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Reilly J, Rodriguez AD, Lamy M, Neils-Strunjas J. Cognition, language, and clinical pathological features of non-Alzheimer's dementias: an overview. JOURNAL OF COMMUNICATION DISORDERS 2010; 43:438-52. [PMID: 20493496 PMCID: PMC2922444 DOI: 10.1016/j.jcomdis.2010.04.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 04/04/2010] [Accepted: 04/19/2010] [Indexed: 05/29/2023]
Abstract
UNLABELLED There are many distinct forms of dementia whose pharmacological and behavioral management differ. Differential diagnosis among the dementia variants currently relies upon a weighted combination of genetic and protein biomarkers, neuroanatomical integrity, and behavior. Diagnostic specificity is complicated by a high degree of overlap in the initial presenting symptoms across dementia subtypes. For this reason, reliable markers are of considerable diagnostic value. Communication disorders have proven to be among the strongest predictors for discriminating among dementia subtypes. As such, speech-language pathologists may be poised to make an increasingly visible contribution to dementia diagnosis and its ongoing management. The value and durability of this potential contribution, however, demands an improved discipline-wide knowledge base about the unique features associated with different dementia variants. To this end we provide an overview of cognition, language, and clinical pathological features of four of the most common non-Alzheimer's dementias: frontotemporal dementia, vascular dementia, Lewy body disease dementia, and Parkinson's disease dementia. LEARNING OUTCOMES Readers will learn characteristics and distinguishing features of several non-Alzheimer's dementias, including Parkinson's disease dementia, frontotemporal dementia, vascular dementia, and Lewy body dementia. Readers will also learn to distinguish between several variants of frontotemporal dementia. Finally, readers will gain knowledge of the term primary progressive aphasia as it relates to the aforementioned dementia etiologies.
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Affiliation(s)
- Jamie Reilly
- Department of Speech, Language, and Hearing Sciences, University of Florida, P.O. Box 117420, Dauer Hall, Gainesville, FL 32610, United States.
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102
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Bodden ME, Mollenhauer B, Trenkwalder C, Cabanel N, Eggert KM, Unger MM, Oertel WH, Kessler J, Dodel R, Kalbe E. Affective and cognitive Theory of Mind in patients with parkinson's disease. Parkinsonism Relat Disord 2010; 16:466-70. [PMID: 20538499 DOI: 10.1016/j.parkreldis.2010.04.014] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 02/24/2010] [Accepted: 04/27/2010] [Indexed: 11/29/2022]
Abstract
Theory of Mind (ToM), which is the ability to infer other people's mental states such as beliefs or desires, is an important prerequisite for social interaction. Affective and cognitive subcomponents of ToM can be impaired selectively in neurological and psychiatric disorders. This study examines ToM in 21 Parkinson's disease (PD) patients and 21 healthy control (HC) subjects, using the computerized "Yoni task" that assesses affective and cognitive ToM abilities and an extensive battery of neuropsychological tests. Furthermore, questionnaires to assess health-related quality of life and depressive symptoms were applied and correlations to ToM were investigated. Compared to the control subjects, PD patients scored lower on both the affective (PD: 76% versus HC: 89%; p = 0.006) and cognitive (PD: 80% versus HC: 92%; p = 0.002) ToM subscales but not on control items (PD: 90% versus HC: 95%; p = 0.077). The ToM abilities were not associated with other cognitive functions, depressive symptoms or clinical data. However, affective ToM was correlated with health-related quality of life (p = 0.01). Parkinson patients are impaired in affective as well as cognitive ToM. These deficits are largely independent from other cognitive impairments, depressive symptoms and motor impairment. The relationship of affective ToM to the health-related quality of life of PD patients points to a clinical relevance of this issue and suggests that ToM dysfunctions must be regarded as an important non-motor feature of Parkinson's disease.
