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Arippa F, Leban B, Monticone M, Cossu G, Casula C, Pau M. A Study on Lower Limb Asymmetries in Parkinson’s Disease during Gait Assessed through Kinematic-Derived Parameters. Bioengineering (Basel) 2022; 9:bioengineering9030120. [PMID: 35324809 PMCID: PMC8945156 DOI: 10.3390/bioengineering9030120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Unilaterality of motor symptoms is a distinctive feature of Parkinson’s Disease (PD) and represents an important co-factor involved in motor deficits and limitations of functional abilities including postural instability and asymmetrical gait. In recent times, an increasing number of studies focused on the characterization of such alterations, which have been associated with increased metabolic cost and risk of falls and may severely compromise their quality of life. Although a large number of studies investigated the gait alterations in people with PD (pwPD), few focused on kinematic parameters and even less investigated interlimb asymmetry under a kinematic point of view. This retrospective study aimed to characterize such aspects in a cohort of 61 pwPD (aged 68.9 ± 9.3 years) and 47 unaffected individuals age- and sex-matched (66.0 ± 8.3 years), by means of computerized 3D gait analysis performed using an optical motion-capture system. The angular trends at hip, knee and ankle joints of pwPD during the gait cycle were extracted and compared with those of unaffected individuals on a point-by-point basis. Interlimb asymmetry was assessed using angle–angle diagrams (cyclograms); in particular, we analyzed area, orientation, trend symmetry and range offset. The results showed that pwPD are characterized by a modified gait pattern particularly at the terminal stance/early swing phase of the gait cycle. Significant alterations of interlimb coordination were detected at the ankle joint (cyclogram orientation and trend symmetry) and at the hip joint (range offset). Such findings might be useful in clinical routine to characterize asymmetry during gait and thus support physicians in the early diagnosis and in the evaluation of the disease progression.
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Affiliation(s)
- Federico Arippa
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (F.A.); (B.L.)
- Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, ARNAS “G. Brotzu”, 09134 Cagliari, Italy;
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (F.A.); (B.L.)
| | - Marco Monticone
- Neurorehabilitation Unit, Department of Neuroscience and Rehabilitation, ARNAS “G. Brotzu”, 09134 Cagliari, Italy;
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
| | - Giovanni Cossu
- Neurophysiology and Movement Disorders Unit, Department of Neurology, ARNAS “G. Brotzu”, 09134 Cagliari, Italy;
| | - Carlo Casula
- Physical Medicine and Rehabilitation Unit, ARNAS “G. Brotzu”, 09134 Cagliari, Italy;
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy; (F.A.); (B.L.)
- Correspondence:
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de Verdal M, Renard D, Collombier L, Boudousq V, Kotzki PO, Labauge P, Castelnovo G. I123-FP-CIT single-photon emission tomography in patients with long-standing mixed tremor. Eur J Neurol 2012; 20:382-8. [DOI: 10.1111/j.1468-1331.2012.03875.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/17/2012] [Indexed: 11/28/2022]
Affiliation(s)
- M. de Verdal
- Department of Neurology; CHU Caremeau; Nimes; France
| | - D. Renard
- Department of Neurology; CHU Caremeau; Nimes; France
| | - L. Collombier
- Department of Nuclear Medicine; CHU Caremeau; Nimes; France
| | - V. Boudousq
- Department of Nuclear Medicine; CHU Caremeau; Nimes; France
| | - P. O. Kotzki
- Department of Nuclear Medicine; CHU Caremeau; Nimes; France
| | - P. Labauge
- Department of Neurology; CHU Caremeau; Nimes; France
| | - G. Castelnovo
- Department of Neurology; CHU Caremeau; Nimes; France
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Abstract
A 68-year-old, normal female volunteer was scanned by positron emission tomography (PET) with [(18)F]6-L-fluorodopa (FD). Striatal FD uptake was in the high normal range. Subsequently, she developed parkinsonism 3.7 years after the scan. A repeat FD PET scan revealed a significant reduction of FD uptake by 20% over the 5.2 year interval. Our observations suggest a relatively short presymptomatic period with fast initial losses of nigral neurons in idiopathic parkinsonism.
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The Assay of Enzyme Activity by Positron Emission Tomography. MOLECULAR IMAGING IN THE CLINICAL NEUROSCIENCES 2012. [DOI: 10.1007/7657_2012_53] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Criswell SR, Perlmutter JS, Videen TO, Moerlein SM, Flores HP, Birke AM, Racette BA. Reduced uptake of [¹⁸F]FDOPA PET in asymptomatic welders with occupational manganese exposure. Neurology 2011; 76:1296-301. [PMID: 21471467 DOI: 10.1212/wnl.0b013e3182152830] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Welding exposes workers to manganese (Mn) fumes, but it is unclear if this exposure damages dopaminergic neurons in the basal ganglia and predisposes individuals to develop parkinsonism. PET imaging with 6-[(18)F]fluoro-l-dopa (FDOPA) is a noninvasive measure of nigrostriatal dopaminergic neuron integrity. The purpose of this study is to determine whether welding exposure is associated with damage to nigrostriatal neurons in asymptomatic workers. METHODS We imaged 20 asymptomatic welders exposed to Mn fumes, 20 subjects with idiopathic Parkinson disease (IPD), and 20 normal controls using FDOPA PET. All subjects were examined by a movement disorders specialist. Basal ganglia volumes of interest were identified for each subject. The specific uptake of FDOPA, K(i), was generated for each region using graphical analysis method. RESULTS Repeated measures general linear model (GLM) analysis demonstrated a strong interaction between diagnostic group and region (F(4,112) = 15.36, p < 0.001). Caudate K(i)s were lower in asymptomatic welders (0.0098 + 0.0013 minutes(-1)) compared to control subjects (0.0111 + 0.0012 minutes(-1), p = 0.002). The regional pattern of uptake in welders was most affected in the caudate > anterior putamen > posterior putamen. This uptake pattern was anatomically reversed from the pattern found in subjects with IPD. CONCLUSIONS Active, asymptomatic welders with Mn exposure demonstrate reduced FDOPA PET uptake indicating dysfunction in the nigrostriatal dopamine system. The caudate K(i) reduction in welders may represent an early (asymptomatic) marker of Mn neurotoxicity and appears to be distinct from the pattern of dysfunction found in symptomatic IPD.
