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Yoon B, Sa HS, Kim HJ. Incidence and risk factors of age-related macular degeneration in patients with Parkinson's disease: a population-based study. Front Aging Neurosci 2024; 16:1331786. [PMID: 38706458 PMCID: PMC11066286 DOI: 10.3389/fnagi.2024.1331786] [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: 11/01/2023] [Accepted: 03/27/2024] [Indexed: 05/07/2024] Open
Abstract
Background and objective The association between age-related macular degeneration (AMD) and Parkinson' disease (PD) remains unclear. The aim of the present study was to assess the incidence of AMD in patients with PD, elucidate differences by age and sex, and investigate potential risk factors for AMD. Methods Data were extracted from the Korean National Health Insurance System database, which covers 97% of the Korean population (2002 through 2019). We calculated the incidence of newly diagnosed AMD in patients with PD and used Cox proportional-hazards models to estimate risk factors for AMD, presenting adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Results Of 172,726 patients with PD, 15,800 were newly diagnosed with AMD during the follow-up, including 5,624 men and 10,176 women. The overall incidence of AMD in patients with PD was 13.59 per 1,000 person-years. Stratified by age group and sex, the incidence was higher in women aged 40-69, and conversely higher in men aged 70-89. Risk of AMD was high in older age groups (aHR = 4.36, 95% CI: 3.74-5.09 in the 70 s), female sex (aHR = 1.07, 95% CI: 1.04-1.11), patients with diabetes mellitus (DM) (aHR = 1.14, 95% CI: 1.10-1.18), and patients with hyperlipidemia (aHR = 1.17, 95% CI: 1.13-1.21). Conclusion Our findings suggest that the AMD incidence is higher in patients with PD than in the general population, with varying patterns of sex differences across age groups. Particularly, old age, female sex, presence of DM, and hyperlipidemia are potential risk factors. Therefore, clinicians should pay greater attention to AMD in patients with PD.
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Affiliation(s)
- Bora Yoon
- Department of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho-Seok Sa
- Department of Ophthalmology, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Amini E, Rohani M, Fasano A, Azad Z, Miri S, Habibi SAH, Emamikhah M, Mirshahi R, Joghataei MT, Gholibeigian Z, Ghasemi Falavarjani K. Neurodegeneration with Brain Iron Accumulation Disorders and Retinal Neurovascular Structure. Mov Disord 2024; 39:411-423. [PMID: 37947042 DOI: 10.1002/mds.29644] [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: 05/09/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The unique neurovascular structure of the retina has provided an opportunity to observe brain pathology in many neurological disorders. However, such studies on neurodegeneration with brain iron accumulation (NBIA) disorders are lacking. OBJECTIVES To investigate NBIA's neurological and ophthalmological manifestations. METHODS This cross-sectional study was conducted on genetically confirmed NBIA patients and an age-gender-matched control group. The thickness of retinal layers, central choroidal thickness (CCT), and capillary plexus densities were measured by spectral domain-optical coherence tomography (SD-OCT) and OCT angiography, respectively. The patients also underwent funduscopy, electroretinography (ERG), visual evoked potential (VEP), and neurological examination (Pantothenate-Kinase Associated Neurodegeneration-Disease Rating Scale [PKAN-DRS]). The generalized estimating equation model was used to consider inter-eye correlations. RESULTS Seventy-four patients' and 80 controls' eyes were analyzed. Patients had significantly decreased visual acuity, reduced inner or outer sectors of almost all evaluated layers, increased CCT, and decreased vessel densities, with abnormal VEP and ERG in 32.4% and 45.9%, respectively. There were correlations between visual acuity and temporal peripapillary nerve fiber layer (positive) and between PKAN-DRS score and disease duration (negative), and scotopic b-wave amplitudes (positive). When considering only the PKAN eyes, ONL was among the significantly decreased retinal layers, with no differences in retinal vessel densities. Evidence of pachychoroid was only seen in patients with Kufor Rakeb syndrome. CONCLUSION Observing pathologic structural and functional neurovascular changes in NBIA patients may provide an opportunity to elucidate the underlying mechanisms and differential retinal biomarkers in NBIA subtypes in further investigations. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elahe Amini
- ENT and Head and Neck Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Alfonso Fasano
- University Health Network University of Toronto, Toronto, Ontario, Canada
| | - Zahra Azad
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Shahnaz Miri
- Vision Neurology Center, San Francisco, California, USA
| | - Seyed Amir Hassan Habibi
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Emamikhah
- Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mirshahi
- Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zeinab Gholibeigian
- Skull Base Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Khalil Ghasemi Falavarjani
- Eye Research Center, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
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Tran KK, Lee PY, Finkelstein DI, McKendrick AM, Nguyen BN, Bui BV, Nguyen CT. Altered Outer Retinal Structure, Electrophysiology and Visual Perception in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:167-180. [PMID: 38189711 PMCID: PMC10836541 DOI: 10.3233/jpd-230293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Visual biomarkers of Parkinson's disease (PD) are attractive as the retina is an outpouching of the brain. Although inner retinal neurodegeneration in PD is well-established this has overlap with other neurodegenerative diseases and thus outer retinal (photoreceptor) measures warrant further investigation. OBJECTIVE To examine in a cross-sectional study whether clinically implementable measures targeting outer retinal function and structure can differentiate PD from healthy ageing and whether these are sensitive to intraday levodopa (L-DOPA) dosing. METHODS Centre-surround perceptual contrast suppression, macular visual field sensitivity, colour discrimination, light-adapted electroretinography and optical coherence tomography (OCT) were tested in PD participants (n = 16) and controls (n = 21). Electroretinography and OCT were conducted before and after midday L-DOPA in PD participants, or repeated after ∼2 hours in controls. RESULTS PD participants had decreased center-surround contrast suppression (p < 0.01), reduced macular visual field sensitivity (p < 0.05), color vision impairment (p < 0.01) photoreceptor dysfunction (a-wave, p < 0.01) and photoreceptor neurodegeneration (outer nuclear layer thinning, p < 0.05), relative to controls. Effect size comparison between inner and outer retinal parameters showed that photoreceptor metrics were similarly robust in differentiating the PD group from age-matched controls as inner retinal changes. Electroretinography and OCT were unaffected by L-DOPA treatment or time. CONCLUSIONS We show that outer retinal outcomes of photoreceptoral dysfunction (decreased cone function and impaired color vision) and degeneration (i.e., outer nuclear layer thinning) were equivalent to inner retinal metrics at differentiating PD from healthy age-matched adults. These findings suggest outer retinal metrics may serve as useful biomarkers for PD.
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Affiliation(s)
- Katie K.N. Tran
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Pei Ying Lee
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - David I. Finkelstein
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Allison M. McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
- Division of Optometry, School of Allied Health, The University of Western Australia, Crawley, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Bao N. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Bang V. Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Christine T.O. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
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Elanwar R, Al Masry H, Ibrahim A, Hussein M, Ibrahim S, Masoud MM. Retinal functional and structural changes in patients with Parkinson's disease. BMC Neurol 2023; 23:330. [PMID: 37723424 PMCID: PMC10506234 DOI: 10.1186/s12883-023-03373-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Visual dysfunction have been well reported as one of the non-motor symptoms in Parkinson's disease (PD). The aim of this study was to evaluate the functional and structural changes in the retina in patients with PD, and to correlate these changes with disease duration and motor dysfunction. METHODS For this case-control study, we recruited patients fulfilling the diagnostic criteria for idiopathic PD according to British Brain Bank criteria, aged between 50 and 80 years. Age- and sex-matched healthy controls aged between 50 and 80 years were also recruited. Motor function for PD patients was assessed using Modified Hoehn and Yahr staging scale (H & Y staging) and Unified Parkinson's Disease Rating Scale (UPDRS). Optical Coherence Tomography (OCT) and full field electroretinogram (ff-ERG) were done to all participants. RESULTS Data from 50 patients and 50 healthy controls were included in the analysis. Patients with idiopathic Parkinson's had significantly reduced peripapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC) thickness compared to healthy controls (P-value < 0.05 in all parameters). They also had significantly delayed latency and reduced amplitude in both dark-adapted rods and the light-adapted cone for both a & b waves compared to healthy controls (P-value < 0.001 in all parameters). There were statistically significant negative correlations between disease duration, and left superior, right inferior and right & left average RNFL thickness [(r) coef. = -0.327, -0.301, -0.275, and -0.285 respectively]. UPDRS total score was negatively correlated with the amplitude of light-adapted of both RT and LT a & b wave and with dark-adapted RT b-wave latency [(r) coef. = -0.311, -0.395, -0.362, -0.419, and -0.342]. CONCLUSION The retinal structure and function were significantly affected in patients with PD in comparison to healthy controls. There was a significant impact of disease duration on retinal thickness, and there was a significant negative correlation between the degree of motor dysfunction in patients with PD and retinal function.
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Affiliation(s)
- Rehab Elanwar
- Neuro Diagnostic Research Center, Beni-Suef University, Beni-Suef, Egypt
| | - Hatem Al Masry
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
| | - Amna Ibrahim
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt.
| | - Sahar Ibrahim
- Department of Ophthalmology, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Mohammed M Masoud
- Department of Neurology, Beni-Suef University, Salah Salem Street, Beni-Suef, Egypt
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Satue M, Castro L, Vilades E, Cordon B, Errea JM, Pueyo A, Chueca EP, Garcia-Martin E. Ability of Swept-source OCT and OCT-angiography to detect neuroretinal and vasculature changes in patients with Parkinson disease and essential tremor. Eye (Lond) 2023; 37:1314-1319. [PMID: 35650321 PMCID: PMC10169798 DOI: 10.1038/s41433-022-02112-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/19/2022] [Accepted: 05/13/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To evaluate the ability of swept-source optical coherence tomography (SS-OCT) implemented with angiography analysis (SS-OCTA) to detect neuro-retinal and vasculature changes in patients with Parkinson's disease (PD) and essential tremor (ET), and to distinguish between both pathologies. SUBJECTS/METHODS A total 42 PD and 26 ET patients and 146 controls underwent retinal evaluation using SS-OCT plus OCT-Angio™. The macular (m) and peripapillary (p) retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), and macular vasculature were assessed. A Linear discriminant function (LDF) was calculated to evaluate the diagnostic ability of SS-OCTA in both PD and ET. RESULTS PD patients presented a reduction in mRNFL (p < 0.005), mGCL (all sectors, p < 0.05) and pRNFL (p < 0.005) vs healthy controls, and in mRNFL and pRNFL vs ET patients (p < 0.001). ET patients showed a significant reduction in mGCL vs controls (p < 0.001). No differences were observed in the macular vasculature between groups. Predictive diagnostic variables were significant only for PD and a LDF was obtained with an area under the ROC curve of 0.796. CONCLUSIONS Neuro-retinal thinning is present in both diseases, being greater in PD. While SS-OCT could be useful in diagnosing ET and PD, the diagnostic potential for SS-OCTA based on an LDF applies only to PD, not ET.