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Affiliation(s)
- Maren E Bodden
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
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103
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Taylor TN, Greene JG, Miller GW. Behavioral phenotyping of mouse models of Parkinson's disease. Behav Brain Res 2010; 211:1-10. [PMID: 20211655 DOI: 10.1016/j.bbr.2010.03.004] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 03/01/2010] [Indexed: 11/25/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative movement disorder afflicting millions of people in the United States. The advent of transgenic technologies has contributed to the development of several new mouse models, many of which recapitulate some aspects of the disease; however, no model has been demonstrated to faithfully reproduce the full constellation of symptoms seen in human PD. This may be due in part to the narrow focus on the dopamine-mediated motor deficits. As current research continues to unmask PD as a multi-system disorder, animal models should similarly evolve to include the non-motor features of the disease. This requires that typically cited behavioral test batteries be expanded. The major non-motor symptoms observed in PD patients include hyposmia, sleep disturbances, gastrointestinal dysfunction, autonomic dysfunction, anxiety, depression, and cognitive decline. Mouse behavioral tests exist for all of these symptoms and while some models have begun to be reassessed for the prevalence of this broader behavioral phenotype, the majority has not. Moreover, all behavioral paradigms should be tested for their responsiveness to L-DOPA so these data can be compared to patient response and help elucidate which symptoms are likely not dopamine-mediated. Here, we suggest an extensive, yet feasible, battery of behavioral tests for mouse models of PD aimed to better assess both non-motor and motor deficits associated with the disease.
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Affiliation(s)
- Tonya N Taylor
- Center for Neurodegenerative Disease, Emory University, Atlanta, GA 30322, United States
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104
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Characteristics of executive function impairment in Parkinson's disease patients without dementia. J Int Neuropsychol Soc 2010; 16:268-77. [PMID: 20003582 DOI: 10.1017/s1355617709991299] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Executive function impairments in Parkinson's disease (PD) are well documented. However, uncertainties remain regarding the impact of these deficits on other areas of cognitive functioning. The goal of this study was to provide a comprehensive assessment of cognitive characteristics in patients with PD without dementia and to assess how any such deficits affected other areas of cognitive functioning. Forty PD patients without dementia were compared to healthy controls using measures of attention and speed of processing and a comprehensive set of executive function tests including working memory, planning, and problem solving. Measures of memory/learning and visuospatial skills were also included to examine the relationship between aspects of executive function and other areas of cognition. Patients with PD showed deficits on measures of executive function, problem solving, and visuospatial skills. However, they were unimpaired on measures of planning, attention, and memory/learning. Deficits in problem solving were only evident for tasks with a high visuospatial content and were no longer significant when visuospatial skills were controlled for. While deficits in executive function and visuospatial skills were apparent for PD patients compared to controls, many aspects of cognition remained intact. These can provide a focus for cognitive intervention strategies that can be effective in delaying decline for PD patients.
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105
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Balas M, Balash Y, Giladi N, Gurevich T. Cognition in multiple system atrophy: neuropsychological profile and interaction with mood. J Neural Transm (Vienna) 2010; 117:369-75. [PMID: 20091064 DOI: 10.1007/s00702-009-0365-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 12/23/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Meirav Balas
- Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
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106
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Nobili F, Campus C, Arnaldi D, De Carli F, Cabassi G, Brugnolo A, Dessi B, Morbelli S, Sambuceti G, Abbruzzese G, Rodriguez G. Cognitive-nigrostriatal relationships in de novo, drug-naïve Parkinson's disease patients: A [I-123]FP-CIT SPECT study. Mov Disord 2010; 25:35-43. [DOI: 10.1002/mds.22899] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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107
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Beste C, Willemssen R, Saft C, Falkenstein M. Response inhibition subprocesses and dopaminergic pathways: Basal ganglia disease effects. Neuropsychologia 2010; 48:366-73. [DOI: 10.1016/j.neuropsychologia.2009.09.023] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 08/21/2009] [Accepted: 09/21/2009] [Indexed: 12/01/2022]
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108
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109
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Kwak Y, Müller MLTM, Bohnen NI, Dayalu P, Seidler RD. Effect of dopaminergic medications on the time course of explicit motor sequence learning in Parkinson's disease. J Neurophysiol 2009; 103:942-9. [PMID: 20018839 DOI: 10.1152/jn.00197.2009] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The capacity to learn new motor sequences is fundamental to adaptive motor behavior. The early phase of motor sequence learning relies on the ventral and anterior striatal circuitry, whereas the late phase relies on the dorsal and posterior striatal circuitry. Early Parkinson's disease (PD) is mainly characterized by dopaminergic denervation of the dorsal and posterior striatum while sparing anterior and ventral regions. Dopaminergic medication improves dorsal and posterior striatum function by compensating for the loss of dopamine. However, previous work has shown that dopaminergic medication interferes with the ventral and anterior striatum function by overdosing this relatively intact structure in early-state PD. Here we test whether these effects are also observed over the time course of motor sequence learning. Fourteen PD patients ON and OFF dopaminergic medications and 11 healthy age-matched control participants performed an explicit motor sequence learning task. When sequence learning was compared across different learning phases in patients ON and OFF medication, a significant impairment associated with medication was observed in the early relative to later phases of learning. The rate of learning in the early phase measured trial by trial in patients ON medication was significantly slower than that in controls and when patients were OFF medication. No significant impairment was found in the later learning phases. These results demonstrate that dopaminergic medications may selectively impair early-phase motor sequence learning. These results extend and generalize the dopamine overdose effects previously reported for (antero)ventral striatum-mediated cognitive tasks to motor sequence learning.
