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Microstructural changes in patients with Parkinson disease and REM sleep behavior disorder: depressive symptoms versus non-depressed. Acta Neurol Belg 2018; 118:415-421. [PMID: 29442234 DOI: 10.1007/s13760-018-0896-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
Abstract
Search for Parkinson's disease (PD) progression biomarkers has led to the identification of both motor and non-motor symptoms relevant of prodromal PD that could be eye-opening to the spreading underlying Lewy body pathogenesis. One most robust predictor of PD is the REM sleep behavior disorder (RBD), and one most common early non-motor symptom of PD is depression. With RBD, frequently coexisting with clinical depression and both predicting dopamine transmission dysfunction, we aimed to survey structural associates of depressive symptoms in early PD patients with comorbid RBD. Through diffusion MRI connectometry, we tracked fiber differences comparing DWI images obtained from 14 patients with depressive symptoms and 18 without depression from a group with comorbid RBD and PD. DWI images and patients were recruited from the Parkinson's Progression Markers Initiative database. PD-RBD patients with depressive symptoms showed pathways with significantly reduced connectivity in the right cingulum, left and right fornix, left inferior longitudinal fasciculus, right corticospinal tract, left middle cerebellar peduncle and genu of corpus callosum (FDR = 0.0228). Diffusivity alteration of the mentioned fibers in depressed, early PD patients with RBD might reflect underlying PD pathology and serve as common structural DWI signatures for early PD diagnosis.
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202
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Dauvilliers Y, Schenck CH, Postuma RB, Iranzo A, Luppi PH, Plazzi G, Montplaisir J, Boeve B. REM sleep behaviour disorder. Nat Rev Dis Primers 2018; 4:19. [PMID: 30166532 DOI: 10.1038/s41572-018-0016-5] [Citation(s) in RCA: 267] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia that is characterized by loss of muscle atonia during REM sleep (known as REM sleep without atonia, or RSWA) and abnormal behaviours occurring during REM sleep, often as dream enactments that can cause injury. RBD is categorized as either idiopathic RBD or symptomatic (also known as secondary) RBD; the latter is associated with antidepressant use or with neurological diseases, especially α-synucleinopathies (such as Parkinson disease, dementia with Lewy bodies and multiple system atrophy) but also narcolepsy type 1. A clinical history of dream enactment or complex motor behaviours together with the presence of muscle activity during REM sleep confirmed by video polysomnography are mandatory for a definite RBD diagnosis. Management involves clonazepam and/or melatonin and counselling and aims to suppress unpleasant dreams and behaviours and improve bedpartner quality of life. RSWA and RBD are now recognized as manifestations of an α-synucleinopathy; most older adults with idiopathic RBD will eventually develop an overt neurodegenerative syndrome. In the future, studies will likely evaluate neuroprotective therapies in patients with idiopathic RBD to prevent or delay α-synucleinopathy-related motor and cognitive decline.
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Affiliation(s)
- Yves Dauvilliers
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France. .,INSERM, U1061, Montpellier, France, Université Montpellier, Montpellier, France.
| | - Carlos H Schenck
- Minnesota Regional Sleep Disorders Center, and Departments of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ronald B Postuma
- Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada
| | - Alex Iranzo
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Pierre-Herve Luppi
- UMR 5292 CNRS/U1028 INSERM, Center of Research in Neuroscience of Lyon (CRNL), SLEEP Team, Université Claude Bernard Lyon I, Faculté de Médecine RTH Laennec, Lyon, France
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS, Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Jacques Montplaisir
- Department of Psychiatry, Université de Montréal, Québec, Canada and Center for Advanced Research in Sleep Medicine (CARSM), Hôpital du Sacré-Coeur de Montréal, Quebec, Canada
| | - Bradley Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
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203
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Postuma RB, Poewe W, Litvan I, Lewis S, Lang AE, Halliday G, Goetz CG, Chan P, Slow E, Seppi K, Schaffer E, Rios-Romenets S, Mi T, Maetzler C, Li Y, Heim B, Bledsoe IO, Berg D. Validation of the MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord 2018; 33:1601-1608. [PMID: 30145797 DOI: 10.1002/mds.27362] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/22/2017] [Accepted: 02/05/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In 2015, the International Parkinson and Movement Disorder Society published clinical diagnostic criteria for Parkinson's disease. These criteria aimed to codify/reproduce the expert clinical diagnostic process and to help standardize diagnosis in research and clinical settings. Their accuracy compared with expert clinical diagnosis has not been tested. The objectives of this study were to validate the International Parkinson and Movement Disorder Society diagnostic criteria against a gold standard of expert clinical diagnosis, and to compare concordance/accuracy of the International Parkinson and Movement Disorder Society criteria to 1988 United Kingdom Brain Bank criteria. METHODS From 8 centers, we recruited 626 parkinsonism patients (434 PD, 192 non-PD). An expert neurologist diagnosed each patient as having PD or non-PD, regardless of International Parkinson and Movement Disorder Society criteria (gold standard, clinical diagnosis). Then a second neurologist evaluated the presence/absence of each individual item from the International Parkinson and Movement Disorder Society criteria. The overall accuracy/concordance rate, sensitivity, and specificity of the International Parkinson and Movement Disorder Society criteria compared with the expert gold standard were calculated. RESULTS Of 434 patients diagnosed with PD, 94.5% met the International Parkinson and Movement Disorder Society criteria for probable PD (5.5% false-negative rate). Of 192 non-PD patients, 88.5% were identified as non-PD by the criteria (11.5% false-positive rate). The overall accuracy for probable PD was 92.6%. In addition, 59.3% of PD patients and only 1.6% of non-PD patients met the International Parkinson and Movement Disorder Society criteria for clinically established PD. In comparison, United Kingdom Brain Bank criteria had lower sensitivity (89.2%, P = 0.008), specificity (79.2%, P = 0.018), and overall accuracy (86.4%, P < 0.001). Diagnostic accuracy did not differ according to age or sex. Specificity improved as disease duration increased. CONCLUSIONS The International Parkinson and Movement Disorder Society criteria demonstrated high sensitivity and specificity compared with the gold standard, expert diagnosis, with sensitivity and specificity both higher than United Kingdom Brain Bank criteria. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ronald B Postuma
- Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Irene Litvan
- Department of Neurosciences, UC San Diego, La Jolla, California, USA
| | - Simon Lewis
- Brain and Mind Centre, Sydney Medical School, Camperdown, Australia
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Glenda Halliday
- Brain and Mind Centre, Sydney Medical School, Camperdown, Australia
| | | | - Piu Chan
- Department of Neurobiology and Neurology, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Elizabeth Slow
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Eva Schaffer
- Klinik für Neurologie, UKSH, Campus Kiel, Christian-Albrechts-Universität, Kiel, Germany
| | | | - Taomian Mi
- Department of Neurobiology and Neurology, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Corina Maetzler
- Klinik für Neurologie, UKSH, Campus Kiel, Christian-Albrechts-Universität, Kiel, Germany
| | - Yuan Li
- Department of Neurobiology and Neurology, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Beatrice Heim
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | | | - Daniela Berg
- Klinik für Neurologie, UKSH, Campus Kiel, Christian-Albrechts-Universität, Kiel, Germany
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204
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Sieurin J, Andel R, Tillander A, Valdes EG, Pedersen NL, Wirdefeldt K. Occupational stress and risk for Parkinson's disease: A nationwide cohort study. Mov Disord 2018; 33:1456-1464. [PMID: 30145813 PMCID: PMC6220861 DOI: 10.1002/mds.27439] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/04/2018] [Accepted: 04/27/2018] [Indexed: 12/03/2022] Open
Abstract
Background: Stress has been suggested as a contributing factor in the etiology of Parkinson's Disease (PD), but epidemiological evidence is sparse. Objective: The objective of this study was to explore the association between occupational stress according to the job demands‐control model and the risk for PD. Methods: We conducted a population‐based cohort study with 2,544,748 Swedes born 1920 to 1950 who had an occupation reported in the population and housing censuses in 1980 or, if missing, in 1970. Job demands and control were measured using a job‐exposure matrix. Incident PD cases were identified using Swedish national health registers from 1987 to 2010. Data were analyzed with Cox regression with age as the underlying time scale, adjusting for sex, education, and chronic obstructive pulmonary disease as a proxy for smoking. Results: During a mean follow‐up time of 21.3 years, 21,544 incident PD cases were identified. High demands were associated with increased PD risk among men, most evident in men with high education. High control was associated with increased PD risk among the low educated. This association was more pronounced in women. High‐strain jobs (high demands and low control) was only associated with increased PDrisk among men with high education, whereas active jobs (high demands and high control) were associated with increased PD risk among men with low education. Interpretation: High job demands appear to increase PD risk in men, especially in men with high education, whereas high job control increases PD risk among low educated, more strongly in women. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Johanna Sieurin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ross Andel
- School of Aging Studies, University of South Florida, Tampa, Florida, USA.,International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Annika Tillander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Elise G Valdes
- School of Aging Studies, University of South Florida, Tampa, Florida, USA.,Relias Learning, Cary, North Carolina, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Karin Wirdefeldt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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205
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Filippi M, Elisabetta S, Piramide N, Agosta F. Functional MRI in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:439-467. [PMID: 30314606 DOI: 10.1016/bs.irn.2018.08.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Functional MRI (fMRI) has been widely used to study abnormal patterns of brain connectivity at rest and activation during a variety of tasks in patients with idiopathic Parkinson's disease (PD). fMRI studies in PD have led to a better understanding of many aspects of the disease including both motor and non-motor symptoms. Although its translation into clinical practice is still at an early stage, fMRI measures hold promise for multiple clinical applications in PD, including the early detection, predicting future change in clinical status, and as a marker of alterations in brain physiology related to neurotherapeutic agents and neurorehabilitative strategies.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Sarasso Elisabetta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy; Laboratory of Movement Analysis, San Raffaele Scientific Institute, Milan, Italy
| | - Noemi Piramide
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
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206
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Kim A, Nigmatullina R, Zalyalova Z, Soshnikova N, Krasnov A, Vorobyeva N, Georgieva S, Kudrin V, Narkevich V, Ugrumov M. Upgraded Methodology for the Development of Early Diagnosis of Parkinson's Disease Based on Searching Blood Markers in Patients and Experimental Models. Mol Neurobiol 2018; 56:3437-3450. [PMID: 30128652 DOI: 10.1007/s12035-018-1315-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/10/2018] [Indexed: 01/08/2023]
Abstract
Numerous attempts to develop an early diagnosis of Parkinson's disease (PD) by searching biomarkers in biological fluids were unsuccessful. The drawback of this methodology is searching markers in patients at the clinical stage without guarantee that they are also characteristic of either preclinical stage or prodromal stage (preclinical-prodromal stage). We attempted to upgrade this methodology by selecting only markers that are found both in patients and in PD animal models. HPLC and RT-PCR were used to estimate the concentration of amino acids, catecholamines/metabolites in plasma and gene expression in lymphocytes in 36 untreated early-stage PD patients and 52 controls, and in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice at modeling the clinical ("symptomatic") stage and preclinical-prodromal ("presymptomatic") stage of PD. It was shown that among 13 blood markers found in patients, 7 markers are characteristic of parkinsonian symptomatic mice and 3 markers of both symptomatic and presymptomatic mice. According to our suggestion, the detection of the same marker in patients and symptomatic animals indicates adequate reproduction of pathogenesis along the corresponding metabolic pathway, whereas the detection of the same marker in presymptomatic animals indicates its specificity for preclinical-prodromal stage. This means that the minority of markers found in patients-decreased concentration of L-3,4-dihydroxyphenylalanine (L-DOPA) and dihydroxyphenylacetic acid (DOPAC) and increased dopamine D3 receptor gene expression-are specific for preclinical-prodromal stage and are suitable for early diagnosis of PD. Thus, we upgraded a current methodology for development of early diagnosis of PD by searching blood markers not only in patients but also in parkinsonian animals.
