1
|
Wu J, Shao W, Liu X, Zheng F, Wang Y, Cai P, Guo Z, Hu H, Yu G, Guo J, Yao L, Wu S, Li H. Microglial exosomes in paraquat-induced Parkinson's disease: Neuroprotection and biomarker clues. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 352:124035. [PMID: 38670424 DOI: 10.1016/j.envpol.2024.124035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/01/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
The exact mechanisms underlying the initiation and exacerbation of Parkinson's disease (PD) by paraquat remain unclear. We have revealed that exosomes mediate neurotoxicity induced by low dose paraquat exposure by transmitting intercellular signaling. Exposure to 40 μM paraquat promoted exosome release from mouse microglia cells (BV2) in vitro. Paraquat exposure at 100 μM caused degeneration of mouse dopaminergic MN9D cells and inhibited microglia exosome uptake by fluorescently labeling exosomes. We established an incubation model for exosomes and dopaminergic neuron cells under PQ treatment. The results indicated that microglial exosomes alleviated degeneration, increasing proliferation and PD-related protein expression of dopaminergic neurons; however, paraquat reversed this effect. Then, through exosome high-throughput sequencing and qRT-PCR experiments, miR-92a-3p and miR-24-3p were observed to transfer from exosomes to dopaminergic neurons, inhibited by paraquat. The specificity of miR-92a-3p and miR-24-3p was verified in PD patients exosomes, indicating the potential diagnostic value of the exosomal miRNAs in paraquat-induced PD. These results suggest glia-neuron communication in paraquat-induced neurodegeneration and may identify stable paraquat-mediated PD biomarkers, offering clues for early recognition and prevention of pesticide-induced degenerative diseases.
Collapse
Affiliation(s)
- Jingwen Wu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fuzhou Center for Disease Control and Prevention, Fuzhou, 350200, China.
| | - Wenya Shao
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Xu Liu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Fuli Zheng
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Yaping Wang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Ping Cai
- The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Department of Health Inspection and Quarantine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Zhenkun Guo
- The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Department of Health Inspection and Quarantine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Hong Hu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Guangxia Yu
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Jianhui Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Linlin Yao
- Affiliated Hospital of Jining Medical University, Jining, 272000, China.
| | - Siying Wu
- The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Huangyuan Li
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Fujian Provincial Key Laboratory of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| |
Collapse
|
2
|
Nabizadeh F, Seyedmirzaei H, Rafiei N, Maryam Vafaei S, Shekouh D, Mehrtabar E, Mirzaaghazadeh E, Mirzaasgari Z. Global prevalence and incidence of Young Onset Parkinson's disease: A systematic review and meta-analysis. J Clin Neurosci 2024; 125:59-67. [PMID: 38754241 DOI: 10.1016/j.jocn.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/20/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND There is a lack of enough evidence regarding the epidemiology of Young-onset Parkinson's disease (YOPD) which is needed by clinicians and healthcare policymakers. AIM Herein, in this systematic review and meta-analysis, we aimed to estimate the global prevalence and incidence rates of YOPD. METHODS We searched the literature in PubMed, Scopus, and Web of Science in May 2022. We included retrospective, prospective, cross-sectional observational population-based studies that reported the prevalence or incidence of PD in individuals younger than 40 years with known diagnostic criteria. RESULTS After two-step screening, 50 studies were eligible to be included in our study. The age-standardized prevalence of YOPD was 10.2 per 100,000 persons globally while it was 14.7 per 100,000 population in European countries. Age-standardized prevalence estimates for 5-year age bands showed that the YOPD prevalence estimates varied from 6.1 per 100,000 population in the group aged 20-24 to 16.1 per 100,000 population in the group aged 35-39. Also, the age-standardized incidence of YOPD was 1.3 per 100,000 person-years population worldwide and 1.2 per 100,000 person-years in the European population. CONCLUSION Based on this systematic review and meta-analysis, the overall prevalence of YOPD is 10.2 per 100,000 population, although estimates of the prevalence and incidence in low-income countries remain scarce. To improve monitoring and certain diagnoses of YOPD, healthcare providers and policymakers should be aware that much more effective tools are required.
Collapse
Affiliation(s)
- Fardin Nabizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Science, Tehran, Iran; Interdisciplinary Neuroscience Research Program (INRP) , Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Rafiei
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Dorsa Shekouh
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Mehrtabar
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | | | - Zahra Mirzaasgari
- Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Barakati T, Ghafari ES, Niakan S, Humkar O, Shadab H, Ehsan H. Clinical Report on an Implant-Supported Overdenture in a Parkinson's Patient. Clin Cosmet Investig Dent 2024; 16:145-152. [PMID: 38798739 PMCID: PMC11122263 DOI: 10.2147/ccide.s462756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Speaking, chewing, and swallowing difficulties can result from Parkinson's disease (PD), which frequently affects the oro-pharyngeal muscles. The reduction in food and hydration intake that is unavoidable leads to a worsening of neurological symptoms. Patients with Parkinson's disease experience significant challenges when adjusting to wearing entire dentures. Each of these problems presents a considerable challenge for the doctor in terms of prosthodontic rehabilitation. This case study describes how a patient with Parkinson's disease was able to employ flexible removable partial dentures supported by implants to replace both their full and partial set of missing teeth. A well-made prosthesis will help the patient with their psychological, functional, and aesthetic impairments.
Collapse
Affiliation(s)
- Tamana Barakati
- Research Department, Queen Mary University of London, London, UK
| | - Elaha Somaya Ghafari
- Department of Periodontology, Kabul University of Medical Science, Kabul, Afghanistan
| | - Somayeh Niakan
- Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Humkar
- Oral Medicine Department, Noman Sadat Institute of Higher Education, Kabul, Afghanistan
| | - Hasina Shadab
- Department of Periodontology, Kabul University of Medical Science, Kabul, Afghanistan
| | | |
Collapse
|
4
|
Danz K, Fleddermann J, Koch M, Fecioru E, Maahs L, Kinsinger N, Krämer J, Kraegeloh A, Wagner S. Evaluation of the Transport and Binding of Dopamine-Loaded PLGA Nanoparticles for the Treatment of Parkinson's Disease Using In Vitro Model Systems. Pharmaceutics 2024; 16:571. [PMID: 38794233 PMCID: PMC11125169 DOI: 10.3390/pharmaceutics16050571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 05/26/2024] Open
Abstract
The treatment of Parkinson's disease has been moving into the focus of pharmaceutical development. Yet, the necessity for reliable model systems in the development phase has made research challenging and in vivo models necessary. We have established reliable, reproducible in vitro model systems to evaluate the binding and transport of dopamine-loaded PLGA nanoparticles for the treatment of Parkinson's disease and put the results in context with comparable in vivo results. The in vitro models have provided similar results concerning the usability of the investigated nanoparticles as the previously used in vivo models and thus provide a good alternative in line with the 3R principles in pharmaceutical research.
Collapse
Affiliation(s)
- Karin Danz
- Fraunhofer Institute for Biomedical Engineering IBMT, Joseph-von-Fraunhofer-Weg 1, 66280 Sulzbach, Germany
| | - Jana Fleddermann
- INM—Leibniz Institute for New Materials, Campus D2 2, 66123 Saarbrücken, Germany (M.K.); (A.K.)
| | - Marcus Koch
- INM—Leibniz Institute for New Materials, Campus D2 2, 66123 Saarbrücken, Germany (M.K.); (A.K.)
| | - Elena Fecioru
- Eurofins PHAST Development GmbH & Co. KG, Byk-Gulden-Str. 2, 78467 Konstanz, Germany
| | - Lorenz Maahs
- Pharmacelsus GmbH, Science Park 2, 66123 Saarbrücken, Germany; (L.M.); (N.K.)
| | - Nicole Kinsinger
- Pharmacelsus GmbH, Science Park 2, 66123 Saarbrücken, Germany; (L.M.); (N.K.)
| | | | - Annette Kraegeloh
- INM—Leibniz Institute for New Materials, Campus D2 2, 66123 Saarbrücken, Germany (M.K.); (A.K.)
| | - Sylvia Wagner
- Fraunhofer Institute for Biomedical Engineering IBMT, Joseph-von-Fraunhofer-Weg 1, 66280 Sulzbach, Germany
| |
Collapse
|
5
|
Saponjic J, Mejías R, Nikolovski N, Dragic M, Canak A, Papoutsopoulou S, Gürsoy-Özdemir Y, Fladmark KE, Ntavaroukas P, Bayar Muluk N, Zeljkovic Jovanovic M, Fontán-Lozano Á, Comi C, Marino F. Experimental Models to Study Immune Dysfunction in the Pathogenesis of Parkinson's Disease. Int J Mol Sci 2024; 25:4330. [PMID: 38673915 PMCID: PMC11050170 DOI: 10.3390/ijms25084330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Parkinson's disease (PD) is a chronic, age-related, progressive multisystem disease associated with neuroinflammation and immune dysfunction. This review discusses the methodological approaches used to study the changes in central and peripheral immunity in PD, the advantages and limitations of the techniques, and their applicability to humans. Although a single animal model cannot replicate all pathological features of the human disease, neuroinflammation is present in most animal models of PD and plays a critical role in understanding the involvement of the immune system (IS) in the pathogenesis of PD. The IS and its interactions with different cell types in the central nervous system (CNS) play an important role in the pathogenesis of PD. Even though culture models do not fully reflect the complexity of disease progression, they are limited in their ability to mimic long-term effects and need validation through in vivo studies. They are an indispensable tool for understanding the interplay between the IS and the pathogenesis of this disease. Understanding the immune-mediated mechanisms may lead to potential therapeutic targets for the treatment of PD. We believe that the development of methodological guidelines for experiments with animal models and PD patients is crucial to ensure the validity and consistency of the results.
Collapse
Affiliation(s)
- Jasna Saponjic
- Department of Neurobiology, Institute of Biological Research “Sinisa Stankovic”, National Institute of the Republic of Serbia, University of Belgrade, 11108 Belgrade, Serbia
| | - Rebeca Mejías
- Department of Physiology, School of Biology, University of Seville, 41012 Seville, Spain; (R.M.); (Á.F.-L.)
- Instituto de Biomedicina de Sevilla, IBiS, Hospital Universitario Virgen del Rocío, CSIC, Universidad de Sevilla, 41013 Seville, Spain
| | - Neda Nikolovski
- Department of Immunology, Institute for Biological Research “Siniša Stanković”, National Institute of the Republic of Serbia, University of Belgrade, 11108 Belgrade, Serbia;
| | - Milorad Dragic
- Laboratory for Neurobiology, Department for General Physiology and Biophysics, Faculty of Biology, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (M.Z.J.)
- Department of Molecular Biology and Endocrinology, Vinca Institute of Nuclear Sciences–National Institute of the Republic of Serbia, University of Belgrade, 11351 Belgrade, Serbia
| | - Asuman Canak
- Department of Medical Services and Techniques, Vocational School of Health Services, Recep Tayyip Erdogan University, Rize 53100, Turkey;
| | - Stamatia Papoutsopoulou
- Department of Biochemistry and Biotechnology, Faculty of Health Sciences, University of Thessaly, Biopolis, 41500 Larisa, Greece; (S.P.); (P.N.)
| | | | - Kari E. Fladmark
- Department of Biological Science, University of Bergen, 5020 Bergen, Norway;
| | - Panagiotis Ntavaroukas
- Department of Biochemistry and Biotechnology, Faculty of Health Sciences, University of Thessaly, Biopolis, 41500 Larisa, Greece; (S.P.); (P.N.)
| | - Nuray Bayar Muluk
- Department of Otorhinolaryngology, Faculty of Medicine, Kirikkale University, Kirikkale 71450, Turkey;
| | - Milica Zeljkovic Jovanovic
- Laboratory for Neurobiology, Department for General Physiology and Biophysics, Faculty of Biology, University of Belgrade, 11000 Belgrade, Serbia; (M.D.); (M.Z.J.)
| | - Ángela Fontán-Lozano
- Department of Physiology, School of Biology, University of Seville, 41012 Seville, Spain; (R.M.); (Á.F.-L.)
