Journal of Movement Disorders

Original Articles

Safinamide as an Adjunct to Levodopa in Asian and Caucasian Patients With Parkinson’s Disease and Motor Fluctuations: A Post Hoc Analysis of the SETTLE Study: Roongroj Bhidayasiri, Takayuki Ishida, Takanori Kamei, Ryan Edbert Husni, Ippei Suzuki, Shey Lin Wu, Jin Whan Cho; J Mov Disord. 2023;16(2):180-190. Published online April 26, 2023; DOI: https://doi.org/10.14802/jmd.22196

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Abstract PDF Supplementary Material: Objective
Safinamide is a selective, reversible monoamine oxidase B inhibitor with demonstrated efficacy and tolerability in placebo-controlled studies and is clinically useful for patients with motor fluctuations. This study evaluated the efficacy and safety of safinamide as a levodopa adjunct therapy in Asian patients with Parkinson’s disease.
Methods
Data from 173 Asian and 371 Caucasian patients from the international Phase III SETTLE study were included in this post hoc analysis. The safinamide dose was increased from 50 mg/day to 100 mg/day if no tolerability issues occurred at week 2. The primary outcome was the change from baseline to week 24 in daily ON-time without troublesome dyskinesia (i.e., ON-time). Key secondary outcomes included changes in Unified Parkinson’s Disease Rating Scale (UPDRS) scores.
Results
Safinamide significantly increased daily ON-time relative to placebo in both groups (least-squares mean: 0.83 hours, p = 0.011 [Asians]; 1.05 hours, p < 0.0001 [Caucasians]). Motor function relative to placebo (UPDRS Part III) improved significantly in Asians (-2.65 points, p = 0.012) but not Caucasians (-1.44 points, p = 0.0576). Safinamide did not worsen Dyskinesia Rating Scale scores in either subgroup, regardless of the presence or absence of dyskinesia at baseline. Dyskinesia was largely mild for Asians and moderate for Caucasians. None of the Asian patients experienced adverse events leading to treatment discontinuation.
Conclusion
Safinamide as a levodopa adjunct is well tolerated and effective in reducing motor fluctuations in both Asian and Caucasian patients. Further studies to investigate the real-world effectiveness and safety of safinamide in Asia are warranted.

Umami and Other Taste Perceptions in Patients With Parkinson’s Disease: Priya Jagota, Nattida Chotechuang, Chanawat Anan, Teeraparp Kitjawijit, Chanchai Boonla, Roongroj Bhidayasiri; J Mov Disord. 2022;15(2):115-123. Published online March 22, 2022; DOI: https://doi.org/10.14802/jmd.21058

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Objective
Studies of taste perceptions in Parkinson’s disease (PD) patients have been controversial, and none of these studies have assessed umami taste. This study aimed to assess umami, along with the other 4 taste functions in PD patients.
Methods
Participants were tested for gustation using the modified filter paper disc method and olfaction using the modified Sniffin’ Stick-16 (mSS-16) test (only 14 culturally suitable items were used). A questionnaire evaluated patients’ subjective olfactory and gustatory dysfunction, taste preference, appetite, and food habits.
Results
A total of 105 PD patients and 101 age- and sex-matched controls were included. The body mass index (BMI) of PD patients was lower than that of controls (PD = 22.62, controls = 23.86, p = 0.028). The mSS-16 score was 10.7 for controls and 6.4 for PD patients (p < 0.001) (normal ≥ 9). Taste recognition thresholds (RTs) for sweet, salty, sour, bitter and umami tastes were significantly higher in PD, indicating poorer gustation. All taste RTs correlated with each other, except for umami. Most patients were unaware of their dysfunction. Patients preferred sweet, salty and umami tastes more than the controls. Dysgeusia of different tastes in patients was differentially associated with poorer discrimination of tastes, an inability to identify the dish and adding extra seasoning to food. BMI and mSS-16 scores showed no correlation in either patients or controls.
Conclusion
PD patients have dysgeusia for all five tastes, including umami, which affects their appetite and diet. Patients preferred sweet, salty and umami tastes. This information can help adjust patients’ diets to improve their nutritional status.