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Affiliation(s)
- Alexander Kim
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, Moscow, Russia
| | - Razina Nigmatullina
- Kazan State Medical University, Ministry of Health of the Russian Federation, Kazan, Russia
| | - Zuleikha Zalyalova
- Kazan State Medical University, Ministry of Health of the Russian Federation, Kazan, Russia
- Kazan Hospital for War Veterans, Ministry of Health of the Republic of Tatarstan, Kazan, Russia
| | | | - Alexey Krasnov
- Institute of Gene Biology, Russian Academy of Sciences, Moscow, Russia
| | | | - Sofia Georgieva
- Institute of Gene Biology, Russian Academy of Sciences, Moscow, Russia
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | | | | | - Michael Ugrumov
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, Moscow, Russia.
- National Research University Higher School of Economics, Moscow, Russia.
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207
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Haghshomar M, Dolatshahi M, Ghazi Sherbaf F, Sanjari Moghaddam H, Shirin Shandiz M, Aarabi MH. Disruption of Inferior Longitudinal Fasciculus Microstructure in Parkinson's Disease: A Systematic Review of Diffusion Tensor Imaging Studies. Front Neurol 2018; 9:598. [PMID: 30093877 PMCID: PMC6070770 DOI: 10.3389/fneur.2018.00598] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder accompanied by a series of pathological mechanisms which contribute to a variety of motor and non-motor symptoms. Recently, there has been an increasing interest in structural diffusion tensor imaging (DTI) in PD which has shed light on our understanding of structural abnormalities underlying PD symptoms or its associations with pathological mechanisms. One of the white matter tracts shown to be disrupted in PD with a possible contribution to some PD symptoms is the inferior longitudinal fasciculus (ILF). On the whole, lower ILF integrity contributes to thought disorders, impaired visual emotions, cognitive impairments such as semantic fluency deficits, and mood disorders. This review outlines the microstructural changes in ILF associated with systemic inflammation and various PD symptoms like cognitive decline, facial emotion recognition deficit, depression, color discrimination deficit, olfactory dysfunction, and tremor genesis. However, few studies have investigated DTI correlates of each symptom and larger studies with standardized imaging protocols are required to extend these preliminary findings and lead to more promising results.
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Affiliation(s)
- Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mehdi Shirin Shandiz
- Department of Medical Physics, Zahedan University of Medical Sciences, Zahedan, Iran
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208
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Rees RN, Acharya AP, Schrag A, Noyce AJ. An early diagnosis is not the same as a timely diagnosis of Parkinson's disease. F1000Res 2018; 7. [PMID: 30079229 PMCID: PMC6053699 DOI: 10.12688/f1000research.14528.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 12/17/2022] Open
Abstract
Parkinson’s disease is a common neurodegenerative condition that has significant costs to the individual patient and to society. The pathology starts up to a decade before symptoms are severe enough to allow a diagnosis using current criteria. Although the search for disease-modifying treatment continues, it is vital to understand what the right time is for diagnosis. Diagnosis of Parkinson’s disease is based on the classic clinical criteria, but the presence of other clinical features and disease biomarkers may allow earlier diagnosis, at least in a research setting. In this review, we identify the benefits of an early diagnosis, including before the classic clinical features occur. However, picking the right point for a “timely” diagnosis will vary depending on the preferences of the individual patient, efficacy (or existence) of disease-modifying treatment, and the ability for health systems to provide support and management for individuals at every stage of the disease. Good evidence for the quality-of-life benefits of existing symptomatic treatment supports the argument for earlier diagnosis at a time when symptoms are already present. This argument would be significantly bolstered by the development of disease-modifying treatments. Benefits of early diagnosis and treatment would affect not only the individual (and their families) but also the wider society and the research community. Ultimately, however, shared decision-making and the principles of autonomy, beneficence, and non-maleficence will need to be applied on an individual basis when considering a “timely” diagnosis.
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Affiliation(s)
- Richard Nathaniel Rees
- Department of Clinical Neuroscience, Institute of Neurology, UCL Hampstead Campus, London, UK
| | - Anita Prema Acharya
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anette Schrag
- Department of Clinical Neuroscience, Institute of Neurology, UCL Hampstead Campus, London, UK
| | - Alastair John Noyce
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.,Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
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209
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Ghazi Sherbaf F, Rostam Abadi Y, Mojtahed Zadeh M, Ashraf-Ganjouei A, Sanjari Moghaddam H, Aarabi MH. Microstructural Changes in Patients With Parkinson's Disease Comorbid With REM Sleep Behaviour Disorder and Depressive Symptoms. Front Neurol 2018; 9:441. [PMID: 29997561 PMCID: PMC6028696 DOI: 10.3389/fneur.2018.00441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of Parkinson's disease (PD) is currently anchored on clinical motor symptoms, which appear more than 20 years after initiation of the neurotoxicity. Extra-nigral involvement in the onset of PD with probable nonmotor manifestations before the development of motor signs, lead us to the preclinical (asymptomatic) or prodromal stages of the disease (various nonmotor or subtle motor signs). REM sleep behavior disorder (RBD) and depression are established prodromal clinical markers of PD and predict worse motor and cognitive outcomes. Nevertheless, taken by themselves, these markers are not yet claimed to be practical in identifying high-risk individuals. Combining promising markers may be helpful in a reliable diagnosis of early PD. Therefore, we aimed to detect neural correlates of RBD and depression in 93 treatment-naïve and non-demented early PD by means of diffusion MRI connectometry. Comparing four groups of PD patients with or without comorbid RBD and/or depressive symptoms with each other and with 31 healthy controls, we found that these two non-motor symptoms are associated with lower connectivity in several white matter tracts including the cerebellar peduncles, corpus callosum and long association fibers such as cingulum, fornix, and inferior longitudinal fasciculus. For the first time, we were able to detect the involvement of short association fibers (U-fibers) in PD neurodegenerative process. Longitudinal studies on larger sample groups are needed to further investigate the reported associations.
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210
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Getz SJ, Levin B. Cognitive and Neuropsychiatric Features of Early Parkinson's Disease. Arch Clin Neuropsychol 2018; 32:769-785. [PMID: 29077803 DOI: 10.1093/arclin/acx091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/05/2017] [Indexed: 12/31/2022] Open
Abstract
The clinical definition of Parkinson's disease (PD) is based on cardinal motor features including bradykinesia as well as an additional symptom of tremor, postural instability, or rigidity. Evidence from neuropathological, imaging, and clinical research suggests a premotor, early phase of PD pathology. Further understanding of the earliest biomarkers of PD is crucial for the development of neuroprotective, disease modifying, cognitive, and psychiatric interventions. Recent research has explored early non-motor markers of PD pathology. This issue is especially timely as the International Parkinson and Movement Disorder Society has recently provided a research definition for prodromal PD which includes combinations of prodromal markers and risk factors aimed at identifying target populations for disease-prevention trials. In this review of early PD, we will outline early non-motor symptoms, early cognitive and neuropsychiatric features, neuropsychological assessment strategies, emerging evidence for early biomarkers, and treatment recommendations.
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Affiliation(s)
- Sarah J Getz
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA
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211
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Skorvanek M, Feketeova E, Kurtis MM, Rusz J, Sonka K. Accuracy of Rating Scales and Clinical Measures for Screening of Rapid Eye Movement Sleep Behavior Disorder and for Predicting Conversion to Parkinson's Disease and Other Synucleinopathies. Front Neurol 2018; 9:376. [PMID: 29887829 PMCID: PMC5980959 DOI: 10.3389/fneur.2018.00376] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/08/2018] [Indexed: 12/12/2022] Open
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by repeated episodes of REM sleep-related vocalizations and/or complex motor behaviors. Definite diagnosis of RBD is based on history and polysomnography, both of which are less accessible due to the lack of trained specialists and high cost. While RBD may be associated with disorders like narcolepsy, focal brain lesions, and encephalitis, idiopathic RBD (iRBD) may convert to Parkinson's disease (PD) and other synucleinopathies in more than 80% of patients and it is to date the most specific clinical prodromal marker of PD. Identification of individuals at high risk for development of PD is becoming one of the most important topics for current PD-related research as well as for future treatment trials targeting prodromal PD. Furthermore, concomitant clinical symptoms, such as subtle motor impairment, hyposmia, autonomic dysfunction, or cognitive difficulties, in subjects with iRBD may herald its phenoconversion to clinically manifest parkinsonism. The assessment of these motor and non-motor symptoms in iRBD may increase the sensitivity and specificity in identifying prodromal PD subjects. This review evaluates the diagnostic accuracy of individual rating scales and validated single items for screening of RBD and the role and accuracy of available clinical, electrophysiological, imaging, and tissue biomarkers in predicting the phenoconversion from iRBD to clinically manifest synucleinopathies.
