Alexandra Rizos

King's College Hospital NHS Foundation Trust

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К. Ray Chaudhuri

King's College Hospital

103

Pablo Martínez‐Martín

Biomedical Research Networking Center on Neurodegenerative Diseases

Anna Sauerbier

University of Cologne

Angelo Antonini

University of Padua

Monty Silverdale

Manchester Academic Health Science Centre

Haidar S. Dafsari

University Hospital Cologne

Lars Timmermann

Philipps University of Marburg

Per Odin

Lund University

Keyoumars Ashkan

King's College Hospital NHS Foundation Trust

Veerle Visser‐Vandewalle

University of Cologne

Cooperative Institutions

King's College London

Parkinson's UK

King's College Hospital NHS Foundation Trust

King's College Hospital

University Hospital Cologne

University College London

University of Cologne

John Wiley & Sons (United States)

National Hospital for Neurology and Neurosurgery

Klinik und Poliklinik für Neurologie

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Slave to the rhythm: Seasonal differences in non-motor symptoms in Parkinson's disease

Parkinsonism & Related Disorders (2019)

Daniel J. van Wamelen Aleksandra Podlewska Valentina Leta Katarzyna Śmiłowska Alexandra Rizos

Motor symptoms

10.1016/j.parkreldis.2019.02.041

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Citations (21)

Assessing the non-motor symptom burden progression in a longitudinal study of 411 Parkinson's patients, using the non-motor symptom questionnaire

Parkinsonism & Related Disorders (2015)

Miguel Grilo Dhaval Trivedi Elisa Moti Rui Barreto Anna Sauerbier

Motor symptoms

Motor dysfunction

10.1016/j.parkreldis.2015.10.055

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Intercultural Translation and Application of the German Version of King’s Parkinson’s Disease Pain Questionnaire in Fluctuating Parkinson’s Disease

Acta Neurologica Scandinavica (2024)

Matthias Löhle Wolfgang H. Jost Alexander Bremer Florin Gandor Alexandra Rizos

Background . Pain is common in Parkinson’s disease (PD) and impairs quality of life. The King’s PD pain questionnaire (KPPQ) is a standardized, reliable, and valid self‐administered questionnaire for screening of pain in PD. We developed a linguistically validated German version of the KPPQ and applied it to a cohort with fluctuating PD. Methods . The interculturally adapted German translation was performed according to internationally accepted procedures in coordination with the authors of the original publication but without further psychometric validation. After final approval by all translators and original authors, the German version was then tested for feasibility and comprehension in 30 PD patients. After final adaption, the German KPPQ together with the German quantitative KPPS were applied to an independent cohort of fluctuating PD patients within the VALIDATE‐PD study. Results . The use of the German version of the KPPQ in clinical practice or in the VALIDATE‐PD study revealed no significant problems of understanding. Sufficient datasets were available from 47 patients with motor fluctuations (24 (51%) males, 23 (49%) females; median (interquartile range (IQR)) age: 65 (58‐73) years; median (IQR) Hoehn and Yahr stage: 2.5 [2‐3]). Total pain was reported by 43 (92%) of participants with a median number of 4 (IQR: 2‐5) pain subtypes. We did not observe any associations of total pain frequency, neither with gender nor with other demographic or clinical parameters. Conclusions . The German version of the KPPQ is recommended as a questionnaire for assessing the frequency of pain and its subtypes in PD in clinical studies and/or routine care.

10.1155/2024/6052552

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Early morning off periods in Parkinson's disease: Characterisation of non motor patterns and treatment effect: An international study

Alexandra Rizos B. Kessel Pablo Martínez‐Martín Per Odin Angelo Antonini

Characterisation of non motor patterns and treatment effect. An international study. A. Rizos1, B. Kessel2, P. Martinez-Martin3, P. Odin4,5, A. Antonini6, A. Martin1, I. Koch1, T. Klemencic Kozul1, A. Douiri7,8, P. Reddy1, S. Robinson1, C. Falup-Pecurariu9, S. Lindvall10 and K. Ray Chaudhuri1,11 on behalf of EUROPAR and EPDA. 1King's College Hospital, London, UK; 2Princess Royal University Hospital, Orpington, UK; 3Carlos III Institute of Health and Alzheimer Centre Reina Sofia Foundation, Madrid, Spain; 4Klinikum Reinkenheide, Bremerhaven, Germany; 5University Hospital, Lund, Sweden; 6RCCS San Camillo Venice and University of Padua, Venice, Italy; 7Primary Care And Public Health Sciences, King's College London, London, UK; 8NIHR cBRC, Guy's and St Thomas' NHS Trust and King's College London, London, UK; 9Transylvania University, Brasov, Romania; 10European Parkinson's Disease Association (EPDA), London, UK and 10University Hospital Lewisham, London, UK;

