301
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Autonomic dysfunction in primary sleep disorders. Sleep Med 2016; 19:40-9. [DOI: 10.1016/j.sleep.2015.10.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/08/2015] [Accepted: 10/12/2015] [Indexed: 11/20/2022]
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302
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Wada-Isoe K, Tanaka K, Uemura Y, Nakashita S, Tajiri Y, Tagashira S, Yamamoto M, Yamawaki M, Kishi M, Nakashima K. Longitudinal course of mild parkinsonian signs in elderly people: A population-based study in Japan. J Neurol Sci 2016; 362:7-13. [DOI: 10.1016/j.jns.2016.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 12/11/2015] [Accepted: 01/07/2016] [Indexed: 11/25/2022]
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303
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Kwon KY, Lee HM, Lee SM, Kang SH, Koh SB. Comparison of motor and non-motor features between essential tremor and tremor dominant Parkinson's disease. J Neurol Sci 2016; 361:34-8. [DOI: 10.1016/j.jns.2015.12.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 11/10/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022]
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304
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Hird N, Ghosh S, Kitano H. Digital health revolution: perfect storm or perfect opportunity for pharmaceutical R&D? Drug Discov Today 2016; 21:900-11. [PMID: 26821131 DOI: 10.1016/j.drudis.2016.01.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/04/2016] [Accepted: 01/19/2016] [Indexed: 12/21/2022]
Abstract
The convergence of technology and medicine has pushed healthcare to the brink of a major disruption that pharma has, until recently, been slow to recognize. Tech players have pioneered the emerging field of digital wellness and health, and pharma is ideally placed to use its expertise in drug development and embrace these technologies to create digital applications that address major medical needs. This review describes digital innovation from a pharma R&D perspective, outlining principal drivers, digital components, opportunities and challenges as well as a sustainable new business model predicated on empowered patients and achieving therapeutic outcomes.
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Affiliation(s)
- Nick Hird
- Takeda Pharmaceutical Company Limited, Fujisawa 251-8555, Japan.
| | - Samik Ghosh
- The Systems Biology Institute, Tokyo 108-0071, Japan
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305
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Evaluation of Nonmotor Symptoms in Diagnosis of Parkinsonism and Tremor. PARKINSON'S DISEASE 2016; 2016:9182946. [PMID: 27403372 PMCID: PMC4923584 DOI: 10.1155/2016/9182946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/22/2016] [Indexed: 11/21/2022]
Abstract
Background. Nonmotor symptoms particularly olfactory dysfunction, RBD, depression, hallucinations, and constipation are currently not included in the typical clinical criteria for diagnosing Lewy body Parkinsonian disorders (LBPD). The aim of this study is to determine the diagnostic value of nonmotor symptoms in patients presenting with Parkinsonism and tremor. Methods. All new patients seen between January 2007 and May 2013 in the Movement Disorders Specialist Clinics of the Royal Melbourne Hospital (RMH), who were referred with a possible neurodegenerative syndrome or concerns of Parkinsonism and/or tremor, were included. Patients underwent routine evaluation with the four-minute “Sniffin Sticks” test, RBD, depression, and constipation. Results. 291 patients were included in the analysis. Conclusion. We found that lower olfaction scores based on “Sniffin Sticks” testing combined with reports of depression and constipation are independent predictors for the diagnosis of the spectrum of Lewy body Parkinsonian disorders (LBPD). Parkinson's disease (PD) cannot be reliably clinically differentiated from other causes of Parkinsonism that share symptomatology and structural abnormalities.
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306
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Kwon DY, Koh SB, Lee JH, Park HK, Kim HJ, Shin HW, Youn J, Park KW, Choi SA, Kim SJ, Choi SM, Park JY, Jeon BS, Kim JY, Chung SJ, Lee CS, Park JH, Ahn TB, Kim WC, Kim HS, Cheon SM, Kim HT, Lee JY, Kim JS, Kim EJ, Kim JM, Lee KS, Kim JS, Kim MJ, Baik JS, Park KJ, Kim HJ, Park MY, Kang JH, Song SK, Kim YD, Yun JY, Lee HW, Oh HG, Cho J, Song IU, Sohn YH, Lee PH, Kim JW. The KMDS-NATION Study: Korean Movement Disorders Society Multicenter Assessment of Non-Motor Symptoms and Quality of Life in Parkinson's Disease NATION Study Group. J Clin Neurol 2016; 12:393-402. [PMID: 27819413 PMCID: PMC5063863 DOI: 10.3988/jcn.2016.12.4.393] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/06/2014] [Accepted: 11/07/2014] [Indexed: 02/03/2023] Open
Abstract
Background and Purpose Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients. Methods We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms. Results In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage. Conclusions The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.
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Affiliation(s)
- Do Young Kwon
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Seong Beom Koh
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hee Kyung Park
- Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Han Joon Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Won Shin
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kun Woo Park
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Sun Ah Choi
- Department of Neurology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Sang Jin Kim
- Department of Neurology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
| | - Seong Min Choi
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
| | - Ji Yun Park
- Department of Neurology, Presbyterian Medical Center, Jeonju, Korea
| | - Beom S Jeon
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Neurology, College of Medicine, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, University of Ulsan College of Medicine, Asan Hospital, Seoul, Korea
| | - Chong Sik Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Hospital, Seoul, Korea
| | - Jeong Ho Park
- Department of Neurology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Tae Beom Ahn
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Won Chan Kim
- Department of Neurology, CHA University College of Medicine, Seongnam, Korea
| | - Hyun Sook Kim
- Department of Neurology, CHA University College of Medicine, Seongnam, Korea
| | - Sang Myung Cheon
- Department of Neurology, Dong-A University Medical Centre, Busan, Korea
| | - Hee Tae Kim
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea
| | - Jee Young Lee
- Department of Neurology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Ji Sun Kim
- Department of Neurology, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Daejeon, Korea
| | - Eun Joo Kim
- Department of Neurology, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Jong Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kwang Soo Lee
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joong Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min Jeong Kim
- Department of Neurology, Kosin University College of Medicine, Busan, Korea
| | - Jong Sam Baik
- Department of Neurology, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea
| | - Ki Jong Park
- Department of Neurology, Gyeongsang National University School of Medicine, Busan, Korea
| | - Hee Jin Kim
- Department of Neurology, Konkuk University School of Medicine, Daejeon, Korea
| | - Mee Young Park
- Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea
| | - Ji Hoon Kang
- Department of Neurology, Jeju National University Hospital, Jeju, Korea
| | - Sook Kun Song
- Department of Neurology, Jeju National University Hospital, Jeju, Korea
| | - Yong Duk Kim
- Department of Neurology, Konyang University Hospital, Daejeon, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Ho Won Lee
- Department of Neurology, School of Medicine, Kyungpook National Univeristy, Daegu, Korea
| | - Hyung Geun Oh
- Department of Neurology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jinwhan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Uk Song
- Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Woo Kim
- Department of Neurology, Dong-A University Medical Centre, Busan, Korea.
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307
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Bergareche A, Rodríguez-Oroz MC, Estanga A, Gorostidi A, López de Munain A, Castillo-Triviño T, Ruiz-Martínez J, Mondragón E, Gaig C, Lomeña F, Sarasqueta C, Tolosa E, Martí-Massó JF. DAT imaging and clinical biomarkers in relatives at genetic risk for LRRK2 R1441G Parkinson's disease. Mov Disord 2015; 31:335-43. [DOI: 10.1002/mds.26478] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 12/25/2022] Open
Affiliation(s)
- Alberto Bergareche
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Ilundain Fundazioa; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
| | - Maria Cruz Rodríguez-Oroz
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
- Ikerbasque. Basque Foundation for Science; Bilbao Spain
| | - Ainara Estanga
- Ilundain Fundazioa; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Department of Neuroscience; University of the Basque Country UPV/EHU; Spain
| | - Ana Gorostidi
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
| | - Adolfo López de Munain
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Ilundain Fundazioa; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
- Department of Neuroscience; University of the Basque Country UPV/EHU; Spain
| | - Tamara Castillo-Triviño
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
| | - Javier Ruiz-Martínez
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
| | - Elisabet Mondragón
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
| | - Carles Gaig
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic and Institut d'Investigació Biomèdiques August Pi i Sunyer; Spain
| | - Francisco Lomeña
- Nuclear Medicine Service, Hospital Clinic de Barcelona, Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Hospital Clinic de Barcelona; Spain
| | - Cristina Sarasqueta
- Unidad de Apoyo Metodológico. Hospital Universitario Donostia. Biodonostia Research Institute, REDISSEC; Spain
| | - Eduardo Tolosa
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
- Neurology Service, Hospital Clinic de Barcelona, IDIBAPS; Spain
| | - José Félix Martí-Massó
- Neurology Service; Hospital Universitario Donostia; San Sebastian Spain
- Ilundain Fundazioa; San Sebastian Spain
- Neuroscience Area. Biodonostia Research Institute; Spain
- Centro de Investigación Biomédicas en Red Enfermedades Neurodegenerativas (CIBERNED), Institute Carlos III, Ministry of Economy and Competitiveness; Spain
- Department of Neuroscience; University of the Basque Country UPV/EHU; Spain
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308
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Vermilyea SC, Emborg ME. α-Synuclein and nonhuman primate models of Parkinson's disease. J Neurosci Methods 2015; 255:38-51. [PMID: 26247888 PMCID: PMC4604057 DOI: 10.1016/j.jneumeth.2015.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/23/2015] [Accepted: 07/24/2015] [Indexed: 12/21/2022]
Abstract
Accumulation of α-synuclein (α-syn) leading to the formation of insoluble intracellular aggregates named Lewy bodies is proposed to have a significant role in Parkinson's disease (PD) pathology. Nonhuman primate (NHP) models of PD have proven essential for understanding the neurobiological basis of the disease and for the preclinical evaluation of first-in-class and invasive therapies. In addition to neurotoxin, aging and intracerebral gene transfer models, a new generation of models using inoculations of α-syn formulations, as well as transgenic methods is emerging. Understanding of their advantages and limitations will be essential when choosing a platform to evaluate α-syn-related pathology and interpreting the test results of new treatments targeting α-syn aggregation. In this review we aim to provide insight on this issue by critically analyzing the differences in endogenous α-syn, as well as α-syn pathology in PD and PD NHP models.
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Affiliation(s)
- Scott C Vermilyea
- Neuroscience Training Program, University of Wisconsin, Madison, United States; Wisconsin National Primate Research Center, University of Wisconsin, Madison, United States.
| | - Marina E Emborg
- Neuroscience Training Program, University of Wisconsin, Madison, United States; Wisconsin National Primate Research Center, University of Wisconsin, Madison, United States; Department of Medical Physics, University of Wisconsin, Madison, 1220 Capitol Court, Madison, WI 53715, United States.
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309
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Erro R, Barone P. Toward the premotor diagnosis of Parkinson's disease: Suggestions from a modelling study. Mov Disord 2015; 30:1873. [PMID: 26575210 DOI: 10.1002/mds.26440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 08/23/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom.,Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Verona, Italy
| | - Paolo Barone
- University of Salerno Center for Neurodegenerative Disease-CEMAND, Salerno, Italy
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310
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Autonomic dysfunction in subjects at high risk for Parkinson's disease. J Neurol 2015; 262:2643-52. [PMID: 26530505 DOI: 10.1007/s00415-015-7888-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/21/2015] [Accepted: 08/22/2015] [Indexed: 12/15/2022]
Abstract
Aim of this project was to evaluate autonomic dysfunction in subjects proposed to be at high risk to develop Parkinson's disease (PD) compared to control subjects and PD patients at different disease stages. Combinations of substantia nigra hyperechogenicity (SN+) assessed by transcranial ultrasound (TCS), hyposmia, lifetime prevalence of depression and mild PD-specific motor signs were used to identify subjects at high risk for motor Parkinson's disease (HR-PD). Supine and standing blood pressure (BP), hearth rate (HR), orthostatic, urinary, sexual and bowel symptoms were evaluated in HR-PD, healthy control subjects and PD patients, divided into mild and advanced stages. The study group consisted of 113 PD patients (mild PD n = 71, advanced PD, n = 42), 40 HR-PD individuals and 50 controls. Compared to controls, HR-PD subjects complained more often about urinary (p = 0.002) and bowel dysfunction (p = 0.001) and had a higher diastolic BP drop after standing (p = 0.01). The cumulative number of autonomic symptoms differentiated PD as well as HR-PD significantly from controls (p < 0.001). Advanced PD patients presented often and severe orthostatic symptoms, not significantly different from mild PD after concomitant medication correction. Our results support the presence of urinary and bowel dysfunction in subjects at high risk for motor PD. Presence and severity of orthostatic symptoms was higher during stages and increase in advanced stages, at least partly due to increase in dopaminergic and conflicting medication. Understanding the progression of non-motor aspects in PD might offer the possibility to use them as targets for disease-modifying therapies.
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311
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Saunders-Pullman R, Alcalay RN, Mirelman A, Wang C, Luciano MS, Ortega RA, Glickman A, Raymond D, Mejia-Santana H, Doan N, Johannes B, Yasinovsky K, Ozelius L, Clark L, Orr-Utreger A, Marder K, Giladi N, Bressman SB. REM sleep behavior disorder, as assessed by questionnaire, in G2019S LRRK2 mutation PD and carriers. Mov Disord 2015; 30:1834-9. [PMID: 26366513 PMCID: PMC4715645 DOI: 10.1002/mds.26413] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/17/2015] [Accepted: 07/26/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Rapid eye movement sleep behavior disorder occurs with idiopathic Parkinson's disease (PD) and often precedes PD. Its frequency in LRRK2-PD and utility as a preclinical marker has not been established. METHODS One hundred forty-four idiopathic PD, 142 LRRK2 G2019S mutation PD, 117 non-manifesting carriers, 93 related noncarriers, and 40 healthy controls completed the Rapid eye movement sleep Behavior Disorder Screening Questionnaire. RESULTS Cut scores were met by 30.6% idiopathic PD, 19.7% LRRK2-PD, 6% nonmanifesting carriers, 20.4% related noncarriers, and 15% controls. The likelihood of abnormal scores was decreased in LRRK2-PD versus idiopathic PD (odds ratio = 0.55, P = 0.03), nonmanifesting carriers versus related noncarriers (OR = 0.25, P < 0.01), and PD of less than 3 years' duration, 1 of 19 LRRK2-PD versus 14 of 41 idiopathic PD (P < 0.05). CONCLUSIONS A lower frequency of abnormal questionnaire scores is seen in LRRK2-PD, especially in early LRRK2-PD, and in nonmanifesting carriers. Therefore, the Rapid eye movement sleep Behavior Disorder Questionnaire is unlikely to serve as a preclinical marker for phenoconversion to PD.
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Affiliation(s)
- Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roy N Alcalay
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Sieratzki Chair of Neurology, Department of Neurology and Neurosurgery, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Cuiling Wang
- Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marta San Luciano
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Roberto A. Ortega
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Amanda Glickman
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Deborah Raymond
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Helen Mejia-Santana
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Nancy Doan
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Brooke Johannes
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Kira Yasinovsky
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Sieratzki Chair of Neurology, Department of Neurology and Neurosurgery, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Laurie Ozelius
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lorraine Clark
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Avi Orr-Utreger
- Genetic Institute, Tel-Aviv Medical Center, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Karen Marder
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Nir Giladi
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Sieratzki Chair of Neurology, Department of Neurology and Neurosurgery, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Susan B Bressman
- Department of Neurology, Mount Sinai Beth Israel Medical Center, New York, NY, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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313
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de Natale E, Ginatempo F, Paulus K, Manca A, Mercante B, Pes G, Agnetti V, Tolu E, Deriu F. Paired neurophysiological and clinical study of the brainstem at different stages of Parkinson’s Disease. Clin Neurophysiol 2015; 126:1871-8. [DOI: 10.1016/j.clinph.2014.12.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/03/2014] [Accepted: 12/24/2014] [Indexed: 11/30/2022]
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314
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Fallon SJ, Smulders K, Esselink RA, van de Warrenburg BP, Bloem BR, Cools R. Differential optimal dopamine levels for set-shifting and working memory in Parkinson's disease. Neuropsychologia 2015; 77:42-51. [DOI: 10.1016/j.neuropsychologia.2015.07.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 12/16/2022]
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315
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Nalls MA, McLean CY, Rick J, Eberly S, Hutten SJ, Gwinn K, Sutherland M, Martinez M, Heutink P, Williams NM, Hardy J, Gasser T, Brice A, Price TR, Nicolas A, Keller MF, Molony C, Gibbs JR, Chen-Plotkin A, Suh E, Letson C, Fiandaca MS, Mapstone M, Federoff HJ, Noyce AJ, Morris H, Van Deerlin VM, Weintraub D, Zabetian C, Hernandez DG, Lesage S, Mullins M, Conley ED, Northover CAM, Frasier M, Marek K, Day-Williams AG, Stone DJ, Ioannidis JPA, Singleton AB. Diagnosis of Parkinson's disease on the basis of clinical and genetic classification: a population-based modelling study. Lancet Neurol 2015; 14:1002-9. [PMID: 26271532 PMCID: PMC4575273 DOI: 10.1016/s1474-4422(15)00178-7] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/23/2015] [Accepted: 07/07/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Accurate diagnosis and early detection of complex diseases, such as Parkinson's disease, has the potential to be of great benefit for researchers and clinical practice. We aimed to create a non-invasive, accurate classification model for the diagnosis of Parkinson's disease, which could serve as a basis for future disease prediction studies in longitudinal cohorts. METHODS We developed a model for disease classification using data from the Parkinson's Progression Marker Initiative (PPMI) study for 367 patients with Parkinson's disease and phenotypically typical imaging data and 165 controls without neurological disease. Olfactory function, genetic risk, family history of Parkinson's disease, age, and gender were algorithmically selected by stepwise logistic regression as significant contributors to our classifying model. We then tested the model with data from 825 patients with Parkinson's disease and 261 controls from five independent cohorts with varying recruitment strategies and designs: the Parkinson's Disease Biomarkers Program (PDBP), the Parkinson's Associated Risk Study (PARS), 23andMe, the Longitudinal and Biomarker Study in PD (LABS-PD), and the Morris K Udall Parkinson's Disease Research Center of Excellence cohort (Penn-Udall). Additionally, we used our model to investigate patients who had imaging scans without evidence of dopaminergic deficit (SWEDD). FINDINGS In the population from PPMI, our initial model correctly distinguished patients with Parkinson's disease from controls at an area under the curve (AUC) of 0·923 (95% CI 0·900-0·946) with high sensitivity (0·834, 95% CI 0·711-0·883) and specificity (0·903, 95% CI 0·824-0·946) at its optimum AUC threshold (0·655). All Hosmer-Lemeshow simulations suggested that when parsed into random subgroups, the subgroup data matched that of the overall cohort. External validation showed good classification of Parkinson's disease, with AUCs of 0·894 (95% CI 0·867-0·921) in the PDBP cohort, 0·998 (0·992-1·000) in PARS, 0·955 (no 95% CI available) in 23andMe, 0·929 (0·896-0·962) in LABS-PD, and 0·939 (0·891-0·986) in the Penn-Udall cohort. Four of 17 SWEDD participants who our model classified as having Parkinson's disease converted to Parkinson's disease within 1 year, whereas only one of 38 SWEDD participants who were not classified as having Parkinson's disease underwent conversion (test of proportions, p=0·003). INTERPRETATION Our model provides a potential new approach to distinguish participants with Parkinson's disease from controls. If the model can also identify individuals with prodromal or preclinical Parkinson's disease in prospective cohorts, it could facilitate identification of biomarkers and interventions. FUNDING National Institute on Aging, National Institute of Neurological Disorders and Stroke, and the Michael J Fox Foundation.
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Affiliation(s)
- Mike A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | | | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Shirley Eberly
- Deptartment of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Samantha J Hutten
- The Michael J Fox Foundation for Parkinson's Research, New York, NY 10018, USA
| | - Katrina Gwinn
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Margaret Sutherland
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Maria Martinez
- INSERM, UMR 1043, Centre de Physiopathologie de Toulouse-Purpan, Toulouse, France; Paul Sabatier University, Toulouse, France
| | - Peter Heutink
- Genome Biology of Neurodegenerative Diseases, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Nigel M Williams
- Institute of Psychological Medicine and Clinical Neurosciences, MRCCentre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - John Hardy
- Reta Lila Weston Institute, University College London Institute of Neurology, London, UK
| | - Thomas Gasser
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Alexis Brice
- Sorbonne Université, UPMC Univ Paris 06, UM 1127, ICM, Paris, France; INSERM, U 1127, and CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; AP-HP, Hôpital de la Salpêtrière, Département de Génétique et Cytogénétique, Paris, France
| | - T Ryan Price
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Aude Nicolas
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Margaux F Keller
- Genetics and Pharmacogenomics, Merck Research Laboratories, West Point, PA, USA; Merck Research Laboratories, Boston, MA, USA
| | - Cliona Molony
- Genetics and Pharmacogenomics, Merck Research Laboratories, West Point, PA, USA; Merck Research Laboratories, Boston, MA, USA
| | - J Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Eunran Suh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Letson
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Massimo S Fiandaca
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Mark Mapstone
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Howard J Federoff
- Department of Neurology, Georgetown University Medical Center, Washington, DC, USA
| | - Alastair J Noyce
- Reta Lila Weston Institute, University College London Institute of Neurology, London, UK
| | - Huw Morris
- Reta Lila Weston Institute, University College London Institute of Neurology, London, UK
| | - Vivianna M Van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Cyrus Zabetian
- Department of Neurology, Division of Neurogenetics, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Dena G Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Suzanne Lesage
- Sorbonne Université, UPMC Univ Paris 06, UM 1127, ICM, Paris, France; INSERM, U 1127, and CNRS, UMR 7225, Institut du Cerveau et de la Moelle Epinière, Paris, France; AP-HP, Hôpital de la Salpêtrière, Département de Génétique et Cytogénétique, Paris, France
| | | | | | | | - Mark Frasier
- The Michael J Fox Foundation for Parkinson's Research, New York, NY 10018, USA
| | - Ken Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | - David J Stone
- Genetics and Pharmacogenomics, Merck Research Laboratories, West Point, PA, USA; Merck Research Laboratories, Boston, MA, USA
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Department of Medicine, Stanford Prevention Research Center, Stanford, CA, USA; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA
| | - Andrew B Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA.