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Affiliation(s)
- Youngbin Kwak
- Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
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110
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Maetzler W, Liepelt I, Berg D. Progression of Parkinson's disease in the clinical phase: potential markers. Lancet Neurol 2009; 8:1158-71. [PMID: 19909914 DOI: 10.1016/s1474-4422(09)70291-1] [Citation(s) in RCA: 207] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Neuromodulatory or even neuroprotective therapy could soon be available for Parkinson's disease (PD), raising the question of how we should define and measure disease progression. Reported evidence suggests that several symptoms worsen with disease duration. Bradykinesia, rigidity, and activities of daily living deteriorate faster at the beginning of the disease, and this deterioration is paralleled by a decline in functional presynaptic dopaminergic activity, as shown by imaging techniques. Cognitive, speech, sleep, and gait difficulties might progress linearly in proportion to disease duration. Reduced variability in heart rate, orthostatic dysfunction, and visual hallucinations start to develop at mid-stage disease and are more common in late stages than earlier stages. In this Review, we summarise our current understanding of the progression of PD-associated symptoms and markers and conclude that an effective measurement of progression of PD must adapt to the different stages of the disease. In addition to routine clinical rating scales, new quantitative assessments of motor and non-motor symptoms, which should be more broadly available, reasonably priced, and easy-to-use, are needed.
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Affiliation(s)
- Walter Maetzler
- Center of Neurology, Department of Neurodegeneration and Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
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111
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Bodden ME, Dodel R, Kalbe E. Theory of mind in Parkinson's disease and related basal ganglia disorders: A systematic review. Mov Disord 2009; 25:13-27. [DOI: 10.1002/mds.22818] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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112
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Borghammer P, Østergaard K, Cumming P, Gjedde A, Rodell A, Hall N, Chakravarty MM. A deformation-based morphometry study of patients with early-stage Parkinson's disease. Eur J Neurol 2009; 17:314-20. [PMID: 19912319 DOI: 10.1111/j.1468-1331.2009.02807.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Previous volumetric magnetic resonance imaging (MRI) studies of Parkinson's disease (PD) utilized primarily voxel-based morphometry (VBM), and investigated mostly patients with moderate- to late-stage disease. We now use deformation-based morphometry (DBM), a method purported to be more sensitive than VBM, to test for atrophy in patients with early-stage PD. METHODS T1-weighted MRI images from 24 early-stage PD patients and 26 age-matched normal control subjects were compared using DBM. Two separate studies were conducted, where two minimally-biased nonlinear intensity-average were created; one for all subjects and another for just the PD patients. The DBM technique creates an average population-based MRI-average in an iterative hierarchical fashion. The nonlinear transformations estimated to match each subject to the MRI-average were then analysed. RESULTS The DBM comparison between patients and controls revealed significant contraction in the left cerebellum, and non-significant trends towards frontal, temporal and cingulate sulcal expansions with frontal and temporal white matter contractions. Within the patient group, the unified PD rating scores were highly correlated with local expansions in or near sulci bordering on frontal and temporal cortex. CONCLUSION Our results suggest that DBM could be a sensitive method for detecting morphological changes in early-stage PD.
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Affiliation(s)
- P Borghammer
- PET Centre, Aarhus University Hospitals, Aarhus, Denmark.
