Background: We examine the effect of eradicating Helicobacter in idiopathic parkinsonism (IP). Marked deterioration, where eradication-therapy failed, prompted an interim report in the first 20 probands to reach de-blinding. The null-hypothesis, "eradication has no effect on principal outcome, mean stride length at free-walking speed," was rejected. We report on study completion in all 30 who had commenced post-treatment assessments.
Methods: This is a randomized, placebo-controlled, parallel-group efficacy study of eradicating biopsy-proven (culture and/or organism on histopathology) Helicobacter pylori infection on the time course of facets of IP, in probands taking no, or stable long-t(1/2), anti-parkinsonian medication. Persistent infection at de-blinding (scheduled 1-year post-treatment) led to open active eradication-treatment.
Results: Stride length improved (73 (95% CI 14-131) mm/year, p = .01) in favor of "successful" blinded active over placebo, irrespective of anti-parkinsonian medication, and despite worsening upper limb flexor rigidity (237 (57-416) Nm x 10(-3)/year, p = .01). This differential effect was echoed following open active, post-placebo. Gait did not deteriorate in year 2 and 3 post-eradication. Anti-nuclear antibody was present in all four proven (two by molecular microbiology only) eradication failures. In the remainder, it marked poorer response during the year after eradication therapy, possibly indicating residual "low-density" infection. We illustrate the importance of eradicating low-density infection, detected only by molecular microbiology, in a proband not receiving anti-parkinsonian medication. Stride length improved (424 (379-468) mm for 15 months post-eradication, p = .001), correction of deficit continuing to 3.4 years. Flexor rigidity increased before hydrogen-breath-test positivity for small intestinal bacterial overgrowth (208 (28-388) Nm x 10(-3), p = .02), increased further during (171 (67-274), p = .001) (15-31 months), and decreased (136 (6-267), p = .04) after restoration of negativity (32-41 months).
Conclusion: Helicobacter is an arbiter of progression, independent of infection-load.
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http://dx.doi.org/10.1111/j.1523-5378.2010.00768.x | DOI Listing |
Med Phys
January 2025
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Respiratory motion during radiotherapy (RT) may reduce the therapeutic effect and increase the dose received by organs at risk. This can be addressed by real-time tracking, where respiration motion prediction is currently required to compensate for system latency in RT systems. Notably, for the prediction of future images in image-guided adaptive RT systems, the use of deep learning has been considered.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Hallym University, Chuncheon, Gangwon-do, Korea, Republic of (South).
Background: In patients with mild cognitive impairment (MCI), the presence or absence of memory deficits is associated with divergent clinical presentations, etiologies, and prognostic outcomes. These differences may also manifest in additional neurologic signs beyond cognitive impairments and are often reflected in distinct magnetic resonance imaging (MRI) profiles. Gait is one of the clinical characteristics that reflects brain function along with cognitive function.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Computer Science & Engineering, Galgotias University, Greater Noida, Uttar Pradesh, India.
A dual-stage model for classifying Parkinson's disease severity, through a detailed analysis of Gait signals using force sensors and machine learning approaches, is proposed in this study. Parkinson's disease is the primary neurodegenerative disorder that results in a gradual reduction in motor function. Early detection and monitoring of the disease progression is highly challenging due to the gradual progression of symptoms and the inadequacy of conventional methods in identifying subtle changes in mobility.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Neurology, School of Medicine, Dong-A University, Seo-gu, Busan, Republic of Korea.
Early detection of Parkinson's disease (PD) and accurate assessment of disease progression are critical for optimizing treatment and rehabilitation. However, there is no consensus on how to effectively detect early-stage PD and classify motor symptom severity using gait analysis. This study evaluated the accuracy of machine learning models in classifying early and moderate-stages of PD based on spatiotemporal gait features at different walking speeds.
View Article and Find Full Text PDFFront Bioeng Biotechnol
December 2024
Department of Mechanical Engineering, Northern Arizona University, Flagstaff, AZ, United States.
Introduction: Walking is essential for daily life but poses a significant challenge for many individuals with neurological conditions like cerebral palsy (CP), which is the leading cause of childhood walking disability. Although lower-limb exoskeletons show promise in improving walking ability in laboratory and controlled overground settings, it remains unknown whether these benefits translate to real-world environments, where they could have the greatest impact.
Methods: This feasibility study evaluated whether an untethered ankle exoskeleton with an adaptable controller can improve spatiotemporal outcomes in eight individuals with CP after low-frequency exoskeleton-assisted gait training on real-world terrain.
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