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1.
Heliyon ; 10(4): e26107, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38440294

RESUMO

Background: Apathy is an important but unrecognised aspect of Parkinson's disease (PD). The optimal therapeutic options for apathy remain unclear. Early recognition and treatment of apathy can reduce the significant burden of disease for patients and their caregivers. Here we conducted a meta-analysis to evaluate the comparative efficacy of different treatment modalities of apathy in PD (CRD42021292099). Methods: We screened Medline, Embase, and PsycINFO databases for articles on therapies for apathy in PD. The outcome of interest is the reduction in apathy scores post-intervention and is measured by standardised mean differences (SMD) with 95% credible intervals (CrI). We included only randomised controlled trials examining interventions targeted at reducing apathy. Results: Nineteen studies involving 2372 patients were included in the quantitative analysis. The network meta-analysis found pharmacotherapy to be the most efficacious treatment, significantly better than brain stimulation (SMD -0.43, 95% CrI -0.78 to -0.07), exercise-based interventions (SMD -0.66, 95% CrI -1.25 to -0.08), supplements (SMD -0.33, 95% CrI -0.67 to 0), and placebo (SMD -0.38, 95% CrI -0.56 to -0.23). Subgroup analysis of pharmacotherapy versus placebo found similar efficacy of dopamine agonists (SMD -0.36, 95% CI -0.59 to -0.12, P = 0.003) and alternative medications (SMD -0.42, 95% CI -0.61 to -0.23, P < 0.001). The remaining comparisons and subgroup analyses did not demonstrate any significant treatment effects. Conclusion: Our meta-analysis of randomised controlled trials showed that pharmacotherapy is the most efficacious treatment option, with dopamine agonists having similar efficacy as other medications. Further research is needed to determine the optimal management strategy.

2.
Nat Commun ; 15(1): 1467, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38368411

RESUMO

The noncentrosymmetric ferromagnetic Weyl semimetal CeAlSi with simultaneous space-inversion and time-reversal symmetry breaking provides a unique platform for exploring novel topological states. Here, by employing multiple experimental techniques, we demonstrate that ferromagnetism and pressure can serve as efficient parameters to tune the positions of Weyl nodes in CeAlSi. At ambient pressure, a magnetism-facilitated anomalous Hall/Nernst effect (AHE/ANE) is uncovered. Angle-resolved photoemission spectroscopy (ARPES) measurements demonstrated that the Weyl nodes with opposite chirality are moving away from each other upon entering the ferromagnetic phase. Under pressure, by tracing the pressure evolution of AHE and band structure, we demonstrate that pressure could also serve as a pivotal knob to tune the positions of Weyl nodes. Moreover, multiple pressure-induced phase transitions are also revealed. These findings indicate that CeAlSi provides a unique and tunable platform for exploring exotic topological physics and electron correlations, as well as catering to potential applications, such as spintronics.

3.
Angew Chem Int Ed Engl ; 62(10): e202216086, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36573848

RESUMO

Searching for functional square lattices in layered superconductor systems offers an explicit clue to modify the electron behavior and find exotic properties. The trigonal SnAs3 structural units in SnAs-based systems are relatively conformable to distortion, which provides the possibility to achieve structurally topological transformation and higher superconducting transition temperatures. In the present work, the functional As square lattice was realized and activated in Li0.6 Sn2 As2 and NaSnAs through a topotactic structural transformation of trigonal SnAs3 to square SnAs4 under pressure, resulting in a record-high Tc among all synthesized SnAs-based compounds. Meanwhile, the conductive channel transfers from the out-of-plane pz orbital to the in-plane px +py orbitals, facilitating electron hopping within the square 2D lattice and boosting the superconductivity. The reorientation of p-orbital following a directed local structure transformation provides an effective strategy to modify layered superconducting systems.

