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    Advances in parkinson's disease research: Exploring biomarkers and therapeutic strategies for halting disease progression
    (Frontiers Media S. A., 2025) Bougea, Anastasia; Değirmenci, Yıldız
    Parkinson's disease (PD) is a multifactorial neurodegenerative disorder, characterized by loss of dopaminergic neurons of substantia nigra (SN) in 1% of people aged above 65 years (Ben-Shlomo et al., 2024). Its complex clinical picture includes motor symptoms such as tremor, bradykinesia, and gait instability, as well as non-motor symptoms (depression, psychosis, cognitive decline) (Schilder et al., 2017;Titova and Chaudhuri, 2017). Current symptomatic therapies have limited long-term efficacy (Aldaajani and Khalil, 2024). A deep analysis of neural network after PD onset could deepen our understanding of the molecular crosstalk and biological processes underlying PD pathogenesis (Tomkins and Manzoni, 2021). However, there is a lack of reliable biomarkers for early diagnosis, presenting barriers to monitoring and developing disease-modifying therapies. There are several different types of biomarkers for PD , such as clinical, neurochemical and genetic (Bougea, 2020). Ten studies provided novel insights into the early detection and monitoring of PD.in the occipital region of the PD group can be usedtilized as a rapid and objective test indicator to screen for depressive symptoms in PD.Zhang et al. identified circadian rhythm genesAK3, RTN3, and LEPR as biomarkers in the progression of PD by regulating NK cells, however, the exact mechanism is not clear.Wang et al. confirmed that authenticated GPR78, CADM3, and CACNA1E were as the biomarkers that mostly mainly participated in pathways, such as the 'cell cycle' and 'hydrogen peroxide catabolic process', and They also found; five types of differential immune cells that differed between PD and control groups were identified. Together, these studies highlight the importance of combination of biomarkers and risk variables into predictive models , improving early diagnosis and monitoring of PD. Sme of them may serve as diagnostics (lncRNAs, P1 amplitude) or predictive (NVU, cathepsin B, APA2, circadian rhythm genesAK3) may shed novel light on the pathogenesis of PD.Both pharmaceutical and non-pharmacological (cognitive training, physical activity, and dietary changes) treatments are used to treat PD symptoms (Degirmenci et al., 2023;Ernst et al., 2024). Seven promising approaches were also highlighted by this showed that acupuncture, cognitive behavioral therapy, exercise and repetitive transcranial magnetic stimulation significantly improved sleep, depression, anxiety, cognition, constipation, and quality of life of PD patients.Studies suggest personalized pharmaceutical and non-pharmacological therapies for PD, with nicotine, Golexanolone, taVNS, acupuncture, and FMT showing promising antiparkinsonian properties, by modulating brain activity. Further research is needed to validate their sustainability, safety, and effectiveness.Bibliometric analysis is a systematic approach to evaluating scientific literature and detecting patterns, and effects by using quantitative tools to filter data from relevant sources (Passas, 2024). This research topic includes two bibliometric studies that significantly expand their respective fields. This research topic combines important studies on the risk factors, treatments, biomarkers and bibliometric analysis. The results of these studies provide a useful guide for clinicians in their practice and to suggest targets for researchers in developing new diagnostics and therapeutic strategies. We conclude that the results of these studies are a useful tool that help clinicians in their practice and motivate researchers to look for new developments.
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    Cognitive impairment in Parkinson’s disease: An updated overview focusing on emerging pharmaceutical treatment approaches
    (MDPI, 2023) Değirmenci, Yıldız; Angelopoulou, Efthalia; Georgakopoulou, Vasiliki Epameinondas; Bougea, Anastasia
    Cognitive impairment in patients with Parkinson’s disease (PD), which may occur in various severities, represents one of the commonest and most disabling non-motor manifestations during the course of the disease, causing a negative impact on patients’ quality of life. Eventually, it becomes a burden for the family members and/or the caregivers of patients, as it progresses to PD dementia. Current pharmacological treatments for cognitive impairment in PD exhibit partial efficacy, while novel effective therapeutic strategies are required. Accumulating preclinical and clinical evidence shows that several agents may provide beneficial effects on patients with PD and cognitive impairment, including ceftriaxone, ambroxol, intranasal insulin, nilotinib, atomoxetine, mevidalen, blarcamesine, prasinezumab, SYN120, ENT-01, NYX-458, GRF6021, fosgonimeton, INT777, Neuropeptide S, silibinin, osmotin, cordycepin, huperzine A, fibroblast growth factor 21, Poloxamer 188, ginsenoside Rb1, thioredoxin-1, tangeretin, istradefylline, and Eugenia uniflora. Potential underlying mechanisms include the inhibition of a-synuclein aggregation, improvement of mitochondrial function, regulation of synaptic plasticity, impact on gut-brain axis, modulation of neuroinflammation, upregulation of neurotrophic factors, as well as cholinergic, dopaminergic, serotoninergic and norepinephrine neurotransmission. In this overview, we aim to cover the clinical aspects of PD associated cognitive impairment, highlighting recent evidence on emerging treatment approaches that are currently under investigation at a preclinical and clinical level.
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    Fluid biomarkers in atypical Parkinsonism: Current state and future perspectives
    (Springer Nature Link, 2025) Bougea, Anastasia; Colosimo, Carlo; Falup‑Pecurariu, Cristian; Palermo, Giovanni; Değirmenci, Yıldız
    Diagnosing Atypical Parkinsonian Syndromes (APS) may be challenging due to overlapping clinical features of Parkinson’s disease (PD), and the lack of pathognomonic diagnostic tests. Fluid biomarkers can be useful tools that make it easier to identify and track diferent APS. Objectives: this narrative review aim to update the current state of fuid biomarker research in APS and their potential implications in clinical practice. A comprehensive literature search was conducted in PubMed and Scopus using the following terms: “Aβ42 amyloid beta with 42 amino acids’’, “ alpha-synuclein’’, “Atypical Parkinso nian Syndromes’’, “corticobasaldegeneration’’, “C reactive protein’’, “cerebrospinal fuid’’, “dementia with Lewy bodies’’, “multiple system atrophy’’, “neuroflament light, oligomericαsyn, phosphorylated α –syn’’, “tau phosphorylated at threonine 181’’, “progressive supranuclear palsy’’, “Seeding Amplifcation Assay’’, “t-tau; total tau”. The lack of high-afnity α-syn antibodies and ligands may contribute to α-syn’s low efcacy as a diagnostic biomarker of APS. Cerebrospinal fuid (CSF) biomarkers refecting Alzheimer pathology, axonal damage (neuroflament light chain) add valuable diagnostic and prog nostic information in the neurochemical characterization of APS. Infammatoryand microRNAs markers need to be further validated before their clinical use. Seeding Amplifcation Assays (SAA), despite their high sensitivity and specifcity, are at this point used only as a research tool, and they are not quantitative or refective of disease severity. Biomarker research for early identifcation and prognosis of APS patients requires multicenter collaboration, validation, and AI-based diagnostics, despite immature biological classifcation systems.