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Affiliation(s)
- S R Criswell
- Department of Neurology, Washington University School of Medicine, 660 South Euclid Ave., Box 8111, St. Louis, MO 63110, USA
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Viallet F, Gayraud D, Bonnefoi B, Renie L, Aurenty R. Morbo di Parkinson idiopatico: aspetti clinici, diagnostici e terapeutici. Neurologia 2010. [DOI: 10.1016/s1634-7072(10)70494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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In vivo imaging of synaptic function in the central nervous system. Behav Brain Res 2009; 204:1-31. [DOI: 10.1016/j.bbr.2009.06.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 05/27/2009] [Accepted: 06/02/2009] [Indexed: 01/07/2023]
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8
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Musiek ES, Torigian DA, Newberg AB. Investigation of Nonneoplastic Neurologic Disorders with PET and MRI. PET Clin 2008; 3:317-34. [DOI: 10.1016/j.cpet.2009.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
The motor symptoms of Parkinson's disease are predominantly due to progressive degeneration of nigral dopaminergic neurons. In most cases there is a substantial asymmetry of clinical symptoms from disease onset, which occurs in sporadic and in hereditary forms of the disease. However, the mechanism of such unilaterality of symptom appearance is not understood. There is only sparse information about whether symptom-side predominance is genetically coded and determined years before symptom onset, or whether it is acquired and related to side differences in vulnerability of the degenerating neurons. In this Personal View we review data for unilaterality of symptoms at different disease stages. We also discuss several pathological, genetic, environmental, and toxic possibilities for explaining the mechanism of side predominance.
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Affiliation(s)
- Ruth Djaldetti
- Department of Neurology, Rabin Medical Centre, Beilinson Campus, Petah Tiqva, Israel.
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Berg D, Hochstrasser H, Schweitzer KJ, Riess O. Disturbance of iron metabolism in Parkinson’s disease — ultrasonography as a biomarker. Neurotox Res 2006; 9:1-13. [PMID: 16464747 DOI: 10.1007/bf03033302] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A central role of iron in the pathogenesis of Parkinson's disease (PD) has been discussed for many years. So far, however, a biomarker indicating increased iron levels in the substantia nigra (SN) in PD patients has been missing. Performing transcranial ultrasound we detected an increased area of SN echogenicity as a typical echofeature in PD, visible already in the early stages of the disease and in subjects with subclinical impairment of the nigrostriatal system. Animal studies and post mortem analyses of human brain tissue revealed that this echofeature is associated with increased iron levels of the substantia nigra as well as a reduced neuromelanin content. The apparently autosomal dominant inheritance of this echofeature in relatives of patients with idiopathic PD indicates a primary role of disturbances of iron metabolism in PD. Consequently performed mutation analyses in genes involved in brain iron metabolism lead to the discovery of specific mutations in the ferritin-H, IRP2 and HFE gene in single PD patients. Moreover, variations in the ceruloplasmin gene were found to be associated with PD or SN hyperechogenicity. Functional relevance of some of these mutations for iron metabolism could be proven. Therefore, SN hyperechogenicity can be regarded as biomarker for both: impairment of the nigrostriatal system and increased iron levels of the SN. Future studies aim at substantiating the hypothesis that healthy subjects with SN hyperechogenicity indeed represent a population at risk for nigrostriatal degeneration, which would have a significant impact on therapeutical options.
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Affiliation(s)
- Daniela Berg
- Hertie Institute of Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany.
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Abstract
FD-PET has proved to be an extremely useful technique for the noninvasive evaluation of nigrostriatal pathophysiology in patients with PD and other movement disorders. The development of ratio methods for image analysis has greatly reduced the complexity of these PET studies and has facilitated data analysis. With the recent advances in cyclotron targetry and automated synthesis modules FD-PET will soon become an important component of the clinical armamentarium.
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Affiliation(s)
- Alan J Fischman
- Division of Nuclear Medicine, Department of Radiology, Massachusetts General Hospital, 32 Fruit Street, Boston, MA 02114, USA.
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Minoshima S, Foster NL, Petrie EC, Albin RL, Frey KA, Kuhl DE. Neuroimaging in dementia with Lewy bodies: metabolism, neurochemistry, and morphology. J Geriatr Psychiatry Neurol 2003; 15:200-9. [PMID: 12489916 DOI: 10.1177/089198870201500405] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia with Lewy bodies (DLB) is recognized as one of the most common forms of neurodegenerative dementia. Neuroimaging contributes to a better understanding of the pathophysiology of DLB by examining alterations in brain metabolism, neurochemisty, and morphology in living patients. Neuroimaging can provide objective and quantifiable antemortem markers for the presence of and the progression of DLB and permits differentiation from other dementias. This article reviews current neuroimaging findings in DLB with particular attention to occipital hypometabolism, dopaminergic and cholinergic deficits, and medial temporal lobe atrophy as measured by positron emission tomography, single-photon emission computed tomography, and magnetic resonance imaging.
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Affiliation(s)
- Satoshi Minoshima
- Departments of Radiology, University of Washington School of Medicine, Seattle, Washington 98195-6004, USA
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Abstract
Parkinson's disease (PD) was noted to have a familial component as early as 1880 (Leroux, 1880). More recently, the discovery of several genetic factors influencing parkinsonism has emphasized the importance of heredity in PD. The clinical spectrum of familial parkinsonism is wide; it includes not only PD, but also dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), essential tremor, and other disorders. In the general population, it is likely that PD results from combined genetic and environmental factors, most of which are not yet known. The discovery of causal mutations in the gene for alpha-synuclein, parkin, and of genetic linkages to chromosomes 2p4, 4p5, and three loci on 1q6-8 have revolutionized PD research. This review focuses on recent progress in the Mendelian genetics of PD and those diseases in which parkinsonism is a prominent feature, and considers how these discoveries modify our beliefs regarding the etiology and pathogenesis of these disorders.
