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Escudero B, López-Valencia L, Arias Horcajadas F, Orio L. Divergent Roles of APOAI and APOM in the Identification of Alcohol Use Disorder and Their Association With Inflammation and Cognitive Decline: A Pilot Study. Int J Neuropsychopharmacol 2024; 27:pyae029. [PMID: 38970624 PMCID: PMC11287869 DOI: 10.1093/ijnp/pyae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 07/04/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) courses with inflammation and cognitive decline. Apolipoproteins have emerged as novel target compounds related to inflammatory processes and cognition. METHODS A cross-sectional study was performed on abstinent AUD patients with at least 1 month of abstinence (n = 33; 72.7% men) and healthy controls (n = 34; 47.1% men). A battery of plasma apolipoproteins (APOAI, APOAII, APOB, APOCII, APOE, APOJ, and APOM), plasma inflammatory markers (LPS, LBP), and their influence on cognition and presence of the disorder were investigated. RESULTS Higher levels of plasma APOAI, APOB, APOE, and APOJ, as well as the proinflammatory LPS, were observed in the AUD group, irrespective of sex, whereas APOM levels were lower vs controls. Hierarchical logistic regression analyses, adjusting for covariates (age, sex, education), associated APOM with the absence of cognitive impairment in AUD and identified APOAI and APOM as strong predictors of the presence or absence of the disorder, respectively. APOAI and APOM did not correlate with alcohol abuse variables or liver status markers, but they showed an opposite profile in their associations with LPS (positive for APOAI; negative for APOM) and cognition (negative for APOAI; positive for APOM) in the entire sample. CONCLUSIONS The HDL constituents APOAI and APOM were differentially regulated in the plasma of AUD patients compared with controls, playing divergent roles in the disorder identification and associations with inflammation and cognitive decline.
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Affiliation(s)
- Berta Escudero
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Leticia López-Valencia
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Francisco Arias Horcajadas
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Riapad: Research Network in Primary Care in Addictions, Spain
| | - Laura Orio
- Instituto de investigación Sanitaria Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, Faculty of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
- Riapad: Research Network in Primary Care in Addictions, Spain
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2
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Sakurai R, Pieruccini‐Faria F, Cornish B, Fraser J, Binns MA, Beaton D, Dilliott AA, Kwan D, Ramirez J, Tan B, Scott CJM, Sunderland KM, Tartaglia C, Finger E, Zinman L, Freedman M, McLaughlin PM, Swartz RH, Symons S, Lang AE, Bartha R, Black SE, Masellis M, Hegele RA, McIlroy W, Montero‐Odasso M. Link among apolipoprotein E E4, gait, and cognition in neurodegenerative diseases: ONDRI study. Alzheimers Dement 2024; 20:2968-2979. [PMID: 38470007 PMCID: PMC11032526 DOI: 10.1002/alz.13740] [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: 06/16/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Apolipoprotein E E4 allele (APOE E4) and slow gait are independently associated with cognitive impairment and dementia. However, it is unknown whether their coexistence is associated with poorer cognitive performance and its underlying mechanism in neurodegenerative diseases. METHODS Gait speed, APOE E4, cognition, and neuroimaging were assessed in 480 older adults with neurodegeneration. Participants were grouped by APOE E4 presence and slow gait. Mediation analyses were conducted to determine if brain structures could explain the link between these factors and cognitive performance. RESULTS APOE E4 carriers with slow gait had the lowest global cognitive performance and smaller gray matter volumes compared to non-APOE E4 carriers with normal gait. Coexistence of APOE E4 and slow gait best predicted global and domain-specific poorer cognitive performances, mediated by smaller gray matter volume. DISCUSSION Gait slowness in APOE E4 carriers with neurodegenerative diseases may indicate extensive gray matter changes associated with poor cognition. HIGHLIGHTS APOE E4 and slow gait are risk factors for cognitive decline in neurodegenerative diseases. Slow gait and smaller gray matter volumes are associated, independently of APOE E4. Worse cognition in APOE E4 carriers with slow gait is explained by smaller GM volume. Gait slowness in APOE E4 carriers indicates poorer cognition-related brain changes.
