Peripheral neuropathy in Parkinson's disease: prevalence and functional impact on gait and balance

• Type: Article in International Scientific Journal
• Date: 2023

Authors

Corra, MF (Author) Other; Vila Cha, N (Author) Other; Sardoeira, A (Author) Other; Hansen, C (Author) Other; Sousa, AP (Author) Other; Reis, I (Author) Other; Sambayeta, F (Author) Other; Damasio, J (Author) Other; Calejo, M (Author) Other; Schicketmueller, A (Author) Other; Laranjinha, I (Author) Other; Salgado, P (Author) Other; Taipa, R (Author) Other; Magalhaes, R (Author) ICBAS; Correia, M (Author) Other; Maetzler, W (Author) Other; Maia, LF (Author) Other

Journal

Title: Brain

Vol. 146

Pages: 225-236

ISSN: 0006-8950

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 41 Citations

Scopus - 46 Citations

Other information

Authenticus ID: P-00X-3SK

DOI: 10.1093/brain/awac026

Abstract (EN): 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. Corra et al. show that peripheral neuropathy is common in Parkinson's disease, with a prevalence of approximately 40%, and has a negative impact on gait and balance, as measured with wearable health technology.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 12