- Instituto de Biomedicina de Sevilla, IBiS, Hospital Universitario Virgen del Rocío, CSIC, Universidad de Sevilla, 41013 Seville, Spain
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy;
| | - Franca Marino
- Center for Research in Medical Pharmacology, School of Medicine, University of Insubria, 21100 Varese, Italy;
| |
Collapse
|
6
|
Sierra-Fernández CR, Garnica-Geronimo LR, Huipe-Dimas A, Ortega-Hernandez JA, Ruiz-Mafud MA, Cervantes-Arriaga A, Hernández-Medrano AJ, Rodríguez-Violante M. Electrocardiographic approach strategies in patients with Parkinson disease treated with deep brain stimulation. Front Cardiovasc Med 2024; 11:1265089. [PMID: 38682099 PMCID: PMC11047133 DOI: 10.3389/fcvm.2024.1265089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/19/2024] [Indexed: 05/01/2024] Open
Abstract
Deep brain stimulation (DBS) is an interdisciplinary and reversible therapy that uses high-frequency electrical stimulation to correct aberrant neural pathways in motor and cognitive neurological disorders. However, the high frequency of the waves used in DBS can interfere with electrical recording devices (e.g., electrocardiogram, electroencephalogram, cardiac monitor), creating artifacts that hinder their interpretation. The compatibility of DBS with these devices varies and depends on factors such as the underlying disease and the configuration of the neurostimulator. In emergencies where obtaining an electrocardiogram is crucial, the need for more consensus on reducing electrical artifacts in patients with DBS becomes a significant challenge. Various strategies have been proposed to attenuate the artifact generated by DBS, such as changing the DBS configuration from monopolar to bipolar, temporarily deactivating DBS during electrocardiographic recording, applying frequency filters both lower and higher than those used by DBS, and using non-standard leads. However, the inexperience of medical personnel, variability in DBS models, or the lack of a controller at the time of approach limit the application of these strategies. Current evidence on their reproducibility and efficacy is limited. Due to the growing elderly population and the rising utilization of DBS, it is imperative to create electrocardiographic methods that are easily accessible and reproducible for general physicians and emergency services.
Collapse
Affiliation(s)
| | | | - Alejandra Huipe-Dimas
- Department of Medical Education, National Institute of Cardiology Ignacio Chávez, Mexico, Mexico
| | | | - María Alejandra Ruiz-Mafud
- Department of Movement Disorders, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico, Mexico
| | - Amin Cervantes-Arriaga
- Department of Movement Disorders, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico, Mexico
| | - Ana Jimena Hernández-Medrano
- Department of Movement Disorders, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico, Mexico
| | - Mayela Rodríguez-Violante
- Department of Movement Disorders, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico, Mexico
| |
Collapse
|
7
|
Ahlskog JE. Parkinson's disease progression is multifaceted: Evidence for the underlying benchmarks. Parkinsonism Relat Disord 2024; 121:106037. [PMID: 38360506 DOI: 10.1016/j.parkreldis.2024.106037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
Long-term Parkinson's disease (PD) progression is not a homogeneous process and manifests in diverse ways over the lifetime. Recognition of progression benchmarks and their substrates is important for treatment and addressing the expectations of patients, as well as for PD research planning.
Collapse
Affiliation(s)
- J Eric Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA.
| |
Collapse
|
8
|
Prajjwal P, Kolanu ND, Reddy YB, Ahmed A, Marsool MDM, Santoshi K, Pattani HH, John J, Chandrasekar KK, Hussin OA. Association of Parkinson's disease to Parkinson's plus syndromes, Lewy body dementia, and Alzheimer's dementia. Health Sci Rep 2024; 7:e2019. [PMID: 38562616 PMCID: PMC10982460 DOI: 10.1002/hsr2.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Background Parkinson's disease (PD) is a condition that affects movement and is usually seen in those over the age of 50. It is caused by the death of dopaminergic neurons, particularly in the substantia nigra. PD has shifted from being perceived as an uncommon condition to a significant neurological illness, mostly due to the increasing number of elderly individuals and the impact of environmental factors. Parkinson's plus syndromes, such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and vascular Parkinsonism (VaP), provide difficulties in distinguishing them clinically from PD since they have similar characteristics. Methodology A thorough examination was performed utilizing the PubMed, Medline, Scopus, and Web of Science databases. The search utilized specific keywords like "Parkinson's disease," "Parkinson's plus syndrome," "Lewy body dementia," "Alzheimer's dementia," "progressive supranuclear palsy," and "multiple system atrophy." The selection criteria were aimed at English-language literature, with a particular focus on examining the connection between PD and associated disorders or dementias. Results and Discussion Parkinson's plus syndromes, such as PSP, MSA, CBD, and VaP, exhibit unique clinical characteristics, imaging results, and diverse reactions to levodopa. This makes it difficult to distinguish them from PD. LBD is characterized by Lewy bodies containing α-synuclein, which leads to both motor and cognitive deficits. PD and Alzheimer's disease (AD) exhibit a complex interaction, including common pathogenic processes, genetic predispositions, and clinical characteristics of dementia. Conclusion The interrelatedness of PD, Parkinson's plus syndromes, LBD, and AD highlights the significance of comprehending shared disease-causing processes. Aberrant protein clumping, impaired functioning of mitochondria, increased oxidative stress, and inflammation in the brain are common factors which can be addressed for specific treatments. More research is essential for understanding complicated connections and developing effective therapies for these sophisticated neurological illnesses.
Collapse
Affiliation(s)
| | | | | | - Aneeqa Ahmed
- Department of Internal MedicineShadan Hospital and Institute of Medical SciencesHyderabadIndia
| | | | | | | | - Jobby John
- Department of NeurologyDr. Somervell Memorial CSI Medical College and HospitalNeyyāttinkaraKarakonamIndia
| | | | | |
Collapse
|
9
|
Daadi EW, Daadi ES, Oh T, Li M, Kim J, Daadi MM. Combining physical & cognitive training with iPSC-derived dopaminergic neuron transplantation promotes graft integration & better functional outcome in parkinsonian marmosets. Exp Neurol 2024; 374:114694. [PMID: 38272159 DOI: 10.1016/j.expneurol.2024.114694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
Parkinson's disease (PD) is a relentlessly progressive and currently incurable neurodegenerative disease with significant unmet medical needs. Since PD stems from the degeneration of midbrain dopaminergic (DA) neurons in a defined brain location, PD patients are considered optimal candidates for cell replacement therapy. Clinical trials for cell transplantation in PD are beginning to re-emerge worldwide with a new focus on induced pluripotent stem cells (iPSCs) as a source of DA neurons since they can be derived from adult somatic cells and produced in large quantities under current good manufacturing practices. However, for this therapeutic strategy to be realized as a viable clinical option, fundamental translational challenges need to be addressed including the manufacturing process, purity and efficacy of the cells, the method of delivery, the extent of host reinnervation and the impact of patient-centered adjunctive interventions. In this study we report on the impact of physical and cognitive training (PCT) on functional recovery in the nonhuman primate (NHP) model of PD after cell transplantation. We observed that at 6 months post-transplant, the PCT group returned to normal baseline in their daily activity measured by actigraphy, significantly improved in their sensorimotor and cognitive tasks, and showed enhanced synapse formation between grafted cells and host cells. We also describe a robust, simple, efficient, scalable, and cost-effective manufacturing process of engraftable DA neurons derived from iPSCs. This study suggests that integrating PCT with cell transplantation therapy could promote optimal graft functional integration and better outcome for patients with PD.
Collapse
Affiliation(s)
- Etienne W Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Elyas S Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Thomas Oh
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA
| | - Mingfeng Li
- Department of Neuroscience, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jeffrey Kim
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA; Department of Cell Systems & Anatomy, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA
| | - Marcel M Daadi
- Southwest National Primate Research Center, Texas Biomedical Research Institute, 8715 W. Military Drive, San Antonio, TX 78227, USA; Department of Cell Systems & Anatomy, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA; Department of Radiology, Long School of Medicine, University of Texas Health at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
| |
Collapse
|
10
|
Grotewold N, Albin RL. Update: Descriptive epidemiology of Parkinson disease. Parkinsonism Relat Disord 2024; 120:106000. [PMID: 38233324 PMCID: PMC10922566 DOI: 10.1016/j.parkreldis.2024.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/19/2024]
Abstract
We review the descriptive epidemiology of Parkinson disease (PD). PD is a prevalent neurologic disorder in high Socio-Demographic Index (SDI) nations with rising prevalence in low and middle SDI nations. PD became a prevalent disorder in high SDI nations during the 20th century. Population growth, population aging, and increased disease duration are major drivers of rising PD prevalence. Exposure to industrial toxicants may also be a contributor to rising PD prevalence. PD is an age-related disorder with incidence likely peaking in the 8th decade of life and prevalence in the 9th decade of life. PD is notable for significant sex difference in PD risk with greater risk in men. There may be ancestral differences in PD prevalence and risk. PD is associated with moderately increased mortality though this may be underestimated. Despite significant research, there is considerable uncertainty about basic features of PD epidemiology.
Collapse
Affiliation(s)
- Nikolas Grotewold
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Roger L Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA; GRECC, VAAAHS, Ann Arbor, MI, 48105, USA; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease Research, Ann Arbor, MI, 48109, USA; University of Michigan Parkinson's Foundation Research Center of Excellence, USA.
| |
Collapse
|
11
|
Mercer MK, Revels JW, Blacklock LC, Banks KP, Johnson LS, Lewis DH, Kuo PH, Wilson S, Elojeimy S. Practical Overview of 123I-Ioflupane Imaging in Parkinsonian Syndromes. Radiographics 2024; 44:e230133. [PMID: 38236751 DOI: 10.1148/rg.230133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Parkinsonian syndromes are a heterogeneous group of progressive neurodegenerative disorders involving the nigrostriatal dopaminergic pathway and are characterized by a wide spectrum of motor and nonmotor symptoms. These syndromes are quite common and can profoundly impact the lives of patients and their families. In addition to classic Parkinson disease, parkinsonian syndromes include multiple additional disorders known collectively as Parkinson-plus syndromes or atypical parkinsonism. These are characterized by the classic parkinsonian motor symptoms with additional distinguishing clinical features. Dopamine transporter SPECT has been developed as a diagnostic tool to assess the levels of dopamine transporters in the striatum. This imaging assessment, which uses iodine 123 (123I) ioflupane, can be useful to differentiate parkinsonian syndromes caused by nigrostriatal degeneration from other clinical mimics such as essential tremor or psychogenic tremor. Dopamine transporter imaging plays a crucial role in diagnosing parkinsonian syndromes, particularly in patients who do not clearly fulfill the clinical criteria for diagnosis. Diagnostic clarification can allow early treatment in appropriate patients and avoid misdiagnosis. At present, only the qualitative interpretation of dopamine transporter SPECT is approved by the U.S. Food and Drug Administration, but quantitative interpretation is often used to supplement qualitative interpretation. The authors provide an overview of patient preparation, common imaging findings, and potential pitfalls that radiologists and nuclear medicine physicians should know when performing and interpreting dopamine transporter examinations. Alternatives to 123I-ioflupane imaging for the evaluation of nigrostriatal degeneration are also briefly discussed. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by Intenzo and Colarossi in this issue.