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Affiliation(s)
- Katrina Gwinn-Hardy
- Division of Intramural Research, Neurogenetics Laboratories, National Institute of Neurological Disease and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Ito K, Nagano-Saito A, Kato T, Arahata Y, Nakamura A, Kawasumi Y, Hatano K, Abe Y, Yamada T, Kachi T, Brooks DJ. Striatal and extrastriatal dysfunction in Parkinson's disease with dementia: a 6-[18F]fluoro-L-dopa PET study. Brain 2002; 125:1358-65. [PMID: 12023324 DOI: 10.1093/brain/awf134] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the relative differences in dopaminergic function through the whole brain in patients with Parkinson's disease without dementia (PD) and with dementia (PDD) using 6-[18F]fluoro-L-dopa (18F-dopa) PET and a voxel-by-voxel analysis. The 10 PD and 10 PDD patients were equivalently disabled, having mean scores of 3.2 +/- 0.6 and 3.2 +/- 0.7, respectively, on the Hoehn and Yahr rating scale. 18F-dopa influx constant (Ki) images of those patients and 15 normal age-matched subjects were transformed into standard stereotactic space. The significant differences between the groups (expressed in mean regional Ki values) were localized with statistical parametric mapping (SPM) on a voxel-by-voxel basis. Compared with the normal group, SPM localized declines of the 18F-dopa Ki bilaterally in the putamen, the right caudate nucleus and the left ventral midbrain for the PD group (P < 0.01, corrected). Compared with the normal group, the PDD group showed reduced 18F-dopa Ki bilaterally in the striatum, midbrain and anterior cingulate area (P < 0.01, corrected). A relative difference in 18F-dopa uptake between PD and PDD was the bilateral decline in the anterior cingulate area and ventral striatum and in the right caudate nucleus in the PDD group (P < 0.001, corrected). Accordingly, we conclude that dementia in PD is associated with impaired mesolimbic and caudate dopaminergic function.
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Affiliation(s)
- Kengo Ito
- Department of Biofunctional Research, National Institute for Longevity Sciences, Obu, Japan.
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16
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Zhang Y, Dawson VL, Dawson TM. Oxidative stress and genetics in the pathogenesis of Parkinson's disease. Neurobiol Dis 2000; 7:240-50. [PMID: 10964596 DOI: 10.1006/nbdi.2000.0319] [Citation(s) in RCA: 326] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Parkinson's Disease (PD) is the second most common chronic neurodegenerative disease characterized by the progressive loss of dopamine neurons, leading to rigidity, slowness of movement, rest tremor, gait disturbances, and imbalance. Although there is effective symptomatic treatment for PD, there is no proven preventative or regenerative therapy. The etiology of this disorder remains unknown. Recent genetic studies have identified mutations in alpha-synuclein as a rare cause of autosomal dominant familial PD and mutations in parkin as a cause of autosomal recessive familial PD. The more common sporadic form of PD is thought to be due to oxidative stress and derangements in mitochondrial complex I activity. Understanding the mechanism by which familial linked mutations and oxidative stress cause PD has tremendous potential for unraveling the mechanisms of dopamine cell death in PD. In this article, we review recent advances in the understanding of the role of genetics and oxidative stress in the pathogenesis of PD.
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Affiliation(s)
- Y Zhang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287, USA
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Dujardin K, Duhamel A, Becquet E, Grunberg C, Defebvre L, Destee A. Neuropsychological abnormalities in first degree relatives of patients with familial Parkinson's disease. J Neurol Neurosurg Psychiatry 1999; 67:323-8. [PMID: 10449554 PMCID: PMC1736525 DOI: 10.1136/jnnp.67.3.323] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the cognitive profile of first degree relatives of patients with familial Parkinson's disease to determine whether these subjects presented signs of neuropsychological dysfunction compared with healthy controls. Results of recent genetic and neuroimaging studies suggest a genetic contribution to the aetiology of Parkinson's disease and underline the interest in identifying preclinical signs of the disease. METHODS A battery of tests evaluating executive function was administered to 41 first degree relatives of patients with well documented familial Parkinson's disease and 39 healthy controls. A factorial discriminant analysis allowed isolation of a subgroup of 15 first degree relatives who could be considered as impaired compared with the healthy controls. Among these 15 "deviant" relatives, nine performed globally worse than the control subjects on all tasks. The six other subjects had mean or even high scores on all task variables, except on those highly correlated with the discriminant score of the factorial discriminant analysis. RESULTS AND CONCLUSION Among the first degree relatives of patients with familial Parkinson's disease, some manifested executive dysfunction comparable with that typically associated with the disease. Such impairment could represent a preclinical form of Parkinson's disease.
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Affiliation(s)
- K Dujardin
- CHRU de Lille, Clinique Neurologique, Neurologie A, Hôpital R. Salengro, 59037 Lille Cedex, France.
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Foley P, Riederer P. Pathogenesis and preclinical course of Parkinson's disease. JOURNAL OF NEURAL TRANSMISSION. SUPPLEMENTUM 1999; 56:31-74. [PMID: 10370902 DOI: 10.1007/978-3-7091-6360-3_2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Idiopathic parkinsonism (IP) is defined by its classic symptomology, its responsiveness to therapies which elevate dopamine levels, and by the failure to identify a specific etiological factor. The progressive and irreversible degeneration of dopaminergic neurons projecting from the substantia nigra pars compacta (SNc) to the striatum and the presence of SNc Lewy bodies are regarded as the essential pathological bases of IP, but neither the initiator(s) nor the nature of the degeneration have been determined, nor its relationship with degenerative changes in other parts of the IP brain. This paper discusses the various hypotheses that have been proposed to explain these phenomena, arguing that IP be regarded as a multisystem disorder, both at the level of individual neurons and at the whole brain level. It is probable that IP is the result of a multifactorial process, and that a cascade of interacting and overlapping biochemical mechanisms determine the course of the disease.
