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Peripheral neuropathy in Parkinson's disease: prevalence and functional impact on gait and balance.
Corrà, Marta Francisca; Vila-Chã, Nuno; Sardoeira, Ana; Hansen, Clint; Sousa, Ana Paula; Reis, Inês; Sambayeta, Firmina; Damásio, Joana; Calejo, Margarida; Schicketmueller, Andreas; Laranjinha, Inês; Salgado, Paula; Taipa, Ricardo; Magalhães, Rui; Correia, Manuel; Maetzler, Walter; Maia, Luís F.
Afiliação
  • Corrà MF; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal.
  • Vila-Chã N; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Sardoeira A; Institute for Research and Innovation in Health (i3s), University of Porto, 4200-135 Porto, Portugal.
  • Hansen C; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Sousa AP; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Reis I; Department of Neurology, Kiel University, 24118 Kiel, Germany.
  • Sambayeta F; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Damásio J; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Calejo M; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Schicketmueller A; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Laranjinha I; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Salgado P; Institute for Medical Engineering and Research Campus STIMULATE, University of Magdeburg, 39106 Magdeburg, Germany.
  • Taipa R; HASOMED GmbH, 39114 Magdeburg, Germany.
  • Magalhães R; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Correia M; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
  • Maetzler W; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, 4050-313 Porto, Portugal.
  • Maia LF; Centro Hospitalar Universitário do Porto (CHUPorto), 4099-001 Porto, Portugal.
Brain ; 146(1): 225-236, 2023 01 05.
Article em En | MEDLINE | ID: mdl-35088837
ABSTRACT
Peripheral neuropathy is a common problem in patients with Parkinson's disease. Peripheral neuropathy's prevalence in Parkinson's disease varies between 4.8-55%, compared with 9% in the general population. It remains unclear whether peripheral neuropathy leads to decreased motor performance in Parkinson's disease, resulting in impaired mobility and increased balance deficits. We aimed to determine the prevalence and type of peripheral neuropathy in Parkinson's disease patients and evaluate its functional impact on gait and balance. A cohort of consecutive Parkinson's disease patients assessed by movement disorders specialists based on the UK Brain Bank criteria underwent clinical, neurophysiological (nerve conduction studies and quantitative sensory testing) and neuropathological (intraepidermal nerve fibre density in skin biopsy punches) evaluation to characterize the peripheral neuropathy type and aetiology using a cross-sectional design. Gait and balance were characterized using wearable health-technology in OFF and ON medication states, and the main parameters were extracted using validated algorithms. A total of 99 Parkinson's disease participants with a mean age of 67.2 (±10) years and mean disease duration of 6.5 (±5) years were assessed. Based on a comprehensive clinical, neurophysiological and neuropathological evaluation, we found that 40.4% of Parkinson's disease patients presented peripheral neuropathy, with a predominance of small fibre neuropathy (70% of the group). In the OFF state, the presence of peripheral neuropathy was significantly associated with shorter stride length (P = 0.029), slower gait speed (P = 0.005) and smaller toe-off angles (P = 0.002) during straight walking; significantly slower speed (P = 0.019) and smaller toe-off angles (P = 0.007) were also observed during circular walking. In the ON state, the above effects remained, albeit moderately reduced. With regard to balance, significant differences between Parkinson's disease patients with and without peripheral neuropathy were observed in the OFF medication state during stance with closed eyes on a foam surface. In the ON states, these differences were no longer observable. We showed that peripheral neuropathy is common in Parkinson's disease and influences gait and balance parameters, as measured with mobile health-technology. Our study supports that peripheral neuropathy recognition and directed treatment should be pursued in order to improve gait in Parkinson's disease patients and minimize balance-related disability, targeting individualized medical care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Parkinson / Doenças do Sistema Nervoso Periférico / Transtornos Neurológicos da Marcha Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Revista: Brain Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Portugal

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Parkinson / Doenças do Sistema Nervoso Periférico / Transtornos Neurológicos da Marcha Tipo de estudo: Prevalence_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Revista: Brain Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Portugal
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