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113
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Carbon M, Reetz K, Ghilardi MF, Dhawan V, Eidelberg D. Early Parkinson's disease: longitudinal changes in brain activity during sequence learning. Neurobiol Dis 2009; 37:455-60. [PMID: 19900556 DOI: 10.1016/j.nbd.2009.10.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 10/29/2009] [Accepted: 10/31/2009] [Indexed: 11/13/2022] Open
Abstract
Impairment of sequence learning is common in Parkinson's disease (PD), but the time course of this cognitive abnormality is not known. We assessed longitudinal changes in sequence learning performance and associated task-related cerebral blood flow in 13 early stage PD patients who underwent H(2)(15)O PET at baseline and again 2 years later. Ten healthy volunteer subjects served as controls. A trend toward decline in learning performance (p=0.08) was evident over the 2 years of follow-up. During this interval, significant declines in learning-related activation were detected in parietal and temporo-occipital association areas and in the right dorsolateral prefrontal cortex. Learning-related activation in these regions was normal at baseline, but declined to subnormal levels (p<0.01) at 2 years. Significant hippocampal activation (p<0.005) was present in the subjects with high learning performance over time. The findings are consistent with a decline in learning-related neural activity in cortical areas with prominent Lewy body formation.
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Affiliation(s)
- Maren Carbon
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY 11030, USA.
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114
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Saka E, Elibol B. Enhanced cued recall and clock drawing test performances differ in Parkinson's and Alzheimer's disease-related cognitive dysfunction. Parkinsonism Relat Disord 2009; 15:688-91. [DOI: 10.1016/j.parkreldis.2009.04.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2008] [Revised: 02/27/2009] [Accepted: 04/23/2009] [Indexed: 11/25/2022]
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115
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Kalaitzakis ME, Pearce RKB. The morbid anatomy of dementia in Parkinson's disease. Acta Neuropathol 2009; 118:587-98. [PMID: 19820956 DOI: 10.1007/s00401-009-0597-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 10/02/2009] [Accepted: 10/02/2009] [Indexed: 12/31/2022]
Abstract
Dementia in Parkinson's disease (PD/PDD) is a common complication with a prevalence of up to 50%, but the specific changes underlying the cognitive decline remain undefined. Neuronal degeneration resulting in the dysfunction of multiple subcortical neurochemical projection systems has been described along with Lewy body-type pathology in cortical and limbic regions. Advanced alpha-synuclein (alphaSyn) pathology is not necessarily sufficient for producing dementia and concomitant Alzheimer's disease (AD) change has also been proposed as a possible substrate of PDD. A lack of consensus in the extant literature likely stems from clinical heterogeneity and variable reliability in clinical characterisation as well as other historical and methodological issues. The concurrent presence of abnormally deposited alphaSyn, amyloid-beta and tau proteins in the PDD brain and the interaction of these molecules in a linked pathological cascade of AD and PD-related mechanisms may prove important in determining the underlying pathological process for the development of dementia in PD and this concept of combined pathologies awaits further investigation.
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Affiliation(s)
- Michail E Kalaitzakis
- Neuropathology Unit, Division of Neuroscience and Mental Health, Department of Clinical Neuroscience, Imperial College Healthcare NHS Trust, Charing Cross Campus, Fulham Palace Road, London W6 8RF, UK.
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116
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Dissociation of decision-making under ambiguity and decision-making under risk in patients with Parkinson's disease: A neuropsychological and psychophysiological study. Neuropsychologia 2009; 47:2882-90. [PMID: 19545579 DOI: 10.1016/j.neuropsychologia.2009.06.014] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2008] [Revised: 05/07/2009] [Accepted: 06/14/2009] [Indexed: 11/22/2022]
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117
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Abstract
Parkinson's disease has now evolved beyond what was considered to be a traditional motor disorder. It is being increasingly recognized that non-motor symptoms such as cognitive impairment, frank dementia, psychosis, depression, autonomic dysfunction and sleep disturbances are just as integral to the disease spectrum. The cholinergic system has been proposed to play a pivotal role in cognitive dysfunction. Based on interpretation of clinical studies in patients with Alzheimer's, cholinesterase inhibitors have also been studied for dementia associated with Parkinson's disease. Most of these include large and small placebo-controlled studies and several pilot studies have indicated that cholinesterase inhibitors have a favorable effect on cognition, psychiatric symptoms and global function in Parkinson's disease dementia. A large randomized placebo-controlled clinical trial showed that rivastigmine had moderate improvement in dementia associated with Parkinson's disease. The magnitude of effects in terms of scores for the cognitive subscale of the Alzheimer's disease assessment scale and Alzheimer's disease cooperative study-clinicians global impression of change were similar to those observed among patients with Alzheimer's disease who were treated with cholinesterase inhibitors. A transdermal patch which gradually releases rivastigmine over the application period is now available for use in mild to moderate dementia associated with Parkinson's disease and Alzheimer's disease.
