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Shoval G, Stubbs B, Balicer RD, Feldman B, Hoshen M, Zalsman G, Sagy R, Hochman E, Weizman A, Krivoy A. Low adherence to antidepressants is associated with increased mortality in Parkinson disease patients. Parkinsonism Relat Disord 2017; 43:92-96. [PMID: 28797565 DOI: 10.1016/j.parkreldis.2017.07.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/14/2017] [Accepted: 07/31/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The purpose of this study was to evaluate the relationship between adherence to antidepressants (AD) and all-cause mortality in a population-based cohort of patients with Parkinson's Disease (PD). METHODS From a database of more than 4 million people, 8553 patients with PD who purchased an AD at least once between the years 2008-2011 were retrospectively followed for all-cause mortality over 4-years. Adherence was measured as a ratio between dispensed and prescribed durations and was modeled as: non-adherence (<20%, n = 1566), poor (20%-50%, n = 1184), moderate (50%-80%, n = 1584), and good (>80%, n = 4219) adherence. Multivariable survival analyses adjusted for demographic and clinical variables including physical comorbidities known to influence mortality were conducted, however there was no adjustment for other psychiatric disorders and medications. RESULTS Unadjusted mortality rates were 20.4%, 25.1%, 23.4% and 25.6% in those classified as non-adherent, poor, moderate and good adherence respectively (χ2 = 18.45, p < 0.0001). The non-adherent and poor adherence groups had significantly increased adjusted mortality hazard ratios (HR) of 1.43 (CI: 1.26-1.62) and 1.26 (CI: 1.1-1.44) respectively compared to the good adherence group. Using the same model, the adjusted HR for death among males was 1.49 [95% CI: 1.36-1.62] compared to females. People with PD and Charslon's Comorbidity Index score of 3-4 (HR 1.3, P < 0.001) and 5+ (HR 1.78, P < 0.001) were more likely to die than those with 0-2 comorbidities. CONCLUSIONS Our findings suggest that poor adherence to AD is associated with increased all-cause mortality in people with PD. Given the high prevalence of depression and AD effectiveness, efforts to promote adherence should be prioritized in clinical practice.
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Affiliation(s)
- Gal Shoval
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel; Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom
| | - Ran D Balicer
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel; Public Health Department, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Becca Feldman
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel
| | - Moshe Hoshen
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA
| | - Roi Sagy
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eldar Hochman
- Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Krivoy
- Clalit Research Institute, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel; Geha Mental Health Center, Petah Tiqva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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202
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Kim J, Jang S, Choe HK, Chung S, Son GH, Kim K. Implications of Circadian Rhythm in Dopamine and Mood Regulation. Mol Cells 2017; 40:450-456. [PMID: 28780783 PMCID: PMC5547214 DOI: 10.14348/molcells.2017.0065] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 11/30/2022] Open
Abstract
Mammalian physiology and behavior are regulated by an internal time-keeping system, referred to as circadian rhythm. The circadian timing system has a hierarchical organization composed of the master clock in the suprachiasmatic nucleus (SCN) and local clocks in extra-SCN brain regions and peripheral organs. The circadian clock molecular mechanism involves a network of transcription-translation feedback loops. In addition to the clinical association between circadian rhythm disruption and mood disorders, recent studies have suggested a molecular link between mood regulation and circadian rhythm. Specifically, genetic deletion of the circadian nuclear receptor Rev-erbα induces mania-like behavior caused by increased midbrain dopaminergic (DAergic) tone at dusk. The association between circadian rhythm and emotion-related behaviors can be applied to pathological conditions, including neurodegenerative diseases. In Parkinson's disease (PD), DAergic neurons in the substantia nigra pars compacta progressively degenerate leading to motor dysfunction. Patients with PD also exhibit non-motor symptoms, including sleep disorder and neuropsychiatric disorders. Thus, it is important to understand the mechanisms that link the molecular circadian clock and brain machinery in the regulation of emotional behaviors and related midbrain DAergic neuronal circuits in healthy and pathological states. This review summarizes the current literature regarding the association between circadian rhythm and mood regulation from a chronobiological perspective, and may provide insight into therapeutic approaches to target psychiatric symptoms in neurodegenerative diseases involving circadian rhythm dysfunction.
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Affiliation(s)
- Jeongah Kim
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988,
Korea
- Department of Biological Sciences, College of Natural Sciences, Seoul National University, Seoul 08826,
Korea
| | - Sangwon Jang
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988,
Korea
| | - Han Kyoung Choe
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988,
Korea
| | - Sooyoung Chung
- Department of Brain and Cognitive Sciences, Scranton College, Ewha Womans University, Seoul 03760,
Korea
| | - Gi Hoon Son
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02473,
Korea
| | - Kyungjin Kim
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988,
Korea
- Korea Brain Research Institute (KBRI), Daegu 41068,
Korea
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203
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Jellinger KA. Neuropathology of Nonmotor Symptoms of Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:13-62. [PMID: 28802920 DOI: 10.1016/bs.irn.2017.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD), a multiorgan neurodegenerative disorder associated with α-synuclein deposits throughout the nervous system and many organs, is clinically characterized by motor and nonmotor features, many of the latter antedating motor dysfunctions by 20 or more years. The causes of the nonmotor manifestations such as olfactory, autonomic, sensory, neuropsychiatric, visuospatial, sleep, and other disorders are unlikely to be related to single lesions. They are mediated by the involvement of both dopaminergic and nondopaminergic systems, and diverse structures outside the nigrostriatal system that is mainly responsible for the motor features of PD. The nonmotor alterations appear in early/prodromal stages of the disease and its further progression, suggesting a topographical and chronological spread of the lesions. This lends further support for the notion that PD is a multiorgan proteinopathy, although the exact relationship between presymptomatic and later developing nonmotor features of PD and neuropathology awaits further elucidation.
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204
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Leinartaité L, Svenningsson P. Folding Underlies Bidirectional Role of GPR37/Pael-R in Parkinson Disease. Trends Pharmacol Sci 2017. [PMID: 28629580 DOI: 10.1016/j.tips.2017.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Since conformational flexibility, which is required for the function of a protein, comes at the expense of structural stability, many proteins, including G-protein-coupled receptors (GPCRs), are under constant risk of misfolding and aggregation. In this regard GPR37 (also named PAEL-R and ETBR-LP-1) takes a prominent role, particularly in relation to Parkinson disease (PD). GPR37 is a substrate for parkin and accumulates abnormally in autosomal recessive juvenile parkinsonism, contributing to endoplasmic reticulum stress and death of dopaminergic neurons. GPR37 also constitutes a core structure of Lewy bodies, demonstrating a more general involvement in PD pathology. However, if folded and matured properly, GPR37 seems to be neuroprotective. Moreover, GPR37 modulates functionality of the dopamine transporter and the dopamine D2 receptor and stimulates dopamine neurotransmission. Here we review the multiple roles of GPR37 with relevance to potential disease modification and symptomatic therapies of PD and highlight unsolved issues in this field.
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Affiliation(s)
- Lina Leinartaité
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
| | - Per Svenningsson
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
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205
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Rutten S, Vriend C, van der Werf YD, Berendse HW, Weintraub D, van den Heuvel OA. The bidirectional longitudinal relationship between insomnia, depression and anxiety in patients with early-stage, medication-naïve Parkinson's disease. Parkinsonism Relat Disord 2017; 39:31-36. [PMID: 28365203 PMCID: PMC5441947 DOI: 10.1016/j.parkreldis.2017.01.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/24/2016] [Accepted: 01/29/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION While anxiety, depression and insomnia frequently (co-)occur in Parkinson's disease (PD) patients, little is known about their temporal relationship. In this study, we tested two hypotheses: i) insomnia predicts an increase in symptoms of depression or anxiety and ii) anxiety or depression at baseline predicts insomnia in PD patients six months later. METHODS We used longitudinal data from a prospective cohort study of early-stage, medication-naïve PD patients. Primary outcome measures were: anxiety symptoms, measured with the State-Trait Anxiety Inventory (STAI); depressive symptoms, measured with the 15-item Geriatric Depression Scale (GDS-15); and insomnia, defined as a score ≥ 2 on item 1.7 of the Movement Disorder Society - Unified Parkinson's Disease Rating Scale. We performed linear and logistic regression analyses, correcting for baseline value of the respective outcome variable. RESULTS Baseline insomnia was not associated with GDS-15 or STAI total score at follow-up. In a post hoc analysis, we found that insomnia predicted a higher STAI State score (B(SE) = 2.50 (1.07), p < 0.05), while the association with the STAI Trait score was not significant. Baseline STAI scores (B(SE) = 0.02 (0.01), p = 0.001) and GDS-15 score (B(SE) = 0.15 (0.05), p < 0.001) were significantly associated with insomnia at follow-up. CONCLUSION Symptoms of anxiety and depression may constitute a risk factor for insomnia in PD. The relationship between insomnia and anxiety is bidirectional, which suggests that both anxiety and sleep disorders can start a negative spiral in PD patients, where one enhances the other. Independent clinical attention for these symptoms in PD patients is therefore warranted.
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Affiliation(s)
- Sonja Rutten
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands.
| | - Chris Vriend
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Henk W Berendse
- Amsterdam Neuroscience, Amsterdam, The Netherlands; Department of Neurology, VUmc, The Netherlands
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, United States
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center (VUmc), The Netherlands; Department of Anatomy & Neurosciences, VUmc, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
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206
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Wei L, Hu X, Zhu Y, Yuan Y, Liu W, Chen H. Aberrant Intra- and Internetwork Functional Connectivity in Depressed Parkinson's Disease. Sci Rep 2017; 7:2568. [PMID: 28566724 PMCID: PMC5451438 DOI: 10.1038/s41598-017-02127-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/06/2017] [Indexed: 01/04/2023] Open
Abstract
Much is known concerning the underlying mechanisms of Parkinson’s disease (PD) with depression, but our understanding of this disease at the neural-system level remains incomplete. This study used resting-state functional MRI (rs-fMRI) and independent component analysis (ICA) to investigate intrinsic functional connectivity (FC) within and between large-scale neural networks in 20 depressed PD (dPD) patients, 35 non-depressed PD (ndPD) patients, and 34 healthy controls (HC). To alleviate the influence caused by ICA model order selection, this work reported results from analyses at 2 levels (low and high model order). Within these two analyses, similar results were obtained: 1) dPD and ndPD patients relative to HC had reduced FC in basal ganglia network (BGN); 2) dPD compared with ndPD patients exhibited increased FC in left frontoparietal network (LFPN) and salience network (SN), and decreased FC in default-mode network (DMN); 3) dPD patients compared to HC showed increased FC between DMN and LFPN. Additionally, connectivity anomalies in the DMN, LFPN and SN correlated with the depression severity in patients with PD. Our findings confirm the involvement of BGN, DMN, LFPN and SN in depression in PD, facilitating the development of more detailed and integrative neural models of PD with depression.