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Li K, Reichmann H, Ziemssen T. Recognition and treatment of autonomic disturbances in Parkinson’s disease. Expert Rev Neurother 2015; 15:1189-203. [DOI: 10.1586/14737175.2015.1095093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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317
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van der Brug MP, Singleton A, Gasser T, Lewis PA. Parkinson's disease: From human genetics to clinical trials. Sci Transl Med 2015; 7:205ps20. [PMID: 26378242 PMCID: PMC5995146 DOI: 10.1126/scitranslmed.aaa8280] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Combining genetic insights into the pathogenesis of Parkinson's disease (PD) with findings from animal and cellular models of this disorder has advanced our understanding of the pathways that lead to the characteristic degeneration of dopaminergic neurons in the brain's nigrostriatal pathway. This has fueled an increase in candidate compounds designed to modulate these pathways and to alter the processes underlying neuronal death in this disorder. Using mitochondrial quality control and the macroautophagy/lysosomal pathways as examples, we discuss the pipeline from a comprehensive genetic architecture for PD through to clinical trials for drugs targeting pathways linked to neurodegeneration in PD. We also identify opportunities and pitfalls on the road to a clinically effective disease-modifying treatment for this disease.
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Affiliation(s)
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Thomas Gasser
- Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen and German Centre for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Patrick A Lewis
- School of Pharmacy, University of Reading, Reading RG6 6AP, UK. Centre for Integrated Neuroscience and Neurodynamics, University of Reading, Reading RG6 6AP, UK. Department of Molecular Neuroscience, UCL Institute of Neurology, Queen's Square, London WC1N 3BG, UK.
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318
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Fedotova EY, Chechetkin AO, Abramycheva NY, Chigaleychik LA, Baziyan BK, Ponomareva ТА, Alexeeva NS, Fedin PA, Kravchenko MA, Varakin YY, Ivanova-Smolenskaya IA, Illarioshkin SN. [Identification of people at the latent stage of Parkinson's disease (the PARKINLAR study): first results and an optimization of the algorithm]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:4-11. [PMID: 26356391 DOI: 10.17116/jnevro2015115614-11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To work out an optimal algorithm to identify people at the latent stage of neurodegenerative process of «parkinsonian» type in the Russian population. MATERIAL AND METHODS Authors launched a two-step study aimed at identifying people at the latent stage of Parkinson's disease (PD) in the Russian population - the PARKINLAR (PARKINsonism, LAtent stage, Russia). As the first step, we formed a group of «primary risk» by the identification in neurologically healthy people of at least one of the following confirmed PD risk factors: a) the substantia nigra hyperechogenicity (ultrasound screening was performed in 193 people); b) mutations in «parkinsonian» genes (genetic screening was performed in 29 relatives of PD patients from families with LRRK2, PARK2 and GBA mutations). Thereby, 37 people comprised the «primary risk» group, of whom 23 agreed to continue further examination (44±10.2 years). A matched group of people without the aforementioned primary biomarkers of PD served as control. As the second step, we undertook in the prescreened groups a complex of investigations assessing the presence of secondary («minor») biomarkers of PD: Sniffin' Sticks olfactory testing; color visual evoked potentials; analysis of goal-directed eye-head-hand movements with the use of a special neuro-cybernetic system; assessment of motor and non-motor symptoms with the use of UPDRS and NMSS scales. RESULTS When comparing the «primary risk» group with controls, maximal differences in the occurrence of symptoms were seen for goal-directed eye movements (43.5% vs. 20.0%) and color vision (39.1% vs. 26.7%). Among these individuals, we found two people with 4 secondary biomarkers and one with 3, and no such observations in controls. People with the combination of a primary biomarker with several secondary biomarkers of PD comprised a group of «high risk» in our study. CONCLUSION Optimization of this algorithm of population screening of people predisposed to the development of PD may be done by expanding the spectrum of biomarkers and assessing their validity in a long-term prospective observational study.
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Affiliation(s)
- E Yu Fedotova
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - A O Chechetkin
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - N Yu Abramycheva
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - L A Chigaleychik
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - B Kh Baziyan
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - Т А Ponomareva
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - N S Alexeeva
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - P A Fedin
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - M A Kravchenko
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | - Yu Ya Varakin
- Research Center of Neurology, Russian Academy of Sciences, Moscow
| | | | - S N Illarioshkin
- Research Center of Neurology, Russian Academy of Sciences, Moscow
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319
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McCann H, Cartwright H, Halliday GM. Neuropathology of α-synuclein propagation and braak hypothesis. Mov Disord 2015; 31:152-60. [DOI: 10.1002/mds.26421] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 01/08/2023] Open
Affiliation(s)
| | | | - Glenda M. Halliday
- Neuroscience Research Australia; Sydney Australia
- University of New South Wales; Sydney Australia
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320
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Abstract
Parkinson's disease is a neurological disorder with evolving layers of complexity. It has long been characterised by the classical motor features of parkinsonism associated with Lewy bodies and loss of dopaminergic neurons in the substantia nigra. However, the symptomatology of Parkinson's disease is now recognised as heterogeneous, with clinically significant non-motor features. Similarly, its pathology involves extensive regions of the nervous system, various neurotransmitters, and protein aggregates other than just Lewy bodies. The cause of Parkinson's disease remains unknown, but risk of developing Parkinson's disease is no longer viewed as primarily due to environmental factors. Instead, Parkinson's disease seems to result from a complicated interplay of genetic and environmental factors affecting numerous fundamental cellular processes. The complexity of Parkinson's disease is accompanied by clinical challenges, including an inability to make a definitive diagnosis at the earliest stages of the disease and difficulties in the management of symptoms at later stages. Furthermore, there are no treatments that slow the neurodegenerative process. In this Seminar, we review these complexities and challenges of Parkinson's disease.
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Affiliation(s)
- Lorraine V Kalia
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
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321
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Kritzinger C, Vollstedt EJ, Hückelheim K, Lorwin A, Graf J, Tunc S, Klein C, Kasten M. Qualitative Characteristics of Depression in Parkinson's Patients and Controls. Behav Neurol 2015; 2015:961372. [PMID: 26351406 PMCID: PMC4553174 DOI: 10.1155/2015/961372] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/16/2015] [Accepted: 07/21/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Depression is common in Parkinson's disease (PD); in light of typical PD pathology it may differ phenomenologically from depression in the general population. OBJECTIVE To assess depressive symptoms in PD patients and control groups and compare symptom profiles. METHODS After postal screening of 10,000 citizens of Lübeck, 642 participants were examined and the Beck Depression Inventory (BDI) was sufficiently answered by 477 subjects. Based on motor examinations, we distinguished PD patients, Healthy Controls (HC, no motor impairment), and Disease Controls (DC, motor impairment other than PD). RESULTS The sample comprised 331 men and 311 women, aged 65 ± 8 years. Out of the overall sample, 198 (41.5%) had a BDI score ≥9. BDI results above 9 points occurred in 34.5% of HC, 50.3% of DC, and 42.4% of PD patients. Compared to the control groups (HC, DC) the PD patients endorsed more "dissatisfaction" and "loss of appetite" but less "feelings of guilt," "self-hate," and "loss of libido." CONCLUSION Depressive symptoms are more frequent in PD patients compared to HC but not DC. Interestingly, the distribution of individual symptoms of the BDI differs between groups with an emphasis on loss of pleasure/enjoyment in the PD group, a symptom typically considered to be dopaminergically transmitted.
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Affiliation(s)
- Cleo Kritzinger
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Eva-Juliane Vollstedt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Katja Hückelheim
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Anne Lorwin
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Julia Graf
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Sinem Tunc
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
| | - Meike Kasten
- Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Institute of Neurogenetics, University of Lübeck, Maria-Goeppert-Straße 1, 23562 Lübeck, Germany
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Vilas D, Ispierto L, Álvarez R, Pont-Sunyer C, Martí MJ, Valldeoriola F, Compta Y, de Fabregues O, Hernández-Vara J, Puente V, Calopa M, Jaumà S, Campdelacreu J, Aguilar M, Quílez P, Casquero P, Lomeña F, Ríos J, Tolosa E. Clinical and imaging markers in premotor LRRK2 G2019S mutation carriers. Parkinsonism Relat Disord 2015; 21:1170-6. [PMID: 26306001 DOI: 10.1016/j.parkreldis.2015.08.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Substantia nigra hyperechogenicity (SN+) has been proposed as a risk marker of Parkinson's disease (PD). Asymptomatic LRRK2 mutation carriers (aLRRK2+), at high risk for developing PD, provide an opportunity for the study of preclinical biomarkers. OBJECTIVE To assess SN echogenicity and other echographic features in LRRK2 G2019S carriers and their clinical and imaging correlates. METHODS Transcranial sonography was performed in 26 LRRK2 G2019S PD patients, 50 first-degree relatives, 31 idiopathic PD (IPD) patients and 26 controls. SN echogenicity and other echographic features were assessed in all study subjects. Dopamine transporter imaging (DAT-SPECT) was performed in 29 first-degree relatives. RESULTS 75% of the LRRK2-PD and 87.5% of the IPD showed SN+ (p = 0.087). aLRRK2+ had a higher frequency of SN+ than non carriers (58.3% vs. 25%, p = 0.039) and controls (58.3% vs. 12.5%; p = 0.002) and had a larger area of SN echogenicity than non carriers (p = 0.030) and controls (p < 0.001). The width of the third ventricle was significantly lower in LRRK2-PD than in IPD (1.9 mm [1.38; 2.75] vs. 3.0 mm [2.3; 5.3]; p = 0.003). Four out of 5 (80%) of the aLRRK2+ with an abnormal DAT-SPECT and four of the 5 (80%) of those with REM sleep behaviour disorder (RBD) had SN+. CONCLUSIONS SN+ is very frequent in LRRK2-PD and aLRRK2+. Most aLRRK2 with possible surrogate markers of PD such as abnormal DAT-SPECT or RBD, also had SN+, which supports that this echofeature might be a marker of PD in these asymptomatic population.
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Affiliation(s)
- Dolores Vilas
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain
| | - Lourdes Ispierto
- Neurology Service, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Ramiro Álvarez
- Neurology Service, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Claustre Pont-Sunyer
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain
| | - María José Martí
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Francesc Valldeoriola
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Yaroslau Compta
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Oriol de Fabregues
- Neurology Service, Hospital Universitari Vall D'Hebron, Barcelona, Catalonia, Spain
| | - Jorge Hernández-Vara
- Neurology Service, Hospital Universitari Vall D'Hebron, Barcelona, Catalonia, Spain
| | - Víctor Puente
- Neurology Service, Hospital Del Mar, Barcelona, Catalonia, Spain
| | - Matilde Calopa
- Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Catalonia, Spain
| | - Serge Jaumà
- Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Catalonia, Spain
| | - Jaume Campdelacreu
- Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Catalonia, Spain
| | - Miquel Aguilar
- Neurology Service, Hospital Universitari Mutua de Terrasa, Barcelona, Catalonia, Spain
| | - Pilar Quílez
- Neurology Service, Hospital Universitari Mutua de Terrasa, Barcelona, Catalonia, Spain
| | | | - Francisco Lomeña
- Nuclear Medicine Service, Hospital Clinic, University of Barcelona, Barcelona, Catalonia, Spain
| | - José Ríos
- Biostatistics and Data Management Core Facility, IDIBAPS, (Hospital Clinic), Barcelona, Spain; Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - Eduardo Tolosa
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut de Neurociències Hospital Clínic, University of Barcelona, Catalonia, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain.
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A diagnostic algorithm for Parkinson's disease: what next? Lancet Neurol 2015; 14:971-3. [PMID: 26271531 DOI: 10.1016/s1474-4422(15)00192-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 07/24/2015] [Indexed: 11/20/2022]
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324
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Mahlknecht P, Seppi K, Frauscher B, Kiechl S, Willeit J, Stockner H, Djamshidian A, Nocker M, Rastner V, Defrancesco M, Rungger G, Gasperi A, Poewe W, Högl B. Probable RBD and association with neurodegenerative disease markers: A population-based study. Mov Disord 2015. [PMID: 26208108 DOI: 10.1002/mds.26350] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The prevalence of rapid eye movement sleep behavior disorder (RBD) and its association with markers of neurodegeneration in the general population are poorly defined. METHODS We assessed the prevalence of probable RBD defined by two validated questionnaires, the RBD Screening Questionnaire (RBDSQ) and the Innsbruck RBD-Inventory (RBD-I), and studied its associations with clinical and imaging markers for neurodegeneration in the Bruneck Study cohort aged 60 y or older. RESULTS Of the 456 participants without Parkinson's disease, 4.6% (RBDSQ; 95%CI, 3.0%-7.0%) and 7.7% (RBD-I; 95%CI, 5.6%-10.5%) had probable RBD. Probable RBD diagnosed with either of the questionnaires was associated with hyposmia (trend; P < 0.1), anxiety (P < 0.05), depression (P < 0.05), antidepressant use (P < 0.05), and self-reported non-motor symptoms (P < 0.01), specifically, dribbling saliva, memory problems, apathy, concentration problems, and anxiety. CONCLUSIONS Our findings may provide a basis for future studies intending to identify cohorts at risk for Lewy body diseases through screening of the general elderly population for RBD.
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Affiliation(s)
- Philipp Mahlknecht
- Department of Neurology, Medical University of Innsbruck, Austria.,Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Birgit Frauscher
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Johann Willeit
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Heike Stockner
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Austria.,Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK
| | - Michael Nocker
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Verena Rastner
- Department of Neurology, Medical University of Innsbruck, Austria
| | | | | | - Arno Gasperi
- Department of Neurology, Hospital of Bruneck, Italy
| | - Werner Poewe
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Austria
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325
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Lee HM, Lee SS, Kim M, Kang SH, Seo WK, Kim JH, Koh SB. Clinical phenotype of drug-naïve Parkinson's disease based on nonmotor symptoms. Arch Gerontol Geriatr 2015; 61:517-22. [PMID: 26183203 DOI: 10.1016/j.archger.2015.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 09/25/2014] [Accepted: 07/03/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nonmotor symptoms in Parkinson's disease (PD) are heterogeneous and can result in a variety of symptoms at various disease stages. The objective of the present study was to identify clinically meaningful nonmotor symptoms and to assess the relationship between changes in nonmotor symptoms and cognition and motor symptoms. METHODS A total of 159 patients who had drug-naïve PD participated in this study. Nonmotor symptoms (Nonmotor Symptoms Scale), PD status (Unified Parkinson's Disease Rating Scale), depression (Geriatric Depression Scale or Montgomery-Asberg Depression Scale) and health-related quality of life (39-item Parkinson's Disease Questionnaire) were assessed. An exploratory factor analysis was performed to establish a nonmotor symptom factor, which was analyzed to evaluate whether the results were associated with the clinical severity measures. RESULTS Exploratory factor analysis revealed one factor comprised of sleep/fatigue, attention/memory and mood/cognition. The modified Hoehn and Yahr Stage, Unified Parkinson's Disease Rating Scale Part III, Montgomery-Asberg Depression Scale and the 39-item Parkinson's Disease Questionnaire Summary Index were independently associated with the sleep/fatigue, attention/memory and mood/cognition domains. The presence of these domains was associated with advanced Parkinson's disease or depressed mood. CONCLUSIONS This study shows that motor impairment and depressed mood in PD are related to sleep/fatigue, attention/memory and mood/cognition. Sleep/fatigue, attention/memory and mood/cognition also had a major impact on health-related quality of life. It is appropriate to identify patients with severe motor symptoms and depressed mood in order to signify the need to consider more detailed care and further assessment.
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Affiliation(s)
- Hye Mi Lee
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea
| | - Seung-Soo Lee
- Department of Information Statistics, Kangwon National University College of Natural Sciences, 1 Kangwondaehak-gil, Chuncheon-si, Gangwon-do 200-701, Republic of Korea
| | - Minjik Kim
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea
| | - Sung Hoon Kang
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea
| | - Woo-Keun Seo
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea
| | - Ji Hyun Kim
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea
| | - Seong-Beom Koh
- Department of Neurology and Parkinson's disease Centre, Korea University College of Medicine at Guro Hospital, 148 Gurodong-Road, Guro-Ku, Seoul 152-703, Republic of Korea.
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326
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Simuni T, Caspell-Garcia C, Coffey C, Chahine LM, Lasch S, Oertel WH, Mayer G, Högl B, Postuma R, Videnovic A, Amara AW, Marek K. Correlates of excessive daytime sleepiness in de novo Parkinson's disease: A case control study. Mov Disord 2015; 30:1371-81. [PMID: 26095202 DOI: 10.1002/mds.26248] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/10/2015] [Accepted: 03/19/2015] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study was undertaken to determine the frequency and correlates of excessive daytime sleepiness in de novo, untreated Parkinson's disease (PD) patients compared with the matched healthy controls. METHODS Data were obtained from the Parkinson's Progression Markers Initiative, an international study of de novo, untreated PD patients and healthy controls. At baseline, participants were assessed with a wide range of motor and nonmotor scales, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Excessive daytime sleepiness was assessed based on the Epworth Sleepiness scale (ESS), with a cutoff of 10. RESULTS Four hundred twenty-three PD subjects and 196 healthy controls were recruited into the study. Mean ESS (min, max) score was 5.8 (0, 20) for the PD subjects and 5.6 (0, 19) for healthy controls (P = 0.54). Sixty-six (15.6%) PD subjects and 24 (12%) healthy controls had ESS of at least 10 (P = 0.28). No difference was seen in demographic characteristics, age of onset, disease duration, PD subtype, cognitive status, or utilization of sedatives between the PD sleepiness-positive versus the negative group. The sleepiness-positive group had higher MDS-UPDRS Part I and II but not III scores, and higher depression and autonomic dysfunction scores. Sleepiness was associated with a marginal reduction of A-beta (P = 0.05) but not alpha-synuclein spinal fluid levels in PD. CONCLUSIONS This largest case control study demonstrates no difference in prevalence of excessive sleepiness in subjects with de novo untreated PD compared with healthy controls. The only clinical correlates of sleepiness were mood and autonomic dysfunction. Ongoing longitudinal analyses will be essential to further examine clinical and biological correlates of sleepiness in PD and specifically the role of dopaminergic therapy.
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Affiliation(s)
- Tanya Simuni
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Lama M Chahine
- The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Shirley Lasch
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | - Geert Mayer
- Hephata-Klinik, Hephata Hessisches Diakoniezentrum e. V
| | - Birgit Högl
- Innsbruck Medical University, Innsbruck, Austria
| | | | | | | | - Ken Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
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327
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Weintraub D, Simuni T, Caspell-Garcia C, Coffey C, Lasch S, Siderowf A, Aarsland D, Barone P, Burn D, Chahine LM, Eberling J, Espay AJ, Foster ED, Leverenz JB, Litvan I, Richard I, Troyer MD, Hawkins KA. Cognitive performance and neuropsychiatric symptoms in early, untreated Parkinson's disease. Mov Disord 2015; 30:919-27. [PMID: 25737166 PMCID: PMC4855523 DOI: 10.1002/mds.26170] [Citation(s) in RCA: 212] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/22/2014] [Accepted: 12/17/2014] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED This study was undertaken to determine the prevalence and correlates of cognitive impairment (CI) and neuropsychiatric symptoms (NPS) in early, untreated patients with Parkinson's disease (PD). BACKGROUND Both CI and NPS are common in PD and impact disease course and quality of life. However, limited knowledge is available about cognitive abilities and NPS. METHODS Parkinson's Progression Markers Initiative (PPMI) is a multi-site study of early, untreated PD patients and healthy controls (HCs), the latter with normal cognition. At baseline, participants were assessed with a neuropsychological battery and for symptoms of depression, anxiety, impulse control disorders (ICDs), psychosis, and apathy. RESULTS Baseline data of 423 PD patients and 196 HCs yielded no between-group differences in demographic characteristics. Twenty-two percent of PD patients met the PD-recommended screening cutoff for CI on the Montral Cognitive Assessment (MoCA), but only 9% met detailed neuropsychological testing criteria for mild cognitive impairment (MCI)-level impairment. The PD patients were more depressed than HCs (P < 0.001), with twice as many (14% vs. 7%) meeting criteria for clinically significant depressive symptoms. The PD patients also experienced more anxiety (P < 0.001) and apathy (P < 0.001) than HCs. Psychosis was uncommon in PD (3%), and no between-group difference was seen in ICD symptoms (P = 0.51). CONCLUSIONS Approximately 10% of PD patients in the early, untreated disease state met traditional criteria of CI, which is a lower frequency compared with previous studies. Multiple dopaminergic-dependent NPS are also more common in these patients compared with the general population, but others associated with dopamine replacement therapy are not or are rare. Future analyses of this cohort will examine biological predictors and the course of CI and NPS. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Chelsea Caspell-Garcia
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Christopher Coffey
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Shirley Lasch
- Institute for Neurodegenerative Disorders (IND) and Molecular NeuroImaging, LLC (MNI), New Haven, Connecticut, USA
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society and the Alzheimer Disease Research Centre, Karolinska Institutet, Stockholm, Sweden; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Paolo Barone
- Neurodegenerative Diseases Centre, Neuroscience Section, Department of Medicine, University of Salerno, Italy
| | - David Burn
- Institute for Ageing and Health, Newcastle University, Newcastle, England
| | - Lama M. Chahine
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jamie Eberling
- Michael J. Fox Foundation for Parkinson’s Research, New York, New York, USA
| | - Alberto J. Espay
- Department of Neurology, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA
| | - Eric D. Foster
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - James B. Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Irene Litvan
- UCSD Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Irene Richard
- Departments of Neurology and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Keith A. Hawkins
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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328
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Lee HM, Koh SB. Many Faces of Parkinson's Disease: Non-Motor Symptoms of Parkinson's Disease. J Mov Disord 2015; 8:92-7. [PMID: 26090081 PMCID: PMC4460545 DOI: 10.14802/jmd.15003] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 01/28/2015] [Accepted: 02/12/2015] [Indexed: 12/21/2022] Open
Abstract
Parkinson’s disease (PD) is a multi-systemic disorder that is characterized by a combination of motor and non-motor symptoms (NMS). The dopaminergic neurodegeneration of PD is involved in the genesis of NMS, but other conditions and side effects of levodopa are also associated with NMS. NMS can develop at all stage of PD and rapid eyeball movement sleep behavior disorder (RBD), constipation, depression, and olfactory dysfunction are considered prodromal signs of PD. Many NMS related with motor deficits and cognitive dysfunction. Some NMS including olfactory dysfunction, RBD and abnormal stereopsis are associated with presence of other NMS of PD. In addition, several NMS can be helpful to differentiate between idiopathic PD and other parkinsonian disorders. Early recognition and management of NMS in PD patients is important for preserving quality of life.
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Affiliation(s)
- Hye Mi Lee
- Department of Neurology, Korea University College of Medicine at Guro Hospital, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University College of Medicine at Guro Hospital, Seoul, Korea
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329
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Montine TJ, Montine KS. Precision medicine: Clarity for the clinical and biological complexity of Alzheimer's and Parkinson's diseases. J Exp Med 2015; 212:601-5. [PMID: 25941321 PMCID: PMC4419342 DOI: 10.1084/jem.20150656] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 04/13/2015] [Indexed: 01/10/2023] Open
Abstract
The goal of precision medicine is to deliver optimally targeted and timed interventions tailored to an individual's molecular drivers of disease. This concept has wide currency in cancer care and in some diseases caused by monogenetic mutations, such as cystic fibrosis, and recently has been endorsed by the White House Office of Science and Technology for more widespread application in medicine. Here we describe our vision of how precision medicine can bring greater clarity to the clinical and biological complexity of the two most common neurodegenerative diseases, Alzheimer's disease and Parkinson's disease.
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Affiliation(s)
- Thomas J Montine
- T.J. Montine and K.S. Montine are at the Department of Pathology, University of Washington, Seattle, WA 98104
| | - Kathleen S Montine
- T.J. Montine and K.S. Montine are at the Department of Pathology, University of Washington, Seattle, WA 98104
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330
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Vilas D, Iranzo A, Pont-Sunyer C, Serradell M, Gaig C, Santamaria J, Tolosa E. Brainstem raphe and substantia nigra echogenicity in idiopathic REM sleep behavior disorder with comorbid depression. J Neurol 2015; 262:1665-72. [DOI: 10.1007/s00415-015-7745-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/31/2015] [Accepted: 04/09/2015] [Indexed: 11/30/2022]
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331
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Jiang P, Scarpa JR, Fitzpatrick K, Losic B, Gao VD, Hao K, Summa KC, Yang HS, Zhang B, Allada R, Vitaterna MH, Turek FW, Kasarskis A. A systems approach identifies networks and genes linking sleep and stress: implications for neuropsychiatric disorders. Cell Rep 2015; 11:835-48. [PMID: 25921536 DOI: 10.1016/j.celrep.2015.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/23/2014] [Accepted: 03/30/2015] [Indexed: 02/06/2023] Open
Abstract
Sleep dysfunction and stress susceptibility are comorbid complex traits that often precede and predispose patients to a variety of neuropsychiatric diseases. Here, we demonstrate multilevel organizations of genetic landscape, candidate genes, and molecular networks associated with 328 stress and sleep traits in a chronically stressed population of 338 (C57BL/6J × A/J) F2 mice. We constructed striatal gene co-expression networks, revealing functionally and cell-type-specific gene co-regulations important for stress and sleep. Using a composite ranking system, we identified network modules most relevant for 15 independent phenotypic categories, highlighting a mitochondria/synaptic module that links sleep and stress. The key network regulators of this module are overrepresented with genes implicated in neuropsychiatric diseases. Our work suggests that the interplay among sleep, stress, and neuropathology emerges from genetic influences on gene expression and their collective organization through complex molecular networks, providing a framework for interrogating the mechanisms underlying sleep, stress susceptibility, and related neuropsychiatric disorders.
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Affiliation(s)
- Peng Jiang
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Joseph R Scarpa
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Karrie Fitzpatrick
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Bojan Losic
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Vance D Gao
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Ke Hao
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Keith C Summa
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - He S Yang
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ravi Allada
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Martha H Vitaterna
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA
| | - Fred W Turek
- Center for Sleep & Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, IL 60208, USA.
| | - Andrew Kasarskis
- Department of Genetics and Genomic Sciences, Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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332
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Mirelman A, Alcalay RN, Saunders-Pullman R, Yasinovsky K, Thaler A, Gurevich T, Mejia-Santana H, Raymond D, Gana-Weisz M, Bar-Shira A, Ozelius L, Clark L, Orr-Urtreger A, Bressman S, Marder K, Giladi N. Nonmotor symptoms in healthy Ashkenazi Jewish carriers of the G2019S mutation in the LRRK2 gene. Mov Disord 2015; 30:981-6. [PMID: 25809001 DOI: 10.1002/mds.26213] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The asymptomatic carriers of the Leucine rich repeat kinase 2 (LRRK2) G2019S mutation represent a population at risk for developing PD. The aim of this study was to assess differences in nonmotor symptoms between nonmanifesting carriers and noncarriers of the G2019S mutation. METHODS Two hundred fifty-three subjects participated in this observational cross-sectional multicenter study. Standard questionnaires assessing anxiety, depression, cognition, smell, nonmotor symptoms, and rapid eye movement (REM) sleep behavior were administered. Analyses were adjusted for age, sex, family relations, education, and site. RESULTS One hundred thirty-four carriers were identified. Carriers had higher nonmotor symptoms score on the Nonmotor symptoms (NMS) questionnaire (P = 0.02). These findings were amplified in carriers older than age 50 y, with higher nonmotor symptoms scores and trait anxiety scores (P < 0.03). CONCLUSIONS In this cross-section study, carriers of the G2019S LRRK2 mutation endorsed subtle nonmotor symptoms. Whether these are early features of PD will require a longitudinal study. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Roy N Alcalay
- College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Rachel Saunders-Pullman
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kira Yasinovsky
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Avner Thaler
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Tanya Gurevich
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Deborah Raymond
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA
| | - Mali Gana-Weisz
- Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Anat Bar-Shira
- Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Laurie Ozelius
- Departments of Genetics and Genomic Sciences and Neurology, Mount Sinai School of Medicine, New York, NY, USA
| | - Lorraine Clark
- Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Center for Human Genetics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Avi Orr-Urtreger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Susan Bressman
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karen Marder
- College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Nir Giladi
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sieratzki Chair in Neurology, Tel-Aviv University, New York, NY, USA
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333
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Postuma RB, Gagnon JF, Bertrand JA, Génier Marchand D, Montplaisir JY. Parkinson risk in idiopathic REM sleep behavior disorder: preparing for neuroprotective trials. Neurology 2015; 84:1104-13. [PMID: 25681454 PMCID: PMC4371408 DOI: 10.1212/wnl.0000000000001364] [Citation(s) in RCA: 313] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 11/19/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To precisely delineate clinical risk factors for conversion from idiopathic REM sleep behavior disorder (RBD) to Parkinson disease, dementia with Lewy bodies, and multiple system atrophy, in order to enable practical planning and stratification of neuroprotective trials against neurodegenerative synucleinopathy. METHODS In a 10-year prospective cohort, we tested prodromal Parkinson disease markers in 89 patients with idiopathic RBD. With Kaplan-Meier analysis, we calculated risk of neurodegenerative synucleinopathy, and using Cox proportional hazards, tested the ability of prodromal markers to identify patients at higher disease risk. By combining predictive markers, we then designed stratification strategies to optimally select patients for definitive neuroprotective trials. RESULTS The risk of defined neurodegenerative synucleinopathy was high: 30% developed disease at 3 years, rising to 66% at 7.5 years. Advanced age (hazard ratio [HR] = 1.07), olfactory loss (HR = 2.8), abnormal color vision (HR = 3.1), subtle motor dysfunction (HR = 3.9), and nonuse of antidepressants (HR = 3.5) identified higher risk of disease conversion. However, mild cognitive impairment (HR = 1.8), depression (HR = 0.63), Parkinson personality, treatment with clonazepam (HR = 1.3) or melatonin (HR = 0.55), autonomic markers, and sex (HR = 1.37) did not clearly predict clinical neurodegeneration. Stratification with prodromal markers increased risk of neurodegenerative disease conversion by 200%, and combining markers allowed sample size reduction in neuroprotective trials by >40%. With a moderately effective agent (HR = 0.5), trials with fewer than 80 subjects per group can demonstrate definitive reductions in neurodegenerative disease. CONCLUSIONS Using stratification with simply assessed markers, it is now not only possible, but practical to include patients with RBD in neuroprotective trials against Parkinson disease, multiple system atrophy, and dementia with Lewy bodies.
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Affiliation(s)
- Ronald B Postuma
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Jean-Francois Gagnon
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Josie-Anne Bertrand
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Daphné Génier Marchand
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada
| | - Jacques Y Montplaisir
- From the Department of Neurology (R.B.P.), McGill University, Montreal General Hospital; Centre d'Études Avancées en Médecine du Sommeil (R.B.P., J.-F.G., J.-A.B., D.G.M., J.Y.M.), Hôpital du Sacré-Cœur de Montréal; Department of Psychology (J.-F.G.), Université du Québec à Montréal; and Department of Psychiatry (J.Y.M.), Université de Montréal, Canada.