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Affiliation(s)
- Maria Satue
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.
- Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain.
| | - Luisa Castro
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Elisa Vilades
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Beatriz Cordon
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Jose M Errea
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Ana Pueyo
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Eva Pilar Chueca
- Parkinson's Association of Aragon Integral Rehabilitation Center, Zaragoza, Spain
| | - Elena Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Miguel Servet Ophthalmology Research and Innovation Group (GIMSO), Aragon Institute for Health Research (IIS Aragón), Zaragoza University, Zaragoza, Spain
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Narrative Review Concerning the Clinical Spectrum of Ophthalmological Impairments in Parkinson's Disease. Neurol Int 2023; 15:140-161. [PMID: 36810467 PMCID: PMC9944508 DOI: 10.3390/neurolint15010012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023] Open
Abstract
Ophthalmic non-motor impairments are common in Parkinson's disease patients, from the onset of the neurodegenerative disease and even prior to the development of motor symptoms. This is a very crucial component of the potential for early detection of this disease, even in its earliest stages. Since the ophthalmological disease is extensive and impacts all extraocular and intraocular components of the optical analyzer, a competent assessment of it would be beneficial for the patients. Because the retina is an extension of the nervous system and has the same embryonic genesis as the central nervous system, it is helpful to investigate the retinal changes in Parkinson's disease in order to hypothesize insights that may also be applicable to the brain. As a consequence, the detection of these symptoms and signs may improve the medical evaluation of PD and predict the illness' prognosis. Another valuable aspect of this pathology is the fact that the ophthalmological damage contributes significantly to the decrease in the quality of life of patients with Parkinson's disease. We provide an overview of the most significant ophthalmologic impairments associated with Parkinson's disease. These results certainly constitute a large number of the prevalent visual impairments experienced by PD patients.
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The Relationship between Visual-Evoked Potential and Optic Coherence Tomography and Clinical Findings in Parkinson Patients. PARKINSON'S DISEASE 2023; 2023:7739944. [PMID: 36873294 PMCID: PMC9981293 DOI: 10.1155/2023/7739944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/14/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
Background In Parkinson's disease (PD), dopamine deficiency is present not only in the nigrostriatal pathway but also in the retinal and visual pathways. Optic coherence tomography (OCT) can be used as morphological evidence of visual influence from early nonmotor symptoms. The aim of this study was to investigate the relationship of OCT and visual evoked potentials (VEPs) of eyes with the severity of clinical findings and ocular findings in PD. Methods A group of 42 patients diagnosed with idiopathic PD and a control group of 29 people between the ages of 45-85 were included in our study. VEP was recorded in the patient and control groups. OCT measurement was made with the Optovue spectral-domain device. Foveal thickness and macular volume were measured in the foveal region and in the parafoveal and perifoveal regions in the temporal, superior, nasal, and inferior quadrants. RNFL (retinal nerve fiber layer) was measured in temporal, superior, nasal, and inferior quadrants. Ganglion cell complex (GCC) was evaluated in the superior and inferior quadrants. Using the UPDRS clinical scale, the relationship between measurements and the differences between the control group and the patient group were evaluated. Results Among the OCT values in our study, foveal, parafoveal, perifoveal thickness, macular volume, RNFL, and GCC measurements were performed for the right and left eyes, and no difference was found between the patient group and the control group. There was no difference in VEP amplitude and latency values between the patient and control groups. The relationships between UPDRS and modified Hoehn Yahr staging and OCT and VEP measurements in the patient revealed no correlation. Conclusions Studies on whether OCT measurements can functionally be a marker or which segments are more valuable for disease progression in patients with PD are needed. Visual dysfunction in PD cannot be attributed only to retinal pathology; however, the retina may provide monitoring of the status of dopaminergic neurodegeneration and axonal loss in PD.
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REDUCED POWER AND PHASE-LOCKING VALUES WERE ACCOMPANIED BY THALAMUS, PUTAMEN AND HIPPOCAMPUS ATROPHY IN PARKINSON'S DISEASE WITH MILD COGNITIVE IMPAIRMENT: AN EVENT-RELATED OSCILLATION STUDY. Neurobiol Aging 2022; 121:88-106. [DOI: 10.1016/j.neurobiolaging.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
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Zhao Y, Dai W, Liu D. Quantitative analysis of related parameters of retinal nerve fiber layer and ganglion cell complex thickness in patients with different degrees of Parkinson's disease. Aging Clin Exp Res 2022; 34:2355-2361. [PMID: 36048412 DOI: 10.1007/s40520-022-02211-y] [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: 03/24/2022] [Accepted: 07/25/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE A quantitative analysis was performed to evaluate the morphologic changes of the retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) in patients with Parkinson's disease (PD). METHODS Thirty PD patients were enrolled, and they were allocated to the mild-to-moderate PD group (n = 15) or severe PD group (n = 15) according to the severity of PD. Twenty healthy volunteers (20 eyes) were included as controls. Optical coherence tomography (OCT) was used to measure the thickness of mean RNFL and each of the sectors: temporal-upper (TU), superior-temporal (ST), superior-nasal (SN), nasal-upper (NU), nasal-lower (NL), inferior-nasal (IN), inferior-temporal (IT), temporal-lower (TL). The thickness of macular GCC, superior GCC, and inferior GCC was also measured. RESULTS No difference was found between the three groups with respect to age, sex and disease course (p > 0.05). The mean RNFL thickness was 118.15 ± 10.25 µm in the control group, 96.12 ± 9.45 µm in the mild-to-moderate PD group, and 80.48 ± 10.35 µm in the severe PD group. Significant differences were found in the mean RNFL thickness and thickness of TU, IN, IT and TL sectors among the three groups (p < 0.05). These values, mean RNFL, TU, IN, IT, and TL, were lower in both the PD groups than those in the control, among them the severe PD group had the lowest values. A quantitative analysis of the macula GCC was also performed. Overall, there were significant differences in mean macula, superior, and inferior GCC thickness among the three groups (p < 0.05). The two PD groups had lower values of mean macula, superior, and inferior GCC thickness than that in the controls (p < 0.05); and the severe PD group had lowest values of these parameters. CONCLUSION In this study, significant thinning of RNFL and macular GCC was found in PD patients. The more serious the illness, the more the thickness becomes thinner. The OCT measurement was found useful in detecting the structural alterations in the retina of PD. The technique may be useful in follow-up of the disease progression after further validation.
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Affiliation(s)
- Ying Zhao
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Weijia Dai
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China.
| | - Dachuan Liu
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China.
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Chen QX, Zhou L, Long T, Qin DL, Wang YL, Ye Y, Zhou XG, Wu JM, Wu AG. Galangin Exhibits Neuroprotective Effects in 6-OHDA-Induced Models of Parkinson’s Disease via the Nrf2/Keap1 Pathway. Pharmaceuticals (Basel) 2022; 15:ph15081014. [PMID: 36015161 PMCID: PMC9413091 DOI: 10.3390/ph15081014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease, and there is still no cure for it. PD is characterized by the degeneration of dopaminergic neurons, and oxidative stress has been considered an important pathological mechanism. Therefore, the discovery of antioxidants to alleviate the oxidative damage of dopaminergic neurons is a promising therapeutic strategy for PD. First, a network pharmacology approach was used, and nine common core targets of galangin and PD were screened, mainly involving cell aging, apoptosis, and cellular responses to hydrogen peroxide and hypoxia. In addition, the Gene Ontology (GO) function and pathway enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) identified apoptosis, PI3K/Akt, and HIF-1 signaling pathways. Furthermore, the molecular docking results revealed a strong affinity between galangin and the NFE2L2/Nrf2 protein. To validate the above predictions, we employed 6-hydroxydopamine (6-OHDA) to induce neuronal death in HT22 cells and Caenorhabditis elegans (C. elegans). MTT, cell morphology observation, and Hoechst 33342-PI staining results showed that galangin significantly increased the viability of 6-OHDA-treated HT22 cells. In addition, galangin inhibited 6-OHDA-induced ROS generation and apoptosis in HT22 cells. Mechanistic studies demonstrated that galangin activates the Nrf2/Keap1 signaling pathway, as evidenced by the decreased protein expression of Keap1 and increased protein expression of Nrf2 and HO-1. In the 6-OHDA-induced PD model of C. elegans, galangin indeed inhibited the degeneration of dopaminergic neurons, improved behavioral ability, and decreased ROS generation. In conclusion, the current study is the first to show that galangin has the capacity to inhibit neuronal degeneration via the Nrf2/Keap1 pathway, suggesting that galangin is a possible PD treatment.
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Affiliation(s)
- Qiu-Xu Chen
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Ling Zhou
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Tao Long
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Da-Lian Qin
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Yi-Ling Wang
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Yun Ye
- Department of Pharmacy, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
| | - Xiao-Gang Zhou
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
| | - Jian-Ming Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
- Correspondence: (J.-M.W.); (A.-G.W.)
| | - An-Guo Wu
- Sichuan Key Medical Laboratory of New Drug Discovery and Druggability Evaluation, Materia Medica, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, School of Pharmacy, Southwest Medical University, Luzhou 646000, China
- Education Ministry Key Laboratory of Medical Electrophysiology, School of Preclinical Medicine, Southwest Medical University, Luzhou 646000, China
- Correspondence: (J.-M.W.); (A.-G.W.)
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Combined drug triads for synergic neuroprotection in retinal degeneration. Biomed Pharmacother 2022; 149:112911. [DOI: 10.1016/j.biopha.2022.112911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
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Zhang Y, Zhang X, Yue Y, Tian T. Retinal Degeneration: A Window to Understand the Origin and Progression of Parkinson’s Disease? Front Neurosci 2022; 15:799526. [PMID: 35185448 PMCID: PMC8854654 DOI: 10.3389/fnins.2021.799526] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Parkinson’s disease (PD), the second most prevalent neurodegenerative disorder, manifests with motor and non-motor symptoms associated with two main pathological hallmarks, including the deterioration of dopaminergic cells and aggregation of alpha-synuclein. Yet, PD is a neurodegenerative process whose origin is uncertain and progression difficult to monitor and predict. Currently, a possibility is that PD may be secondary to long lasting peripheral affectations. In this regard, it has been shown that retinal degeneration is present in PD patients. Although it is unknown if retinal degeneration precedes PD motor symptoms, the possibility exists since degeneration of peripheral organs (e.g., olfaction, gut) have already been proven to antedate PD motor symptoms. In this paper, we explore this possibility by introducing the anatomical and functional relationship of retina and brain and providing an overview of the physiopathological changes of retinal structure and visual function in PD. On the basis of the current status of visual deficits in individuals with PD, we discuss the modalities and pathological mechanism of visual function or morphological changes in the retina and focus on the correlation between visual impairment and some representative structural features with clinical significance. To consider retinal degeneration as a contributor to PD origin and progress is important because PD evolution may be monitored and predicted by retinal studies through state-of-the-art techniques of the retina. It is significant to integrally understand the role of retinal morphological and functional changes in the neurodegenerative process for the diagnosis and therapeutic strategies of PD.
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Affiliation(s)
- Yanyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoguang Zhang
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunhua Yue
- Department of Neurology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Yunhua Yue,
| | - Tian Tian
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Tian Tian,
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Kumar Das N, Das M. Structural changes in retina (Retinal nerve fiber layer) following mild traumatic brain injury and its association with development of visual field defects. Clin Neurol Neurosurg 2021; 212:107080. [PMID: 34883282 DOI: 10.1016/j.clineuro.2021.107080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 11/21/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mild traumatic brain injury (mTBI)is the most common form of traumatic brain injury accounting for 70-80% of all brain injuries annually. There is increasing evidence that long lasting morphological and functional consequence can be present in visual system following mTBI. Among all the visual manifestation, awareness of Visual field defects is important because it may compromise the social, personal or professional life of any individual. Retinal structural changes such as thinning of Retinal nerve fiber layer (RFNL)captured using optical coherence tomography have emerged as a possible biomarker in many neurological diseases however very little is known in cases with mTBI OBJECTIVE: (I) To demonstrate the structural changes/morphological changes in retina if any following mTBI. (II) Whether the structural changes in retina have any association with the development of Visual field deficits leading to Visual function impairment following mTBI (III) Clinical relevance of structural changes in retina as a possible biomarker for visual function impairment due to visual field deficits. MATERIALS AND METHODS Our study included 60 patients with mTBI who fulfilled the inclusion criteria. All patients underwent a detailed ophthalmic evaluation with special focus on temporal recording of Retinal nerve layer thickness using SD- Optical Coherence Tomography and Visual field (Visual field Index) by Humphrey Automated Field Analyser. RESULTS 30% of eyes had significant thinning of RFNL (> 30% of the base line thickness) at 6 months following mTBI. Visual function impairment due to visual field deficits (VFI < 80%) at 6 months was seen in 40% of the eyes. The structural changes and visual function impairment peaked at 6 months' post injury. A strong Association was noted between RFNL thinning and manifestation of Visual field deficits (VFI < 80%) leading to visual function impairment (P < 0.001). The Correlation Co-efficient between thinning of RFNL and Visual field deficits had a positive correlation(p < 0.001). CONCLUSION This novel study has demonstrated that visual functional impairment due to Visual field deficits is a real possibility following mTBI. Monitoring of retinal parameter such as thinning of Retinal nerve fiber layer, using Optical coherence tomography, can be a biomarker for early detection or development of visual field defects in mTBI.
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Affiliation(s)
- Narendra Kumar Das
- Department of Neurosurgery, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Patia, Bhubaneswar, Odisha, India.
| | - Matuli Das
- Department of Ophthalmology, Member-Medical Education Unit, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Patia, Bhubaneswar, Odisha, India.
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Abdulhussein D, Kanda M, Aamir A, Manzar H, Yap TE, Cordeiro MF. Apoptosis in health and diseases of the eye and brain. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2021; 126:279-306. [PMID: 34090617 DOI: 10.1016/bs.apcsb.2021.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Apoptosis is a form of programmed cell death (PCD) and enables the immunologically silent disposal of senescent or unwanted cells, causing minimal damage to the surrounding environment. Apoptosis can occur via intrinsic or extrinsic pathways that initiate a series of intracellular and extracellular signaling events. This ultimately leads to the clearance of the cell by phagocytes. This normal physiological mechanism may be accelerated in several diseases including those involving the eyes and brain, leading to loss of structure and function. This review presents the role of PCD in the health of the eyes and brain, and the evidence presented for its aberrant role in disease.
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Affiliation(s)
- Dalia Abdulhussein
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom
| | - Mumta Kanda
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, United Kingdom
| | - Abdullah Aamir
- Whipps Cross Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Haider Manzar
- The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom
| | - Timothy E Yap
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, United Kingdom; The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom
| | - M Francesca Cordeiro
- The Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, United Kingdom; The Imperial College Ophthalmic Research Group (ICORG), Imperial College London, London, United Kingdom; Glaucoma and Retinal Neurodegeneration Group, UCL Institute of Ophthalmology, London, United Kingdom.
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15
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Song A, Johnson N, Ayala A, Thompson AC. Optical Coherence Tomography in Patients with Alzheimer's Disease: What Can It Tell Us? Eye Brain 2021; 13:1-20. [PMID: 33447120 PMCID: PMC7802785 DOI: 10.2147/eb.s235238] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/09/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Although Alzheimer's disease (AD) is a leading cause of dementia worldwide, its clinical diagnosis remains a challenge. Optical coherence tomography (OCT) and OCT with angiography (OCTA) are non-invasive ophthalmic imaging tools with the potential to detect retinal structural and microvascular changes in patients with AD, which may serve as biomarkers for the disease. In this systematic review, we evaluate whether certain OCT and OCTA parameters are significantly associated with AD and mild cognitive impairment (MCI). METHODS PubMed database was searched using a combination of MeSH terms to identify studies for review. Studies were organized by participant diagnostic groups, type of imaging modality, and OCT/OCTA parameters of interest. Participant demographic data was also collected and baseline descriptive statistics were calculated for the included studies. RESULTS Seventy-one studies were included for review, representing a total of 6757 patients (2350 AD, 793 MCI, 2902 healthy controls (HC), and 841 others with a range of other neurodegenerative diagnoses). The mean baseline ages were 72.78±3.69, 71.52±2.88, 70.55±3.85 years for AD, MCI and HC groups, respectively. The majority of studies noted significant structural and functional decline in AD patients when compared to HC. Although analysis of MCI groups yielded more mixed results, a similar pattern of decline was often noted amongst patients with MCI relative to HC. OCT and OCTA measurements were also shown to correlate with established measures of AD such as neuropsychological testing or neuroimaging. CONCLUSION OCT and OCTA show great potential as non-invasive technologies for the diagnosis of AD. However, further research is needed to determine whether there are AD-specific patterns of structural or microvascular change in the retina and optic nerve that distinguish AD from other neurodegenerative diseases. Development of sensitive and specific OCT/OCTA parameters will be necessary before they can be used to detect AD in clinical settings.
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Affiliation(s)
- Ailin Song
- Duke University School of Medicine, Durham, NC, USA
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Zhou WC, Tao JX, Li J. Optical coherence tomography measurements as potential imaging biomarkers for Parkinson's disease: A systematic review and meta-analysis. Eur J Neurol 2020; 28:763-774. [PMID: 33107159 DOI: 10.1111/ene.14613] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/15/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Retinal pathological changes may precede or accompany the deterioration of brain tissue in Parkinson's disease (PD). The purpose of this meta-analysis was to assess the usefulness of optical coherence tomography (OCT) measurements as potential imaging biomarkers for PD. METHODS PubMed, Embase, Web of Science and Cochrane Library databases were systematically searched for observational studies (published prior to 30 May 2020) comparing the OCT measurements between PD patients and healthy controls (HCs). Our main end-points were peripapillary retinal nerve fiber layer (pRNFL) thickness, macular ganglion cell complex thickness, macular thickness and macular volume. Pooled data were assessed by use of a random-effects model. RESULTS A total of 36 observational studies were identified that included 1712 patients with PD (2548 eyes) and 1778 HCs (2646 eyes). Compared with the HC group, the PD group showed a significant reduction in mean pRNFL thickness (weighted mean difference [WMD] -3.51 μm, 95% confidence interval [CI] -4.84, -2.18; p = 0.000), all quadrants at the pRNFL (WMD range -7.65 to -2.44 μm, all p < 0.05), macular fovea thickness (WMD -5.62 μm, 95% CI -7.37, -3.87; p = 0.000), all outer sector thicknesses at the macula (WMD range -4.68 to -4.10 μm, all p < 0.05), macular volume (WMD -0.21 mm3 , 95% CI -0.36, -0.06; p < 0.05) and macular ganglion cell complex thickness (WMD -4.18 μm, 95% CI -6.07, -2.29; p < 0.05). CONCLUSIONS Our pooled data confirmed robust associations between retinal OCT measurements and PD, highlighting the usefulness of OCT measurements as potential imaging biomarkers for PD.
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Affiliation(s)
- Wen-Chuan Zhou
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jin-Xin Tao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
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Huang L, Zhang D, Ji J, Wang Y, Zhang R. Central retina changes in Parkinson's disease: a systematic review and meta-analysis. J Neurol 2020; 268:4646-4654. [PMID: 33174132 DOI: 10.1007/s00415-020-10304-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Central retina imaging is important for early Parkinson's disease (PD) recognition. We aimed to investigate central retina changes using spectral domain-optical coherence tomography (SD-OCT) in PD patients. METHODS We systematically searched PubMed and EMBASE to identify studies comparing the whole or individual layer thickness of central retina between PD patients and health controls using SD-OCT from inception to April 25, 2020. Data were extracted at eye level. We pooled the mean difference with random effects model. Subgroup analysis and mete-regression were done to detect possible source of heterogeneity. RESULTS We included 27 studies (28 sets of data) enrolling 1470 PD patients (2288 eyes) and 1552 health controls (2524 eyes) in our meta-analysis. Compared with control eyes, the whole thickness of central retina decreased significantly at fovea center by mean difference - 2.70 μm (95% CI [- 4.87, - 0.53], p = 0.01) and in all quadrants in PD eyes. The combination of ganglion cell layer and inner plexiform layer thinned by an average mean difference of - 3.17 μm (95% CI [- 5.07, - 1.26], p = 0.001). The nerve fiber layer thinned by an average mean difference - 0.66 μm (95% CI [- 1.09 to - 0.23], p = 0.003). There was no significant difference in the thickness of inner nuclear layer, outer plexiform layer and outer nuclear layer between eyes of PD and controls. The results of subgroup analysis and mete-regression were consistent. CONCLUSION The whole thickness, the thickness of the combination of ganglion cell layer and inner plexiform layer, and nerve fiber layer of central retina decreased significantly in PD patients.
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Affiliation(s)
- Lele Huang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjingbei Street, Heping District, Shenyang, 110001, People's Republic of China
| | - Dan Zhang
- Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China
- Dalian Medical University, 9 Western Sections, Lvshun South Street, Lvshunkou District, Dalian, 116044, People's Republic of China
| | - Jianling Ji
- Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China
- Dalian Medical University, 9 Western Sections, Lvshun South Street, Lvshunkou District, Dalian, 116044, People's Republic of China
| | - Yujie Wang
- Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China
| | - Ruijun Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjingbei Street, Heping District, Shenyang, 110001, People's Republic of China.
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Abstract
PURPOSE To evaluate visual and retinal changes in patients with bipolar disorder. To analyze the correlation between structural changes and visual function parameters. METHODS Thirty patients with bipolar disorder and 80 healthy controls underwent visual function evaluation with Early Treatment Diabetic Retinopathy Study charts at 100%, 2.50%, and 1.25% contrast, Pelli-Robson chart, and color vision Farnsworth and Lanthony tests. Analysis of the different retinal layers was performed using Spectralis optical coherence tomography with automated segmentation software. Correlation analysis between structural and functional parameters was conducted. RESULTS Patients with bipolar disorder presented worse color vision compared with controls (Lanthony's index, P = 0.002). Full macular thickness, the retinal nerve fiber layer (RNFL), ganglion cell layer, and inner plexiform layer were reduced in patients compared with healthy individuals (P < 0.005). The inner nuclear layer was significantly thickened in patients (P < 0.005). Peripapillary RNFL thickness was reduced in all temporal sectors (P < 0.005). Significant correlations were found between visual acuity and the RNFL thickness, the Pelli-Robson score and the inner plexiform layer, and between the Lanthony's color index and the ganglion cell layer thickness. CONCLUSION Patients with bipolar disorder present quantifiable thinning of the macular RNFL, ganglion cell layer, and inner plexiform layer, as well as in the peripapillary RNFL thickness, and increasing thinning in the inner nuclear layer.
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Beyaz SG, Ülgen AM, Çakir B. The Effects of the Amount of Fluid Used in Epiduroscopic Laser Neural Discectomy Procedures on Intraocular Pressure and an Evaluation of the Ocular Findings. PAIN MEDICINE 2020; 21:1357-1361. [PMID: 32022864 DOI: 10.1093/pm/pnz347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION During epiduroscopic laser neural discectomy (ELNP) procedures, the amount of fluid used in the epidural area may cause increased intracranial pressure. This study aimed to investigate the effect of increased epidural pressure on intraocular pressure and other ocular findings due to the amount of fluid delivered to the epidural area and the rate of delivery of the fluid. MATERIAL AND METHODS After obtaining approval from the Ethics Committee of Sakarya University Faculty of Medicine, patients who underwent ELNP in the Department of Anesthesiology and Reanimation Department, Algology Clinic, between January 2017 and May 2017 were included in this retrospective study. To evaluate the ocular findings after the operation, measurements obtained using an optical coherence tomography device were retrieved from the patient files and evaluated. RESULTS Data from the medical files of 52 patients from the hospital system were evaluated. There was no significant difference between preoperative and postoperative retinal nerve fiber layer (RNFL) thickness, mean central macular thickness, optic disk area, and vertical cup-to-disk ratio (P > 0.05). CONCLUSIONS Epiduroscopy procedures include intermittent or continuous infusion of saline into the epidural area. Currently, the volume of fluid that should be given to the epidural area in epiduroscopy procedures is very controversial. As a result of this study, we concluded that the amount of fluid used during ELNP, at 107.25 mL and 8.33 mL/min, had no effect on the intraocular pressure, optic disk diameter, macular thickness, or peripapillary RNFL thickness; thus, it was safe for ELNP.
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Affiliation(s)
- Serbülent Gökhan Beyaz
- Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Sakarya University, Sakarya, Republic of Turkey
| | | | - Burçin Çakir
- Ophthalmology, Sakarya University Training and Research Hospital, Sakarya, Republic of Turkey
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Han G, Han J, Han K, Youn J, Chung TY, Lim DH. Visual Acuity and Development of Parkinson's Disease: A Nationwide Cohort Study. Mov Disord 2020; 35:1532-1541. [PMID: 32710579 DOI: 10.1002/mds.28184] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Visual dysfunction in Parkinson's disease (PD) is well known from previous reports, but the association of visual deficits with PD development has not yet been studied. The aim of this research was to evaluate the association of visual acuity with the risk of PD occurrence using a nationwide cohort in South Korea. METHODS Among the population participating in the National Health Insurance Service, which is mandatory for all South Koreans, 6,055,113 individuals who had taken part in health screening programs between January 1, 2009, and December 31, 2012, were included in the cohort and followed until December 31, 2017. The hazard ratio was calculated for groups with high and low visual acuity using multivariate adjusted Cox regression analysis. RESULTS A total of 22,872 subjects (0.38%) were diagnosed as having PD within the study period. Groups with low visual acuity showed a higher incidence of PD compared with groups with good visual acuity. Compared with the reference group (visual acuity better than 20/20), the adjusted hazard ratios and 95% confidence intervals (CIs) was 1.315 (95% CI, 1.261-1.371) for the group with visual acuity between 20/20 and 20/60, 1.357 (95% CI, 1.277-1.442) for the group with visual acuity between 20/60 and 10/100, and 1.267 (95% CI, 1.193-1.343) for the group with visual acuity less than 10/100. CONCLUSIONS Low visual acuity was associated with the development of PD. This suggests that visual dysfunction is one of the premotor symptoms for PD development. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Gyule Han
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jisang Han
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinyoung Youn
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
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Feitosa-Santana C, Fernandes Costa M, Ballalai Ferraz H, Andrade LAF, Moura AL, Amaro E, Hamer RD, Fix Ventura D. Visual losses in early-onset and late-onset Parkinson's disease. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2020; 37:A285-A293. [PMID: 32400706 DOI: 10.1364/josaa.382042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
Patients with Parkinson's disease (PD) manifest visual losses. However, it is not known whether these losses are equivalent in both early-onset (EOPD) and late-onset (LOPD) patients. We evaluated contrast sensitivity and color vision in EOPD and LOPD patients and in age-matched controls. Losses occurred in both patient groups but were more pronounced in EOPD, consistent with the notion that non-motor symptoms are affected by age of symptom onset. More studies of visual function in EOPD and LOPD patients are needed to understand how aging is related to the pathophysiology of non-motor PD symptomatology. This would permit earlier diagnosis and, perhaps, better management of the disease.
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Does retina play a role in Parkinson's Disease? Acta Neurol Belg 2020; 120:257-265. [PMID: 31965540 DOI: 10.1007/s13760-020-01274-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/06/2020] [Indexed: 12/19/2022]
Abstract
Visual disorder is one of the non-motor symptoms found in Parkinson's disease (PD). It can be easily identified in the early stages even before the spread of pathological conditions to the brain parts. Studies have revealed that loss of dopamine (DA) cells in retinal layers is a prime cause for both retinal disturbance and pathological conditions of PD. This reduction of DA in retina is due to the aggregation of phosphorylated α-synuclein (aSyn) in the intra-retinal region, which eventually results in visual impairment in PD. Until now, very limited studies have been focused on the mechanism of aSyn influence and DA depletion as a cause for both retinal layer dysfunction and PD. Thus, more research is warranted to provide the missing connection between the exact role of DA and aSyn as a risk factor for visual problems in PD. Hence, the current review's focus is on the function and effects of DA degeneration in retinal cells of PD. Further, we suggest that iron plays a major role in regulating the aggregation of aSyn in the DA cells of retina and brain in PD. The study finds that the unidentified pathophysiological role of retinal degeneration in PD is an essential biomarker that needs further investigation to use it as a novel therapy in treating retinal dysfunctions in PD.
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Hong SB, Ahn J, Yoo D, Shin JY, Jeon B, Lee JY. Contrast sensitivity impairment in drug-naïve Parkinson's disease patients associates with early cognitive decline. Neurol Sci 2020; 41:1837-1842. [PMID: 32062736 DOI: 10.1007/s10072-020-04289-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate the contrast sensitivity function in drug-naïve Parkinson's disease (PD) patients and its predictive value with longitudinal follow-up data. METHODS We included newly diagnosed non-demented PD patients who performed contrast sensitivity test between 2013 and 2014. Contrast sensitivity function at drug-naïve state in PD patients was compared with age-matched normal control data of our center. Correlation between contrast sensitivity function and parkinsonian motor and non-motor features including the Mini-Mental State Exam (MMSE) score at the time of diagnosis were analyzed by linear regression. With longitudinal follow-up data after initiating anti-parkinsonian therapy, the risk conferred on subsequent visual hallucinations and cognitive impairment requiring anti-dementia drugs was analyzed by dichotomizing PD group based on the initial contrast sensitivity function. RESULTS Forty-eight patients were finally included, and mean follow-up periods were 43 months. Contrast sensitivity function in drug-naïve PD patients was significantly worse than controls. Contrast sensitivity function correlated with sleep disturbance (p = 0.001) and global cognitive status reflected by the MMSE score (p = 0.020). It also associated with further decline in the MMSE during the follow-ups (p = 0.029). Patients with below average contrast sensitivity function at the time of diagnosis showed higher risk of cognitive decline requiring anti-dementia drugs (adjusted odds ratio = 4.68, p = 0.04) and of visual hallucinations (adjusted odds ratio = 12.54, p = 0.04) than those above average function during the follow-up. CONCLUSION Contrast sensitivity impairment in drug-naïve PD patients associates with clinical demand for therapeutic intervention of cognitive decline as well as development of visual hallucinations in the early course of the disease.
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Affiliation(s)
- Sang Bin Hong
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Shindaebang-dong, Seoul, 07061, South Korea.,Department of Neurology, Seoul National University Hospital & Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Shindaebang-dong, Seoul, 07061, South Korea
| | - Dalla Yoo
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Shindaebang-dong, Seoul, 07061, South Korea.,Department of Neurology, Seoul National University Hospital & Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
| | - Joo Young Shin
- Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Shindaebang-dong, Seoul, 07061, South Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital & Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, Shindaebang-dong, Seoul, 07061, South Korea.
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Retinal nerve fiber layer thickness in patients with essential tremor and Parkinson’s disease. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.661757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Katunina EA, Shipilova NN, Titova NV, Maluchina EA, Zhuk VA, Ivanova MZ. [Creativity in patients with Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:128-132. [PMID: 31851184 DOI: 10.17116/jnevro2019119111128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In some cases, a variety of creative abilities appear in patients with Parkinson's disease receiving dopaminergic therapy. These are the creativity of thinking, unusual motivation and efficiency, which are not inherent to the patients before. The author considers a spectrum of these changes, as well as their possible pathobiochemical and pathophysiological basis. The connection between creativity in art and impulsive-compulsive disorders is discussed. Specific personality traits, type of temperament and emotional stability can play a significant role in the development of creative abilities. It is important to recognize and control the severity of the creative potential of patients with Parkinson's disease, improving the quality of life, and to increase self-esteem, psychological attitude and social adaptation among these patients preventing the excesses of this process.
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Affiliation(s)
- E A Katunina
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - N N Shipilova
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - N V Titova
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - E A Maluchina
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - V A Zhuk
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - M Z Ivanova
- Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
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Lee J, Ahn J, Oh S, Shin JY, Kim YK, Nam H, Jeon B. Retina Thickness as a Marker of Neurodegeneration in Prodromal Lewy Body Disease. Mov Disord 2019; 35:349-354. [DOI: 10.1002/mds.27914] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/02/2019] [Accepted: 10/06/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jee‐Young Lee
- Department of Neurology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Jeeyun Ahn
- Department of Ophthalmology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Sohee Oh
- Department of Biomedical Statistics Seoul Metropolitan Government‐Seoul National University Boramae Medical Center Seoul Republic of Korea
| | - Joo Young Shin
- Department of Ophthalmology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Hyunwoo Nam
- Department of Neurology Seoul Metropolitan Government‐Seoul National University Boramae Medical Center and Seoul National University College of Medicine Seoul Republic of Korea
| | - Beomseok Jeon
- Department of Neurology Seoul National University Hospital and Seoul National University College of Medicine Seoul Republic of Korea
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Lauring JO, Pelowski M, Specker E, Ishizu T, Haugbøl S, Hollunder B, Leder H, Stender J, Kupers R. Parkinson's disease and changes in the appreciation of art: A comparison of aesthetic and formal evaluations of paintings between PD patients and healthy controls. Brain Cogn 2019; 136:103597. [PMID: 31491732 DOI: 10.1016/j.bandc.2019.103597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022]
Abstract
Parkinson's disease (PD) is a progressing neurodegenerative disease predominantly involving the loss of dopamine producing neurons with hallmark symptoms of motor disorders and cognitive, motivational, emotional, and perceptual impairments. Intriguingly, PD can also be connected-often anecdotally-with a sudden burst of artistic creativity, motivation, or changed quality/style of produced art. This has led to growing empirical interest, promising a window into brain function and the unique neurological signature of artists. This topic also fits a growing interest from researchers in other areas, including Alzheimer's or other dementia, which have suggested that specific changes in art production/appraisal may provide a unique basis for therapy, diagnosis, or understanding of these diseases. However, whether PD also shows similar impacts on how we perceive and evaluate art has never been systematically addressed. We compared a cohort of PD patients against age-matched healthy controls, asking participants to rate paintings using scales of liking and beauty and terms pertaining to artworks' formal and conceptual qualities previously designed to provide a rubric for symptom identification. We found no evidence for PD-related differences in liking or beauty. However, PD patients showed higher ratings on assessed "emotionality," potentially relating to the tie between PD, dopamine pathways, and emotion/reward.
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Affiliation(s)
- Jon O Lauring
- Department of Neuroscience and Pharmacology, BRAINlab, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark.
| | - Matthew Pelowski
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Eva Specker
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Tomohiro Ishizu
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; Faculty of Biosciences, Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK
| | - Steven Haugbøl
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
| | - Barbara Hollunder
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Helmut Leder
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Johan Stender
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
| | - Ron Kupers
- Department of Neuroscience and Pharmacology, BRAINlab, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
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Bayram D, Yüksel G, Bayram T, Tireli H. Optical Coherence Tomography Findings in Parkinson's and Alzheimer's Disease -Retinal Changes in Neurodegenerative Disease. ACTA ACUST UNITED AC 2019; 58:103-107. [PMID: 34188591 DOI: 10.29399/npa.23640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/03/2019] [Indexed: 11/07/2022]
Abstract
Introduction To investigate retinal nerve fiber layer (RNFL), macular, foveal and parafoveal thickness in patient with early stage Parkinson's (PD) and Alzheimer's disease (AD) by optical coherence tomography (OCT) and to compare results with healthy control group and between both disease. Methods Participants with AD dementia (n: 15) and PD (n: 15), besides 15 age-sex matched controls were enrolled in the study and received OCT assessments. Clinical disability grade in PD was determined by the Unified Parkinson's Disease Rating Scale and Hoehn Yahr (H-Y) Scale was used to determine the stage of PD. Standardized Mini Mental Test (SMMT) and Montreal Cognitive Rating Scale (MOCA) were used for neurocognitive evaluation of patients with AD. The relationship between OCT and test results was analyzed. Results OCT measurements did show significant decrease in temporal, nasal, inferiorR (R means examination of retina in two sections as superior and inferior instead of four quadrants) RNFL thickness and foveal, parafoveal, macular thickness of AD group compared to control group. Temporal, inferior and inferiorR RNFL thickness were thinner in patients with PD than those of control group but these differences were not significant. However the superiorR and superior RNFL thickness decreased significantly in the PD group as the disease duration increased. There was no relationship between SMMT, MOCA, UPDRS, H-Y scores and OCT results. Conclusion As several studies have reported different results so far, we thought that the use of OCT in early diagnosis and follow-up of the course of both diseases was not appropriate until many studies indicated the same result.
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Affiliation(s)
- Derya Bayram
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Gülbün Yüksel
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Tamer Bayram
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Hülya Tireli
- University of Health Sciences Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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Yener GG, Fide E, Özbek Y, Emek-Savaş DD, Aktürk T, Çakmur R, Güntekin B. The difference of mild cognitive impairment in Parkinson's disease from amnestic mild cognitive impairment: Deeper power decrement and no phase-locking in visual event-related responses. Int J Psychophysiol 2019; 139:48-58. [DOI: 10.1016/j.ijpsycho.2019.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/28/2022]
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Lucas A, Thirion A, Schwan R, Krieg J, Angioi-Duprez K, Laprevote V, Schwitzer T. Association between increased retinal background noise and co-occurrent regular cannabis and alcohol use. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:335-340. [PMID: 30292729 DOI: 10.1016/j.pnpbp.2018.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/10/2018] [Accepted: 10/04/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Cannabis consumption is widespread across the world, and the co-occurrence of cannabis use and alcohol consumption is common. The study of background noise - resting-state neural activity, in the absence of stimulation - is an approach that could enable the neurotoxicity of these substances to be explored. Preliminary results have shown that delta-9-tetrahydrocannabinol (Δ9-THC) causes an increase in neural noise in the brain. Neurons in the brain and the retina share a neurotransmission system and have similar anatomical and functional properties. Retinal function, evaluated using an electroretinogram (ERG), may therefore reflect central neurochemistry. This study analyses retinal background noise in a population of regular co-occurrent cannabis and alcohol consumers. METHODS We recorded the flash ERGs of 26 healthy controls and 45 regular cannabis consumers, separated into two groups based on their alcohol consumption: less than or equal to 4 glasses per week (CU ≤ 4) or strictly >4 glasses per week (CU >4). In order to extract the background noise, the Fourier transform of the pseudo-periodic and sinusoidal signals of the 3.0 flicker-response sequence was calculated. This sequence represents the vertical transmission of the signal from cones to bipolar cells. The magnitude of the background noise is defined as the average of the magnitudes of the two neighbouring harmonics: harmonic -1 (low frequency noise) and harmonic +1 (high frequency noise). RESULTS The magnitude of harmonic -1 was significantly increased between the groups CU > 4 (6.78 (±1.24)) and CU ≤ 4 (5.69 (±1.80)) among regular users of cannabis and alcohol. A significant increase in the average magnitude of the two harmonics was found between the groups CU > 4 (5.12 (±0.92)) and CU ≤ 4 (4.36 (±1.14)). No significant difference was observed with regard to the magnitude of the harmonic +1. CONCLUSIONS The increase in background noise may reflect the neurotoxicity of cannabis, potentiated by alcohol consumption, on retinal neurons dynamic. This neural disruption of the response generated by retinal stimulation may be attributable to altered neurotransmitter release.
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Affiliation(s)
- Alice Lucas
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Audrey Thirion
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
| | - Raymund Schwan
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Maison des Addictions, CHRU Nancy, Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Julien Krieg
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | | | - Vincent Laprevote
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Maison des Addictions, CHRU Nancy, Nancy, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
| | - Thomas Schwitzer
- Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France.
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Al-Louzi O, Sotirchos ES, Vidal-Jordana A, Beh SC, Button J, Ying HS, Balcer LJ, Frohman EM, Saidha S, Calabresi PA, Newsome SD. Characteristics of morphologic macular abnormalities in neuroimmunology practice. Mult Scler 2019; 25:361-371. [PMID: 29125422 PMCID: PMC6929206 DOI: 10.1177/1352458517741206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Morphologic macular abnormalities (MMAs) are frequently seen on macular optical coherence tomography (OCT) imaging in neuroimmunology practice, yet studies pragmatically assessing prevalence and risk factors of MMAs to date are limited. OBJECTIVE To describe the characteristics of MMAs in a neuroimmunology-based academic practice. METHODS Cross-sectional study of 1450 patients (2900 eyes) who underwent spectral-domain macular OCT between June 2010 and June 2012. The association between MMAs and demographic variables was analyzed using mixed-effects logistic regression. Odds ratios (ORs) were calculated per 5-year age increments. RESULTS MMAs were observed in 338/2872 eyes (11.7%) of 232/1445 participants (16.1%). The most common abnormalities identified, included drusen (6.0%), epiretinal membrane (ERM; 5.5%), and microcystoid macular pathology (MMP; 1.9%). Overall, patients with MMAs were older (OR: 1.79, p = 5 × 10-5) and more likely to be males (OR: 2.45, p = 0.014). In particular, advancing age was associated with higher risk of drusen and ERM (OR: 1.80 and 4.26, p = 2 × 10-5 and 7 × 10-3, respectively). MMP prevalence declined with age (OR: 0.73, p = 0.015) and was associated with African-American ethnicity (OR: 15.0, p = 5 × 10-5). CONCLUSION Unexpected or incidental MMAs are common in patients assessed with OCT in neuroimmunology practice, emphasizing the importance of comprehensive OCT image review for risk stratification and appropriate ophthalmology referral.
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Affiliation(s)
- Omar Al-Louzi
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
| | - Elias S. Sotirchos
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
| | - Angela Vidal-Jordana
- Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (Cemcat), Edifici Cemcat, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona
| | - Shin C. Beh
- Department of Neurology and Ophthalmology, University of Texas Southwestern, Dallas, TX, USA
| | - Julia Button
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
| | - Howard S. Ying
- Department of Ophthalmology, Boston Medical Center, Boston, MA 02118
| | - Laura J. Balcer
- Departments of Neurology, Population Health and Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Elliot M. Frohman
- Department of Neurology and Ophthalmology, University of Texas Southwestern, Dallas, TX, USA
| | - Shiv Saidha
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
| | - Peter A. Calabresi
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
| | - Scott D. Newsome
- Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins hospital, Baltimore, MD 21287
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Why would Parkinson's disease lead to sudden changes in creativity, motivation, or style with visual art?: A review of case evidence and new neurobiological, contextual, and genetic hypotheses. Neurosci Biobehav Rev 2019; 100:129-165. [PMID: 30629980 DOI: 10.1016/j.neubiorev.2018.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 12/13/2022]
Abstract
Parkinson's disease (PD) is a devastating diagnosis with, however, potential for an extremely intriguing aesthetic component. Despite motor and cognitive deficits, an emerging collection of studies report a burst of visual artistic output and alterations in produced art in a subgroup of patients. This provides a unique window into the neurophysiological bases for why and how we might create and enjoy visual art, as well as into general brain function and the nature of PD or other neurodegenerative diseases. However, there has not been a comprehensive organization of literature on this topic. Nor has there been an attempt to connect case evidence and knowledge on PD with present understanding of visual art making in psychology and neuroaesthetics in order to propose hypotheses for documented artistic changes. Here, we collect the current research on this topic, tie this to PD symptoms and neurobiology, and provide new theories focusing on dopaminergic neuron damage, over-stimulation from dopamine agonist therapy, and context or genetic factors revealing the neurobiological basis of the visual artistic brain.