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Affiliation(s)
- Matej Skorvanek
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - Eva Feketeova
- Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovakia
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
| | - Monica M. Kurtis
- Movement Disorders Unit, Department of Neurology, Hospital Ruber Internacional, Madrid, Spain
| | - Jan Rusz
- Department of Neurology, Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Karel Sonka
- Department of Neurology, Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czechia
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212
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Heldmann M, Heeren J, Klein C, Rauch L, Hagenah J, Münte TF, Kasten M, Brüggemann N. Neuroimaging abnormalities in individuals exhibiting Parkinson's disease risk markers. Mov Disord 2018; 33:1412-1422. [PMID: 29756356 DOI: 10.1002/mds.27313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 12/23/2017] [Accepted: 12/31/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The concept of prodromal Parkinson's disease (PD) involves variable combinations of nonmotor features and subtle motor abnormalities as a result of ongoing neurodegeneration in the brain stem including substantia nigra (SN) and abnormal findings upon transcranial sonography and nuclear imaging. Except for nuclear imaging, the predictive value of risk markers for the conversion to overt PD is low. OBJECTIVE The objective of this study was to determine whether PD risk markers are associated with changes in brain structure and to what extent cognitive changes are risk markers for PD. METHODS Diffusion-weighted imaging, voxel-based morphometry, and cortical thickness analysis was performed in 29 individuals with hyposmia and/or an increased SN hyperechogenicity (SN+) upon transcranial sonography and 28 controls without these 2 risk markers. Classical parkinsonian signs were an exclusion criterion. All of the participants underwent a neuropsychological test battery addressing executive functions, learning ability, and verbal fluency. RESULTS In the PD risk group, diffusion-weighted imaging mean diffusivity was increased in 4 left hemisphere clusters (posterior thalamus, inferior longitudinal fasciculus, fornix, corticospinal tract). A negative relationship of mean diffusivity and smell function was present for the posterior thalamus and the corticospinal tract. There was a significant correlation of mean diffusivity values and SN+ in all clusters. Neither voxel-based morphometry nor cortical thickness analysis revealed any group differences. No relevant group differences were observed for cognitive tests included. CONCLUSION PD-free individuals with PD risk markers show microstructural changes of the white matter, including areas relevant for motor and limbic processes. In addition, our study provides for the first time a neuroanatomical correlate for SN hyperechogenicity. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Janna Heeren
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Linus Rauch
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Johann Hagenah
- Department of Neurology, Westküstenklinikum Heide, Heide, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Gross A, Racette BA, Camacho-Soto A, Dube U, Searles Nielsen S. Use of medical care biases associations between Parkinson disease and other medical conditions. Neurology 2018; 90:e2155-e2165. [PMID: 29743207 DOI: 10.1212/wnl.0000000000005678] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 03/30/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine how use of medical care biases the well-established associations between Parkinson disease (PD) and smoking, smoking-related cancers, and selected positively associated comorbidities. METHODS We conducted a population-based, case-control study of 89,790 incident PD cases and 118,095 randomly selected controls, all Medicare beneficiaries aged 66 to 90 years. We ascertained PD and other medical conditions using ICD-9-CM codes from comprehensive claims data for the 5 years before PD diagnosis/reference. We used logistic regression to estimate age-, sex-, and race-adjusted odds ratios (ORs) between PD and each other medical condition of interest. We then examined the effect of also adjusting for selected geographic- or individual-level indicators of use of care. RESULTS Models without adjustment for use of care and those that adjusted for geographic-level indicators produced similar ORs. However, adjustment for individual-level indicators consistently decreased ORs: Relative to ORs without adjustment for use of care, all ORs were between 8% and 58% lower, depending on the medical condition and the individual-level indicator of use of care added to the model. ORs decreased regardless of whether the established association is known to be positive or inverse. Most notably, smoking and smoking-related cancers were positively associated with PD without adjustment for use of care, but appropriately became inversely associated with PD with adjustment for use of care. CONCLUSION Use of care should be considered when evaluating associations between PD and other medical conditions to ensure that positive associations are not attributable to bias and that inverse associations are not masked.
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Affiliation(s)
- Anat Gross
- From the Department of Neurology (A.G., B.A.R., A.C.-S., U.D., S.S.N.), Washington University School of Medicine, St. Louis, MO; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Brad A Racette
- From the Department of Neurology (A.G., B.A.R., A.C.-S., U.D., S.S.N.), Washington University School of Medicine, St. Louis, MO; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Alejandra Camacho-Soto
- From the Department of Neurology (A.G., B.A.R., A.C.-S., U.D., S.S.N.), Washington University School of Medicine, St. Louis, MO; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Umber Dube
- From the Department of Neurology (A.G., B.A.R., A.C.-S., U.D., S.S.N.), Washington University School of Medicine, St. Louis, MO; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Susan Searles Nielsen
- From the Department of Neurology (A.G., B.A.R., A.C.-S., U.D., S.S.N.), Washington University School of Medicine, St. Louis, MO; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa.
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Abstract
PURPOSE OF REVIEW Parkinson's disease (PD) is the second most common neurodegenerative disorder. Sleep dysfunction is one of the most common non-motor manifestations of PD that has gained significant interest over the past two decades due to its impact on the daily lives of PD patients, poorly understood mechanisms, and limited treatment options. In this review, we discuss the most common sleep disorders in PD and present recent investigations that have broadened our understanding of the epidemiology, clinical manifestations, diagnosis, and treatment of disturbed sleep and alertness in PD. RESENT FINDINGS The etiology of impaired sleep-wake cycles in PD is multifactorial. Sleep dysfunction in PD encompasses insomnia, REM sleep behavior disorder, sleep-disordered breathing, restless legs syndrome, and circadian dysregulation. Despite the high prevalence of sleep dysfunction in PD, evidence supporting the efficacy of treatment strategies is limited. We are at the opportune time to advance our understanding of sleep dysfunction in PD, which will hopefully lead to mechanisms-driven interventions for better sleep and allow us to approach sleep as a modifiable therapeutic target for other non-motor and motor manifestations in PD.
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Affiliation(s)
- Aleksandar Videnovic
- Movement Disorders Unit, Massachusetts General Hospital, Boston, MA, 02114, USA. .,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA. .,MGH Neurological Clinical Research Institute, 165 Cambridge Street, Suite 600, Boston, MA, 02446, USA.
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215
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Liu JB, Leng JL, Zhang XJ, Wang ZX, Duan ZW, Mao CJ, Liu CF. Investigation of non-motor symptoms in first-degree relatives of patients with Parkinson's disease. Parkinsonism Relat Disord 2018; 52:62-68. [PMID: 29606605 DOI: 10.1016/j.parkreldis.2018.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/17/2018] [Accepted: 03/25/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Non-motor symptoms (NMS) are important prodromal characteristics of Parkinson's disease (PD). However, the incidence of NMS in first-degree relatives, such as siblings of PD patients, is still unknown. METHODS A total of 98 PD patients of the Affiliated Hospital of Yangzhou University were recruited; 210 siblings of these patients were included in a first-degree relatives (FDR) group and 250 healthy individuals were included in a control group. Various scales were used to assess NMS, including depression, anxiety, cognitive function, sleep status, constipation, daytime sleepiness, Rapid-Eye-Movement Sleep Behavior Disorder (RBD), and Restless Legs Syndrome (RLS). RESULTS NMS were more common in the PD group than the control group. The incidence of anxiety (OR = 3.434, 95%CI: 2.058-5.731, P < 0.001), depression (OR = 2.438, 95%CI: 1.289-4.609, P = 0.005), and RBD (OR = 4.120, 95%CI: 1.897-8.945, P < 0.001) was higher in the FDR group than the control group. There were non-significant differences in constipation, cognitive impairment, sleep disorder, daytime sleepiness, and RLS between the two groups. The incidence of RLS in FDR of PD with an age of onset <60 years was higher than in the controls (OR = 2.273, 95%CI: 1.107-4.667, P = 0.023). CONCLUSIONS Siblings of PD are more likely to suffer from anxiety, depression and RBD than the general population. RLS is more common in siblings of PD with onset age<60 than in the general population. It is speculated that PD patients and their siblings have common pathogenic genetic factors and early living environment for neurodegeneration.
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Affiliation(s)
- Jiang-Bing Liu
- Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
| | - Jun-Ling Leng
- Emergency Department, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
| | - Xin-Jiang Zhang
- Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
| | - Zhao-Xia Wang
- Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
| | - Zuo-Wei Duan
- Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China.
| | - Cheng-Jie Mao
- Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
| | - Chun-Feng Liu
- Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China.
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216
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Neuroimaging in Parkinson's disease: focus on substantia nigra and nigro-striatal projection. Curr Opin Neurol 2018; 30:416-426. [PMID: 28537985 DOI: 10.1097/wco.0000000000000463] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW The diagnosis of Parkinson disease is based on clinical features; however, unmet need is an imaging signature for Parkinson disease and the early differential diagnosis with atypical parkinsonisms. A summary of the molecular imaging and MRI recent evidences for Parkinson disease diagnosis will be presented in this review. RECENT FINDINGS The nigro-striatal dysfunction explored by dopamine transporter imaging is not a mandatory diagnostic criterion for Parkinson disease, recent evidence supported its utility as in-vivo proof of degenerative parkinsonisms, and there might be compensatory mechanisms leading to an early overestimation. The visualization of abnormalities in substantia nigra by MRI has been recently described as sensitive and specific tool for Parkinson disease diagnosis, even in preclinical conditions, whereas it is not useful for distinguishing between Parkinson disease and atypical parkinsonisms. The relationship between the nigral anatomical changes, evaluated as structural alterations or neuromelanin signal decrease and the dopaminergic nigro-striatal function needs to be further clarified. SUMMARY With the hopeful advent of potential neuroprotective drugs for PD, it is crucial to have imaging measures that are able to detect at risk subjects. Moreover it is desirable to increase the knowledge about which measure better predicts the probability and the time of clinical conversion to PD.
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217
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Rizzi N, Brunialti E, Cerri S, Cermisoni G, Levandis G, Cesari N, Maggi A, Blandini F, Ciana P. In vivo imaging of early signs of dopaminergic neuronal death in an animal model of Parkinson's disease. Neurobiol Dis 2018; 114:74-84. [PMID: 29486298 DOI: 10.1016/j.nbd.2018.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/02/2018] [Accepted: 02/21/2018] [Indexed: 12/23/2022] Open
Abstract
The Parkinson's disease (PD) evolves over an extended period of time with the onset occurring long before clinical signs begin to manifest. Characterization of the molecular events underlying the PD onset is instrumental for the development of diagnostic markers and preventive treatments, progress in this field is hindered by technical limitations. We applied an imaging approach to demonstrate the activation of Nrf2 transcription factor as a hallmark of neurodegeneration in neurotoxin-driven models of PD. In dopaminergic SK-N-BE neuroblastoma cells, Nrf2 activation was detected in cells committed to die as proven by time lapse microscopy; in the substantia nigra pars compacta area of the mouse brain, the Nrf2 activation preceded dopaminergic neurodegeneration as demonstrated by in vivo and ex vivo optical imaging, a finding confirmed by co-localization experiments carried out by immunohistochemistry. Collectively, our results identify the Nrf2 signaling as an early marker of neurodegeneration, anticipating dopaminergic neurodegeneration and motor deficits.