Collapse
Affiliation(s)
- Megan K Mercer
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Jonathan W Revels
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Lisa C Blacklock
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Kevin P Banks
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Lester S Johnson
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - David H Lewis
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Phillip H Kuo
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Shannon Wilson
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| | - Saeed Elojeimy
- From the Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 211N, MSC 323, Charleston, SC 29425 (M.K.M., S.E.); Department of Radiology, New York University Langone Health Long Island, New York, NY (J.W.R.); Department of Radiology, University of New Mexico, Albuquerque, NM (L.C.B.); Department of Radiology, Brooke Army Medical Center, San Antonio, Tex (K.P.B.); Department of Radiology, Eastern Virginia Medical School, Norfolk, Va (L.S.J., S.W.); Department of Radiology, University of Washington, Seattle, Wash (D.H.L.); and Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Ariz (P.H.K.)
| |
Collapse
|
12
|
Ben-Shlomo Y, Darweesh S, Llibre-Guerra J, Marras C, San Luciano M, Tanner C. The epidemiology of Parkinson's disease. Lancet 2024; 403:283-292. [PMID: 38245248 PMCID: PMC11123577 DOI: 10.1016/s0140-6736(23)01419-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/26/2023] [Accepted: 07/05/2023] [Indexed: 01/22/2024]
Abstract
The epidemiology of Parkinson's disease shows marked variations in time, geography, ethnicity, age, and sex. Internationally, prevalence has increased over and above demographic changes. There are several potential reasons for this increase, including the decline in other competing causes of death. Whether incidence is increasing, especially in women or in many low-income and middle-income countries where there is a shortage of high-quality data, is less certain. Parkinson's disease is more common in older people and men, and a variety of environmental factors have been suggested to explain why, including exposure to neurotoxic agents. Within countries, there appear to be ethnic differences in disease risk, although these differences might reflect differential access to health care. The cause of Parkinson's disease is multifactorial, and involves genetic and environmental factors. Both risk factors (eg, pesticides) and protective factors (eg, physical activity and tendency to smoke) have been postulated to have a role in Parkinson's disease, although elucidating causality is complicated by the long prodromal period. Following the establishment of public health strategies to prevent cardiovascular diseases and some cancers, chronic neurodegenerative diseases such as Parkinson's disease and dementia are gaining a deserved higher priority. Multipronged prevention strategies are required that tackle population-based primary prevention, high-risk targeted secondary prevention, and Parkinson's disease-modifying therapies for tertiary prevention. Future international collaborations will be required to triangulate evidence from basic, applied, and epidemiological research, thereby enhancing the understanding and prevention of Parkinson's disease at a global level.
Collapse
Affiliation(s)
- Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Sirwan Darweesh
- Centre of Expertise for Parkinson and Movement Disorders, Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | | | - Connie Marras
- The Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Marta San Luciano
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Caroline Tanner
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
13
|
Cao Z, Yuan Y, White AJ, Li C, Luo Z, D’Aloisio AA, Huang X, Kaufman JD, Sandler DP, Chen H. Air Pollutants and Risk of Parkinson's Disease among Women in the Sister Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:17001. [PMID: 38175185 PMCID: PMC10766011 DOI: 10.1289/ehp13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Air pollutants may contribute to the development of Parkinson's disease (PD), but empirical evidence is limited and inconsistent. OBJECTIVES This study aimed to prospectively investigate the associations of PD with ambient exposures to fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and nitrogen dioxide (NO 2 ). METHODS We analyzed data from 47,108 US women from the Sister Study, enrolled from 2003-2009 (35-80 years of age) and followed through 2018. Exposures of interest included address-level ambient PM 2.5 and NO 2 in 2009 and their cumulative averages from 2009 to PD diagnosis with varying lag-years. The primary outcome was PD diagnosis between 2009 and 2018 (n = 163 ). We used multivariable Cox proportional hazards and time-varying Cox models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS NO 2 exposure in 2009 was associated with PD risk in a dose-response manner. The HR and 95% CI were 1.22 (95% CI: 1.03, 1.46) for one interquartile [4.8 parts per billion (ppb)] increment in NO 2 , adjusting for age, race and ethnicity, education, smoking status, alcohol drinking, caffeine intake, body mass index, physical activity, census region, residential area type, area deprivation index (ADI), and self-reported health status. The association was confirmed in secondary analyses with time-varying averaged cumulative exposures. For example, the multivariable adjusted HR for PD per 4.8 ppb increment in NO 2 was 1.25 (95% CI: 1.05, 1.50) in the 2-year lag analysis using cumulative average exposure. Post hoc subgroup analyses overall confirmed the association. However, statistical interaction analyses found that the positive association of NO 2 with PD risk was limited to women in urban, rural, and small town areas and women with ≥ 50 th percentile ADI but not among women from suburban areas or areas with < 50 th percentile ADI. In contrast, PM 2.5 exposure was not associated with PD risk with the possible exception for women from the Midwest region of the US (HR interquartile -range = 2.49 , 95% CI: 1.20, 5.14) but not in other census regions. DISCUSSION In this nationwide cohort of US women, higher level exposure to ambient NO 2 is associated with a greater risk of PD. This finding needs to be independently confirmed and the underlying mechanisms warrant further investigation. https://doi.org/10.1289/EHP13009.
Collapse
Affiliation(s)
- Zichun Cao
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Yaqun Yuan
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Alexandra J. White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Aimee A. D’Aloisio
- Social & Scientific Systems, DLH Holdings Corporation, Durham, North Carolina, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| |
Collapse
|
14
|
Dorsey ER, Bloem BR. Parkinson's Disease Is Predominantly an Environmental Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:451-465. [PMID: 38217613 PMCID: PMC11091623 DOI: 10.3233/jpd-230357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/15/2024]
Abstract
Parkinson's disease is the world's fastest growing brain disorder, and exposure to environmental toxicants is the principal reason. In this paper, we consider alternative, but unsatisfactory, explanations for its rise, including improved diagnostic skills, aging populations, and genetic causes. We then detail three environmental toxicants that are likely among the main causes of Parkinson's disease- certain pesticides, the solvent trichloroethylene, and air pollution. All three environmental toxicants are ubiquitous, many affect mitochondrial functioning, and all can access humans via various routes, including inhalation and ingestion. We reach the hopeful conclusion that most of Parkinson's disease is thus preventable and that we can help to create a world where Parkinson's disease is increasingly rare.
Collapse
Affiliation(s)
- E. Ray Dorsey
- Center for Health + Technology and Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Bastiaan R. Bloem
- Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, the Netherlands
| |
Collapse
|
15
|
Dorsey ER, De Miranda BR, Horsager J, Borghammer P. The Body, the Brain, the Environment, and Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:363-381. [PMID: 38607765 DOI: 10.3233/jpd-240019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The brain- and body-first models of Lewy body disorders predict that aggregated alpha-synuclein pathology usually begins in either the olfactory system or the enteric nervous system. In both scenarios the pathology seems to arise in structures that are closely connected to the outside world. Environmental toxicants, including certain pesticides, industrial chemicals, and air pollution are therefore plausible trigger mechanisms for Parkinson's disease and dementia with Lewy bodies. Here, we propose that toxicants inhaled through the nose can lead to pathological changes in alpha-synuclein in the olfactory system that subsequently spread and give rise to a brain-first subtype of Lewy body disease. Similarly, ingested toxicants can pass through the gut and cause alpha-synuclein pathology that then extends via parasympathetic and sympathetic pathways to ultimately produce a body-first subtype. The resulting spread can be tracked by the development of symptoms, clinical assessments, in vivo imaging, and ultimately pathological examination. The integration of environmental exposures into the brain-first and body-first models generates testable hypotheses, including on the prevalence of the clinical conditions, their future incidence, imaging patterns, and pathological signatures. The proposed link, though, has limitations and leaves many questions unanswered, such as the role of the skin, the influence of the microbiome, and the effects of ongoing exposures. Despite these limitations, the interaction of exogenous factors with the nose and the gut may explain many of the mysteries of Parkinson's disease and open the door toward the ultimate goal -prevention.
Collapse
Affiliation(s)
- E Ray Dorsey
- Department of Neurology and Center for Health and Technology, University of Rochester Medical Center, Rochester, NY, USA
| | - Briana R De Miranda
- Department of Neurology, Center for Neurodegeneration and Experimental Therapeutics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
16
|
Wyse RK, Isaacs T, Barker RA, Cookson MR, Dawson TM, Devos D, Dexter DT, Duffen J, Federoff H, Fiske B, Foltynie T, Fox S, Greenamyre JT, Kieburtz K, Kordower JH, Krainc D, Matthews H, Moore DJ, Mursaleen L, Schwarzschild MA, Stott SR, Sulzer D, Svenningsson P, Tanner CM, Carroll C, Simon DK, Brundin P. Twelve Years of Drug Prioritization to Help Accelerate Disease Modification Trials in Parkinson's Disease: The International Linked Clinical Trials Initiative. JOURNAL OF PARKINSON'S DISEASE 2024; 14:657-666. [PMID: 38578902 PMCID: PMC11191436 DOI: 10.3233/jpd-230363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/07/2024]
Abstract
In 2011, the UK medical research charity Cure Parkinson's set up the international Linked Clinical Trials (iLCT) committee to help expedite the clinical testing of potentially disease modifying therapies for Parkinson's disease (PD). The first committee meeting was held at the Van Andel Institute in Grand Rapids, Michigan in 2012. This group of PD experts has subsequently met annually to assess and prioritize agents that may slow the progression of this neurodegenerative condition, using a systematic approach based on preclinical, epidemiological and, where possible, clinical data. Over the last 12 years, 171 unique agents have been evaluated by the iLCT committee, and there have been 21 completed clinical studies and 20 ongoing trials associated with the initiative. In this review, we briefly outline the iLCT process as well as the clinical development and outcomes of some of the top prioritized agents. We also discuss a few of the lessons that have been learnt, and we conclude with a perspective on what the next decade may bring, including the introduction of multi-arm, multi-stage clinical trial platforms and the possibility of combination therapies for PD.
Collapse
Affiliation(s)
| | | | - Roger A. Barker
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Mark R. Cookson
- Cell Biology and Gene Expression Section, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Ted M. Dawson
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Devos
- Department of Medical Pharmacology and Neurology, University of Lille, CHU Lille, Lille Neurosciences and Cognition Inserm UMR-S-U1172, Lille, France
| | | | | | - Howard Federoff
- Henry and Susan Samueli College of Health Sciences, University of California, Irvine CA, USA
| | - Brian Fiske
- Research Programs, The Michael J. Fox Foundation for Parkinson’s Research, New York, NY, USA
| | - Thomas Foltynie
- Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Susan Fox
- Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - J. Timothy Greenamyre
- Department of Neurology, Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karl Kieburtz
- Department of Neurology Center for Health and Technology, University of Rochester, Rochester, NY, USA
| | - Jeffrey H. Kordower
- ASU-Banner Neurodegenerative Disease Research Center and School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Dimitri Krainc
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | | | | | - David Sulzer
- Department of Neurology, Columbia University, New York, NY, USA
| | | | - Caroline M. Tanner
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Camille Carroll
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - David K. Simon
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Patrik Brundin
- Neuroscience and Rare Diseases, Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland
| |
Collapse
|
17
|
Al-Kuraishy HM, Al-Gareeb AI, Selim HM, Alexiou A, Papadakis M, Negm WA, Batiha GES. Does vitamin D protect or treat Parkinson's disease? A narrative review. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:33-40. [PMID: 37555855 PMCID: PMC10771600 DOI: 10.1007/s00210-023-02656-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/30/2023] [Indexed: 08/10/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative brain disease (NBD) developed due to dopaminergic neuron loss in the substantia nigra (SN). Vitamin D (VD), VD receptor (VDR), and VD metabolites are highly expressed in the human brain and play a critical role in maintaining different brain functions. VDRs are highly expressed in the SN that regulates the activity of dopaminergic neurons and synaptic plasticity. VD exerts protective and therapeutic effects against the development of PD by modulating dopaminergic neurons of SN. VD reduces oxidative stress and neuroinflammation in PD because of its anti-inflammatory and antioxidant activities. Different studies revealed the protective effect of VD in the management of PD. However, the potential therapeutic effect of VD in well-established PD remains controversial. Therefore, this review aims to elucidate VD's preventive and therapeutic roles in PD. In conclusion, VD deficiency is associated with increased PD risk, but VD supplementation in well-established PD plays little role.
