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Wang L, Bao Y, Duan X, Li H, Ding H, Yu F, Yang J, Hu Y, Huang D. A diagnostic model for Parkinson's disease based on circadian rhythm-related genes. J Transl Med 2024; 22:635. [PMID: 38978048 PMCID: PMC11229228 DOI: 10.1186/s12967-024-05424-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/19/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Circadian rhythm (CR) disturbance is intricately associated with Parkinson's disease (PD). However, the involvement of CR-related mechanisms in the pathogenesis and progression of PD remains elusive. METHODS A total of 141 PD patients and 113 healthy participants completed CR-related clinical examinations in this study. To further investigate the CR-related mechanisms in PD, we obtained datasets (GSE7621, GSE20141, GSE20292) from the Gene Expression Omnibus database to identify differentially expressed genes between PD patients and healthy controls and further selected CR-related genes (CRRGs). Subsequently, the least absolute shrinkage and selection operator (LASSO) followed by logistic algorithms were employed to identify the hub genes and construct a diagnostic model. The predictive performance was evaluated by area under the curve (AUC), calibration curve, and decision curve analyses in the training set and external validation sets. Finally, RT‒qPCR and Western blotting were conducted to verify the expression of these hub genes in blood samples. In addition, Pearson correlation analysis was utilized to validate the association between expression of hub genes and circadian rhythm function. RESULTS Our clinical observational study revealed that even early-stage PD patients exhibited a higher likelihood of experiencing sleep disturbances, nocturnal hypertension, reverse-dipper blood pressure, and reduced heart rate variability compared to healthy controls. Furthermore, 4 CR-related hub genes (AGTR1, CALR, BRM14, and XPA) were identified and subsequently incorporated as candidate biomarkers to construct a diagnostic model. The model showed satisfactory diagnostic performance in the training set (AUC = 0.941), an external validation set GSE20295 (AUC = 0.842), and our clinical centre set (AUC = 0.805). Additionally, the up-regulation of CALR, BRM14 and the down-regulation of AGTR1, XPA were associated with circadian rhythm disruption. CONCLUSION CR disturbance seems to occur in the early stage of PD. The diagnostic model based on CR-related genes demonstrated robust diagnostic efficacy, offering novel insights for future clinical diagnosis of PD and providing a foundation for further exploration into the role of CR-related mechanisms in the progression of PD.
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Affiliation(s)
- Lufeng Wang
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Yiwen Bao
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Xiaofan Duan
- Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hongxia Li
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Hao Ding
- Department of Neurology, Shanghai Baoshan Luodian Hospital, Shanghai, 201908, China
| | - Fei Yu
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Jie Yang
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Yongbo Hu
- Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, 200433, China.
| | - Dongya Huang
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.
- School Med, Tongji University, East Hospital, No. 150 Jimo Road, Shanghai, 200092, China.
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de Jager L, Vidigal CB, de Campos BH, Reginato GS, Fernandes LM, Ariza D, Higashi-Mckeown CM, Bertozzi MM, Rasquel de Oliveira FS, Verri Junior WA, Ceravolo GS, Crestani CC, Pinge-Filho P, Martins-Pinge MC. Role of the iNOS isoform in the cardiovascular dysfunctions of male rats with 6-OHDA-induced Parkinsonism. Nitric Oxide 2023; 134-135:49-60. [PMID: 37054808 DOI: 10.1016/j.niox.2023.04.003] [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: 01/30/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023]
Abstract
INTRODUCTION Available studies have shown the involvement of nitric oxide (NO) in the processes that lead to neurodegeneration in PD. Also, the use of inhibitors of the inducible isoform of NO-synthase (iNOS) promotes neuroprotection and attenuates dopamine (DA) loss in experimental models of Parkinsonism. In addition, NO also appears to be involved in cardiovascular changes in 6-hydroxydopamine (6-OHDA)-induced Parkinsonism. The current study aimed to evaluate the effects of iNOS inhibition on cardiovascular and autonomic function in animals that were subjected to Parkinsonism by the administration of 6-OHDA. MATERIALS AND METHODS The animals underwent stereotaxic surgery for bilateral microinfusion of the neurotoxin 6-OHDA (6 mg/mL in 0.2% ascorbic acid in sterile saline solution) or vehicle solution for the Sham group. From the day of stereotaxis until the day of femoral artery catheterization, the animals were treated with the iNOS inhibitor, S-methylisothiourea (SMT; 10 mg/kg; i.p.) or saline solution (0.9%; i.p.) for 7 days. The animals were divided into four groups: Sham-Saline, Sham-SMT, 6-OHDA-Saline, and 6-OHDA-SMT. Subsequent analyses were performed on these four groups. After 6 days, they underwent catheterization of the femoral artery, and 24 hours later, mean arterial pressure (MAP) and heart rate (HR) were recorded. Another group of animals (the 6-OHDA and Sham groups) was assessed for aortic vascular reactivity after 7 days of bilateral infusion of 6-OHDA or vehicle, in which cumulative concentration-effect curves (CCEC) were made for phenylephrine (Phenyl), acetylcholine and sodium nitroprusside (NPS). Also, CCEC in the presence of Nw-nitro-arginine-methyl-ester (l-NAME) (10-5 M), SMT (10-6 M), and indomethacin (10-5M) blockers were made. RESULTS The effectiveness of the 6-OHDA lesion was confirmed with the reduction of DA in 6-OHDA animals. However, treatment with SMT could not reverse the loss of DA. Concerning the baseline parameters, SBP and MAP values were lower in 6-OHDA animals compared to their Sham control, with no effect of treatment with SMT. In the analysis of SBP variability, a decrease in variance, the VLFabs component, and the LFabs component were observed in the 6-OHDA groups when compared to their controls, regardless of treatment with SMT. It was also observed that intravenous injections of SMT resulted in an increase in BP and a decrease in HR. However, the response was not different between the Sham and 6-OHDA groups. In vascular function, there was a hyporeactivity to Phenyl in the 6-OHDA group, and when investigating the mechanisms of this hyporeactivity, it was seen that the Rmax to Phenyl increased with incubation with SMT, indicating that iNOS could be involved in the vascular hyporeactivity of animals with Parkinsonism. CONCLUSION Thus, the set of results presented in this study suggests that part of the cardiovascular dysfunction in animals subjected to 6-OHDA Parkinsonism may be peripheral and involve the participation of endothelial iNOS.
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Affiliation(s)
- Lorena de Jager
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | - Camila Borecki Vidigal
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | - Blenda Hyedra de Campos
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | - Gabriela Souza Reginato
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | - Lorena Maria Fernandes
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | - Deborah Ariza
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | | | - Mariana Marques Bertozzi
- Departamento de Ciências Patológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
| | | | | | | | - Carlos César Crestani
- Faculdade de Ciências Farmacêuticas de Araraquara, Departamento de Princípios Ativos Naturais e Toxicologia, Universidade Estadual Paulista, UNESP Araraquara, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Universidade Estadual de Londrina - UEL, Londrina, PR, Brazil
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Central Aortic Pressure and Arterial Stiffness in Parkinson’s Disease: A Comparative Study. PARKINSON'S DISEASE 2022; 2022:6723950. [PMID: 35864933 PMCID: PMC9296341 DOI: 10.1155/2022/6723950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/06/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Background Cardiovascular autonomic dysfunction, which leads to hemodynamic disorders, is commonly observed in patients with Parkinson's disease (PD). Central aortic pressure (CAP) is the systolic blood pressure (SBP) at the root of the aorta. In young people, CAP is lower than peripheral arterial blood pressure. In older people, the difference between CAP and peripheral arterial blood pressure decreases depending on the extent of arterial stiffness (AS). In patients with AS, CAP increases. CAP is thus regarded as an indicator of AS. Objective To compare CAP and other hemodynamic parameters for AS between patients with Parkinson's disease and control group. We also aimed to evaluate changes in these hemodynamic parameters after the levodopa (LD) intake. Methods We included 82 patients with PD and 76 healthy controls. Age, sex, disease duration, disease subtype, Hoehn–Yahr stage (H&Y), and nonmotor symptoms (NMS) were documented. TensioMed Software v.3.0.0.1 was used to measure CAP, peripheral arterial blood pressure, pulse pressure (PP), heart rate (HR), mean arterial pressure (MAP), augmentation index (AI), pulse wave velocity, and ejection time. All patients were being treated with LD, and measurements were performed 1 h before and 1 h after LD intake. Results Baseline peripheral arterial blood pressure and CAP values were significantly higher in the PD group than in the control group (p < 0.001 and p=0.02, respectively). Most cardiac hemodynamic parameters, including peripheral arterial blood pressure and CAP, decreased significantly (p < 0.02 and p < 0.001, respectively) after LD intake in the PD group. Disease subtype, duration, and severity did not affect any of the hemodynamic parameters. When NMS were evaluated, patients with psychosis and dementia showed higher baseline parameters. Conclusion Loss of postganglionic noradrenergic innervation is well-known with PD. Several cardiac hemodynamic parameters were affected, suggesting cardiac autonomic dysfunction in these patients. The data obtained were independent of disease severity, duration, and subtype. After LD intake, most of these parameters decreased, which might have a positive effect on the vascular burden.
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Martins-Pinge MC, de Jager L, de Campos BH, Bezerra LO, Turini PG, Pinge-Filho P. Nitric Oxide Involvement in Cardiovascular Dysfunctions of Parkinson Disease. Front Pharmacol 2022; 13:898797. [PMID: 35899105 PMCID: PMC9309809 DOI: 10.3389/fphar.2022.898797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
Parkinson’s disease (PD) is characterized by the loss of dopaminergic neurons in the substantia nigra, causing motor changes. In addition to motor symptoms, non-motor dysfunctions such as psychological, sensory and autonomic disorders are recorded. Manifestations related to the autonomic nervous system include the cardiovascular system, as postural hypotension, postprandial hypotension, and low blood pressure. One of the mediators involved is the nitric oxide (NO). In addition to the known roles such as vasodilator, neuromodulator, NO acts as an important mediator of the immune response, increasing the inflammatory response provoked by PD in central nervous system. The use of non-specific NOS inhibitors attenuated the neurodegenerative response in animal models of PD. However, the mechanisms by which NO contributes to neurodegeneration are still not well understood. The literature suggest that the contribution of NO occurs through its interaction with superoxides, products of oxidative stress, and blocking of the mitochondrial respiratory chain, resulting in neuronal death. Most studies involving Parkinsonism models have evaluated brain NO concentrations, with little data available on its peripheral action. Considering that studies that evaluated the involvement of NO in the neurodegeneration in PD, through NOS inhibitors administration, showed neuroprotection in rats, it has prompted new studies to assess the participation of NOS isoforms in cardiovascular changes induced by parkinsonism, and thus to envision new targets for the treatment of cardiovascular disorders in PD. The aim of this study was to conduct a literature review to assess available information on the involvement of nitric oxide (NO) in cardiovascular aspects of PD.
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Affiliation(s)
- Marli Cardoso Martins-Pinge
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina—UEL, Londrina, Brazil
- *Correspondence: Marli Cardoso Martins-Pinge,
| | - Lorena de Jager
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina—UEL, Londrina, Brazil
| | - Blenda Hyedra de Campos
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina—UEL, Londrina, Brazil
| | - Lorena Oliveira Bezerra
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina—UEL, Londrina, Brazil
| | - Pamela Giovana Turini
- Departamento de Ciências Fisiológicas, Universidade Estadual de Londrina—UEL, Londrina, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Universidade Estadual de Londrina- UEL, Londrina, Brazil
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Valente HB, Gervazoni NDL, Laurino MJL, Vanzella LM, Stoco-Oliveira MC, Rodrigues MV, André LB, Ribeiro F, de Carvalho AC, Vanderlei LCM. Autonomic and cardiorespiratory responses to the active tilt test in individuals with Parkinson disease: cross-sectional study. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:689-698. [PMID: 36254441 PMCID: PMC9685817 DOI: 10.1055/s-0042-1755225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. OBJECTIVE To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. METHODS A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. RESULTS At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. CONCLUSION Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.
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Affiliation(s)
- Heloisa Balotari Valente
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Natacha de Lima Gervazoni
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Maria Júlia Lopez Laurino
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Laís Manata Vanzella
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Mileide Cristina Stoco-Oliveira
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Mariana Viana Rodrigues
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Larissa Borba André
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Felipe Ribeiro
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Augusto Cesinando de Carvalho
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Luiz Carlos Marques Vanderlei
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
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Papapetropoulos S, Pontius A, Finger E, Karrenbauer V, Lynch DS, Brennan M, Zappia S, Koehler W, Schoels L, Hayer SN, Konno T, Ikeuchi T, Lund T, Orthmann-Murphy J, Eichler F, Wszolek ZK. Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia: Review of Clinical Manifestations as Foundations for Therapeutic Development. Front Neurol 2022; 12:788168. [PMID: 35185751 PMCID: PMC8850408 DOI: 10.3389/fneur.2021.788168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
A comprehensive review of published literature was conducted to elucidate the genetics, neuropathology, imaging findings, prevalence, clinical course, diagnosis/clinical evaluation, potential biomarkers, and current and proposed treatments for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare, debilitating, and life-threatening neurodegenerative disorder for which disease-modifying therapies are not currently available. Details on potential efficacy endpoints for future interventional clinical trials in patients with ALSP and data related to the burden of the disease on patients and caregivers were also reviewed. The information in this position paper lays a foundation to establish an effective clinical rationale and address the clinical gaps for creation of a robust strategy to develop therapeutic agents for ALSP, as well as design future clinical trials, that have clinically meaningful and convergent endpoints.
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Affiliation(s)
- Spyros Papapetropoulos
- Vigil Neuroscience, Inc, Cambridge, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
| | | | - Elizabeth Finger
- Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Virginija Karrenbauer
- Neurology Medical Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - David S. Lynch
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | | | | | | | - Ludger Schoels
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Stefanie N. Hayer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Takuya Konno
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Troy Lund
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
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Olfactory Impairment in Parkinson’s Disease Patients with Tremor Dominant Subtype Compared to Those with Akinetic Rigid Dominant Subtype: A Pilot Study. Brain Sci 2022; 12:brainsci12020196. [PMID: 35203959 PMCID: PMC8869930 DOI: 10.3390/brainsci12020196] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Parkinson’s disease (PD) may present different motor subtypes depending on the predominant symptoms (tremor or rigidity/bradykinesia). Slower disease progression and cognitive decline were observed in tremor-dominant (TD) patients compared to those with the akinetic-rigid dominant (ARD) subtype. Although olfactory dysfunctions are well-known disturbances in PD patients, correlations among PD different subtypes and olfactory impairment were not clearly studied. Thus, we investigated the possible olfactory impairment in PD patients with TD and ARD subtypes as compared to healthy controls. Methods: A sample of 132 participants were enrolled: 62 PD patients divided into ARD (n = 42) and TD (n = 20) subgroups using tremor/rigidity ratio, and 70 healthy controls. Olfactory function was assessed with the Sniffin’ Sticks Test. Results: Odor threshold was significantly lower in the ARD than in the TD subtype, while odor identification, discrimination scores, and their sum (TDI score) were not significantly different. On multivariate linear regression analysis, the tremor/rigidity ratio was a significant predictor of odor threshold. Conclusions: Our pilot study showed a significant olfactory dysfunction in PD patients with the ARD subtype. This evidence confirms the biological relevance of clinical subgroups in PD patients, suggesting the existence of a different pathophysiological mechanism between the ARD and TD clinical subtypes.
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Cuenca-Bermejo L, Almela P, Navarro-Zaragoza J, Fernández Villalba E, González-Cuello AM, Laorden ML, Herrero MT. Cardiac Changes in Parkinson's Disease: Lessons from Clinical and Experimental Evidence. Int J Mol Sci 2021; 22:13488. [PMID: 34948285 PMCID: PMC8705692 DOI: 10.3390/ijms222413488] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 01/18/2023] Open
Abstract
Dysautonomia is a common non-motor symptom in Parkinson's disease (PD). Most dysautonomic symptoms appear due to alterations in the peripheral nerves of the autonomic nervous system, including both the sympathetic and parasympathetic nervous systems. The degeneration of sympathetic nerve fibers and neurons leads to cardiovascular dysfunction, which is highly prevalent in PD patients. Cardiac alterations such as orthostatic hypotension, heart rate variability, modifications in cardiogram parameters and baroreflex dysfunction can appear in both the early and late stages of PD, worsening as the disease progresses. In PD patients it is generally found that parasympathetic activity is decreased, while sympathetic activity is increased. This situation gives rise to an imbalance of both tonicities which might, in turn, promote a higher risk of cardiac damage through tachycardia and vasoconstriction. Cardiovascular abnormalities can also appear as a side effect of PD treatment: L-DOPA can decrease blood pressure and aggravate orthostatic hypotension as a result of a negative inotropic effect on the heart. This unwanted side effect limits the therapeutic use of L-DOPA in geriatric patients with PD and can contribute to the number of hospital admissions. Therefore, it is essential to define the cardiac features related to PD for the monitorization of the heart condition in parkinsonian individuals. This information can allow the application of intervention strategies to improve the course of the disease and the proposition of new alternatives for its treatment to eliminate or reverse the motor and non-motor symptoms, especially in geriatric patients.
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Affiliation(s)
- Lorena Cuenca-Bermejo
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - Pilar Almela
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - Javier Navarro-Zaragoza
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - Emiliano Fernández Villalba
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - Ana-María González-Cuello
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
| | - María-Luisa Laorden
- Department of Pharmacology, School of Medicine, Biomedical Research Institute of Murcia (IMIB), University of Murcia, 30100 Murcia, Spain; (P.A.); (J.N.-Z.); (M.-L.L.)
| | - María-Trinidad Herrero
- Clinical and Experimental Neuroscience Group/Biomedical Research Institute of Murcia (NiCE-IMIB)/Institute for Aging Research, School of Medicine, University of Murcia, 30100 Murcia, Spain; (L.C.-B.); (A.-M.G.-C.)
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El Mokadem MO, Hassan A, Hussein M, Mohamed YM. The potential role of 2D-speckle tracking echocardiography for detecting left ventricular systolic dysfunction in patients with Parkinson's disease: a case control study. Acta Cardiol 2021; 76:979-986. [PMID: 33308047 DOI: 10.1080/00015385.2020.1858251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The prevalence of heart failure among patients with Parkinson's disease (PD) was found to be twice that of the general population. The aim of this work is to evaluate the global left ventricular systolic function in patients with PD in comparison with healthy controls using speckle tracking echocardiography and to correlate the global left ventricular systolic function with both motor and cognitive functions in PD patients. METHODS A case-control study was conducted on 40 patients diagnosed with PD and 40 healthy controls. Evaluation and staging of PD were performed using the Modified Hoehn and Yahr staging scale (H&Y staging) and Unified Parkinson's Disease Rating Scale (UPDRS). Cognitive assessment for PD patients was done using Parkinson's Disease - Cognitive Rating Scale (PD-CRS). Conventional and two-dimensional (2D) speckle-tracking strain echocardiography was done for both groups to assess the global left ventricular systolic function. RESULTS There was a statistically significant difference between PD patients and controls regarding global longitudinal strain (p = 0.025), left ventricular end-diastolic dimension (p = 0.032), left ventricular end-systolic dimension (p = 0.003) and ejection fraction (p = 0.015). There were statistically significant negative correlations between both H&Y staging and UPDRS and both GLS (p ˂ 0.001, p ˂ 0.001) and EF (p = 0.017, p = 0.05). There were statistically significant positive correlations between PD-CRS and both GLS (p = 0.025) and EF (p = 0.012). CONCLUSION PD patients were found to have significant subclinical left ventricular systolic dysfunction in comparison with healthy controls. Such dysfunction was correlated with the severity of the motor disability and cognitive impairment.
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Affiliation(s)
| | - Amr Hassan
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
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Heart Rate Variability Analyses in Parkinson's Disease: A Systematic Review and Meta-Analysis. Brain Sci 2021; 11:brainsci11080959. [PMID: 34439578 PMCID: PMC8394422 DOI: 10.3390/brainsci11080959] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 12/16/2022] Open
Abstract
Recent evidence suggests that the vagus nerve and autonomic dysfunction play an important role in the pathogenesis of Parkinson's disease. Using heart rate variability analysis, the autonomic modulation of cardiac activity can be investigated. This meta-analysis aims to assess if analysis of heart rate variability may indicate decreased parasympathetic tone in patients with Parkinson's disease. The MEDLINE, EMBASE and Cochrane Central databases were searched on 31 December 2020. Studies were included if they: (1) were published in English, (2) analyzed idiopathic Parkinson's disease and healthy adult controls, and (3) reported at least one frequency- or time-domain heart rate variability analysis parameter, which represents parasympathetic regulation. We included 47 studies with 2772 subjects. Random-effects meta-analyses revealed significantly decreased effect sizes in Parkinson patients for the high-frequency spectral component (HFms2) and the short-term measurement of the root mean square of successive normal-to-normal interval differences (RMSSD). However, heterogeneity was high, and there was evidence for publication bias regarding HFms2. There is some evidence that a more advanced disease leads to an impaired parasympathetic regulation. In conclusion, short-term measurement of RMSSD is a reliable parameter to assess parasympathetically impaired cardiac modulation in Parkinson patients. The measurement should be performed with a predefined respiratory rate.
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11
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Turossi Amorim ED, de Jager L, Martins AB, Rodrigues AT, Cruz Lucchetti BF, Ariza D, Pinge‐Filho P, Crestani CC, Uchoa ET, Martins‐Pinge MC. Glutamate and GABA neurotransmission are increased in paraventricular nucleus of hypothalamus in rats induced to 6-OHDA parkinsonism: Involvement of nNOS. Acta Physiol (Oxf) 2019; 226:e13264. [PMID: 30716212 DOI: 10.1111/apha.13264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/24/2019] [Accepted: 01/30/2019] [Indexed: 02/02/2023]
Abstract
AIM Parkinson's disease (PD) is a progressive neurodegenerative disease that manifests itself clinically after reaching an advanced pathological stage. Besides motor signals, PD patients present cardiovascular and autonomic alterations. Recent data showed that rats induced to Parkinsonism by 6-hydroxydopamine (6-OHDA) administration in the substantia nigra pars compacta (SNpc) showed lower mean arterial pressure (MAP) and heart rate (HR), as reduction in sympathetic modulation. The paraventricular nucleus of the hypothalamus (PVN) is an important site for autonomic and cardiovascular control, and amino acid neurotransmission has a central role. We evaluate PVN amino acid neurotransmission in cardiovascular and autonomic effects of 6-OHDA Parkinsonism. METHODS Male Wistar rats were submitted to guide cannulas implantation into the PVN. 6-OHDA or sterile saline (sham) was administered bilaterally in the SNpc. After 7 days, cardiovascular recordings in conscious state was performed. RESULTS Bicuculline promoted an increase in MAP and HR in sham group and exacerbated those effects in 6-OHDA group. NBQX (non-NMDA inhibitor) did not promote changes in sham as in 6-OHDA group. On the other hand, PVN microinjection of LY235959 (NMDA inhibitor) in sham group did not induced cardiovascular alterations, but decreased MAP and HR in 6-OHDA group. Compared to Sham group, 6-OHDA lesion increased the number of neuronal nitric oxide synthase (nNOS)-immunoreactive neurons in the PVN and, nNOS inhibition promoted higher increases in MAP and HR. CONCLUSION Our data suggest that the decreased baseline blood pressure and heart rate in animals with Parkinsonism may be due to an increased GABAergic tone via nNOS in the PVN.
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Affiliation(s)
- Eric Diego Turossi Amorim
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Lorena de Jager
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Andressa Busetti Martins
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Ananda Totti Rodrigues
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | | | - Deborah Ariza
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Phileno Pinge‐Filho
- Departament of Pathological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Carlos Cesar Crestani
- Laboratory of Pharmacology, School of Pharmaceutical Sciences UNESP ‐ Univ Estadual Paulista Araraquara Brazil
| | - Ernane Torres Uchoa
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
| | - Marli Cardoso Martins‐Pinge
- Departament of Physiological Sciences, Center of Biological Sciences State University of Londrina Londrina Brazil
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12
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Interoceptive processing deficit: A behavioral marker for subtyping Parkinson's disease. Parkinsonism Relat Disord 2018; 53:64-69. [PMID: 29748110 DOI: 10.1016/j.parkreldis.2018.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/27/2018] [Accepted: 05/02/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Non-motor symptoms in Parkinson's disease (PD), such as cognitive, emotional, autonomic and somatosensory alterations, are not ubiquitous but vary between the tremor dominant (TD) and postural instability/gait difficulty (PIGD) subtypes of the syndrome. Non-motor phenomena (e.g., anxiety, depression and apathy) have been related to representation of autonomic and somatosensory sensations (interoception), and recent findings suggest interoceptive deficits in PD. OBJECTIVES To test whether interoceptive processing is differently affected in TD and PIGD phenotypes, by assessing both interoceptive accuracy and sensibility in PD patients with TD and PIGD subtypes, and in healthy controls. METHODS Interoceptive accuracy was measured by the heartbeat perception task requiring participants to count their own heartbeats in a given time interval. A time-estimation, control task was also administered asking participants to count the seconds in a set period of time. Interoceptive sensibility was assessed by a questionnaire of subjective interoception. Finally, the patients underwent measures of anxiety, depression, apathy and anhedonia, and impulsive-compulsive disturbances. RESULTS The main results showed reduced interoceptive accuracy and sensibility in TD patients relative to both PIGD patients and healthy controls. Reduced interoceptive accuracy of TD group was a reliable result since their performance on the time estimation control task was comparable to that of both PIGD patients and healthy controls. CONCLUSIONS These findings demonstrate that the behavioural assessment of different aspects of interoceptive processing can provide with a further marker for subtyping patients with PD.
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13
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Piqueras-Flores J, López-García A, Moreno-Reig Á, González-Martínez A, Hernández-González A, Vaamonde-Gamo J, Jurado-Román A. Structural and functional alterations of the heart in Parkinson’s disease. Neurol Res 2017; 40:53-61. [DOI: 10.1080/01616412.2017.1390933] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jesús Piqueras-Flores
- Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Ana López-García
- Neurology Department. Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Álvaro Moreno-Reig
- Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | - Julia Vaamonde-Gamo
- Neurology Department. Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Alfonso Jurado-Román
- Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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14
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Visanji NP, Bhudhikanok GS, Mestre TA, Ghate T, Udupa K, AlDakheel A, Connolly BS, Gasca-Salas C, Kern DS, Jain J, Slow EJ, Faust-Socher A, Kim S, Azhu Valappil R, Kausar F, Rogaeva E, William Langston J, Tanner CM, Schüle B, Lang AE, Goldman SM, Marras C. Heart rate variability in leucine-rich repeat kinase 2-associated Parkinson's disease. Mov Disord 2017; 32:610-614. [PMID: 28071824 DOI: 10.1002/mds.26896] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/15/2016] [Accepted: 11/20/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Heart rate variability is reduced in idiopathic PD, indicating cardiac autonomic dysfunction likely resulting from peripheral autonomic synucleinopathy. Little is known about heart rate variability in leucine-rich repeat kinase 2-associated PD. OBJECTIVES This study investigated heart rate variability in LRRK2-associated PD. METHODS Resting electrocardiograms were obtained from 20 individuals with LRRK2-associated PD, 37 nonmanifesting carriers, 48 related noncarriers, 26 idiopathic PD patients, and 32 controls. Linear regression modelling compared time and frequency domain values, adjusting for age, sex, heart rate, and disease duration. RESULTS Low-frequency power and the ratio of low-high frequency power were reduced in idiopathic PD versus controls (P < .008, P < .029 respectively). In contrast, individuals with LRRK2-associated PD were not statistically different from controls in any parameter measured. Furthermore, all parameters trended toward being higher in LRRK2-associated PD when compared with idiopathic PD. CONCLUSIONS Heart rate variability may remain intact in LRRK2-associated PD, adding to a growing literature supporting clinical-pathologic differences between LRRK2-associated and idiopathic PD. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Naomi P Visanji
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | | | - Tiago A Mestre
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Taneera Ghate
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Kaviraj Udupa
- Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Amaal AlDakheel
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Barbara S Connolly
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Carmen Gasca-Salas
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Drew S Kern
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Jennifer Jain
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Elizabeth J Slow
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Achinoam Faust-Socher
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Sam Kim
- The Parkinson's Institute and Clinical Center, Sunnyvale, California, USA
| | | | - Farah Kausar
- The Parkinson's Institute and Clinical Center, Sunnyvale, California, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - J William Langston
- The Parkinson's Institute and Clinical Center, Sunnyvale, California, USA
| | - Caroline M Tanner
- University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
| | - Birgitt Schüle
- The Parkinson's Institute and Clinical Center, Sunnyvale, California, USA
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
| | - Samuel M Goldman
- University of California, San Francisco, San Francisco, California, USA.,San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and Edmund J Saffra Program in Parkinson's Disease, Tornto Western Hospital, Toronto, Ontario, Canada
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15
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Yoon JH, Kim MS, Lee SM, Kim HJ, Hong JM. Heart rate variability to differentiate essential tremor from early-stage tremor-dominant Parkinson's disease. J Neurol Sci 2016; 368:55-8. [PMID: 27538602 DOI: 10.1016/j.jns.2016.06.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/30/2016] [Accepted: 06/27/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Essential tremor (ET) and Parkinson's disease (PD) are the most common movement disorders in the elderly, but it is difficult to differentiate ET from early-stage tremor-dominant Parkinson's disease (TDPD). METHODS We investigated heart rate variability (HRV) in 23 patients with ET, 27 patients with TDPD, and 23 healthy controls. HRV was determined using the RR intervals of a 5-min electrocardiogram recording. Measurements of beat-to-beat RR variability, including time domains [(standard deviation of the normal-to-normal RR interval (SDNN), and the root mean square difference of successive RR intervals (RMSSD)] and frequency domains [low-frequency (LF) and high-frequency (HF) components and total spectral power (TP)], were assessed retrospectively.x RESULTS In the TDPD group, SDNN, LF, HF, and TP were significantly lower than those in the ET group. In a receiver operating characteristic area under the curve (AUC) analysis, LF was the best potential diagnostic marker (AUC=0.87). CONCLUSION Non-invasive and routine electrocardiography may be helpful in differentiating ET from TDPD during the early disease stage.
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Affiliation(s)
- Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
| | - Min Seung Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Sun Min Lee
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun Jae Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - Ji Man Hong
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
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16
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Espay AJ, Bonato P, Nahab FB, Maetzler W, Dean JM, Klucken J, Eskofier BM, Merola A, Horak F, Lang AE, Reilmann R, Giuffrida J, Nieuwboer A, Horne M, Little MA, Litvan I, Simuni T, Dorsey ER, Burack MA, Kubota K, Kamondi A, Godinho C, Daneault JF, Mitsi G, Krinke L, Hausdorff JM, Bloem BR, Papapetropoulos S. Technology in Parkinson's disease: Challenges and opportunities. Mov Disord 2016; 31:1272-82. [PMID: 27125836 DOI: 10.1002/mds.26642] [Citation(s) in RCA: 315] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 03/15/2016] [Accepted: 03/18/2016] [Indexed: 12/21/2022] Open
Abstract
The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capture of more and previously inaccessible phenomena in Parkinson's disease (PD). However, more information has not translated into a greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include noncompatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (among vulnerable elderly patients in particular), and the gap between the "big data" acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms that enable multichannel data capture sensitive to the broad range of motor and nonmotor problems that characterize PD and are adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to (1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones, (2) enhance the tailoring of symptomatic therapy, (3) improve subgroup targeting of patients for future testing of disease-modifying treatments, and (4) identify objective biomarkers to improve the longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the task force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and the quality of life of individuals with PD. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Paolo Bonato
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Fatta B Nahab
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tübingen, Germany.,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - John M Dean
- Davis Phinney Foundation for Parkinson's, Boulder, Colorado, USA
| | - Jochen Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Bjoern M Eskofier
- Digital Sports Group, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Aristide Merola
- Department of Neuroscience "Rita Levi Montalcini", Città della salute e della scienza di Torino, Torino, Italy
| | - Fay Horak
- Department of Neurology, Oregon Health & Science University, Portland VA Medical System, Portland, Oregon.,APDM, Inc., Portland, Oregon, USA
| | - Anthony E Lang
- Morton and Gloria Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Ralf Reilmann
- George-Huntington-Institute, Muenster, Germany.,Department of Radiology, University of Muenster, Muenster, Germany.,Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | | | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Malcolm Horne
- Global Kinetics Corporation & Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Max A Little
- Department of Mathematics, Aston University, Birmingham, UK.,Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Irene Litvan
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - E Ray Dorsey
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
| | - Michelle A Burack
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
| | - Ken Kubota
- Michael J Fox Foundation for Parkinson's Research, New York City, New York, USA
| | - Anita Kamondi
- Department of Neurology, National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Catarina Godinho
- Center of Interdisciplinary Research Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
| | - Jean-Francois Daneault
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Lothar Krinke
- Medtronic Neuromodulation, Minneapolis, Minnesota, USA
| | - Jeffery M Hausdorff
- Sackler School of Medicine, Tel Aviv University and Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
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Pascale E, Di Battista ME, Rubino A, Purcaro C, Valente M, Fattapposta F, Ferraguti G, Meco G. Genetic Architecture of MAPT Gene Region in Parkinson Disease Subtypes. Front Cell Neurosci 2016; 10:96. [PMID: 27147968 PMCID: PMC4826864 DOI: 10.3389/fncel.2016.00096] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/29/2016] [Indexed: 01/30/2023] Open
Abstract
The microtubule-associated protein tau (MAPT) region has been conceptualized as a model of the interaction between genetics and functional disease outcomes in neurodegenerative disorders, such as Parkinson disease (PD). Indeed, haplotype-specific differences in expression and alternative splicing of MAPT transcripts affect cellular functions at different levels, increasing susceptibility to a range of neurodegenerative processes. In order to evaluate a possible link between MAPT variants, PD risk and PD motor phenotype, we analyzed the genetic architecture of MAPT in a cohort of PD patients. We observed a statistically significant association between the H1 haplotype and PD risk (79.5 vs 69.5%; χ2 = 9.9; OR, 1.7; 95% CI, 1.2–2.4; p = 0.002). The effect was more evident in non tremor dominant (TD) PD subjects (NTD-PD) (82 vs 69.5%; χ2 = 13.6; OR, 2.03; 95% CI, 1.4–3; p = 0.0003), while no difference emerged between PD subgroup of tremor dominant patients (TD-PD) and control subjects. Examination of specific intra-H1 variations showed that the H1h subhaplotype was overrepresented in NTD-PD patients compared with controls (p = 0.007; OR, 2.9; 95% CI, 1.3–6.3). Although we cannot exclude that MAPT variation may be associated with ethnicity, our results may support the hypothesis that MAPT H1 clade and a specific H1 subhaplotype influence the risk of PD and modulate the clinical expression of the disease, including motor phenotype.
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Affiliation(s)
- Esterina Pascale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University Rome, Italy
| | - Maria Elena Di Battista
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza UniversityRome, Italy; Research Centre of Social Diseases (CIMS), Sapienza UniversityRome, Italy
| | - Alfonso Rubino
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza UniversityRome, Italy; Research Centre of Social Diseases (CIMS), Sapienza UniversityRome, Italy
| | - Carlo Purcaro
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza UniversityRome, Italy; Research Centre of Social Diseases (CIMS), Sapienza UniversityRome, Italy
| | - Marcella Valente
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza UniversityRome, Italy; Research Centre of Social Diseases (CIMS), Sapienza UniversityRome, Italy
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza University Rome, Italy
| | - Giampiero Ferraguti
- Department of Cellular Biotechnologies and Hematology, Sapienza University Rome, Italy
| | - Giuseppe Meco
- Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza UniversityRome, Italy; Research Centre of Social Diseases (CIMS), Sapienza UniversityRome, Italy
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