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Pérez-Carbonell L, Iranzo A. REM sleep and neurodegeneration. J Sleep Res 2024:e14263. [PMID: 38867555 DOI: 10.1111/jsr.14263] [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: 03/17/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
Several brainstem, subcortical and cortical areas are involved in the generation of rapid eye movement (REM) sleep. The alteration of these structures as a result of a neurodegenerative process may therefore lead to REM sleep anomalies. REM sleep behaviour disorder is associated with nightmares, dream-enacting behaviours and increased electromyographic activity in REM sleep. Its isolated form is a harbinger of synucleinopathies such as Parkinson's disease or dementia with Lewy bodies, and neuroprotective interventions are advocated. This link might also be present in patients taking antidepressants, with post-traumatic stress disorder, or with a history of repeated traumatic head injury. REM sleep likely contributes to normal memory processes. Its alteration has also been proposed to be part of the neuropathological changes occurring in Alzheimer's disease.
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Affiliation(s)
- Laura Pérez-Carbonell
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK
| | - Alex Iranzo
- Neurology Service, Sleep Disorders Centre, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED, University of Barcelona, Barcelona, Spain
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2
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Heinzel S, Jureczek J, Kainulainen V, Nieminen AI, Suenkel U, von Thaler AK, Kaleta C, Eschweiler GW, Brockmann K, Aho VTE, Auvinen P, Maetzler W, Berg D, Scheperjans F. Elevated fecal calprotectin is associated with gut microbial dysbiosis, altered serum markers and clinical outcomes in older individuals. Sci Rep 2024; 14:13513. [PMID: 38866914 PMCID: PMC11169261 DOI: 10.1038/s41598-024-63893-0] [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: 03/08/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024] Open
Abstract
Fecal calprotectin is an established marker of gut inflammation in inflammatory bowel disease (IBD). Elevated levels of fecal calprotectin as well as gut microbial dysbiosis have also been observed in other clinical conditions. However, systemic and multi-omics alterations linked to elevated fecal calprotectin in older individuals remain unclear. This study comprehensively investigated the relationship between fecal calprotectin levels, gut microbiome composition, serum inflammation and targeted metabolomics markers, and relevant lifestyle and medical data in a large sample of older individuals (n = 735; mean age ± SD: 68.7 ± 6.3) from the TREND cohort study. Low (0-50 μg/g; n = 602), moderate (> 50-100 μg/g; n = 64) and high (> 100 μg/g; n = 62) fecal calprotectin groups were stratified. Several pro-inflammatory gut microbial genera were significantly increased and short-chain fatty acid producing genera were decreased in high vs. low calprotectin groups. In serum, IL-17C, CCL19 and the toxic metabolite indoxyl sulfate were increased in high vs. low fecal calprotectin groups. These changes were partially mediated by the gut microbiota. Moreover, the high fecal calprotectin group showed increased BMI and a higher disease prevalence of heart attack and obesity. Our findings contribute to the understanding of fecal calprotectin as a marker of gut dysbiosis and its broader systemic and clinical implications in older individuals.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurology, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany.
- Institute of Medical Informatics and Statistics, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany.
- Department of Neurology, University Medical Centre Schleswig-Holstein, Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Jenna Jureczek
- Department of Neurology, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany
- Institute of Medical Informatics and Statistics, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany
| | - Veera Kainulainen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Anni I Nieminen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Ulrike Suenkel
- Department of Psychiatry and Psychotherapy, German Center of Mental Health, Tübingen University Hospital, Tübingen, Germany
| | | | - Christoph Kaleta
- Institute of Experimental Medicine, Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein (UKSH), Kiel, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, German Center of Mental Health, Tübingen University Hospital, Tübingen, Germany
- Geriatric Center, University Hospital Tübingen, Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Velma T E Aho
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
| | - Petri Auvinen
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Walter Maetzler
- Department of Neurology, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany
| | - Daniela Berg
- Department of Neurology, University Medical Centre Schleswig-Holstein (UKSH), Kiel, Germany
| | - Filip Scheperjans
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
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Rees RN, Noyce AJ, Schrag AE. Identification of Prodromal Parkinson Disease: We May Be Able to But Should We? Neurology 2024; 102:e209394. [PMID: 38759130 PMCID: PMC11175649 DOI: 10.1212/wnl.0000000000209394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/20/2024] [Indexed: 05/19/2024] Open
Abstract
Parkinson disease (PD) remains a progressive and incurable disease. Research over the past decade provides strong evidence of a detectible phase before the clinical diagnosis, known as the prodromal phase of PD (pPD). In this article, we review the debate about disclosure of risk of progression to PD and related disorders to individuals through the perspectives of the pillars of medical ethics: beneficence, nonmaleficence, autonomy, and justice. There is evidence that lifestyle modification may have positive effects on onset and progression of PD, providing justification of potential benefit. From a societal perspective, a diagnosis of pPD could allow targeted recruitment to disease-modifying trials. Regarding nonmaleficence, direct evidence that catastrophic reactions are scarce is largely derived from studies of monogenic conditions, which may not be generalizable. Diagnosis of PD can be traumatic, and appropriate communication and evaluation of circumstances to weigh up disclosure is crucial. Future research should therefore examine the potential harms of early and of false-positive diagnoses and specifically examine these matters in diverse populations. Autonomy balances the right to know and the right not to know, so an individualized patient-centered approach and shared decision-making is essential, acknowledging that knowledge of being in the prodromal phase could prolong autonomy in the longer term. Distributive justice brings focus toward health care and related planning at the individual and societal level and affects the search for disease modification in PD. We must acknowledge that waiting for established disease states is likely to be too little, too late and results in failures of expensive trials and wasted participant and researcher effort. Ultimately, clinicians must arrive at a decision with the patient that solicits and integrates patients' goals, taking into account their individual life circumstances, perspectives, and philosophies, recognizing that one size cannot fit all.
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Affiliation(s)
- Richard N Rees
- From the Department of Clinical and Movement Neuroscience (R.N.R., A.E.S.), UCL Queen Square Institute of Neurology, University College London; Centre for Preventive Neurology (A.J.N.) and Wolfson Institute of Population Health (A.J.N.), Queen Mary University of London; and Department of Neurology (R.N.R.), St George's University NHS Foundation Trust, London, UK
| | - Alastair J Noyce
- From the Department of Clinical and Movement Neuroscience (R.N.R., A.E.S.), UCL Queen Square Institute of Neurology, University College London; Centre for Preventive Neurology (A.J.N.) and Wolfson Institute of Population Health (A.J.N.), Queen Mary University of London; and Department of Neurology (R.N.R.), St George's University NHS Foundation Trust, London, UK
| | - Anette E Schrag
- From the Department of Clinical and Movement Neuroscience (R.N.R., A.E.S.), UCL Queen Square Institute of Neurology, University College London; Centre for Preventive Neurology (A.J.N.) and Wolfson Institute of Population Health (A.J.N.), Queen Mary University of London; and Department of Neurology (R.N.R.), St George's University NHS Foundation Trust, London, UK
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Wang Q, Bian J, Sun Y, Shi Y, Zhao Z, Zhao H. Motor dysfunction in Parkinson's patients: depression differences in a latent growth model. Front Aging Neurosci 2024; 16:1393887. [PMID: 38887609 PMCID: PMC11181910 DOI: 10.3389/fnagi.2024.1393887] [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: 02/29/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024] Open
Abstract
Objective This study aims to utilize latent growth model (LGM) to explore the developmental trajectory of motor dysfunction in Parkinson's disease (PD) patients and investigate the relationship between depression and motor dysfunction. Methods Four-year follow-up data from 389 PD patients were collected through the Parkinson's Progression Marker Initiative (PPMI). Firstly, a univariate LGM was employed to examine the developmental trajectory of motor dysfunction in PD patients. Subsequently, depression levels were introduced as covariates into the model, and depression was further treated as a parallel growth latent variable to study the longitudinal relationship between motor dysfunction and depression. Results In the trajectory analysis of motor dysfunction, the fit indices for the quadratic growth LGM model were χ2 = 7.419, df = 6, CFI = 0.998, TLI = 0.997, SRMR = 0.019, and RMSEA = 0.025, indicating that the growth trend of motor dysfunction follows a quadratic curve rather than a simple linear pattern. Introducing depression symptoms as time-varying covariates to explore their effect on motor dysfunction revealed significant positive correlations (β = 0.383, p = 0.026; β = 0.675, p < 0.001; β = 0.385, p = 0.019; β = 0.415, p = 0.014; β = 0.614, p = 0.003), suggesting that as depression levels increase, motor dysfunction scores also increase. Treating depression as a parallel developmental process in the LGM, the regression coefficients for depression intercept on motor dysfunction intercept, depression slope on motor dysfunction slope, and depression quadratic factor on motor dysfunction quadratic factor were 0.448 (p = 0.046), 1.316 (p = 0.003), and 1.496 (p = 0.038), respectively. These significant regression coefficients indicate a complex relationship between depression and motor dysfunction, involving not only initial level associations but also growth trends over time and possible quadratic effects. Conclusion This study indicates a quadratic growth trajectory for motor dysfunction in PD, suggesting a continuous increase in severity with a gradual deceleration in growth rate. The relationship between depression and motor dysfunction is complex, involving initial associations, evolving trends over time, and potential quadratic effects. Exacerbation of depressive symptoms may coincide with motor function deterioration.
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Affiliation(s)
- QiuShuang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jing Bian
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yi Sun
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - YaoZhou Shi
- Department of Orthopedics, First Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - ZiXuan Zhao
- Department of Public Administration, School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - HuaShuo Zhao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Kmiecik MJ, Micheletti S, Coker D, Heilbron K, Shi J, Stagaman K, Filshtein Sonmez T, Fontanillas P, Shringarpure S, Wetzel M, Rowbotham HM, Cannon P, Shelton JF, Hinds DA, Tung JY, Holmes MV, Aslibekyan S, Norcliffe-Kaufmann L. Genetic analysis and natural history of Parkinson's disease due to the LRRK2 G2019S variant. Brain 2024; 147:1996-2008. [PMID: 38804604 PMCID: PMC11146432 DOI: 10.1093/brain/awae073] [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: 10/11/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 05/29/2024] Open
Abstract
The LRRK2 G2019S variant is the most common cause of monogenic Parkinson's disease (PD); however, questions remain regarding the penetrance, clinical phenotype and natural history of carriers. We performed a 3.5-year prospective longitudinal online study in a large number of 1286 genotyped LRRK2 G2019S carriers and 109 154 controls, with and without PD, recruited from the 23andMe Research Cohort. We collected self-reported motor and non-motor symptoms every 6 months, as well as demographics, family histories and environmental risk factors. Incident cases of PD (phenoconverters) were identified at follow-up. We determined lifetime risk of PD using accelerated failure time modelling and explored the impact of polygenic risk on penetrance. We also computed the genetic ancestry of all LRRK2 G2019S carriers in the 23andMe database and identified regions of the world where carrier frequencies are highest. We observed that despite a 1 year longer disease duration (P = 0.016), LRRK2 G2019S carriers with PD had similar burden of motor symptoms, yet significantly fewer non-motor symptoms including cognitive difficulties, REM sleep behaviour disorder (RBD) and hyposmia (all P-values ≤ 0.0002). The cumulative incidence of PD in G2019S carriers by age 80 was 49%. G2019S carriers had a 10-fold risk of developing PD versus non-carriers. This rose to a 27-fold risk in G2019S carriers with a PD polygenic risk score in the top 25% versus non-carriers in the bottom 25%. In addition to identifying ancient founding events in people of North African and Ashkenazi descent, our genetic ancestry analyses infer that the G2019S variant was later introduced to Spanish colonial territories in the Americas. Our results suggest LRRK2 G2019S PD appears to be a slowly progressive predominantly motor subtype of PD with a lower prevalence of hyposmia, RBD and cognitive impairment. This suggests that the current prodromal criteria, which are based on idiopathic PD, may lack sensitivity to detect the early phases of LRRK2 PD in G2019S carriers. We show that polygenic burden may contribute to the development of PD in the LRRK2 G2019S carrier population. Collectively, the results should help support screening programmes and candidate enrichment strategies for upcoming trials of LRRK2 inhibitors in early-stage disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Paul Cannon
- 23andMe, Inc., Research, Sunnyvale, CA 94086, USA
| | | | | | - Joyce Y Tung
- 23andMe, Inc., Research, Sunnyvale, CA 94086, USA
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Thaler A, Livne V, Rubinstein E, Omer N, Faust-Socher A, Cohen B, Giladi N, Shirvan JC, Cedarbaum JM, Gana-Weisz M, Goldstein O, Orr-Urtreger A, Alcalay RN, Mirelman A. Mild cognitive impairment among LRRK2 and GBA1 patients with Parkinson's disease. Parkinsonism Relat Disord 2024; 123:106970. [PMID: 38691978 DOI: 10.1016/j.parkreldis.2024.106970] [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: 09/22/2023] [Revised: 03/18/2024] [Accepted: 04/07/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is common in Parkinson's disease (PD). We aimed to assess the incidence of MCI among patients with PD, carriers of mutations in LRRK2 and GBA1 genes, based on the movement disorder society (MDS) criteria for the diagnosis of MCI in early-stage PD. METHODS Patients with PD were included if they scored ≤2 on the Hoehn and Yahr and ≤6 years since motor symptom onset. A group of age and gender matched healthy adults served as controls. A neuropsychological cognitive battery was used covering five cognitive domains (executive functions, working memory, memory, visuospatial and language). MCI was explored while applying two methods (level I and II). Frequency of MCI was assessed in comparison between groups. RESULTS 70 patients with idiopathic PD (iPD) (68 % males), 42 patients with LRRK2-PD (61 % males), 83 patients with GBA1-PD (63 % males) and 132 age and gender matched controls (61 % males), participated in this study. PD groups were similar in clinical characteristics. Level I criteria were positive in 57.5 % of iPD, 43 % of LRRK2-PD and 63.4 % of the GBA1-PD (p = 0.071). Level II criteria was met by 39 % of iPD, 14 % LRRK2-PD and 41 % of GBA1-PD (p < 0.001), when using a 2 standard-deviation (SD) threshold. GBA1-PD and iPD showed impairments on multiple domains even in the more conservative 2 SD, reflecting MCI. CONCLUSIONS The majority of our PD cohort was classified as MCI when assessed with strict criteria. GBA1-PD and iPD showed a more widespread pattern of MCI compared with LRRK2-PD.
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Affiliation(s)
- Avner Thaler
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel; Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Israel; Sagol School of Neuroscience, Tel-Aviv University, Israel.
| | - Vered Livne
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel
| | | | - Nurit Omer
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel; Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Israel
| | - Achinoam Faust-Socher
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel
| | - Batsheva Cohen
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Israel
| | - Nir Giladi
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel; Sagol School of Neuroscience, Tel-Aviv University, Israel
| | | | | | - Mali Gana-Weisz
- Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Orly Goldstein
- Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Avi Orr-Urtreger
- Faculty of Medicine, Tel-Aviv University, Israel; Sagol School of Neuroscience, Tel-Aviv University, Israel; Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Roy N Alcalay
- Faculty of Medicine, Tel-Aviv University, Israel; Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Israel; Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Israel; Genomic Research Laboratory for Neurodegeneration, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Anat Mirelman
- Faculty of Medicine, Tel-Aviv University, Israel; Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Israel; Sagol School of Neuroscience, Tel-Aviv University, Israel
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Wanyi Z, Jiao Y, Wen H, Bin X, Xuefei W, Lan J, Liuyin Z. Bidirectional communication of the gut-brain axis: new findings in Parkinson's disease and inflammatory bowel disease. Front Neurol 2024; 15:1407241. [PMID: 38854967 PMCID: PMC11157024 DOI: 10.3389/fneur.2024.1407241] [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: 03/26/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Parkinson's disease (PD) and inflammatory bowel disease (IBD) are the two chronic inflammatory diseases that are increasingly affecting millions of people worldwide, posing a major challenge to public health. PD and IBD show similarities in epidemiology, genetics, immune response, and gut microbiota. Here, we review the pathophysiology of these two diseases, including genetic factors, immune system imbalance, changes in gut microbial composition, and the effects of microbial metabolites (especially short-chain fatty acids). We elaborate on the gut-brain axis, focusing on role of gut microbiota in the pathogenesis of PD and IBD. In addition, we discuss several therapeutic strategies, including drug therapy, fecal microbiota transplantation, and probiotic supplementation, and their potential benefits in regulating intestinal microecology and relieving disease symptoms. Our analysis will provide a new understanding and scientific basis for the development of more effective therapeutic strategies for these diseases.
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Affiliation(s)
- Zhang Wanyi
- Department of Neurology, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Yan Jiao
- Department of Nursing, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Huang Wen
- Department of Neurology, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Xu Bin
- Outpatient Department, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Wang Xuefei
- Department of Neurology, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Jiang Lan
- Outpatient Department, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
| | - Zhou Liuyin
- Department of Respiratory Medicine, Chongqing Emergency Medical Center, Chongging University Central Hospital, Chongqing, China
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Bartl M, Nilsson J, Dakna M, Weber S, Schade S, Xylaki M, Fernandes Gomes B, Ernst M, Muntean ML, Sixel-Döring F, Trenkwalder C, Zetterberg H, Brinkmalm A, Mollenhauer B. Lysosomal and synaptic dysfunction markers in longitudinal cerebrospinal fluid of de novo Parkinson's disease. NPJ Parkinsons Dis 2024; 10:102. [PMID: 38760408 PMCID: PMC11101466 DOI: 10.1038/s41531-024-00714-1] [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: 11/24/2023] [Accepted: 04/19/2024] [Indexed: 05/19/2024] Open
Abstract
Lysosomal and synaptic dysfunctions are hallmarks in neurodegeneration and potentially relevant as biomarkers, but data on early Parkinson's disease (PD) is lacking. We performed targeted mass spectrometry with an established protein panel, assessing autophagy and synaptic function in cerebrospinal fluid (CSF) of drug-naïve de novo PD, and sex-/age-matched healthy controls (HC) cross-sectionally (88 PD, 46 HC) and longitudinally (104 PD, 58 HC) over 10 years. Multiple markers of autophagy, synaptic plasticity, and secretory pathways were reduced in PD. We added samples from prodromal subjects (9 cross-sectional, 12 longitudinal) with isolated REM sleep behavior disorder, revealing secretogranin-2 already decreased compared to controls. Machine learning identified neuronal pentraxin receptor and neurosecretory protein VGF as most relevant for discriminating between groups. CSF levels of LAMP2, neuronal pentraxins, and syntaxins in PD correlated with clinical progression, showing predictive potential for motor- and non-motor symptoms as a valid basis for future drug trials.
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Affiliation(s)
- Michael Bartl
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany.
- Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Goettingen, Goettingen, Germany.
| | - Johanna Nilsson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Mohammed Dakna
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Sandrina Weber
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Mary Xylaki
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Bárbara Fernandes Gomes
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Marielle Ernst
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Friederike Sixel-Döring
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurology, Philipps-University, Marburg, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Ann Brinkmalm
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
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9
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Schejter-Margalit T, Binyamin NB, Thaler A, Maidan I, Cedarbaum JM, Orr-Urtreger A, Gana Weisz M, Goldstein O, Giladi N, Mirelman A, Kizony R. Validity of the Short Weekly Calendar Planning Activity in patients with Parkinson disease and nonmanifesting LRRK2 and GBA carriers. Eur J Neurol 2024:e16327. [PMID: 38743695 DOI: 10.1111/ene.16327] [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: 08/21/2023] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND AND PURPOSE Subtle executive dysfunction is common in people newly diagnosed with Parkinson disease (PD), even when general cognitive abilities are intact. This study examined the Short Weekly Calendar Planning Activity (WCPA-10)'s known-group construct validity, comparing persons with PD to healthy controls (HCs) and nonmanifesting carriers of LRRK2 and GBA gene mutations to HCs. Additionally, convergent and ecological validity was examined. METHODS The study included 73 participants: 22 with idiopathic PD (iPD) who do not carry any of the founder GBA mutations or LRRK2-G2019S, 29 nonmanifesting carriers of the G2019S-LRRK2 (n = 14) and GBA (n = 15) mutations, and 22 HCs. Known-group validity was determined using the WCPA-10, convergent validity by also using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT), and ecological validity by using the WCPA-10, Schwab and England Activities of Daily Living Scale (SE ADL), and Physical Activity Scale for the Elderly (PASE). RESULTS Known-group validity of the WCPA-10 was established for the iPD group only; they followed fewer rules (p = 0.020), were slower (p = 0.003) and less efficient (p = 0.001), used more strategies (p = 0.017) on the WCPA-10, and achieved significantly lower CTT scores (p < 0.001) than the HCs. The nonmanifesting carriers and HCs were similar on all cognitive tests. Convergent and ecological validity of the WCPA-10 were partially established, with few correlations between WCPA-10 outcome measures and the MoCA (r = 0.50, r = 0.41), CTT-2 (r = 0.43), SE ADL (r = 0.41), and PASE (r = 0.54, r = 0.46, r = 0.31). CONCLUSIONS This study affirms the known-group validity for most (four) WCPA-10 scores and partially confirms its convergent and ecological validity for PD.
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Affiliation(s)
- Tamara Schejter-Margalit
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Occupational Therapy Department, University of Haifa, Haifa, Israel
| | | | - Avner Thaler
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jesse M Cedarbaum
- Yale University School of Medicine and Coeruleus Clinical Sciences, Woodbridge, Connecticut, USA
| | - Avi Orr-Urtreger
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Genomic Research Laboratory for Neurodegeneration, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Mali Gana Weisz
- Genomic Research Laboratory for Neurodegeneration, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Orly Goldstein
- Genomic Research Laboratory for Neurodegeneration, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Rachel Kizony
- Occupational Therapy Department, University of Haifa, Haifa, Israel
- Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel
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Bhidayasiri R, Sringean J, Phumphid S, Anan C, Thanawattano C, Deoisres S, Panyakaew P, Phokaewvarangkul O, Maytharakcheep S, Buranasrikul V, Prasertpan T, Khontong R, Jagota P, Chaisongkram A, Jankate W, Meesri J, Chantadunga A, Rattanajun P, Sutaphan P, Jitpugdee W, Chokpatcharavate M, Avihingsanon Y, Sittipunt C, Sittitrai W, Boonrach G, Phonsrithong A, Suvanprakorn P, Vichitcholchai J, Bunnag T. The rise of Parkinson's disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and "eat, move, sleep" lifestyle interventions to prevent or slow the rise of non-communicable diseases in Thailand. Front Neurol 2024; 15:1386608. [PMID: 38803644 PMCID: PMC11129688 DOI: 10.3389/fneur.2024.1386608] [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: 02/15/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
The rising prevalence of Parkinson's disease (PD) globally presents a significant public health challenge for national healthcare systems, particularly in low-to-middle income countries, such as Thailand, which may have insufficient resources to meet these escalating healthcare needs. There are also many undiagnosed cases of early-stage PD, a period when therapeutic interventions would have the most value and least cost. The traditional "passive" approach, whereby clinicians wait for patients with symptomatic PD to seek treatment, is inadequate. Proactive, early identification of PD will allow timely therapeutic interventions, and digital health technologies can be scaled up in the identification and early diagnosis of cases. The Parkinson's disease risk survey (TCTR20231025005) aims to evaluate a digital population screening platform to identify undiagnosed PD cases in the Thai population. Recognizing the long prodromal phase of PD, the target demographic for screening is people aged ≥ 40 years, approximately 20 years before the usual emergence of motor symptoms. Thailand has a highly rated healthcare system with an established universal healthcare program for citizens, making it ideal for deploying a national screening program using digital technology. Designed by a multidisciplinary group of PD experts, the digital platform comprises a 20-item questionnaire about PD symptoms along with objective tests of eight digital markers: voice vowel, voice sentences, resting and postural tremor, alternate finger tapping, a "pinch-to-size" test, gait and balance, with performance recorded using a mobile application and smartphone's sensors. Machine learning tools use the collected data to identify subjects at risk of developing, or with early signs of, PD. This article describes the selection and validation of questionnaire items and digital markers, with results showing the chosen parameters and data analysis methods to be robust, reliable, and reproducible. This digital platform could serve as a model for similar screening strategies for other non-communicable diseases in Thailand.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Saisamorn Phumphid
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Chanawat Anan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | | | - Suwijak Deoisres
- National Electronics and Computer Technology Centre, Pathum Thani, Thailand
| | - Pattamon Panyakaew
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Suppata Maytharakcheep
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Vijittra Buranasrikul
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Tittaya Prasertpan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Sawanpracharak Hospital, Nakhon Sawan, Thailand
| | | | - Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Araya Chaisongkram
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Worawit Jankate
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Jeeranun Meesri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Araya Chantadunga
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Piyaporn Rattanajun
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Phantakarn Sutaphan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Weerachai Jitpugdee
- Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Marisa Chokpatcharavate
- Chulalongkorn Parkinson's Disease Support Group, Department of Medicine, Faculty of Medicine, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Yingyos Avihingsanon
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Society, Bangkok, Thailand
| | - Chanchai Sittipunt
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Society, Bangkok, Thailand
| | | | | | | | | | | | - Tej Bunnag
- Thai Red Cross Society, Bangkok, Thailand
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11
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Wang M, Tan C, Shen Q, Cai S, Liu Q, Liao H. Altered functional-structural coupling may predict Parkinson's patient's depression. Brain Struct Funct 2024; 229:897-907. [PMID: 38478052 DOI: 10.1007/s00429-024-02780-w] [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: 11/21/2023] [Accepted: 02/20/2024] [Indexed: 04/10/2024]
Abstract
We aimed to elucidate the neurobiological basis of depression in Parkinson's disease and identify potential imaging markers for depression in patients with Parkinson's disease. We recruited 43 normal controls (NC), 46 depressed Parkinson's disease patients (DPD) and 56 non-depressed Parkinson's disease (NDPD). All participants underwent routine T2-weighted, T2Flair, and resting-state scans on the same 3.0 T magnetic resonance imaging (MRI) scanner at our hospital. Pre-processing includes calculating surface-based Regional Homogeneity (2DReHo) and cortical thickness. Then we defined the correlation coefficient between 2DReHo and cortical thickness as the functional-structural coupling index. Between-group comparisons were conducted on the Fisher's Z-transformed correlation coefficients. To identify specific regions of decoupling, the 2DReHo for each participant were divided by cortical thickness at each vertex, followed by threshold-free cluster enhancement (TFCE) multiple comparison correction. Binary logistic regression analysis was performed with DPD as the dependent variable, and significantly altered indicators as the independent variables. Receiver operating characteristic curves were constructed to compare the diagnostic performance of individual predictors and combinations using R and MedCalc software. DPD patients exhibited a significantly lower whole-brain functional-structural coupling index than NDPD patients and NC. Abnormal functional-structural coupling was primarily observed in the left inferior parietal lobule and right primary and early visual cortices in DPD patients. Receiver operating characteristic analysis revealed that the combination of cortical functional-structural coupling, surface-based ReHo, and thickness had the best diagnostic performance, achieving a sensitivity of 65% and specificity of 77.7%. This is the first study to explore the relationship between functional and structural changes in DPD patients and evaluate the diagnostic performance of these altered correlations to predict depression in Parkinson's disease patients. We posit that these changes in functional-structural relationships may serve as imaging biomarkers for depression in Parkinson's disease patients, potentially aiding in the classification and diagnosis of Parkinson's disease. Additionally, our findings provide functional and structural imaging evidence for exploring the neurobiological basis of depression in Parkinson's disease.