Citations

Citations to this article as recorded by

Gustatory dysfunction is related to Parkinson's disease: A systematic review and meta‐analysis
Il‐Youp Kwak, Kyung Soo Kim, Hyun Jin Min
International Forum of Allergy & Rhinology.2023;[Epub] CrossRef

Brief communication

Validation of the Thai Version of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale: Priya Jagota, Prachaya Srivanitchapoom, Sitthi Petchrutchatachart, Surat Singmaneesakulchai, Apichart Pisarnpong, Praween Lolekha, Suwanna Setthawatcharawanich, Parnsiri Chairangsaris, Natlada Limotai, Pawut Mekawichai, Pattamon Panyakaew, Onanong Phokaewvarangkul, Jirada Sringean, Yuvadee Pitakpatapee, Nancy LaPelle, Pablo Martinez-Martin, Xuehan Ren, Sheng Luo, Glenn T. Stebbins, Christopher G. Goetz, Roongroj Bhidayasiri; J Mov Disord. 2022;15(2):151-155. Published online March 16, 2022; DOI: https://doi.org/10.14802/jmd.21104

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Abstract PDF Supplementary Material

Objective
This study aims to validate the Thai translation of the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS).
Methods
The English version was translated into Thai and then back-translated into English. The translated version underwent 2 rounds of cognitive pretesting to assess the ease of comprehension, ease of use and comfort with the scale. Then, it underwent large clinimetric testing.
Results
The Thai version was validated in 354 PD patients. The comparative fit index (CFI) for all four parts of the Thai version of the MDS-UPDRS was 0.93 or greater. Exploratory factor analysis identified isolated item differences in factor structure between the Thai and English versions.
Conclusion
The overall factor structure of the Thai version was consistent with that of the English version based on the high CFIs (all CFI ≥ 0.90). Hence, it can be designated the official Thai version of the MDS-UPDRS.

Citations

Citations to this article as recorded by

Global Epidemiology of Movement Disorders: Rare or Underdiagnosed?
Sarah A. O'Shea, Ludy C. Shih
Seminars in Neurology.2023; 43(01): 004. CrossRef
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Warongporn Phuenpathom, Pattamon Panyakaew, Peerapon Vateekul, Decho Surangsrirat, Akarin Hiransuthikul, Roongroj Bhidayasiri
Parkinsonism & Related Disorders.2022; 105: 43. CrossRef

Letter to the editor

Peak-Dose Ballism Associated with Declining Implantable Pulse Generator Battery Life in Deep Brain Stimulation for Parkinson’s Disease: Denzel Chong Jen-Rei, Lim Thien Thien, Lee Hock Keong, Hoe Wei Leng, Onanong Phokaewvarangkul, Roongroj Bhidayasiri; J Mov Disord. 2021;14(2):166-169. Published online December 7, 2020; DOI: https://doi.org/10.14802/jmd.20078

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PDF Supplementary Material

Review Article

COVID-19: An Early Review of Its Global Impact and Considerations for Parkinson’s Disease Patient Care: Roongroj Bhidayasiri, Sasivimol Virameteekul, Jong-Min Kim, Pramod Kr. Pal, Sun-Ju Chung; J Mov Disord. 2020;13(2):105-114. Published online April 30, 2020; DOI: https://doi.org/10.14802/jmd.20042

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Abstract PDF

While many infectious disorders are unknown to most neurologists, COVID-19 is very different. It has impacted neurologists and other health care workers, not only in our professional lives but also through the fear and panic within our own families, colleagues, patients and their families, and even in the wider public. COVID-19 affects all sorts of individuals, but the elderly with underlying chronic conditions are particularly at risk of severe disease, or even death. Parkinson’s disease (PD) shares a common profile as an age-dependent degenerative disorder, frequently associated with comorbidities, particularly cardiovascular diseases, so PD patients will almost certainly fall into the high-risk group. Therefore, the aim of this review is to explore the risk of COVID-19 in PD based on the susceptibility to severe disease, its impact on PD disease severity, potential long-term sequelae, and difficulties of PD management during this outbreak, where neurologists face various challenges on how we can maintain effective care for PD patients without exposing them, or ourselves, to the risk of infection. It is less than six months since the identification of the original COVID-19 case on New Year’s Eve 2019, so it is still too early to fully understand the natural history of COVID-19 and the evidence on COVID-19-related PD is scant. Though the possibilities presented are speculative, they are theory-based, and supported by prior evidence from other neurotrophic viruses closely related to SARS-CoV-2. Neurologists should be on high alert and vigilant for potential acute and chronic complications when encountering PD patients who are suspected of having COVID-19.

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Letter to the editor

Beyond the Classic Segawa Disease, GCH1-Associated Neurodegenerative Parkinsonism: Practical Considerations for Physicians: Jirat Chenbhanich, Jirada Sringean, Roongroj Bhidayasiri; J Mov Disord. 2017;10(2):102-104. Published online April 18, 2017; DOI: https://doi.org/10.14802/jmd.17009

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