Retrograde Procedural Memory in Parkinson’s Disease: A Cross-Sectional, Case-Control Study

in Journal of Parkinson's Disease (2022)

Background: The analysis of the procedural memory is particularly relevant in neurodegenerative disorders like Parkinson’s disease, due to the central role of the basal ganglia in procedural memory. It ... [more ▼]

Background: The analysis of the procedural memory is particularly relevant in neurodegenerative disorders like Parkinson’s disease, due to the central role of the basal ganglia in procedural memory. It has been shown that anterograde procedural memory, the ability to learn a new skill, is impaired in Parkinson’s disease. However, retrograde procedural memory, the long-term retention and execution of skills learned in earlier life stages, has not yet been systematically investigated in Parkinson’s disease. Objective: This study aims to investigate retrograde procedural memory in people with Parkinson’s disease.We hypothesized that retrograde procedural memory is impaired in people with Parkinson’s disease compared to an age- and gender-matched control group. Methods: First, we developed the CUPRO evaluation system, an extended evaluation system based on the Cube Copying Test, to distinguish the cube copying procedure, representing functioning of retrograde procedural memory, and the final result, representing the visuo-constructive abilities. Development of the evaluation system included tests of discriminant validity. Results: Comparing people with typical Parkinson’s disease (n = 201) with age- and gender-matched control subjects (n = 201), we identified cube copying performance to be significantly impaired in people with Parkinson’s disease (p = 0.008) No significant correlation was observed between retrograde procedural memory and disease duration. Conclusion: We demonstrated lower cube copying performance in people with Parkinson’s disease compared to control subjects, which suggests an impaired functioning of retrograde procedural memory in Parkinson’s disease. [less ▲]

Determinants of Self-Stigma in People with Parkinson's Disease: A Mixed Methods Scoping Review

in Journal of Parkinson's Disease (2021)

Background: Self-stigma in people with Parkinson's disease (PD) can substantially impact quality of life and possibilities for social participation. An integrative analysis of determinants of self-stigma ... [more ▼]

Background: Self-stigma in people with Parkinson's disease (PD) can substantially impact quality of life and possibilities for social participation. An integrative analysis of determinants of self-stigma has been lacking. Objective: We sought to explore which complementary insights from qualitative and quantitative studies, as well as from expert consultation, could be gained. Methods: An established mixed methods study design was employed to first conduct a mixed methods scoping review of published qualitative and quantitative literature, and then consult with experts to arrive at an exhaustive list of determinants of self-stigma after a thematic synthesis. Results: A total of 87 unique determinants of self-stigma were identified. Quantitative studies and expert consultations mainly identified personal determinants of people with self-stigma (e.g., age, anxiety, or apathy). In contrast, qualitative studies identified social situations associated with self-stigma (e.g., joint meals of people with typical PD with others). Notably, self-stigma of people with PD was found to be particularly salient in unfamiliar places, at the working place or in contact with people without PD. Across methods, cognitive impairment, tremor, and abnormal walk and unsteady gait, respectively, were associated with self-stigma. Conclusion: The mixed method study design yielded complementary insights, but also factors commonly associated with self-stigma across methods. Future prioritization exercises may gain further insights into self-stigma of people with PD. Facilitating social encounters by both addressing needs of affected people and raising knowledge and public awareness may improve quality of life in people with PD [less ▲]

Mitochondria and Parkinson's Disease: Clinical, Molecular, and Translational Aspects

in Journal of Parkinson's Disease (2020)

Management of Parkinson’s Disease 20 Years from Now: Towards Digital Health Pathways

in Journal of Parkinson's Disease (2018)

[en] Current best medical treatment for patients with Parkinson’s disease (PD) involves a medical professional who applies state-of-the-art knowledge of diagnostics and treatment— as derived from cohort ... [more ▼]

[en] Current best medical treatment for patients with Parkinson’s disease (PD) involves a medical professional who applies state-of-the-art knowledge of diagnostics and treatment— as derived from cohort studies and clinical trials— to the healthcare process of individual patients. Thus, the much-needed personalization of medicine depends on the abilities, experience and intuition of medical professionals to adjust group-based knowledge to individual decision making. Within 20 years from now, such personal clinical decisions will be largely supported by digital means, also defining a new ecosystem of healthcare often referred to as “digital medicine”. We expect that the next phase of digitalization will include new “digital health pathways”: data-driven personalized decision support that is based on a combination of multimodal data sources, including evidence-based medical knowledge (e.g., clinical guidelines), personal disease profiles (including genetic determinants of disease progression and treatment response), insights into individual disease trajectories (thereby defining subgroups of patients) and individual patients’ needs. Here, we illustrate the potential of this development by sketching the contours of a digitally supported care pathway for gait disability and falls. Such digital health pathways will support the introduction of personalized medicine for PD patients, allowing patients to benefit optimally from individually tailored treatments. This should result in a better quality of life for patients and lower costs for society. [less ▲]