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334
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Lewis SJG. Neurological update: emerging issues in gait disorders. J Neurol 2015; 262:1590-5. [DOI: 10.1007/s00415-015-7686-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
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335
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Beavan M, McNeill A, Proukakis C, Hughes DA, Mehta A, Schapira AHV. Evolution of prodromal clinical markers of Parkinson disease in a GBA mutation-positive cohort. JAMA Neurol 2015; 72:201-8. [PMID: 25506732 PMCID: PMC4326672 DOI: 10.1001/jamaneurol.2014.2950] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE Numerically, the most important genetic risk factor for the development of Parkinson disease (PD) is the presence of a glucocerebrosidase gene (GBA) mutation. OBJECTIVE To evaluate longitudinally and clinically a GBA mutation-positive cohort and the evolution of the prodromal features of PD. DESIGN, SETTING, AND PARTICIPANTS Participants in a study of the etiology and prodrome of PD were reevaluated in this clinic-based 2-year follow-up report. Patients with type 1 Gaucher disease (GD) and heterozygous GBA mutation carriers were recruited in 2010 from the Lysosomal Storage Disorder Unit at the Royal Free Hospital, London, England. Thirty patients who previously received a diagnosis of type 1 GD, 28 heterozygous GBA mutation carriers, and 26 genetically unrelated controls were included. Exclusion criteria included a diagnosis of PD or dementia for both the patients with GD and the GBA mutation carriers and any existing neurological disease for the controls. MAIN OUTCOMES AND MEASURES Assessment was performed for clinical markers using standardized scales for hyposmia, rapid eye movement sleep behavior disorder, depression, autonomic dysfunction, cognitive function, and parkinsonian motor signs (using the Unified Parkinson's Disease Rating Scale motor subscale [UPDRS part III]). RESULTS Over 2 years, depression scores were significantly worse for heterozygous carriers (mean baseline, 0.65; mean follow-up, 2.88; P = .01), rapid eye movement sleep behavior disorder scores were significantly worse for patients with GD (mean baseline, 0.93; mean follow-up, 2.93; P < .001) and heterozygotes (mean baseline, 0.10; mean follow-up, 2.30; P < .001), and UPDRS part III scores were significantly worse for patients with GD (mean baseline, 4.29; mean follow-up, 7.82; P < .001) and heterozygotes (mean baseline, 1.97; mean follow-up, 4.50; P < .001). For controls, there was a small but significant deterioration in the UPDRS part II (activities of daily living) score (mean baseline, 0.00; mean follow-up, 0.58; P = .006). At 2 years, olfactory and cognitive assessment scores were lower in patients with GD and heterozygotes compared with controls, but they did not differ significantly from baseline. When the results from the patients with GD and the heterozygotes were combined, a significant deterioration from baseline was observed, as reflected in the Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (mean baseline, 0.51; mean follow-up, 2.63; P < .001), Beck Depression Inventory (mean baseline, 1.72; mean follow-up, 4.44; P = .002), and UPDRS part II (mean baseline, 0.88; mean follow-up, 2.01; P < .001) and part III scores (mean baseline, 3.09; mean follow-up, 6.10; P < .001) (all P < .01), and at 2 years, significant differences in University of Pennsylvania Smell Identification Test, Unified Multiple System Atrophy Rating Scale, Mini-Mental State Examination, Montreal Cognitive Assessment, and UPDRS part II and part III scores were observed between patients with GD/heterozygotes and controls (all P < .05). CONCLUSIONS AND RELEVANCE This study indicates that, as a group, GBA mutation-positive individuals show a deterioration in clinical markers consistent with the prodrome of PD. Within this group of individual, 10% appear to be evolving at a more rapid rate.
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Affiliation(s)
- Michelle Beavan
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK
| | - Alisdair McNeill
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK
| | - Christos Proukakis
- Department of Clinical Neurosciences, UCL Institute of Neurology, London, UK
| | - Derralynn A Hughes
- Lysosomal Storage Disorders Unit, Royal Free London NHS Trust and Department Haematology, UCL, London, UK
| | - Atul Mehta
- Lysosomal Storage Disorders Unit, Royal Free London NHS Trust and Department Haematology, UCL, London, UK
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Louter M, Maetzler W, Prinzen J, van Lummel RC, Hobert M, Arends JBAM, Bloem BR, Streffer J, Berg D, Overeem S, Liepelt-Scarfone I. Accelerometer-based quantitative analysis of axial nocturnal movements differentiates patients with Parkinson's disease, but not high-risk individuals, from controls. J Neurol Neurosurg Psychiatry 2015; 86:32-7. [PMID: 24777169 DOI: 10.1136/jnnp-2013-306851] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There is a need for prodromal markers to diagnose Parkinson's disease (PD) as early as possible. Knowing that most patients with overt PD have abnormal nocturnal movement patterns, we hypothesised that such changes might occur already in non-PD individuals with a potentially high risk for future development of the disease. METHODS Eleven patients with early PD (Hoehn & Yahr stage ≤2.5), 13 healthy controls and 33 subjects with a high risk of developing PD (HR-PD) were investigated. HR-PD was defined by the occurrence of hyperechogenicity of the substantia nigra in combination with prodromal markers (eg, slight motor signs, olfactory dysfunction). A triaxial accelerometer was used to quantify nocturnal movements during two nights per study participant. Outcome measurements included mean acceleration, and qualitative axial movement parameters, such as duration and speed. RESULTS Mean acceleration of nocturnal movements was lower in patients with PD compared to controls. Frequency and speed of axial movements did not differ between patients with PD and controls, but mean size and duration were lower in PD. The HR-PD group did not significantly differ from the control group in any of the parameters analysed. CONCLUSIONS Compared with controls, patients with PD had an overall decreased mean acceleration, as well as smaller and shorter nocturnal axial movements. These changes did not occur in our potential HR-PD individuals, suggesting that relevant axial movement alterations during sleep have either not developed or cannot be detected by the means applied in this at-risk cohort.
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Affiliation(s)
- Maartje Louter
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical centre, Nijmegen, The Netherlands Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
| | - Walter Maetzler
- Department for Neurodegenerative Diseases, Centre of Neurology, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | | | - Markus Hobert
- Department for Neurodegenerative Diseases, Centre of Neurology, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johan B A M Arends
- Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands Department of Electrical Engineering, University of Technology, Eindhoven, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical centre, Nijmegen, The Netherlands
| | - Johannes Streffer
- Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - Daniela Berg
- Department for Neurodegenerative Diseases, Centre of Neurology, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Sebastiaan Overeem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical centre, Nijmegen, The Netherlands Sleep Medicine Centre Kempenhaeghe, Heeze, The Netherlands
| | - Inga Liepelt-Scarfone
- Department for Neurodegenerative Diseases, Centre of Neurology, German Center of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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337
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Mahlknecht P, Kiechl S, Stockner H, Willeit J, Gasperi A, Poewe W, Seppi K. Predictors for mild parkinsonian signs: a prospective population-based study. Parkinsonism Relat Disord 2014; 21:321-4. [PMID: 25585991 DOI: 10.1016/j.parkreldis.2014.12.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/09/2014] [Accepted: 12/16/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Mild parkinsonian signs (MPS) are common in the elderly population and are associated with a wide range of adverse health outcomes, including incident Parkinson's disease (PD). We aimed to prospectively evaluate potential risk factors for incident MPS. METHODS Participants of the population-based Bruneck Study representative for the general elderly community underwent a baseline assessment of substantia nigra (SN)-echogenicity with transcranial sonography, olfactory function with the Sniffin' Sticks identification test and vascular risk according to the Framingham risk score as well as a baseline and 5-year follow-up neurological examination. MPS were defined according to established criteria based on the entire motor section of the Unified PD Rating Scale. Participants with PD at baseline or follow-up and subjects with MPS at baseline were excluded. A logistic regression analysis adjusted for age and sex was used to detect risk factors for incident MPS in the remaining 393 participants. RESULTS SN-hyperechogenicity and hyposmia were related to the development of MPS with odds ratios of 2.0 (95%CI, 1.1-3.7) and 1.6 (95%CI, 1.0-2.7), respectively, while increased vascular risk was not. Having both, SN-hyperechogenicity and hyposmia, was associated with an odds ratio of 3.0 (95%CI, 1.2-7.7) for incident MPS. Among the various motor domains, increased SN-echogenicity predicted the development of bradykinesia and rigidity, whereas diminished olfactory function predicted the development of impaired axial motor function. CONCLUSIONS In addition to their established roles as risk factors for PD, SN-hyperechogenicity and hyposmia are associated with an increased risk for MPS in the general elderly community.
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Affiliation(s)
- Philipp Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria; Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
| | - Stefan Kiechl
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Heike Stockner
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Johann Willeit
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Arno Gasperi
- Department of Neurology, Hospital of Bruneck, Bruneck, Italy.
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
| | - Klaus Seppi
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
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Erro R, Santangelo G, Barone P, Picillo M, Amboni M, Longo K, Giordano F, Moccia M, Allocca R, Pellecchia MT, Vitale C. Do subjective memory complaints herald the onset of mild cognitive impairment in Parkinson disease? J Geriatr Psychiatry Neurol 2014; 27:276-81. [PMID: 24789732 DOI: 10.1177/0891988714532015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Longitudinal studies on healthy participants have shown that subjective memory impairment (defined as subjective cognitive complaints with normal cognitive objective performance) might be a strong predictor of mild cognitive impairment (MCI). Parkinson disease (PD) also manifests cognitive disturbances, but whether subjective memory complaints may predict the development of MCI in PD has not yet been explored. METHODS We prospectively screened newly diagnosed, untreated patients with PD in order to evaluate whether subjective memory complaints may predict development of MCI over a 2-year follow-up evaluation. RESULTS We enrolled 76 de novo untreated patients with PD. Of the 76 patients, 23 (30.3%) complained memory issues. Among the patients cognitively unimpaired at baseline, those with subjective complaints were more likely to develop MCI at follow-up. The regression model confirmed that presence of subjective memory complaints at baseline was an independent predictor of development of MCI at follow-up. DISCUSSION This is the first prospective study to explore the relationship between subjective and objective cognitive deficits in newly diagnosed, untreated patients. Our results provide preliminary evidence that subjective memory complaints might predict future development of MCI.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London (UCL), London, United Kingdom
| | - Gabriella Santangelo
- Department of Psychology, Neuropsychology Laboratory, Second University of Naples, Caserta, Italy IDC Hermitage-Capodimonte, Naples, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases-CEMAND, University of Salerno, Salerno, Italy
| | - Marina Picillo
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | | | | | - Flavio Giordano
- Center for Neurodegenerative Diseases-CEMAND, University of Salerno, Salerno, Italy
| | - Marcello Moccia
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | - Roberto Allocca
- Department of Neurological Science, University of Naples "Federico II", Naples, Italy
| | | | - Carmine Vitale
- IDC Hermitage-Capodimonte, Naples, Italy Department of Motor Sciences, University of Naples "Parthenope", Naples, Italy
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339
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dos Santos AB, Kohlmeier KA, Barreto GE. Are Sleep Disturbances Preclinical Markers of Parkinson’s Disease? Neurochem Res 2014; 40:421-7. [DOI: 10.1007/s11064-014-1488-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
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340
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Pagano G, Tan EE, Haider JM, Bautista A, Tagliati M. Constipation is reduced by beta-blockers and increased by dopaminergic medications in Parkinson's disease. Parkinsonism Relat Disord 2014; 21:120-5. [PMID: 25483722 DOI: 10.1016/j.parkreldis.2014.11.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Constipation is one of most frequent non-motor symptoms of Parkinson's disease (PD) and it may precede the clinical diagnosis of PD by years, with negative effects on quality of life. In contrast to motor features, levodopa is ineffective and possibly detrimental on constipation. Treatment of constipation in PD is non-specific and frequently unsuccessful. Stemming from a clinical observation of unexpected relief of bothersome constipation, abdominal bloating and pain after treatment with the beta-blocker carvedilol in one patient, we have evaluated the association between the use of beta-blockers and the presence of constipation in a large, unselected PD cohort. METHODS Retrospective review of the medical records of every patient with a diagnosis of PD seen in the Movement Disorders clinic at Cedars-Sinai Medical Center from October 2010 to April 2014. RESULTS 341 medical records with a primary diagnosis of PD were reviewed, 336 of which contained information about constipation. Overall, 205/336 patients (61%) reported constipation. Among the 66 subjects treated with beta-blockers at the time of the encounter of record, only 28 (42.4%) reported constipation. By comparison, among the 270 subjects not treated with beta-blockers, 177 (65.5%) had constipation (χ(2) test p value = 0.001). Multivariate logistic analysis showed an odds ratio (OR) of 0.293 for beta-blockers (95% C.I. 0.161-0.535, p = 0.0001), 2.287 for levodopa (95% C.I. 1.271-4.117, p = 0.006) and 1.805 for dopamine agonists (95% C.I. 1.039-3.136, p = 0.036). CONCLUSIONS Beta-blockers are associated with a lower risk of constipation, while dopaminergic treatments appear to increase risk of constipation.