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Affiliation(s)
- Nicoletta Rizzi
- Center of Excellence for Neurodegenerative Diseases, Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Electra Brunialti
- Center of Excellence for Neurodegenerative Diseases, Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Silvia Cerri
- Laboratory of Functional Neurochemistry, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Pavia, Italy
| | - Greta Cermisoni
- Center of Excellence for Neurodegenerative Diseases, Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Giovanna Levandis
- Laboratory of Functional Neurochemistry, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Pavia, Italy
| | - Nicoletta Cesari
- Centro Clinico-Veterinario e Zootecnico-Sperimentale d'Ateneo, University of Milan, Via dell'Università 6, 26900 Lodi, Italy
| | - Adriana Maggi
- Center of Excellence for Neurodegenerative Diseases, Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy
| | - Fabio Blandini
- Laboratory of Functional Neurochemistry, IRCCS Mondino Foundation, via Mondino 2, 27100 Pavia, Pavia, Italy
| | - Paolo Ciana
- Center of Excellence for Neurodegenerative Diseases, Department of Oncology and Hemato-Oncology, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.
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Arnerić SP, Kern VD, Stephenson DT. Regulatory-accepted drug development tools are needed to accelerate innovative CNS disease treatments. Biochem Pharmacol 2018; 151:291-306. [PMID: 29410157 DOI: 10.1016/j.bcp.2018.01.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/26/2018] [Indexed: 02/07/2023]
Abstract
Central Nervous System (CNS) diseases represent one of the most challenging therapeutic areas for successful drug approvals. Developing quantitative biomarkers as Drug Development Tools (DDTs) can catalyze the path to innovative treatments, and improve the chances of drug approvals. Drug development and healthcare management requires sensitive, reliable, validated, and regulatory accepted biomarkers and endpoints. This review highlights the regulatory paths and considerations for developing DDTs required to advance biomarker and endpoint use in clinical development (e.g., consensus CDISC [Clinical Data Interchange Standards Consortium] data standards, precompetitive sharing of anonymized patient-level data, and continual alignment with regulators). Summarized is the current landscape of biomarkers in a range of CNS diseases including Alzheimer disease, Parkinson Disease, Amyotrophic Lateral Sclerosis, Autism Spectrum Disorders, Depression, Huntington's disease, Multiple Sclerosis and Traumatic Brain Injury. Advancing DDTs for these devastating diseases that are both validated and qualified will require an integrated, cross-consortium approach to accelerate the delivery of innovative CNS therapeutics.
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Affiliation(s)
- Stephen P Arnerić
- Critical Path for Alzheimer's Disease, Crititcal Path Institute, United States.
| | - Volker D Kern
- Critical Path for Alzheimer's Disease, Crititcal Path Institute, United States
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219
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Munoz DG, Fujioka S. Caffeine and Parkinson disease: A possible diagnostic and pathogenic breakthrough. Neurology 2018; 90:205-206. [PMID: 29298853 DOI: 10.1212/wnl.0000000000004898] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- David G Munoz
- From the Department of Laboratory Medicine and Pathobiology (D.G.M.), University of Toronto, Canada; and Department of Neurology (S.F.), Fukuoka University, Japan.
| | - Shinsuke Fujioka
- From the Department of Laboratory Medicine and Pathobiology (D.G.M.), University of Toronto, Canada; and Department of Neurology (S.F.), Fukuoka University, Japan
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220
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Fujimaki M, Saiki S, Li Y, Kaga N, Taka H, Hatano T, Ishikawa KI, Oji Y, Mori A, Okuzumi A, Koinuma T, Ueno SI, Imamichi Y, Ueno T, Miura Y, Funayama M, Hattori N. Serum caffeine and metabolites are reliable biomarkers of early Parkinson disease. Neurology 2018; 90:e404-e411. [PMID: 29298852 PMCID: PMC5791797 DOI: 10.1212/wnl.0000000000004888] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/29/2017] [Indexed: 12/29/2022] Open
Abstract
Objective To investigate the kinetics and metabolism of caffeine in serum from patients with Parkinson disease (PD) and controls using liquid chromatography–mass spectrometry. Methods Levels of caffeine and its 11 metabolites in serum from 108 patients with PD and 31 age-matched healthy controls were examined by liquid chromatography–mass spectrometry. Mutations in caffeine-associated genes were screened by direct sequencing. Results Serum levels of caffeine and 9 of its downstream metabolites were significantly decreased even in patients with early PD, unrelated to total caffeine intake or disease severity. No significant genetic variations in CYP1A2 or CYP2E1, encoding cytochrome P450 enzymes primarily involved in metabolizing caffeine in humans, were detected compared with controls. Likewise, caffeine concentrations in patients with PD with motor complications were significantly decreased compared with those without motor complications. No associations between disease severity and single nucleotide variants of the ADORA2A gene encoding adenosine 2A receptor were detected, implying a dissociation of receptor sensitivity changes and phenotype. The profile of serum caffeine and metabolite levels was identified as a potential diagnostic biomarker by receiver operating characteristic curve analysis. Conclusion Absolute lower levels of caffeine and caffeine metabolite profiles are promising diagnostic biomarkers for early PD. This is consistent with the neuroprotective effect of caffeine previously revealed by epidemiologic and experimental studies. Classification of evidence This study provides Class III evidence that decreased serum levels of caffeine and its metabolites identify patients with PD.
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Affiliation(s)
- Motoki Fujimaki
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Shinji Saiki
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan.
| | - Yuanzhe Li
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Naoko Kaga
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Hikari Taka
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Taku Hatano
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Kei-Ichi Ishikawa
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Yutaka Oji
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Akio Mori
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Ayami Okuzumi
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Takahiro Koinuma
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Shin-Ichi Ueno
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Yoko Imamichi
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Takashi Ueno
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshiki Miura
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Manabu Funayama
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- From the Department of Neurology (M.F., S.S., Y.L., T.H., K.-I.I., Y.O., A.M., A.O., T.K., S.-I.U., Y.I., M.F., N.H.), Research Institute for Diseases of Old Age (M.F., N.H.), and Laboratory of Proteomics and Biomolecular Science (N.K., H.T., T.U., Y.M.), Juntendo University School of Medicine, Tokyo, Japan.
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Ghazi Sherbaf F, Mohajer B, Ashraf-Ganjouei A, Mojtahed Zadeh M, Javinani A, Sanjari Moghaddam H, Shirin Shandiz M, Aarabi MH. Serum Insulin-Like Growth Factor-1 in Parkinson's Disease; Study of Cerebrospinal Fluid Biomarkers and White Matter Microstructure. Front Endocrinol (Lausanne) 2018; 9:608. [PMID: 30450079 PMCID: PMC6224341 DOI: 10.3389/fendo.2018.00608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 09/24/2018] [Indexed: 01/07/2023] Open
Abstract
Background: Growing evidence shows that impaired signaling of Insulin-like Growth Factor-1 (IGF-1) is associated with neurodegenerative disorders, such as Parkinson's disease (PD). However, there is still controversy regarding its proinflammatory or neuroprotective function. In an attempt to elucidate the contribution of IGF-1 in PD, we aimed to discover the relation between serum IGF-1 levels in drug-naïve early PD patients and cerebrospinal fluid (CSF) biomarkers as well as microstructural changes in brain white matter. Methods: The association between quartiles of serum IGF-1 levels and CSF biomarkers (α-synuclein, dopamine, amyloid-β1-42, total tau, and phosphorylated tau) was investigated using adjusted regression models in 404 drug-naïve early PD patients with only mild motor manifestations and 188 age- and sex-matched healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). By using region of interest analysis and connectometry approach, we tracked the white matter microstructural integrity and diffusivity patterns in a subgroup of study participants with available diffusion MRI data to investigate the association between subcomponents of neural pathways with serum IGF-1 levels. Results: PD patients had higher levels of IGF-1 compared to HC, although not statistically significant (mean difference: 3.60, P = 0.44). However, after adjustment for possible confounders and correction for False Discovery Rate (FDR), IGF-1 was negatively correlated with CSF α-synuclein, total and phosphorylated tau levels only in PD subjects. The imaging analysis proved a significant negative correlation (FDR corrected P-value = 0.013) between continuous levels of serum IGF-1 in patients with PD and the connectivity, but not integrity, in following fibers while controlling for age, sex, body mass index, depressive symptoms, education years, cognitive status and disease duration: middle cerebellar peduncle, cingulum, genu and splenium of the corpus callosum. No significant association was found between brain white matter microstructral measures or CSF markers of healthy controls and levels of IGF-1. Conclusion: Altered connectivity in specific white matter structures, mainly involved in cognitive and motor deterioration, in association with higher serum IGF-1 levels might propose IGF-1 as a potential associate of worse outcome in response to higher burden of α-synucleinopathy and tauopathy in PD.