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Affiliation(s)
- Ryota Sakurai
- Research Team for Social Participation and Healthy AgingTokyo Metropolitan Institute for Geriatrics and GerontologyItabashi‐kuTokyoJapan
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
| | - Frederico Pieruccini‐Faria
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
- Department of MedicineDivision of Geriatric MedicineParkwood HospitalWestern University, Parkwood InstituteLondonOntarioCanada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Lab, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Lab, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Malcolm A. Binns
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
| | - Derek Beaton
- Data Science and Advanced Analytics, St. Michael's Hospital, Unity Health TorontoTorontoOntarioCanada
| | - Allison Ann Dilliott
- Department of Neurology and NeurosurgeryMontreal Neurological Institute, McGill UniversityMontréalQuebecCanada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's UniversityKingstonOntarioCanada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
| | | | | | - Carmela Tartaglia
- Krembil Brain InstituteUniversity Health Network Memory Clinic, Toronto Western HospitalTorontoOntarioCanada
- Tanz Centre for Research in Neurodegenerative Diseases, University of TorontoTorontoOntarioCanada
| | - Elizabeth Finger
- Department of Clinical Neurological SciencesSchulich School of Medicine and Dentistry, Western UniversityLondonOntarioCanada
| | - Lorne Zinman
- Sunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health SciencesTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
- Division of NeurologyBaycrest Health SciencesTorontoOntarioCanada
| | - Paula M. McLaughlin
- Halifax Clinical Psychology Residency ProgramNova Scotia Health AuthorityHalifaxNova ScotiaCanada
| | - Richard H. Swartz
- Sunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Medicine (Neurology)University of TorontoTorontoOntarioCanada
| | - Sean Symons
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Anthony E. Lang
- Division of NeurologyDepartment of MedicineEdmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders ClinicToronto Western HospitalUniversity of TorontoTorontoOntarioCanada
| | - Robert Bartha
- Department of Medical BiophysicsSchulich School of Medicine and Dentistry, Robarts Research Institute, Western UniversityLondonOntarioCanada
| | - Sandra E. Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology)Sunnybrook Research Institute, Sunnybrook HSC, University of TorontoTorontoOntarioCanada
| | - Robert A. Hegele
- Schulich School of Medicine and Dentistry, Western UniversityLondonOntarioCanada
- Robarts Research Institute, Western UniversityLondonOntarioCanada
| | - William McIlroy
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - ONDRI Investigators
- Research Team for Social Participation and Healthy AgingTokyo Metropolitan Institute for Geriatrics and GerontologyItabashi‐kuTokyoJapan
| | - Manuel Montero‐Odasso
- Gait & Brain Lab, St. Joseph' Health Care London, Lawson Health Research, Western University, Division of Geriatric MedicineLondonOntarioCanada
- Gait and Brain Lab, Division of Geriatric Medicineand Lawson Health Research InstituteParkwood Institute, Western UniversityLondonOntarioCanada
- Division of Geriatric MedicineDepartment of MedicineSchulich School of Medicine and Dentistry, Western University, Parkwood InstituteLondonOntarioCanada
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3
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Kapan A, Haider S, Wakolbinger M, Spatt J. Associations of Apolipoprotein ε4 Genotypes with Motor and Nonmotor Symptoms in Parkinson's Disease: A Cross-Sectional Study. Mov Disord Clin Pract 2023; 10:1611-1619. [PMID: 38026513 PMCID: PMC10654815 DOI: 10.1002/mdc3.13862] [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: 12/21/2022] [Revised: 06/20/2023] [Accepted: 08/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background The apolipoprotein E (APOE) ε4 allele has been associated with cognitive decline in Parkinson's disease (PD), but little is known about its relationship with motor and other nonmotor symptoms and whether APOE ε4 retains an influence on cognition when other factors are considered. Objective To investigate the impact of APOE ε4 on motor/nonmotor symptoms and its relationship with other factors affecting cognition in individuals with PD. Methods We analyzed data from 7616 individuals, comparing motor/nonmotor symptoms in different APOE genotypes using binary logistic regression. Multivariate logistic regression examined factors associated with cognitive impairments, including APOE ε4, Geriatric Depression Scale (GDS) score, Non-motor Symptom Questionnaire (NMS) score, Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II score, and physical activity level. Results APOE ε4 heterozygosity was modestly associated with lower cognitive scores (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.99), whereas no significant association was found for any other nonmotor and motor symptoms. However, in multivariate analysis, cognitive impairment was associated with higher GDS (OR, 1.28; 95% CI, 1.23-1.34), NMS (OR, 1.22; 95% CI, 1.19-1.25), and MDS-UPDRS Part II (OR, 1.07; 95% CI, 1.06-1.09) scores, whereas physical activity was negatively associated (OR, 0.99; 95% CI, 0.98-0.99). APOE ε4 was no longer significant after adjusting for these factors. Conclusions There is a link between cognition and APOE ε4 in patients with PD; however, when considering multiple factors, APOE ε4 plays a subordinate role. Other factors, such as depression, physical activity, and other nonmotor symptoms, demonstrate a stronger influence on cognitive impairment.
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Affiliation(s)
- Ali Kapan
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria
| | - Sandra Haider
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria
| | - Maria Wakolbinger
- Department of Social and Preventive Medicine, Center for Public HealthMedical University of ViennaViennaAustria
| | - Josef Spatt
- Faculty for MedicineSigmund Freud University ViennaViennaAustria
- Neurological DepartmentEvangelical Hospital ViennaViennaAustria
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Brien DC, Riek HC, Yep R, Huang J, Coe B, Areshenkoff C, Grimes D, Jog M, Lang A, Marras C, Masellis M, McLaughlin P, Peltsch A, Roberts A, Tan B, Beaton D, Lou W, Swartz R, