Journal ArticleDOI
The CamPaIGN study of Parkinson's disease: 10-year outlook in an incident population-based cohort
Caroline H. Williams-Gray,Sarah L Mason,Jonathan R. Evans,Thomas Foltynie,Carol Brayne,Trevor W. Robbins,Roger A. Barker +6 more
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TLDR
The CamPaIGN study as mentioned in this paper has been the first to prospectively track disease evolution from diagnosis in an unselected population-representative incident cohort, focusing on three key irreversible milestones: postural instability (Hoehn and Yahr 3), dementia and death.Abstract:
Background Prognosis in Parkinson9s disease (PD) remains poorly understood due to a lack of unbiased data on the natural history of treated PD. The CamPaIGN study has been the first to prospectively track disease evolution from diagnosis in an unselected population-representative incident cohort. We now report the 10-year follow-up data, focusing on three key irreversible milestones: postural instability (Hoehn and Yahr 3), dementia and death. Methods The cohort was collected between December 2000 and 2002. Those meeting diagnostic criteria (n=142) were followed-up until 1 January 2012. Clinical, neuropsychological and genetic testing were performed. Progression to key milestones was evaluated using Kaplan–Meier and Cox regression survival analyses. Results At 10 years, 55% had died, 68% had postural instability and 46% dementia. 23% had a good outcome at 10 years (surviving free of dementia/postural instability). Death rate was comparable with the UK population (standardised mortality ratio 1.29 (0.97–1.61)). Death certificates indicated PD was a substantial contributor in only 20%, with pneumonia being the commonest cause of death. Age, non-tremor-dominant motor phenotype and comorbidity predicted earlier postural instability. Baseline predictors of dementia were age, motor impairment, ‘posterior-cortical’ cognitive deficits and MAPT genotype. Conclusions (1) outlook in PD is heterogeneous, with most dying or developing dementia or postural instability by 10 years from diagnosis, but a quarter still doing well, with preserved mobility and intact cognition; (2) death is not directly related to PD in the majority; (3) baseline clinical and genetic variables are predictive of outcome and may be helpful in selecting patients for clinical trials.read more
Citations
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Journal ArticleDOI
Diagnosis and Treatment of Parkinson Disease: A Review
TL;DR: Patients experiencing complications, such as worsening symptoms and functional impairment when a medication dose wears off ("off periods"), medication-resistant tremor, and dyskinesias, benefit from advanced treatments such as therapy with levodopa-carbidopa enteral suspension or deep brain stimulation.
Journal ArticleDOI
Cognitive decline in Parkinson disease
Dag Aarsland,Byron Creese,Byron Creese,Marios Politis,K. Ray Chaudhuri,Dominic Ffytche,Daniel Weintraub,Daniel Weintraub,Daniel Weintraub,Clive Ballard,Clive Ballard +10 more
TL;DR: New genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms.
Journal ArticleDOI
Lewy body dementias
Zuzana Walker,Zuzana Walker,Katherine L. Possin,Bradley F Boeve,Dag Aarsland,Dag Aarsland,Dag Aarsland +6 more
TL;DR: The most pertinent progress from the past 10 years is summarized, outlining some of the challenges for the future, which will require refinement of diagnosis and clarification of the pathogenesis, leading to disease-modifying treatments.
Journal ArticleDOI
Visual dysfunction in Parkinson's disease.
Rimona S. Weil,Rimona S. Weil,Anette Schrag,Jason D. Warren,Sebastian J. Crutch,Andrew J. Lees,Huw R. Morris,Huw R. Morris +7 more
TL;DR: The role of visual dysfunction as a marker of dementia in Parkinson’s disease is discussed and links between visual changes and other features of Parkinson's disease are examined.
Journal ArticleDOI
Parkinson's disease dementia: a neural networks perspective
TL;DR: It is argued that Parkinson’s disease dementia reflects dysfunction in seven distinct brain networks, with implications for therapeutic approaches.
References
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Diagnostic and Statistical Manual of Mental Disorders
Vijay A. Mittal,Elaine F. Walker +1 more
TL;DR: An issue concerning the criteria for tic disorders is highlighted, and how this might affect classification of dyskinesias in psychotic spectrum disorders.
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Parkinsonism: Onset, progression, and mortality
Margaret M. Hoehn,Melvin D. Yahr +1 more
TL;DR: Controversy over the effectiveness of therapeutic measures for parkinsonism is due partially to this wide variability and to the paucity of clinical information about the natural history of the syndrome.
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Murat Emre,Dag Aarsland,Dag Aarsland,Richard G. Brown,David J. Burn,Charles Duyckaerts,Yoshikino Mizuno,Gerald A. Broe,Jeffrey L. Cummings,Dennis W. Dickson,Serge Gauthier,Jennifer G. Goldman,Christopher G. Goetz,Arnos Korczyn,Andrew J. Lees,Richard Levy,Irene Litvan,Ian G. McKeith,Warren Olanow,Werner Poewe,Niall Quinn,Christina Sampaio,Eduardo Tolosa,Bruno Dubois +23 more
TL;DR: Clinical diagnostic criteria for probable and possible PD‐D are proposed, characterized by impairment in attention, memory, executive and visuo‐spatial functions, behavioral symptoms such as affective changes, hallucinations, and apathy are frequent.
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The Sydney Multicenter Study of Parkinson's Disease : The Inevitability of Dementia at 20 years
TL;DR: After 20 years follow-up of newly diagnosed patients with Parkinson's disease (PD), 100 of 136 (74%) have died and 17 people with dementia had postmortems, while others had mixed neuropathology.
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Murat Emre,Dag Aarsland,Dag Aarsland,Richard G. Brown,David J. Burn,Charles Duyckaerts,Yoshikino Mizuno,Gerald A. Broe,Jeffrey L. Cummings,Dennis W. Dickson,Serge Gauthier,Jennifer G. Goldman,Christopher G. Goetz,Arnos Korczyn,Andrew J. Lees,Richard Levy,Irene Litvan,Ian G. McKeith,Warren Olanow,Werner Poewe,Niall Quinn,Christina Sampaio,Eduardo Tolosa,Bruno Dubois +23 more