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Affiliation(s)
| | - Bahram Mohajer
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ali Javinani
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Shirin Shandiz
- Department of Medical Physics, Zahedan University of Medical Sciences, Zahedan, Iran
- *Correspondence: Mehdi Shirin Shandiz
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Mohammad Hadi Aarabi
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Langley MR, Ghaisas S, Ay M, Luo J, Palanisamy BN, Jin H, Anantharam V, Kanthasamy A, Kanthasamy AG. Manganese exposure exacerbates progressive motor deficits and neurodegeneration in the MitoPark mouse model of Parkinson's disease: Relevance to gene and environment interactions in metal neurotoxicity. Neurotoxicology 2018; 64:240-255. [PMID: 28595911 PMCID: PMC5736468 DOI: 10.1016/j.neuro.2017.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
Abstract
Parkinson's disease (PD) is now recognized as a neurodegenerative condition caused by a complex interplay of genetic and environmental influences. Chronic manganese (Mn) exposure has been implicated in the development of PD. Since mitochondrial dysfunction is associated with PD pathology as well as Mn neurotoxicity, we investigated whether Mn exposure augments mitochondrial dysfunction and neurodegeneration in the nigrostriatal dopaminergic system using a newly available mitochondrially defective transgenic mouse model of PD, the MitoPark mouse. This unique PD model recapitulates key features of the disease including progressive neurobehavioral changes and neuronal degeneration. We exposed MitoPark mice to a low dose of Mn (10mg/kg, p.o.) daily for 4 weeks starting at age 8 wks and then determined the behavioral, neurochemical and histological changes. Mn exposure accelerated the rate of progression of motor deficits in MitoPark mice when compared to the untreated MitoPark group. Mn also worsened olfactory function in this model. Most importantly, Mn exposure intensified the depletion of striatal dopamine and nigral TH neuronal loss in MitoPark mice. The neurodegenerative changes were accompanied by enhanced oxidative damage in the striatum and substantia nigra (SN) of MitoPark mice treated with Mn. Furthermore, Mn-treated MitoPark mice had significantly more oligomeric protein and IBA-1-immunoreactive microglia cells, suggesting Mn augments neuroinflammatory processes in the nigrostriatal pathway. To further confirm the direct effect of Mn on impaired mitochondrial function, we also generated a mitochondrially defective dopaminergic cell model by knocking out the TFAM transcription factor by using a CRISPR-Cas9 gene-editing method. Seahorse mitochondrial bioenergetic analysis revealed that Mn decreases mitochondrial basal and ATP-linked respiration in the TFAM KO cells. Collectively, our results reveal that Mn can augment mitochondrial dysfunction to exacerbate nigrostriatal neurodegeneration and PD-related behavioral symptoms. Our study also demonstrates that the MitoPark mouse is an excellent model to study the gene-environment interactions associated with mitochondrial defects in the nigral dopaminergic system as well as to evaluate the contribution of potential environmental toxicant interactions in a slowly progressive model of Parkinsonism.
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Affiliation(s)
- Monica R Langley
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Shivani Ghaisas
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Muhammet Ay
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Jie Luo
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Bharathi N Palanisamy
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Huajun Jin
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Vellareddy Anantharam
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Arthi Kanthasamy
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States
| | - Anumantha G Kanthasamy
- Parkinson Disorders Research Program, Iowa Center for Advanced Neurotoxicology, Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, United States.
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223
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Parkinson’s Disease: Contemporary Concepts and Clinical Management. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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224
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Ubeda-Bañon I, Flores-Cuadrado A, Saiz-Sanchez D, Martinez-Marcos A. Differential Effects of Parkinson's Disease on Interneuron Subtypes within the Human Anterior Olfactory Nucleus. Front Neuroanat 2017; 11:113. [PMID: 29259548 PMCID: PMC5723292 DOI: 10.3389/fnana.2017.00113] [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] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/21/2017] [Indexed: 11/13/2022] Open
Abstract
Synucleinopathies (including α-synucleinopathies), which include Parkinson's disease (PD), manifest themsevles early on (stage 1) in the olfactory system; preferentially in the anterior olfactory nucleus (AON). In particular, the non-motor, early manifestations of PD include hyposmia, which is the partial loss of the sense of smell. The neural basis of hyposmia in PD, however, is poorly understood; but the AON appears to be a key structure in the disease's progression. We analyzed whether α-synuclein was involved in the differential interneuron vulnerability associated with PD in the retrobulbar, cortical anterior and cortical posterior divisions of the AON. First, we determined the expression of the calcium binding interneuron markers, calretinin, calbindin and parvalbumin, as well as non-calcium binding interneuron marker, somatostatin, in neuronal cell bodies alone (cells/mm2) and in neuronal cell bodies and neurites (% of area fraction) of post-mortem tissue from PD cases and age-matched controls (n = 4 for each) by immunofluorescent confocal microscopy. Results indicated that parvalbumin expression was upregulated in neuronal cell bodies throughout the anterior olfactory nucleus of PD cases compared with controls. Furthermore, there was increased calbindin, calretinin and parvalbumin expression in the cell bodies and neurites of neurons in the retrobulbar division and also increased parvalbumin expression in the neurites of neurons in the cortical division; calretinin expression was also increased in neuronal cell bodies and neurites in the cortical posterior division. Second, we analyzed the co-localization of the above markers with α-synuclein, with results indicating that α-synuclein co-localized with the calcium-binding proteins, but only partially with somatostatin. Taken together, these results indicate differential expression levels among different neural markers in the divisions of the AON in PD cases and point to several possibilities, among them: possible neuroprotective mechanisms of calcium-binding proteins against α-synuclein; and the differential involvement of somatostatin in α-synuclein-positive cell bodies and neurites.
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Affiliation(s)
- Isabel Ubeda-Bañon
- Neuroplasticity and Neurodegeneration Laboratory, CRIB, Ciudad Real Medical School, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Alicia Flores-Cuadrado
- Neuroplasticity and Neurodegeneration Laboratory, CRIB, Ciudad Real Medical School, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Daniel Saiz-Sanchez
- Neuroplasticity and Neurodegeneration Laboratory, CRIB, Ciudad Real Medical School, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Alino Martinez-Marcos
- Neuroplasticity and Neurodegeneration Laboratory, CRIB, Ciudad Real Medical School, University of Castilla-La Mancha, Ciudad Real, Spain
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225
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Shi J, Tian J, Li T, Qin B, Fan D, Ni J, Wei M, Zhang X, Liu N, Liu J, Li Y, Liu W, Wang Y. Efficacy and safety of SQJZ herbal mixtures on nonmotor symptoms in Parkinson disease patients: Protocol for a randomized, double-blind, placebo-controlled trial. Medicine (Baltimore) 2017; 96:e8824. [PMID: 29390272 PMCID: PMC5815684 DOI: 10.1097/md.0000000000008824] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a multisystemic neurodegenerative disorder, Parkinson disease (PD) has a broad spectrum of symptoms including motor and nonmotor symptoms (NMS). As shown in studies, NMS can also impact patient's quality of life, and many of them often go untreated. Chinese herbal medicines with multiconstituent may alleviate NMS in PD patients. This research is carried out to assess the efficacy and safety of a Chinese herbal formula for NMS, with its Chinese name acronym of SQJZ. METHODS/DESIGN It will be a multicenter, randomized, double-blind, placebo-controlled trial. Idiopathic PD with a Hoehn and Yahr scale score ≤4, aged 18 to 80 years, will be involved. About 240 patients will be randomly assigned to either SQJZ or placebo in a 2:1 ratio. There is a 2-week run-in period before the randomization, and the follow-up will be 24 weeks, including 12-week treatment period, with visit once every 4 weeks and 12-week washout follow-up. All participants are asked to maintain the regular medication schedule. SQJZ formula will consist of Chinese herbs with effects for insomnia, constipation, anxiety, and so on. The primary outcome will be measured using NMS scale, and secondary outcomes will include unified PD rating scale, PD sleep scale, the Parkinson fatigue scale, the constipation severity instrument, and PD Questionnaire-39. The primary efficacy analysis will be based on the intention-to-treat method, and mixed-model repeated-measures analyses will be used. DISCUSSION The findings from this research might provide evidence of the efficacy and safety of SQJZ Chinese herbal formula for treating NMS in PD patients. The results will sustain the broader use of SQJZ formula in PD.
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Affiliation(s)
- Jing Shi
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Jinzhou Tian
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Ting Li
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | | | | | - Jingnian Ni
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Mingqing Wei
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Xuekai Zhang
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Na Liu
- Peking University Third Hospital
| | - Jianping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine
| | - Yumeng Li
- Institute of Neurodegenerative Diseases at Dongzhimen Hospital, Beijing University of Chinese Medicine
| | - Weiwei Liu
- Consulting Center of Biomedical Statistics, The Academy of Military Medical Sciences
| | - Yongyan Wang
- Institute of Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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226
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Wen MC, Heng HS, Hsu JL, Xu Z, Liew GM, Au WL, Chan LL, Tan LC, Tan EK. Structural connectome alterations in prodromal and de novo Parkinson's disease patients. Parkinsonism Relat Disord 2017; 45:21-27. [PMID: 28964628 DOI: 10.1016/j.parkreldis.2017.09.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/16/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022]
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227
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Abstract
So-called idiopathic rapid eye movement (REM) sleep behaviour disorder (RBD), formerly seen as a rare parasomnia, is now recognized as the prodromal stage of an α-synucleinopathy. Given the very high risk that patients with idiopathic RBD have of developing α-synucleinopathies, such as Parkinson disease (PD), PD dementia, dementia with Lewy bodies or multiple system atrophy, and the outstandingly high specificity and very long interval between the onset of idiopathic RBD and the clinical manifestations of α-synucleinopathies, the prodromal phase of this disorder represents a unique opportunity for potentially disease-modifying intervention. This Review provides an update on classic and novel biomarkers of α-synuclein-related neurodegeneration in patients with idiopathic RBD, focusing on advances in imaging and neurophysiological, cognitive, autonomic, tissue-specific and other biomarkers. We discuss the strengths, potential weaknesses and suitability of these biomarkers for identifying RBD and neurodegeneration, with an emphasis on predicting progression to overt α-synucleinopathy. The role of video polysomnography in providing quantifiable and potentially treatment-responsive biomarkers of neurodegeneration is highlighted. In light of all these advances, and the now understood role of idiopathic RBD as an early manifestation of α-synuclein disease, we call for idiopathic RBD to be reconceptualized as isolated RBD.
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228
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Fengler S, Liepelt-Scarfone I, Brockmann K, Schäffer E, Berg D, Kalbe E. Cognitive changes in prodromal Parkinson's disease: A review. Mov Disord 2017; 32:1655-1666. [PMID: 28980730 DOI: 10.1002/mds.27135] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 12/31/2022] Open
Abstract
Although other nonmotor phenomena representing possible prodromal symptoms of Parkinson's disease have been described in some detail, the occurrence and characteristics of cognitive decline in this early phase of the disease are less well understood. The aim of this review is to summarize the current state of research on cognitive changes in prodromal PD. Only a small number of longitudinal studies have been conducted that examined cognitive function in individuals with a subsequent PD diagnosis. However, when we consider data from at-risk groups, the evidence suggests that cognitive decline may occur in a substantial number of individuals who have the potential for developing PD. In terms of specific cognitive domains, executive function in particular and, less frequently, memory scores are reduced. Prospective longitudinal studies are thus needed to clarify whether cognitive, and specifically executive, decline might be added to the prodromal nonmotor symptom complex that may precede motor manifestations of PD by years and may help to update the risk scores used for early identification of PD. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sophie Fengler
- Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany.,Psychological Gerontology, Institute of Gerontology, University of Vechta, Vechta, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Eva Schäffer
- Department of Neurology, Christian-Albrechts-University, Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Kiel, Germany
| | - Elke Kalbe
- Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany.,Psychological Gerontology, Institute of Gerontology, University of Vechta, Vechta, Germany
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229
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Meng Y, Suppiah S, Mithani K, Solomon B, Schwartz ML, Lipsman N. Current and emerging brain applications of MR-guided focused ultrasound. J Ther Ultrasound 2017; 5:26. [PMID: 29034095 PMCID: PMC5629772 DOI: 10.1186/s40349-017-0105-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 09/28/2017] [Indexed: 12/30/2022] Open
Abstract
MRI guided focused ultrasound is an emerging technique that uses acoustic energy to noninvasively treat intracranial disorders. At high frequencies, it can be used to raise tissue temperatures and ablate discrete brain targets with sub-millimeter accuracy. This application is currently under investigation for a broad range of clinical applications, including brain tumors, movement disorders, and psychiatric conditions. At low frequencies MRI guided focused ultrasound can be used to modulate neuronal activity and in conjunction with injected microbubbles, can open the blood-brain barrier to enhance the delivery of therapeutic compounds. The last decade has seen dramatic advances in the science of MRI guided focused ultrasound, helping elucidate both its mechanisms and potential in pre-clinical models, and its translational promise across myriad clinical applications. This review provides an update of current and emerging MRI guided focused ultrasound applications for intracranial disorders and describes future directions and challenges for the field.
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Affiliation(s)
- Ying Meng
- Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON Canada
| | - Suganth Suppiah
- Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON Canada
| | - Karim Mithani
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON Canada
| | - Benjamin Solomon
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON Canada
| | - Michael L Schwartz
- Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON Canada
| | - Nir Lipsman
- Division of Neurosurgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON Canada
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230
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Brundin P, Dave KD, Kordower JH. Therapeutic approaches to target alpha-synuclein pathology. Exp Neurol 2017; 298:225-235. [PMID: 28987463 DOI: 10.1016/j.expneurol.2017.10.003] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 01/09/2023]
Abstract
Starting two decades ago with the discoveries of genetic links between alpha-synuclein and Parkinson's disease risk and the identification of aggregated alpha-synuclein as the main protein constituent of Lewy pathology, alpha-synuclein has emerged as the major therapeutic target in Parkinson's disease and related synucleinopathies. Following the suggestion that alpha-synuclein pathology gradually spreads through the nervous system following a stereotypic pattern and the discovery that aggregated forms of alpha-synuclein can propagate pathology from one cell to another, and thereby probably aggravate existing deficits as well as generate additional symptoms, the idea that alpha-synuclein is a viable therapeutic target gained further support. In this review we describe current challenges and possibilities with alpha-synuclein as a therapeutic target. We briefly highlight gaps in the knowledge of the role of alpha-synuclein in disease, and propose that a deeper understanding of the pathobiology of alpha-synuclein can lead to improved therapeutic strategies. We describe several treatment approaches that are currently being tested in advanced animal experiments or already are in clinical trials. We have divided them into approaches that reduce alpha-synuclein production; inhibit alpha-synuclein aggregation inside cells; promote its degradation either inside or outside cells; and reduce its uptake by neighbouring cells following release from already affected neurons. Finally, we briefly discuss challenges related to the clinical testing of alpha-synuclein therapies, for example difficulties in monitoring target engagement and the need for relatively large trials of long duration. We conclude that alpha-synuclein remains one of the most compelling therapeutic targets for Parkinson's disease, and related synucleinopathies, and that the multitude of approaches being tested provides hope for the future.
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Affiliation(s)
- Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI 49503, USA.
| | - Kuldip D Dave
- The Michael J Fox Foundation, New York, NY 10017, USA
| | - Jeffrey H Kordower
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI 49503, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
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231
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Chauhan R, Chen KF, Kent BA, Crowther DC. Central and peripheral circadian clocks and their role in Alzheimer's disease. Dis Model Mech 2017; 10:1187-1199. [PMID: 28993311 PMCID: PMC5665458 DOI: 10.1242/dmm.030627] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Molecular and cellular oscillations constitute an internal clock that tracks the time of day and permits organisms to optimize their behaviour and metabolism to suit the daily demands they face. The workings of this internal clock become impaired with age. In this review, we discuss whether such age-related impairments in the circadian clock interact with age-related neurodegenerative disorders, such as Alzheimer's disease. Findings from mouse and fly models of Alzheimer's disease have accelerated our understanding of the interaction between neurodegeneration and circadian biology. These models show that neurodegeneration likely impairs circadian rhythms either by damaging the central clock or by blocking its communication with other brain areas and with peripheral tissues. The consequent sleep and metabolic deficits could enhance the susceptibility of the brain to further degenerative processes. Thus, circadian dysfunction might be both a cause and an effect of neurodegeneration. We also discuss the primary role of light in the entrainment of the central clock and describe important, alternative time signals, such as food, that play a role in entraining central and peripheral circadian clocks. Finally, we propose how these recent insights could inform efforts to develop novel therapeutic approaches to re-entrain arrhythmic individuals with neurodegenerative disease.
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Affiliation(s)
- Ruchi Chauhan
- Department of Genetics, University of Cambridge, Downing Street, Cambridge, CB2 3EH, UK
| | - Ko-Fan Chen
- Institute of Neurology, UCL, London, WC1N 3BG, UK
| | - Brianne A Kent
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, V6T 1Z3, Canada
| | - Damian C Crowther
- Neuroscience, Innovative Medicines and Early Development, AstraZeneca, Granta Park, Cambridge, CB21 6GH, UK
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232
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Fuchs H, Aguilar-Pimentel JA, Amarie OV, Becker L, Calzada-Wack J, Cho YL, Garrett L, Hölter SM, Irmler M, Kistler M, Kraiger M, Mayer-Kuckuk P, Moreth K, Rathkolb B, Rozman J, da Silva Buttkus P, Treise I, Zimprich A, Gampe K, Hutterer C, Stöger C, Leuchtenberger S, Maier H, Miller M, Scheideler A, Wu M, Beckers J, Bekeredjian R, Brielmeier M, Busch DH, Klingenspor M, Klopstock T, Ollert M, Schmidt-Weber C, Stöger T, Wolf E, Wurst W, Yildirim AÖ, Zimmer A, Gailus-Durner V, Hrabě de Angelis M. Understanding gene functions and disease mechanisms: Phenotyping pipelines in the German Mouse Clinic. Behav Brain Res 2017; 352:187-196. [PMID: 28966146 DOI: 10.1016/j.bbr.2017.09.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/18/2017] [Accepted: 09/25/2017] [Indexed: 02/07/2023]
Abstract
Since decades, model organisms have provided an important approach for understanding the mechanistic basis of human diseases. The German Mouse Clinic (GMC) was the first phenotyping facility that established a collaboration-based platform for phenotype characterization of mouse lines. In order to address individual projects by a tailor-made phenotyping strategy, the GMC advanced in developing a series of pipelines with tests for the analysis of specific disease areas. For a general broad analysis, there is a screening pipeline that covers the key parameters for the most relevant disease areas. For hypothesis-driven phenotypic analyses, there are thirteen additional pipelines with focus on neurological and behavioral disorders, metabolic dysfunction, respiratory system malfunctions, immune-system disorders and imaging techniques. In this article, we give an overview of the pipelines and describe the scientific rationale behind the different test combinations.
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Affiliation(s)
- Helmut Fuchs
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Juan Antonio Aguilar-Pimentel
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Oana V Amarie
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Lore Becker
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Julia Calzada-Wack
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Yi-Li Cho
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Lillian Garrett
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Sabine M Hölter
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Martin Irmler
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Martin Kistler
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Markus Kraiger
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Philipp Mayer-Kuckuk
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Kristin Moreth
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Birgit Rathkolb
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-University München, Feodor-Lynen-Str. 25, 81377 Munich, Germany
| | - Jan Rozman
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Patricia da Silva Buttkus
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Irina Treise
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Annemarie Zimprich
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Kristine Gampe
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Christine Hutterer
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Claudia Stöger
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Stefanie Leuchtenberger
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Holger Maier
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Manuel Miller
- Research Unit Comparative Medicine, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Angelika Scheideler
- Research Unit Comparative Medicine, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Moya Wu
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Johannes Beckers
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Chair of Experimental Genetics, School of Life Science Weihenstephan, Technische Universität München, Alte Akademie 8, 85354 Freising, Germany
| | - Raffi Bekeredjian
- Department of Cardiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Markus Brielmeier
- Research Unit Comparative Medicine, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Dirk H Busch
- Institute for Medical Microbiology, Immunology and Hygiene, Technische Universität München, Trogerstr. 30, 81675 Munich, Germany
| | - Martin Klingenspor
- Chair of Molecular Nutritional Medicine, Technical University Munich, EKFZ - Else Kröner Fresenius Center for Nutritional Medicine, Gregor-Mendel-Str. 2, 85350 Freising-Weihenstephan, Germany; ZIEL - Institute for Food and Health, Technical University Munich, Gregor-Mendel-Str. 2, 85350 Freising-Weihenstephan, Germany
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur-Institute, Klinikum der Ludwig-Maximilians-Universität München, Ziemssenstr. 1a, 80336 Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), 80336 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Adolf-Butenandt-Institut, Ludwig-Maximilians-Universität München, Schillerstr. 44, 80336 Munich, Germany; German Center for Vertigo and Balance Disorders, 81377 Munich, Germany
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, 29, Rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, 5000 Odense C, Denmark
| | - Carsten Schmidt-Weber
- Center of Allergy & Environment (ZAUM), Technische Universität München, and Helmholtz Zentrum München, Ingolstädter-Landstr., 85764 Neuherberg, Germany
| | - Tobias Stöger
- Institute of Lung Biology and Disease, Member of the German Center for Lung Research (DZL), Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, D-85764 Neuherberg, Germany
| | - Eckhard Wolf
- Institute of Molecular Animal Breeding and Biotechnology, Gene Center, Ludwig-Maximilians-University München, Feodor-Lynen-Str. 25, 81377 Munich, Germany
| | - Wolfgang Wurst
- Institute of Developmental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; German Center for Neurodegenerative Diseases (DZNE), 80336 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Adolf-Butenandt-Institut, Ludwig-Maximilians-Universität München, Schillerstr. 44, 80336 Munich, Germany; Chair of Developmental Genetics, Technische Universität München Freising-Weihenstephan, c/o Helmholtz Zentrum München Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Ali Önder Yildirim
- Institute of Lung Biology and Disease, Member of the German Center for Lung Research (DZL), Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, D-85764 Neuherberg, Germany
| | - Andreas Zimmer
- Institute of Molecular Psychiatry, Medical Faculty, University of Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany
| | - Valérie Gailus-Durner
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany
| | - Martin Hrabě de Angelis
- German Mouse Clinic, Institute of Experimental Genetics, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Ingolstädter-Landstr. 1, 85764 Neuherberg, Germany; Chair of Experimental Genetics, School of Life Science Weihenstephan, Technische Universität München, Alte Akademie 8, 85354 Freising, Germany.
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233
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Matar E, Lewis SJ. REM sleep behaviour disorder: not just a bad dream. Med J Aust 2017; 207:262-268. [PMID: 28899330 DOI: 10.5694/mja17.00321] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/17/2017] [Indexed: 02/04/2023]
Abstract
Rapid eye movement (REM) sleep behaviour disorder (RBD) is a parasomnia characterised by the loss of the normal atonia during the REM stage of sleep, resulting in overt motor behaviours that usually represent the enactment of dreams. Patients will seek medical attention due to sleep-related injuries or unpleasant dream content. Idiopathic RBD which occurs independently of any other disease occurs in up to 2% of the older population. Meanwhile, secondary RBD is very common in association with certain neurodegenerative conditions. RBD can also occur in the context of antidepressant use, obstructive sleep apnoea and narcolepsy. RBD can be diagnosed with a simple screening question followed by confirmation with polysomnography to exclude potential mimics. Treatment for RBD is effective and involves treatment of underlying causes, modification of the sleep environment, and pharmacotherapy with either clonazepam or melatonin. An important finding in the past decade is the recognition that almost all patients with idiopathic RBD will ultimately go on to develop Parkinson disease or dementia with Lewy bodies. This suggests that idiopathic RBD represents a prodromal phase of these conditions. Physicians should be aware of the risk of phenoconversion. They should educate idiopathic RBD patients to recognise the symptoms of these conditions and refer as appropriate for further testing and enrolment into research trials focused on neuroprotective measures.
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Affiliation(s)
- Elie Matar
- Brain and Mind Centre, University of Sydney, Sydney, NSW
| | - Simon Jg Lewis
- Brain and Mind Centre, University of Sydney, Sydney, NSW
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234
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Le W, Dong J, Li S, Korczyn AD. Can Biomarkers Help the Early Diagnosis of Parkinson's Disease? Neurosci Bull 2017; 33:535-542. [PMID: 28866850 DOI: 10.1007/s12264-017-0174-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/27/2017] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disease with progressive loss of dopamine neurons. PD patients usually manifest a series of motor and non-motor symptoms. In order to provide better early diagnosis and subsequent disease-modifying therapies for PD patients, there is an urgent need to identify sensitive and specific biomarkers. Biomarkers can be divided into four categories: clinical, imaging, biochemical, and genetic. Ideal biomarkers not only improve our understanding of PD pathogenesis and progression, but also provide benefits for early risk evaluation and clinical diagnosis of PD. Although many efforts have been made and several biomarkers have been extensively investigated, few if any have been found useful for early diagnosis. Here, we summarize recent developments in the discovered biomarkers of PD and discuss their merits and limitations for the early diagnosis of PD.
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Affiliation(s)
- Weidong Le
- Liaoning Provincial Center for Clinical Research on Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China. .,Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China. .,Collaborative Innovation Center for Brain Science, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China.
| | - Jie Dong
- Liaoning Provincial Center for Clinical Research on Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China.,Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China
| | - Song Li
- Liaoning Provincial Center for Clinical Research on Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China.,Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, 116021, China
| | - Amos D Korczyn
- Department of Neurology, Sackler School of Medicine, Tel Aviv University, 69978, Ramat-Aviv, Israel.
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235
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Birba A, García-Cordero I, Kozono G, Legaz A, Ibáñez A, Sedeño L, García AM. Losing ground: Frontostriatal atrophy disrupts language embodiment in Parkinson’s and Huntington’s disease. Neurosci Biobehav Rev 2017; 80:673-687. [DOI: 10.1016/j.neubiorev.2017.07.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
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236
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Searles Nielsen S, Warden MN, Camacho-Soto A, Willis AW, Wright BA, Racette BA. A predictive model to identify Parkinson disease from administrative claims data. Neurology 2017; 89:1448-1456. [PMID: 28864676 DOI: 10.1212/wnl.0000000000004536] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 07/11/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To use administrative medical claims data to identify patients with incident Parkinson disease (PD) prior to diagnosis. METHODS Using a population-based case-control study of incident PD in 2009 among Medicare beneficiaries aged 66-90 years (89,790 cases, 118,095 controls) and the elastic net algorithm, we developed a cross-validated model for predicting PD using only demographic data and 2004-2009 Medicare claims data. We then compared this model to more basic models containing only demographic data and diagnosis codes for constipation, taste/smell disturbance, and REM sleep behavior disorder, using each model's receiver operator characteristic area under the curve (AUC). RESULTS We observed all established associations between PD and age, sex, race/ethnicity, tobacco smoking, and the above medical conditions. A model with those predictors had an AUC of only 0.670 (95% confidence interval [CI] 0.668-0.673). In contrast, the AUC for a predictive model with 536 diagnosis and procedure codes was 0.857 (95% CI 0.855-0.859). At the optimal cut point, sensitivity was 73.5% and specificity was 83.2%. CONCLUSIONS Using only demographic data and selected diagnosis and procedure codes readily available in administrative claims data, it is possible to identify individuals with a high probability of eventually being diagnosed with PD.
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Affiliation(s)
- Susan Searles Nielsen
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa
| | - Mark N Warden
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa
| | - Alejandra Camacho-Soto
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa
| | - Allison W Willis
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa
| | - Brenton A Wright
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa
| | - Brad A Racette
- From the Department of Neurology (S.S.N., M.N.W., A.C.-S., B.A.W., B.A.R.), Washington University School of Medicine, St. Louis, MO; Departments of Neurology and Biostatistics and Epidemiology (A.W.W.), University of Pennsylvania School of Medicine, Philadelphia; and School of Public Health, Faculty of Health Sciences (B.A.R.), University of the Witwatersrand, Parktown, South Africa.
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237
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Van Kampen JM, Robertson HA. The BSSG rat model of Parkinson's disease: progressing towards a valid, predictive model of disease. EPMA J 2017; 8:261-271. [PMID: 29021837 PMCID: PMC5613678 DOI: 10.1007/s13167-017-0114-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/16/2017] [Indexed: 12/13/2022]
Abstract
ABSTRACT Parkinson's disease (PD) is a neurodegenerative disorder, classically considered a movement disorder. A great deal is known about the anatomical connections and neuropathology and pharmacological changes of PD, as they relate to the loss of dopaminergic function and the appearance of cardinal motor symptoms. Our understanding of the role of dopamine in PD has led to the development of effective pharmacological treatments of the motor symptoms in the form of dopamine replacement therapy using levodopa and dopaminergic agonists. Much of the information concerning these drug treatments has been obtained using classical neurotoxic models that mimic dopamine depletion (e.g., 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine or MPTP, 6-hydroxydopamine, reserpine). However, PD is more than a disorder of the nigrostriatal dopamine pathway. Our understanding of the neuropathology of PD has undergone massive changes, with the discovery that mutations in α-synuclein cause a familial form of PD and that PD pathology may spread, affecting multiple neurotransmitter systems and brain regions. These new developments in our understanding of PD demand that we reconsider our animal models. While classic neurotoxin models have been useful for the development of effective symptomatic treatments for motor manifestations, the paucity of a valid animal model exhibiting the progressive development of multiple key features of PD pathophysiology and phenotype has impeded the search for neuroprotective therapies, capable of slowing or halting disease progression. RELEVANCE OF THE ARTICLE FOR PREDICTIVE PREVENTIVE AND PERSONALISED MEDICINE What characteristics would a good animal model of human PD have? In so much as is possible, a good model would exhibit as many behavioral, anatomical, biochemical, immunological, and pathological changes as are observed in the human condition, developing progressively, with clear, identifiable biomarkers along the way. Here, we review the BSSG rat model of PD, a novel environmental model of PD, with strong construct, face, and predictive validity. This model offers an effective tool for the screening of preventive therapies that may prove to be more predictive of their effects in human patients.
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Affiliation(s)
- Jackalina M. Van Kampen
- Neurodyn Life Sciences, NRC Building, 550 University Ave., Charlottetown, PE C1A 4P3 Canada
- Department of Biomedical Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3 Canada
| | - Harold A. Robertson
- Neurodyn Life Sciences, NRC Building, 550 University Ave., Charlottetown, PE C1A 4P3 Canada
- Department of Biomedical Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3 Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2 Canada
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239
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Dayan E, Browner N. Alterations in striato-thalamo-pallidal intrinsic functional connectivity as a prodrome of Parkinson's disease. Neuroimage Clin 2017; 16:313-318. [PMID: 28856094 PMCID: PMC5565766 DOI: 10.1016/j.nicl.2017.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/27/2017] [Accepted: 08/01/2017] [Indexed: 11/29/2022]
Abstract
Although the diagnosis of Parkinson's disease (PD) remains anchored around the cardinal motor symptoms of bradykinesia, rest tremor, rigidity and postural instability, it is becoming increasingly clear that the clinical phase of the disease is preceded by a long period of neurodegeneration, which is not readily evident in terms of motor dysfunction. The neurobiological mechanisms that underpin this prodromal phase of PD remain poorly understood. Based on converging evidence of basal ganglia (BG) dysfunction in early PD, we set out to establish whether the prodromal phase of the disease is characterized by alterations in functional communication within the input and output structures of the BG. We analyzed resting-state functional MRI data collected from patients with REM sleep behavior disorder (RBD) and/or hyposmia, two of the strongest markers of prodromal PD, in comparison to age-matched controls. Relative to controls, subjects in the prodromal group showed reduced intra- and interhemispheric functional connectivity in a striato-thalamo-pallidal network. Functional connectivity alterations were restricted to the BG and did not extend to functional connections with the cortex. The data suggest that local interactions between input and output BG structures may be disrupted already in the prodromal phase of PD.