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Affiliation(s)
- Shilpa Chitnis
- UT Southwestern Medical Center-Neurology, 5323 Harry Hines Blvd, Dallas, Texas 75390-9036, USA.
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118
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Kurz MW, Dekomien G, Nilsen OB, Larsen JP, Aarsland D, Alves G. APOE alleles in Parkinson disease and their relationship to cognitive decline: a population-based, longitudinal study. J Geriatr Psychiatry Neurol 2009; 22:166-70. [PMID: 19321880 DOI: 10.1177/0891988709332945] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Apolipoprotein E gene alleles have been linked to various cardiovascular and neurodegenerative disorders. There have been conflicting reports of associations between Apolipoprotein E alleles and Parkinson disease and Parkinson disease dementia. To investigate the role of Apolipoprotein E alleles in Parkinson disease and Parkinson disease dementia, we have determined Apolipoprotein E genotypes in a group of patients with Parkinson disease (n = 95) and compared them with those of healthy control participants (n = 73). Additionally, in 64 longitudinally followed patients with Parkinson disease, the allele types were correlated to development and progression of dementia and to time from onset of Parkinson disease to dementia using multivariate and survival analyses. The Apolipoprotein E e4e4 genotype was more common in patients with Parkinson disease (7.4%) than in healthy controls (1.4%; P = .03). No significant associations between the Apolipoprotein E genotype and development and progression of dementia or time to dementia were found. More studies with larger Parkinson disease samples are warranted.
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119
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Depression Impairs Executive Functioning in Parkinson Disease Patients With Low Educational Level. Cogn Behav Neurol 2009; 22:167-72. [DOI: 10.1097/wnn.0b013e3181b278f9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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120
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Zoccolella S, dell'Aquila C, Abruzzese G, Antonini A, Bonuccelli U, Canesi M, Cristina S, Marchese R, Pacchetti C, Zagaglia R, Logroscino G, Defazio G, Lamberti P, Livrea P. Hyperhomocysteinemia in levodopa-treated patients with Parkinson's disease dementia. Mov Disord 2009; 24:1028-33. [PMID: 19353704 DOI: 10.1002/mds.22511] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Dementia is a frequent non-motor feature of Parkinson's disease (PD). Elevated plasma homocysteine (Hcy) levels have been associated with both cognitive impairment and dementia. Increased Hcy levels have been observed in levodopa-treated patients with PD. The objective of our study was to evaluate the association between plasma Hcy levels and dementia in PD. We performed a multicenter cross-sectional study on patients with PD with (PDD) and without (PDnD) dementia and age- and sex-matched healthy controls. We compared Hcy levels in patients with PDD and PDnD and healthy controls, and we performed logistic regression analysis to search for an association between the presence of dementia and increased Hcy levels in PD. Patients with PD (121), PDD (42), and PDnD (79), and age- and sex-matched controls (154) were enrolled. Hcy levels were higher in patients with PD compared to controls (17.5 micromol/L +/- 10.2 vs. 11 +/- 4.1; P < 0.00001). Among patients with PD, Hcy levels were higher in the PDD group compared to the PDnD group (20.7 micromol/L +/- 12.1 vs. 15.8 +/- 8.5; P = 0.002). In a multivariate logistic regression model, higher Hcy levels [Odds ratios comparing the top (>18.9 micromol/L) with the bottom tertile (<12.4 micromol/L): 3.68; 95% CI: 1.14-11.83] were significantly associated with dementia. These data support the association between elevated Hcy levels and the presence of dementia in PD.