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Affiliation(s)
- Luqing Wei
- Key laboratory of Personality and Cognition, Faculty of Psychology, Southwest University, Chongqing, 400715, P.R. China
| | - Xiao Hu
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Yajing Zhu
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China
| | - Yonggui Yuan
- Department of Psychiatry and Psychosomatics, Affiliated ZhongDa Hospital of Southeast University, Institute of Neuropsychiatry of Southeast University, Nanjing, 210009, P.R. China
| | - Weiguo Liu
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, P.R. China.
| | - Hong Chen
- Key laboratory of Personality and Cognition, Faculty of Psychology, Southwest University, Chongqing, 400715, P.R. China.
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207
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Santiago JA, Bottero V, Potashkin JA. Dissecting the Molecular Mechanisms of Neurodegenerative Diseases through Network Biology. Front Aging Neurosci 2017; 9:166. [PMID: 28611656 PMCID: PMC5446999 DOI: 10.3389/fnagi.2017.00166] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 05/12/2017] [Indexed: 12/27/2022] Open
Abstract
Neurodegenerative diseases are rarely caused by a mutation in a single gene but rather influenced by a combination of genetic, epigenetic and environmental factors. Emerging high-throughput technologies such as RNA sequencing have been instrumental in deciphering the molecular landscape of neurodegenerative diseases, however, the interpretation of such large amounts of data remains a challenge. Network biology has become a powerful platform to integrate multiple omics data to comprehensively explore the molecular networks in the context of health and disease. In this review article, we highlight recent advances in network biology approaches with an emphasis in brain-networks that have provided insights into the molecular mechanisms leading to the most prevalent neurodegenerative diseases including Alzheimer’s (AD), Parkinson’s (PD) and Huntington’s diseases (HD). We discuss how integrative approaches using multi-omics data from different tissues have been valuable for identifying biomarkers and therapeutic targets. In addition, we discuss the challenges the field of network medicine faces toward the translation of network-based findings into clinically actionable tools for personalized medicine applications.
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Affiliation(s)
- Jose A Santiago
- Department of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University of Medicine and ScienceNorth Chicago, IL, United States
| | - Virginie Bottero
- Department of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University of Medicine and ScienceNorth Chicago, IL, United States
| | - Judith A Potashkin
- Department of Cellular and Molecular Pharmacology, The Chicago Medical School, Rosalind Franklin University of Medicine and ScienceNorth Chicago, IL, United States
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208
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Federico A, Trentin M, Zanette G, Mapelli D, Picelli A, Smania N, Tinazzi M, Tamburin S. Diagnosing mild cognitive impairment in Parkinson's disease: which tests perform best in the Italian population? Neurol Sci 2017; 38:1461-1468. [PMID: 28550344 DOI: 10.1007/s10072-017-3000-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 05/17/2017] [Indexed: 08/30/2023]
Abstract
Mild cognitive impairment (MCI) is common in patients with Parkinson's disease (PD) and should be recognized early because it represents a predictor of PD-related dementia and worse disease course. Diagnostic criteria for PD-related MCI (PD-MCI) have recently been defined by a Movement Disorders Society (MDS) task force. The present study explored which neuropsychological tests perform best for a level II (i.e., comprehensive neuropsychological assessment) diagnosis of PD-MCI according to the MDS task force criteria in Italian-speaking PD patients. To this aim, we assessed a comprehensive 23-item neuropsychological battery, derived the best-performing 10-test battery (i.e., two tests per domain for each of the five cognitive domains), and explored its accuracy for diagnosing PD-MCI in comparison to the full battery in a group of PD patients. A secondary aim was to explore the role of this battery for subtyping PD-MCI according to single-domain vs. multiple-domain involvement. The 10-test battery showed 73% sensitivity and 100% specificity for diagnosing PD-MCI, and 69% sensitivity and 100% specificity for PD-MCI subtyping. In patients older than 70 years, we derived a slightly different 10-test battery with 84% sensitivity and 100% specificity for PD-MCI diagnosis, and 86% sensitivity and 100% specificity for PD-MCI subtyping. These 10-item neuropsychological batteries might represent a good trade-off between diagnostic accuracy and time of application, and their role in PD-MCI diagnosis and subtyping should be further explored in future prospective studies.
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Affiliation(s)
- Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Michela Trentin
- Neurology Unit Pederzoli Hospital, Peschiera del Garda, Italy
| | | | - Daniela Mapelli
- Department of General Psychology, Human Inspired Technologies Research Center, University of Padua, Padua, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.,Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.,Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro 10, 37134, Verona, Italy.
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209
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Wang X, Zeng F, Jin WS, Zhu C, Wang QH, Bu XL, Luo HB, Zou HQ, Pu J, Zhou ZH, Cui XP, Wang QS, Shi XQ, Han W, Wu Q, Chen HS, Lin H, Zhang LL, Zhang M, Lian Y, Xu ZQ, Zhou HD, Zhang T, Wang YJ. Comorbidity burden of patients with Parkinson's disease and Parkinsonism between 2003 and 2012: A multicentre, nationwide, retrospective study in China. Sci Rep 2017; 7:1671. [PMID: 28490759 PMCID: PMC5431825 DOI: 10.1038/s41598-017-01795-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 03/31/2017] [Indexed: 01/19/2023] Open
Abstract
Parkinson’s disease (PD) and Parkinsonism are common neurodegenerative disorders with continuously increasing prevalence, causing high global burdens. However, data concerning the comorbidity burden of patients with PD or Parkinsonism in China are lacking. To investigate the health condition and comorbidity burden, a total of 3367 PD and 823 Parkinsonism patients were included from seven tertiary hospitals in seven cities across China from 2003 to 2012. Their comorbidity burden was collected and quantified by the Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI). The comorbidity spectra differed between PD and Parkinsonism patients. Compared with PD patients, Parkinsonism patients were older (69.8 ± 11.5 vs. 67.9 ± 11.4, P < 0.001); had a higher comorbidity burden, including ECI (1.1 ± 1.2 vs. 1.0 ± 1.2, P < 0.001) and CCI (1.3 ± 1.6 vs. 1.1 ± 1.5, P < 0.001); and had higher hospitalization expenses. The ECI (1.1 ± 1.3 vs. 0.9 ± 1.1, P < 0.001) and CCI (1.3 ± 1.6 vs. 0.9 ± 1.2, P < 0.001) were higher in males than in females. The average length of stay and daily hospitalization expenses increased with age, as did ECI and CCI. This is the first study to report the disease burden of Chinese PD and Parkinsonism patients. It provides useful information to better understand their health status, and to raise the awareness of clinicians for providing better health care.
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Affiliation(s)
- Xin Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Fan Zeng
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Wang-Sheng Jin
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Chi Zhu
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Qing-Hua Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Xian-Le Bu
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Hong-Bo Luo
- Department of Neurology, Lanzhou General Hospital, Lanzhou, 730050, China
| | - Hai-Qiang Zou
- Department of Neurology, Guangzhou General Hospital, Guangzhou, 510010, China
| | - Jie Pu
- Department of Neurology, Wuhan General Hospital, Wuhan, 430070, China
| | - Zhong-He Zhou
- Department of Neurology, Shenyang General Hospital, Shenyang, 110016, China
| | - Xiao-Ping Cui
- Department of Neurology, Fuzhou General Hospital, Fuzhou, 350025, China
| | - Qing-Song Wang
- Department of Neurology, Chengdu General Hospital, Chengdu, 610083, China
| | - Xiang-Qun Shi
- Department of Neurology, Lanzhou General Hospital, Lanzhou, 730050, China
| | - Wei Han
- Department of Prevention Medicine, Guangzhou General Hospital, Guangzhou, 510010, China
| | - Qiang Wu
- Department of Neurology, Wuhan General Hospital, Wuhan, 430070, China
| | - Hui-Sheng Chen
- Department of Neurology, Shenyang General Hospital, Shenyang, 110016, China
| | - Hang Lin
- Department of Neurology, Fuzhou General Hospital, Fuzhou, 350025, China
| | - Li-Li Zhang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Meng Zhang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Yan Lian
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.,Department of Preventive Medicine, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Zhi-Qiang Xu
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Hua-Dong Zhou
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
| | - Tao Zhang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
| | - Yan-Jiang Wang
- Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
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210
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Birchall EL, Walker HC, Cutter G, Guthrie S, Joop A, Memon RA, Watts RL, Standaert DG, Amara AW. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson's disease. Brain Stimul 2017; 10:651-656. [PMID: 28065487 PMCID: PMC5410399 DOI: 10.1016/j.brs.2016.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Depression is common in Parkinson's disease (PD) and adversely affects quality of life. Both unilateral and bilateral subthalamic (STN) deep brain stimulation (DBS) effectively treat the motor symptoms of PD, but questions remain regarding the impact of unilateral STN DBS on non-motor symptoms, such as depression. METHODS We report changes in depression, as measured by the Hamilton Depression Rating Scale (HAMD-17), in 50 consecutive PD patients who underwent unilateral STN DBS. Participants were also evaluated with UPDRS part III, Parkinson's Disease Questionnaire-39, and Pittsburgh Sleep Quality Index. The primary outcome was change in HAMD-17 at 6 months versus pre-operative baseline, using repeated measures analysis of variance (ANOVA). Secondary outcomes included the change in HAMD-17 at 3, 12, 18, and 24 months post-operatively and correlations amongst outcome variables using Pearson correlation coefficients. As a control, we also evaluated changes in HAMD-17 in 25 advanced PD patients who did not undergo DBS. RESULTS Participants with unilateral STN DBS experienced significant improvement in depression 6 months post-operatively (4.94 ± 4.02) compared to preoperative baseline (7.90 ± 4.44) (mean ± SD) (p = <0.0001). HAMD-17 scores did not correlate with UPDRS part III at any time-point. Interestingly, the HAMD-17 was significantly correlated with sleep quality and quality of life at baseline, 3 months, and 6 months post-operatively. Participants without DBS experienced no significant change in HAMD-17 over the same interval. CONCLUSION Unilateral STN DBS improves depression 6 months post-operatively in patients with PD. Improvement in depression is maintained over time and correlates with improvement in sleep quality and quality of life.