Collapse
Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, 14132, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, Baghdad, 14132, Iraq
| | - Hend Mostafa Selim
- Biochemistry Department, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia
- AFNP Med, 1030, Wien, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, Heusnerstrasse 40, University of Witten-Herdecke, 42283, Wuppertal, Germany.
| | - Walaa A Negm
- Department of Pharmacognosy, Faculty of Pharmacy, Tanta University, Tanta, 31527, Egypt.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt.
| |
Collapse
|
18
|
Albin RL, Grotewold N. What is the Parkinson Pandemic? Mov Disord 2023; 38:2141-2144. [PMID: 37859586 PMCID: PMC10843050 DOI: 10.1002/mds.29637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Affiliation(s)
- Roger L. Albin
- Dept. of Neurology, University of Michigan, Ann Arbor, MI, USA
- Neurology Service & GRECC, VAAAHS, Ann Arbor, MI, USA
- University of Michigan Morris K. Udall Center of Excellence for Parkinson;s Disease Reseach
- Parkinson’s Foundation Research Center of Excellence
| | | |
Collapse
|
19
|
Dammertz L, Schrag A, Bohlken J, Heuer J, Kohring C, Schorlemmer J, Akmatov MK, Bätzing J, Holstiege J. Falling incidence of Parkinson's disease in Germany. Eur J Neurol 2023; 30:3124-3131. [PMID: 37498553 DOI: 10.1111/ene.16000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/22/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND AND PURPOSE Idiopathic Parkinson's disease (IPD) is a progressive neurodegenerative disorder that is strongly associated with age. The aim of the present study was to describe current sex- and age-specific trends and regional differences in the incidence of IPD diagnosed in older people in Germany. METHODS This study was based on nationwide outpatient claims and drug prescription data from the German Statutory Health Insurance, covering approximately 87% of the general population. We conducted a cohort study in patients aged 50 years or older with observation time of at least 4 years. To assess the robustness of nationwide annual IPD incidence trends from 2013 to 2019, three case definitions with varying levels of stringency regarding coded outpatient diagnoses and drug prescriptions were applied. RESULTS In 2019, the population at risk comprised 30,575,726 persons. Using the primary and most specific case definition, annual age- and sex-standardized cumulative IPD incidence decreased stepwise from 137 (2013) to 106 (2019) new cases per 100,000 persons. The decline in incidence was seen in both sexes, in all age groups and in the majority of German regions. The relative decrease (2013-2019) in the annual age- and sex-standardized IPD incidence varied from 23% to 28% among case definitions. CONCLUSION Our findings indicate a nationwide decline in the age- and sex-standardized incidence of IPD from 2013 to 2019 in Germany. This trend was consistent using different case definitions. Further research is needed to elucidate the factors underlying this trend.
Collapse
Affiliation(s)
- Lotte Dammertz
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP) der Medizinischen Fakultät der Universität Leipzig, Leipzig, Germany
| | - Joachim Heuer
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Claudia Kohring
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | | | - Manas K Akmatov
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Jörg Bätzing
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| | - Jakob Holstiege
- Department of Epidemiology and Healthcare Atlas, Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany
| |
Collapse
|
20
|
Al-kuraishy HM, Alexiou A, Papadakis M, Elhussieny O, Saad HM, Batiha GES. New insights on the potential effect of vinpocetine in Parkinson's disease: one of the neglected warden and baffling topics. Metab Brain Dis 2023; 38:1831-1840. [PMID: 37335452 PMCID: PMC10348926 DOI: 10.1007/s11011-023-01254-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Vinpocetine (VPN) is an ethyl apovincaminate that has anti-inflammatory and antioxidant effects by inhibiting the expression of nuclear factor kappa B (NF-κB) and phosphodiesterase enzyme 1 (PDE-1). VPN is used in the management of stroke, dementia, and other neurodegenerative brain diseases. VPN may be effective in treating Parkinson's disease (PD). Therefore, this review aimed to clarify the mechanistic role of VPN in the management of PD. VPN has protective and restorative effects against neuronal injury by reducing neuroinflammation, and improvement of synaptic plasticity and cerebral blood flow. VPN protects dopaminergic neurons by reducing oxidative stress, lipid peroxidation, glutamate neurotoxicity, and regulation of Ca+ 2 overloads. VPN can alleviate PD neuropathology through its anti-inflammatory, antioxidant, antiapoptotic and neurogenic effects. VPN through inhibition of PDE1 improves cyclic adenosine monophosphate (cAMP)/cyclic guanosine monophosphate (cGMP) signaling in the dopaminergic neurons of the substantia nigra (SN). VPN improves PD neuropathology through PDE1 inhibition with a subsequent increase of the cAMP/cGMP signaling pathway. Therefore, increasing cAMP leads to antioxidant effects, while augmentation of cGMP by VPN leads to anti-inflammatory effects which reduced neurotoxicity and development of motor severity in PD. In conclusion, this review indicated that VPN could be effective in the management of PD.
Collapse
Affiliation(s)
- Hayder M. Al-kuraishy
- Department of Pharmacology, Toxicology and Medicine, Medical Faculty, College of Medicine, Al- Mustansiriyah University, P.O. Box 14132, Baghdad, Iraq
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW 2770 Australia
- AFNP Med, 1030 Wien, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Heusnerstrasse 40, Wuppertal, Germany
| | - Omnya Elhussieny
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Matrouh University, 51744 Marsa Matruh, Egypt
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, 51744 Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511 Egypt
| |
Collapse
|
21
|
Abaza A, Jamil A, Gutlapalli SD, Ali M, Oble MJP, Sonia SN, George S, Shahi SR, Ali Z, Khan S. Parkinson's Neuropathology Puzzle: A Systematic Review Uncovering the Pathological Culprits Behind the Neurological Disease. Cureus 2023; 15:e44353. [PMID: 37664277 PMCID: PMC10472082 DOI: 10.7759/cureus.44353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023] Open
Abstract
Being one of the most prevalent progressive neurodegenerative disorders (falling second only to Alzheimer's disease) with a clinical pattern affecting millions of lives all over the world, Parkinson's disease (PD) has never failed to attract a formidable interest from the vast majority of neurologists and researchers worldwide. This review article will analyze the pathophysiology, etiology, genetics, and pathological stages of Parkinson's disease with their corresponding clinical sequels. A review article was conducted using research databases including PubMed, PubMed Central, Springer, and Elsevier. The research articles reviewed using databases were written in English, German, Japanese, and Chinese and published within the preceding 50 years. Based on the article's findings, we concluded that Parkinson's disease is a progressive disorder with a variety of motor and non-motor symptoms that are influenced by a cascade of pathological neuronal abnormalities such as Lewy neurites and Lewy bodies that gradually build up with an eventual consequence of neurodegeneration of dopamine-secreting neurons. Multiple genetic mutations, pathophysiological events, and environmental factors act as the foundation to initiate that cascade.
Collapse
Affiliation(s)
- Abdelrahman Abaza
- Pathology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Aneeque Jamil
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Sai Dheeraj Gutlapalli
- Internal Medicine, Richmond University Medical Center Affiliated With Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Marya Ali
- Psychiatry, Nishtar Medical University, Multan, PAK
| | - Mrinal J P Oble
- Medicine, Kempegowda Institute of Medical Sciences and Research Centre, Bengaluru, IND
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Shamsun Nahar Sonia
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | | | - Srushti R Shahi
- Medicine, St. Martinus University Faculty of Medicine (SMUFOM), Willemstad, CUW
| | - Zahra Ali
- Medicine, Bolan Medical College, Quetta, PAK
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| |
Collapse
|
22
|
Vale TC, Cardoso FEC, da Silva DJ, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Caramelli P, Barbosa MT. Clinical and functional correlates of parkinsonism in a population-based sample of individuals aged 75 + : the Pietà study. BMC Neurol 2023; 23:276. [PMID: 37479964 PMCID: PMC10360246 DOI: 10.1186/s12883-023-03290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Parkinsonism is strongly associated with ageing, and many studies have suggested that parkinsonian signs may affect up to half of older adults and is associated with a wide range of adverse health outcomes. We compared clinical and functional characteristics of oldest-old community-dwelling individuals with parkinsonism (parkinsonian group [PG]) to individuals without parkinsonism (non-parkinsonian group [NPG]. METHODS The Pietà study is a population-based study conducted in Caeté, southeast Brazil, involving 607 individuals aged 75 + years submitted to an extensive clinical evaluation. A subset of 65 PG individuals (61.5% women, median age of 82 years) was compared to 542 NPG individuals (64.8% women, median age of 80 years). RESULTS PG individuals had significantly more functional impairment, clinical comorbidities (including number of falls, loss of bladder control and dysphagia) and major depression. Multivariate analysis revealed that older age, higher UPDRSm scores, lower category fluency test (animals/minute) and delayed recall memory scores were associated with PG. This group was also more cognitively impaired, with lower performance than NPG individuals in the Mini-Mental State Examination, category fluency test (animals/minute), clock drawing and in delayed recall (p < 0.001 for all tests). UPDRSm scores were the most contributing factor to cognition that independently explained variability in functionality of the entire sample. CONCLUSION Individuals aged 75 + years with parkinsonism were significantly more clinically and functionally impaired in this population-based sample. Cognitive dysfunction explained most of the loss of functionality in these patients. UPDRS-m scores contributed independently to explain variability in functionality in the whole sample.
Collapse
Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
- Movement Disorders Unit, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
| | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danilo Jorge da Silva
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Elisa de Paula Franca Resende
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Antônio Lúcio Teixeira
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
23
|
Kwon MJ, Kim JK, Kim JH, Kim JH, Kim MJ, Kim NY, Choi HG, Kim ES. Exploring the Link between Chronic Kidney Disease and Parkinson's Disease: Insights from a Longitudinal Study Using a National Health Screening Cohort. Nutrients 2023; 15:3205. [PMID: 37513623 PMCID: PMC10385674 DOI: 10.3390/nu15143205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Chronic kidney disease (CKD) and Parkinson's disease (PD) are common illnesses found in the geriatric population. A potential link between CKD and PD emergence has been hypothesized; however, existing conclusions are disputed. In this longitudinal research, we analyzed data acquired from the Korean National Health Insurance Service-Health Screening Cohort. The dataset comprised the health information of 16,559 individuals clinically diagnosed with CKD and 66,236 control subjects of comparable ages, all aged ≥40 years. These subjects participated in health examinations from 2002 to 2019. To assess the correlation between CKD and PD, we employed overlap-weighted Cox proportional hazard regression models. The unadjusted, crude hazard ratio for PD was greater in the CKD group than in the control group (crude hazard ration (HR) 1.20; 95% confidence interval (CI) = 1.04-1.39; p = 0.011). However, the Cox proportional hazard regression analysis, incorporating propensity score overlap weighting, revealed no significant discrepancy after considering confounding variables such as demographic factors, socio-economic status, lifestyle, and concurrent health conditions (adjusted HR (aHR), 1.09; 95% CI = 0.97-1.22; p = 0.147). Subgroup analyses showed a higher probability of PD development among certain CKD individuals, including those who resided in rural areas (aHR, 1.19; 95% CI = 1.03-1.37; p = 0.022), maintained a normal weight (aHR, 1.29; 95% CI = 1.08-1.56; p = 0.006), or had fasting blood glucose levels ≥100 mg/dL (aHR, 1.18; 95% CI = 1.00-1.39; p = 0.046). Therefore, these clinical or environmental factors may influence the incidence of PD in CKD patients. In conclusion, our results suggest that the general CKD population may not exhibit a greater propensity for PD than their non-CKD counterparts. However, this might be contingent upon specific lifestyle and comorbid conditions. Thus, certain lifestyle alterations could be crucial in mitigating the potential manifestation of PD in patients diagnosed with CKD.