4.
Int Rev Neurobiol ; 165: 103-133, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208897

RESUMO

The Coronavirus Disease 2019 (Covid-19) pandemic has profoundly affected the quality of life (QoL) and health of the general population globally over the past 2 years, with a clear impact on people with Parkinson's Disease (PwP, PD). Non-motor symptoms have been widely acknowledged to hold a vital part in the clinical spectrum of PD, and, although often underrecognized, they significantly contribute to patients' and their caregivers' QoL. Up to now, there have been numerous reports of newly emerging or acutely deteriorating non-motor symptoms in PwP who had been infected by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), while some of these symptoms, like fatigue, pain, depression, anxiety and cognitive impairment, have also been identified as part of the long-COVID syndrome due to their persistent nature. The subjacent mechanisms, mediating the appearance or progression of non-motor symptoms in the context of Covid-19, although probably multifactorial in origin, remain largely unknown. Such mechanisms might be, at least partly, related solely to the viral infection per se or the lifestyle changes imposed during the pandemic, as many of the non-motor symptoms seem to be prevalent even among Covid-19 patients without PD. Here, we summarize the available evidence and implications of Covid-19 in non-motor PD symptoms in the acute and chronic, if applicable, phase of the infection, with a special reference on studies of PwP.


Assuntos
COVID-19 , COVID-19/complicações , Humanos , Pandemias , Qualidade de Vida/psicologia , SARS-CoV-2 , Síndrome de COVID-19 Pós-Aguda
5.
Int Rev Neurobiol ; 165: 283-305, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208905

RESUMO

The Coronavirus Disease 2019 (Covid-19) pandemic and the consequent restrictions imposed worldwide have posed an unprecedented challenge to research and training in Parkinson's disease (PD). The pandemic has caused loss of productivity, reduced access to funding, an oft-acute switch to digital platforms, and changes in daily work protocols, or even redeployment. Frequently, clinical and research appointments were suspended or changed as a solution to limit the risk of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) spread and infection, but since the care and research in the field of movement disorders had traditionally been performed at in-person settings, the repercussions of the pandemic have even been more keenly felt in these areas. In this chapter, we review the implications of this impact on neurological research and training, with an emphasis on PD, as well as highlight lessons that can be learnt from how the Covid-19 pandemic has been managed in terms of restrictions in these crucial aspects of the neurosciences. One of the solutions brought to the fore has been to replace the traditional way of performing research and training with remote, and therefore socially distanced, alternatives. However, this has introduced fresh challenges in international collaboration, contingency planning, study prioritization, safety precautions, artificial intelligence, and various forms of digital technology. Nonetheless, in the long-term, these strategies will allow us to mitigate the adverse impact on PD research and training in future crises.


Assuntos
COVID-19 , Doença de Parkinson , Inteligência Artificial , Humanos , Pandemias , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapia , SARS-CoV-2
7.
Int Rev Neurobiol ; 152: 131-156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32450994

RESUMO

Stress is ubiquitous with many factors contributing to its effects, including psychological responses and associated biological factors, including cortisol related physiological responses, and inflammation. Also in Parkinson's disease there is growing evidence for the role of stress in some key symptoms, even stretching to the prodromal stage. Here we discuss the possible contributions of the range and nature of stress in PD and we aim to summarize the current knowledge about the role of stress-related responses on motor and non-motor symptoms, the underlying pathophysiology, and the potential implications for treatment.


Assuntos
Hidrocortisona/metabolismo , Doença de Parkinson/fisiopatologia , Estresse Psicológico/fisiopatologia , Animais , Humanos , Hidrocortisona/genética , Sistema Hipotálamo-Hipofisário , Doença de Parkinson/complicações , Doença de Parkinson/metabolismo , Doença de Parkinson/psicologia , Sistema Hipófise-Suprarrenal , Sintomas Prodrômicos , Estresse Psicológico/etiologia , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia
8.
Nat Commun ; 10(1): 2217, 2019 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101813

RESUMO

Cd3As2 is a three-dimensional Dirac semimetal with separated Dirac points in momentum space. In spite of extensive transport and spectroscopic studies on its exotic properties, the evidence of superconductivity in its surface states remains elusive. Here, we report the observation of proximity-induced surface superconductivity in Nb/Cd3As2 hybrid structures. Our four-terminal transport measurement identifies a pronounced proximity-induced pairing gap (gap size comparable to Nb) on the surfaces, which exhibits a flat conductance plateau in differential conductance spectra, consistent with our theoretical simulations. The surface supercurrent from Nb/Cd3As2/Nb junctions is also achieved with a Fraunhofer/SQUID-like pattern under out-of-plane/in-plane magnetic fields, respectively. The resultant mapping shows a predominant distribution on the top and bottom surfaces as the bulk carriers are depleted, which can be regarded as a higher dimensional analog of edge supercurrent in two-dimensional quantum spin Hall insulators. Our study provides the evidence of surface superconductivity in Dirac semimetals.