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Affiliation(s)
- Elizabeth L Birchall
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Harrison C Walker
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States; Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gary Cutter
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Stephanie Guthrie
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allen Joop
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Raima A Memon
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ray L Watts
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David G Standaert
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Amy W Amara
- Division of Movement Disorders, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
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Shin MS, Kim TW, Lee JM, Sung YH, Lim BV. Treadmill exercise alleviates depressive symptoms in rotenone-induced Parkinson disease rats. J Exerc Rehabil 2017; 13:124-129. [PMID: 28503522 PMCID: PMC5412483 DOI: 10.12965/jer.1734966.483] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/18/2017] [Indexed: 11/22/2022] Open
Abstract
Parkinson disease (PD) is characterized by selective loss of the dopaminergic neurons. The symptoms of depression following PD are closely associated with reduced activity of the serotonergic system in the dorsal raphe. We explored the antidepressive effect of exercise and its possible mechanism using the rotenone-induced PD rats. PD rats were induced by subcutaneously injection with rotenone for 14 days. The rats in the exercise groups were made to run on a treadmill for 30 min once a day during 14 consecutive days. Forced swimming test, immunohistochemistry for serotonin (5-hydroxytryptamine, 5-HT), tryptophan hydroxylase (TPH), and western blot for serotonin 1A (5-HT1A) receptor were conducted. Injection of rotenone induced PD rats. PD rats showed depressive state and treadmill exercise ameliorated this depressive state. 5-HT, TPH, and 5-HT1A receptor expressions in the dorsal raphe were suppressed by rotenone injection and treadmill exercise increased the expressions of 5-HT, TPH, and 5-HT1A receptor in the rotenone-injected rats. The present results show that treadmill exercise ameliorated depressive symptoms in the rotenone-induced PD rats. The antidepressive effect of treadmill exercise might be ascribed to the enhancement of serotonergic function through upregulation of 5-HT1A expression in the dorsal raphe.
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Affiliation(s)
- Mal-Soon Shin
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Tae-Woon Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jae-Min Lee
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
| | - Baek-Vin Lim
- Division of Leisure & Sports Science, Department of Exercise Prescription, Dongseo University, Busan, Korea
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212
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Who Can Diagnose Parkinson's Disease First? Role of Pre-motor Symptoms. Arch Med Res 2017; 48:221-227. [DOI: 10.1016/j.arcmed.2017.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/24/2017] [Indexed: 01/15/2023]
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213
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Lehericy S, Vaillancourt DE, Seppi K, Monchi O, Rektorova I, Antonini A, McKeown MJ, Masellis M, Berg D, Rowe JB, Lewis SJG, Williams-Gray CH, Tessitore A, Siebner HR. The role of high-field magnetic resonance imaging in parkinsonian disorders: Pushing the boundaries forward. Mov Disord 2017; 32:510-525. [PMID: 28370449 DOI: 10.1002/mds.26968] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 12/22/2016] [Accepted: 01/15/2017] [Indexed: 12/28/2022] Open
Abstract
Historically, magnetic resonance imaging (MRI) has contributed little to the study of Parkinson's disease (PD), but modern MRI approaches have unveiled several complementary markers that are useful for research and clinical applications. Iron- and neuromelanin-sensitive MRI detect qualitative changes in the substantia nigra. Quantitative MRI markers can be derived from diffusion weighted and iron-sensitive imaging or volumetry. Functional brain alterations at rest or during task performance have been captured with functional and arterial spin labeling perfusion MRI. These markers are useful for the diagnosis of PD and atypical parkinsonism, to track disease progression from the premotor stages of these diseases and to better understand the neurobiological basis of clinical deficits. A current research goal using MRI is to generate time-dependent models of the evolution of PD biomarkers that can help understand neurodegeneration and provide reliable markers for therapeutic trials. This article reviews recent advances in MRI biomarker research at high-field (3T) and ultra high field-imaging (7T) in PD and atypical parkinsonism. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stéphane Lehericy
- Institut du Cerveau et de la Moelle épinière - ICM, Centre de NeuroImagerie de Recherche - CENIR, Sorbonne Universités, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, Department of Neurology and Centre for Movement Disorders and Neurorestoration, Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Klaus Seppi
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria and Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Oury Monchi
- Department of Clinical Neurosciences, Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Irena Rektorova
- First Department of Neurology, School of Medicine, St. Anne's University Hospital, Brain and Mind Research Program, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, istituto di ricovero e cura a carattere scientifico (IRCCS) Hospital San Camillo, Venice and Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Martin J McKeown
- Pacific Parkinson's Research Center, Department of Medicine (Neurology), University of British Columbia Vancouver, BC, Canada
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University of Kiel and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University, and Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Caroline H Williams-Gray
- John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Department of Neurology, Copenhagen University Hospital Bispebjerg, Hvidovre, Denmark
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Naoi M, Maruyama W, Shamoto-Nagai M. Type A monoamine oxidase and serotonin are coordinately involved in depressive disorders: from neurotransmitter imbalance to impaired neurogenesis. J Neural Transm (Vienna) 2017; 125:53-66. [PMID: 28293733 DOI: 10.1007/s00702-017-1709-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/12/2017] [Indexed: 12/30/2022]
Abstract
Type A monoamine oxidase (MAOA) catabolizes monoamine transmitters, serotonin, norepinephrine and dopamine, and plays a major role in the onset, progression and therapy of neuropsychiatric disorders. In depressive disorders, increase in MAOA expression and decrease in brain levels of serotonin and norepinephrine are proposed as the major pathogenic factors. The functional polymorphism of MAOA gene and genes in serotonin signal pathway are associated with depression. This review presents recent advance in studies on the role of MAOA in major depressive disorder and related emotional disorders. MAOA and serotonin regulate the prenatal development and postnatal maintenance of brain architecture and neurocircuit, as shown by MAOA-deficient humans and MAO knockout animal models. Impaired neurogenesis in the mature hippocampus has been proposed as "adult neurogenesis" hypothesis of depression. MAOA modulates the sensitivity to stress in the stages of brain development and maturation, and the interaction of gene-environmental factors in the early stage regulates the onset of depressive behaviors in adulthood. Vice versa environmental factors affect MAOA expression by epigenetic regulation. MAO inhibitors not only restore compromised neurotransmitters, but also protect neurons from cell death in depression through induction of anti-apoptotic Bcl-2 and prosurvival neurotrophic factors, especially brain-derived neurotrophic factor, the deficiency of which is detected in depression. This review discusses novel role of MAOA and serotonin in the pathogenesis and therapy of depressive disorders.
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Affiliation(s)
- Makoto Naoi
- Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, 12 Araike, Iwasaki-cho, Nisshin, Aichi, 320-0195, Japan.
| | - Wakako Maruyama
- Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, 12 Araike, Iwasaki-cho, Nisshin, Aichi, 320-0195, Japan
| | - Masayo Shamoto-Nagai
- Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, 12 Araike, Iwasaki-cho, Nisshin, Aichi, 320-0195, Japan
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Perrin AJ, Nosova E, Co K, Book A, Iu O, Silva V, Thompson C, McKeown MJ, Stoessl AJ, Farrer MJ, Appel-Cresswell S. Gender differences in Parkinson's disease depression. Parkinsonism Relat Disord 2017; 36:93-97. [DOI: 10.1016/j.parkreldis.2016.12.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 12/07/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
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Zheng J, Yang X, Zhao Q, Tian S, Huang H, Chen Y, Xu Y. Association between gene polymorphism and depression in Parkinson's disease: A case-control study. J Neurol Sci 2017; 375:231-234. [PMID: 28320136 DOI: 10.1016/j.jns.2017.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/21/2017] [Accepted: 02/01/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate possible associations of Parkinson's disease (PD) with polymorphism in depression-related genes and in the alpha-synuclein (SNCA) gene. METHODS A consecutive series of patients with PD were divided into those with depression and those without it. Patients (330) were genotyped at four single-nucleotide polymorphisms (SNPs) in four genes previously associated with depression, as well as four SNPs in the PD-associated SNCA gene. RESULTS Of 330 patients, 125 (37.9%) had depression and 205 (62.1%) did not. Univariate analysis revealed significant differences between the two groups in minor allele frequency at the SNP rs1545843 in the SLC6A15 gene (p<0.05), as well as in frequencies of genotypes and minor alleles at rs78162420 in the TPH2 gene (all p<0.05). Logistic regression identified the following risk factors for depression among patients with PD: Hoehn and Yahr stage>2 (OR 1.759, 95%CI 1.035-2.989, p=0.037), AA genotype at rs1545843 (OR 1.866, 95%CI 1.017-3.426, p=0.044), and AC genotype at rs78162420 (OR 5.036, 95%CI 1.451-17.484, p=0.011). CONCLUSIONS Among patients with PD, depression is associated with polymorphism at rs78162420 and rs1545843, both previously linked with depression. Our results may help clarify the pathogenesis of depression in PD.
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Affiliation(s)
- Jinhua Zheng
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Xinglong Yang
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Quanzhen Zhao
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Sijia Tian
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Hongyan Huang
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Yalan Chen
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China
| | - Yanming Xu
- Department of Neurology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, Sichuan Province 610041, PR China.