Collapse
Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Jwa-Kyung Kim
- Division of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Joo-Hee Kim
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea
| | - Hyo Geun Choi
- Suseo Seoul E.N.T. Clinic and MD Analytics, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea
| | - Eun Soo Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| |
Collapse
|
24
|
Kwon MJ, Kim JH, Kang HS, Lim H, Kim MJ, Kim NY, Kim SH, Choi HG, Kim ES. Possible Incidental Parkinson's Disease following Asthma: A Nested Case-Control Study in Korea. J Pers Med 2023; 13:jpm13050718. [PMID: 37240888 DOI: 10.3390/jpm13050718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
A connection between asthma and the occurrence of Parkinson's disease (PD) has been suggested, but the findings have been contentious and require verification. In this nested case-control study using data from the Korean National Health Insurance Service-Health Screening Cohort (2002-2019), which comprised 9029 participants with PD and 36,116 matched controls, we explored the relationship between asthma and incident PD. An overlap-weighted logistic regression model was used to measure the probability of asthma and PD. After adjusting for various covariates, we found that asthma was related to a 1.11-fold greater probability of PD (95% confidence interval: 1.06-1.16). A subgroup analysis showed that this effect was independent of age, sex, residential area, or alcohol consumption, and that it was still noticeable even among patients with a high income; those with a normal weight or obesity; those who were non-smokers or current smokers; and those with no history of chronic obstructive pulmonary disease, hypertension, hyperglycemia, hyperlipidemia, or anemia. Thus, these findings may indicate that asthma may slightly augment the likelihood of PD in the Korean adult population regardless of demographic or lifestyle factors, making it difficult to predict PD in asthma patients.
Collapse
Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Division of Neuropathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
- Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Hyun Lim
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea
| | - Se Hoon Kim
- Department of Pathology, Division of Neuropathology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hyo Geun Choi
- Suseo Seoul E.N.T. Clinic and MD Analytics, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea
| | - Eun Soo Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| |
Collapse
|
25
|
Cha S, Chang WK, Cho HM, Han K, Paik NJ, Kwon S, Kim WS. Dysphagia Requiring Medical Attention in Parkinson's Disease: A Korean Population-Based Study. J Korean Med Sci 2023; 38:e114. [PMID: 37069809 PMCID: PMC10111039 DOI: 10.3346/jkms.2023.38.e114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/31/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) experience both motor and non-motor symptoms, including dysphagia. Although PD is closely associated with dysphagia, the prevalence or risk of dysphagia in PD is unclear, especially in Asian countries. METHODS The prevalence of PD and dysphagia with PD in the general population was analyzed using the Korean National Health Insurance Service (NHIS) database. The prevalence per 100,000 persons of PD and dysphagia with PD from 2006 to 2015 was analyzed in the general population aged ≥ 40 years. Patients newly diagnosed with PD between 2010 and 2015 were compared with those without PD. RESULTS The prevalence of PD and dysphagia in patients with PD increased continuously during the study period and was highest in the ninth decade of life. The percentage of patients with dysphagia in patients with PD increased with age. Patients with PD showed an adjusted hazard ratio of 3.132 (2.955-3.320) for dysphagia compared to those without PD. CONCLUSION This nationwide study showed increasing trends in the prevalence of PD and dysphagia among patients with PD in Korea between 2006 and 2015. The risk of dysphagia was three times higher in patients with PD than that in those without PD, highlighting the importance of providing particular attention.
Collapse
Affiliation(s)
- Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee-Mun Cho
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sohyun Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
| |
Collapse
|
26
|
Dorsey ER, Ray A. Paraquat, Parkinson's Disease, and Agnotology. Mov Disord 2023. [PMID: 36876974 DOI: 10.1002/mds.29371] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/07/2023] Open
Affiliation(s)
- E Ray Dorsey
- Department of Neurology and Center for Health + Technology, University of Rochester Medical Center, Rochester, New York, USA
| | - Amit Ray
- Department of English, Rochester Institute of Technology, Rochester, New York, USA
| |
Collapse
|
27
|
Kang SH, Moon SJ, Kang M, Chung SJ, Cho GJ, Koh SB. Incidence of Parkinson's disease and modifiable risk factors in Korean population: A longitudinal follow-up study of a nationwide cohort. Front Aging Neurosci 2023; 15:1094778. [PMID: 36865411 PMCID: PMC9971569 DOI: 10.3389/fnagi.2023.1094778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction We aimed to investigate the incidence of Parkinson's disease (PD) by age and year for each sex as well as the modifiable risk factors for PD. Using data from the Korean National Health Insurance Service, 938,635 PD and dementia-free participants aged ≥40 years who underwent general health examinations were followed to December 2019. Methods We analyzed the PD incidence rates according to age, year and sex. To investigate the modifiable risk factors for PD, we used the Cox regression model. Additionally, we calculated the population-attributable fraction to measure the impact of the risk factors on PD. Results During follow-up, 9,924 of the 938,635 (1.1%) participants developed PD. The incidence of PD increased continuously from 2007 to 2018, reaching 1.34 per 1,000 person-years in 2018. The incidence of PD also increases with age, up to 80 y. Presence of hypertension (SHR = 1.09, 95% CI 1.05 to 1.14), diabetes (SHR = 1.24, 95% CI 1.17 to 1.31), dyslipidemia (SHR = 1.12, 95% CI 1.07 to 1.18), ischemic stroke (SHR = 1.26, 95% CI 1.17 to 1.36), hemorrhagic stroke (SHR = 1.26, 95% CI 1.08 to 1.47), ischemic heart disease (SHR = 1.09, 95% CI 1.02 to 1.17), depression (SHR = 1.61, 95% CI 1.53 to 1.69), osteoporosis (SHR = 1.24, 95% CI 1.18 to 1.30), and obesity (SHR = 1.06, 95% CI 1.01 to 1.10) were independently associated with a higher risk for PD. Discussion Our results highlight the effect of modifiable risk factors for PD in the Korean population, which will help establish health care policies to prevent the development of PD.
Collapse
Affiliation(s)
- Sung Hoon Kang
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seok-Joo Moon
- Smart Healthcare Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Minwoong Kang
- Department of Biomedical Research Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Su Jin Chung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea,*Correspondence: Seong-Beom Koh,
| |
Collapse
|
28
|
Vos M, Klein C, Hicks AA. Role of Ceramides and Sphingolipids in Parkinson's Disease. J Mol Biol 2023:168000. [PMID: 36764358 DOI: 10.1016/j.jmb.2023.168000] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
Sphingolipids, including the basic ceramide, are a subset of bioactive lipids that consist of many different species. Sphingolipids are indispensable for proper neuronal function, and an increasing number of studies have emerged on the complexity and importance of these lipids in (almost) all biological processes. These include regulation of mitochondrial function, autophagy, and endosomal trafficking, which are affected in Parkinson's disease (PD). PD is the second most common neurodegenerative disorder and is characterized by the loss of dopaminergic neurons. Currently, PD cannot be cured due to the lack of knowledge of the exact pathogenesis. Nonetheless, important advances have identified molecular changes in mitochondrial function, autophagy, and endosomal function. Furthermore, recent studies have identified ceramide alterations in patients suffering from PD, and in PD models, suggesting a critical interaction between sphingolipids and related cellular processes in PD. For instance, autosomal recessive forms of PD cause mitochondrial dysfunction, including energy production or mitochondrial clearance, that is directly influenced by manipulating sphingolipids. Additionally, endo-lysosomal recycling is affected by genes that cause autosomal dominant forms of the disease, such as VPS35 and SNCA. Furthermore, endo-lysosomal recycling is crucial for transporting sphingolipids to different cellular compartments where they will execute their functions. This review will discuss mitochondrial dysfunction, defects in autophagy, and abnormal endosomal activity in PD and the role sphingolipids play in these vital molecular processes.
Collapse
Affiliation(s)
- Melissa Vos
- Institute of Neurogenetics, University of Luebeck, 23562 Luebeck, Germany.
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, 23562 Luebeck, Germany
| | - Andrew A Hicks
- Institute for Biomedicine (affiliated to the University of Luebeck, Luebeck, Germany), Eurac Research, 39100 Bolzano, Italy. https://twitter.com/andrewhicks
| |
Collapse
|
29
|
Leandro LA, Zotz TGG, Camilotti BM, Olandoski M, Moreira CA. Effect of physical therapy on the isokinetic performance of knee flexors and extensors and functional balance in older adults with Parkinson's disease, according to severity. J Bodyw Mov Ther 2023. [DOI: 10.1016/j.jbmt.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
|
30
|
Song Y, Racette BA, Camacho-Soto A, Searles Nielsen S. Biologic targets of prescription medications and risk of neurodegenerative disease in United States Medicare beneficiaries. PLoS One 2023; 18:e0285011. [PMID: 37195983 DOI: 10.1371/journal.pone.0285011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVE To identify prescription medications associated with a lower risk of three neurodegenerative diseases: Parkinson disease, Alzheimer disease, and amyotrophic lateral sclerosis. METHODS We conducted a population-based, case-control study of U.S. Medicare beneficiaries in 2009 (42,885 incident neurodegenerative disease cases, 334,387 randomly selected controls). Using medication data from 2006-2007, we categorized all filled medications according to their biological targets and mechanisms of action on those targets. We used multinomial logistic regression models, while accounting for demographics, indicators of smoking, and health care utilization, to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for 141 target-action pairs and each neurodegenerative disease. For target-action pairs inversely associated with all three diseases, we attempted replication in a cohort study that included an active comparator group. We constructed the cohort by following controls forward for incident neurodegenerative disease from the beginning of 2010 until death or end of 2014, i.e., up to five years after the two-year exposure lag. We used Cox proportional hazards regression while accounting for the same covariates. RESULTS The most consistent inverse association across both studies and all three neurodegenerative diseases was for xanthine dehydrogenase/oxidase blockers, represented by the gout medication, allopurinol. Allopurinol was associated with a 13-34% lower risk for each neurodegenerative disease group in multinomial regression, and a mean reduction of 23% overall, as compared to individuals who did not use allopurinol. In the replication cohort we observed a significant 23% reduction for neurodegenerative disease in the fifth year of follow-up, when comparing allopurinol users to non-users, and more marked associations with an active comparator group. We observed parallel associations for a related target-action pair unique to carvedilol. DISCUSSION/CONCLUSION Xanthine dehydrogenase/oxidase blockade might reduce risk of neurodegenerative disease. However, further research will be necessary to confirm that the associations related to this pathway are causal or to examine whether this mechanism slows progression.
Collapse
Affiliation(s)
- Yizhe Song
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Brad A Racette
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, United States of America
- Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Alejandra Camacho-Soto
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- Department of Orthopedics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Susan Searles Nielsen
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| |
Collapse
|
31
|
Camerucci E, Mullan AF, Turcano P, Bower J, Piat C, Ahlskog J, Savica R. 40-Year Incidence of Early-Onset Parkinson's Disease in Southeast Minnesota. JOURNAL OF PARKINSON'S DISEASE 2023; 13:893-898. [PMID: 37522219 PMCID: PMC10578273 DOI: 10.3233/jpd-230049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Parkinson's disease (PD) most commonly surfaces at middle age. An earlier onset is named early-onset Parkinson's disease (EOPD), but the exact definition is a matter of ongoing scientific debate. OBJECTIVE To investigate 40-year EOPD incidence trends in a population-based cohort of parkinsonism in Olmsted County, Minnesota. METHODS We used the Rochester Epidemiology Project (REP) to identify all incident EOPD cases in Olmsted County, 1976-2015. A movement-disorder specialist reviewed all cases to confirm the EOPD diagnosis. For EOPD definition, we used two age cut-offs: motor-symptom onset at or before 50 and 55 years. RESULTS EOPD incidence was 1.43/100,000 person-years for ≤55 and 0.55/100,000 for ≤50 years. Men had a higher incidence in both groups [1.84 vs. 1.03 (p = 0.04); and 0.70 vs. 0.40 (p = 0.24), respectively]. EOPD incidence of patients with motor-symptom onset before age 55 increased from 1.02/100.000 person-year 1976-1985, to 1.32/100.000 person-year 2006-2015. A similar trend was observed when ≤50 years cut-off was used (0.28/100,000 person-years 1976-1985, to 0.59/100,000 person-year 2006-2015). However, negative binomial regression found no significant change in incidence per 10 years (RR = 1.04 and 1.24 in the two groups). Incidence was consistently higher in men than women. Median time from EOPD-symptom onset to death was shorter in the EOPD ≤55 group (21.9 years) compared to the EOPD ≤50 group (25.6 years). CONCLUSION We observed an increased trend in the incidence of EOPD with both cut-off ages. Overall, incidence of EOPD was 1.43 (≤55) and 0.55 (≤50) cases per 100,000 person-years, higher in men.
Collapse
Affiliation(s)
- Emanuele Camerucci
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Pierpaolo Turcano
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - James Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Capucine Piat
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J.E. Ahlskog
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
32
|
Lamotte G, Singer W. Synucleinopathies. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:175-202. [PMID: 37620069 DOI: 10.1016/b978-0-323-98817-9.00032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
The α-synucleinopathies include pure autonomic failure, multiple system atrophy, dementia with Lewy bodies, and Parkinson disease. The past two decades have witnessed significant advances in the diagnostic strategies and symptomatic treatment of motor and nonmotor symptoms of the synucleinopathies. This chapter provides an in-depth review of the pathophysiology, pathology, genetic, epidemiology, and clinical and laboratory autonomic features that distinguish the different synucleinopathies with an emphasis on autonomic failure as a common feature. The treatment of the different synucleinopathies is discussed along with the proposal for multidisciplinary, individualized care models that optimally address the various symptoms. There is an urgent need for clinical scientific studies addressing patients at risk of developing synucleinopathies and the investigation of disease mechanisms, biomarkers, potential disease-modifying therapies, and further advancement of symptomatic treatments for motor and nonmotor symptoms.
Collapse
Affiliation(s)
- Guillaume Lamotte
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Wolfgang Singer
- Department of Neurology, Mayo Clinic, Rochester, MN, United States.
| |
Collapse
|
33
|
Srinivasan SR. Targeting Circuit Abnormalities in Neurodegenerative Disease. Mol Pharmacol 2023; 103:38-44. [PMID: 36310030 DOI: 10.1124/molpharm.122.000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 02/03/2023] Open
Abstract
Despite significant improvement in our ability to diagnose both common and rare neurodegenerative diseases and understand their underlying biologic mechanisms, there remains a disproportionate lack of effective treatments, reflecting the complexity of these disorders. Successfully advancing novel treatments for neurodegenerative disorders will require reconsideration of traditional approaches, which to date have focused largely on specific disease proteins or cells of origin. This article proposes reframing these diseases as conditions of dysfunctional circuitry as a complement to ongoing efforts. Specifically reviewed is how aberrant spiking is a common downstream mechanism in numerous neurodegenerative diseases, often driven by dysfunction in specific ion channels. Surgical modification of this electrical activity via deep brain stimulation is already an approved modality for many of these disorders. Therefore, restoring proper electrical activity by targeting these channels pharmacologically represents a viable strategy for intervention, not only for symptomatic management but also as a potential disease-modifying therapy. Such an approach is likely to be a promising route to treating these devastating disorders, either as monotherapy or in conjunction with current drugs. SIGNIFICANCE STATEMENT: Despite extensive research and improved understanding of the biology driving neurodegenerative disease, there has not been a concomitant increase in approved therapies. Accordingly, it is time to shift our perspective and recognize these diseases also as disorders of circuitry to further yield novel drug targets and new interventions. An approach focused on treating dysfunctional circuitry has the potential to reduce or reverse patient symptoms and potentially modify disease course.
Collapse
|
34
|
Kolicheski A, Turcano P, Tamvaka N, McLean PJ, Springer W, Savica R, Ross OA. Early-Onset Parkinson's Disease: Creating the Right Environment for a Genetic Disorder. JOURNAL OF PARKINSON'S DISEASE 2022; 12:2353-2367. [PMID: 36502340 PMCID: PMC9837689 DOI: 10.3233/jpd-223380] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Parkinson's disease (PD) by its common understanding is a late-onset sporadic movement disorder. However, there is a need to recognize not only the fact that PD pathogenesis expands beyond (or perhaps to) the brain but also that many early-onset patients develop motor signs before the age of 50 years. Indeed, studies have shown that it is likely the protein aggregation observed in the brains of patients with PD precedes the motor symptoms by perhaps a decade. Studies on early-onset forms of PD have shown it to be a heterogeneous disease with multiple genetic and environmental factors determining risk of different forms of disease. Genetic and neuropathological evidence suggests that there are α-synuclein centric forms (e.g., SNCA genomic triplication), and forms that are driven by a breakdown in mitochondrial function and specifically in the process of mitophagy and clearance of damaged mitochondria (e.g., PARKIN and PINK1 recessive loss-of-function mutations). Aligning genetic forms with recognized environmental influences will help better define patients, aid prognosis, and hopefully lead to more accurately targeted clinical trial design. Work is now needed to understand the cross-talk between these two pathomechanisms and determine a sense of independence, it is noted that autopsies studies for both have shown the presence or absence of α-synuclein aggregation. The integration of genetic and environmental data is critical to understand the etiology of early-onset forms of PD and determine how the different pathomechanisms crosstalk.
Collapse
Affiliation(s)
- Ana Kolicheski
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Pierpaolo Turcano
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA,
Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Nicole Tamvaka
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,
Mayo Graduate School, Neuroscience Track, Mayo Clinic, Jacksonville, FL, USA
| | - Pamela J. McLean
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,
Mayo Graduate School, Neuroscience Track, Mayo Clinic, Jacksonville, FL, USA
| | - Wolfdieter Springer
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,
Mayo Graduate School, Neuroscience Track, Mayo Clinic, Jacksonville, FL, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA,
Mayo Graduate School, Neuroscience Track, Mayo Clinic, Jacksonville, FL, USA,
Department of Medicine, University College Dublin, Dublin, Ireland,
Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA,Department of Biology, University of NorthFlorida, Jacksonville, FL, USA,Correspondence to: Owen A. Ross, PhD, Department of Neuroscience, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Tel.: +1 904 953 6280; Fax: +1 904 953 7370; E-mail:
| |
Collapse
|
35
|
Abstract
Parkinson disease (PD) is the second most common age-related neurodegenerative condition diagnosed in North America. We recently demonstrated, using multiple epidemiological data sources, that the prevalence of PD diagnoses was greater than previously reported and currently used for clinical, research, and policy decision-making. Prior PD incidence estimates have varied, for unclear reasons. There is a need for improved estimates of PD incidence, not only for care delivery planning and future policy but also for increasing our understanding of disease risk. The objective of this study was thus to investigate the incidence of Parkinson disease across five epidemiological cohorts in North America in a common year, 2012. The cohorts contained data on 6.7 million person-years of adults ages 45 and older, and 9.3 million person-years of adults ages 65 and older. Our estimates of age-sex-adjusted incidence of PD ranged from 108 to 212 per 100,000 among persons ages 65 and older, and from 47 to 77 per 100,00 among persons ages 45 and older. PD incidence increased with age and was higher among males. We also found persistent spatial clustering of incident PD diagnoses in the U.S. PD incidence estimates varied across our data sources, in part due to case ascertainment and diagnosis methods, but also possibly due to the influence of population factors (prevalence of genetic risk factors or protective markers) and geographic location (exposure to environmental toxins). Understanding the source of these variations will be important for health care policy, research, and care planning.
Collapse
|
36
|
Heronemus M, Hostetter TA, Smith AA, Forster JE, Brenner LA. Parkinson's disease and suicide among individuals seeking care within the United States Veterans Health Administration. Parkinsonism Relat Disord 2022; 105:58-61. [PMID: 36370654 DOI: 10.1016/j.parkreldis.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Independently, veterans and individuals with Parkinson's Disease (PD) are at increased risk for suicide. To our knowledge, the risk of suicide among veterans with PD has yet to be evaluated. This study aimed to examine the associations between PD and risk of suicide, as well as suicide means among those using Veteran Health Administration (VHA) services. METHODS Retrospective cohort study of individuals who used VHA services between 1/1/2001-12/31/2019. Cox proportional hazard models were used to estimate the hazard of suicide for those with PD relative to those without. A nested-case control study was carried out among the suicide decedents where logistic regression was used to assess the relationship between PD and suicide by firearms versus suicide by any other means. RESULTS The unadjusted hazard of death by suicide for those with a PD diagnosis, relative to those without, was 1.51 (95% CI: 1.32-1.72, p < 0.0001), and was still significant after controlling for age/gender, and psychiatric/chronic physical health diagnoses (HR: 1.50; 95% CI: 1.32-1.72, p < 0.0001; HR:1.21, 95% CI:1.06-1.38, p = 0.006, respectively). Compared to the non-PD cohort, the PD group also had higher rates of mood, anxiety, and psychotic disorders. There was no significant difference between the method of suicide for those with PD versus those without PD (p = 0.60). Most suicide deaths among both cohorts were firearm-related (PD = 78.9%, No-PD = 80.3%). CONCLUSIONS PD is associated with an elevated risk for suicide. Based on the high rate of deaths by firearm, increased efforts to facilitate lethal means safety among veterans is warranted.
Collapse
Affiliation(s)
- Marc Heronemus
- University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA
| | - Trisha A Hostetter
- Veterans Health Administration (VHA), Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, USA
| | - Alexandra A Smith
- Veterans Health Administration (VHA), Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, USA
| | - Jeri E Forster
- University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA; Veterans Health Administration (VHA), Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, USA
| | - Lisa A Brenner
- University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, Aurora, CO, USA; University of Colorado, Anschutz Medical Campus, Departments of Psychiatry and Neurology, Aurora, CO, USA.
| |
Collapse
|
37
|
Jayaraj R, Azimullah S, Parekh KA, Ojha SK, Beiram R. Effect of citronellol on oxidative stress, neuroinflammation and autophagy pathways in an in vivo model of Parkinson's disease. Heliyon 2022; 8:e11434. [DOI: 10.1016/j.heliyon.2022.e11434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/23/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
|
38
|
Camerucci E, Mullan AF, Turcano P, Stang CD, Bower J, Savica R. WITHDRAWN: 40-Year incidence of early-onset Parkinson's disease (EOPD) in Southeast Minnesota. Parkinsonism Relat Disord 2022; 104:64-67. [PMID: 36244163 DOI: 10.1016/j.parkreldis.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/23/2022] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
This article has been withdrawn: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been withdrawn at the request of the editor and publisher. The publisher regrets that an error occurred which led to the premature publication of this paper. This error bears no reflection on the article or its authors. The publisher apologizes to the authors and the readers for this unfortunate error.