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Childs C, Barker LA, Gage AM, Loosemore M. Investigating possible retinal biomarkers of head trauma in Olympic boxers using optical coherence tomography. Eye Brain 2018; 10:101-110. [PMID: 30588143 PMCID: PMC6299469 DOI: 10.2147/eb.s183042] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose Changes to retina have been reported after a number of neurodegenerative conditions. The purpose of this study was to investigate retinal structures in Olympic boxers exposed to frequent head blows. Methods Retinal imaging offers potential as a non-invasive biomarker of neuropathology. Macula and retinal nerve fiber layer (RNFL) thickness was measured using optical coherence tomography (OCT) in UK Olympic boxers attending two mandatory eye screening programs, 18 months apart. Data from the two eye screenings provide longitudinal data of retinal change over time. Sedentary healthy subjects (controls) without past or present history of concussion were also screened at the time of the second boxer screening to provide comparison of cross-sectional data. Results Sixteen Olympic boxers aged 20–33 years and 20 sedentary healthy controls, aged 24–45 years, were recruited. Significant macula thickening was observed over time (18 months) in 75% of right and 50% of left eye sectors. For RNFL, left eye quadrants thickened. For right eye RNFL quadrants, thickening and thinning of this layer were observed. Cross-sectional results showed thinner macula sectors and RNFL quadrants in Olympic boxers compared to controls. Conclusion Significant change to macula and RNFL densities, occurring over an 18 month interval is an unexpected finding in otherwise heathy elite sportsmen. In addition, macula and RNFL were thinner than healthy sedentary controls. OCT may prove clinically useful as a candidate retinal biomarker of neuropathological change after mild traumatic brain injury and/or repeat head blows.
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Affiliation(s)
- Charmaine Childs
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, South Yorkshire, UK,
| | - Lynne A Barker
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Alex Md Gage
- Alex Gage Family Optometrist, Sheffield, South Yorkshire, UK
| | - Mike Loosemore
- Institute of Sport, Exercise and Health (ISEH), London, UK
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Polo V, Satue M, Gavin A, Vilades E, Orduna E, Cipres M, Garcia-Campayo J, Navarro-Gil M, Larrosa JM, Pablo LE, Garcia-Martin E. Ability of swept source OCT to detect retinal changes in patients with bipolar disorder. Eye (Lond) 2018; 33:549-556. [PMID: 30382239 DOI: 10.1038/s41433-018-0261-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 05/15/2018] [Accepted: 06/04/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the ability of swept source optical coherence tomography (SS-OCT) to detect retinal changes in patients with bipolar disorder (BD). METHODS Twenty-three patients with BD and 23 controls underwent retinal evaluation using SS deep range imaging (DRI) Triton OCT. Full retinal thickness, the ganglion cell layer (GCL), the retinal nerve fiber layer (RNFL), and choroidal thickness were evaluated with automated segmentation software. RESULTS Patients with BD were shown to have significant thinning of the macular full retinal thickness in the center (p = 0.049), inner temporal (p = 0.045), inner nasal (p = 0.016), and inner inferior (p = 0.016) of the ETDRS areas. The macular GCL layer was reduced in patients compared with controls (average, p = 0.002; superior, p = 0.009; superonasal, p = 0.009; inferonasal, p = 0.003; and inferior, p = 0.009). Peripapillary reduction of full retinal thickness (average, p < 0.001; superotemporal, p < 0.001; superonasal, p = 0.003; nasal, p = 0.005; and inferotemporal, p = 0.033), GCL (nasal, p = 0.025), and RNFL thickness (average, p = 0.002; superotemporal, p < 0.001; and superonasal, p = 0.045) was observed in patients compared with controls. No significant differences were observed in choroidal thickness measurements. CONCLUSIONS BD patients were shown to have quantifiable thinning of full retinal thickness and the GCL in the macular area, as well as a peripapillary reduction of the RNFL and GCL thickness. The analysis of the retinal sublayers with SS-OCT may be a useful indicator to show degeneration and monitor disease progression in bipolar disorder.
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Affiliation(s)
- Vicente Polo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Maria Satue
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain. .,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain.
| | - Alicia Gavin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Elisa Vilades
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Elvira Orduna
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Marta Cipres
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Javier Garcia-Campayo
- Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain.,Department of Psychiatry, Miguel Servet University Hospital, Zaragoza, Spain
| | - Mayte Navarro-Gil
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Zaragoza, Spain
| | - Jose M Larrosa
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Luis E Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.,Aragon Health Research Institute (IIS Aragon, IACS), Zaragoza, Spain
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Abstract
Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementia following Alzheimer disease. It stems from the formation of Lewy bodies, which contain aggregates of the misfolded protein, α-synuclein. These deposit in areas of the nervous system and brain, leading to neuronal cell death and causing clinically apparent symptoms. Because of its clinical overlap with other forms of dementia, DLB is often underdiagnosed and misdiagnosed. There is currently no cure for DLB and treatments are aimed at ameliorating specific symptoms.
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Affiliation(s)
- Angela M Sanford
- Division of Geriatrics, Saint Louis University School of Medicine, 1402 South Grand Boulevard, M238, St Louis, MO 63104, USA.
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36
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Ahn J, Lee JY, Kim TW, Yoon EJ, Oh S, Kim YK, Kim JM, Woo SJ, Kim KW, Jeon B. Retinal thinning associates with nigral dopaminergic loss in de novo Parkinson disease. Neurology 2018; 91:e1003-e1012. [PMID: 30111550 DOI: 10.1212/wnl.0000000000006157] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 06/07/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyze the relationship between retinal thinning and nigral dopaminergic loss in de novo Parkinson disease (PD). METHODS Forty-nine patients with PD and 54 age-matched controls were analyzed. Ophthalmologic examination and macula optical coherence tomography scans were performed with additional microperimetry, N-(3-[18F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane PET, and 3T MRI scans were done in patients with PD only. Retinal layer thickness and volume were measured in subfields of the 1-, 2.22-, and 3.45-mm Early Treatment of Diabetic Retinopathy Study circle and compared in patients with PD and controls. Correlation of inner retinal layer thinning with microperimetric response was examined in patients with PD, and the relationships between retinal layer thickness and dopamine transporter densities in the ipsilateral caudate, anterior and posterior putamen, and substantia nigra were analyzed. RESULTS Retinal layer thinning was observed in the temporal and inferior 2.22-mm sectors (false discovery rate-adjusted p < 0.05) of drug-naive patients with PD, particularly the inner plexiform and ganglion cell layers. The thickness of these layers in the inferior 2.22-mm sector showed a negative correlation with the Hoehn and Yahr stage (p = 0.032 and 0.014, respectively). There was positive correlation between macular sensitivity and retinal layer thickness in all 3.45-mm sectors, the superior 2.22-mm sector, and 1-mm circle (p < 0.05 for all). There was an association between retinal thinning and dopaminergic loss in the left substantia nigra (false discovery rate-adjusted p < 0.001). CONCLUSION Retinal thinning is present in the early stages of PD, correlates with disease severity, and may be linked to nigral dopaminergic degeneration. Retinal imaging may be useful for detection of pathologic changes occurring in early PD.
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Affiliation(s)
- Jeeyun Ahn
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Jee-Young Lee
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea.
| | - Tae Wan Kim
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea.
| | - Eun Jin Yoon
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Sohee Oh
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Yu Kyeong Kim
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Jong-Min Kim
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Se Joon Woo
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Ki Woong Kim
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Beomseok Jeon
- From the Departments of Ophthalmology (J.A., T.W.K.), Neurology (J.-Y.L.), Nuclear Medicine (E.J.Y., Y.K.K.), and Biomedical Statistics (S.O.), Seoul Metropolitan Government-Seoul National University Boramae Medical Center and Seoul National University College of Medicine; Departments of Neurology (J.M.K.), Ophthalmology (S.J.W.), and Psychiatry (K.W.K.), Seoul National University Bundang Hospital and Seoul National University College of Medicine; and Department of Neurology (B.J.), Seoul National University Hospital and Seoul National University College of Medicine, South Korea
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Ortuño-Lizarán I, Beach TG, Serrano GE, Walker DG, Adler CH, Cuenca N. Phosphorylated α-synuclein in the retina is a biomarker of Parkinson's disease pathology severity. Mov Disord 2018; 33:1315-1324. [PMID: 29737566 PMCID: PMC6146055 DOI: 10.1002/mds.27392] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND PD patients often have visual alterations, for example, loss of visual acuity, contrast sensitivity or motion perception, and diminished electroretinogram responses. PD pathology is mainly characterized by the accumulation of pathological α-synuclein deposits in the brain, but little is known about how synucleinopathy affects the retina. OBJECTIVE To study the correlation between α-synuclein deposits in the retina and brain of autopsied subjects with PD and incidental Lewy body disease. METHODS We evaluated the presence of phosphorylated α-synuclein in the retina of autopsied subjects with PD (9 subjects), incidental Lewy body disease (4 subjects), and controls (6 subjects) by immunohistochemistry and compared the retinal synucleinopathy with brain disease severity indicators. RESULTS Whereas controls did not show any phosphorylated α-synuclein immunoreactivity in their retina, all PD subjects and 3 of 4 incidental Lewy body disease subjects had phosphorylated α-synuclein deposits in ganglion cell perikarya, dendrites, and axons, some of them resembling brain Lewy bodies and Lewy neurites. The Lewy-type synucleinopathy density in the retina significantly correlated with Lewy-type synucleinopathy density in the brain, with the Unified Parkinson's disease pathology stage and with the motor UPDRS. CONCLUSION These data suggest that phosphorylated α-synuclein accumulates in the retina in parallel with that in the brain, including in early stages preceding development of clinical signs of parkinsonism or dementia. Therefore, the retina may provide an in vivo indicator of brain pathology severity, and its detection could help in the diagnosis and monitoring of disease progression. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Thomas G. Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, Spain
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38
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Pardue MT, Allen RS. Neuroprotective strategies for retinal disease. Prog Retin Eye Res 2018; 65:50-76. [PMID: 29481975 PMCID: PMC6081194 DOI: 10.1016/j.preteyeres.2018.02.002] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/14/2018] [Accepted: 02/20/2018] [Indexed: 12/20/2022]
Abstract
Diseases that affect the eye, including photoreceptor degeneration, diabetic retinopathy, and glaucoma, affect 11.8 million people in the US, resulting in vision loss and blindness. Loss of sight affects patient quality of life and puts an economic burden both on individuals and the greater healthcare system. Despite the urgent need for treatments, few effective options currently exist in the clinic. Here, we review research on promising neuroprotective strategies that promote neuronal survival with the potential to protect against vision loss and retinal cell death. Due to the large number of neuroprotective strategies, we restricted our review to approaches that we had direct experience with in the laboratory. We focus on drugs that target survival pathways, including bile acids like UDCA and TUDCA, steroid hormones like progesterone, therapies that target retinal dopamine, and neurotrophic factors. In addition, we review rehabilitative methods that increase endogenous repair mechanisms, including exercise and electrical stimulation therapies. For each approach, we provide background on the neuroprotective strategy, including history of use in other diseases; describe potential mechanisms of action; review the body of research performed in the retina thus far, both in animals and in humans; and discuss considerations when translating each treatment to the clinic and to the retina, including which therapies show the most promise for each retinal disease. Despite the high incidence of retinal diseases and the complexity of mechanisms involved, several promising neuroprotective treatments provide hope to prevent blindness. We discuss attractive candidates here with the goal of furthering retinal research in critical areas to rapidly translate neuroprotective strategies into the clinic.
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Affiliation(s)
- Machelle T Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA, 30033, USA; Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Atlanta, GA, 30332, USA.
| | - Rachael S Allen
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA, 30033, USA
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39
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Abbasi M, Gupta V, Chitranshi N, You Y, Dheer Y, Mirzaei M, Graham SL. Regulation of Brain-Derived Neurotrophic Factor and Growth Factor Signaling Pathways by Tyrosine Phosphatase Shp2 in the Retina: A Brief Review. Front Cell Neurosci 2018; 12:85. [PMID: 29636665 PMCID: PMC5880906 DOI: 10.3389/fncel.2018.00085] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/09/2018] [Indexed: 01/31/2023] Open
Abstract
SH2 domain-containing tyrosine phosphatase-2 (PTPN11 or Shp2) is a ubiquitously expressed protein that plays a key regulatory role in cell proliferation, differentiation and growth factor (GF) signaling. This enzyme is well expressed in various retinal neurons and has emerged as an important player in regulating survival signaling networks in the neuronal tissues. The non-receptor phosphatase can translocate to lipid rafts in the membrane and has been implicated to regulate several signaling modules including PI3K/Akt, JAK-STAT and Mitogen Activated Protein Kinase (MAPK) pathways in a wide range of biochemical processes in healthy and diseased states. This review focuses on the roles of Shp2 phosphatase in regulating brain-derived neurotrophic factor (BDNF) neurotrophin signaling pathways and discusses its cross-talk with various GF and downstream signaling pathways in the retina.
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Affiliation(s)
- Mojdeh Abbasi
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Vivek Gupta
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Nitin Chitranshi
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Yuyi You
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Save Sight Institute, University of Sydney, Sydney, NSW, Australia
| | - Yogita Dheer
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Mehdi Mirzaei
- Australian Proteome Analysis Facility, Macquarie University, Sydney, NSW, Australia.,Department of Molecular Sciences, Macquarie University, Sydney, NSW, Australia
| | - Stuart L Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.,Save Sight Institute, University of Sydney, Sydney, NSW, Australia
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40
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Obis J, Satue M, Alarcia R, Pablo LE, Garcia-Martin E. Update on visual function and choroidal-retinal thickness alterations in Parkinson's disease. ACTA ACUST UNITED AC 2018; 93:231-238. [PMID: 29454631 DOI: 10.1016/j.oftal.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 01/06/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative process that affects 7.5 million people around the world. Since 2004, several studies have demonstrated changes in various retinal layers in PD using optical coherence tomography (OCT). However, there are some discrepancies in the results of those studies. Some of them have correlated retinal thickness with the severity or duration of the disease, demonstrating that OCT measurements may be an innocuous and easy biomarker for PD progression. Other studies have demonstrated visual dysfunctions since early phases of the disease. Lastly, the most recent studies that use Swept Source OCT technology, have found choroidal thickness increase in PD patients and provide new information related to the retinal degenerative process in this disease. The aim of this paper is to review the literature on OCT and PD, in order to determine the altered retinal and choroidal parameters in PD and their possible clinical usefulness, and also the visual dysfunctions with higher impact in these patients.
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Affiliation(s)
- J Obis
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - M Satue
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - R Alarcia
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - L E Pablo
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - E Garcia-Martin
- Departamento de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, España
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41
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Souza BOF, Abou Rjeili M, Quintana C, Beaulieu JM, Casanova C. Spatial Frequency Selectivity Is Impaired in Dopamine D2 Receptor Knockout Mice. Front Integr Neurosci 2018; 11:41. [PMID: 29379422 PMCID: PMC5775240 DOI: 10.3389/fnint.2017.00041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 12/29/2017] [Indexed: 01/11/2023] Open
Abstract
Dopamine is a neurotransmitter implicated in several brain functions, including vision. In the present study, we investigated the impacts of the lack of D2 dopamine receptors on the structure and function of the primary visual cortex (V1) of D2-KO mice using optical imaging of intrinsic signals. Retinotopic maps were generated in order to measure anatomo-functional parameters such as V1 shape, cortical magnification factor, scatter, and ocular dominance. Contrast sensitivity and spatial frequency selectivity (SF) functions were computed from responses to drifting gratings. When compared to control mice, none of the parameters of the retinotopic maps were affected by D2 receptor loss of function. While the contrast sensitivity function of D2-KO mice did not differ from their wild-type counterparts, SF selectivity function was significantly affected as the optimal SF and the high cut-off frequency (p < 0.01) were higher in D2-KO than in WT mice. These findings show that the lack of function of D2 dopamine receptors had no influence on cortical structure whereas it had a significant impact on the spatial frequency selectivity and high cut-off. Taken together, our results suggest that D2 receptors play a specific role on the processing of spatial features in early visual cortex while they do not seem to participate in its development.
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Affiliation(s)
| | - Mira Abou Rjeili
- Laboratory of Visual Neuroscience, Optometry School, University of Montreal, Montreal, QC, Canada
| | - Clémentine Quintana
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Jean M Beaulieu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Christian Casanova
- Laboratory of Visual Neuroscience, Optometry School, University of Montreal, Montreal, QC, Canada
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42
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Unlu M, Gulmez Sevim D, Gultekin M, Karaca C. Correlations among multifocal electroretinography and optical coherence tomography findings in patients with Parkinson's disease. Neurol Sci 2018; 39:533-541. [PMID: 29349656 DOI: 10.1007/s10072-018-3244-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/02/2018] [Indexed: 11/26/2022]
Abstract
To assess the correlation between functional and anatomical evaluations with multifocal electroretinography (mfERG) and spectral-domain optical coherence tomography (SD-OCT) in patients with Parkinson's disease (PD). This cross-sectional study involved 116 eyes of 58 patients with PD and 30 age- and sex-matched control subjects. All study participants underwent a comprehensive neuro-ophthalmic examination, retinal single-layer thicknesses and volumes, and peripapillary retinal nerve fiber layer (pRNFL) measurements with SD-OCT, and the patients' mfERG recordings were evaluated. The macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), and photoreceptor layer (PR) thicknesses, and mRNFL, RPE, and PR volumes were found lower in PD compared to those of controls, while outer plexiform layer (OPL) volumes were increased (p < 0.05). We found delayed implicit times and decreased amplitudes in the mfERG of PD patients versus those in control subjects (p < 0.05). We found significant correlations between outer macular volumes, PR thicknesses, and N1 amplitudes of rings 2 and 3and P1 amplitudes of rings 3, 4, and 5. Our study revealed thinning of both inner and outer retinal single layers, increased OPL volume, and delayed implicit times and decreased amplitudes in the mfERG of PD patients versus control subjects and correlation between structural and functional parameters. Our findings point out that SD-OCT and mfERG could both serve as non-invasive tools for evaluating ophthalmic manifestations of Parkinson's disease.
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Affiliation(s)
- Metin Unlu
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey.
| | - Duygu Gulmez Sevim
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey
| | - Murat Gultekin
- School of Medicine, Neurology Department, Erciyes University, 38039, Kayseri, Turkey
| | - Cagatay Karaca
- School of Medicine, Ophthalmology Department, Erciyes University, 38039, Kayseri, Turkey
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43
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Satue M, Obis J, Alarcia R, Orduna E, Rodrigo MJ, Vilades E, Gracia H, Otin S, Fuertes MI, Polo V, Larrosa JM, Pablo LE, Garcia-Martin E. Retinal and Choroidal Changes in Patients with Parkinson’s Disease Detected by Swept-Source Optical Coherence Tomography. Curr Eye Res 2017; 43:109-115. [DOI: 10.1080/02713683.2017.1370116] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maria Satue
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Javier Obis
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Raquel Alarcia
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
- Neurology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Elvira Orduna
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Maria J Rodrigo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Elisa Vilades
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Hector Gracia
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Sofia Otin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Maria I Fuertes
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Vicente Polo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Jose M Larrosa
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Luis E Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
| | - Elena Garcia-Martin
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
- Aragon Health Research Institute (IIS Aragon- IACS), Zaragoza, Spain
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44
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Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci 2017; 18:435-450. [PMID: 28592904 DOI: 10.1038/nrn.2017.62] [Citation(s) in RCA: 1048] [Impact Index Per Article: 149.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many of the motor symptoms of Parkinson disease (PD) can be preceded, sometimes for several years, by non-motor symptoms that include hyposmia, sleep disorders, depression and constipation. These non-motor features appear across the spectrum of patients with PD, including individuals with genetic causes of PD. The neuroanatomical and neuropharmacological bases of non-motor abnormalities in PD remain largely undefined. Here, we discuss recent advances that have helped to establish the presence, severity and effect on the quality of life of non-motor symptoms in PD, and the neuroanatomical and neuropharmacological mechanisms involved. We also discuss the potential for the non-motor features to define a prodrome that may enable the early diagnosis of PD.