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Clinical Determinants of Parkinson's Disease‐associated Pain Using the King's Parkinson's Disease Pain Scale

Movement Disorders Clinical Practice (2016)

Mayela Rodríguez‐Violante Alonso Alvarado‐Bolaños Amin Cervantes‐Arriaga Pablo Martínez‐Martín Alexandra Rizos

Pain is a frequent feature in Parkinson's disease (PD). Current knowledge on pain and its associated factors in PD has been obtained using nondisease-specific tools. Recently, the King's Parkinson's Disease Pain Scale (KPPS) was published as the first disease-specific scale. The aim of this study was to assess PD-associated pain and its main determinants using the KPPS.A cross-sectional study was carried out. Consecutive patients with PD were recruited from a movement disorders clinic. Clinical and demographical data were collected. The KPPS, the Movement Disorders Society Unified Parkinson's Disease Rating Scale, and the Non-Motor Symptoms Scale were used to assess all participants.In total, 314 patients were included. Overall, 88.6% of the sample reported at least 1 type of pain. The mean ± standard KPPS score was 18.8 ± 19.5. Factors associated with higher KPSS scores were female sex (P < 0.001), levodopa treatment (P < 0.001), the presence of depressed mood (P < 0.001), wearing off (P = 0.003), and dyskinesia (P = 0.005). Participants who had postural instability and gait difficulty motor subtypes had higher KPPS scores compared with those who had other subtypes. Multivariate regression analysis showed that only sex, motor subtype, depressed mood, and Non-Motor Symptoms Scale sleep/fatigue domain scores achieved statistical significance as determinants (all P < 0.01).PD-associated pain is a frequent symptom that tends to increase in both frequency and severity as disease progresses. Risk factors for increased burden include female gender, postural instability and gait difficulty motor subtypes, mood alterations, and sleep/fatigue disturbances.

Movement Disorders

10.1002/mdc3.12469

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Exploring hyperhidrosis and related thermoregulatory symptoms as a possible clinical identifier for the dysautonomic subtype of Parkinson’s disease

Journal of Neurology (2019)

Daniel J. van Wamelen Valentina Leta Aleksandra Podlewska Yi Min Wan Katarina Krbot

To identify associated (non-)motor profiles of Parkinson's disease (PD) patients with hyperhidrosis as a dominant problem.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.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).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.

Depression

10.1007/s00415-019-09325-w

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No evidence for an association of voxel-based morphometry with short-term non-motor outcomes in deep brain stimulation for Parkinson’s disease

npj Parkinson s Disease (2024)

Philipp Alexander Loehrer Wibke Schumacher Stefanie T. Jost Monty Silverdale Jan Niklas Petry‐Schmelzer

Abstract Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an established therapy in advanced Parkinson’s disease (PD). Motor and non-motor outcomes, however, show considerable inter-individual variability. Preoperative morphometry-based metrics have recently received increasing attention to explain treatment effects. As evidence for the prediction of non-motor outcomes is limited, we sought to investigate the association between metrics of voxel-based morphometry and short-term non-motor outcomes following STN-DBS in this prospective open-label study. Forty-nine PD patients underwent structural MRI and a comprehensive clinical assessment at preoperative baseline and 6-month follow-up. Voxel-based morphometry was used to assess associations between cerebral volume and non-motor outcomes corrected for multiple comparisons using a permutation-based approach. We replicated existing results associating volume loss of the superior frontal cortex with subpar motor outcomes. Overall non-motor burden, however, was not significantly associated with morphometric features, limiting its use as a marker to inform patient selection and holistic preoperative counselling.