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Affiliation(s)
- Gennaro Pagano
- Department of Medicine and Health Sciences, School of Medicine, University of Molise, Campobasso, Italy; Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy; Department of Neurology, Cedar-Sinai Medical Center, Los Angeles, CA, USA
| | - Echo E Tan
- Department of Neurology, Cedar-Sinai Medical Center, Los Angeles, CA, USA
| | - Janelle M Haider
- Department of Neurology, Cedar-Sinai Medical Center, Los Angeles, CA, USA
| | - Alyssa Bautista
- Department of Neurology, Cedar-Sinai Medical Center, Los Angeles, CA, USA
| | - Michele Tagliati
- Department of Neurology, Cedar-Sinai Medical Center, Los Angeles, CA, USA.
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Increased all-cause mortality with psychotropic medication in Parkinson's disease and controls: A national register-based study. Parkinsonism Relat Disord 2014; 20:1124-8. [DOI: 10.1016/j.parkreldis.2014.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 06/29/2014] [Accepted: 07/12/2014] [Indexed: 11/24/2022]
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342
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Hasmann SE, Berg D, Hobert MA, Weiss D, Lindemann U, Streffer J, Liepelt-Scarfone I, Maetzler W. Instrumented functional reach test differentiates individuals at high risk for Parkinson's disease from controls. Front Aging Neurosci 2014; 6:286. [PMID: 25386137 PMCID: PMC4208400 DOI: 10.3389/fnagi.2014.00286] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 09/26/2014] [Indexed: 01/05/2023] Open
Abstract
The functional reach (FR) test as a complex measure of balance including limits of stability has been proven to differentiate between patients with Parkinson’s disease (PD) and controls (CO). Recently, it has been shown that the instrumentation of the FR (iFR) with a wearable sensor may increase this diagnostic accuracy. This cross-sectional study aimed at investigating whether the iFR has the potential to differentiate individuals with high risk for PD (HRPD) from CO, as the delineation of such individuals would allow for, e.g., early neuromodulation. Thirteen PD patients, 13 CO, and 31 HRPD were investigated. HRPD was defined by presence of an enlarged area of hyperechogenicity in the mesencephalon on transcranial sonography and either one motor sign or two risk and prodromal markers of PD. All participants were asked to reach with their right arm forward as far as possible and hold this position for 10 s. During this period, sway parameters were assessed with an accelerometer (Dynaport, McRoberts) worn at the lower back. Extracted parameters that differed significantly between PD patients and CO in our cohort [FR distance (shorter in PD), anterior–posterior and mediolateral acceleration (both lower in PD)] as well as JERK, which has been shown to differentiate HRPD from CO and PD in a previous study, were included in a model, which was then used to differentiate HRPD from CO. The model yielded an area under the curve of 0.77, with a specificity of 85%, and a sensitivity of 74%. These results suggest that the iFR can contribute to an assessment panel focusing on the definition of HRPD individuals.
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Affiliation(s)
- Sandra E Hasmann
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Markus A Hobert
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - David Weiss
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Ulrich Lindemann
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital , Stuttgart , Germany
| | - Johannes Streffer
- Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson and Johnson , Beerse , Belgium
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Center for Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
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343
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Saunders-Pullman R, Mirelman A, Wang C, Alcalay RN, San Luciano M, Ortega R, Raymond D, Mejia-Santana H, Ozelius L, Clark L, Orr-Utreger A, Marder K, Giladi N, Bressman SB. Olfactory identification in LRRK2 G2019S mutation carriers: a relevant marker? Ann Clin Transl Neurol 2014; 1:670-8. [PMID: 25493281 PMCID: PMC4241794 DOI: 10.1002/acn3.95] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 12/12/2022] Open
Abstract
Objective Olfactory impairment is a potential marker for impending phenoconversion to Parkinson disease (PD) that may precede the development of disease by several years. Because of low specificity, it may be of greater predictive value in those with genetic mutations and its potential as a marker for developing LRRK2 PD should be evaluated. Methods We examined olfactory identification in 126 LRRK2 G2019S mutation carriers with PD, 125 mutation carriers not manifesting PD, 126 noncarriers with idiopathic PD, 106 noncarrier family members without PD, and 35 unrelated controls. We compared olfactory performance and performed mixture modeling to identify possible subgroups of olfactory performance in LRRK2 PD and nonmanifesting carriers. Results Adjusting for sex, age, cognitive score, site, and smoking history, LRRK2 PD had better olfactory scores compared to idiopathic PD (mean olfaction difference: −3.7, P < 0.001), and both LRRK2 PD and idiopathic PD had worse olfaction than controls (−12.8, −9.1, both P < 0.001). LRRK2 PD were less likely to be hyposmic than idiopathic PD (54.8% vs. 80.2%, P < 0.001). Nonmanifesting carriers and noncarrier family members did not differ. Mixture model analysis identified three classes in the LRRK2 PD and nonmanifesting carriers, suggesting that there are subgroups with poor olfactory identification in both LRRK2 PD and nonmanifesting carriers. Interpretation Therefore, olfactory identification deficit is less likely to be an obligate feature in LRRK2 PD than idiopathic PD, and while a relevant marker in some, a subset of carriers who eventually phenoconvert may proceed directly to PD without prior impaired olfaction.
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Affiliation(s)
- Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel Medical Center New York City, New York ; Department of Neurology, Icahn School of Medicine at Mount Sinai New York City, New York ; Department of Neurology, Albert Einstein College of Medicine Bronx, New York
| | - Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University Tel-Aviv, Israel
| | - Cuiling Wang
- Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine Bronx, New York
| | - Roy N Alcalay
- Department of Neurology, College of Physicians and Surgeons, Columbia University New York City, New York ; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University New York City, New York
| | - Marta San Luciano
- Department of Neurology, University of California San Francisco San Francisco, California
| | - Robert Ortega
- Department of Neurology, Mount Sinai Beth Israel Medical Center New York City, New York
| | - Deborah Raymond
- Department of Neurology, Mount Sinai Beth Israel Medical Center New York City, New York
| | - Helen Mejia-Santana
- Department of Neurology, College of Physicians and Surgeons, Columbia University New York City, New York ; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University New York City, New York
| | - Laurie Ozelius
- Department of Neurology, Icahn School of Medicine at Mount Sinai New York City, New York ; Department of Genetics, Icahn School of Medicine at Mount Sinai New York City, New York
| | - Lorraine Clark
- Department of Neurology, College of Physicians and Surgeons, Columbia University New York City, New York ; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University New York City, New York
| | - Avi Orr-Utreger
- Genetic Institute, Tel-Aviv Medical Center, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University Tel-Aviv, Israel
| | - Karen Marder
- Department of Neurology, College of Physicians and Surgeons, Columbia University New York City, New York ; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University New York City, New York ; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University New York City, New York ; Department of Psychiatry, Columbia University Medical Center New York City, New York
| | - Nir Giladi
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University Tel-Aviv, Israel
| | - Susan B Bressman
- Department of Neurology, Mount Sinai Beth Israel Medical Center New York City, New York ; Department of Neurology, Icahn School of Medicine at Mount Sinai New York City, New York
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Yang HJ, Kim YE, Yun JY, Ehm G, Kim HJ, Jeon BS. Comparison of sleep and other non-motor symptoms between SWEDDs patients and de novo Parkinson's disease patients. Parkinsonism Relat Disord 2014; 20:1419-22. [PMID: 25446342 DOI: 10.1016/j.parkreldis.2014.09.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/15/2014] [Accepted: 09/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND SWEDDs (Scans Without Evidence of Dopaminergic Deficits) was defined from a series of pharmaceutical trials on Parkinson's disease (PD). Non-motor features including sleep-related problems are common even in early-stage PD patients; however, little is known about the burden of the non-motor symptoms in SWEDDs patients. METHODS The Non-motor Symptoms Assessment Scale (NMSS), revised version of the Parkinson's Disease Sleep Scale (PDSS-2), Epworth Sleepiness Scale (ESS), and EuroQol 5-Dimension (EQ-5D) were applied to evaluate 17 SWEDDs patients and 28 de novo PD patients. The presence of clinically probable rapid eye movement sleep behavior disorder (cpRBD) was assessed using the International Classification of Sleep Disorders-Revised (ICSD-R) criteria. RESULTS The total NMSS score for the SWEDDs group was significantly lower than for the de novo PD group (p = 0.032). The most distinct difference was in taste or smell change (p < 0.000). Prevalence of cpRBD was higher in de novo PD patients than in SWEDDs patients (p = 0.030), though no significant differences in the PDSS-2 total score (p = 0.496) or the ESS score (p = 0.517) were found. The SWEDDs patients did not significantly differ from the de novo PD patients with regard to quality of life, as measured by the EQ-5D index score (p = 0.177). CONCLUSIONS The patients with SWEDDs have less non-motor problems than newly diagnosed untreated PD patients. Given the difficulty distinguishing between SWEDDs and early PD, identifying some of non-motor symptoms, such as RBD or olfactory impairment, could aid clinicians in their work.
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Affiliation(s)
- Hui-Jun Yang
- Department of Neurology, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Gwanhee Ehm
- Department of Neurology and Movement Disorder Center, Parkinson's Disease Study Group and Neuroscience Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea
| | - Han-Joon Kim
- Department of Neurology and Movement Disorder Center, Parkinson's Disease Study Group and Neuroscience Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea
| | - Beom Seok Jeon
- Department of Neurology and Movement Disorder Center, Parkinson's Disease Study Group and Neuroscience Research Institute, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, Republic of Korea.