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Affiliation(s)
- P Foley
- Department of Psychiatry, University of Würzburg, Federal Republic of Germany
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Ito K, Morrish PK, Rakshi JS, Uema T, Ashburner J, Bailey DL, Friston KJ, Brooks DJ. Statistical parametric mapping with 18F-dopa PET shows bilaterally reduced striatal and nigral dopaminergic function in early Parkinson's disease. J Neurol Neurosurg Psychiatry 1999; 66:754-8. [PMID: 10329749 PMCID: PMC1736402 DOI: 10.1136/jnnp.66.6.754] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To apply statistical parametric mapping to 18F-dopa PET data sets, to examine the regional distribution of changes in dopaminergic metabolism in early asymmetric Parkinson's disease. METHODS Thirteen normal volunteers (age 57.7 (SD 16.5) years; four women, nine men ) and six patients (age 50.3 (SD 13.5) years; three women, three men) with asymmetric (right sided) Parkinson's disease were studied. Images from each dynamic dopa PET dataset were aligned and parametric images of 18F-dopa influx (Ki) were created for each subject. The Ki images were transformed into standard stereotactic space. The Ki values of the caudate and putamen on spatially normalised images were compared with the Ki values before normalisation. The application of statistical parametric mapping (SPM) allowed statistical comparison of regional Ki values on a voxel by voxel basis between healthy volunteers and patients with Parkinson's disease. RESULTS There was a strong correlation between the Ki values before and after spatial normalisation (r=0.898, p=0.0001). Significant decreases in the Ki values were found for the Parkinson's desease group throughout the entire left putamen (p< 0.001) and focally in the dorsal right putamen (p<0.001). Decreased Ki values were also shown bilaterally in the substantia nigra (p< 0.01). CONCLUSION Using (SPM) and 18F-dopa PET, reductions in both striatal and nigral brain dopaminergic function could be demonstrated in early Parkinson's disease.
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Affiliation(s)
- K Ito
- MRC Cyclotron Unit, Hammersmith Hospital, London, UK.
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Reed BR, Jagust WJ. Opening a window on cerebral cholinergic function: PET imaging of acetylcholinesterase. Neurology 1999; 52:680-2. [PMID: 10078708 DOI: 10.1212/wnl.52.4.680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Though effective symptomatic therapies for Parkinson's disease exist, currently no treatment is proven to slow the progression of the underlying disease. Our growing understanding of the mechanisms of neuronal models, however, offers hope that neuroprotective strategies will soon be a standard part of the treatment of PD. Current approaches to the development of neuroprotective strategies are based on the hypothesized roles of oxidative stress and excitotoxicity in the degenerative process. In this article, we review evidence in support of these hypotheses as well as attempts to achieve neuroprotection in PD based on these and other mechanisms.
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Affiliation(s)
- D K Simon
- Neurology Service, Massachusetts General Hospital, Boston, USA
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Schapira AH. Mitochondrial involvement in Parkinson's disease, Huntington's disease, hereditary spastic paraplegia and Friedreich's ataxia. BIOCHIMICA ET BIOPHYSICA ACTA 1999; 1410:159-70. [PMID: 10076024 DOI: 10.1016/s0005-2728(98)00164-9] [Citation(s) in RCA: 236] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Respiratory chain dysfunction has been identified in several neurodegenerative disorders. In Friedreich's ataxia (FA) and Huntington's disease (HD), where the respective mutations are in nuclear genes encoding non-respiratory chain mitochondrial proteins, the defects in oxidative phosphorylation are clearly secondary. In Parkinson's disease (PD) the situation is less clear, with some evidence for a primary role of mitochondrial DNA in at least a proportion of patients. The pattern of the respiratory chain defect may provide some clue to its cause; in PD there appears to be a selective complex I deficiency; in HD and FA the deficiencies are most severe in complex II/III with a less severe defect in complex IV. Aconitase activity in HD and FA is severely decreased in brain and muscle, respectively, but appears to be normal in PD brain. Free radical generation is thought to be of importance in both HD and FA, via excitotoxicity in HD and abnormal iron handling in FA. The oxidative damage observed in PD may be secondary to the mitochondrial defect. Whatever the cause(s) and sequence of events, respiratory chain deficiencies appear to play an important role in the pathogenesis of neurodegeneration. The mitochondrial abnormalities induced may converge on the function of the mitochondrion in apoptosis. This mode of cell death is thought to play an important role in neurodegenerative diseases and it is tempting to speculate that the observed mitochondrial defects in PD, HD and FA result directly in apoptotic cell death, or in the lowering of a cell's threshold to undergo apoptosis. Clarifying the role of mitochondria in pathogenesis may provide opportunities for the development of treatments designed to reverse or prevent neurodegeneration.
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Affiliation(s)
- A H Schapira
- University Department of Clinical Neurosciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF,
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23
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Abstract
A genetic contribution to the etiology of Parkinson's disease (PD) is now well established, based on the demonstration of a familial aggregation of the disease as demonstrated by several case control and twin studies, and on the description of large multigenerational families, in whom PD is inherited in a Mendelian fashion. In a few families with autosomal dominant inheritance and typical Lewy-body pathology, a gene locus has been mapped to the long arm of chromosome 4, and mutations have been identified in the gene for alpha-synuclein. A gene causing autosomal recessive parkinsonism of juvenile onset has been mapped to chromosome 6, and the causative gene has been identified and named Parkin. This form of parkinsonism differs pathologically from the sporadic disease, as no Lewy bodies are found in the substantia nigra. A third locus, again in families with dominant inheritance, typical Lewy-body pathology and late onset, has been mapped to chromosome 2pl3. At present, there is no evidence that any of these genes for familial Parkinsonian syndromes have a direct role in the etiology of the common sporadic form of PD. However, the elucidation of the molecular sequence of events leading to nigral degeneration in these inherited cases is likely to shed light on the molecular pathogenesis of this common neurodegenerative disorder.