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Affiliation(s)
- Stefano Zoccolella
- Clinic of Nervous System Diseases, Medical and Neurological Sciences, Azienda Ospedaliero-Universitaria Ospedali Riuniti, University of Foggia, Italy
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121
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Luchtman DW, Shao D, Song C. Behavior, neurotransmitters and inflammation in three regimens of the MPTP mouse model of Parkinson's disease. Physiol Behav 2009; 98:130-8. [DOI: 10.1016/j.physbeh.2009.04.021] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 04/24/2009] [Accepted: 04/27/2009] [Indexed: 01/19/2023]
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122
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Liepelt I, Reimold M, Maetzler W, Godau J, Reischl G, Gaenslen A, Herbst H, Berg D. Cortical hypometabolism assessed by a metabolic ratio in Parkinson's disease primarily reflects cognitive deterioration-[18
F]FDG-PET. Mov Disord 2009; 24:1504-11. [DOI: 10.1002/mds.22662] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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123
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Graziottin A, Serafini A. Depression and the menopause: why antidepressants are not enough? ACTA ACUST UNITED AC 2009; 15:76-81. [DOI: 10.1258/mi.2009.009021] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Gender differences, related to varying sexual hormone levels and hormone secretion patterns across the lifespan, contribute to women's vulnerability to mood disorders and major depression. Women are more prone than men to depression, from puberty onwards, with a specific exposure across the menopausal transition. However, controversy still exists in considering fluctuation/loss of estrogen as a specific aetiologic factor contributing to depression in perimenopause and beyond. Aims To briefly review the interaction between changes in menopausal hormone levels, mood disorders, associated neuropsychological co-morbidities and ageing, and to evaluate the currently available therapeutic options for perimenopausal mood disorders: (a) treatment of light to moderate mood disorders with hormonal therapy (HT); (b) treatment of major depression with antidepressants; (c) the synergistic effect between HT and antidepressants in treating menopausal depression. Results Depression across the menopause has a multifactorial aetiology. Predictive factors include: previous depressive episodes such as premenstrual syndrome and/or postpartum depression; co-morbidity with major menopausal symptoms, especially hot flashes, nocturnal sweating, insomnia; menopause not treated with HT; major existential stress; elevated body mass index; low socioeconomic level and ethnicity. Postmenopausal depression is more severe, has a more insidious course, is more resistant to conventional antidepressants in comparison with premenopausal women and has better outcomes when antidepressants are combined with HT. Conclusion The current evidence contributes to a re-reading of the relationship between menopause and depression. The combination of the antidepressant with HT seems to offer the best therapeutic potential in terms of efficacy, rapidity of improvement and consistency of remission in the follow-up.
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Affiliation(s)
| | - Audrey Serafini
- IRCCS San Raffaele Department of Obstetrics and Gynecology, Milan, Italy
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124
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Gómez A, Ferrer I. Increased oxidation of certain glycolysis and energy metabolism enzymes in the frontal cortex in Lewy body diseases. J Neurosci Res 2009; 87:1002-13. [PMID: 18855937 DOI: 10.1002/jnr.21904] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Lipoxidative damage of aldolase A, enolase 1, and glyceraldehyde dehydrogenase (GAPDH) was found in the frontal cortex in a percentage of aged controls by bidimensional gel electrophoresis, Western blot test, in-gel digestion, and mass spectrometry. Aldolase A and enolase 1 were altered in 12 of 19 cases, whereas oxidation of GAPDH was found in 6 of 19 controls. The three enzymes were oxidized in the frontal cortex in the majority of cases of incidental Parkinson's disease (iPD), PD, and dementia with Lewy bodies (DLB). Differences were statistically significant (chi(2) test) for GAPDH in PD and DLB. Densitometric studies have shown that the ratio of oxidized protein per spot is higher in iPD, PD, and DLB compared with controls. These findings show oxidation of three enzymes linked with glycolysis and energy metabolism in the adult human brain as well as increased oxidation of aldolase A, enolase 1, and GAPDH in the frontal cortex in Lewy body diseases. Modifications of these enzymes may result in decreased activity and may partly account for impaired metabolism and function of the frontal lobe in PD.