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217
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Alterations of p11 in brain tissue and peripheral blood leukocytes in Parkinson's disease. Proc Natl Acad Sci U S A 2017; 114:2735-2740. [PMID: 28137881 DOI: 10.1073/pnas.1621218114] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Individuals with Parkinson's disease (PD) often suffer from comorbid depression. P11 (S100A10), a member of the S100 family of proteins, is expressed widely throughout the body and is involved in major depressive disorder and antidepressant response. Central p11 levels are reduced in postmortem tissue from depressed individuals; however, p11 has not yet been investigated in PD patients with depression or those without depression. We investigated p11 levels in postmortem PD brains and assessed whether peripheral p11 levels correlate with disease severity. Substantia nigra, putamen, and cortical p11 protein levels were assessed in postmortem brain samples from PD patients and matched controls. In a different set of postmortem brains, p11 mRNA expression was measured in dopaminergic cells from the substantia nigra. Both p11 protein and mRNA levels were decreased in PD patients. Peripheral p11 protein levels were investigated in distinct leukocyte populations from PD patients with depression and those without depression. Monocyte, natural killer (NK) cell, and cytotoxic T-cell p11 levels were positively associated with the severity of PD, and NK cell p11 levels were positively associated with depression scores. Given that inflammation plays a role in both PD and depression, it is intriguing that peripheral p11 levels are altered in immune cells in both conditions. Our data provide insight into the pathological alterations occurring centrally and peripherally in PD. Moreover, if replicated in other cohorts, p11 could be an easily accessible biomarker for monitoring the severity of PD, especially in the context of comorbid depression.
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Svenningsson P, Pålhagen S, Mathé AA. Neuropeptide Y and Calcitonin Gene-Related Peptide in Cerebrospinal Fluid in Parkinson's Disease with Comorbid Depression versus Patients with Major Depressive Disorder. Front Psychiatry 2017; 8:102. [PMID: 28659833 PMCID: PMC5466951 DOI: 10.3389/fpsyt.2017.00102] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/24/2017] [Indexed: 11/13/2022] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease in the world. The diagnosis of PD is based on movement dysfunctions. Many patients also suffer from comorbid depression in spite of adequate treatment with dopamine replacement, indicating that also other non-dopaminergic mechanisms are involved. Indeed, neuropeptides are critically implicated in the pathophysiology of major depressive disorder (MDD). To increase our understanding of the biochemical basis of depression in PD patients, we examined the levels of neuropeptide Y (NPY) and calcitonin gene-related peptide (CGRP) in cerebrospinal fluid (CSF) from PD patients, with or without comorbid depression, and compared them to the levels in patients with MDD. We also compared the levels of NPY and CGRP with 5-hydroxyindoleacetic acid (5-HIAA), the major serotonin metabolite. Both NPY and CGRP were higher in PD patients with comorbid depression compared to MDD patients. No similar difference was found in 5-HIAA levels. Accordingly, there were no correlations between NPY and 5-HIAA or CGRP and 5-HIAA levels. The finding of higher NPY and CGRP CSF levels in PD patients with MDD raises the possibility that different pathophysiological processes may underlie depression in PD and MDD.
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Affiliation(s)
- Per Svenningsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sven Pålhagen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aleksander A Mathé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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220
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Schrag A, Taddei RN. Depression and Anxiety in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:623-655. [DOI: 10.1016/bs.irn.2017.05.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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221
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Szatmari S, Illigens BMW, Siepmann T, Pinter A, Takats A, Bereczki D. Neuropsychiatric symptoms in untreated Parkinson's disease. Neuropsychiatr Dis Treat 2017; 13:815-826. [PMID: 28352181 PMCID: PMC5360401 DOI: 10.2147/ndt.s130997] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuropsychiatric and cognitive symptoms are common in Parkinson's disease (PD) and may precede and exceed motor symptoms as major factors impacting disease course and quality of life. Neuropsychiatric symptoms (NPS) in PD are various and are attributed to pathologic changes within multiple brain regions, to psychological stress, and to adverse effects of dopamine replacement therapy. Sleep disorders and mood symptoms such as apathy, depression, and anxiety may antedate the development of motor symptoms by years, while other NPS such as impulse control disorders, psychosis, and cognitive impairment are more common in later stages of the disease. Few studies report on NPS in the early, untreated phase of PD. We reviewed the current literature on NPS in PD with a focus on the early, drug-naive stages of PD. Among these early disease stages, premotor and early motor phases were separately addressed in our review, highlighting the underlying pathophysiological mechanisms as well as epidemiological characteristics, clinical features, risk factors, and available techniques of clinical assessment.
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Affiliation(s)
- Szabolcs Szatmari
- Department of Neurology, Sibiu County Emergency Hospital, Sibiu; 2nd Department of Neurology, Targu Mures Emergency Clinical County Hospital, Targu Mures, Romania; János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Timo Siepmann
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Alexandra Pinter
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Family Medicine
| | - Annamaria Takats
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
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Call to Caution with the Use of Atypical Antipsychotics for Treatment of Depression in Older Adults. Geriatrics (Basel) 2016; 1:geriatrics1040033. [PMID: 31022826 PMCID: PMC6371141 DOI: 10.3390/geriatrics1040033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/12/2016] [Accepted: 12/14/2016] [Indexed: 11/30/2022] Open
Abstract
Atypical antipsychotics are increasingly being used to manage depression in older adults where these symptoms can often be refractory to first-line treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). Unfortunately, atypical antipsychotics can be associated with the development of extrapyramidal symptoms (EPS), with drug-induced parkinsonism (DIP) being the most common movement disorder induced by this class of medication. The management of treatment-resistant depression in older adults is of particular concern as depression is a common feature of idiopathic Parkinson’s disease (IPD) and can manifest prior to the development of motor symptoms. Herein, we discuss the use of atypical antipsychotics for the management of depression in older adults including the risk of DIP and propose that antipsychotics may potentially unmask IPD.
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223
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Molina Ruiz RM, Evans AH, Velakoulis D, Looi JC. A guide to management of neuropsychiatric manifestations of Parkinson's disease. Australas Psychiatry 2016; 24:534-537. [PMID: 27329643 DOI: 10.1177/1039856216654394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This clinical update review focuses on treatment approaches of neuropsychiatric manifestations in Parkinson's disease. METHODS We conducted a systematic search of the literature using Pubmed and selected recent and relevant papers for this review. RESULTS Neuropsychiatric symptoms in Parkinson's disease usually require optimization of levodopa therapy as a first step. Most psychotropic drugs can be used in Parkinson's disease, however there is still lack of an evidence base due to limited studies and difficulties in diagnosis of neuropsychiatric disorders. Non-pharmacological treatments have also proved effective in Parkinson's disease. Cognitive impairment requires special consideration. CONCLUSIONS Management of neuropsychiatric manifestations in Parkinson's disease is complicated by the lack of evidence. Treatment should be individualized and benefits and risks must be balanced.
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Affiliation(s)
- Rosa M Molina Ruiz
- Universitary Hospital Fundación Alcorcón, Rey Juan Carlos University, Madrid, Spain
| | - Andrew H Evans
- Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne & Northwestern Mental Health, Melbourne, VIC, Australia
| | - Jeffrey Cl Looi
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne & Northwestern Mental Health, Melbourne, VIC, and; Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Garran, ACT, Australia
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224
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Rutten S, Vriend C, Smit JH, Berendse HW, Hoogendoorn AW, van den Heuvel OA, van der Werf YD. A double-blind randomized controlled trial to assess the effect of bright light therapy on depression in patients with Parkinson's disease. BMC Psychiatry 2016; 16:355. [PMID: 27769202 PMCID: PMC5073442 DOI: 10.1186/s12888-016-1050-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 09/24/2016] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A disturbed circadian rhythm seems to be a causal factor in the occurrence of depressive disorders in patients with Parkinson's disease (PD). The circadian rhythm can be restored with light. Therefore, Bright Light Therapy (BLT) might be a new treatment option for depression in PD patients. METHODS/DESIGN In this double-blind controlled trial, 84 subjects with idiopathic PD are randomized to either BLT or a control light condition. The BLT condition emits white light with an intensity of 10,000 Lux, while the control device emits dim white light of 200 Lux, which is presumed to be too low to influence the circadian rhythm. Subjects receive 30 min of home treatment twice daily for three months. Timing of treatment is based on the individual chronotype. After finishing treatment, subjects enter a follow-up period of six months. The primary outcome of the study is the severity of depressive symptoms, as measured with the Hamilton Depression Rating Scale. Secondary outcomes are alternative depression measures, objective and subjective sleep measures, and salivary melatonin and cortisol concentrations. For exploratory purposes, we also assess the effects on motor symptoms, global cognitive function, comorbid psychiatric disorders, quality of life and caregiver burden. Data will be analyzed using a linear mixed models analysis. DISCUSSION Performing a placebo-controlled trial on the effects of BLT in PD patients is challenging, as the appearance of the light may provide clues on the treatment condition. Moreover, fixed treatment times lead to an improved sleep-wake rhythm, which also influences the circadian system. With our study design, we do not compare BLT to placebo treatment, i.e. an ineffective control treatment. Rather, we compare structuring of the sleep-wake cycle in both conditions with additional BLT in the experimental condition, and additional dim light in the control condition. Participants are not informed about the exact details of the two light devices and the expected therapeutic effect, and expectancies are rated prior to the start of treatment. Ideally, the design of a future study on BLT should include two extra treatment arms where BLT and control light are administered at random times. TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov on May 17th 2012 (ClinicalTrials.gov Identifier: NCT01604876 ).
