1. Cognitive processes and neurophysiological mechanisms of time processing in Parkinson's disease : a narrative reviewLisa Buikema, Aleksander Sadikov, Marjan Jahanshahi, Ruben Saman Vinke, Dejan Georgiev, 2026, pregledni znanstveni članek Povzetek: Parkinson’s disease (PD) is defined by the presence of motor symptoms, such as bradykinesia. However, it also involves less well-understood cognitive deficits, including impairments in time processing: the ability to perceive, estimate, and produce time intervals accurately. In this review, we summarize the existing literature on time processing in PD, with an emphasis on the different tasks used to study it, as well as on the cognitive processes and neurophysiological mechanisms contributing to time processing deficits in PD. Findings: show that temporal processing deficits in PD span both motor and cognitive/perceptual domains. While dopamine replacement therapy can improve motor timing, its effects on cognitively controlled tasks—particularly those requiring attention and longer intervals—are limited. These deficits reflect dysfunction across basal ganglia, prefrontal, cerebellar, and other brain circuits, and may involve additional neurotransmitter systems such as acetylcholine, serotonin, and noradrenalin. The variety of experimental tasks used to study timing reveals the need for more precise assessments that clearly separate motor and cognitive components. Furthermore, different cognitive processes, such as explicit, implicit, sub-second, and supra-second timing as well as attention and working memory, are involved in time processing in PD. Temporal dysfunction in PD is multidimensional, resulting from a complex system of interacting neural processes. A more complete understanding of time processing in PD is needed, focusing on exploration of the non-dopaminergic aspects of time processing, and improving the design of timing tasks to better identify specific deficits and treatment targets.
Ključne besede: Parkinson’s disease, time processing, dopamine basal ganglia, cognitive impairment, bradyphrenia, working memory, bradykinesia
Objavljeno v DiRROS: 05.05.2026; Ogledov: 120; Prenosov: 107
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2. Far from being the end of the road : taking a closer look at neuropalliative care in Parkinson's diseaseManon Auffret, Fran Borovečki, Beatrice Heim, Wolfgang H. Jost, Per Odin, Fabrizio Stocchi, Maja Trošt, Marc Vérin, 2025, pregledni znanstveni članek Povzetek: Parkinson's disease (PD) is now recognized as a multisystem, heterogeneous neurodegenerative disease with fluctuating trajectories and complex symptom profiles. Despite therapeutic advances, many patients (particularly women and those in late stages) and their caregivers face substantial unmet needs across physical, psychological, social, and spiritual domains, which highlight the need for a more integrative care model. Palliative care, defined as holistic, person-centered care for individuals with life-limiting illnesses, is increasingly recognized as particularly relevant in PD, from early to terminal stages. However, its implementation in neurology remains limited, notably due to persistent misconceptions, and delayed or absent referrals. This narrative review therefore aims to equip PD care teams with a clearer understanding of palliative care principles and their applicability to PD, by synthesizing emerging evidence in neuropalliative care, and providing practical recommendations for integration into routine neurological practice. Building on the specificities of quality of care for chronic conditions, optimal neuropalliative care in PD involves regular (re)assessment of symptoms and priorities, effective management of the chronic-palliative interface, good communication, continuity of care (including neurological care until the end of life), and a multidisciplinary network of professionals working both in the community and in specialized clinics, while leaving room for the involvement of caregivers. Far from being "the end of the road", neuropalliative care is a strategic and compassionate response to the evolving complexity of PD, which ultimately enhances quality of life, supports families, and reinforces the neurologist's pivotal role in longitudinal, person-centered care.