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Affiliation(s)
- Anna Gómez
- Institut Neuropatologia, Servei Anatomia Patològica, Idibell-Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
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Louis ED. Factor analysis of motor and nonmotor signs in essential tremor: are these signs all part of the same underlying pathogenic process? Neuroepidemiology 2009; 33:41-6. [PMID: 19365141 DOI: 10.1159/000211952] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 02/18/2009] [Indexed: 11/19/2022] Open
Abstract
Essential tremor (ET) has traditionally been viewed as monosymptomatic. However, there is an emerging appreciation of an expanded number of motor manifestations as well as a new awareness of nonmotor manifestations. The current goal, through factor analyses, was to determine how these diverse signs relate to one another and shed light on their pathogenic bases. One hundred and thirty-eight ET patients had detailed neurological examinations. In these analyses, three separate factors emerged, explaining 58.7% of the variance. Factor I was comprised of the hallmark feature of ET, action tremor. It also included intention tremor, which is generally viewed as a sign of cerebellar dysfunction, and tremor duration. Factor II was comprised of cognitive test scores and age, and factor III, of rest tremor. Cognitive test scores did not fall into the same domain as motor features or tremor duration. These results suggest that: (1) the process that underlies cognitive dysfunction in ET is distinct from that which is responsible for action and intention tremors and their progression over time, and (2) cognitive dysfunction in ET is not likely due to cerebellar degeneration. Age loaded with cognitive test scores, further raising the possibility that age-related processes (e.g. Alzheimer-type changes) could underlie cognitive changes in ET.
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Affiliation(s)
- Elan D Louis
- GH Sergievsky Center, Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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McAuley MT, Kenny RA, Kirkwood TBL, Wilkinson DJ, Jones JJL, Miller VM. A mathematical model of aging-related and cortisol induced hippocampal dysfunction. BMC Neurosci 2009; 10:26. [PMID: 19320982 PMCID: PMC2680862 DOI: 10.1186/1471-2202-10-26] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 03/25/2009] [Indexed: 11/23/2022] Open
Abstract
Background The hippocampus is essential for declarative memory synthesis and is a core pathological substrate for Alzheimer's disease (AD), the most common aging-related dementing disease. Acute increases in plasma cortisol are associated with transient hippocampal inhibition and retrograde amnesia, while chronic cortisol elevation is associated with hippocampal atrophy. Thus, cortisol levels could be monitored and managed in older people, to decrease their risk of AD type hippocampal dysfunction. We generated an in silicomodel of the chronic effects of elevated plasma cortisol on hippocampal activity and atrophy, using the systems biology mark-up language (SBML). We further challenged the model with biologically based interventions to ascertain if cortisol associated hippocampal dysfunction could be abrogated. Results The in silicoSBML model reflected the in vivoaging of the hippocampus and increased plasma cortisol and negative feedback to the hypothalamic pituitary axis. Aging induced a 12% decrease in hippocampus activity (HA), increased to 30% by acute and 40% by chronic elevations in cortisol. The biological intervention attenuated the cortisol associated decrease in HA by 2% in the acute cortisol simulation and by 8% in the chronic simulation. Conclusion Both acute and chronic elevations in cortisol secretion increased aging-associated hippocampal atrophy and a loss of HA in the model. We suggest that this first SMBL model, in tandem with in vitroand in vivostudies, may provide a backbone to further frame computational cortisol and brain aging models, which may help predict aging-related brain changes in vulnerable older people.
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Affiliation(s)
- Mark T McAuley
- Henry Wellcome Building, Biogerontology Building, Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, England, NE4 6BE, UK.
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Jesse S, Steinacker P, Lehnert S, Gillardon F, Hengerer B, Otto M. Neurochemical approaches in the laboratory diagnosis of Parkinson and Parkinson dementia syndromes: a review. CNS Neurosci Ther 2009; 15:157-82. [PMID: 19298613 PMCID: PMC2730483 DOI: 10.1111/j.1755-5949.2008.00064.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The diagnosis of Parkinson disease (PD) is rendered on the basis of clinical parameters, whereby laboratory chemical tests or morphological imaging is only called upon to exclude other neurodegenerative diseases. The differentiation between PD and other diseases of the basal ganglia, especially the postsynaptic Parkinson syndromes multisystem atrophy (MSA) and progressive supranuclear palsy (PSP), is of decisive importance, on the one hand, for the response to an appropriate therapy, and on the other hand, for the respective prognosis of the disease. However, particularly at the onset of symptoms, it is difficult to precisely distinguish these diseases from each other, presenting with an akinetic-rigid syndrome. It is not yet possible to conduct a neurochemical differentiation of Parkinson syndromes. Therefore, a reliable biomarker is still to be found that might predict the development of Parkinson dementia. Since this situation is currently the subject of various different studies, the following synopsis is intended to provide a brief summary of the investigations addressing the field of the early neurochemical differential diagnosis of Parkinson syndromes and the early diagnosis of Parkinson dementia, from direct alpha-synuclein detection to proteomic approaches. In addition, an overview of the tested biomarkers will be given with regard to their possible introduction as a screening method.
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Affiliation(s)
- Sarah Jesse
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Stefan Lehnert
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Frank Gillardon
- Department of CNS Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach/Riß, Germany
| | - Bastian Hengerer
- Department of CNS Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach/Riß, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
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Beste C, Dziobek I, Hielscher H, Willemssen R, Falkenstein M. Effects of stimulus-response compatibility on inhibitory processes in Parkinson’s disease. Eur J Neurosci 2009; 29:855-60. [DOI: 10.1111/j.1460-9568.2009.06621.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ezquerra M, Campdelacreu J, Gaig C, Compta Y, Muñoz E, Martí MJ, Valldeoriola F, Tolosa E. Lack of association of APOE and tau polymorphisms with dementia in Parkinson’s disease. Neurosci Lett 2008; 448:20-3. [DOI: 10.1016/j.neulet.2008.10.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2008] [Revised: 09/30/2008] [Accepted: 10/07/2008] [Indexed: 11/25/2022]
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130
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Current world literature. Trauma and rehabilitation. Curr Opin Neurol 2008; 21:762-4. [PMID: 18989123 DOI: 10.1097/wco.0b013e32831cbb85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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131
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Lee PH, Yong SW, An YS. Changes in Cerebral Glucose Metabolism in Patients with Parkinson Disease with Dementia After Cholinesterase Inhibitor Therapy. J Nucl Med 2008; 49:2006-11. [DOI: 10.2967/jnumed.108.054668] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
With an increase in the aging population, the incidence of Parkinson's disease (PD), a disabling neurodegenerative disorder mainly affecting motor function, will inevitably present a challenge to an already overburdened healthcare system. Current medical and surgical therapies offer symptomatic relief but do not provide a cure. Experimental studies suggest that GDNF has the ability to protect degenerating dopamine neurons in PD as well as promote regeneration of the nigrostriatal dopamine system. However, clinical trials of GDNF infusion to date remain inconclusive. This review will examine the experimental and clinical evidence of GDNF use in PD with particular focus on its potential as an effective therapy in the treatment of PD.
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Affiliation(s)
- Murray Hong
- Cell Restoration Laboratory, Departments of Anatomy & Neurobiology & Surgery (Neurosurgery), Dalhousie University, Room 12H1, 5850 College Street, Halifax, Nova Scotia, Canada B3H 1X5
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Dodel R, Csoti I, Ebersbach G, Fuchs G, Hahne M, Kuhn W, Oechsner M, Jost W, Reichmann H, Schulz JB. Lewy body dementia and Parkinson’s disease with dementia. J Neurol 2008; 255 Suppl 5:39-47. [PMID: 18787881 DOI: 10.1007/s00415-008-5007-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Effects of right-unilateral 6-hydroxydopamine infusion-induced memory impairment and oxidative stress: relevance for Parkinson’s disease. Open Life Sci 2008. [DOI: 10.2478/s11535-008-0023-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractMale Wistar rats were subjected to right-unilateral 6-hydroxydopamine (6-OHDA) (2 μg/μl) lesions of the ventral tegmental area (VTA) or the substantia nigra (SN), or were sham-operated, and their ability to acquire the operant task was studied by means of Y-maze and shuttle-box tasks. Lesions of both the VTA and the SN resulted in an impairment of conditioned avoidance response and increase of crossing latency tested by means of shuttle-box task, suggesting significant effects of long-term memory. 6-OHDA significantly decreased spontaneous alternation in Y-maze task, suggesting effects on spatial memory, especially on short-term memory. In addition, 6-OHDA lesions of the VTA and the SN induced reductions in superoxide dismutase (SOD), glutathione peroxidase (GPX) activities and malondialdehyde (MDA) levels in the temporal lobe rather than in the frontal lobe homogenates. Our results provide further support for the toxic effects of 6-OHDA-induced memory impairment and oxidative stress with relevance for Parkinson’s disease.
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