Julia Węgrzynek-Gallina

Glial cell line-derived neurotrophic factor (GDNF) and brain-derived neurotrophic factor (BDNF) are proteins essential for neuronal survival and implicated in Parkinson’s disease (PD) pathophysiology. Although reduced levels of these neurotrophins have been observed in PD, their relationship with disease progression remains unclear. We conducted a systematic review by independently searching four databases using predefined keywords: Parkinson AND (GDNF OR BDNF OR neurotroph) AND (serum OR blood OR cerebrospinal fluid). After screening 2132 records, 35 studies qualified for inclusion. Changes in neurotrophic factors’ levels were evaluated in relation to disease severity and duration. Many studies reported a decline in BDNF levels associated with more severe motor symptoms. Some studies noted increased BDNF levels in advanced PD. This pattern may be affected by levodopa treatment, suggesting that elevated BDNF levels in advanced PD could reflect a treatment-related effect rather than disease progression itself. Reduced levels of both GDNF and BDNF were linked to cognitive decline, with BDNF also decreased in PD patients with depression. Serum BDNF levels were associated with motor severity and neuropsychiatric symptoms. BDNF levels in PD may increase with longer disease duration, likely due to levodopa treatment effects. However, lower BDNF levels are seen in cognitive decline and depression, frequent non-motor symptoms of PD. Further research is required to clarify BDNF dynamics and to determine GDNF’s role in motor progression and cognitive decline.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes and obesity due to their metabolic effects. Emerging evidence suggests they may also have neuroprotective effects, indicating their potential as disease-modifying therapies in neurodegenerative disorders such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). Preclinical studies in animal models have demonstrated that GLP-1RAs can reduce neuroinflammation, oxidative stress, neuronal apoptosis, and pathological protein aggregation, while enhancing glucose metabolism and mitochondrial function. This narrative review analyzed results from human clinical trials evaluating GLP-1RAs in AD and PD, based on a search of four databases (Web of Science, Medline, Embase, and Clinical Trials). The analysis included eleven studies. In AD, clinical trials suggest that GLP-1RAs such as liraglutide and semaglutide may enhance brain glucose metabolism, facilitate glucose transport across the blood–brain barrier, and benefit neuronal networks. However, most studies did not demonstrate improvements in cognitive functions or radiological markers. Short-term clinical trials of GLP-1RAs, including exenatide and lixisenatide, demonstrated promising effects on motor and selected non-motor symptoms in patients with PD, but their disease-modifying effects remain unproven. GLP-1RAs showed a favorable safety profile. Despite promising findings, small study populations, heterogeneous protocols, and short observation periods limit definitive conclusions. Further larger, long-term studies are needed, particularly to clarify the risk–benefit balance, weight control, and long-term outcomes.

Introduction: Parkinson’s disease is a neurodegenerative disorder leading to the loss of independence and deterioration in patients’ quality of life. In recent years, researchers have developed various forms of rehabilitation as a support strategy alongside drug treatment. It has been suggested that music therapy can have a positive impact on both cognitive and motor function in Parkinson’s disease patients and, more importantly, improve quality of life. Aim of the study: The purpose of this systematic review was to assess the latest research and summarise the possibilities and effectiveness of music therapy. Materials and methods: Four databases were systematically searched and analysed from 1 January 2021 to 14 February 2023, according to the established criteria and definition. Results: Thirteen studies were included in the analysis. The methodology of the studies varied. Most of them were short-term and involved a small number of participants. Studies examining the impact of singing, dancing and playing instruments, were included in the analysis. Of the studies, 69.2% reported positive effects on motor function, 84.6% on cognitive function, and 53.8% on improved mental well-being. Conclusions: Although the research methodology needs further refinement, the benefits of music therapy on motor, cognitive, and mental functioning are evident in short-term studies. The potential beneficial effects in long-term follow-up require further research.

Background and Objectives: The rapid growth of the number of advanced Parkinson’s disease (PD) patients has caused a significant increase in the use of device-aided therapies (DATs), including levodopa–carbidopa intestinal gel (LCIG) and continuous subcutaneous apomorphine infusion (CSAI). The objective of this study was to evaluate patients’ satisfaction and the factors influencing preferences for CSAI and LCIG. Materials and Methods: The research focused on individuals diagnosed with advanced PD undergoing DAT at the Neurology Department of the University Hospital in Katowice. A telephone survey conducted between June and July 2024 evaluated the experiences of patients with LCIG and CSAI. The Parkinson’s Disease Questionnaire (PDQ-8) and the Stress Scale for Family Caregivers (BSFC-s) were applied. Based on medical record data comprising reasons for the exclusion of individuals, disease-related and treatment data were collected. Results: Among the original cohort of 64 patients, 50 completed the survey, including 31 who might choose between infusion therapies. The average patient ages were 70.6 ± 4.7 (CSAI) and 71.2 ± 7.2 years (LCIG), with disease durations of 15 (IQR: 12–19) and 18 (IQR: 13–19) years, respectively. LCIG patients presented higher PDQ-8 scores (20 (IQR: 13–27) vs. 13 (IQR: 6–19), p = 0.008), and higher BSFC-s scores (19 (IQR: 12–21) vs. 9 (IQR: 2.5–13), p = 0.011). Furthermore, significant factors influencing patient preferences included fear of surgery (75% vs. 36.8%, p = 0.043) and concerns about DAT safety (83.3% vs. 47.4%, p = 0.049). Conclusions: LCIG and CSAI therapies offer benefits and disadvantages, with safety concerns and fear of surgery seeming to be decisive in the decision-making process.