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Affiliation(s)
- Eran Dayan
- Department of Radiology, Biomedical Research Imaging Center and Neuroscience Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Nina Browner
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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240
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Alterations in neuronal control of body weight and anxiety behavior by glutathione peroxidase 4 deficiency. Neuroscience 2017. [DOI: 10.1016/j.neuroscience.2017.05.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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241
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Rousseaux MWC, Shulman JM, Jankovic J. Progress toward an integrated understanding of Parkinson's disease. F1000Res 2017; 6:1121. [PMID: 28751973 PMCID: PMC5510019 DOI: 10.12688/f1000research.11820.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, affecting over 10 million individuals worldwide. While numerous effective symptomatic treatments are currently available, no curative or disease-modifying therapies exist. An integrated, comprehensive understanding of PD pathogenic mechanisms will likely address this unmet clinical need. Here, we highlight recent progress in PD research with an emphasis on promising translational findings, including (i) advances in our understanding of disease susceptibility, (ii) improved knowledge of cellular dysfunction, and (iii) insights into mechanisms of spread and propagation of PD pathology. We emphasize connections between these previously disparate strands of PD research and the development of an emerging systems-level understanding that will enable the next generation of PD therapeutics.
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Affiliation(s)
- Maxime W C Rousseaux
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St, Houston, TX, 77030, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Joshua M Shulman
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St, Houston, TX, 77030, USA.,Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.,Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 7200 Cambridge, Houston, TX, 77030-4202, USA.,Department of Neuroscience, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 7200 Cambridge, Houston, TX, 77030-4202, USA
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242
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Abstract
Purpose of review Sleep disorders are among the most challenging non-motor features of Parkinson's disease (PD) and significantly affect quality of life. Research in this field has gained recent interest among clinicians and scientists and is rapidly evolving. This review is dedicated to sleep and circadian dysfunction associated with PD. Recent findings Most primary sleep disorders may co-exist with PD; majority of these disorders have unique features when expressed in the PD population. Summary We discuss the specific considerations related to the common sleep problems in Parkinson's disease including insomnia, rapid eye movement sleep behavior disorder, restless legs syndrome, sleep disordered breathing, excessive daytime sleepiness and circadian rhythm disorders. Within each of these sleep disorders, we present updated definitions, epidemiology, etiology, diagnosis, clinical implications and management. Furthermore, areas of potential interest for further research are outlined.
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243
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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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244
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Joshi N, Rolheiser TM, Fisk JD, McKelvey JR, Schoffer K, Phillips G, Armstrong M, Khan MN, Leslie RA, Rusak B, Robertson HA, Good KP. Lateralized microstructural changes in early-stage Parkinson's disease in anterior olfactory structures, but not in substantia nigra. J Neurol 2017; 264:1497-1505. [PMID: 28653210 DOI: 10.1007/s00415-017-8555-3] [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: 03/02/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/17/2022]
Abstract
Parkinson's disease (PD) is a progressive neurological disorder characterized by motor symptoms as well as severe deficits in olfactory function and microstructural changes in olfactory brain regions. Because of the evidence of asymmetric neuropathological features in early-stage PD, we examined whether lateralized microstructural changes occur in olfactory brain regions and the substantia nigra in a group of early-stage PD patients. Using diffusion tensor imaging (DTI) and the University of Pennsylvania Smell Identification Test (UPSIT), we assessed 24 early-stage PD patients (Hoehn and Yahr stage 1 or 2) and 26 healthy controls (HC). We used DTI and a region of interest (ROI) approach to study the microstructure of the left and right anterior olfactory structures (AOS; comprising the olfactory bulbs and anterior end of the olfactory tracts) and the substantia nigra (SN). PD patients had reduced UPSIT scores relative to HC and showed increased mean diffusivity (MD) in the SN, with no lateralized differences. Significant group differences in fractional anisotropy (FA) and MD were seen in the AOS, but these differences were restricted to the right side and were not associated with the primary side of motor symptoms amongst PD patients. No associations were observed between lateralized motor impairment and lateralized microstructural changes in AOS. Impaired olfaction and microstructural changes in AOS are useful for early identification of PD but asymmetries in AOS microstructure seem unrelated to the laterality of PD motor symptoms.
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Affiliation(s)
- N Joshi
- Department of Psychiatry, IWK Hospital, Halifax, NS, Canada
| | - T M Rolheiser
- Department of Psychiatry, Dalhousie University, 4064 AJLB, 5909 Veterans Memorial Lane, Halifax, NS, Canada
| | - J D Fisk
- Department of Psychology, Nova Scotia Health Authority, Central Zone, Halifax, NS, Canada
| | - J R McKelvey
- Division of Neurology, Department of Medicine, Nova Scotia Health Authority, Halifax, NS, Canada
| | - K Schoffer
- Division of Neurology, Department of Medicine, Nova Scotia Health Authority, Halifax, NS, Canada
| | - G Phillips
- Division of Respirology, Department of Medicine, Nova Scotia Health Authority, Halifax, NS, Canada
| | - M Armstrong
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - M N Khan
- Department of Radiology, IWK Hospital, Halifax, NS, Canada
| | - R A Leslie
- Department of Medical Neurosciences, Dalhousie University, Halifax, NS, Canada
| | - B Rusak
- Department of Psychiatry, Dalhousie University, 4064 AJLB, 5909 Veterans Memorial Lane, Halifax, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - H A Robertson
- Department of Psychiatry, Dalhousie University, 4064 AJLB, 5909 Veterans Memorial Lane, Halifax, NS, Canada.,Division of Neurology, Department of Medicine, Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - K P Good
- Department of Psychiatry, Dalhousie University, 4064 AJLB, 5909 Veterans Memorial Lane, Halifax, NS, Canada. .,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
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Abstract
Since the first formal description of Parkinson disease (PD) two centuries ago, our understanding of this common neurodegenerative disorder has expanded at all levels of description, from the delineation of its clinical phenotype to the identification of its neuropathological features, neurochemical processes and genetic factors. Along the way, findings have led to novel hypotheses about how the disease develops and progresses, challenging our understanding of how neurodegenerative disorders wreak havoc on human health. In this Timeline article, I recount the fascinating 200-year journey of PD research.
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Affiliation(s)
- Serge Przedborski
- Departments of Neurology, Pathology, and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA
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246
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Barber TR, Klein JC, Mackay CE, Hu MTM. Neuroimaging in pre-motor Parkinson's disease. Neuroimage Clin 2017; 15:215-227. [PMID: 28529878 PMCID: PMC5429242 DOI: 10.1016/j.nicl.2017.04.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/10/2017] [Accepted: 04/15/2017] [Indexed: 12/23/2022]
Abstract
The process of neurodegeneration in Parkinson's disease begins long before the onset of clinical motor symptoms, resulting in substantial cell loss by the time a diagnosis can be made. The period between the onset of neurodegeneration and the development of motoric disease would be the ideal time to intervene with disease modifying therapies. This pre-motor phase can last many years, but the lack of a specific clinical phenotype means that objective biomarkers are needed to reliably detect prodromal disease. In recent years, recognition that patients with REM sleep behaviour disorder (RBD) are at particularly high risk of future parkinsonism has enabled the development of large prodromal cohorts in which to investigate novel biomarkers, and neuroimaging has generated some of the most promising results to date. Here we review investigations undertaken in RBD and other pre-clinical cohorts, including modalities that are well established in clinical Parkinson's as well as novel imaging methods. Techniques such as high resolution MRI of the substantia nigra and functional imaging of Parkinsonian brain networks have great potential to facilitate early diagnosis. Further longitudinal studies will establish their true value in quantifying prodromal neurodegeneration and predicting future Parkinson's.
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Affiliation(s)
- Thomas R Barber
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
| | - Johannes C Klein
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Department of Psychiatry, University of Oxford, UK; Oxford Centre for Human Brain Activity (OHBA), University of Oxford, UK
| | - Michele T M Hu
- Oxford Parkinson's Disease Centre (OPDC), University of Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
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247
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Non-human primate models of PD to test novel therapies. J Neural Transm (Vienna) 2017; 125:291-324. [PMID: 28391443 DOI: 10.1007/s00702-017-1722-y] [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] [Received: 11/16/2016] [Accepted: 04/04/2017] [Indexed: 12/13/2022]
Abstract
Non-human primate (NHP) models of Parkinson disease show many similarities with the human disease. They are very useful to test novel pharmacotherapies as reviewed here. The various NHP models of this disease are described with their characteristics including the macaque, the marmoset, and the squirrel monkey models. Lesion-induced and genetic models are described. There is no drug to slow, delay, stop, or cure Parkinson disease; available treatments are symptomatic. The dopamine precursor, L-3,4-dihydroxyphenylalanine (L-Dopa) still remains the gold standard symptomatic treatment of Parkinson. However, involuntary movements termed L-Dopa-induced dyskinesias appear in most patients after chronic treatment and may become disabling. Dyskinesias are very difficult to manage and there is only amantadine approved providing only a modest benefit. In this respect, NHP models have been useful to seek new drug targets, since they reproduce motor complications observed in parkinsonian patients. Therapies to treat motor symptoms in NHP models are reviewed with a discussion of their translational value to humans. Disease-modifying treatments tested in NHP are reviewed as well as surgical treatments. Many biochemical changes in the brain of post-mortem Parkinson disease patients with dyskinesias are reviewed and compare well with those observed in NHP models. Non-motor symptoms can be categorized into psychiatric, autonomic, and sensory symptoms. These symptoms are present in most parkinsonian patients and are already installed many years before the pre-motor phase of the disease. The translational usefulness of NHP models of Parkinson is discussed for non-motor symptoms.
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248
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Velázquez-Pérez L, Rodríguez-Labrada R, Laffita-Mesa JM. Prodromal spinocerebellar ataxia type 2: Prospects for early interventions and ethical challenges. Mov Disord 2017; 32:708-718. [DOI: 10.1002/mds.26969] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | - José Miguel Laffita-Mesa
- Centre for the Research and Rehabilitation of Hereditary Ataxias; Holguín Cuba
- Department of Clinical Neuroscience; Karolinska Universitetssjukhuset; Stockholm Sweden
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249
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Taddei RN, Spinnato F, Jenner P. New Symptomatic Treatments for the Management of Motor and Nonmotor Symptoms of Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 132:407-452. [DOI: 10.1016/bs.irn.2017.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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