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Article ; Online: Challenges of Teleneurology in the Care of Complex Neurodegenerative Disorders

Seyed-Mohammad Fereshtehnejad / Johan Lökk

Healthcare, Vol 11, Iss 24, p

The Case of Parkinson’s Disease with Possible Solutions

2023 Volume 3187

Abstract: Teleneurology is a specialist field within the realm of telemedicine, which is dedicated to delivering neurological care and consultations through virtual encounters. Teleneurology has been successfully used in acute care (e.g., stroke) and outpatient ... ...

Abstract	Teleneurology is a specialist field within the realm of telemedicine, which is dedicated to delivering neurological care and consultations through virtual encounters. Teleneurology has been successfully used in acute care (e.g., stroke) and outpatient evaluation for chronic neurological conditions such as epilepsy and headaches. However, for some neurologic entities like Parkinson’s disease, in which an in-depth physical examination by palpating muscles and performing neurologic maneuvers is the mainstay of monitoring the effects of medication, the yield and feasibility of a virtual encounter are low. Therefore, in this prospective review, we discuss two promising teleneurology approaches and propose adjustments to enhance the value of virtual encounters by improving the validity of neurological examination: ‘hybrid teleneurology’, which involves revising the workflow of virtual encounters; and ‘artificial intelligence (AI)-assisted teleneurology’, namely the use of biosensors and wearables and data processing using AI.
Keywords	telemedicine ; teleneurology ; neurodegeneration ; Parkinson’s disease ; virtual encounter ; Medicine ; R
Subject code	629
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Predicting severity and prognosis in Parkinson's disease from brain microstructure and connectivity

Nooshin Abbasi / Seyed-Mohammad Fereshtehnejad / Yashar Zeighami / Kevin Michel-Herve Larcher / Ronald B. Postuma / Alain Dagher

NeuroImage: Clinical, Vol 25, Iss , Pp - (2020)

2020

Abstract: Objectives: Investigating biomarkers to demonstrate progression of Parkinson's disease (PD) is of high priority. We investigated the association of brain structural properties with progression of clinical outcomes and their ability to differentiate ... ...

Abstract	Objectives: Investigating biomarkers to demonstrate progression of Parkinson's disease (PD) is of high priority. We investigated the association of brain structural properties with progression of clinical outcomes and their ability to differentiate clinical subtypes of PD.Methods: A comprehensive set of clinical features was evaluated at baseline and 4.5-year follow-up for 144 de-novo PD patients from the Parkinson's Progression Markers Initiative. We created a global composite outcome (GCO) by combining z-scores of non-motor and motor symptoms, motor signs, overall activities of daily living and global cognition, as a single numeric indicator of prognosis. We classified patients into three subtypes based on multi-domain clinical criteria: ‘mild motor-predominant’, ‘intermediate’ and ‘diffuse-malignant’. We analyzed diffusion-weighted scans at the early drug-naïve stage and extracted fractional anisotropy and mean diffusivity (MD) of basal ganglia and cortical sub-regions. Then, we employed graph theory to calculate network properties and used network-based statistic to investigate our primary hypothesis.Results: Baseline MD of globus pallidus was associated with worsening of motor severity, cognition, and GCO after 4.5 years of follow-up. Connectivity disruption at baseline was correlated with decline in cognition, and increase in GCO. Baseline MD of nucleus accumbens, globus pallidus and basal-ganglia were linked to clinical subtypes at 4.5-year of follow-up. Disruption in sub-cortical networks associated with being subtyped as ‘diffuse-malignant’ versus ‘mild motor-predominant’ after 4.5 years.Conclusions: Diffusion imaging analysis at the early de-novo stage of PD was able to differentiate clinical sub-types of PD after 4.5 years and was highly associated with future clinical outcomes of PD.
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610 ; 616
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Serum neurofilament light chain predicts long term clinical outcomes in multiple sclerosis

Simon Thebault / Mohammad Abdoli / Seyed-Mohammad Fereshtehnejad / Daniel Tessier / Vincent Tabard-Cossa / Mark S. Freedman

Scientific Reports, Vol 10, Iss 1, Pp 1-

2020 Volume 11

Abstract: Abstract Serum neurofilament light chain (NfL) is emerging as an important biomarker in multiple sclerosis (MS). Our objective was to evaluate the prognostic value of serum NfL levels obtained close to the time of MS onset with long-term clinical ... ...