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Affiliation(s)
- Sonja Rutten
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 887, 1081 HL, Amsterdam, The Netherlands. .,Department of Anatomy and Neurosciences, VU University Medical Center, Gustav Mahlerlaan 3004, 1000 MB, Amsterdam, The Netherlands.
| | - Chris Vriend
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 887, 1081 HL Amsterdam, The Netherlands ,Department of Anatomy and Neurosciences, VU University Medical Center, Gustav Mahlerlaan 3004, 1000 MB Amsterdam, The Netherlands ,Amsterdam Neuroscience, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Jan H. Smit
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 887, 1081 HL Amsterdam, The Netherlands ,Amsterdam Neuroscience, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Henk W. Berendse
- Amsterdam Neuroscience, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands ,Department of Neurology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Adriaan W. Hoogendoorn
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 887, 1081 HL Amsterdam, The Netherlands
| | - Odile A. van den Heuvel
- Department of Psychiatry, VU University Medical Center/GGZ inGeest, A.J. Ernststraat 887, 1081 HL Amsterdam, The Netherlands ,Department of Anatomy and Neurosciences, VU University Medical Center, Gustav Mahlerlaan 3004, 1000 MB Amsterdam, The Netherlands ,Amsterdam Neuroscience, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Ysbrand D. van der Werf
- Department of Anatomy and Neurosciences, VU University Medical Center, Gustav Mahlerlaan 3004, 1000 MB Amsterdam, The Netherlands ,Amsterdam Neuroscience, de Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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225
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Melatoninergic System in Parkinson's Disease: From Neuroprotection to the Management of Motor and Nonmotor Symptoms. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:3472032. [PMID: 27829983 PMCID: PMC5088323 DOI: 10.1155/2016/3472032] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/25/2016] [Indexed: 12/13/2022]
Abstract
Melatonin is synthesized by several tissues besides the pineal gland, and beyond its regulatory effects in light-dark cycle, melatonin is a hormone with neuroprotective, anti-inflammatory, and antioxidant properties. Melatonin acts as a free-radical scavenger, reducing reactive species and improving mitochondrial homeostasis. Melatonin also regulates the expression of neurotrophins that are involved in the survival of dopaminergic neurons and reduces α-synuclein aggregation, thus protecting the dopaminergic system against damage. The unbalance of pineal melatonin synthesis can predispose the organism to inflammatory and neurodegenerative diseases such as Parkinson's disease (PD). The aim of this review is to summarize the knowledge about the potential role of the melatoninergic system in the pathogenesis and treatment of PD. The literature reviewed here indicates that PD is associated with impaired brain expression of melatonin and its receptors MT1 and MT2. Exogenous melatonin treatment presented an outstanding neuroprotective effect in animal models of PD induced by different toxins, such as 6-hydroxydopamine (6-OHDA), 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), rotenone, paraquat, and maneb. Despite the neuroprotective effects and the improvement of motor impairments, melatonin also presents the potential to improve nonmotor symptoms commonly experienced by PD patients such as sleep and anxiety disorders, depression, and memory dysfunction.
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Rosenthal LS, Salnikova YA, Pontone GM, Pantelyat A, Mills KA, Dorsey ER, Wang J, Wu SS, Mari Z. Changes in Verbal Fluency in Parkinson's Disease. Mov Disord Clin Pract 2016; 4:84-89. [PMID: 30713950 DOI: 10.1002/mdc3.12421] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 11/08/2022] Open
Abstract
Background The test for semantic verbal fluency is quick and easy to administer. Decreases in semantic verbal fluency would suggest executive dysfunction among individuals with Parkinson's disease (PD). Methods The National Parkinson Foundation's Outcomes Project is a multicenter study that seeks to determine best practices in PD management. We analyzed data from the baseline and two annual follow-up visits to determine the annual rate of verbal fluency change and determinants of that change. Linear mixed modeling was used to assess relationships between verbal fluency, clinical characteristics, quality of life, and caregiver burden. Results There were 1,322 participants with an average age of 67.3 years, of whom 37% were women. Mean baseline verbal fluency scores at baseline were 18.81 (standard deviation = 6.25). Verbal fluency scores did not change among patients who were at our cohort's average age and average PD duration (8.4 years) and who had no other associated conditions (beta = -0.02; P = 0.80). Verbal fluency, however, did decrease for individuals with PD duration greater than the average (beta = -0.25; P = 0.03), age greater than the average (beta = -0.022; P < 0.01), a Hoehn and Yahr >=3 (beta = -0.31; P = 0.04), and in those with cardiovascular disease (beta = -0.32; P = 0.01) or psychiatric symptomatology (beta = -0.34; P = 0.01). Individuals with higher verbal fluency scores had better quality of life (P < 0.01) and decreased caregiver burden (P < 0.01). Conclusions Clinicians should monitor verbal fluency scores to evaluate cognitive decline among individuals with PD. Modifiable risk factors for verbal fluency changes include psychiatric symptomatology and cardiovascular disease. Clinicians may use verbal fluency testing to identify individuals at risk for decreased quality of life and increased caregiver burden, allowing for focused interventions.
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Affiliation(s)
- Liana S Rosenthal
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Yekaterina A Salnikova
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Gregory M Pontone
- Department of Psychiatry Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Alexander Pantelyat
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Kelly A Mills
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - E Ray Dorsey
- Department of Neurology University of Rochester Medical Center Rochester New York USA
| | - Jiangxia Wang
- Department of Biostatistics Bloomberg School of Public Health Baltimore Maryland USA
| | - Samuel S Wu
- Department of Biostatistics College of Public Health & Health Professions and College of Medicine University of Florida Gainesville Florida USA
| | - Zoltan Mari
- Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA
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227
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Almeida OP, McCaul K, Hankey GJ, Yeap BB, Golledge J, Flicker L. Affective Disorders, Psychosis and Dementia in a Community Sample of Older Men with and without Parkinson's Disease. PLoS One 2016; 11:e0163781. [PMID: 27689715 PMCID: PMC5045171 DOI: 10.1371/journal.pone.0163781] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/14/2016] [Indexed: 12/24/2022] Open
Abstract
Background Dementia and affective and psychotic symptoms are commonly associated with Parkinson’s disease, but information about their prevalence and incidence in community representative samples remains sparse. Methods We recruited a community-representative sample 38173 older men aged 65–85 years in 1996 and used data linkage to ascertain the presence of PD, affective disorders, psychotic disorders and dementia. Diagnoses followed the International Classification of Disease coding system. Age was recorded in years. Follow up data were available until December 2011. Results The mean age of participants was 72.5 years and 333 men (0.9%) had PD at study entry. Affective and psychotic disorders and dementia were more frequent in men with than without PD (respective odds ratios: 6.3 [95%CI = 4.7, 8.4]; 14.2 [95%CI = 8.4, 24.0] and 18.2 [95%CI = 13.4, 24.6]). Incidence rate ratios of affective and psychotic disorders were higher among men with than without PD, although ratios decreased with increasing age. The age-adjusted hazard ratio (HR) of an affective episode associated with PD was 5.0 (95%CI = 4.2, 5.9). PD was associated with an age-adjusted HR of 8.6 (95%CI = 6.1, 12.0) for psychotic disorders and 6.1 (95%CI = 5.5, 6.8) for dementia. PD and dementia increased the HR of depressive and psychotic disorders. Conclusions PD increases the risk of affective and psychotic disorders, as well as dementia, among community dwelling older men. The risk of a recorded diagnosis of affective and psychotic disorders decreases with increasing age.
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Affiliation(s)
- Osvaldo P. Almeida
- School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia
- WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- Department of Psychiatry, Royal Perth Hospital, Perth, Australia
- * E-mail:
| | - Kieran McCaul
- WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
| | - Graeme J. Hankey
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
- Department of Neurology, Sir Charles Gairdner Hospital, Perth, Australia
| | - Bu B. Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
- Department of Endocrinology, Fiona Stanley Hospital, Perth, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Australia
- Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Australia
| | - Leon Flicker
- WA Centre for Health & Ageing of Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
- Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
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228
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Integrative transcriptomic meta-analysis of Parkinson's disease and depression identifies NAMPT as a potential blood biomarker for de novo Parkinson's disease. Sci Rep 2016; 6:34579. [PMID: 27680512 PMCID: PMC5041099 DOI: 10.1038/srep34579] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/15/2016] [Indexed: 02/06/2023] Open
Abstract
Emerging research indicates that depression could be one of the earliest prodromal symptoms or risk factors associated with the pathogenesis of Parkinson’s disease (PD), the second most common neurodegenerative disorder worldwide, but the mechanisms underlying the association between both diseases remains unknown. Understanding the molecular networks linking these diseases could facilitate the discovery of novel diagnostic and therapeutics. Transcriptomic meta-analysis and network analysis of blood microarrays from untreated patients with PD and depression identified genes enriched in pathways related to the immune system, metabolism of lipids, glucose, fatty acids, nicotinamide, lysosome, insulin signaling and type 1 diabetes. Nicotinamide phosphoribosyltransferase (NAMPT), an adipokine that plays a role in lipid and glucose metabolism, was identified as the most significant dysregulated gene. Relative abundance of NAMPT was upregulated in blood of 99 early stage and drug-naïve PD patients compared to 101 healthy controls (HC) nested in the cross-sectional Parkinson’s Progression Markers Initiative (PPMI). Thus, here we demonstrate that shared molecular networks between PD and depression provide an additional source of biologically relevant biomarkers. Evaluation of NAMPT in a larger prospective longitudinal study including samples from other neurodegenerative diseases, and patients at risk of PD is warranted.
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229
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Hall JM, Shine JM, O'Callaghan C, Walton CC, Gilat M, Naismith SL, Lewis SJG. Freezing of Gait and its Associations in the Early and Advanced Clinical Motor Stages of Parkinson's Disease: A Cross-Sectional Study. JOURNAL OF PARKINSONS DISEASE 2016; 5:881-91. [PMID: 26444088 DOI: 10.3233/jpd-150581] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Freezing of gait is a common disabling symptom of Parkinson's disease (PD) with limited treatment options. The pathophysiological mechanisms of freezing behaviour are still contentious. OBJECTIVE To investigate the prevalence of freezing of gait and its associations with increasing disease severity to gain a better understanding of the underlying pathophysiology. METHODS This exploratory study included 389 idiopathic PD patients, divided into four groups; early and advanced PD with freezing of gait, and early and advanced PD without freezing of gait. Motor, cognitive and affective symptoms, REM sleep behaviour disorder and autonomic function were assessed. RESULTS Regardless of disease stage, patients with freezing of gait had more severe motor symptoms and a predominant non-tremor phenotype. In the early stages, freezers had a selective impairment in executive function and had more marked REM sleep behaviour disorder. Autonomic disturbances were not associated with freezing of gait across early or advanced disease stages. CONCLUSION These findings support the notion that impairments across the frontostriatal pathways are intricately linked to the pathophysiology underlying freezing of gait across all stages of PD. Features of REM sleep behaviour disorder suggest a contribution to freezing from brainstem pathology but this does not extend to more general autonomic dysfunction.