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Affiliation(s)
- T Gasser
- Neurologische Klinik und Poliklinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
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Affiliation(s)
- O Bandmann
- University Department of Clinical Neurology, Institute of Neurology, Queen Square, London, UK
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25
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Newberg AB, Alavi A. Changes in the central nervous system during long-duration space flight: implications for neuro-imaging. ADVANCES IN SPACE RESEARCH : THE OFFICIAL JOURNAL OF THE COMMITTEE ON SPACE RESEARCH (COSPAR) 1998; 22:185-196. [PMID: 11541396 DOI: 10.1016/s0273-1177(98)80010-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of this paper is to review the potential functional and morphological effects of long duration space flight on the human central nervous system (CNS) and how current neuroimaging techniques may be utilized to study these effects. It must be determined if there will be any detrimental changes to the CNS from long term exposure to the space environment if human beings are to plan interplanetary missions or establish permanent space habitats. Research to date has focused primarily on the short term changes in the CNS as the result of space flight. The space environment has many factors such as weightlessness, electromagnetic fields, and radiation, that may impact upon the function and structure of the CNS. CNS changes known to occur during and after long term space flight include neurovestibular disturbances, cephalic fluid shifts, alterations in sensory perception, changes in proprioception, psychological disturbances, and cognitive changes. Animal studies have shown altered plasticity of the neural cytoarchitecture, decreased neuronal metabolism in the hypothalamus, and changes in neurotransmitter concentrations. Recent progress in the ability to study brain morphology, cerebral metabolism, and neurochemistry in vivo in the human brain would provide ample opportunity to investigate many of the changes that occur in the CNS as a result of space flight. These methods include positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI).
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Affiliation(s)
- A B Newberg
- Division of Nuclear Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
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Scott WK, Staijich JM, Yamaoka LH, Speer MC, Vance JM, Roses AD, Pericak-Vance MA. Genetic complexity and Parkinson's disease. Deane Laboratory Parkinson Disease Research Group. Science 1997; 277:387-8; author reply 389. [PMID: 9518366 DOI: 10.1126/science.277.5324.387] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Walker Z, Costa DC, Janssen AG, Walker RW, Livingstone G, Katona CL. Dementia with lewy bodies: a study of post-synaptic dopaminergic receptors with iodine-123 iodobenzamide single-photon emission tomography. EUROPEAN JOURNAL OF NUCLEAR MEDICINE 1997; 24:609-14. [PMID: 9169566 DOI: 10.1007/bf00841397] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Dementia with Lewy bodies (DLB) can at present only be diagnosed with certainty by neuropathological examination. Diagnosis during life remains at best probable, based on the presence of symptoms known from autopsy studies to be frequently associated with DLB. The greatest practical clinical problem lies in distinguishing DLB and Alzheimer's disease (AD). In DLB there is a considerable degeneration of nigral neurones with depletion of striatal dopamine. In contrast, AD is not associated with significant changes in dopamine metabolism. Iodine-123 iodobenzamide single-photon emission tomography (IBZM-SPET) measures post-synaptic dopamine D2 neuroreceptor availability in the corpus striatum, but is nevertheless a method for assessing the integrity of the nigrostriatal dopaminergic pathway. Sixteen clinically diagnosed DLB patients, 15 normal controls and 13 AD patients underwent IBZM-SPET. All subjects were scanned 1.5-2 h after intravenous injection of 185 MBq of 123I-IBZM. Circular regions of interest were employed to calculate radioactivity ratios in each hemisphere as follows: caudate nucleus/frontal cortex, putamen/frontal cortex and caudate nucleus/putamen. The DLB patients had significantly lower left caudate/putamen ratios (95% confidence intervals: DLB 0.893-0.965, AD 0.972-1.175, controls 1.031-1.168) than either controls or AD patients, and significantly lower right caudate/putamen ratios (95% confidence intervals: DLB 0.926-1.019, AD 0.954-1.103, controls 1. 027-1.144) than controls. Our data suggest that patients with DLB diagnosed by clinical criteria have changes in striatal post-synaptic D2 receptors. This may be of value in distinguishing DLB from AD during life.
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Affiliation(s)
- Z Walker
- University College London Medical School, London and Princess Alexandra Hospital, Harlow, Essex, UK
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Hagan JJ, Middlemiss DN, Sharpe PC, Poste GH. Parkinson's disease: prospects for improved drug therapy. Trends Pharmacol Sci 1997; 18:156-63. [PMID: 9184476 DOI: 10.1016/s0165-6147(97)01050-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
L-Dopa has long been the mainstay of therapy for Parkinson's disease but its long-term shortcomings, principally uncoordinated, spasmodic or irregular movements (dyskinesias) and fluctuating control of motor symptoms (on/off fluctuations), are well documented. The postulated neuroprotective properties of L-deprenyl, often used as an adjunct to L-dopa, are under scrutiny and doubts have also been raised regarding its safety. Alternative therapeutic approaches are clearly needed. In this review, Jim Hagan, Derek Middlemiss, Paul Sharpe and George Poste outline some new approaches to treatment, with an emphasis on novel, selective dopamine receptor agonists. In addition, Parkinson's disease is commonly thought to be caused by the neurotoxic effects of an unidentified agent but recent data indicate a greater genetic component than previously recognized. Developments in the genetics of Parkinson's disease may provide the key to the next generation of therapeutics.
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Affiliation(s)
- J J Hagan
- SmithKline Beecham Pharmaceuticals, Harlow, UK
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Piccini P, Morrish PK, Turjanski N, Sawle GV, Burn DJ, Weeks RA, Mark MH, Maraganore DM, Lees AJ, Brooks DJ. Dopaminergic function in familial Parkinson's disease: a clinical and 18F-dopa positron emission tomography study. Ann Neurol 1997; 41:222-9. [PMID: 9029071 DOI: 10.1002/ana.410410213] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There is increasing evidence for familial aggregation in Parkinson's disease (PD). It is possible that some asymptomatic relatives of PD patients have subclinical nigral Lewy body pathology and their identification could help determine the true prevalence of the disease. We used 18F-dopa positron emission tomography to investigate nigrostriatal dopaminergic terminal function in asymptomatic members of 7 unrelated kindreds in which at least 2 members had parkinsonism. Eight (25%) of the 32 asymptomatic relatives showed abnormal putamen 18F-dopa uptake (2.5 standard deviations below the normal mean). When discriminant function analysis was applied, all of these 8 subjects plus another 3 were classified with high probability as having PD. On neurological examination, 5 of the 32 relatives scanned had an isolated mild postural tremor and 2 of these 5 had reduced putamen uptake. Our findings provide further support for a role of inheritance in the etiology of PD and suggest that the penetrance for nigrostriatal dopaminergic dysfunction in familial clusters of PD is higher than the prevalence of clinical parkinsonism reported in epidemiological surveys.
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Affiliation(s)
- P Piccini
- Medical Research Council Cyclotron Unit, Hammersmith Hospital, London, United Kingdom
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Yost Y, Conway T. Synthesis and preliminary evaluation of (S)-(2-[18F]fluoro-4,5-dihydroxyphenyl)-2-methyl L-alanine, (S)-[18F]-FMEDOPA, a potentially improved imaging agent for the presynaptic dopaminergic nervous system. Nucl Med Biol 1996; 23:857-65. [PMID: 8971852 DOI: 10.1016/s0969-8051(96)00056-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The synthesis and preliminary rat biodistribution studies of (S)-(2-[18F]fluoro-4,5-dihydroxyphenyl)-2-methyl L-alanine, (S)-[18F]-FMEDOPA, a potentially improved imaging agent for the presynaptic dopaminergic nervous system, are reported. (S)-[18F]-FMEDOPA produces a higher striatum-to-cerebellum (S/C) radioactivity ratio than the currently used PET imaging agent, (S)-[18F]-FDOPA, does at 180 min after administration.
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Affiliation(s)
- Y Yost
- PET Imaging Service, Veterans Administration Medical Center, Minneapolis, MN 55417, USA
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Ernst M, Zametkin AJ, Matochik JA, Pascualvaca D, Jons PH, Hardy K, Hankerson JG, Doudet DJ, Cohen RM. Presynaptic dopaminergic deficits in Lesch-Nyhan disease. N Engl J Med 1996; 334:1568-72. [PMID: 8628337 DOI: 10.1056/nejm199606133342403] [Citation(s) in RCA: 146] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Lesch-Nyhan disease is a rare, devastating, X-linked recessive disorder of purine synthesis. Patients present with hyperuricemia, choreoathetosis, dystonia, and aggressive and self-injurious behavior. Although the genetic and biochemical abnormalities have been identified, the causes of the neuropsychiatric syndrome remain unclear. METHODS We used positron-emission tomography to measure presynaptic accumulation of fluorodopa F 18 tracer in the dopaminergic regions of the brains of 12 patients with Lesch-Nyhan disease (age, 10 to 20 years) and 15 healthy controls (age, 12 to 23). The results were expressed as ratios of specific to nonspecific radioactive counts. A low ratio indicates decreased dopa decarboxylase activity and dopamine storage. RESULTS The fluorodopa F 18 ratio was significantly lower in the putamen (31 percent of control values), caudate nucleus (39 percent), frontal cortex (44 percent), and ventral tegmental complex (substantia nigra and ventral tegmentum; 57 percent) in the patients with Lesch-Nyhan disease than in the controls. Uptake of the tracer was abnormally low even in the youngest patients tested, and there was no overlap in the values between patients and controls. CONCLUSIONS Patients with Lesch-Nyhan disease have abnormally few dopaminergic nerve terminals and cell bodies. The abnormality involves all dopaminergic pathways and is not restricted to the basal ganglia. These dopaminergic deficits are pervasive and appear to be developmental in origin, which suggests that they contribute to the characteristic neuropsychiatric manifestations of the disease.
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Affiliation(s)
- M Ernst
- Laboratory of Cerebral Metabolism, National Institute of Mental Health, Bethesda, MD 20892-4030, USA
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Abstract
The neurophysiological analysis of tremor has a long tradition. These attempts were directed to understand the mechanisms underlying tremor, on the one hand, and to develop tools to better diagnose the different types of tremor, on the other. Meanwhile, reasonable criteria are available to distinguish between centrally and peripherally mediated tremors. However, no generally accepted means exist to differentiate the different forms of central tremors. Frequency is a useful classifier for cerebellar tremor, rubral tremor, and orthostatic tremor. Although the highest amplitudes are found in Parkinson's disease, this parameter does not well distinguish between the different tremors. Waveform analysis of tremor is a promising tool to separate between the different tremors. Polymyography is pathognomonic for some rare forms of tremor. New approaches to classify tremors are based on positron emission tomography scanning, analysis of ballistic movement, and reflex testing. The means to separate myoclonias from tremors include EEG/EMG correlation techniques, long-latency reflexes, and polymyography. Provided these techniques are applied in the setting of careful clinical analysis of tremor syndromes, they may prove to be helpful in clinical practice.
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Affiliation(s)
- G Deuschl
- Department of Neurology, Christian-Albrechts Universität zu Kiel, Germany
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Newberg AB, Alavi A. The study of neurological disorders using positron emission tomography and single photon emission computed tomography. J Neurol Sci 1996; 135:91-108. [PMID: 8867064 DOI: 10.1016/0022-510x(95)00289-e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- A B Newberg
- Department of Radiology, University of Pennsylvania, Philadelphia 19104, USA
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Planté-Bordeneuve V, Taussig D, Thomas F, Ziégler M, Said G. A clinical and genetic study of familial cases of Parkinson's disease. J Neurol Sci 1995; 133:164-72. [PMID: 8583221 DOI: 10.1016/0022-510x(95)00190-d] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We assessed a group of patients with a family history of Parkinson's disease (PD) in order to see if they differed clinically from sporadic cases and to study their genetic characteristics. Index cases were selected on the basis of clinically typical PD, and at least one affected relative. Fourteen families including 110 first degree and 40 second degree relatives were ascertained. A total of 31 individuals (17 females and 14 males) were found to be affected. This group was compared for selected clinical parameters to 31 age matched patients with sporadic PD. No statistical difference was found between the two groups. In familial cases, both the clinical parameters studied and the course of the disease varied within and between families, as observed in sporadic cases. The genetic transmission was compatible with an autosomal dominant model. The total segregation ratio of 0.25 suggested an incomplete penetrance, which increased with age, from 0 below the age of 30 to 0.43 over the age of 70. Age at onset was earlier in children than in their parents in the 8 multigeneration kindreds studied (mean difference 26 +/- 4.6 years, p = 0.01), whereas it was identical within a generation (mean difference 4.7 +/- 5.7 years, p = 0.1). Although we cannot exclude an ascertainment bias, our results are compatible with an anticipation phenomenon, which deserves further studies for confirmation.
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Affiliation(s)
- V Planté-Bordeneuve
- Service de Neurologie, CHU de Bicêtre, Université Paris XI, Le Kremlin Bicêtre, France
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Bonifati V, Fabrizio E, Vanacore N, De Mari M, Meco G. Familial Parkinson's disease: a clinical genetic analysis. Can J Neurol Sci 1995; 22:272-9. [PMID: 8599769 DOI: 10.1017/s0317167100039469] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To study the frequency, clinical features and clinical genetics of familial Parkinson's disease (PD). METHODS Family history for PD and tremors was studied in 100 consecutive PD cases. Spouses served as controls. Clinical features were compared between personally verified familial and sporadic PD cases, from the same consecutive clinical series. Clinical genetic analysis was performed in a larger group of non-consecutive multicase PD families. RESULTS Family history for PD was positive in 24% of consecutive PD cases and in 6% of spouse controls (p < 0.001). When family history for isolated tremor is also considered, the number of positive cases rises to 43% compared with 9% in controls (p < 0.001). Nine of the consecutive cases had at least one living affected relative, for a total of 20 familial PD cases. These familial cases showed an earlier onset age when compared with sporadic ones from the same consecutive series. Within 22 non-consecutive PD families with at least two living and personally examined PD cases (total 52 PD cases), the crude segregation ratios were similar for parents and siblings and the lifetime cumulative risks approached 0.4 in siblings and tended to be comparable, but at later ages, in parents. Ancestral relatives were all unilaterally distributed. In some families, anticipation of onset age in new generations was observed. CONCLUSIONS The frequency of positive family history for PD and for PD and tremor is higher among PD cases than controls. Familial and sporadic PD only differ in onset age. The clinical genetic analyses support autosomal dominant inheritance with strongly age-related penetrance as most likely in familial PD.
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Affiliation(s)
- V Bonifati
- Department of Neurosciences, La Sapienza University, Rome, Italy
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Affiliation(s)
- A H Schapira
- Department of Clinical Neurosciences, Royal Free Hospital School of Medicine, London, UK
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Rinne JO, Burn DJ, Mathias CJ, Quinn NP, Marsden CD, Brooks DJ. Positron emission tomography studies on the dopaminergic system and striatal opioid binding in the olivopontocerebellar atrophy variant of multiple system atrophy. Ann Neurol 1995; 37:568-73. [PMID: 7755350 DOI: 10.1002/ana.410370505] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Ten patients with sporadic olivopontocerebellar atrophy and autonomic failure were studied with positron emission tomography. Subjects underwent both an [11C]diprenorphine and an [18F]fluorodopa scan. The mean caudate-occipital uptake ratio for [11C]diprenorphine was significantly reduced to 88% and the putamen-occipital uptake ratio to 85% of the control values. Individually, 4 of the 10 patients had significantly reduced opioid binding in the putamen. Mean putamen [18F]fluorodopa uptake was significantly diminished (to 71% of the control mean); individually 7 patients had significantly reduced uptake. There was a significant positive correlation between putamen-occipital uptake ratios for [11C]diprenorphine and putamen uptake of [18F]fluorodopa. Our results suggest that subclinical nigrostriatal dysfunction is present in the majority of patients with sporadic olivopontocerebellar atrophy, in accordance with it being part of the spectrum of multiple system atrophy.
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Affiliation(s)
- J O Rinne
- Medical Research Council Cyclotron Unit, Hammersmith Hospital, London, England
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Affiliation(s)
- G V Sawle
- Division of Clinical Neurology, Queens Medical Centre, Nottingham, UK
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Weeks RA, Brooks DJ. Positron emission tomography and central neurotransmitter systems in movement disorders. Fundam Clin Pharmacol 1994; 8:503-17. [PMID: 7721227 DOI: 10.1111/j.1472-8206.1994.tb00831.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This article discusses the anatomical and neurochemical structure of the basal ganglia and reviews the Positron Emission Tomographic (PET) ligands available for investigating these pathways. We discuss how clinical PET studies have improved our understanding of the neurochemical changes underlying principal movement disorders.
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Affiliation(s)
- R A Weeks
- MRC Cyclotron Unit, Hammersmith Hospital, London, UK
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Planté-Bordeneuve V, Davis MB, Maraganore DM, Marsden CD, Harding AE. Debrisoquine hydroxylase gene polymorphism in familial Parkinson's disease. J Neurol Neurosurg Psychiatry 1994; 57:911-3. [PMID: 8057112 PMCID: PMC1073072 DOI: 10.1136/jnnp.57.8.911] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Recent molecular genetic studies of the cytochrome P-450 system enzyme CYP2D6, which hydroxylates debrisoquine, have indicated an excess of mutant alleles in patients with Parkinson's disease compared with controls. This indicates that the CYP2D6 locus confers genetic susceptibility to Parkinson's disease. CYP2D6 polymorphism has been investigated in 48 patients with familial Parkinson's disease, from 22 families, and 88 of their unaffected relatives. An excess of CYP2D6 mutant alleles in patients compared with healthy relatives was found only in subjects over the age of 60 years, presumably reflecting the age related prevalence of this disease. There was no difference in distribution of genotypes, however, between sib pairs concordant or discordant for Parkinson's disease. Linkage analysis, exclusively with affected family members, yielded negative lod scores. These data indicate that the CYP2D6 locus is not the major determinant of genetic susceptibility in familial Parkinson's disease.
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Affiliation(s)
- V Planté-Bordeneuve
- University Department of Clinical Neurology (Neurogenetics and Movement Disorders Sections), Institute of Neurology, London, UK
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Holthoff VA, Vieregge P, Kessler J, Pietrzyk U, Herholz K, Bönner J, Wagner R, Wienhard K, Pawlik G, Heiss WD. Discordant twins with Parkinson's disease: positron emission tomography and early signs of impaired cognitive circuits. Ann Neurol 1994; 36:176-82. [PMID: 8053653 DOI: 10.1002/ana.410360209] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We evaluated 7 pairs of twins (2 monozygotic and 5 dizygotic) discordant for Parkinson's disease (PD), of whom the cotwins showed no signs of motor impairment on neurological examination. All subjects underwent positron emission tomographic measurements of cerebral glucose metabolism and dopaminergic, nigrostriatal function following injection of 2-[18F]fluoro-2-deoxy-D-glucose and L-6-[18F]fluorodopa ([18F]dopa), respectively, as well as testing for anterograde, verbal episodic, and semantic memory performance. Statistical analysis demonstrated significant reduction of striatal [18F]dopa uptake not only in the twin patients with PD but also in all of the cotwins, who showed significantly (p < 0.05) impaired [18F]dopa metabolism in at least one of the striatal measures including caudate, putaminal, and the rostrocaudal putaminal gradient of [18F]dopa uptake. Compared with age-matched controls, regional glucose metabolism was unchanged in all the twins. Neuropsychological testing showed significant (p < 0.05) impairment in verbal memory processing in the twin patients with PD and in 6 of the cotwins. Semantic memory skills were affected in 2 twin patients only. A significant correlation was found between scores obtained in Buschke's Selective Reminding Test and striatal [18F]dopa uptake, further substantiating the role of dopaminergic pathways in memory processing. The present study is the first to reveal not only significant disturbance of nigrostriatal dopaminergic function in verbal episodic memory that is known to be affected in PD. Larger studies with a longitudinal design will be necessary to answer the question of whether cognitive changes found in the cotwin group are signs of incipient PD.
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Affiliation(s)
- V A Holthoff
- Max-Planck-Institut für neurologische Forschung, Cologne, Germany
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Planté-Bordeneuve V, Davis MB, Maraganore DM, Marsden CD, Harding AE. Tyrosine hydroxylase polymorphism in familial and sporadic Parkinson's disease. Mov Disord 1994; 9:337-9. [PMID: 7913740 DOI: 10.1002/mds.870090312] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Tyrosine hydroxylase (TH) is a theoretical candidate gene determining susceptibility to Parkinson's disease (PD), and an association between one allele of a polymorphism at the TH locus and sporadic PD has been reported. We investigated TH polymorphism in 44 patients with sporadic PD, 48 patients with familial PD and 89 of their unaffected relatives, and 50 control subjects. No evidence of allelic association was detected in either familial or sporadic PD, and linkage analysis excluded the TH locus, or a closely linked gene, as a major determinant of familial PD.
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Affiliation(s)
- V Planté-Bordeneuve
- University Department of Clinical Neurology, Institute of Neurology, London, England
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Sawle GV. The detection of preclinical Parkinson's disease: what is the role of positron emission tomography? Mov Disord 1993; 8:271-7. [PMID: 8341290 DOI: 10.1002/mds.870080304] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
On clinical criteria alone, the diagnosis of early Parkinson's disease can be difficult and, by definition, the prospective recognition of preclinical Parkinson's disease is impossible. Positron emission tomography (PET) using [18F]dopa as tracer has been proposed as a means of identifying patients with preclinical disease. The number of subjects detected to date has been few; most have been identified by serendipity or during the course of family studies. This review examines the significance of a single abnormal scan in an apparently healthy subject in terms of the relationship between normal and abnormal values and the time course of the disease.
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Affiliation(s)
- G V Sawle
- Clinical Sciences Section, Hammersmith Hospital, London, England
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Abstract
Parkinsonism is a feature not only of Parkinson's disease but also of many other diseases affecting basal ganglia function. Functional imaging (PET and SPECT) can demonstrate the various resting patterns of disruption of regional cerebral blood flow, metabolism, and neuropharmacology associated with different parkinsonian disorders. 18F-dopa PET also has the potential to detect subclinical dysfunction of dopaminergic terminals in at-risk subjects. Finally, functional imaging can help us understand the nature of the networks involved in performing different motor tasks, and can reveal how these networks malfunction in the presence of bradykinesia or parkinsonian tremor.
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Affiliation(s)
- D J Brooks
- MRC Cyclotron Unit, Hammersmith Hospital, London, UK
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