Abstract	Abstract Serum neurofilament light chain (NfL) is emerging as an important biomarker in multiple sclerosis (MS). Our objective was to evaluate the prognostic value of serum NfL levels obtained close to the time of MS onset with long-term clinical outcomes. In this prospective cohort study, we identified patients with serum collected within 5 years of first MS symptom onset (baseline) with more than 15 years of routine clinical follow-up. Levels of serum NfL were quantified in patients and matched controls using digital immunoassay (SiMoA HD-1 Analyzer, Quanterix). Sixty-seven patients had a median follow-up of 18.9 years (range 15.0–27.0). The median serum NfL level in patient baseline samples was 10.1 pg/mL, 38.5% higher than median levels in 37 controls (7.26 pg/mL, p = 0.004). Baseline NfL level was most helpful as a sensitive predictive marker to rule out progression; patients with levels less 7.62 pg/mL were 4.3 times less likely to develop an EDSS score of ≥ 4 (p = 0.001) and 7.1 times less likely to develop progressive MS (p = 0.054). Patients with the highest NfL levels (3rd-tertile, > 13.2 pg/mL) progressed most rapidly with an EDSS annual rate of 0.16 (p = 0.004), remaining significant after adjustment for sex, age, and disease-modifying treatment (p = 0.022). This study demonstrates that baseline sNfL is associated with long term clinical disease progression. sNfL may be a sensitive marker of subsequent poor clinical outcomes.
Keywords	Medicine ; R ; Science ; Q
Subject code	610 ; 616
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Orthostatic Hypotension in Patients with Parkinson’s Disease and Atypical Parkinsonism

Seyed-Mohammad Fereshtehnejad / Johan Lökk

Parkinson's Disease, Vol

2014 Volume 2014

Keywords	Medicine ; R ; Internal medicine ; RC31-1245 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Neurology. Diseases of the nervous system ; RC346-429
Publishing date	2014-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Active Aging for Individuals with Parkinson’s Disease

Seyed-Mohammad Fereshtehnejad / Johan Lökk

Parkinson's Disease, Vol

Definitions, Literature Review, and Models

2014 Volume 2014

Keywords	Medicine ; R ; Internal medicine ; RC31-1245 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Neurology. Diseases of the nervous system ; RC346-429
Publishing date	2014-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Analysis of Being Active Based on Older Adults’ Experience

Elham Mohammadi / Talat Allahyari / Ali Darvishpoor Kakhaki / Hasan Saraei / Seyed Mohammad Fereshtehnejad

Sālmand, Vol 11, Iss 4, Pp 504-

A Qualitative Study of Active Aging Strategies

2017 Volume 517

Abstract: Objectives In recent decades, it has become important to approach aging issues from the point of view that can ensure older adults’ Quality of Life (QoL). As a result, countries have adopted a positive perspective with regard to aging, including active ... ...

Abstract	Objectives In recent decades, it has become important to approach aging issues from the point of view that can ensure older adults’ Quality of Life (QoL). As a result, countries have adopted a positive perspective with regard to aging, including active aging. The fact is that indigenous understanding of active aging is an unavoidable necessity for every society. Thus, the current study’s aim was to understand active aging strategies based on older adults’ experience. Methods & Materials This qualitative study, conducted during 2014-2016, used the Grounded theory method. It was initiated with the help of purposeful sampling and continued by way of applying theoretical sampling. The study field was cultural centers, artistic-cultural associations, and parks of Tehran. Data saturation was achieved through semi-structured interviews carried out among 35 elders. Data were analyzed and coded through coding suggested by the Strauss and Corbin method. Reliability of data was fulfilled in accordance with the Schwandt, Lincoln and Guba criteria. Results Based on the experience of elders, active aging strategies consisted of 41 concepts, 7 subcategories, and 5 main categories. The categories and subcategories included primary strategies of isolation avoidance (not staying at home and interactionism), social participation (including continuity of career roles, volunteerism and institutional participation), strategies of active attitude and learning, physical activity and management of home’s time and daily life Conclusion Active aging requires applying strategies in 3 areas: elders’ attitude, home environment, and society. For active aging in the country, practitioners and social planners need to strictly consider these 3 areas.
Keywords	Active aging ; Strategies ; Grounded theory ; Active attitude ; Geriatrics ; RC952-954.6 ; Public aspects of medicine ; RA1-1270
Subject code	300
Language	Persian
Publishing date	2017-03-01T00:00:00Z
Publisher	University of Social Welfare & Rehabilitation Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessment of a prognostic MRI biomarker in early de novo Parkinson's disease

