Chaudhuri's Dashboard of Vitals in Parkinson's syndrome: an unmet need underpinned by real life clinical tests

Mubasher A Qamar; Silvia Rota; Lucia Batzu; Indu Subramanian; Cristian Falup-Pecurariu; Nataliya Titova; Vinod Metta; Lulia Murasan; Per Odin; Chandrasekhara Padmakumar; Prashanth L Kukkle; Rupam Borgohain; Rukmini Mridula Kandadai; Vinay Goyal; Kallo Ray Chaudhuri

doi:10.3389/fneur.2023.1174698

Chaudhuri's Dashboard of Vitals in Parkinson's syndrome: an unmet need underpinned by real life clinical tests

Front Neurol. 2023 May 25:14:1174698. doi: 10.3389/fneur.2023.1174698. eCollection 2023.

Authors

Mubasher A Qamar^{1

2}, Silvia Rota^{1

2}, Lucia Batzu^{1

2}, Indu Subramanian^{3

4}, Cristian Falup-Pecurariu^{5

6}, Nataliya Titova^{7

8}, Vinod Metta^{1

2}, Lulia Murasan^{5

6}, Per Odin⁹, Chandrasekhara Padmakumar¹⁰, Prashanth L Kukkle^{11

12}, Rupam Borgohain³, Rukmini Mridula Kandadai¹³, Vinay Goyal¹⁴, Kallo Ray Chaudhuri^{1

2}

Affiliations

¹ Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, Division of Neuroscience, King's College London, London, United Kingdom.
² King's College Hospital NHS Foundation Trust, London, United Kingdom.
³ Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
⁴ Parkinson's Disease Research, Education and Clinical Centers, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, United States.
⁵ Faculty of Medicine, Transilvania University of Braşov, Brașov, Romania.
⁶ Department of Neurology, County Clinic Hospital, Brașov, Romania.
⁷ Department of Neurology, Neurosurgery and Medical Genetics, Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation, Moscow, Russia.
⁸ Department of Neurodegenerative Diseases, Federal State Budgetary Institution "Federal Center of Brain Research and Neurotechnologies" of the Federal Medical Biological Agency, Moscow, Russia.
⁹ Department of Neurology, University Hospital, Lund, Sweden.
¹⁰ Older Person's Medical Clinic, Broadmeadow, NSW, Australia.
¹¹ Center for Parkinson's Disease and Movement Disorders, Manipal Hospital, Karnataka, India, Bangalore.
¹² Parkinson's Disease and Movement Disorders Clinic, Bangalore, Karnataka, India.
¹³ Department of Neurology, Nizam's Institute of Medical Sciences, Autonomous University, Hyderabad, India.
¹⁴ Neurology Department, Medanta, Gurugram, India.

Abstract

We have recently published the notion of the "vitals" of Parkinson's, a conglomeration of signs and symptoms, largely nonmotor, that must not be missed and yet often not considered in neurological consultations, with considerable societal and personal detrimental consequences. This "dashboard," termed the Chaudhuri's vitals of Parkinson's, are summarized as 5 key vital symptoms or signs and comprise of (a) motor, (b) nonmotor, (c) visual, gut, and oral health, (d) bone health and falls, and finally (e) comorbidities, comedication, and dopamine agonist side effects, such as impulse control disorders. Additionally, not addressing the vitals also may reflect inadequate management strategies, leading to worsening quality of life and diminished wellness, a new concept for people with Parkinson's. In this paper, we discuss possible, simple to use, and clinically relevant tests that can be used to monitor the status of these vitals, so that these can be incorporated into clinical practice. We also use the term Parkinson's syndrome to describe Parkinson's disease, as the term "disease" is now abandoned in many countries, such as the U.K., reflecting the heterogeneity of Parkinson's, which is now considered by many as a syndrome.

Keywords: Parkinson’s disease; dashboard; gut; motor; nonmotor; oral; vision; vitals.

Publication types

Review