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Affiliation(s)
- Anthony H V Schapira
- Department of Clinical Neurosciences, University College London (UCL) Institute of Neurology, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | - K Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence, King's College Hospital, King's College London, Camberwell Road, London SE5 9RS, UK
| | - Peter Jenner
- Neurodegenerative Diseases Research Group, Institute of Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, Newcomen Street, London SE1 1UL, UK
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45
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Comparison of peripapillary choroidal thickness between healthy subjects and patients with Parkinson's disease. PLoS One 2017; 12:e0177163. [PMID: 28510576 PMCID: PMC5433703 DOI: 10.1371/journal.pone.0177163] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/24/2017] [Indexed: 01/10/2023] Open
Abstract
Purpose To study peripapillary choroidal thickness (PPCT) in healthy subjects using swept-source optical coherence tomography (SS-OCT), and to evaluate PPCT differences between Parkinson´s disease (PD) patients, and age- and sex-matched healthy controls. Design Case-control study Methods 80 healthy subjects and 40 PD patients were consecutively recruited in this single institution study. The healthy subjects were divided into two populations: a teaching population (n = 40, used to establish choroidal zones) and a validating population (n = 40, used to compare measurements with PD patients). An optic disc 6.0×6.0 mm three-dimensional scan was obtained using Deep Range Imaging (DRI) OCT Triton. A 26×26 cube-grid centered on the optic disc was generated to automatically measure choroidal thickness. Five concentric choroidal zones were established and used to compare PPCT between healthy and PD patients. Results PPCT was significantly thicker in PD patients compared with controls in all four concentric zones evaluated (p≤0.0001). PPCT followed a similar pattern in controls and PD; it was thicker in the temporosuperior region, followed by the superior, temporal, nasal, and inferior regions. Conclusion PD patients presented with an increased PPCT in all zones surrounding the optic disc compared with healthy subjects. The peripapillary choroidal tissue showed a concentric pattern, with the thickness increasing with increasing distance from the optic nerve. SS-OCT could be useful for evaluating choroidal thinning in clinical practice.
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46
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Korshunov KS, Blakemore LJ, Trombley PQ. Dopamine: A Modulator of Circadian Rhythms in the Central Nervous System. Front Cell Neurosci 2017; 11:91. [PMID: 28420965 PMCID: PMC5376559 DOI: 10.3389/fncel.2017.00091] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/15/2017] [Indexed: 01/11/2023] Open
Abstract
Circadian rhythms are daily rhythms that regulate many biological processes – from gene transcription to behavior – and a disruption of these rhythms can lead to a myriad of health risks. Circadian rhythms are entrained by light, and their 24-h oscillation is maintained by a core molecular feedback loop composed of canonical circadian (“clock”) genes and proteins. Different modulators help to maintain the proper rhythmicity of these genes and proteins, and one emerging modulator is dopamine. Dopamine has been shown to have circadian-like activities in the retina, olfactory bulb, striatum, midbrain, and hypothalamus, where it regulates, and is regulated by, clock genes in some of these areas. Thus, it is likely that dopamine is essential to mechanisms that maintain proper rhythmicity of these five brain areas. This review discusses studies that showcase different dopaminergic mechanisms that may be involved with the regulation of these brain areas’ circadian rhythms. Mechanisms include how dopamine and dopamine receptor activity directly and indirectly influence clock genes and proteins, how dopamine’s interactions with gap junctions influence daily neuronal excitability, and how dopamine’s release and effects are gated by low- and high-pass filters. Because the dopamine neurons described in this review also release the inhibitory neurotransmitter GABA which influences clock protein expression in the retina, we discuss articles that explore how GABA may contribute to the actions of dopamine neurons on circadian rhythms. Finally, to understand how the loss of function of dopamine neurons could influence circadian rhythms, we review studies linking the neurodegenerative disease Parkinson’s Disease to disruptions of circadian rhythms in these five brain areas. The purpose of this review is to summarize growing evidence that dopamine is involved in regulating circadian rhythms, either directly or indirectly, in the brain areas discussed here. An appreciation of the growing evidence of dopamine’s influence on circadian rhythms may lead to new treatments including pharmacological agents directed at alleviating the various symptoms of circadian rhythm disruption.
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Affiliation(s)
- Kirill S Korshunov
- Program in Neuroscience, Florida State University,Tallahassee, FL, USA.,Department of Biological Science, Florida State University,Tallahassee, FL, USA
| | - Laura J Blakemore
- Program in Neuroscience, Florida State University,Tallahassee, FL, USA.,Department of Biological Science, Florida State University,Tallahassee, FL, USA
| | - Paul Q Trombley
- Program in Neuroscience, Florida State University,Tallahassee, FL, USA.,Department of Biological Science, Florida State University,Tallahassee, FL, USA
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47
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Misra SL, Kersten HM, Roxburgh RH, Danesh-Meyer HV, McGhee CN. Corneal nerve microstructure in Parkinson's disease. J Clin Neurosci 2017; 39:53-58. [PMID: 28268149 DOI: 10.1016/j.jocn.2017.02.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 02/10/2017] [Indexed: 02/06/2023]
Abstract
Ocular surface changes and blink abnormalities are well-established in Parkinson's disease. Blink rate may be influenced by corneal sub-basal nerve density, however, this relationship has not yet been investigated in Parkinson's disease. This case-control study examined the ocular surface in patients with moderately severe Parkinson's disease, including confocal microscopy of the cornea. Fifteen patients with moderately severe Parkinson's disease (modified Hoehn and Yahr grade 3 or 4) and fifteen control participants were recruited. Ophthalmic assessment included slit-lamp examination, blink rate assessment, central corneal aesthesiometry and in vivo corneal confocal microscopy. The effect of disease laterality was also investigated. Of the 15 patients with Parkinson's disease, ten were male and the mean age was 65.5±8.6years. The corneal sub-basal nerve plexus density was markedly reduced in patients with Parkinson's disease (7.56±2.4mm/mm2) compared with controls (15.91±2.6mm/mm2) (p<0.0001). Corneal sensitivity did not differ significantly between the patients with Parkinson's disease (0.79±1.2mBAR) and the control group (0.26±0.35mBAR), p=0.12. Sub-basal nerve density was not significantly different between the eye ipsilateral to the side of the body with most-severe motor symptoms, and the contralateral eye. There was a significant positive correlation between ACE-R scores and sub-basal corneal nerve density (R2=0.66, p=0.02). This is the first study to report a significant reduction in corneal sub-basal nerve density in Parkinson's disease and demonstrate an association with cognitive dysfunction. These results provide further evidence to support the involvement of the peripheral nervous system in Parkinson's disease, previously thought to be a central nervous system disorder.
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Nguyen CTO, Hui F, Charng J, Velaedan S, van Koeverden AK, Lim JKH, He Z, Wong VHY, Vingrys AJ, Bui BV, Ivarsson M. Retinal biomarkers provide "insight" into cortical pharmacology and disease. Pharmacol Ther 2017; 175:151-177. [PMID: 28174096 DOI: 10.1016/j.pharmthera.2017.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The retina is an easily accessible out-pouching of the central nervous system (CNS) and thus lends itself to being a biomarker of the brain. More specifically, the presence of neuronal, vascular and blood-neural barrier parallels in the eye and brain coupled with fast and inexpensive methods to quantify retinal changes make ocular biomarkers an attractive option. This includes its utility as a biomarker for a number of cerebrovascular diseases as well as a drug pharmacology and safety biomarker for the CNS. It is a rapidly emerging field, with some areas well established, such as stroke risk and multiple sclerosis, whereas others are still in development (Alzheimer's, Parkinson's, psychological disease and cortical diabetic dysfunction). The current applications and future potential of retinal biomarkers, including potential ways to improve their sensitivity and specificity are discussed. This review summarises the existing literature and provides a perspective on the strength of current retinal biomarkers and their future potential.
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Affiliation(s)
- Christine T O Nguyen
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia.
| | - Flora Hui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jason Charng
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Shajan Velaedan
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Anna K van Koeverden
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Jeremiah K H Lim
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Zheng He
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Vickie H Y Wong
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Algis J Vingrys
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Bang V Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
| | - Magnus Ivarsson
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, 3010, Victoria, Australia
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Cabrera DeBuc D, Somfai GM, Koller A. Retinal microvascular network alterations: potential biomarkers of cerebrovascular and neural diseases. Am J Physiol Heart Circ Physiol 2016; 312:H201-H212. [PMID: 27923786 DOI: 10.1152/ajpheart.00201.2016] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 11/04/2016] [Accepted: 11/11/2016] [Indexed: 12/12/2022]
Abstract
Increasing evidence suggests that the conditions of retinal microvessels are indicators to a variety of cerebrovascular, neurodegenerative, psychiatric, and developmental diseases. Thus noninvasive visualization of the human retinal microcirculation offers an exceptional opportunity for the investigation of not only the retinal but also cerebral microvasculature. In this review, we show how the conditions of the retinal microvessels could be used to assess the conditions of brain microvessels because the microvascular network of the retina and brain share, in many aspects, standard features in development, morphology, function, and pathophysiology. Recent techniques and imaging modalities, such as optical coherence tomography (OCT), allow more precise visualization of various layers of the retina and its microcirculation, providing a "microscope" to brain microvessels. We also review the potential role of retinal microvessels in the risk identification of cerebrovascular and neurodegenerative diseases. The association between vision problems and cerebrovascular and neurodegenerative diseases, as well as the possible role of retinal microvascular imaging biomarkers in cerebrovascular and neurodegenerative screening, their potentials, and limitations, are also discussed.
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Affiliation(s)
- Delia Cabrera DeBuc
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida;
| | - Gabor Mark Somfai
- Semmelweis University, Budapest, Hungary.,Augenzentrum, Pallas Kliniken, Olten, Switzerland
| | - Akos Koller
- Institute of Natural Sciences, University of Physical Education, Budapest, Hungary; and.,Department of Physiology, New York Medical College, Valhalla, New York
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Optical Coherence Tomography as a Biomarker for Diagnosis, Progression, and Prognosis of Neurodegenerative Diseases. J Ophthalmol 2016; 2016:8503859. [PMID: 27840739 PMCID: PMC5093273 DOI: 10.1155/2016/8503859] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/28/2016] [Accepted: 09/27/2016] [Indexed: 01/28/2023] Open
Abstract
Neurodegenerative diseases present a current challenge for accurate diagnosis and for providing precise prognostic information. Developing imaging biomarkers for multiple sclerosis (MS), Parkinson disease (PD), and Alzheimer's disease (AD) will improve the clinical management of these patients and may be useful for monitoring treatment effectiveness. Recent research using optical coherence tomography (OCT) has demonstrated that parameters provided by this technology may be used as potential biomarkers for MS, PD, and AD. Retinal thinning has been observed in these patients and new segmentation software for the analysis of the different retinal layers may provide accurate information on disease progression and prognosis. In this review we analyze the application of retinal evaluation using OCT technology to provide better understanding of the possible role of the retinal layers thickness as biomarker for the detection of these neurodegenerative pathologies. Current OCT analysis of the retinal nerve fiber layer and, specially, the ganglion cell layer thickness may be considered as a good biomarker for disease diagnosis, severity, and progression.
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