9.
J Neurol ; 266(7): 1736-1742, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30997572

RESUMO

OBJECTIVE: To identify associated (non-)motor profiles of Parkinson's disease (PD) patients with hyperhidrosis as a dominant problem. METHODS: This is a cross-sectional, exploratory, analysis of participants enrolled in the Non-motor Longitudinal International Study (NILS; UKCRN No: 10084) at the Parkinson's Centre at King's College Hospital (London, UK). Hyperhidrosis scores (yes/no) on question 28 of the Non-Motor Symptom Questionnaire were used to classify patients with normal sweat function (n = 172) and excessive sweating (n = 56) (Analysis 1; n = 228). NMS scale (NMSS) question 30 scores were used to stratify participants based on hyperhidrosis severity (Analysis 2; n = 352) using an arbitrary severity grading: absent score 0 (n = 267), mild 1-4 (n = 49), moderate 5-8 (n = 17), and severe 9-12 (n = 19). NMS burden, as well as PD sleep scale (PDSS) scores were then analysed along with other correlates. RESULTS: No differences were observed in baseline demographics between groups in either analysis. Patients with hyperhidrosis exhibited significantly higher total NMSS burden compared to those without (p < 0.001). Secondary analyses revealed higher dyskinesia scores, worse quality of life and PDSS scores, and higher anxiety and depression levels in hyperhidrosis patients (p < 0.001). Tertiary analyses revealed higher NMSS item scores for fatigue, sleep initiation, restless legs, urinary urgency, and unexplained pain (p < 0.001). CONCLUSIONS: Chronic hyperhidrosis appears to be associated with a dysautonomia dominant subtype in PD patients, which is also associated with sleep disorders and a higher rate of dyskinesia (fluctuation-related hyperhidrosis). These data should prompt the concept of hyperhidrosis being used as a simple clinical screening tool to identify PD patients with autonomic symptoms.


Assuntos
Regulação da Temperatura Corporal/fisiologia , Hiperidrose/diagnóstico , Doença de Parkinson/diagnóstico , Disautonomias Primárias/diagnóstico , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Humanos , Hiperidrose/epidemiologia , Hiperidrose/fisiopatologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/epidemiologia , Doença de Parkinson/fisiopatologia , Disautonomias Primárias/epidemiologia , Disautonomias Primárias/fisiopatologia , Estudos Retrospectivos
10.
J Neurol ; 266(11): 2605-2619, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30377818

RESUMO

Parkinson's disease (PD) is the second commonest neurodegenerative disorder in the world with a rising prevalence. The pathophysiology is multifactorial but aggregation of misfolded α-synuclein is considered to be a key underpinning mechanism. Amyloid-ß (Aß) and tau deposition are also comorbid associations and especially Aß deposition is associated with cognitive decline in PD. Some existing evidence suggests that low cerebrospinal fluid (CSF) Aß42 is predictive of future cognitive impairment in PD. Recent studies also show that CSF Aß is associated with the postural instability and gait difficulties (PIGD) or the newly proposed cholinergic subtype of PD, a possible risk factor for cognitive decline in PD. The glial-lymphatic system, responsible for convective solute clearance driven by active fluid transport through aquaporin-4 water channels, may be implicated in brain amyloid deposition. A better understanding of the role of this system and more specifically the role of Aß in PD symptomatology, could introduce new treatment and repurposing drug-based strategies. For instance, apomorphine infusion has been shown to promote the degradation of Aß in rodent models. This is further supported in a post-mortem study in PD patients although clinical implications are unclear. In this review, we address the clinical implication of cerebral Aß deposition in PD and elaborate on its metabolism, its role in cognition and motor function/gait, and finally assess the potential effect of apomorphine on Aß deposition in PD.


Assuntos
Peptídeos beta-Amiloides/metabolismo , Doença de Parkinson/metabolismo , Animais , Humanos
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