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Affiliation(s)
- Julie M Hall
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia.,School of Social Sciences and Psychology, University of Western Sydney, Sydney, NSW, Australia
| | - James M Shine
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia.,Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,School of Psychology, Stanford University, California, USA
| | - Claire O'Callaghan
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia.,Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Courtney C Walton
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia.,Healthy Brain Ageing Program, Ageing Brain Centre, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Moran Gilat
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Ageing Brain Centre, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
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230
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Robertson EE, Hall DA, McAsey AR, O'Keefe JA. Fragile X-associated tremor/ataxia syndrome: phenotypic comparisons with other movement disorders. Clin Neuropsychol 2016; 30:849-900. [PMID: 27414076 PMCID: PMC7336900 DOI: 10.1080/13854046.2016.1202239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The purpose of this paper is to review the typical cognitive and motor impairments seen in fragile X-associated tremor/ataxia syndrome (FXTAS), essential tremor (ET), Parkinson disease (PD), spinocerebellar ataxias (SCAs), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) in order to enhance diagnosis of FXTAS patients. METHODS We compared the cognitive and motor phenotypes of FXTAS with each of these other movement disorders. Relevant neuropathological and neuroimaging findings are also reviewed. Finally, we describe the differences in age of onset, disease severity, progression rates, and average lifespan in FXTAS compared to ET, PD, SCAs, MSA, and PSP. We conclude with a flow chart algorithm to guide the clinician in the differential diagnosis of FXTAS. RESULTS By comparing the cognitive and motor phenotypes of FXTAS with the phenotypes of ET, PD, SCAs, MSA, and PSP we have clarified potential symptom overlap while elucidating factors that make these disorders unique from one another. In summary, the clinician should consider a FXTAS diagnosis and testing for the Fragile X mental retardation 1 (FMR1) gene premutation if a patient over the age of 50 (1) presents with cerebellar ataxia and/or intention tremor with mild parkinsonism, (2) has the middle cerebellar peduncle (MCP) sign, global cerebellar and cerebral atrophy, and/or subcortical white matter lesions on MRI, or (3) has a family history of fragile X related disorders, intellectual disability, autism, premature ovarian failure and has neurological signs consistent with FXTAS. Peripheral neuropathy, executive function deficits, anxiety, or depression are supportive of the diagnosis. CONCLUSIONS Distinct profiles in the cognitive and motor domains between these movement disorders may guide practitioners in the differential diagnosis process and ultimately lead to better medical management of FXTAS patients.
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Affiliation(s)
- Erin E Robertson
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Deborah A Hall
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
| | - Andrew R McAsey
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
| | - Joan A O'Keefe
- a Department of Anatomy and Cell Biology , Rush University , Chicago , IL , USA
- b Department of Neurological Sciences , Rush University , Chicago , IL , USA
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231
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Diaz AP, Freitas FC, de Oliveira Thais ME, da Silva Areas FZ, Schwarzbold ML, Debona R, Nunes JC, Guarnieri R, Martinez-Ramirez D, Prediger RD, Wagle Shukla A, Linhares MN, Walz R. Variables associated with physical health-related quality of life in Parkinson’s disease patients presenting for deep brain stimulation. Neurol Sci 2016; 37:1831-1837. [DOI: 10.1007/s10072-016-2681-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 07/20/2016] [Indexed: 11/29/2022]
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232
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Kalkman HO, Feuerbach D. Modulatory effects of α7 nAChRs on the immune system and its relevance for CNS disorders. Cell Mol Life Sci 2016; 73:2511-30. [PMID: 26979166 PMCID: PMC4894934 DOI: 10.1007/s00018-016-2175-4] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/25/2016] [Accepted: 03/01/2016] [Indexed: 02/08/2023]
Abstract
The clinical development of selective alpha-7 nicotinic acetylcholine receptor (α7 nAChR) agonists has hitherto been focused on disorders characterized by cognitive deficits (e.g., Alzheimer's disease, schizophrenia). However, α7 nAChRs are also widely expressed by cells of the immune system and by cells with a secondary role in pathogen defense. Activation of α7 nAChRs leads to an anti-inflammatory effect. Since sterile inflammation is a frequently observed phenomenon in both psychiatric disorders (e.g., schizophrenia, melancholic and bipolar depression) and neurological disorders (e.g., Alzheimer's disease, Parkinson's disease, and multiple sclerosis), α7 nAChR agonists might show beneficial effects in these central nervous system disorders. In the current review, we summarize information on receptor expression, the intracellular signaling pathways they modulate and reasons for receptor dysfunction. Information from tobacco smoking, vagus nerve stimulation, and cholinesterase inhibition is used to evaluate the therapeutic potential of selective α7 nAChR agonists in these inflammation-related disorders.
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Affiliation(s)
- Hans O Kalkman
- Neuroscience Research, NIBR, Fabrikstrasse 22-3.001.02, 4002, Basel, Switzerland.
- , Gänsbühlgartenweg 7, 4132, Muttenz, Switzerland.
| | - Dominik Feuerbach
- Neuroscience Research, NIBR, Fabrikstrasse 22-3.001.02, 4002, Basel, Switzerland
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233
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Rizek P, Kumar N, Jog MS. An update on the diagnosis and treatment of Parkinson disease. CMAJ 2016; 188:1157-1165. [PMID: 27221269 DOI: 10.1503/cmaj.151179] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Philippe Rizek
- Department of Clinical Neurological Sciences, Western University, London, Ont
| | - Niraj Kumar
- Department of Clinical Neurological Sciences, Western University, London, Ont
| | - Mandar S Jog
- Department of Clinical Neurological Sciences, Western University, London, Ont.
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234
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Arnhold M, Dening Y, Chopin M, Arévalo E, Schwarz M, Reichmann H, Gille G, Funk RHW, Pan-Montojo F. Changes in the sympathetic innervation of the gut in rotenone treated mice as possible early biomarker for Parkinson's disease. Clin Auton Res 2016; 26:211-22. [PMID: 27178445 PMCID: PMC4877429 DOI: 10.1007/s10286-016-0358-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/02/2016] [Indexed: 12/21/2022]
Abstract
Introduction Involvement of the peripheral nervous system (PNS) is relatively common in Parkinson’s disease (PD) patients. PNS alterations appear early in the course of the disease and are responsible for some of the non-motor symptoms observed in PD patients. In previous studies, we have shown that environmental toxins can trigger the disease by acting on the enteric nervous system. Material and methods Here, we analyzed the effect of mitochondrial Complex I inhibition on sympathetic neuritis in vivo and sympathetic neurons in vitro. Combining in vivo imaging and protein expression profiling. Results we found that rotenone, a widely used mitochondrial Complex I inhibitor decreases the density of sympathetic neurites innervating the gut in vivo, while in vitro, it induces the redistribution of intracellular alpha-synuclein and neurite degeneration. Interestingly, sympathetic neurons are much more resistant to rotenone exposure than mesencephalic dopaminergic neurons. Conclusion Altogether, these results suggest that enteric sympathetic denervation could be an initial pre-motor alteration in PD progression that could be used as an early biomarker of the disease. Electronic supplementary material The online version of this article (doi:10.1007/s10286-016-0358-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mike Arnhold
- Klinik und Poliklinik für Neurologie, Uniklinikum Carl-Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
| | - Yanina Dening
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
| | - Michaël Chopin
- The Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Esteban Arévalo
- Institut für Anatomie, TU-Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Mathias Schwarz
- Institut für Anatomie, TU-Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Heinz Reichmann
- Klinik und Poliklinik für Neurologie, Uniklinikum Carl-Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
- Center for Regenerative Therapies Dresden, Tatzberg 47/49, 01307, Dresden, Germany
| | - Gabriele Gille
- Klinik und Poliklinik für Neurologie, Uniklinikum Carl-Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany
| | - Richard H W Funk
- Institut für Anatomie, TU-Dresden, Fetscherstr. 74, 01307, Dresden, Germany
- Center for Regenerative Therapies Dresden, Tatzberg 47/49, 01307, Dresden, Germany
| | - Francisco Pan-Montojo
- Neurologische Klinik und Poliklinik, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany.
- Munich Cluster for Systems Neurology, Munich, Germany.
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235
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Huang P, Lou Y, Xuan M, Gu Q, Guan X, Xu X, Song Z, Luo W, Zhang M. Cortical abnormalities in Parkinson's disease patients and relationship to depression: A surface-based morphometry study. Psychiatry Res Neuroimaging 2016; 250:24-28. [PMID: 27107157 DOI: 10.1016/j.pscychresns.2016.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/06/2016] [Accepted: 03/03/2016] [Indexed: 11/24/2022]
Abstract
Depression is a common occurrence in patients with Parkinson's disease (PD). Brain deficits may be the underlying cause of depression in PD. In the present study, we investigated whether morphometric alterations contribute to depression in PD. Seventeen depressed PD patients, 17 non-depressed PD patients and 45 normal controls were enrolled in the study. All subjects went through neurological and psychiatric clinical assessments. T1 weighted magnetic resonance imaging and surface-based morphometric analyses were performed to examine morphometric abnormalities in PD patients and their relationship to depression. We found that compared with normal controls, PD patients exhibited significantly decreased cortical thickness in the left precentral gyrus and the right postcentral gyrus extending to the middle frontal gyrus. Compared with non-depressed PD patients, depressed patients showed significantly increased cortical areas in the orbitofrontal regions and insula, which may imply white matter atrophy in these areas. The results of orbitofrontal and insula white matter atrophy are consistent with our previous finding that white matter integrity and functional connectivity are damaged in these regions in depressed PD patients, confirming their contribution to depression in PD.
