoehn and Yahr stage 0, 1 and 2) and healthy controls. The impairment of smooth pursuit, saccades, antisaccades, and memory-guided saccades was evaluated with eye-tracker analysis using a battery of tests.Results: Forty-two subjects with early-stage idiopathic PD and 50 healthy controls participated in the study. There were no statistically significant differences in age, gender, years of education, or cognition between the groups. Early-stage PD patients showed impairment in velocity, phase, and range of motion of smooth pursuit eye movements, as well as impaired precision and recollection performing visually guided memory saccades. Consequently, there is also a reading dysfunction, with slower reading speed and longer eye fixations. No significant differences were found regarding reflexive saccades and antisaccades between these two groups.Conclusion: Results suggest that impaired smooth pursuit movements, memory-guided saccades and reading functions are present in early-stage PD, even without other expressed motor symptoms. These findings could potentially contribute to the development of new and non-invasive diagnostic biomarkers in PD.
Keywords: biomarkers, early-stage, eye movements, Parkinson's disease, smooth pursuit
Published in DiRROS: 27.01.2026; Views: 113; Downloads: 65
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Abstract: Background: Quality of life (QoL) is a commonly used outcome measure in people with chronicneurological diseases (CND). As valuable as QoL is, it does not take into account aspects of subjective well-being (SWB) such as subjective happiness, meaning in life, life satisfaction and hope; all constructs that areconsidered central to well-being.ObjectivesObjectives: The goal was to assess how the different aspects of SWB are altered in Parkinson’s disease(PD) and dystonia relative to healthy controls (HCs) and to identify the most important predictors of differentdimensions of SWB in PD and dystonia.MethodsMethods: Eighty-two people with PD, 63 with dystonia, and 50 HCs were surveyed using various measuresof SWB.ResultsResults: People with PD and dystonia had significantly lower satisfaction with life than HCs, with self-esteemand loneliness being significant covariates. Although people with PD and dystonia had significantly lessmeaning in life, they still sought meaning in life as much as HCs. Self-esteem, resilience and neuroticism weresignificant covariates for the presence of “meaning in life.” There were no significant group differences insubjective happiness or hope. In people with PD, mood (depression and anxiety), personality traits (extraversionand self-esteem), disease duration, and pain/discomfort were significant predictors of various measures ofSWB. The main significant predictor of SWB in dystonia was depression, which predicted 49% of the variance insubjective happiness.ConclusionsConclusions: These results emphasize the importance of SWB as a field of investigation and clinical care in themanagement of people with PD and dystonia
Keywords: dystonia, Parkinson's disease, positive psychology, self-esteem, subjective well-being
Published in DiRROS: 10.12.2025; Views: 822; Downloads: 132
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Abstract: 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.
Keywords: advanced Parkinson’s Disease, device-aided therapies, long-term effect of device-aided therapies
Published in DiRROS: 02.12.2025; Views: 476; Downloads: 121
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Abstract: 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.
Keywords: Parkinson’s disease, wearable sensors, freezing of gait, symptoms
Published in DiRROS: 24.11.2025; Views: 614; Downloads: 146
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Abstract: 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.
Keywords: EEG, semi-tandem stance, COP (Center of pressure), Parkinson's disease, cognitive-motor dual-tasking
Published in DiRROS: 08.09.2025; Views: 370; Downloads: 175
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