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Affiliation(s)
- Min Wang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qin Shen
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sainan Cai
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qinru Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiyan Liao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China.
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12
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Yan Y, Zhang M, Ren W, Zheng X, Chang Y. Neuromelanin-sensitive magnetic resonance imaging: Possibilities and promises as an imaging biomarker for Parkinson's disease. Eur J Neurosci 2024; 59:2616-2627. [PMID: 38441250 DOI: 10.1111/ejn.16296] [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: 09/23/2023] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 05/22/2024]
Abstract
Parkinson's disease (PD) is an age-related progressive neurodegenerative disorder characterized by both motor and non-motor symptoms resulting from the death of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and noradrenergic neurons in the locus coeruleus (LC). The current diagnosis of PD primarily relies on motor symptoms, often leading to diagnoses in advanced stages, where a significant portion of SNpc dopamine neurons has already succumbed. Therefore, the identification of imaging biomarkers for early-stage PD diagnosis and disease progression monitoring is imperative. Recent studies propose that neuromelanin-sensitive magnetic resonance imaging (NM-MRI) holds promise as an imaging biomarker. In this review, we summarize the latest findings concerning NM-MRI characteristics at various stages in patients with PD and those with atypical parkinsonism. In conclusion, alterations in neuromelanin within the LC are associated with non-motor symptoms and prove to be a reliable imaging biomarker in the prodromal phase of PD. Furthermore, NM-MRI demonstrates efficacy in differentiating progressive supranuclear palsy (PSP) from PD and multiple system atrophy with predominant parkinsonism. The spatial patterns of changes in the SNpc can be indicative of PD progression and aid in distinguishing between PSP and synucleinopathies. We recommend that patients with PD and individuals at risk for PD undergo regular NM-MRI examinations. This technology holds the potential for widespread use in PD diagnosis.
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Affiliation(s)
- Yayun Yan
- Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Mengchao Zhang
- Department of Radiology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Wenhua Ren
- Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Xiaoqi Zheng
- Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
| | - Ying Chang
- Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China
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13
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Castelli MB, Alonso-Recio L, Carvajal F, Serrano JM. Does the Montreal Cognitive Assessment (MoCA) identify cognitive impairment profiles in Parkinson's disease? An exploratory study. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:238-247. [PMID: 34894908 DOI: 10.1080/23279095.2021.2011727] [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: 06/14/2023]
Abstract
An important proportion of patients with Parkinson's Disease (PD) present signs of cognitive impairment, although this is heterogeneous. In an attempt to classify this, the dual syndrome hypothesis distinguishes between two profiles: one defined by attentional and executive problems with damage in anterior cerebral regions, and another with mnesic and visuospatial alterations, with damage in posterior cerebral regions. The Montreal Cognitive Assessment (MoCA) is one of the recommended screening tools, and one of the most used, to assess cognitive impairment in PD. However, its ability to specifically identify these two profiles of cognitive impairment has not been studied. The aim of this study was, therefore, to analyze the capacity of the MoCA to detect cognitive impairment, and also to identify anterior and posterior profiles defined by the dual syndrome hypothesis. For this purpose, 59 patients with idiopathic PD were studied with the MoCA and a neuropsychological battery of tests covering all cognitive domains. Results of logistic regression analysis with ROC (Receiver Operating Characteristic) curves showed that MoCA detected cognitive impairment and identified patients with a profile of anterior/attentional and executive deficit, with acceptable sensibility and specificity. However, it did not identify patients with a posterior/mnesic-visuospatial impairment. We discuss the reasons for the lack of sensitivity of MoCA in this profile, and other possible implications of these results with regards the usefulness of this tool to assess cognitive impairment in PD.
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Affiliation(s)
- María Belén Castelli
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Alonso-Recio
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Madrid, Spain
| | - Fernando Carvajal
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Manuel Serrano
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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14
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Horsager J, Borghammer P. Brain-first vs. body-first Parkinson's disease: An update on recent evidence. Parkinsonism Relat Disord 2024; 122:106101. [PMID: 38519273 DOI: 10.1016/j.parkreldis.2024.106101] [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: 01/30/2024] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
We recently proposed a new disease model of Parkinson's disease - the a-Synuclein Origin site and Connectome model. The model posits that the initial pathology starts either in the olfactory bulb or amygdala leading to a brain-first subtype, or in the enteric nervous system leading to a body-first subtype. These subtypes should be distinguishable early in the disease course on a range of imaging, clinical, and neuropathological markers. Here, we review recent original human studies, which tested the predictions of the model. Molecular imaging studies were generally in agreement with the model, whereas structural imaging studies, such as MRI volumetry, showed conflicting findings. Most large-scale clinical studies were supportive, reporting clustering of relevant markers of the body-first subtype, including REM-sleep behavior disorder, constipation, autonomic dysfunction, neuropsychiatric symptoms, and cognitive impairment. Finally, studies of a-synuclein deposition in antemortem and postmortem tissues revealed distribution of pathology, which generally supports the model.
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Affiliation(s)
- Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Denmark.
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
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15
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Plastini MJ, Abdelnour C, Young CB, Wilson EN, Shahid-Besanti M, Lamoureux J, Andreasson KI, Kerchner GA, Montine TJ, Henderson VW, Poston KL. Multiple biomarkers improve diagnostic accuracy across Lewy body and Alzheimer's disease spectra. Ann Clin Transl Neurol 2024; 11:1197-1210. [PMID: 38436140 DOI: 10.1002/acn3.52034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/20/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE More than half of neurodegenerative disease patients have multiple pathologies at autopsy; however, most receive one diagnosis during life. We used the α-synuclein seed amplification assay (αSyn-SAA) and CSF biomarkers for amyloidosis and Alzheimer's disease (AD) neuropathological change (ADNC) to determine the frequency of co-pathologies in participants clinically diagnosed with Lewy body (LB) disease or AD. METHODS Using receiver operating characteristic analyses on retrospective CSF samples from 150 participants determined αSyn-SAA accuracy, sensitivity, and specificity for identifying clinically defined LB disease and predicting future change in clinical diagnosis. CSF biomarkers helped determine the frequency of concomitant Lewy body pathology, ADNC, and/or amyloidosis in participants with LB disease and AD, across clinical spectra. RESULTS Following a decade-long follow-up, the clinically or autopsy-defined diagnosis changed for nine participants. αSyn-SAA demonstrated improved accuracy (91.3%), sensitivity (89.3%), and specificity (93.3%) for identifying LB disease compared to all non-LB disease, highlighting the limitations of clinical diagnosis alone. When examining biomarkers of co-pathology, amyloidosis was present in 18%, 48%, and 71% (χ2(2) = 13.56, p = 0.001) and AD biomarkers were present in 0%, 8.7%, and 42.9% (χ2(2) = 18.44, p < 0.001) of LB disease participants with different stages of cognitive impairment respectively. Co-occurring biomarkers for αSyn-SAA and amyloidosis were present in 12% and 14% of AD compared to 43% and 57% LB disease participants with different stages of cognitive impairment (χ2(3) = 13.87, p = 0.003). INTERPRETATION Our study shows that using a combination of αSyn-SAA and AD biomarkers can identify people with αSyn, ADNC, and co-pathology better and earlier than traditional clinical diagnostic criteria alone.
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Affiliation(s)
- Melanie J Plastini
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Christina B Young
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Edward N Wilson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Marian Shahid-Besanti
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | | | - Katrin I Andreasson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, 94158, USA
| | - Geoffrey A Kerchner
- Pharma Research and Early Development, F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - Thomas J Montine
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Victor W Henderson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
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16
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Chopra A, Lang AE, Höglinger G, Outeiro TF. Towards a biological diagnosis of PD. Parkinsonism Relat Disord 2024; 122:106078. [PMID: 38472075 DOI: 10.1016/j.parkreldis.2024.106078] [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: 01/23/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Since the original description by James Parkinson, Parkinson's disease (PD) has intrigued us for over 200 years. PD is a progressive condition that is incurable so far, and affects millions of people worldwide. Over the years, our knowledge has expanded tremendously, and a range of criteria have been put forward and used to try to define PD. However, owing to the complexity of the problem, it is still not consensual how to diagnose and classify a disease that manifests with diverse features, and that responds differently to existing therapies and to those under development. We are now living a time when 'biological' information is becoming abundant, precise, and accessible enabling us to attempt to incorporate different sources of information to classify different forms of PD. These refinements are essential for basic science, as they will enable us to develop improved models for studying PD, and to implement new findings into clinical practice, as this will be the path towards effective personalized medicine.
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Affiliation(s)
- Avika Chopra
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany
| | - Anthony E Lang
- Edmond J Safra Program in Parkinson's Disease, Krembil Brain Institute, University Health Network and the Department of Medicine, University of Toronto, Canada
| | - Günter Höglinger
- Department of Neurology, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
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17
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Choi S, Kim R, Kang N, Byun K, Park K, Jun JS. Associations of Orthostatic Hypotension and Orthostatic Intolerance with Domain-Specific Cognitive Decline in Patients with Early Parkinson Disease: An 8-Year Follow-up. J Am Med Dir Assoc 2024; 25:866-870. [PMID: 37935379 DOI: 10.1016/j.jamda.2023.10.002] [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: 04/25/2023] [Revised: 09/27/2023] [Accepted: 10/01/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVE Although orthostatic hypotension (OH) and orthostatic intolerance (OI) are prevalent in patients with Parkinson disease (PD), it remains unclear how these conditions primarily affect the trajectory of decline in specific cognitive domains. This study aimed to explore the effects of OH and OI on longitudinal domain-specific cognitive changes in patients with PD. DESIGN An 8-year follow-up of the Parkinson Progression Markers Initiative cohort study. SETTING AND PARTICIPANTS A total of 403 patients with early, untreated PD and 195 matched healthy controls were included. They were classified into OH, OI, and normal groups. OH was defined according to the international consensus, and OI was defined as the presence of orthostatic symptoms without meeting the criteria for OH. METHODS The patients underwent detailed neuropsychological testing annually for up to 8 years of follow-up. Linear mixed effects models were used to investigate the associations between OH, OI, and longitudinal cognitive changes. RESULTS The prevalence of both OH and OI in patients with PD was significantly higher than that in controls (13.4% vs 7.2%, P = .002, for OH, and 29.3% vs 14.4%, P < .001, for OI). The OH group in patients with PD showed a faster decline in Letter-Number Sequencing (LNS) (β = -0.11, 95% CI -0.20 to -0.02, t = -2.44, P = .015) and Semantic Fluency Test (SFT) (β = -0.44, 95% CI -0.81 to -0.08, t = -2.42, P = .016) scores than the normal group. Similarly, the OI group showed a steeper decline in LNS (β = -0.08, 95% CI -0.14 to -0.01, t = -2.20, P = .028) and SFT (β = -0.36, 95% CI -0.63 to -0.08, t = -2.55, P = .011) scores compared to the normal group. There were no significant longitudinal changes in the other neuropsychological test scores between the groups. CONCLUSIONS AND IMPLICATIONS Both OH and OI may be associated with a faster decline in executive function among cognitive domains of patients with PD. These findings may highlight the potential importance of orthostatic blood pressure control in PD patients with OH and even those with orthostatic symptoms without OH.
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Affiliation(s)
- Seohee Choi
- Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea
| | - Ryul Kim
- Department of Neurology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
| | - Nyeonju Kang
- Division of Sport Science, Sport Science Institute & Health Promotion Center, Incheon National University, Incheon, South Korea
| | - Kyeongho Byun
- Division of Sport Science, Sport Science Institute & Health Promotion Center, Incheon National University, Incheon, South Korea
| | - Kiwon Park
- Department of Mechatronics Engineering, Incheon National University, Incheon, South Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
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Longo C, Romano DL, Pennacchio M, Malaguti MC, Di Giacopo R, Giometto B, Papagno C. Are the criteria for PD-MCI diagnosis comprehensive? A Machine Learning study with modified criteria. Parkinsonism Relat Disord 2024; 124:106987. [PMID: 38701720 DOI: 10.1016/j.parkreldis.2024.106987] [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: 01/10/2024] [Revised: 04/11/2024] [Accepted: 04/28/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Mild cognitive impairment in Parkinson's disease (PD-MCI) includes deficits in different cognitive domains, and one domain to explore for neurocognitive impairment following the DSM-V is social cognition. However, this domain is not included in current criteria for PD-MCI diagnosis. Moreover, tests vary across studies. It is, therefore, crucial to optimize cognitive assessment in PD-MCI. We aimed to do so by using Machine Learning. METHODS 275 PD patients were included. Four cognitive batteries were created: two Standard ones (Levels I and II), applying current criteria and "traditional" tests; two Alternative ones (Levels I and II), which incorporated a test of social cognition. These batteries were included in the Random Forest (RF) classifier. To assess RF performance, the AUC was considered, and the Variable Importance Index was estimated to understand the contribution of each test in PD-MCI classification. RESULTS Standard Level I and II showed an AUC of 0.852 and 0.892, while Alternative Level I and II showed an AUC of 0.898 and of 0.906. Variable Importance Index revealed that TMT B-A, Ekman test, RAVLT-IR, MoCA, and Action Naming were tests that most contributed to PD-MCI classification. CONCLUSION The Alternative level I assessment demonstrated a similar classification capacity to the Standard level II assessment. This finding suggests that in the cognitive assessment of PD patients, it is crucial to consider the most affected cognitive domains in this clinical population, including social cognition. Taken together, these results suggest to revise current criteria for the diagnosis of PD-MCI.
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Affiliation(s)
- Chiara Longo
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy; Department of Psychology, University of Milano-Bicocca, 20126, Milan, Italy.
| | | | - Maria Pennacchio
- Department of Psychology, University of Milano-Bicocca, 20126, Milan, Italy; Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
| | - Maria Chiara Malaguti
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy
| | - Raffaella Di Giacopo
- Department of Neurology, "Santa Maria del Carmine Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38068, Rovereto, Italy
| | - Bruno Giometto
- Department of Neurology, "Santa Chiara Hospital", Azienda Provinciale per I Servizi Sanitari (APSS), 38122, Trento, Italy; Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences (CIMeC), University of Trento, 38068, Rovereto, Italy
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Kluge A, Schaeffer E, Bunk J, Sommerauer M, Röttgen S, Schulte C, Roeben B, von Thaler AK, Welzel J, Lucius R, Heinzel S, Xiang W, Eschweiler GW, Maetzler W, Suenkel U, Berg D. Detecting Misfolded α-Synuclein in Blood Years before the Diagnosis of Parkinson's Disease. Mov Disord 2024. [PMID: 38651526 DOI: 10.1002/mds.29766] [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: 07/25/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Identifying individuals with Parkinson's disease (PD) already in the prodromal phase of the disease has become a priority objective for opening a window for early disease-modifying therapies. OBJECTIVE The aim was to evaluate a blood-based α-synuclein seed amplification assay (α-syn SAA) as a novel biomarker for diagnosing PD in the prodromal phase. METHODS In the TREND study (University of Tuebingen) biennial blood samples of n = 1201 individuals with/without increased risk for PD were taken prospectively over 4 to 10 years. We retrospectively analyzed blood samples of 12 participants later diagnosed with PD during the study to detect and amplify pathological α-syn conformers derived from neuronal extracellular vesicles using (1) immunoblot analyses with an antibody against these conformers and (2) an α-syn-SAA. Additionally, blood samples of n = 13 healthy individuals from the TREND cohort and n = 20 individuals with isolated rapid eye movement sleep behavior disorder (iRBD) from the University Hospital Cologne were analyzed. RESULTS All individuals with PD showed positive immunoblots and a positive α-syn SAA at the time of diagnosis. Moreover, all PD patients showed a positive α-syn SAA 1 to 10 years before clinical diagnosis. In the iRBD cohort, 30% showed a positive α-syn SAA. All healthy controls had a negative SAA. CONCLUSIONS We here demonstrate the possibility to detect and amplify pathological α-syn conformers in peripheral blood up to 10 years before the clinical diagnosis of PD in individuals with and without iRBD. The findings of this study indicate that this blood-based α-syn SAA assay has the potential to serve as a diagnostic biomarker for prodromal PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Annika Kluge
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Eva Schaeffer
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Josina Bunk
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Michael Sommerauer
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Sinah Röttgen
- Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
| | - Claudia Schulte
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany
| | - Anna-Katharina von Thaler
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Julius Welzel
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ralph Lucius
- Institute of Anatomy, Kiel University, Kiel, Germany
| | - Sebastian Heinzel
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Wei Xiang
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhard W Eschweiler
- Geriatric Center, University Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Ulrike Suenkel
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
| | - Daniela Berg
- Department of Neurology, University Hospital Kiel, Christian-Albrechts-University Kiel, Kiel, Germany
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20
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Roeben B, Liepelt-Scarfone I, Lerche S, Zimmermann M, Wurster I, Sünkel U, Schulte C, Deuschle C, Eschweiler GW, Maetzler W, Gasser T, Berg D, Brockmann K. Longitudinal cognitive decline characterizes the profile of non-PD-manifest GBA1 mutation carriers. NPJ Parkinsons Dis 2024; 10:88. [PMID: 38649346 PMCID: PMC11035543 DOI: 10.1038/s41531-024-00706-1] [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: 11/02/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
With disease-modifying treatment for Parkinson's disease (PD) associated with variants in the glucocerebrosidase gene (GBA1) under way, the challenge to design clinical trials with non-PD-manifest GBA mutation carriers (GBA1NMC) comes within close reach. To delineate trajectories of motor and non-motor markers as well as serum neurofilament light (sNfL) levels and to evaluate clinical endpoints as outcomes for clinical trials in GBA1NMC, longitudinal data of 56 GBA1NMC carriers and 112 age- and sex-matched GBA1 wildtype participants (GBA1wildtype) with up to 9 years of follow-up was analyzed using linear mixed-effects models (LMEM) and Kaplan-Meier survival analysis of clinical endpoints for motor and cognitive function. GBA1NMC showed worse performance in Pegboard, 20 m fast walking, global cognition as well as in executive and memory function at baseline. Longitudinally, LMEM revealed a higher annual increase of the MDS-UPDRS III bradykinesia subscore in GBA1NMC compared to GBA1wildtype, but comparable trajectories of all other motor and non-motor markers as well as sNfL. Kaplan-Meier survival analysis showed a significantly earlier progression to clinical endpoints of cognitive decline in GBA1NMC. Incidence of PD was significantly higher in GBA1NMC. In conclusion, our study extends data on GBA1NMC indicating early cognitive decline as a potentially characteristic feature. Comprehensive longitudinal assessments of cognitive function are crucial to delineate the evolution of early changes in GBA1NMC enabling a more accurate stratification and allow for a more precise definition of trial design and sample size.
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Grants
- Dr. Roeben was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #478-0-0).
- Janssen Research and Development (Janssen R&D)
- Michael J. Fox Foundation for Parkinson’s Research (Michael J. Fox Foundation)
- European Commission (EC)
- EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)
- Novartis
- International Parkinson Fonds (Germany) GmbH (IPD) German Ministry for Education and Research (BMBF)
- Dr. Zimmermann was supported by the Clinician Scientist program of the Medical Faculty of the University of Tübingen (grant #481-0-0).
- Dr. Wurster received funding from the Michael J. Fox Foundation in form of the Edmond J. Safra Fellowship in Movement Disorders.
- German Ministry for Education and Research (BMBF), German Research Council (DFG), German Innovationsfonds
- Robert Bosch Stiftung (Robert Bosch Foundation)
- Dr. Maetzler receives or received funding from the European Union, the German Federal Ministry of Education of Research, German Research Council, Michael J. Fox Foundation, Robert Bosch Foundation, Neuroalliance, Lundbeck, Sivantos and Janssen.
- Dr. Gasser receives research support from Novartis, the European Union, BMBF (the Federal Ministry of Education and Research), and Helmholtz Association.
- Janssen Pharmaceuticals (Janssen Pharmaceuticals, Inc.)
- Teva Pharmaceutical Industries (Teva Pharmaceutical Industries Ltd.)
- Abbott | Abbott Pharmaceuticals
- Boehringer Ingelheim (Boehringer Ingelheim Pharmaceuticals)
- UCB | UCB US
- Deutsches Zentrum für Neurodegenerative Erkrankungen (German Center for Neurodegenerative Diseases)
- Dr. Berg has received funding for travel or speaker honoraria from Lundbeck Inc., Novartis, UCB/ SCHWARZ PHARMA, Merck Serono, Biogen, Zambon, AbbVie, and BIALLtd.; and has received research support from Janssen, Teva Pharmaceutical Industries Ltd., Solvay Pharmaceuticals, Inc./Abbott, Boehringer, UCB, Michael J Fox Foundation, BMBF, dPV (German Parkinson’s disease association), Neuroallianz, DZNE, Center of Integrative Neurosciences and the Damp Foundation.
- Dr. Brockmann has received research grants from the University of Tuebingen (Clinician Scientist), the German Society of Parkinson’s disease (dpv), the Michael J. Fox Foundation (MJFF), the German Centre for Neurodegenerative Diseases (DZNE, MIGAP) and the German Federal Ministry of Education and Research (BMBF) in the frame of ERACoSysMed2 (FKZ 031L0137B).
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Affiliation(s)
- Benjamin Roeben
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany.
| | - Inga Liepelt-Scarfone
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
- IB-Hochschule, Stuttgart, Germany
| | - Stefanie Lerche
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Milan Zimmermann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Isabel Wurster
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Ulrike Sünkel
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Claudia Schulte
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Christian Deuschle
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
- Geriatric Center at the University Hospital of Tübingen, Calwer Str. 14, 72076, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Thomas Gasser
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
| | - Daniela Berg
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, and Kiel University, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- German Center for Neurodegenerative Diseases, University of Tübingen, Otfried-Müller-Str. 27, 72076, Tübingen, Germany
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21
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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.
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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;
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22
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van Wegen EEH, van Balkom TD, Hirsch MA, Rutten S, van den Heuvel OA. Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230228. [PMID: 38607762 DOI: 10.3233/jpd-230228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Affiliation(s)
- Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- i
| | - Tim D van Balkom
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Mark A Hirsch
- Carolinas Medical Center, Atrium Health Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, NC, USA
- Wake Forest School of Medicine, Department of Orthopedic Surgery and Rehabilitation, Winston-Salem, NC, USA
| | - Sonja Rutten
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
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23
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Liu P, Chen L, He X, Mao L. Predictors of the Rapid Progression in Prodromal Parkinson's Disease: A Longitudinal Follow-Up Study. Gerontology 2024; 70:595-602. [PMID: 38565088 DOI: 10.1159/000538515] [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: 10/24/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is characterized by a prodromal phase preceding the onset of classic motor symptoms. The duration and clinical manifestations of prodromal PD vary widely, indicating underlying heterogeneity within this stage. This discrepancy prompts the question of whether specific factors contribute to the divergent rates of progression in prodromal PD. METHODS This study included prodromal PD patients from the Parkinson's progression marker initiative. They were followed up to assess the disease progression. The data collected during the follow-up period were analyzed to identify potential predictors of rapid disease progression in prodromal PD. RESULTS In this study, 61 individuals with prodromal PD were enrolled. Among them, 43 patients presented with both RBD and hyposmia, 17 had hyposmia alone, and 1 had RBD alone at baseline. 13 (21.3%) prodromal PD participants exhibited rapid disease progression, with two of these cases advancing to non-neurological diseases. Significant differences were observed between the rapid progression group and no rapid progression group in terms of MDS-UPDRS II score and UPSIT score. Longitudinal analysis showed a significant increase in the MDS-UPDRS III score and MDS-UPDRS total score in the rapid progression group. Regression analyses identified the MDS-UPDRS II score and UPSIT score as predictors of rapid disease progression in prodromal PD. CONCLUSION Our study findings suggest that the MDS-UPDRS II score and UPSIT score may serve as clinical markers associated with rapid disease progression. Further research and development of precise biomarkers and advanced assessment methods are needed to enhance our understanding of prodromal PD and its progression patterns.
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Affiliation(s)
- Peng Liu
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Linxi Chen
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
- Department of Pathology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Xinwei He
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
| | - Lingqun Mao
- Department of Neurology, Taizhou Central Hospital, Taizhou University Hospital, Taizhou, China
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24
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Yoo SW, Ryu DW, Oh YS, Ha S, Lyoo CH, Kim Y, Yoo JY, Kim JS. Estimating motor progression trajectory pursuant to temporal dynamic status of cardiac denervation in Parkinson's disease. J Neurol 2024; 271:2019-2030. [PMID: 38183421 DOI: 10.1007/s00415-023-12158-3] [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: 11/02/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a multifaceted disease that encompasses diverse clinical phenotypes. The diversity of PD could be subtyped based on the temporal dynamic status of cardiac sympathetic innervation; (1) initially, denervated myocardium (peripheral nervous system-predominant; PNS-predominant), (2) preserved myocardium (central nervous system-predominant; CNS-predominant), and (3) preserved myocardium who developed cardiac sympathetic denervation (CSD) on the subsequent imaging (Converter; delayed cardiac denervation). This study assessed how the cardiac denervation could reflect the pathobiology. We investigated whether this phenotyping could help predict the motor progression trajectory of PD. METHODS Cardiac sympathetic innervation was evaluated using initial and sequential 123I-meta-iodobenzylguanidine myocardial scintigraphy and patients were stratified into three groups as above. Motor severity and progression were evaluated in each patient. The association between subtypes and dopaminergic nigrostriatal degeneration was analyzed. The influence of cardiac denervation on motor progression was also investigated. RESULTS Among the enrolled 195 patients, 144 PD subjects were defined as PNS-predominant, 16 as Converter, and 35 as CNS-predominant. The most severe nigrostriatal degeneration was observed in the PNS-predominant group and the dopaminergic degeneration was the most asymmetric in the CNS-predominant group. Positive linear trends of nigrostriatal degeneration and its asymmetric degeneration of striatum and globus pallidus were found across the patterns of cardiac sympathetic innervation (PNS-predominant vs. Converter vs. CNS-predominant). It indicated an increasing degree of asymmetric degeneration among the groups. A longitudinal estimation of motor progression revealed distinct cardiac denervation trajectories for each subtype. CONCLUSIONS These results implicated that the subtypes of CSD might indicate a predominant origin and spreading pattern of pathobiology.
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Affiliation(s)
- Sang-Won Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Woo Ryu
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon-Sang Oh
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seunggyun Ha
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yuna Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji-Yeon Yoo
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
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Kulcsarova K, Skorvanek M. Challenges and Future of the International Parkinson and Movement Disorder Society Prodromal Parkinson's Disease Criteria: Are We On the Right Track? Mov Disord 2024; 39:637-643. [PMID: 38310367 DOI: 10.1002/mds.29724] [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: 11/08/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/05/2024] Open
Affiliation(s)
- Kristina Kulcsarova
- Department of Neurology, P. J. Safarik University, Kosice, Slovakia
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
- Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Safarik University, Kosice, Slovakia
| | - Matej Skorvanek
- Department of Neurology, P. J. Safarik University, Kosice, Slovakia
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovakia
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Park JW, Okamoto LE, Kim SH, Lee CN, Park KW, Baek SH, Sung JH, Jeon N, Koh SB, Gamboa A, Shibao CA, Diedrich A, Kim BJ, Biaggioni I. Sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson's disease. Clin Auton Res 2024; 34:269-279. [PMID: 38652421 DOI: 10.1007/s10286-024-01031-6] [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: 12/11/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The specific characteristics of autonomic involvement in patients with early Parkinson's disease (PD) are unclear. This study aimed to evaluate the characteristics of autonomic dysfunction in drug-naïve patients with early-stage PD without orthostatic hypotension (OH) by analyzing Valsalva maneuver (VM) parameters. METHODS We retrospectively analyzed drug-naïve patients without orthostatic hypotension (n = 61) and controls (n = 20). The patients were subcategorized into early PD (n = 35) and mid-PD (n = 26) groups on the basis of the Hoehn and Yahr staging. VM parameters, including changes in systolic blood pressure at late phase 2 (∆SBPVM2), ∆HRVM3, Valsalva ratio (VR), pressure recovery time, adrenergic baroreflex sensitivity, and vagal baroreflex sensitivity, were assessed. RESULTS In the early PD group, ∆SBPVM2, a marker of sympathetic function, was significantly lower compared with that in controls (risk ratio = 0.95, P = 0.027). Receiver operating characteristic (ROC) curve analysis showed an optimal cut-off value of -10 mmHg for ∆SBPVM2 [P = 0.002, area under the curve (AUC): 0.737]. VR exhibited an inverse relationship with Unified Parkinson's Disease Rating Scale Part 3 scores in the multivariable regression analysis (VR: P = 0.038, β = -28.61), whereas age showed a positive relationship (age: P = 0.027, β = 0.35). CONCLUSION The ∆BPVM2 parameter of the VM may help detect autonomic nervous system involvement in early-PD without OH. Our results suggest that sympathetic dysfunction is an early manifestation of autonomic dysfunction in patients with PD.
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Affiliation(s)
- Jin-Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Luis E Okamoto
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sung-Hwan Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Chan-Nyoung Lee
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Kun Woo Park
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Namjoon Jeon
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Alfredo Gamboa
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cyndya A Shibao
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - André Diedrich
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University Medicine, #73, Goryeodae-Ro, Seongbuk-gu, Seoul, 02841, Korea.
- BK21 FOUR R&E Center for Learning Health Systems, Graduate School, Korea University, Seoul, Republic of Korea, Seoul, Korea.
| | - Italo Biaggioni
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Zheng Y, Li Y, Cai H, Kou W, Yang C, Li S, Wang J, Zhang N, Feng T. Alterations of Peripheral Lymphocyte Subsets in Isolated Rapid Eye Movement Sleep Behavior Disorder. Mov Disord 2024. [PMID: 38529776 DOI: 10.1002/mds.29798] [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: 01/04/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Adaptive immune dysfunction may play a crucial role in Parkinson's disease (PD) development. Isolated rapid eye movement sleep behavior disorder (iRBD) represents the prodromal stage of synucleinopathies, including PD. Elucidating the peripheral adaptive immune system is crucial in iRBD, but current knowledge remains limited. OBJECTIVE This study aimed to characterize peripheral lymphocyte profiles in iRBD patients compared with healthy control subjects (HCs). METHODS This cross-sectional study recruited polysomnography-confirmed iRBD patients and age- and sex-matched HCs. Venous blood was collected from each participant. Flow cytometry was used to evaluate surface markers and intracellular cytokine production in peripheral blood mononuclear cells. RESULTS Forty-four iRBD patients and 36 HCs were included. Compared with HCs, patients with iRBD exhibited significant decreases in absolute counts of total lymphocytes and CD3+ T cells. In terms of T cell subsets, iRBD patients showed higher frequencies and counts of proinflammatory T helper 1 cells and INF-γ+ CD8+ T cells, along with lower frequencies and counts of anti-inflammatory T helper 2 cells. A significant increase in the frequency of central memory T cells in CD8+ T cells was also observed in iRBD. Regarding B cells, iRBD patients demonstrated reduced frequencies and counts of double-negative memory B cells compared with control subjects. CONCLUSIONS This study demonstrated alterations in the peripheral adaptive immune system in iRBD, specifically in CD4+ and INF-γ+ CD8+ T cell subsets. An overall shift toward a proinflammatory state of adaptive immunity was already evident in iRBD. These observations might provide insights into the optimal timing for initiating immune interventions in PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Yuanchu Zheng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yatong Li
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huihui Cai
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenyi Kou
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chen Yang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Siming Li
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ning Zhang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
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Sekimitsu S, Shweikh Y, Shareef S, Zhao Y, Elze T, Segrè A, Wiggs J, Zebardast N. Association of retinal optical coherence tomography metrics and polygenic risk scores with cognitive function and future cognitive decline. Br J Ophthalmol 2024; 108:599-606. [PMID: 36990674 DOI: 10.1136/bjo-2022-322762] [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: 10/19/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE To evaluate the potential of retinal optical coherence tomography (OCT) measurements and polygenic risk scores (PRS) to identify people at risk of cognitive impairment. METHODS Using OCT images from 50 342 UK Biobank participants, we examined associations between retinal layer thickness and genetic risk for neurodegenerative disease and combined these metrics with PRS to predict baseline cognitive function and future cognitive deterioration. Multivariate Cox proportional hazard models were used to predict cognitive performance. P values for retinal thickness analyses are false-discovery-rate-adjusted. RESULTS Higher Alzheimer's disease PRS was associated with a thicker inner nuclear layer (INL), chorio-scleral interface (CSI) and inner plexiform layer (IPL) (all p<0.05). Higher Parkinson's disease PRS was associated with thinner outer plexiform layer (p<0.001). Worse baseline cognitive performance was associated with thinner retinal nerve fibre layer (RNFL) (aOR=1.038, 95% CI (1.029 to 1.047), p<0.001) and photoreceptor (PR) segment (aOR=1.035, 95% CI (1.019 to 1.051), p<0.001), ganglion cell complex (aOR=1.007, 95% CI (1.002 to 1.013), p=0.004) and thicker ganglion cell layer (aOR=0.981, 95% CI (0.967 to 0.995), p=0.009), IPL (aOR=0.976, 95% CI (0.961 to 0.992), p=0.003), INL (aOR=0.923, 95% CI (0.905 to 0.941), p<0.001) and CSI (aOR=0.998, 95% CI (0.997 to 0.999), p<0.001). Worse future cognitive performance was associated with thicker IPL (aOR=0.945, 95% CI (0.915 to 0.999), p=0.045) and CSI (aOR=0.996, 95% CI (0.993 to 0.999) 95% CI, p=0.014). Prediction of cognitive decline was significantly improved with the addition of PRS and retinal measurements. CONCLUSIONS AND RELEVANCE Retinal OCT measurements are significantly associated with genetic risk of neurodegenerative disease and may serve as biomarkers predictive of future cognitive impairment.
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Affiliation(s)
| | - Yusrah Shweikh
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, UK
| | - Sarah Shareef
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Yan Zhao
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Tobias Elze
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Ayellet Segrè
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Janey Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Zatti C, Pilotto A, Hansen C, Rizzardi A, Catania M, Romijnders R, Purin L, Pasolini MP, Schaeffer E, Galbiati A, Ferini-Strambi L, Berg D, Maetzler W, Padovani A. Turning alterations detected by mobile health technology in idiopathic REM sleep behavior disorder. NPJ Parkinsons Dis 2024; 10:64. [PMID: 38499543 PMCID: PMC10948811 DOI: 10.1038/s41531-024-00682-6] [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: 06/17/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
Idiopathic REM sleep Behavior Disorder (iRBD) is a condition at high risk of developing Parkinson's disease (PD) and other alpha-synucleinopathies. The aim of the study was to evaluate subtle turning alterations by using Mobile health technology in iRBD individuals without subthreshold parkinsonism. A total of 148 participants (23 persons with polysomnography-confirmed iRBD without subthreshold parkinsonism, 60 drug-naïve PD patients, and 65 age-matched controls were included in this prospective cross-sectional study. All underwent a multidimensional assessment including cognitive and non-motor symptoms assessment. Then a Timed-Up-and-Go test (TUG) at normal and fast speed was performed using mobile health technology on the lower back (Rehagait®, Hasomed, Germany). Duration, mean, and peak angular velocities of the turns were compared using a multivariate model correcting for age and sex. Compared to controls, PD patients showed longer turn durations and lower mean and peak angular velocities of the turns in both TUGs (all p ≤ 0.001). iRBD participants also showed a longer turn duration and lower mean (p = 0.006) and peak angular velocities (p < 0.001) compared to controls, but only in the TUG at normal speed. Mobile health technology assessment identified subtle alterations of turning in subjects with iRBD in usual, but not fast speed. Longitudinal studies are warranted to evaluate the value of objective turning parameters in defining the risk of conversion to PD in iRBD and in tracking motor progression in prodromal PD.
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Affiliation(s)
- Cinzia Zatti
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy
- Department of continuity of care and frailty, Neurology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy.
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy.
- Department of continuity of care and frailty, Neurology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Clint Hansen
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Andrea Rizzardi
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy
| | - Marcello Catania
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy
- Department of continuity of care and frailty, Neurology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Robbin Romijnders
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Leandro Purin
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy
- Department of continuity of care and frailty, Neurology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Maria P Pasolini
- Department of Clinical and Experimental Sciences, Neurophysiology Unit, University of Brescia, Brescia, Italy
| | - Eva Schaeffer
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Andrea Galbiati
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre, Milan, Italy
- Faculty of Psychology, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Luigi Ferini-Strambi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre, Milan, Italy
- Faculty of Psychology, "Vita-Salute" San Raffaele University, Milan, Italy
| | - Daniela Berg
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
- Laboratory of digital Neurology and biosensors, University of Brescia, Brescia, Italy
- Department of continuity of care and frailty, Neurology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, Neurophysiology Unit, University of Brescia, Brescia, Italy
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30
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Kulcsarova K, Skorvanek M, Postuma RB, Berg D. Defining Parkinson's Disease: Past and Future. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230411. [PMID: 38489197 DOI: 10.3233/jpd-230411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Parkinson's disease (PD) is the second most common still relentlessly progressive neurodegenerative disorder with a long period in which the pathophysiological process is already spreading but cardinal motor symptoms are not present. This review outlines the major developments and milestones in our understanding of PD that have shaped the way we define this disorder. Past criteria and definitions of PD have been based on clinical motor manifestations enabling diagnosis of the disease only in later symptomatic stages. Nevertheless, with advancing knowledge of disease pathophysiology and aim of early disease detection, a major shift of the diagnostic paradigm is being advocated towards a biological definition similar to other neurodegenerative disorders including Alzheimer's disease and Huntington's disease, with the ultimate goal of an earlier, disease course modifying therapy. We summarize the major pillars of this possible approach including in vivo detection of neuronal α-synuclein aggregation, neurodegeneration and genetics and outline their possible application in different contexts of use in the frame of biological PD definition.
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Affiliation(s)
- Kristina Kulcsarova
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic
- Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Safarik University, Kosice, Slovak Republic
| | - Matej Skorvanek
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic
| | - Ronald B Postuma
- Department of Neurology, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Daniela Berg
- Department of Neurology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
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31
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Moceri S, Bäuerle N, Habermeyer J, Ratz-Wirsching V, Harrer J, Distler J, Schulze-Krebs A, Timotius IK, Bluhm A, Hartlage-Rübsamen M, Roßner S, Winkler J, Xiang W, Hörsten SV. Young human alpha synuclein transgenic (BAC-SNCA) mice display sex- and gene-dose-dependent phenotypic disturbances. Behav Brain Res 2024; 460:114781. [PMID: 38043677 DOI: 10.1016/j.bbr.2023.114781] [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: 05/31/2023] [Revised: 11/10/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Parkinson's disease (PD) is a common neurodegenerative movement disorder, characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta and the accumulation of aggregated alpha synuclein (aSyn). The disease often presents with early prodromal non-motor symptoms and later motor symptoms. Diagnosing PD based purely on motor symptoms is often too late for successful intervention, as a significant neuronal loss has already occurred. Furthermore, the lower prevalence of PD in females is not well understood, highlighting the need for a better understanding of the interaction between sex and aSyn, the crucial protein for PD pathogenesis. Here, we conducted a comprehensive phenotyping study in 1- to 5-month-old mice overexpressing human aSyn gene (SNCA) in a bacterial artificial chromosome (BAC-SNCA). We demonstrate a SNCA gene-dose-dependent increase of human aSyn and phosphorylated aSyn, as well as a decrease in tyrosine hydroxylase expression in BAC-SNCA mice, with more pronounced effects in male mice. Phosphorylated aSyn was already found in the dorsal motor nucleus of the vagus nerve of 2-month-old mice. This was time-wise associated with significant gait altrations in BAC-SNCA mice as early as 1 and 3 months of age using CatWalk gait analysis. Furthermore, anxiety-related behavioral tests revealed an increase in anxiety levels in male BAC-SNCA mice. Finally, 5-month-old male BAC-SNCA mice exhibited a SNCA gene-dose-dependent elevation in energy expenditure in automated home-cage monitoring. For the first time, these findings describe early-onset, sex- and gene-dose-dependent, aSyn-mediated disturbances in BAC-SNCA mice, providing a model for sex-differences, early-onset neuropathology, and prodromal symptoms of PD.
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Affiliation(s)
- Sandra Moceri
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Natascha Bäuerle
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johanna Habermeyer
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Veronika Ratz-Wirsching
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Julia Harrer
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Jörg Distler
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Anja Schulze-Krebs
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Ivanna K Timotius
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; Department of Electronic Engineering, Satya Wacana Christian University, 50711 Salatiga, Indonesia
| | - Alexandra Bluhm
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, 04103 Leipzig, Germany
| | | | - Steffen Roßner
- Paul-Flechsig-Institute for Brain Research, University of Leipzig, 04103 Leipzig, Germany
| | - Jürgen Winkler
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Wei Xiang
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
| | - Stephan von Hörsten
- Department of Experimental Therapy, Preclinical Experimental Center, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
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32
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Tóth Š, Kulcsárová K, Maretta M, Kunová A, Mechírová E, Gdovinová Z, Feketeová E, Ribeiro Ventosa J, Baloghová J, Bekeová M, Christová P, Mrázová S, Muránska S, Zeidan D, Škorvánek M. α-synuclein antibody 5G4 identifies idiopathic REM-sleep behavior disorder in abdominal skin biopsies. Parkinsonism Relat Disord 2024; 120:105956. [PMID: 38217955 DOI: 10.1016/j.parkreldis.2023.105956] [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: 08/15/2023] [Revised: 11/25/2023] [Accepted: 12/06/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Idiopathic REM-sleep behavior disorder (iRBD) is considered the most specific prodromal marker of Parkinson's disease (PD). With the need to improve early detection of prodromal α-synucleinopathies, several methods to identify peripheral α-synuclein (α-syn) pathology have been exploited in manifest and prodromal PD with varying diagnostic accuracy. Recently, a disease specific 5G4 antibody has been evaluated in skin biopsies of manifest PD patients. The aim of our study was to analyze the 5G4 α-syn immunoreactivity in skin biopsies of deeply phenotyped subjects with iRBD and controls. METHODS The study cohort consisted of 28 patients with PD, 24 subjects with iRBD and 27 healthy controls, recruited from the CEGEMOD, PDBIOM and PARCAS cohorts. All subjects were deeply phenotyped and assessed for prodromal PD (pPD) probability based on MDS research criteria. Abdominal skin punch biopsies were processed and stained using a conformation specific 5G4 α-syn antibody as well as axonal markers SMI-31 and S100. RESULTS 5G4-positivity was identified in 23/28 PD patients, 20/24 iRBD subjects and 8/27 healthy controls. Compared to healthy controls, sensitivity and specificity reached 83.33 % and 70.37 % for iRBD; and 82.14 % and 70.37 % for PD, respectively. 5G4-positivity rate in our study was irrespective of the calculated pPD probability of iRBD subjects. CONCLUSIONS This work establishes the diagnostic yield of conformation specific 5G4 α-syn antibody testing in skin biopsies of subjects with pPD, specifically iRBD. The diagnostic accuracy for this method seems to be similar for both manifest and prodromal PD and is not dependent on the pPD probability ratios.
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Affiliation(s)
- Štefan Tóth
- Department of Histology and Embryology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic.
| | - Kristína Kulcsárová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic; Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Šafárik University, Kosice, Slovak Republic
| | - Milan Maretta
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic
| | - Alexandra Kunová
- Department of Histology and Embryology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Eva Mechírová
- Department of Histology and Embryology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Zuzana Gdovinová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic
| | - Eva Feketeová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic
| | - Joaquim Ribeiro Ventosa
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic; Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Šafárik University, Kosice, Slovak Republic
| | - Janette Baloghová
- Department of Dermatovenerology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Dermatovenerology, University Hospital of L. Pasteur, Košice, Slovak Republic
| | - Martina Bekeová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Petronela Christová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Soňa Mrázová
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Soňa Muránska
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Dema Zeidan
- Department of Histology and Embryology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic
| | - Matej Škorvánek
- Department of Neurology, Medical Faculty of P. J. Šafárik University, Košice, Slovak Republic; Department of Neurology, University Hospital of L. Pasteur, Košice, Slovak Republic
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Marrie RA, Maxwell CJ, Rotstein DL, Tsai CC, Tremlett H. Prodromes in demyelinating disorders, amyotrophic lateral sclerosis, Parkinson disease, and Alzheimer's dementia. Rev Neurol (Paris) 2024; 180:125-140. [PMID: 37567819 DOI: 10.1016/j.neurol.2023.07.002] [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: 05/29/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 08/13/2023]
Abstract
A prodrome is an early set of symptoms, which indicates the onset of a disease; these symptoms are often non-specific. Prodromal phases are now recognized in multiple central nervous system diseases. The depth of understanding of the prodromal phase varies across diseases, being more nascent for multiple sclerosis for example, than for Parkinson disease or Alzheimer's disease. Key challenges when identifying the prodromal phase of a disease include the lack of specificity of prodromal symptoms, and consequent need for accessible and informative biomarkers. Further, heterogeneity of the prodromal phase may be influenced by age, sex, genetics and other poorly understood factors. Nonetheless, recognition that an individual is in the prodromal phase of disease offers the opportunity for earlier diagnosis and with it the opportunity for earlier intervention.
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Affiliation(s)
- R A Marrie
- Departments of Internal Medicine and Community Health Sciences, Rady Faculty of Health Sciences, Max-Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - C J Maxwell
- Schools of Pharmacy and Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; ICES, Toronto, Ontario, Canada
| | - D L Rotstein
- Department of Medicine, University of Toronto, 6, Queen's Park Crescent West, 3rd floor, M5S 3H2 Toronto, Ontario, Canada; Saint-Michael's Hospital, 30, Bond Street, M5B 1W8 Toronto, Ontario, Canada
| | - C-C Tsai
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H Tremlett
- Faculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada
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Yoon SY, Heo SJ, Kim YW, Lee SC, Shin J, Lee JW. Depressive Symptoms and the Subsequent Risk of Parkinson's Disease: A Nationwide Cohort Study. Am J Geriatr Psychiatry 2024; 32:339-348. [PMID: 37953133 DOI: 10.1016/j.jagp.2023.10.006] [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: 07/18/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Only a few studies have focused on depressive symptoms and Parkinson's disease (PD) risk. As a time lag exists from the onset of depressive symptoms to the diagnosis of depression, elucidating the association between depressive symptoms and PD development might be helpful for the early prediction of PD. We investigate the association between depressive symptoms and subsequent PD risk using nationwide population-based cohort database. DESIGN AND SETTING Cohort study using the Korean National Health Insurance Service data between 2007 and 2017, with longitudinal follow-up until 2019. PARTICIPANTS A total of 98,296 elderly people responded to a self-reported questionnaire from the National Health Screening Program on depressive symptoms. MEASUREMENTS The association between depressive symptoms such as 1) decreased activity or motivation, 2) worthlessness, and 3) hopelessness and PD risk was analyzed. RESULTS During median 5.06-year follow-up, 839 PD cases occurred: 230 in individuals with depressive symptoms and 609 in those without symptoms. Results showed an increased risk of PD development in those with depressive symptoms (HR = 1.47, 95% CI, 1.26-1.71), with dose-response association between the number of depressive symptoms and PD risk. Even in those already diagnosed with depression, combined depressive symptoms were linked to a higher risk compared to those without symptoms (with symptoms, HR = 2.71, 95% CI, 2.00-3.68; without symptoms, HR = 1.84, 95% CI, 1.43-2.36). CONCLUSION Individuals with depressive symptoms were at an increased risk of developing PD, and there was a dose-response association between the number of depressive symptoms and PD risk.
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Affiliation(s)
- Seo Yeon Yoon
- Department and Research Institute of Rehabilitation Medicine (SYY, YWK, SCL), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok-Jae Heo
- Department of Biostatistics and Computing (SJH), Yonsei University Graduate School, Seoul, Republic of Korea
| | - Yong Wook Kim
- Department and Research Institute of Rehabilitation Medicine (SYY, YWK, SCL), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Chul Lee
- Department and Research Institute of Rehabilitation Medicine (SYY, YWK, SCL), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaeyong Shin
- Department of Preventive Medicine and Public Health (JS), Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jang Woo Lee
- Department of Physical Medicine and Rehabilitation (JWL), National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
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Imarisio A, Yahyavi I, Avenali M, Di Maio A, Buongarzone G, Galandra C, Picascia M, Filosa A, Gasparri C, Monti MC, Rondanelli M, Pacchetti C, Errico F, Valente EM, Usiello A. Blood D-serine levels correlate with aging and dopaminergic treatment in Parkinson's disease. Neurobiol Dis 2024; 192:106413. [PMID: 38253208 DOI: 10.1016/j.nbd.2024.106413] [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: 12/28/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024] Open
Abstract
We recently described increased D- and L-serine concentrations in the striatum of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated monkeys, the post-mortem caudate-putamen of human Parkinson's disease (PD) brains and the cerebrospinal fluid (CSF) of de novo living PD patients. However, data regarding blood D- and L-serine levels in PD are scarce. Here, we investigated whether the serum profile of D- and L-serine, as well as the other glutamate N-methyl-D-aspartate ionotropic receptor (NMDAR)-related amino acids, (i) differs between PD patients and healthy controls (HC) and (ii) correlates with clinical-demographic features and levodopa equivalent daily dose (LEDD) in PD. Eighty-three consecutive PD patients and forty-one HC were enrolled. PD cohort underwent an extensive clinical characterization. Serum levels of D- and L-serine, L-glutamate, L-glutamine, L-aspartate, L-asparagine and glycine were determined using High Performance Liquid Chromatography. In age- and sex-adjusted analyses, no differences emerged in the serum levels of D-serine, L-serine and other NMDAR-related amino acids between PD and HC. However, we found that D-serine and D-/Total serine ratio positively correlated with age in PD but not in HC, and also with PD age at onset. Moreover, we found that higher LEDD correlated with lower levels of D-serine and the other excitatory amino acids. Following these results, the addition of LEDD as covariate in the analyses disclosed a selective significant increase of D-serine in PD compared to HC (Δ ≈ 38%). Overall, these findings suggest that serum D-serine and D-/Total serine may represent a valuable biochemical signature of PD.
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Affiliation(s)
- Alberto Imarisio
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy; Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Isar Yahyavi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Micol Avenali
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Anna Di Maio
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Gabriele Buongarzone
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Caterina Galandra
- Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Marta Picascia
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Asia Filosa
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Clara Gasparri
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona "Istituto Santa Margherita", University of Pavia, 27100 Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Claudio Pacchetti
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Francesco Errico
- CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy; Department of Agricultural Sciences, University of Naples "Federico II", 80055 Portici, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy; Neurogenetics Research Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy.
| | - Alessandro Usiello
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania "Luigi Vanvitelli", 81100 Caserta, Italy; CEINGE Biotecnologie Avanzate Franco Salvatore, Naples, Italy
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Chamberlin KW, Li C, Luo Z, D'Aloisio AA, Pinto JM, Sandler DP, Chen H. Use of nonsteroidal anti-inflammatory drugs and poor olfaction in women. Int Forum Allergy Rhinol 2024; 14:639-650. [PMID: 37548119 DOI: 10.1002/alr.23241] [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: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND It is unclear whether regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with poor olfaction in older adults. METHODS We selected 4020 participants, aged 50 to 79 years in 2018, from 36,492 eligible participants in the National Institute of Environmental Health Sciences Sister Study, according to their self-reported olfaction status. Of these, 3406 women completed the 12-item Brief Smell Identification Test. We defined poor olfaction as a test score ≤9 in the primary analysis. We then estimated odds ratios (ORs) and 95% confidence intervals (CIs) from weighted logistic models, accounting for the study design, missing exposures/outcomes, and covariates. RESULTS Overall, NSAID use was not associated with poor olfaction. However, we found evidence for potential multiplicative interactions. Specifically, the OR comparing regular versus never use of aspirin was 1.8 (95% CI, 1.1-3.2) among women who had not regularly used nonaspirin NSAIDs, while the corresponding OR was 0.8 (95% CI, 0.5-1.2) among nonaspirin NSAID users (P for interaction = 0.016). Similar results were seen for ibuprofen alone versus ibuprofen with other NSAID use (P for interaction = 0.010). Among women using either drug alone, associations with poor olfaction increased with increasing duration and cumulative dose. Post hoc analyses showed that the interactions could not be readily explained by potential biases. Other NSAIDs were not associated with olfaction. CONCLUSION Long-term regular use of aspirin or ibuprofen was associated with poor olfaction among women who never regularly used other types of NSAIDs. These preliminary findings warrant independent confirmation.
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Affiliation(s)
- Keran W Chamberlin
- Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, Michigan, 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
| | - Jayant M Pinto
- Department of Surgery, The University of Chicago, Chicago, Illinois, 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
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Matsushima T, Yoshinaga K, Wakasugi N, Togo H, Hanakawa T. Functional connectivity-based classification of rapid eye movement sleep behavior disorder. Sleep Med 2024; 115:5-13. [PMID: 38295625 DOI: 10.1016/j.sleep.2024.01.019] [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: 04/23/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Isolated rapid eye movement sleep behavior disorder (iRBD) is a clinically important parasomnia syndrome preceding α-synucleinopathies, thereby prompting us to develop methods for evaluating latent brain states in iRBD. Resting-state functional magnetic resonance imaging combined with a machine learning-based classification technology may help us achieve this purpose. METHODS We developed a machine learning-based classifier using functional connectivity to classify 55 patients with iRBD and 97 healthy elderly controls (HC). Selecting 55 HCs randomly from the HC dataset 100 times, we conducted a classification of iRBD and HC for each sampling, using functional connectivity. Random forest ranked the importance of functional connectivity, which was subsequently used for classification with logistic regression and a support vector machine. We also conducted correlation analysis of the selected functional connectivity with subclinical variations in motor and non-motor functions in the iRBDs. RESULTS Mean classification performance using logistic regression was 0.649 for accuracy, 0.659 for precision, 0.662 for recall, 0.645 for f1 score, and 0.707 for the area under the receiver operating characteristic curve (p < 0.001 for all). The result was similar in the support vector machine. The classifier used functional connectivity information from nine connectivities across the motor and somatosensory areas, parietal cortex, temporal cortex, thalamus, and cerebellum. Inter-individual variations in functional connectivity were correlated with the subclinical motor and non-motor symptoms of iRBD patients. CONCLUSIONS Machine learning-based classifiers using functional connectivity may be useful to evaluate latent brain states in iRBD.
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Affiliation(s)
- Toma Matsushima
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8501, Japan; Department of Biotechnology and Life Science, Tokyo University of Agriculture and Technology, Koganei, Tokyo, 184-8588, Japan
| | - Kenji Yoshinaga
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Noritaka Wakasugi
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8501, Japan
| | - Hiroki Togo
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8501, Japan; Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Takashi Hanakawa
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8501, Japan; Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan.
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Yin P, Niu X, Guan C, Zhang Z, Liu Y, Li J, Cui G, Zan K, Xu C. Relationship between increased serum neurofilament light chain and glial fibrillary acidic protein levels with non-motor symptoms in patients with Parkinson's disease. Psychogeriatrics 2024; 24:415-425. [PMID: 38339819 DOI: 10.1111/psyg.13088] [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: 10/01/2023] [Revised: 01/14/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND This study set out to investigate the relationship between serum neurofilament light chain (NFL), glial fibrillary acidic protein (GFAP), and various non-motor symptoms (NMSs) in patients with Parkinson's disease (PD). METHODS The study included 37 healthy controls (HCs) and 51 PD patients. Clinical assessments of PD symptoms were conducted for all PD patients. The NMSS was utilised to evaluate the NMS burden (NMSB) in individuals. Based on the severity of NMSB, we further categorised the PD group into two subgroups: mild-moderate NMSB group and severe-very severe NMSB group. The amounts of NFL and GFAP in the serum were measured using an extremely sensitive single molecule array (Simoa) method. Statistical analyses were performed on the collected data using SPSS 26.0 and R (version 3.6.3). RESULTS Serum GFAP and NFL levels in the PD group with severe-very severe NMSB were significantly higher than those in the mild-moderate NMSB group (GFAP: P < 0.007; NFL: P < 0.009). Serum NFL and GFAP levels had positive correlations with NMSS total scores (GFAP: r = 0.326, P = 0.020; NFL: r = 0.318, P = 0.023) and multiple subdomains. The relationship between the attention/memory domains of NMSS and NFL levels is significantly positive (r = 0.283, P = 0.044). Similarly, the mood/apathy domains of NMSS are also significantly positively correlated with GFAP levels (r = 0.441, P = 0.001). Patients with emotional problems or cognitive impairment had higher GFAP or NFL levels, respectively. Furthermore, it has been demonstrated that NMSs play a mediating role in the quality of life of patients with PD. Moreover, the combination of NFL and GFAP has proven to be more effective than using a single component in identifying PD patients with severe-very severe NMSB. CONCLUSIONS The severity of NMSs in PD patients, particularly cognitive and emotional symptoms, was found to be associated with the levels of serum NFL and GFAP. This study marks the first attempt to examine the connection between NMSs of PD and the simultaneous identification of NFL and GFAP levels.
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Affiliation(s)
- Peixiao Yin
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Xuebin Niu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Chenyang Guan
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Zixuan Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Yuning Liu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Jinyu Li
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Kun Zan
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
| | - Chuanying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Neurology, The First Clinical College, Xuzhou Medical University, Xuzhou, China
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Pasricha TS, Guerrero-Lopez IL, Kuo B. Management of Gastrointestinal Symptoms in Parkinson's Disease: A Comprehensive Review of Clinical Presentation, Workup, and Treatment. J Clin Gastroenterol 2024; 58:211-220. [PMID: 38260966 PMCID: PMC10855995 DOI: 10.1097/mcg.0000000000001961] [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: 09/07/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024]
Abstract
Gastrointestinal symptoms in Parkinson's disease (PD) are among the most prevalent and debilitating of complications and present unique diagnostic and management challenges. Patients with PD commonly experience dysphagia, nausea, bloating, and constipation related to pathologic involvement of the enteric nervous system. In turn, gastrointestinal complications may impact motor fluctuations and the efficacy of levodopa therapy. This review will explore the common gastrointestinal manifestations of PD with an emphasis on clinical presentation, workup, and treatment strategies.
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Affiliation(s)
- Trisha S. Pasricha
- Division of Gastroenterology, Massachusetts General Hospital
- Harvard Medical School, Boston, MA
| | | | - Braden Kuo
- Division of Gastroenterology, Massachusetts General Hospital
- Harvard Medical School, Boston, MA
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Mahlknecht P, Poewe W. Pharmacotherapy for Disease Modification in Early Parkinson's Disease: How Early Should We Be? JOURNAL OF PARKINSON'S DISEASE 2024:JPD230354. [PMID: 38427503 DOI: 10.3233/jpd-230354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Slowing or halting progression continues to be a major unmet medical need in Parkinson's disease (PD). Numerous trials over the past decades have tested a broad range of interventions without ultimate success. There are many potential reasons for this failure and much debate has focused on the need to test 'disease-modifying' candidate drugs in the earliest stages of disease. While generally accepted as a rational approach, it is also associated with significant challenges around the selection of trial populations as well as trial outcomes and durations. From a health care perspective, intervening even earlier and before at-risk subjects have gone on to develop overt clinical disease is at the heart of preventive medicine. Recent attempts to develop a framework for a biological definition of PD are aiming to enable 'preclinical' and subtype-specific diagnostic approaches. The present review addresses past efforts towards disease-modification, including drug targets and reasons for failure, as well as novel targets that are currently being explored in disease-modification trials in early established PD. The new biological definitions of PD may offer new opportunities to intervene even earlier. We critically discuss the potential and challenges around planning 'disease-prevention' trials in subjects with biologically defined 'preclinical' or prodromal PD.
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Affiliation(s)
- Philipp Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Ozawa M, Morishima R, Shimizu T, Takahashi K. Correlation with sympathetic skin response, 123I-MIBG scintigraphy, and 123I-FP-CIT SPECT in Parkinson's disease. Neurophysiol Clin 2024; 54:102956. [PMID: 38422587 DOI: 10.1016/j.neucli.2024.102956] [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: 10/24/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD), and other parkinsonian syndromes are known to cause striatonigral dopaminergic system dysfunction and autonomic disturbances, including the vasomotor and sudomotor nervous systems. The detection of 123I-FP-CIT SPECT (DaT scan) imaging and autonomic dysfunction helps differentiate PD from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). The sympathetic skin response (SSR) is a simple, non-invasive electrophysiological test that assesses the sympathetic sudomotor nervous system. It is reported that the SSR is impaired in patients with PD, MSA, and PSP. OBJECTIVE To study the relationship between SSR, 123I-metaiodobenzylguanidine (MIBG) cardiac scintigraphy and DaT scan imaging parameters in patients with PD, MSA, and PSP. METHODS The study included 62, 25, and 19 patients with PD, MSA, and PSP, respectively. The SSR, MIBG cardiac scintigraphy, and DaT scan imaging were examined. The amplitude and latency of the SSR were measured in all limbs and were compared with the results of MIBG cardiac scintigraphy and DAT scan imaging. RESULTS The SSR amplitudes were lower than reported normal subjects' reference values in PD, MSA, and PSP. The SSR amplitude only correlated with MIBG cardiac scintigraphy and DaT scan imaging parameters in PD. Multiple regression analyses also showed a significant relationship between the amplitudes of SSR and DaT scan imaging in PD. CONCLUSION Unlike MSA, and PSP, the sudomotor nervous system is parallelly involved with cardiac sympathetic and central dopaminergic dysfunction from the early stage of PD.
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Affiliation(s)
- Masakazu Ozawa
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan; Department of Neurology, The Jikei University School of medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Ryo Morishima
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan.
| | - Toshio Shimizu
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan
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Yamakado H, Takahashi R. Experimental Animal Models of Prodromal Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230393. [PMID: 38427504 DOI: 10.3233/jpd-230393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
There is an estimated 35-45% loss of striatal dopamine at the time of diagnosis of Parkinson's disease (PD), and cases clinically diagnosed in the early stages may already be pathologically in advanced stages. Recent large-scale clinical trials of disease-modifying therapies (DMT) also suggest the necessity of targeting patients at earlier stages of the disease. From this perspective, the prodromal phase of PD is currently the focus of attention, emphasizing the need for a prodromal mouse model that accurately reflects the pathophysiology, along with early biomarkers. To establish prodromal animal model of PD with high face validity that reflects the disease state, the model must possess high construct validity that accurately incorporates clinical and pathological features in the prodromal phase. Furthermore, as a preclinical model of DMT, the model must possess high predictive validity to accurately evaluate the response to intervention. This review provides an overview of animal models which reflect the characteristics of prodromal PD, including alpha-synuclein (aS) accumulation and associated early non-motor symptoms, with a focus on the aS propagation model and genetic model. In addition, we discuss the challenges associated with these models. The genetic model often fails to induce motor symptoms, while aS propagation models skip the crucial step of initial aS aggregate formation, thereby not fully replicating the entire natural course of the disease. Identifying factors that induce the transition from prodromal to symptomatic phase is important as a preclinical model for DMT to prevent or delay the onset of the disease.
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Affiliation(s)
- Hodaka Yamakado
- Department of Therapeutics for Multiple System Atrophy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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43
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Bayram E, Reho P, Litvan I, Ding J, Gibbs JR, Dalgard CL, Traynor BJ, Scholz SW, Chia R. Genetic analysis of the X chromosome in people with Lewy body dementia nominates new risk loci. NPJ Parkinsons Dis 2024; 10:39. [PMID: 38378815 PMCID: PMC10879525 DOI: 10.1038/s41531-024-00649-7] [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: 09/25/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Sex influences the prevalence and symptoms of Lewy body dementia (LBD). However, genome-wide association studies typically focus on autosomal variants and exclude sex-specific risk factors. We addressed this gap by performing an X chromosome-wide association study using whole-genome sequence data from 2591 LBD cases and 4391 controls. We identified a significant risk locus within intron 1 of MAP3K15 (rs141773145, odds ratio = 2.42, 95% confidence interval = 1.65-3.56, p-value = 7.0 × 10-6) in female LBD cases conditioned for APOE ε4 dosage. The locus includes an enhancer region that regulates MAP3K15 expression in ganglionic eminence cells derived from primary cultured neurospheres. Rare variant burden testing showed differential enrichment of missense mutations in TEX13A in female LBD cases, that did not reach significance (p-value = 1.34 × 10-4). These findings support the sex-specific effects of genetic factors and a potential role of Alzheimer's-related risk for females with LBD.
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Affiliation(s)
- Ece Bayram
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California San Diego, La Jolla, CA, USA
| | - Paolo Reho
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California San Diego, La Jolla, CA, USA
| | - Jinhui Ding
- Computational Biology Group, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
| | - J Raphael Gibbs
- Computational Biology Group, Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD, USA
| | - Clifton L Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The American Genome Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Bryan J Traynor
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, USA
- Neuromuscular Diseases Research Section, National Institute on Aging, Bethesda, MD, USA
- Therapeutics Development Laboratory, National Center for Advancing Translational Sciences, Rockville, MD, USA
| | - Sonja W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, USA
| | - Ruth Chia
- Neuromuscular Diseases Research Section, National Institute on Aging, Bethesda, MD, USA.
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44
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Maetzler W, Mirelman A, Pilotto A, Bhidayasiri R. Identifying Subtle Motor Deficits Before Parkinson's Disease is Diagnosed: What to Look for? JOURNAL OF PARKINSON'S DISEASE 2024:JPD230350. [PMID: 38363620 DOI: 10.3233/jpd-230350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Motor deficits typical of Parkinson's disease (PD), such as gait and balance disturbances, tremor, reduced arm swing and finger movement, and voice and breathing changes, are believed to manifest several years prior to clinical diagnosis. Here we describe the evidence for the presence and progression of motor deficits in this pre-diagnostic phase in order to provide suggestions for the design of future observational studies for an effective, quantitatively oriented investigation. On the one hand, these future studies must detect these motor deficits in as large (potentially, population-based) cohorts as possible with high sensitivity and specificity. On the other hand, they must describe the progression of these motor deficits in the pre-diagnostic phase as accurately as possible, to support the testing of the effect of pharmacological and non-pharmacological interventions. Digital technologies and artificial intelligence can substantially accelerate this process.
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Affiliation(s)
- Walter Maetzler
- Department of Neurology University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
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45
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Fang S, Lee PAH, Wang Z, Zhao B. The Impact of 90 Parkinson's Disease-Risk Single Nucleotide Polymorphisms on Urinary Bis(monoacylglycerol)phosphate Levels in the Prodromal and PD Cohorts. Int J Mol Sci 2024; 25:2286. [PMID: 38396963 PMCID: PMC10889274 DOI: 10.3390/ijms25042286] [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: 12/27/2023] [Revised: 02/01/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder with a prolonged prodromal phase. Higher urinary bis(monoacylglycerol)phosphate (BMP) levels associate with LRRK2 (leucine-rich repeat kinase 2) and GBA1 (glucocerebrosidase) mutations, and are considered as potential noninvasive biomarkers for predicting those mutations and PD progression. However, their reliability has been questioned, with inadequately investigated genetics, cohorts, and population. In this study, multiple statistical hypothesis tests were employed on urinary BMP levels and sequences of 90 PD-risk single nucleotide polymorphisms (SNPs) from Parkinson's Progression Markers Institution (PPMI) participants. Those SNPs were categorized into four groups based on their impact on BMP levels in various cohorts. Variants rs34637584 G/A and rs34637584 A/A (LRRK2 G2019S) were identified as the most relevant on increasing urinary BMP levels in the PD cohort. Meanwhile, rs76763715 T/T (GBA1) was the primary factor elevating BMP levels in the prodromal cohort compared to its T/C and C/C variants (N370S) and the PD cohort. Proteomics analysis indicated the changed transport pathways may be the reasons for elevated BMP levels in prodromal patients. Our findings demonstrated that higher urinary BMP levels alone were not reliable biomarkers for PD progression or gene mutations but might serve as supplementary indicators for early diagnosis and treatment.
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Affiliation(s)
| | | | - Zejian Wang
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China; (S.F.); (P.A.H.L.)
| | - Bo Zhao
- Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China; (S.F.); (P.A.H.L.)
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46
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Mills KA, Du Y, Coughlin JM, Foss CA, Horti AG, Jenkins K, Skorobogatova Y, Spiro E, Motley CS, Dannals RF, Song JJ, Choi YR, Redding-Ochoa J, Troncoso J, Dawson VL, Kam TI, Pomper MG, Dawson TM. Exploring [ 11C]CPPC as a CSF1R-targeted PET Imaging Marker for Early Parkinson's Disease Severity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.05.28.23290647. [PMID: 37398476 PMCID: PMC10312881 DOI: 10.1101/2023.05.28.23290647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Neuroinflammation through enhanced innate immunity is thought play a role in the pathogenesis of Parkinson's disease (PD). Methods for monitoring neuroinflammation in living patients with PD are currently limited to positron emission tomography (PET) ligands that lack specificity in labeling immune cells in the nervous system. The colony stimulating factor 1 receptor (CSF1R) plays a crucial role in microglial function, an important cellular contributor to the nervous system's innate immune response. Using immunologic methods, we show that CSF1R in human brain is colocalized with the microglial marker, ionized calcium binding adaptor molecule 1 (Iba1). In PD, CSF1R immunoreactivity is significantly increased in PD across multiple brain regions, with the largest differences in the midbrain versus controls. Autoradiography revealed significantly increased [3H]JHU11761 binding in the inferior parietal cortex of PD patients. PET imaging demonstrated that higher [11C]CPPC binding in the striatum was associated with greater motor disability in PD. Furthermore, increased [11C]CPPC binding in various regions correlated with more severe motor disability and poorer verbal fluency. This study finds that CSF1R expression is elevated in PD and that [11C]CPPC-PET imaging of CSF1R is indicative of motor and cognitive impairments in the early stages of the disease. Moreover, the study underscores the significance of CSF1R as a promising biomarker for neuroinflammation in Parkinson's disease, suggesting its potential use for non-invasive assessment of disease progression and severity, leading to earlier diagnosis and targeted interventions.
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Affiliation(s)
- Kelly A Mills
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Yong Du
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Jennifer M Coughlin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Catherine A Foss
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Andrew G Horti
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Katelyn Jenkins
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Yana Skorobogatova
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Ergi Spiro
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Chelsie S Motley
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Robert F Dannals
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
| | - Jae-Jin Song
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Yu Ree Choi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Javier Redding-Ochoa
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Juan Troncoso
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pathology (Neuropathology), Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Valina L Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tae-In Kam
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Martin G Pomper
- Johns Hopkins University School of Medicine, Russell H. Morgan Dept. of Radiology and Radiologic Science, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, US
- Department of Radiology, University of Texas Southwestern School of Medicine, Dallas, TX, USA (current)
| | - Ted M Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, US
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47
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Watanabe H, Dijkstra JM, Nagatsu T. Parkinson's Disease: Cells Succumbing to Lifelong Dopamine-Related Oxidative Stress and Other Bioenergetic Challenges. Int J Mol Sci 2024; 25:2009. [PMID: 38396687 PMCID: PMC10888576 DOI: 10.3390/ijms25042009] [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: 12/29/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
The core pathological event in Parkinson's disease (PD) is the specific dying of dopamine (DA) neurons of the substantia nigra pars compacta (SNc). The reasons why SNc DA neurons are especially vulnerable and why idiopathic PD has only been found in humans are still puzzling. The two main underlying factors of SNc DA neuron vulnerability appear related to high DA production, namely (i) the toxic effects of cytoplasmic DA metabolism and (ii) continuous cytosolic Ca2+ oscillations in the absence of the Ca2+-buffer protein calbindin. Both factors cause oxidative stress by producing highly reactive quinones and increasing intra-mitochondrial Ca2+ concentrations, respectively. High DA expression in human SNc DA neuron cell bodies is suggested by the abundant presence of the DA-derived pigment neuromelanin, which is not found in such abundance in other species and has been associated with toxicity at higher levels. The oxidative stress created by their DA production system, despite the fact that the SN does not use unusually high amounts of energy, explains why SNc DA neurons are sensitive to various genetic and environmental factors that create mitochondrial damage and thereby promote PD. Aging increases multiple risk factors for PD, and, to a large extent, PD is accelerated aging. To prevent PD neurodegeneration, possible approaches that are discussed here are (1) reducing cytoplasmic DA accumulation, (2) blocking cytoplasmic Ca2+ oscillations, and (3) providing bioenergetic support.
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Affiliation(s)
- Hirohisa Watanabe
- Department of Neurology, School of Medicine, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Johannes M. Dijkstra
- Center for Medical Science, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Toshiharu Nagatsu
- Center for Research Promotion and Support, Fujita Health University, Toyoake 470-1192, Aichi, Japan;
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48
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Ahn JH, Kang MC, Youn J, Park KA, Han KD, Jung JH. Nonarteritic anterior ischemic optic neuropathy and incidence of Parkinson's disease based on a nationwide population based study. Sci Rep 2024; 14:2930. [PMID: 38316950 PMCID: PMC10844599 DOI: 10.1038/s41598-024-53196-9] [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: 07/18/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
This study aimed to investigate the association between nonarteritic anterior ischemic optic neuropathy (NAION) and Parkinson's disease (PD) using a retrospective, nationwide, population-based cohort in South Korea. This study utilized data from the Korean National Health Insurance database, including 43,960 NAION patients and 219,800 age- and sex-matched controls. Cox proportional hazards regression models were used to assess the risk of developing PD in the NAION group compared to the control group after adjusting for various confounding factors. Subgroup analyses were conducted based on sex, age, and comorbidities. The incidence rate of PD was higher in the NAION group (1.326 per 1000 person-years) than in the control group (0.859 per 1000 person-years). After adjusting for confounding factors, the risk of developing PD was significantly higher in the NAION group (adjusted hazard ratio [aHR] 1.516, 95% confidence interval [CI] 1.300-1.769). Subgroup analyses did not reveal a significant difference in the risk of PD development based on sex, age, or comorbidities. This retrospective, nationwide, population-based cohort study revealed a significant association between NAION and an increased risk of developing PD in a South Korean population. The incidence rate of PD was observed to be higher in individuals diagnosed with NAION than in age- and sex-matched controls even after adjusting for potential confounding variables, with the risk being approximately 51.6% higher in the NAION group. Further research is necessary to elucidate the underlying pathophysiological mechanisms linking NAION to PD and to determine whether similar associations exist in other ethnic and geographical populations.
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Affiliation(s)
- Jong Hyeon Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Min Chae Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jin-Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
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49
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Blokhin V, Pavlova EN, Katunina EA, Nodel MR, Kataeva GV, Moskalets ER, Pronina TS, Ugrumov MV. Dopamine Synthesis in the Nigrostriatal Dopaminergic System in Patients at Risk of Developing Parkinson's Disease at the Prodromal Stage. J Clin Med 2024; 13:875. [PMID: 38337569 PMCID: PMC10856030 DOI: 10.3390/jcm13030875] [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: 12/11/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
Parkinson's disease (PD) is diagnosed by the onset of motor symptoms and treated long after its onset. Therefore, the development of the early diagnosis of PD is a priority for neurology. Advanced methodologies for this include (1) searching for patients at risk of developing prodromal PD based on premotor symptoms; (2) searching for changes in the body fluids in these patients as diagnostic biomarkers; (3) verifying the diagnosis of prodromal PD and diagnostic-value biomarkers using positron emission tomography (PET); (4) anticipating the development of motor symptoms. According to our data, the majority of patients (n = 14) at risk of developing PD selected in our previous study show pronounced interhemispheric asymmetry in the incorporation of 18F-DOPA into dopamine synthesis in the striatum. This was assessed for the caudate nucleus and putamen separately using the specific binding coefficient, asymmetry index, and putamen/caudate nucleus ratio. Interhemispheric asymmetry in the incorporation of 18F-DOPA into the striatum provides strong evidence for its dopaminergic denervation and the diagnostic value of previously identified blood biomarkers. Of the 17 patients at risk of developing prodromal PD studied using PET, 3 patients developed motor symptoms within a year. Thus, our study shows the promise of using the described methodology for the development of early diagnosis of PD.
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Affiliation(s)
- Victor Blokhin
- Laboratory of Neural and Neuroendocrine Regulations, Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow 119334, Russia; (V.B.); (E.N.P.); (T.S.P.)
| | - Ekaterina N. Pavlova
- Laboratory of Neural and Neuroendocrine Regulations, Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow 119334, Russia; (V.B.); (E.N.P.); (T.S.P.)
| | - Elena A. Katunina
- Federal Center of Brain Research and Neurotechnologies of the Russian Federal Medical and Biological Agency, Moscow 117513, Russia;
- Faculty of Medicine, Department of Neurology, Neurosurgery and Medical Genetics, N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow 117997, Russia
| | - Marina R. Nodel
- Department of Nervous Diseases and Neurosurgery, Sechenov First Moscow State Medical University (Sechenov University), Moscow 119435, Russia;
| | - Galina V. Kataeva
- Federal State Budget Institution Granov Russian Research Center of Radiology and Surgical Technologies Ministry of Health of the Russian Federation (RRCRST) 70, Leningradskaya Street, Pesochny, St. Petersburg 197758, Russia;
| | | | - Tatiana S. Pronina
- Laboratory of Neural and Neuroendocrine Regulations, Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow 119334, Russia; (V.B.); (E.N.P.); (T.S.P.)
| | - Michael V. Ugrumov
- Laboratory of Neural and Neuroendocrine Regulations, Koltzov Institute of Developmental Biology of Russian Academy of Sciences, Moscow 119334, Russia; (V.B.); (E.N.P.); (T.S.P.)
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50
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Wang S, An N, Wang Y, Li Y, Li H, Bai Y. Knowledge mapping of prodromal Parkinson's disease: A bibliometric review and analysis (2000-2023). Medicine (Baltimore) 2024; 103:e36985. [PMID: 38306521 PMCID: PMC10843421 DOI: 10.1097/md.0000000000036985] [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: 11/22/2023] [Accepted: 12/22/2023] [Indexed: 02/04/2024] Open
Abstract
The prodromal period of Parkinson's disease (PD) is currently a hot topic in PD research. However, no bibliometric analysis has been conducted in this research field. This study aimed to provide a comprehensive overview of the status, hotspots, and trends in the prodromal period of PD using bibliometrics. CiteSpace and visualization of similarities viewer were used to analyze articles and reviews on the prodromal period of PD in the Web of Science Core Collection (WoSCC) database. We analyzed the data on countries, institutions, journals, authors, keywords, and cited references. In total, 909 articles from 65 countries, including the United States (n = 265, 29.15%) and Germany (n = 174, 19.14%), were included. The number of articles and reviews related to the prodromal period of PD has increased yearly. The University of Tubingen (n = 45, 4.95%), McGill University (n = 33, 3.63%), and University of London (n = 33, 3.63%) were the research institutions with the most published studies. Movement Disorders is the journal with the largest number of published papers (n = 98, 10.8%) and the most cited publications (co-citation = 7035). These publications are from 4681 authors, with Berg (n = 49, 5.39%) and Postuma (n = 40, 4.40%) publishing the most publications, and Postuma's study (n = 1206) having the most citations. Studying the nonmotor symptoms of PD precursors is a major topic in this research field. This is the first bibliometric study to comprehensively summarize the research trends and developments in the prodromal period of PD. This information identifies recent research frontiers and hotspots and provides a reference for scholars studying the prodromal period of PD.
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Affiliation(s)
- Shun Wang
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Ning An
- Second Clinical Medical College, Heilongjiang University of Traditional Chinese Medicine, Heilongjiang, China
| | - Yulin Wang
- Department of Science and Technology, Heilongjiang University of Traditional Chinese Medicine, Heilongjiang, China
| | - Yuan Li
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Hailong Li
- Department of Acupuncture and Moxibustion, Heilongjiang Academy of Traditional Chinese Medicine, Heilongjiang, China
| | - Yan Bai
- Department of Acupuncture and Moxibustion, Heilongjiang Academy of Traditional Chinese Medicine, Institute of Acupuncture and Moxibustion, Heilongjiang, China
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