Ključne besede: disease trajectories, end-of-life, neuropalliative care, palliative care, Parkinson’s disease, uncertainty
Objavljeno v DiRROS: 22.04.2026; Ogledov: 103; Prenosov: 82
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4. Breaking barriers in Parkinson's care : the multidisciplinary team approachZvezdan Pirtošek, 2024, izvirni znanstveni članek Povzetek: Parkinson’s disease is a complex neurodegenerative disorder presenting a range of motor and non-motor symptoms that greatly impact both patients and caregivers. The diverse needs arising from these symptoms make a multidisciplinary team (MDT) approach crucial for effective management. This article explores the role and benefits of MDTs in Parkinson’s care, highlighting how collaborative models improve clinical outcomes and quality of life. MDTs integrate neurologists, nurse specialists, therapists, and other professionals to deliver comprehensive, patient-centered care. The inclusion of patients and caregivers fosters shared decision-making, enhancing health outcomes. However, challenges like limited controlled trials, lack of comprehensive guidelines, and under-referral remain. Innovative models, such as telehealth and communitybased care, offer promising solutions, especially in underserved regions. The article advocates for further research and standardized guidelines to optimize the MDT approach for Parkinson’s disease.
Ključne besede: Parkinson's disease, multidisciplinary teams, patient-centered management, healthcare integration, barriers to multidisciplinary approach
Objavljeno v DiRROS: 13.03.2026; Ogledov: 169; Prenosov: 106
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5. Gait and balance worsening after bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS) for Parkinson’s disease : a systematic reviewJules M Janssen Daalen, Ashok K. Selvaraj, Hisse Arnts, Bastiaan R. Bloem, Ronald H.M.A Bartels, Dejan Georgiev, Rianne A.J. Esselink, Ruben Saman Vinke, 2025, izvirni znanstveni članek Povzetek: Background Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a widely applied therapy in Parkinson’s disease (PD). Occasionally, postoperative worsening of gait or balance occurs, even in the face of a persistently gratifying appendicular symptom improvement. The characteristics vary considerably, and the risk factors for this postoperative gait or balance worsening are largely unknown. We systematically investigated the literature for all cases of gait or balance worsening after STN-DBS in PD and explored its characteristics and determinants. In consecutive populations with best medical treatment as the control group, we also explored its incidence. Methods We searched PubMed, Embase and Cochrane. We considered all cases occurring between 1 month after surgery (to exclude immediate postoperative complications as most likely cause) and 12 months after surgery (to exclude disease progression). Results From 2719 entries, we included 20 studies (n=1010 operated patients). Freezing of gait and falls were the most commonly reported symptoms. The first worsening of symptoms occurred between 3 and 6 months after surgery. Modulation of pedunculopontine afferents was more likely associated with worsening of gait and balance. In controlled trials with consecutive patients, 24 cases (15.9%) were reported, compared with 5.8% with best medical treatment (p=0.0013). Conclusions Gait or balance worsening after STN-DBS is a complex phenomenon that cannot readily be explained by mere disease progression. The multifactorial nature warrants further study in gait labs and through advanced imaging techniques. Future studies should also estimate the actual incidence, which we could not establish as we excluded cohorts without any reported cases.
Ključne besede: Parkinson's disease, deep-brain stimulation, gait, balance
Objavljeno v DiRROS: 27.02.2026; Ogledov: 292; Prenosov: 201
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6. Microbial diversity in drug-naïve Parkinson’s disease patientsEliša Papić, Valentino Rački, Mario Hero, Ana Nyasha Zimani, Mojca Čižek-Sajko, Gloria Rožmarić, Nada Starčević-Čizmarević, Saša Ostojić, Miljenko Kapović, Goran Hauser, Aleš Maver, Borut Peterlin, Anja Kovanda, Vladimira Vuletić, 2025, izvirni znanstveni članek Povzetek: Parkinson’s disease (PD) is a neurological disorder characterized by rigidity, bradykinesia and tremor. Several genetic and environmental causes of PD are known, and there is emerging evidence of the possible contribution of the gut microbiome to the disease onset, severity, and response to therapy. While previous research has shown several differences in the microbiome of PD patients under therapy as opposed to healthy controls, few prospective studies have included drug-naïve patients. In order to evaluate the gut microbiome composition prior to therapy initiation, we collected and performed 16S rRNA gene sequencing of the stool samples from 49 drug-naïve PD patients and compared them to 34 diet and lifestyle-matched controls from the Croatian population (GiOPARK Project). While no significant alpha diversity difference was observed between the patients and controls, the differential relative abundance analysis showed an increase in Bacteroides fluxus, B. interstinalis, B. eggerthii, and Dielma fastidiosa in the drug-naïve PD patients compared to controls, while Alistipes, Barnesiella and Dialister spp. were decreased in patients compared to controls. Despite preserved overall diversity, these changes may indicate early microbial dysbiosis and represent a foundation for future studies exploring microbiome changes across disease progression and treatment.