Collapse
Affiliation(s)
| | - Aidan F Mullan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Cole D Stang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - James Bower
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
39
|
Mehanna R, Smilowska K, Fleisher J, Post B, Hatano T, Pimentel Piemonte ME, Kumar KR, McConvey V, Zhang B, Tan E, Savica R. Age Cutoff for Early-Onset Parkinson's Disease: Recommendations from the International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinson's Disease. Mov Disord Clin Pract 2022; 9:869-878. [PMID: 36247919 PMCID: PMC9547138 DOI: 10.1002/mdc3.13523] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/09/2022] Open
Abstract
Background Early-onset Parkinson's disease (EOPD)/young-onset Parkinson's disease (YOPD) is defined as Parkinson's disease (PD) with an age at onset (AAO) after age 21 years but before the usual AAO for PD. Consensus is lacking, and the reported maximal age for EOPD/YOPD has varied from 40 to 60 years, leading to a lack of uniformity in published studies and difficulty in harmonization of data. EOPD and YOPD have both been used in the literature, somewhat interchangeably. Objective To define the nomenclature and AAO cutoff for EOPD/YOPD. Methods An extensive review of the literature and task force meetings were conducted. Conclusions were reached by consensus. Results First, the literature has seen a shift from the use of YOPD toward EOPD. This seems motivated by an attempt to avoid age-related stigmatization of patients. Second, in defining EOPD, 56% of the countries use 50 or 51 years as the cutoff age. Third, the majority of international genetic studies in PD use an age cutoff of younger than 50 years to define EOPD. Fourth, many studies suggest that changes in the estrogen level can affect the predisposition to develop PD, making the average age at menopause of 50 years an important factor to consider when defining EOPD. Fifth, considering the differential impact of the AAO of PD on professional and social life, using 50 years as the upper cutoff for the definition of EOPD seems reasonable. Conclusions This task force recommends the use of EOPD rather than YOPD. It defines EOPD as PD with AAO after 21 years but before 50 years.
Collapse
Affiliation(s)
- Raja Mehanna
- UTMove, Departement of NeurologyUniversity of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Katarzyna Smilowska
- Department of NeurologySilesian Center of NeurologyKatowicePoland
- Department of Neurology5th Regional HospitalSosnowiecPoland
| | - Jori Fleisher
- Department of Neurological SciencesRush University School of MedicineChicagoIllinoisUSA
| | - Bart Post
- Department of NeurologyRadboudumcNijmegenThe Netherlands
| | - Taku Hatano
- Department of NeurologyJuntendo University School of MedicineTokyoJapan
| | - Maria Elisa Pimentel Piemonte
- Physical Therapy, Speech Therapy, and Occupational TherapyDepartment, Medical School, University of São PauloSão PauloBrazil
| | - Kishore Raj Kumar
- Molecular Medicine Laboratory and Department of Neurology, Concord Repatriation General Hospital, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Kinghorn Centre for Clinical GenomicsGarvan Institute of Medical ResearchDarlinghurstNew South WalesAustralia
| | | | - Baorong Zhang
- Department of NeurologyThe Second Affiliated HospitalHangzhouChina
| | - Eng‐King Tan
- Department of NeurologyNational Neuroscience InstituteSingaporeSingapore
| | | |
Collapse
|
40
|
Saleh M, Markovic M, Olson KE, Gendelman HE, Mosley RL. Therapeutic Strategies for Immune Transformation in Parkinson’s Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:S201-S222. [PMID: 35871362 PMCID: PMC9535567 DOI: 10.3233/jpd-223278] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dysregulation of innate and adaptive immunity can lead to alpha-synuclein (α-syn) misfolding, aggregation, and post-translational modifications in Parkinson’s disease (PD). This process is driven by neuroinflammation and oxidative stress, which can contribute to the release of neurotoxic oligomers that facilitate dopaminergic neurodegeneration. Strategies that promote vaccines and antibodies target the clearance of misfolded, modified α-syn, while gene therapy approaches propose to deliver intracellular single chain nanobodies to mitigate α-syn misfolding, or to deliver neurotrophic factors that support neuronal viability in an otherwise neurotoxic environment. Additionally, transformative immune responses provide potential targets for PD therapeutics. Anti-inflammatory drugs represent one strategy that principally affects innate immunity. Considerable research efforts have focused on transforming the balance of pro-inflammatory effector T cells (Teffs) to favor regulatory T cell (Treg) activity, which aims to attenuate neuroinflammation and support reparative and neurotrophic homeostasis. This approach serves to control innate microglial neurotoxic activities and may facilitate clearance of α-syn aggregates accordingly. More recently, changes in the intestinal microbiome have been shown to alter the gut-immune-brain axis leading to suppressed leakage of bacterial products that can promote peripheral inflammation and α-syn misfolding. Together, each of the approaches serves to interdict chronic inflammation associated with disordered immunity and neurodegeneration. Herein, we examine research strategies aimed at improving clinical outcomes in PD.
Collapse
Affiliation(s)
- Maamoon Saleh
- Department of Pharmacology and Experimental Neuroscience, Center for Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE, USA
| | - Milica Markovic
- Department of Pharmacology and Experimental Neuroscience, Center for Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE, USA
| | - Katherine E. Olson
- Department of Pharmacology and Experimental Neuroscience, Center for Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE, USA
| | - Howard E. Gendelman
- Department of Pharmacology and Experimental Neuroscience, Center for Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE, USA
| | - R. Lee Mosley
- Department of Pharmacology and Experimental Neuroscience, Center for Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
41
|
Wang Y, Wu S, Li Q, Lang W, Li W, Jiang X, Wan Z, Chen J, Wang H. Epigallocatechin-3-gallate: A phytochemical as a promising drug candidate for the treatment of Parkinson’s disease. Front Pharmacol 2022; 13:977521. [PMID: 36172194 PMCID: PMC9511047 DOI: 10.3389/fphar.2022.977521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Epigallocatechin 3-gallate (EGCG), an abundant polyphenolic component derived from green tea extract, possesses versatile bioactivities that can combat many diseases. During the last decade, EGCG was shown to be effective in experimental models of Parkinson’s disease (PD). Several experimental studies have suggested that it has pleiotropic neuroprotective effects, which has enhanced the appeal of EGCG as a therapeutic strategy in PD. In this review, we compiled recent updates and knowledge of the molecular mechanisms underlying the neuroprotective effects of EGCG in PD. We focused on the effects of EGCG on apoptosis, oxidative stress, inflammation, ferroptosis, modulation of dopamine production, and the aggregation of α-synuclein. The review highlights the pharmacological features of EGCG and its therapeutic implications in PD. Taken together, the accumulated data indicate that EGCG is a promising neuroprotective compound for the treatment of PD.
Collapse
Affiliation(s)
- Yumin Wang
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Shuang Wu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qiang Li
- Department of Neurology, The Affiliated Hospital of Chifeng University, Chifeng, China
| | - Weihong Lang
- Department of Psychological Medicine, The Affiliated Hospital of Chifeng University, Chifeng, China
| | - Wenjing Li
- Department of Neurology, The Affiliated Hospital of Chifeng University, Chifeng, China
| | - Xiaodong Jiang
- Department of Anatomy, College of Basic Medicine, Chifeng University Health Science Center, Chifeng, China
| | - Zhirong Wan
- Department of Neurology,Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
| | - Jichao Chen
- Department of Respiratory and Critical Care Medicine, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
- *Correspondence: Jichao Chen, ; Hongquan Wang,
| | - Hongquan Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- *Correspondence: Jichao Chen, ; Hongquan Wang,
| |
Collapse
|
42
|
Liu XL, Liu SY, Barret O, Tamagnan GD, Qiao HW, Song TB, Lu J, Chan P. Diagnostic value of striatal 18F-FP-DTBZ PET in Parkinson’s disease. Front Aging Neurosci 2022; 14:931015. [PMID: 35936768 PMCID: PMC9355024 DOI: 10.3389/fnagi.2022.931015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/30/2022] [Indexed: 12/25/2022] Open
Abstract
Background18F-FP-DTBZ has been proven as a biomarker for quantifying the concentration of presynaptic vesicular monoamine transporter 2 (VMAT2). However, its clinical application is still limited.ObjectivesTo evaluate the difference in dopaminergic integrity between patients with Parkinson’s disease (PD) and healthy controls (HC) using 18F-FP-DTBZ PET in vivo and to determine the diagnostic value of standardized uptake value ratios (SUVRs) using the Receiver Operating Characteristic (ROC) curve.MethodsA total of 34 PD and 31 HC participants were enrolled in the PET/MR derivation cohort, while 89 PD and 18 HC participants were recruited in the PET/CT validation cohort. The Hoehn–Yahr Scale and the third part of the MDS-Unified Parkinson’s Disease Rating Scale (MDSUPDRS-III) were used to evaluate the disease staging and severity. All assessments and PET scanning were performed in drug-off states. The striatum was segmented into five subregions as follows: caudate, anterior dorsal putamen (ADP), anterior ventral putamen (AVP), posterior dorsal putamen (PDP), and posterior ventral putamen (PVP) using automatic pipeline built with the PMOD software (version 4.105). The SUVRs of the targeted subregions were calculated using the bilateral occipital cortex as the reference region.ResultsRegarding the diagnostic value, ROC curve and blind validation showed that the contralateral PDP (SUVR = 3.43) had the best diagnostic accuracy (AUC = 0.973; P < 0.05), with a sensitivity of 97.1% (95% CI: 82.9–99.8%), specificity of 100% (95% CI: 86.3–100%), positive predictive value (PPV) of 100% (95% CI: 87.0–100%), negative predictive value (NPV) of 96.9% (95% CI: 82.0–99.8%), and an accuracy of 98.5% for the diagnosis of PD in the derivation cohort. Blind validation of 18F-FP-DTBZ PET imaging diagnosis was done using the PET/CT cohort, where participants with a SUVR of the PDP <3.43 were defined as PD. Kappa test showed a consistency of 0.933 (P < 0.05) between clinical diagnosis and imaging diagnosis, with a sensitivity of 98.9% (95% CI: 93.0–99.9%), specificity of 94.4% (95% CI: 70.6–99.7%), PPV of 98.9% (95% CI: 93.0–99.9%), NPV of 94.4% (95% CI: 70.6–99.7%), and a diagnostic accuracy of 98.1%.ConclusionsOur results showed that an SUVR threshold of 3.43 in the PDP could effectively distinguish patients with PD from HC.
Collapse
Affiliation(s)
- Xiu-Lin Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shu-Ying Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Chinese Institute for Brain Research (CIBR), Beijing, China
- Shu-Ying Liu,
| | - Olivier Barret
- CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodégénératives, Université Paris-Saclay, Fontenay-aux-Roses, France
| | - Gilles D. Tamagnan
- Mental Health PET Radioligand Development (MHPRD) Program, Yale University, New Haven, CT, United States
| | - Hong-Wen Qiao
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tian-Bin Song
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Beijing, China
- *Correspondence: Piu Chan,
| |
Collapse
|
43
|
Li D, Huang LT, Zhang CP, Li Q, Wang JH. Insights Into the Role of Platelet-Derived Growth Factors: Implications for Parkinson’s Disease Pathogenesis and Treatment. Front Aging Neurosci 2022; 14:890509. [PMID: 35847662 PMCID: PMC9283766 DOI: 10.3389/fnagi.2022.890509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Parkinson’s disease (PD), the second most common neurodegenerative disease after Alzheimer’s disease, commonly occurs in the elderly population, causing a significant medical and economic burden to the aging society worldwide. At present, there are few effective methods that achieve satisfactory clinical results in the treatment of PD. Platelet-derived growth factors (PDGFs) and platelet-derived growth factor receptors (PDGFRs) are important neurotrophic factors that are expressed in various cell types. Their unique structures allow for specific binding that can effectively regulate vital functions in the nervous system. In this review, we summarized the possible mechanisms by which PDGFs/PDGFRs regulate the occurrence and development of PD by affecting oxidative stress, mitochondrial function, protein folding and aggregation, Ca2+ homeostasis, and cell neuroinflammation. These modes of action mainly depend on the type and distribution of PDGFs in different nerve cells. We also summarized the possible clinical applications and prospects for PDGF in the treatment of PD, especially in genetic treatment. Recent advances have shown that PDGFs have contradictory roles within the central nervous system (CNS). Although they exert neuroprotective effects through multiple pathways, they are also associated with the disruption of the blood–brain barrier (BBB). Our recommendations based on our findings include further investigation of the contradictory neurotrophic and neurotoxic effects of the PDGFs acting on the CNS.