Introduction and objective: Many studies have investigated the interplay between Parkinson’s disease and diabetes mellitus, suggesting that glucose metabolism impairment may worsen the clinical course of Parkinson’s disease. This study aimed to explore the association between diabetes mellitus and the course of Parkinson’s disease. Materials and methods: A retrospective study was performed by analysing the clinical data of patients diagnosed with Parkinson’s disease who were hospitalised in University Clinical Centre of the Medical University of Silesia from 2019 to 2021. The study group comprised 241 patients selected according to the study’s inclusion and exclusion criteria. Their clinical conditions were assessed using body mass index, the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), the Hoehn–Yahr scale, Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and Beck Depression Inventory (BDI). Data were collected on current anti-parkinsonian treatment, fasting glycaemia, lipid panel, and thyroid stimulating hormone, homocysteine and vitamin D3 levels. Results: The study group included 31 patients diagnosed with diabetes mellitus and 240 patients without glucose metabolism impairment. Both groups were matched by considering age, disease duration, and gender distribution. Diabetic patients displayed a higher MDS-UPDRS part III OFF rating (42 [31–55] vs. 48 [39–59]; p = 0.0043), higher MDS-UPDRS part III ON rating (17 [11–26] vs. 26.5 [19–32]; p = 0.0009) and higher BDI score (7 [4–11] vs. 11 [9–16]; p = 0.0013). As expected, patients with diabetes mellitus had a higher fasting glycaemia, total cholesterol, lower high-density lipoprotein cholesterol and higher body mass index. Conclusions: Our study confirms the relationship between diabetes mellitus and a worse clinical course for Parkinson’s disease.

Wprowadzenie: Celem badań była analiza profilu pacjentów przyjmowanych z powodu infekcji COVID-19 w Oddziale Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych Uniwersyteckiego Centrum Klinicznego Śląskiego Uniwersytetu Medycznego w Katowicach. Materiał i metody: Retrospektywna analiza objęła wszystkich kolejnych pacjentów z potwierdzoną infekcją COVID-19 przyjętych do Oddziału Chorób Wewnętrznych w okresie od listopada 2020 do czerwca 2021. Przeanalizowano dane takie jak: wiek, płeć, data przyjęcia do oddziału, długość hospitalizacji, tryb przyjęcia, postawione rozpoznania główne i choroby towarzyszące, tryb wypisu pacjentów i przyczyny śmierci w przypadku hospitalizacji zakończonej zgonem. Wyniki: Grupa badana liczyła 232 pacjentów (124 (53.4%) mężczyzn) ze zdiagnozowaną infekcją COVID-19. Średni wiek badanych wynosił 66.5±14.7 (24-96) lat. W tej grupie zaobserwowano istotnie statystyczny związek śmiertelności pacjentów ze współistniejącą niewydolnością serca i chorobą niedokrwienną serca oraz liczbą obciążeń sercowo-naczyniowych. Średni czas hospitalizacji wynosił 9.96±6.35 (0-35) dni. Był on istotnie dłuższy wśród pacjentów cierpiących na chorobę nerek i dróg moczowych (11 (6,0-14,0) vs. 9 (5,0-15,0) dni, p=0,022), a szczególnie ze stwierdzoną infekcją dróg moczowych (13,5 (9,0-18,8) vs. 9 (5,0-12,0) dni, p=0.003). Współistniejące zakażenia inne niż infekcja COVID-19 (9 (5,0-12,0) vs. 5 (10,3-23,0) dni, p<0.001) oraz niedobór witaminy D (8 (4,0-12,0) vs. 12 (10,0-17,0) dni, p<0,001) również stanowiły istotny czynnik wydłużający pobyt szpitalny. Wnioski: Wśród pacjentów hospitalizowanych z powodu infekcji COVID-19, obciążenia sercowo-naczyniowe stanowią istotny czynnik zwiększający śmiertelność pacjentów. Współistniejące zakażenia innego rodzaju oraz niedobór witaminy D mogą natomiast wydłużać hospitalizację.

Purpose: Stroke mimics (SMs) are conditions that present similarly to acute cerebrovascular accidents (CVA), potentially leading to diagnostic errors made by physicians or emergency medical teams (EMT). This study aimed to analyse the profile of patients transferred by EMT to the neurological...

Background: New neurological complications of COVID-19 infection have been reported in recent research. Among them, the spectrum of anti-MOG positive diseases, defined as anti-MOG antibody associated disease (MOGAD), is distinguished, which can manifest as optic neuritis, myelitis, or various forms of encephalitis (MOGAE).Materials and methods: This study reports a new case of MOGAE following SARS-CoV-2 infection. A literature review of other MOGAE cases associated with COVID-19 infection was conducted and summarized.Results: A 60-year-old male patient, who had previously been infected with COVID-19, was admitted to the Neurology Department with a rapidly progressive deterioration of his cognitive functions that lasted for about 3 months. On neurological examination, the Mini-Mental State Examination (MMSE) score was 17, which further deteriorated to 13. In addition, central paresis of the right VIIth nerve and pyramidal hemiparesis on the right side were noted. The MRI of the brain showed multiple hyperintense lesions. The CSF examination revealed an elevated total protein level with a normal cell count, and serum showed a positive finding of anti-MOG antibodies. Taking into account all the information, the diagnosis of MOGAE, following COVID-19 infection, was made. A total of 9 similar cases of MOGAE associated with SARS-CoV-2 infection were identified in the available literature. Among them 2 cases presented progressive cognitive dysfunction and another 5 altered mental status. The most frequently described MRI changes were hyperintense lesions located cortically and/or subcortically. Anti-MOG antibodies were positive in all patients. In 5 cases they were detected only in serum, in 2 cases in serum and CSF, and in 2 cases the origin was not reported.Conclusion: The reported cases of MOGAE following COVID-19 infection suggest an increasing new clinical problem, and show an association between COVID-19 and MOGADs.