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Sieber BA, Landis S, Koroshetz W, Bateman R, Siderowf A, Galpern WR, Dunlop J, Finkbeiner S, Sutherland M, Wang H, Lee VMY, Orr HT, Gwinn K, Ludwig K, Taylor A, Torborg C, Montine TJ. Prioritized research recommendations from the National Institute of Neurological Disorders and Stroke Parkinson's Disease 2014 conference. Ann Neurol 2014; 76:469-72. [PMID: 25164235 DOI: 10.1002/ana.24261] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 08/26/2014] [Accepted: 08/26/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Beth-Anne Sieber
- National Institute of Neurological Disorders and Stroke, Bethesda, MD
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347
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Walter U, Heilmann R, Kaulitz L, Just T, Krause BJ, Benecke R, Höppner J. Prediction of Parkinson's disease subsequent to severe depression: a ten-year follow-up study. J Neural Transm (Vienna) 2014; 122:789-97. [PMID: 25217967 DOI: 10.1007/s00702-014-1313-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022]
Abstract
Major depressive disorder (MDD) has been associated with an increased risk of subsequent Parkinson's disease (PD) in case-control and cohort studies. However, depression alone is unlikely to be a useful marker of prodromal PD due to its low specificity. In this longitudinal observational study, we assessed whether the presence of other potential markers of prodromal PD predicts the subsequent development of PD in MDD patients. Of 57 patients with severe MDD but no diagnosis of PD who underwent a structured interview, olfactory and motor investigation and transcranial sonography at baseline, 46 (36 women; mean age 54.9 ± 11.7 years) could be followed for up to 11 (median, 10) years. Three patients (2 women; age 64, 65 and 70 years) developed definite PD after 1, 7, and 9 years, respectively. The combined finding of mild asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity predicted subsequent PD in all patients who could be followed for longer than 1 year. Out of the whole study cohort, only the subjects with subsequent PD presented with the triad of asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity in combination with at least two out of four reportable risk factors (family history of PD, current non-smoker, non-coffee drinker, constipation) at baseline investigation. Post-hoc analysis revealed that additional rating of eye and eye-lid motor abnormalities might further improve the prediction of PD in larger cohorts. Findings of this pilot-study suggest that MDD patients at risk of subsequent PD can be identified using an inexpensive non-invasive diagnostic battery.
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Affiliation(s)
- Uwe Walter
- Department of Neurology, University of Rostock, Rostock, Germany,
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348
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Ritz B, Lee PC, Lassen CF, Arah OA. Parkinson disease and smoking revisited: ease of quitting is an early sign of the disease. Neurology 2014; 83:1396-402. [PMID: 25217056 DOI: 10.1212/wnl.0000000000000879] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess whether being able to quit smoking is an early marker of Parkinson disease (PD) onset rather than tobacco being "neuroprotective," we analyzed information about ease of quitting and nicotine substitute use. METHODS For this case-control study, we identified 1,808 patients with PD diagnosed between 1996 and 2009 from Danish registries, matched 1,876 population controls on sex and year of birth, and collected lifestyle information. We estimated odds ratios and 95% confidence intervals with logistic regression adjusting for matching factors and confounders. RESULTS Fewer patients with PD than controls ever established a smoking habit. Among former smokers, those with greater difficulty quitting or using nicotine substitutes were less likely to develop PD, with the risk being lowest among those reporting "extremely difficult to quit" compared with "easy to quit." Nicotine substitute usage was strongly associated with quitting difficulty and duration of smoking, i.e., most strongly among current smokers, followed by former smokers who had used nicotine substitutes, and less strongly among former smokers who never used substitutes. CONCLUSIONS Our data support the notion that patients with PD are able to quit smoking more easily than controls. These findings are compatible with a decreased responsiveness to nicotine during the prodromal phase of PD. We propose that ease of smoking cessation is an aspect of premanifest PD similar to olfactory dysfunction, REM sleep disorders, or constipation and suggests that the apparent "neuroprotective" effect of smoking observed in epidemiologic studies is due to reverse causation.
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Affiliation(s)
- Beate Ritz
- From the Department of Epidemiology (B.R., O.A.A.), University of California at Los Angeles School of Public Health; Department of Neurology (B.R.), School of Medicine, University of California at Los Angeles; Department of Health Care Management (P.-C.L.), College of Healthcare Administration and Management, National Taipei University of Nursing Health Sciences, Taiwan; and Danish Cancer Society Research Center (C.F.L.), Danish Cancer Society, Copenhagen, Denmark.
| | - Pei-Chen Lee
- From the Department of Epidemiology (B.R., O.A.A.), University of California at Los Angeles School of Public Health; Department of Neurology (B.R.), School of Medicine, University of California at Los Angeles; Department of Health Care Management (P.-C.L.), College of Healthcare Administration and Management, National Taipei University of Nursing Health Sciences, Taiwan; and Danish Cancer Society Research Center (C.F.L.), Danish Cancer Society, Copenhagen, Denmark
| | - Christina F Lassen
- From the Department of Epidemiology (B.R., O.A.A.), University of California at Los Angeles School of Public Health; Department of Neurology (B.R.), School of Medicine, University of California at Los Angeles; Department of Health Care Management (P.-C.L.), College of Healthcare Administration and Management, National Taipei University of Nursing Health Sciences, Taiwan; and Danish Cancer Society Research Center (C.F.L.), Danish Cancer Society, Copenhagen, Denmark
| | - Onyebuchi A Arah
- From the Department of Epidemiology (B.R., O.A.A.), University of California at Los Angeles School of Public Health; Department of Neurology (B.R.), School of Medicine, University of California at Los Angeles; Department of Health Care Management (P.-C.L.), College of Healthcare Administration and Management, National Taipei University of Nursing Health Sciences, Taiwan; and Danish Cancer Society Research Center (C.F.L.), Danish Cancer Society, Copenhagen, Denmark
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349
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Tönges L, Szegö EM, Hause P, Saal KA, Tatenhorst L, Koch JC, D Hedouville Z, Dambeck V, Kügler S, Dohm CP, Bähr M, Lingor P. Alpha-synuclein mutations impair axonal regeneration in models of Parkinson's disease. Front Aging Neurosci 2014; 6:239. [PMID: 25309425 PMCID: PMC4159996 DOI: 10.3389/fnagi.2014.00239] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/21/2014] [Indexed: 12/27/2022] Open
Abstract
The dopaminergic (DAergic) nigrostriatal tract has an intrinsic regenerative capacity which can be impaired in Parkinson's disease (PD). Alpha-synuclein (aSyn) is a major pathogenic component in PD but its impact on DAergic axonal regeneration is largely unknown. In this study, we expressed pathogenic variants of human aSyn by means of recombinant adeno-associated viral vectors in experimental paradigms of DAergic regeneration. In a scratch lesion model in vitro, both aSyn(A30P) and aSyn(A53T) significantly reduced DAergic neurite regeneration and induced loss of TH-immunopositive cells while aSyn(WT) showed only minor cellular neurotoxic effects. The striatal density of TH-immunopositive axons in the striatal 6-OHDA lesion mouse model was attenuated only by aSyn(A30P). However, striatal expression levels of the regeneration marker GAP-43 in TH-immunopositive fibers were reduced by both aSyn(A30P) and aSyn(A53T), but not by aSyn(WT), which was associated with an activation of the ROCK signaling pathway. Nigral DAergic cell loss was only mildly enhanced by additional overexpression of aSyn variants. Our findings indicate that mutations of aSyn have a strong impact on the regenerative capacity of DAergic neurons, which may contribute to their pathogenic effects.
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Affiliation(s)
- Lars Tönges
- Department of Neurology, University Medicine Göttingen Göttingen, Germany ; Nanoscale Microscopy and Molecular Physiology of the Brain, Cluster of Excellence 171-DFG Research Center 103 (CNMPB) Göttingen, Germany
| | - Eva M Szegö
- Department of Neurodegeneration and Restorative Research, University Medicine Göttingen Göttingen, Germany
| | - Patrizia Hause
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Kim-Ann Saal
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Lars Tatenhorst
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Jan Christoph Koch
- Department of Neurology, University Medicine Göttingen Göttingen, Germany ; Nanoscale Microscopy and Molecular Physiology of the Brain, Cluster of Excellence 171-DFG Research Center 103 (CNMPB) Göttingen, Germany
| | - Zara D Hedouville
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Vivian Dambeck
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Sebastian Kügler
- Department of Neurology, University Medicine Göttingen Göttingen, Germany ; Nanoscale Microscopy and Molecular Physiology of the Brain, Cluster of Excellence 171-DFG Research Center 103 (CNMPB) Göttingen, Germany
| | - Christoph P Dohm
- Department of Neurology, University Medicine Göttingen Göttingen, Germany ; Nanoscale Microscopy and Molecular Physiology of the Brain, Cluster of Excellence 171-DFG Research Center 103 (CNMPB) Göttingen, Germany
| | - Mathias Bähr
- Department of Neurology, University Medicine Göttingen Göttingen, Germany
| | - Paul Lingor
- Department of Neurology, University Medicine Göttingen Göttingen, Germany ; Nanoscale Microscopy and Molecular Physiology of the Brain, Cluster of Excellence 171-DFG Research Center 103 (CNMPB) Göttingen, Germany
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350
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Plouvier AOA, Hameleers RJMG, van den Heuvel EAJ, Bor HH, Olde Hartman TC, Bloem BR, van Weel C, Lagro-Janssen ALM. Prodromal symptoms and early detection of Parkinson's disease in general practice: a nested case-control study. Fam Pract 2014; 31:373-8. [PMID: 24869632 DOI: 10.1093/fampra/cmu025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Timely diagnosis of Parkinson's disease (PD), facilitating early intervention, depends largely on the GP's awareness of early symptomatology. For general practice, it is unknown which prodromal symptoms (symptoms preceding the typical motor symptoms of PD) demand the GP's alertness. OBJECTIVE To assess prodromal symptoms that should alert the GP to the possibility of PD in primary care patients. METHODS A nested case-control study was carried out in a population of approximately 12000 patients registered in the Continuous Morbidity Registration database affiliated with the University of Nijmegen in the Netherlands. The database pools subject data from four primary care practices. The subjects comprised all 86 patients diagnosed with PD between 1972 and 2007, and 78 controls, matched by sex, age, socioeconomic status and primary care practice. The primary measures of outcome were the prodromal symptoms presenting in the two years prior to the diagnosis of PD. The number (and type) of referrals and diagnostic tests were also assessed. RESULTS In the two-year period prior to diagnosis, PD patients more often presented with functional somatic symptoms, constipation, hyperhidrosis and sleep disorders than controls. Patients also more frequently experienced more than one prodromal symptom and were more often referred within the primary care team or to a medical specialist. CONCLUSIONS Prodromal symptoms of PD are encountered in general practice. GPs should be alert when patients present with multiple prodromal symptoms in a two-year period, especially considering the benefits of early intervention, and the future possibilities for disease-modifying therapy.
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Affiliation(s)
| | | | | | - Hans H Bor
- Department of Primary and Community Care and
| | | | - Bastiaan R Bloem
- Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands and
| | - Chris van Weel
- Department of Primary and Community Care and Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia
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