Yashar Zeighami / Seyed-Mohammad Fereshtehnejad / Mahsa Dadar / D. Louis Collins / Ronald B. Postuma / Alain Dagher

NeuroImage: Clinical, Vol 24, Iss , Pp - (2019)

2019

Abstract: Background: Commonly used neuroimaging biomarkers in Parkinson's disease (PD) are useful for diagnosis but poor at predicting outcomes. We explored whether an atrophy pattern from whole-brain structural MRI, measured in the drug-naïve early stage, could ... ...

Abstract	Background: Commonly used neuroimaging biomarkers in Parkinson's disease (PD) are useful for diagnosis but poor at predicting outcomes. We explored whether an atrophy pattern from whole-brain structural MRI, measured in the drug-naïve early stage, could predict PD prognosis. Methods: 362 de novo PD patients with T1-weighted MRI (n = 222 for the main analysis, 140 for the validation analysis) were recruited from the Parkinson's Progression Markers Initiative (PPMI). We investigated a previously identified PD-specific network atrophy pattern as a potential biomarker of disease severity and prognosis. Progression trajectories of motor function (MDS-UPDRS-part III), cognition (Montreal Cognitive Assessment (MoCA)), and a global composite outcome measure were compared between atrophy tertiles using mixed effect models. The prognostic value of the MRI atrophy measure was compared with 123I ioflupane single photon emission computed tomography, the postural-instability-gait-disturbance score, and cerebrospinal fluid markers. Findings: After 4.5 years follow-up, PD-specific atrophy network score at baseline significantly predicted change in UPDRS-part III (r = −0.197, p = .003), MoCA (r = 0.253, p = .0002) and global composite outcome (r = −0.249, p = .0002). Compared with the 3rd tertile (i.e. least atrophy), the tertile with the highest baseline atrophy (i.e. the 1st tertile) had a 3-point annual faster progression in UPDRS-part III (p = .012), faster worsening of posture-instability gait scores (+0.21 further annual increase, p < .0001), faster decline in MoCA (−0.74 further annual decline in MoCA, p = .0372) and a + 0.38 (p = .0029) faster annual increase in the global composite z-score. All findings were replicated in a validation analysis using 1.5T MRI. Receiver operating characteristic analysis confirmed the superiority of the MRI biomarker, although it had modest AUC values (0.63). By comparison, the other biomarkers were limited in their ability to predict prognosis either in the main or validation analysis. ...
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors Affecting the Efficacy of Pramipexole in Patients with Restless Legs Syndrome

Mohammad Rezvani / Babak Zamani / Seyed-Mohammad Fereshtehnejad

Acta Medica Iranica, Vol 51, Iss 6, Pp 377-

2013 Volume 385

Abstract: Dopamine agonists, particularly nonergot dopamine agonists such as pramipexole, have become the mainstay of therapy for patients with symptoms of restless legs syndrome (RLS). This study was designed to evaluate the factors affecting the efficacy of ... ...

Abstract	Dopamine agonists, particularly nonergot dopamine agonists such as pramipexole, have become the mainstay of therapy for patients with symptoms of restless legs syndrome (RLS). This study was designed to evaluate the factors affecting the efficacy of pramipexole in patients with RLS. Fifty-nine eligible RLS patients referred to neurology clinic of Rasoul-e-Akram Hospital (Tehran, Iran) were recruited in this study. All of the patients received an oral dose of 0.18 mg pramipexole. The severity of RLS symptoms were evaluated including sleep disorder, symptomatic days per week and symptomatic hours per day, both at the beginning and at the end of follow-up time. Different baseline and follow-up variables were also recorded and their relationships with the outcomes were assessed. The mean severity values of different symptoms significantly decreased after treatment with pramipexole (P<0.001). Female gender (P<0.05) and duration of treatment (P<0.05) were significant factors to achieve >50% reduction in symptomatic days per week and symptomatic hours per day. Moreover, the cutoff point of 3.5 mo for duration of treatment could potentially differentiate >50% reduction in severity of sleep disorder from the ones with <50% reduction with sensitivity and specificity of 56.8% and 78.6%, respectively. Our findings show that female gender and duration of treatment were the factors affecting the effectiveness of pramipexole in RLS patients. If tolerated by the patients, a longer duration of treatment with pramipexole is more effective in RLS.
Keywords	Efficacy ; Pramipexole ; Restless Legs Syndrome (RLS) ; Treatment ; Medicine (General) ; R5-920
Subject code	610 ; 150
Language	English
Publishing date	2013-06-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors Affecting the Efficacy of Pramipexole in Patients with Restless Legs Syndrome