Ključne besede: Parkinson’s disease, neurological disorder, gut microbiome, microbial diversity, microbial dysbiosis
Objavljeno v DiRROS: 23.02.2026; Ogledov: 380; Prenosov: 193
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7. Smooth pursuit and memory saccades are impaired in early-stage Parkinson’s disease patientsZvonimir Popović, Tihana Gilman Kurić, Ines Rajkovača Latić, Sara Matosa, Luka Kusic, Andrea De Gobbis, Aleksander Sadikov, Vida Groznik, Dejan Georgiev, Svetlana Tomić, 2026, izvirni znanstveni članek Povzetek: 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.
Ključne besede: biomarkers, early-stage, eye movements, Parkinson's disease, smooth pursuit
Objavljeno v DiRROS: 27.01.2026; Ogledov: 362; Prenosov: 194
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8. The role of blood-based biomarkers in Parkinsonian disorders, Alzheimer’s disease and frontotemporal dementiaMarta Campagnolo, Eleonora Fiorenzato, Giulia Musso, Valentina Misenti, Simone Cauzzo, Annachiara Cagnin, Roberta Binudo, Cinzia Bussè, Carmelo Alessandro Fogliano, Stefano Mozzetta, Marco Vincenzo Narici, 2025, izvirni znanstveni članek Povzetek: The complexity of neurodegenerative disorders necessitates an integrative approach that incorporates morphological, functional, and molecular biomarkers. The advent of highly sensitive single-molecule array (Simoa®) assays has significantly enhanced the accuracy of blood-based biomarker quantification, including glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and phosphorylated tau181 (p-tau181). This study evaluates the diagnostic utility of these biomarkers in neurodegenerative diseases. We analyzed data from 279 individuals from the PADUA-CESNE cohort: 120 with Parkinson's disease (PD), 88 with Alzheimer's disease (AD), 16 with frontotemporal dementia (FTD), 11 with multiple system atrophy (MSA), 14 with progressive supranuclear palsy (PSP), and 30 cognitively unimpaired controls. NfL levels were significantly lower in PD and AD compared to atypical parkinsonisms and FTD, effectively distinguishing MSA and PSP from controls. NfL also negatively correlated with Montreal Cognitive Assessment (MoCA) scores in AD and PD, indicating its association with cognitive decline. Elevated GFAP levels were observed in both PD and AD and inversely correlated with global cognition. Combining GFAP and p-tau181 improved AD differentiation from PD and other parkinsonian disorders, while the integration of all three biomarkers facilitated the distinction between AD and FTD. Notably, lower NfL levels (<20 ng/L) in conjunction with elevated p-tau181 were indicative of AD, whereas NfL levels below 40 ng/L were suggestive of PD. In conclusion, NfL serves as a sensitive indicator of neurodegeneration, albeit with limited specificity. However, by establishing biomarker concentration thresholds and integrating complementary biomarkers, blood-based assays may enhance the differential diagnosis of neurodegenerative diseases, providing valuable clinical insights.
Ključne besede: blood-based biomarkers, glial fibrillary acidic protein (GFAB), neurodegenerative diseases, Neurofilament light chain (NfL), Parkinson’s disease, Phosphorylated tau181 (p-tau181)
Objavljeno v DiRROS: 13.01.2026; Ogledov: 337; Prenosov: 226
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9. Subjective well-being and its predictors in Parkinson's disease and dystonia : a comparative studySuzette Shahmoon, Dejan Georgiev, Paul Jarman, Kailash P. Bhatia, Patricia Limousin, Marjan Jahanshahi, 2025, izvirni znanstveni članek Povzetek: 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
Ključne besede: dystonia, Parkinson's disease, positive psychology, self-esteem, subjective well-being
Objavljeno v DiRROS: 10.12.2025; Ogledov: 997; Prenosov: 284
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10. 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: 570; Prenosov: 289
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