Subthalamic Nucleus

Voxel-based morphometry

10.1038/s41531-024-00695-1

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FM2-2 Exploratory analysis whether wearable sensor data can correlate with aspects of non-motor symptoms in parkinson’s: a real life study with the parkinson’s kinetigraphTM

Journal of Neurology Neurosurgery & Psychiatry (2019)

Shweta Hota Aleksandra Podlewska Alexandra Rizos DV Wamelen К. Ray Chaudhuri

Objectives To determine the association between the range and nature of non-motor symptoms (NMS) in people with Parkinson’s (PwP) and validated Parkinson’s KinetigraphTM (PKG) outcome measures. Design Cross-sectional retrospective study of participants enrolled in the Non-motor Longitudinal International Study (NILS, UKCRN No: 10084) at King’s College Hospital, London. Subjects 108 PwP with a PKG recording within 4 months of a NILS assessment were included in the analysis. Methods PKG is a validated accelerometery-based measure for motor function in PwP, reporting scores for global bradykinesia (BKS) and dyskinesia (DKS). NMS were assessed by the NMS scale (NMSS). Results Using multiple linear regression, BKS was predicted by NMSS domains 6 (gastrointestinal tract; p=0.006) and 8 (sexual function; p=0.003). DKS was predicted by domains 3 (mood/cognition; p=0.016), domain 4 (perceptual problems; p=0.025), domain 6 (gastrointestinal tract; p=0.029) and domain 9 (miscellaneous, p=0.003). In these domains, anxiety, delusions, dysphagia, hyposmia, weight change and hyperhidrosis significantly predicted DKS. In addition, carbidopa dose predicted NMSS total scores (p=0.037), but not total LEDD (p=0.91). Conclusions In PwP, measures of BK and DK were mainly associated with gastrointestinal problems, underpinning the importance of gastric absorption of oral medications and constipation and the related motor effects in PwP. Interestingly, carbidopa appears to have a role in non-motor symptoms in PwP, which deserves further investigation.

Carbidopa

10.1136/jnnp-2019-abn.75

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Restless legs syndrome in Parkinson's disease is associated with fatigue and insomnia but not daytime sleepiness: Study of 329 cases

J. A. Boot P. Ramakrishna Reddy Abdel Douiri Steven J Robinson Alexandra Rizos

Restless Legs Syndrome

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Intercultural adaptation of the PUKSoPC in German language

Der Nervenarzt (2023)

Vasilija Stopic Alexandra Rizos Jane Simpson Fiona Eccles Till A. Dembek

Zusammenfassung Hintergrund Die gefühlte Kontrolle von Menschen mit Parkinson-Erkrankung spielt eine große Rolle für ihre Lebensqualität. Simpson et al. entwickelten eine für die Parkinson-Erkrankung spezifische Skala der gefühlten Kontrolle namens Parkinson’s UK Scale of Perceived Control (PUKSoPC). Wir stellen in dieser Arbeit eine interkulturell adaptierte deutsche Übersetzung der englischen Originalversion vor. Methoden Nach Zustimmung der Originalautoren wurde ein international etabliertes Prozedere für die interkulturelle Adaptation eingesetzt. Die englischsprachige Originalversion wurde unabhängig von zwei bilingualen Neurowissenschaftlern übersetzt und anschließend von beiden eine Konsensusversion gebildet. Diese wurde an 10 Parkinson-Patientinnen und -Patienten getestet und von zwei weiteren Neurowissenschaftlern unabhängig in die englische Sprache rückübersetzt. Nach Bildung einer Konsensusversion wurde diese englische Version von allen vier Übersetzern mit der Originalversion verglichen. Differenzen zwischen den Versionen resultierten in Modifikationen der deutschen Übersetzung, sodass die Rückübersetzung möglichst genau dem Original entsprach. Die finale Version wurde von zwei der Originalautoren genehmigt und an 50 Parkinson-Patientinnen und -Patienten klinisch getestet. Ergebnisse Im Rahmen des Übersetzungsprozesses einigten sich die vier Übersetzer auf eine kulturell adaptierte deutsche Fassung der PUKSoPC. Bei der Testung der finalen Version an 50 Parkinson-Patientinnen und -Patienten zeigten sich keine sprachlichen oder inhaltlichen Probleme. Diskussion Die vorgestellte, sprachlich validierte deutsche Version der PUKSoPC steht nun zur Erhebung der gefühlten Kontrolle von Parkinson-Patientinnen und -Patienten in Forschung und klinischem Alltag zur Verfügung.

10.1007/s00115-023-01569-2

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