Collapse
Affiliation(s)
- Dan Li
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Cheng-pu Zhang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiang Li
- Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qiang Li,
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- Jia-He Wang,
| |
Collapse
|
44
|
Dilmaghani S, Atieh J, Khanna L, Hosfield EA, Camilleri M, Katzka DA. Severity of dysphagia is associated with hospitalizations and mortality in patients with Parkinson's disease. Neurogastroenterol Motil 2022; 34:e14280. [PMID: 34628711 DOI: 10.1111/nmo.14280] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/11/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Aspiration pneumonia is the commonest cause of hospitalizations and death in patients with Parkinson's disease (PD). Among these patients, the relationships between severity of dysphagia, hospitalizations for related complications, and death are not robustly defined. Our aim was to characterize the relationship between PD-related oropharyngeal dysfunction and clinically relevant outcomes. METHODS Retrospective cohort study of 312 patients with PD at a tertiary center who underwent videofluoroscopic swallow studies conducted by expert therapists between 2010 and 2015. Level of swallowing function was represented using the 7-point Functional Oral Intake Scale (FOIS) (7 = normal function). Significance and relative risk calculations utilized Poisson regression. Time to composite outcome of first hospitalization or death was summarized using Kaplan-Meier curve with log-rank test. KEY RESULTS One hundred thirty eight patients had a recorded FOIS score. The prevalence of oropharyngeal dysfunction was 76.1%. The median duration of follow-up was 26.8 months. In multivariate analyses, patients with FOIS 5 (RR = 2.01 [95% CI: 1.22, 3.32]), FOIS 3 (RR = 2.78 [95% CI: 1.75, 4.40]), and FOIS 1 (RR = 2.50 [95% CI: 1.49, 4.20]) were significantly associated with increased risk of hospitalization or death compared to FOIS 7 after co-variate adjustments. GERD was also associated with a significant increased risk of hospitalization or death (RR = 1.28 [95% CI: 1.01, 1.64]). Time to first hospitalization or death was shorter in patients with lower FOIS scores (p < 0.00005). CONCLUSIONS AND INFERENCES Severity of oropharyngeal dysphagia, as measured by the FOIS, is associated with poorer survival and shorter time to hospitalization for dysphagia-related complications, pneumonia, or death in PD.
Collapse
Affiliation(s)
- Saam Dilmaghani
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, Minnesota, USA
| | - Jessica Atieh
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, Minnesota, USA
| | - Lehar Khanna
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, Minnesota, USA
| | - Emily A Hosfield
- Division of Speech Pathology, Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, Minnesota, USA
| | - David A Katzka
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Rochester, Minnesota, USA
| |
Collapse
|
45
|
Okunoye O, Marston L, Walters K, Schrag A. Change in the incidence of Parkinson's disease in a large UK primary care database. NPJ Parkinsons Dis 2022; 8:23. [PMID: 35292689 PMCID: PMC8924194 DOI: 10.1038/s41531-022-00284-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/21/2022] [Indexed: 11/09/2022] Open
Abstract
Parkinson's disease (PD) has the fastest rising prevalence of all neurodegenerative diseases worldwide. However, it is unclear whether its incidence has increased after accounting for age and changes in diagnostic patterns in the same population. We conducted a cohort study in individuals aged ≥50 years within a large UK primary care database between January 2006 and December 2016. To account for possible changes in diagnostic patterns, we calculated the incidence of PD using four case definitions with different stringency derived from the combination of PD diagnosis, symptoms, and treatment. Using the broadest case definition, the incidence rate (IR) per 100,000 person years at risk (PYAR) was 149 (95% CI 143.3-155.4) in 2006 and 144 (95% CI 136.9-150.7) in 2016. In conclusion, the incidence of PD in the UK remained stable between 2006 and 2016, when accounting for age and diagnostic patterns, suggesting no major change in underlying risk factors for PD during this time period in the UK.
Collapse
Affiliation(s)
- Olaitan Okunoye
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK.
| |
Collapse
|
46
|
Canonico M, Artaud F, Degaey I, Moisan F, Kabore R, Portugal B, Nguyen TTH, Pesce G, Boutron-Ruault MC, Roze E, Elbaz A. Incidence of Parkinson's disease in French women from the E3N cohort study over 27 years of follow-up. Eur J Epidemiol 2022; 37:513-523. [PMID: 35286513 DOI: 10.1007/s10654-022-00851-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 02/06/2022] [Indexed: 11/03/2022]
Abstract
Parkinson's disease (PD) is an uncommon disease with a long prodromal period and higher incidence in men than women. Large cohort studies of women with a long follow-up are needed. Within the E3N French cohort study (98,995 women, 40-65 years at baseline), we identified 3,584 participants who self-reported PD or used anti-parkinsonian drugs over 27 years (1992-2018). We obtained medical records to validate PD diagnosis (definite, probable, possible, no). When medical records were not available, we used a validated algorithm based on drug claims to predict PD status. We retained a PD diagnosis for 1,294 women (medical records, 62%; algorithm, 38%). After exclusion of prevalent/possible cases, cases without age at diagnosis, and women lost to follow-up, our analyses included 98,069 women, of whom 1,200 had incident PD (mean age at diagnosis = 71.8 years; incidence rate = 0.494/1,000 person-years). Age-adjusted incidence rates increased over the six first years of follow-up, possibly due to healthy volunteer bias, and remained stable thereafter, similar to incidence rates in women from Western Europe. Forty three percent of PD cases occurred after 20 years of follow-up (2012-2018). The cumulative incidence of PD from 50 to 90 years was 2.41% (95% confidence interval [CI] = 2.27-2.65). PD incidence was lower in ever than never smokers (hazard ratio = 0.86, 95% CI = 0.76-0.96). In conclusion, we estimated PD incidence rates in French women over a 27-year follow-up, and showed stable incidence between 2002 and 2018. The long follow-up and large sample size make this study a valuable resource to improve our knowledge on PD etiology in women.
Collapse
Affiliation(s)
- Marianne Canonico
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Fanny Artaud
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Isabelle Degaey
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Frédéric Moisan
- Santé publique France, French Public Health Agency, Direction Santé Environnement Travail, Saint-Maurice, France
| | - Rahime Kabore
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Berta Portugal
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Thi Thu Ha Nguyen
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Giancarlo Pesce
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Marie-Christine Boutron-Ruault
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Emmanuel Roze
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, Paris, France.,INSERM U1127, CNRS 7225, Institut du Cerveau, Paris, France
| | - Alexis Elbaz
- Paris-Saclay University, Paris-South University, UVSQ, Center for Research in Epidemiology and Population Health, INSERM, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France.
| |
Collapse
|
47
|
A nationwide study of the incidence, prevalence and mortality of Parkinson's disease in the Norwegian population. NPJ Parkinsons Dis 2022; 8:19. [PMID: 35236852 PMCID: PMC8891365 DOI: 10.1038/s41531-022-00280-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/12/2022] [Indexed: 01/19/2023] Open
Abstract
Epidemiological studies of Parkinson's disease (PD) show variable and partially conflicting findings with regard to incidence, prevalence, and mortality. These differences are commonly attributed to technical and methodological factors, including small sample sizes, differences in diagnostic practices, and population heterogeneity. We leveraged the Norwegian Prescription Database, a population-based registry of drug prescriptions dispensed from Norwegian pharmacies to assess the incidence, prevalence, and mortality of PD in Norway. The diagnosis of PD was defined based on the prescription of dopaminergic drugs for the indication of PD over a continuous time. During 2004-2017, 12,229 males and 9831 females met our definition for PD diagnosis. PD prevalence increased over the observation period, with larger changes observed in the older age groups. Incidence and prevalence of PD increased with age, peaking at 85 years. The male/female prevalence ratio was 1.5 across all ages, whereas the incidence ratio increased with age, from 1.4 in those 60 years, to 2.03 among those >90 years. While PD mortality was generally higher than that of the general population, mortality odds ratios decreased with age, approaching 1.0 among individuals >90 years old. When adjusted for the sex-specific mortality of the general population, the mortality among females with PD was equal to or higher than the mortality among males with PD. Our findings demonstrate that the epidemiological features of PD, including sex-differences, are age and time-period dependent and indicate that sex differences in PD mortality are unlikely to stem from disease-specific negative impact of survival in males.
Collapse
|
48
|
Pascual-Valdunciel A, Rajagopal A, Pons JL, Delp S. Non-invasive electrical stimulation of peripheral nerves for the management of tremor. J Neurol Sci 2022; 435:120195. [PMID: 35220113 PMCID: PMC9590374 DOI: 10.1016/j.jns.2022.120195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/06/2021] [Accepted: 02/17/2022] [Indexed: 12/22/2022]
Abstract
Pathological tremor in patients with essential tremor and Parkinsons disease is typically treated using medication or neurosurgical interventions. There is a widely recognized need for new treatments that avoid the side effects of current medications and do not carry the risks of surgical interventions. Building on decades of research and engineering development, non-invasive electrical stimulation of peripheral nerves has emerged as a safe and effective strategy for reducing pathologic tremor in essential tremor. This review surveys the peripheral electrical stimulation (PES) literature and summarizes effectiveness, safety, clinical translatability, and hypothesized tremor-reduction mechanisms of various PES approaches. The review also proposes guidelines for assessing tremor in the context of evaluating new therapies that combine the strengths of clinician assessments, patient evaluations, and novel motion sensing technology. The review concludes with a summary of future directions for PES, including expanding clinical access for patients with Parkinson's disease and leveraging large, at-home datasets to learn more about tremor physiology and treatment effect that will better characterize the state of tremor management and accelerate discovery of new therapies. Growing evidence suggests that non-invasive electrical stimulation of afferent neural pathways provides a viable new option for management of pathological tremor, with one specific PES therapy cleared for prescription and home use, suggesting that PES be considered along with medication and neurosurgical interventions for treatment of tremor. This article is part of the Special Issue "Tremor" edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh.
Collapse
Affiliation(s)
- Alejandro Pascual-Valdunciel
- Northwestern University, Evanston, IL, USA; E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Spain
| | | | - Jose L Pons
- Northwestern University, Evanston, IL, USA; Shirley Ryan AbilityLab, Chicago, IL, USA.
| | | |
Collapse
|
49
|
Subramanian I, Mathur S, Oosterbaan A, Flanagan R, Keener AM, Moro E. Unmet Needs of Women Living with Parkinson's Disease: Gaps and Controversies. Mov Disord 2022; 37:444-455. [DOI: 10.1002/mds.28921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Indu Subramanian
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | | | - Annelien Oosterbaan
- Department of Neurology Radboud University Medical Center Nijmegen The Netherlands
| | | | - Adrienne M. Keener
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | - Elena Moro
- Grenoble Alpes University, Faculty of Medicine, Division of Neurology CHUGA, Grenoble Institute of Neurosciences Grenoble France
| |
Collapse
|
50
|
Heterogeneous digital biomarker integration out-performs patient self-reports in predicting Parkinson's disease. Commun Biol 2022; 5:58. [PMID: 35039601 PMCID: PMC8763910 DOI: 10.1038/s42003-022-03002-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/23/2021] [Indexed: 11/09/2022] Open
Abstract
Parkinson's disease (PD) is one of the first diseases where digital biomarkers demonstrated excellent performance in differentiating disease from healthy individuals. However, no study has systematically compared and leveraged multiple types of digital biomarkers to predict PD. Particularly, machine learning works on the fine-motor skills of PD are limited. Here, we developed deep learning methods that achieved an AUC (Area Under the receiver operator characteristic Curve) of 0.933 in identifying PD patients on 6418 individuals using 75048 tapping accelerometer and position records. Performance of tapping is superior to gait/rest and voice-based models obtained from the same benchmark population. Assembling the three models achieved a higher AUC of 0.944. Notably, the models not only correlated strongly to, but also performed better than patient self-reported symptom scores in diagnosing PD. This study demonstrates the complementary predictive power of tapping, gait/rest and voice data and establishes integrative deep learning-based models for identifying PD.
Collapse
|