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Affiliation(s)
- Peiyu Huang
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuting Lou
- Department of Neurology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Xuan
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhe Song
- Department of Neurology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Binjiang Hospital, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Luo
- Department of Neurology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Preliminary evidence for human globus pallidus pars interna neurons signaling reward and sensory stimuli. Neuroscience 2016; 328:30-9. [PMID: 27109924 PMCID: PMC4884665 DOI: 10.1016/j.neuroscience.2016.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/07/2016] [Accepted: 04/14/2016] [Indexed: 12/04/2022]
Abstract
Non-motor responses of human GPi neurons are described. Cells were identified that showed increased firing to reward-stimuli. Visual-sensory responses unrelated to reward also observed.
The globus pallidus pars interna (GPi) is a component of the basal ganglia, a network of subcortical nuclei that process motor, associative, and limbic information. While non-human primate studies have suggested a role for the GPi in non-motor functions, there have been no single-unit studies of non-motor electrophysiological behavior of human GPi neurons. We therefore sought to extend these findings by collecting single-unit recordings from awake patients during functional stereotactic neurosurgery targeting the GPi for deep brain stimulation. To assess cellular responses to non-motor information, patients performed a reward task where virtual money could be won, lost, or neither, depending on their performance while cellular activity was monitored. Changes in the firing rates of isolated GPi neurons after the presentation of reward-related stimuli were compared between different reward contingencies (win, loss, null). We observed neurons that modulated their firing rate significantly to the presentation of reward-related stimuli. We furthermore found neurons that responded to visual-stimuli more broadly. This is the first single-unit evidence of human GPi neurons carrying non-motor information. These results are broadly consistent with previous findings in the animal literature and suggest non-motor information may be represented in the single-unit activity of human GPi neurons.
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237
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Corvol JC, Goni S, Bordet R. Translational research on cognitive and behavioural disorders in neurological and psychiatric diseases. Therapie 2016; 71:1-13, 15-26. [PMID: 27080626 DOI: 10.1016/j.therap.2016.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
The important medical and social burden of nervous system diseases contrasts with the currently limited therapeutic armamentarium and with the difficulty encountered in developing new therapeutic options. These failures can be explained by the conjunction of various phenomena related to the limitations of animal models, the narrow focus of research on precise pathophysiological mechanisms, and methodological issues in clinical trials. It is perhaps the paradigm itself of the way research is conducted that may be the real reason for our incapacity to find effective strategies. The purpose of this workshop was to define overall lines of research that could lead to the development of effective novel therapeutic solutions. Research has long focused on diseases per se rather than on cognitive and behavioural dimensions common to several diseases. Their expression is often partial and variable, but can today be well-characterised using neurophysiological or imaging methods. This dimensional or syndromic vision should enable a new insight to the question, taking a transnosographic approach to re-position research and to propose: translational models exploring the same functions in animal models and in humans; identification of homogeneous groups of patients defined according to the clinical, anatomico-functional and molecular characteristics; and preclinical and clinical developments enriched by the use of cognitive-behavioural, biological neurological, and imaging biomarkers. For this mutation to be successful, it must be accompanied by synchronised action from the public authorities and by ad hoc measures from the regulatory agencies.
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Affiliation(s)
- Jean-Christophe Corvol
- Inserm UMRS 1127, CIC 1422, CNRS UMR 7225, département des maladies du système nerveux, hôpital Pitié-Salpêtrière, AP-HP, UPMC - université Paris 06, Sorbonne universités, bâtiment ICM, 47/83, boulevard de l'Hôpital, 75013 Paris, France.
| | - Sylvia Goni
- Lundbeck SAS, 92445 Issy-les-Moulineaux, France
| | - Régis Bordet
- Inserm U1171, Degenerative and Vascular Cognitive Disorders, CHU, université de Lille, 59000 Lille, France
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Swank C, Trudelle-Jackson E, Medley A, Thompson M, Jackson A. A Comparison of Physical Activity and Dual Task Gait Among Persons with Parkinson's Disease and Healthy Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2016. [DOI: 10.3109/02703181.2015.1134747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chad Swank
- School of Physical Therapy, Texas Woman's University, Dallas, Texas, USA
| | | | - Ann Medley
- School of Physical Therapy, Texas Woman's University, Dallas, Texas, USA
| | - Mary Thompson
- School of Physical Therapy, Texas Woman's University, Dallas, Texas, USA
| | - Allen Jackson
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, Texas, USA
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239
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Lamberti VM, Pereira B, Lhommée E, Bichon A, Schmitt E, Pelissier P, Kistner A, Fraix V, Castrioto A, Esselink RAJ, Durif F, Krack P. Profile of Neuropsychiatric Symptoms in Parkinson’s Disease: Surgical Candidates Compared to Controls. JOURNAL OF PARKINSONS DISEASE 2016; 6:133-42. [DOI: 10.3233/jpd-150698] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Valérie M.J. Lamberti
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bruno Pereira
- CHU Clermont-Ferrand, DRCI, Biostatistics Unit, Clermont-Ferrand, France
| | - Eugénie Lhommée
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Amélie Bichon
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Emmanuelle Schmitt
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Pierre Pelissier
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Andrea Kistner
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Valérie Fraix
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Anna Castrioto
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
| | - Rianne A. J. Esselink
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frank Durif
- CHU Clermont-Ferrand, Neurology Department; CHU Gabriel Montpied, and Université Clermont 1, UFR Medecine, EA7280, Clermont-Ferrand, France
| | - Paul Krack
- Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation, CHU Grenoble Alpes, F-38000 Grenoble, France
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France
- Inserm, U1216, F-38000 Grenoble, France
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Peña E, Mata M, López-Manzanares L, Kurtis M, Eimil M, Martínez-Castrillo JC, Navas I, Posada IJ, Prieto C, Ruíz-Huete C, Vela L, Venegas B. Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid. Neurologia 2016; 33:S0213-4853(16)00055-4. [PMID: 27004670 DOI: 10.1016/j.nrl.2016.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.
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Affiliation(s)
- E Peña
- Servicio de Neurología, Hospital Sanitas La Moraleja, Madrid, España.
| | - M Mata
- Servicio de Neurología, Hospital Infanta Sofía, Madrid, España
| | | | - M Kurtis
- Servicio de Neurología, Hospital Ruber Internacional, Madrid, España
| | - M Eimil
- Servicio de Neurología, Hospital de Torrejón, Madrid, España
| | | | - I Navas
- Servicio de Neurología, Hospital Fundación Jiménez Díaz, Madrid, España
| | - I J Posada
- Servicio de Neurología, Hospital 12 de Octubre, Madrid, España
| | - C Prieto
- Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España
| | - C Ruíz-Huete
- Servicio de Neurología, Clínica del Rosario, Madrid, España
| | - L Vela
- Servicio de Neurología, Hospital Fundación Alcorcón, Madrid, España
| | - B Venegas
- Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España
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241
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Felice VD, Quigley EM, Sullivan AM, O'Keeffe GW, O'Mahony SM. Microbiota-gut-brain signalling in Parkinson's disease: Implications for non-motor symptoms. Parkinsonism Relat Disord 2016; 27:1-8. [PMID: 27013171 DOI: 10.1016/j.parkreldis.2016.03.012] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/15/2016] [Accepted: 03/15/2016] [Indexed: 12/19/2022]
Abstract
Parkinson's disease is the second most common neurodegenerative disorder, affecting 1-2% of the population over 65 years of age. The primary neuropathology is the loss of midbrain dopaminergic neurons, resulting in characteristic motor deficits, upon which the clinical diagnosis is based. However, a number of significant non-motor symptoms (NMS) are also evident that appear to have a greater impact on the quality of life of these patients. In recent years, it has become increasingly apparent that neurobiological processes can be modified by the bi-directional communication that occurs along the brain-gut axis. The microbiota plays a key role in this communication throughout different routes in both physiological and pathological conditions. Thus, there has been an increasing interest in investigating how microbiota changes within the gastrointestinal tract may be implicated in health and disease including PD. Interestingly α-synuclein-aggregates, the cardinal neuropathological feature in PD, are present in both the submucosal and myenteric plexuses of the enteric nervous system, prior to their appearance in the brain, indicating a possible gut to brain route of "prion-like" spread. In this review we highlight the potential importance of gut to brain signalling in PD with particular focus on the role of the microbiota as major player in this communication.
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Affiliation(s)
- Valeria D Felice
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Eamonn M Quigley
- APC Microbiome Institute, University College Cork, Cork, Ireland; Division of Gastroenterology and Hepatology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital, and Weill Cornell Medical College, 6550 Fannin St, SM 1001, Houston, TX 77030, USA
| | - Aideen M Sullivan
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Gerard W O'Keeffe
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Siobhain M O'Mahony
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland. http://publish.ucc.ie/researchprofiles/C003/somahony
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242
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Barker RA, Williams-Gray CH. Review: The spectrum of clinical features seen with alpha synuclein pathology. Neuropathol Appl Neurobiol 2016; 42:6-19. [DOI: 10.1111/nan.12303] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/06/2016] [Accepted: 01/10/2016] [Indexed: 12/15/2022]
Affiliation(s)
- R. A. Barker
- Department of Clinical Neurosciences; John van Geest Centre for Brain Repair; University of Cambridge; Cambridge UK
| | - C. H. Williams-Gray
- Department of Clinical Neurosciences; John van Geest Centre for Brain Repair; University of Cambridge; Cambridge UK
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243
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Corvol JC, Goni S, Bordet R, Azuar C, Blin O, Checler F, David DJ, Durif F, Fernagut PO, Dupouey J, Otten L, Gaillard R, Kemel ML, Micallef J, Perault-Pochat MC, Pitel AL, Truffinet P. Recherche translationnelle sur les troubles cognitifs et comportementaux dans les maladies neurologiques et psychiatriques. Therapie 2016. [DOI: 10.1016/j.therap.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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244
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Environmental risk factors and Parkinson's disease: An umbrella review of meta-analyses. Parkinsonism Relat Disord 2016; 23:1-9. [DOI: 10.1016/j.parkreldis.2015.12.008] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/24/2015] [Accepted: 12/14/2015] [Indexed: 12/26/2022]
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245
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Evaluation of Nonmotor Symptoms in Diagnosis of Parkinsonism and Tremor. PARKINSON'S DISEASE 2016; 2016:9182946. [PMID: 27403372 PMCID: PMC4923584 DOI: 10.1155/2016/9182946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/22/2016] [Indexed: 11/21/2022]
Abstract
Background. Nonmotor symptoms particularly olfactory dysfunction, RBD, depression, hallucinations, and constipation are currently not included in the typical clinical criteria for diagnosing Lewy body Parkinsonian disorders (LBPD). The aim of this study is to determine the diagnostic value of nonmotor symptoms in patients presenting with Parkinsonism and tremor. Methods. All new patients seen between January 2007 and May 2013 in the Movement Disorders Specialist Clinics of the Royal Melbourne Hospital (RMH), who were referred with a possible neurodegenerative syndrome or concerns of Parkinsonism and/or tremor, were included. Patients underwent routine evaluation with the four-minute “Sniffin Sticks” test, RBD, depression, and constipation. Results. 291 patients were included in the analysis. Conclusion. We found that lower olfaction scores based on “Sniffin Sticks” testing combined with reports of depression and constipation are independent predictors for the diagnosis of the spectrum of Lewy body Parkinsonian disorders (LBPD). Parkinson's disease (PD) cannot be reliably clinically differentiated from other causes of Parkinsonism that share symptomatology and structural abnormalities.