Mohammad Rezvani / Babak Zamani / Seyed-Mohammad Fereshtehnejad

Acta Medica Iranica, Vol 51, Iss

2013 Volume 6

Abstract	Dopamine agonists, particularly nonergot dopamine agonists such as pramipexole, have become the mainstay of therapy for patients with symptoms of restless legs syndrome (RLS). This study was designed to evaluate the factors affecting the efficacy of pramipexole in patients with RLS. Fifty-nine eligible RLS patients referred to neurology clinic of Rasoul-e-Akram Hospital (Tehran, Iran) were recruited in this study. All of the patients received an oral dose of 0.18 mg pramipexole. The severity of RLS symptoms were evaluated including sleep disorder, symptomatic days per week and symptomatic hours per day, both at the beginning and at the end of follow-up time. Different baseline and follow-up variables were also recorded and their relationships with the outcomes were assessed. The mean severity values of different symptoms significantly decreased after treatment with pramipexole (P<0.001). Female gender (P<0.05) and duration of treatment (P<0.05) were significant factors to achieve >50% reduction in symptomatic days per week and symptomatic hours per day. Moreover, the cutoff point of 3.5 mo for duration of treatment could potentially differentiate >50% reduction in severity of sleep disorder from the ones with <50% reduction with sensitivity and specificity of 56.8% and 78.6%, respectively. Our findings show that female gender and duration of treatment were the factors affecting the effectiveness of pramipexole in RLS patients. If tolerated by the patients, a longer duration of treatment with pramipexole is more effective in RLS.
Keywords	Efficacy ; Pramipexole ; Restless legs syndrome (RLS) ; Treatment ; Medicine (General) ; R5-920
Subject code	610 ; 150
Language	English
Publishing date	2013-06-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: White matter hyperintensities are linked to future cognitive decline in de novo Parkinson's disease patients

Mahsa Dadar / Yashar Zeighami / Yvonne Yau / Seyed-Mohammad Fereshtehnejad / Josefina Maranzano / Ronald B. Postuma / Alain Dagher / D. Louis Collins

NeuroImage: Clinical, Vol 20, Iss , Pp 892-

2018 Volume 900

Abstract: White Matter Hyperintensities (WMHs) are associated with cognitive decline in aging and Alzheimer's disease. However, the pathogenesis of cognitive decline in Parkinson's disease (PD) is not as clearly related to vascular causes, and therefore the role ... ...

Abstract	White Matter Hyperintensities (WMHs) are associated with cognitive decline in aging and Alzheimer's disease. However, the pathogenesis of cognitive decline in Parkinson's disease (PD) is not as clearly related to vascular causes, and therefore the role of WMHs as a marker of small-vessel disease (SVD) in PD is less clear. Currently, SVD in PD is assessed and treated independently of the disease. However, if WMH as the major MRI sign of SVD has a higher impact on cognitive decline in PD patients than in healthy controls, vascular pathology needs to be assessed and treated with a higher priority in this population. Here we investigate whether the presence of WMHs leads to increased cognitive decline in de novo PD, and if these effects relate to cortical atrophy. WMHs and cortical thickness were measured in de novo PD patients and age-matched controls (NPD = 365, NControl = 174) from Parkinson's Progression Markers Initiative (PPMI) to study the relationship between baseline WMHs, future cognitive decline (follow-up: 4.09 ± 1.14 years) and cortical atrophy (follow-up: 1.05 ± 0.10 years). PD subjects with high baseline WMH loads had significantly greater cognitive decline than i) PD subjects with low WMH load, and ii) control subjects with high WMH load. Furthermore, in PD subjects, high WMH load resulted in more cortical thinning in the right frontal lobe. Theses results show that the presence of WMHs in de novo PD patients predicts greater future cognitive decline and cortical atrophy than in normal aging. Keywords: Parkinson's disease, White matter hyperintensities, Magnetic resonance imaging, Cognitive decline, De novo patients
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7 ; Neurology. Diseases of the nervous system ; RC346-429
Subject code	616
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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