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246
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Houeto JL, Magnard R, Dalley JW, Belin D, Carnicella S. Trait Impulsivity and Anhedonia: Two Gateways for the Development of Impulse Control Disorders in Parkinson's Disease? Front Psychiatry 2016; 7:91. [PMID: 27303314 PMCID: PMC4884740 DOI: 10.3389/fpsyt.2016.00091] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/17/2016] [Indexed: 12/03/2022] Open
Abstract
Apathy and impulsivity are two major comorbid syndromes of Parkinson's disease (PD) that may represent two extremes of a behavioral spectrum modulated by dopamine-dependent processes. PD is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta to which are attributed the cardinal motor symptoms of the disorder. Dopamine replacement therapy (DRT), used widely to treat these motor symptoms, is often associated with deficits in hedonic processing and motivation, including apathy and depression, as well as impulse control disorders (ICDs). ICDs comprise pathological gambling, hypersexuality, compulsive shopping, binge eating, compulsive overuse of dopaminergic medication, and punding. More frequently observed in males with early onset PD, ICDs are associated not only with comorbid affective symptoms, such as depression and anxiety, but also with behavioral traits, such as novelty seeking and impulsivity, as well as with personal or familial history of alcohol use. This constellation of associated risk factors highlights the importance of inter-individual differences in the vulnerability to develop comorbid psychiatric disorders in PD patients. Additionally, withdrawal from DRT in patients with ICDs frequently unmasks a severe apathetic state, suggesting that apathy and ICDs may be caused by overlapping neurobiological mechanisms within the cortico-striato-thalamo-cortical networks. We suggest that altered hedonic and impulse control processes represent distinct prodromal substrates for the development of these psychiatric symptoms, the etiopathogenic mechanisms of which remain unknown. Specifically, we argue that deficits in hedonic and motivational states and impulse control are mediated by overlapping, yet dissociable, neural mechanisms that differentially interact with DRT to promote the emergence of ICDs in vulnerable individuals. Thus, we provide a novel heuristic framework for basic and clinical research to better define and treat comorbid ICDs in PD.
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Affiliation(s)
- Jean-Luc Houeto
- Service de Neurologie, CIC-INSERM 1402, CHU de Poitiers, Université de Poitiers , Poitiers , France
| | - Robin Magnard
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
| | - Jeffrey W Dalley
- Department of Psychology, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - David Belin
- Department of Pharmacology, University of Cambridge , Cambridge , UK
| | - Sebastien Carnicella
- INSERM U1216, Grenoble Institut des Neurosciences (GIN), University Grenoble Alpes , Grenoble , France
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247
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Song X, Hu X, Zhou S, Xu Y, Zhang Y, Yuan Y, Liu Y, Zhu H, Liu W, Gao JH. Association of specific frequency bands of functional MRI signal oscillations with motor symptoms and depression in Parkinson's disease. Sci Rep 2015; 5:16376. [PMID: 26574049 PMCID: PMC4648086 DOI: 10.1038/srep16376] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/13/2015] [Indexed: 12/03/2022] Open
Abstract
A novel empirical mode decomposition method was adopted to investigate the dissociative or interactive neural impact of depression and motor impairments in Parkinson’s disease (PD). Resting-state fMRI data of 59 PD subjects were first decomposed into characteristic frequency bands, and the main effects of motor severity and depression and their interaction on the energy of blood-oxygen-level-dependent signal oscillation in specific frequency bands were then evaluated. The results show that the severity of motor symptoms is negatively correlated with the energy in the frequency band of 0.10–0.25 Hz in the bilateral thalamus, but positively correlated with 0.01–0.027 Hz band energy in the bilateral postcentral gyrus. The severity of depression, on the other hand, is positively correlated with the energy of 0.10–0.25 Hz but negatively with 0.01–0.027 Hz in the bilateral subgenual gyrus. Notably, the interaction between motor and depressive symptoms is negatively correlated with the energy of 0.10–0.25 Hz in the substantia nigra, hippocampus, inferior orbitofrontal cortex, and temporoparietal junction, but positively correlated with 0.02–0.05 Hz in the same regions. These findings indicate unique associations of fMRI band signals with motor and depressive symptoms in PD in specific brain regions, which may underscore the neural impact of the comorbidity and the differentiation between the two PD-related disorders.
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Affiliation(s)
- Xiaopeng Song
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Xiao Hu
- Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
| | - Shuqin Zhou
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Yuanyuan Xu
- Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
| | - Yi Zhang
- School of Life Science and Technology, Xidian University, Xi'an, Shanxi 710071, China
| | - Yonggui Yuan
- Department of Psychiatry and Psychosomatics, Affiliated ZhongDa Hospital of Southeast University, Institute of Neuropsychiatry of Southeast University, Nanjing 210009, China
| | - Yijun Liu
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Huaiqiu Zhu
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Weiguo Liu
- Department of Neurology, Brain Hospital Affiliated to Nanjing Medical University, Nanjing 210029, China
| | - Jia-Hong Gao
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China.,Center for MRI Research, Beijing City Key Lab for Medical Physics and Engineering, McGovern Institution for Brain Research, Peking University, Beijing, 100871, China
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248
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Screening for Mild Cognitive Impairment in Parkinson's Disease: Comparison of the Italian Versions of Three Neuropsychological Tests. PARKINSONS DISEASE 2015; 2015:681976. [PMID: 26634171 PMCID: PMC4655066 DOI: 10.1155/2015/681976] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 11/17/2022]
Abstract
Mild cognitive impairment (MCI) is frequent in Parkinson's disease (PD). Recently proposed criteria for MCI in PD (PD-MCI) indicate level I diagnosis based on abbreviated assessment and level II based on comprehensive neuropsychological evaluation. The study explored the sensitivity and specificity of the Italian versions of three neuropsychological tests for level I diagnosis of PD-MCI. We recruited 100 consecutive PD patients. After screening for inclusion criteria, 43 patients were included. The sensitivity and specificity of the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Addenbrooke's Cognitive Examination Revised (ACE-R) in comparison to level II diagnosis of PD-MCI were examined. PD-MCI was diagnosed (level II) in 51% of patients. Disease duration was significantly longer and PD motor scales were more severely impaired in MCI group. The receiver-operator characteristics curve documented nonsignificant difference in the performance of the three tests, with slight advantage of MMSE (corrected data). The time of administration favored MMSE. In Italian-speaking PD patients, MMSE might represent a good screening tool for PD-MCI, because of the shorter time of administration and the performance comparable to those of MoCA and ACE-R. Further studies are needed to validate the new PD-MCI criteria across different languages and cultures.
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249
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Caudal D, Alvarsson A, Björklund A, Svenningsson P. Depressive-like phenotype induced by AAV-mediated overexpression of human α-synuclein in midbrain dopaminergic neurons. Exp Neurol 2015; 273:243-52. [DOI: 10.1016/j.expneurol.2015.09.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 08/18/2015] [Accepted: 09/03/2015] [Indexed: 01/10/2023]
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250
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Crossley NA, Scott J, Ellison-Wright I, Mechelli A. Neuroimaging distinction between neurological and psychiatric disorders. Br J Psychiatry 2015; 207:429-34. [PMID: 26045351 PMCID: PMC4629073 DOI: 10.1192/bjp.bp.114.154393] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 10/19/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is unclear to what extent the traditional distinction between neurological and psychiatric disorders reflects biological differences. AIMS To examine neuroimaging evidence for the distinction between neurological and psychiatric disorders. METHOD We performed an activation likelihood estimation meta-analysis on voxel-based morphometry studies reporting decreased grey matter in 14 neurological and 10 psychiatric disorders, and compared the regional and network-level alterations for these two classes of disease. In addition, we estimated neuroanatomical heterogeneity within and between the two classes. RESULTS Basal ganglia, insula, sensorimotor and temporal cortex showed greater impairment in neurological disorders; whereas cingulate, medial frontal, superior frontal and occipital cortex showed greater impairment in psychiatric disorders. The two classes of disorders affected distinct functional networks. Similarity within classes was higher than between classes; furthermore, similarity within class was higher for neurological than psychiatric disorders. CONCLUSIONS From a neuroimaging perspective, neurological and psychiatric disorders represent two distinct classes of disorders.
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Affiliation(s)
| | | | | | - Andrea Mechelli
- Nicolas A. Crossley, MRCPsych, PhD, Jessica Scott, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London; Ian Ellison-Wright, MRCPsych, Avon and Wiltshire Mental Health Partnership NHS Trust, Salisbury; Andrea Mechelli, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
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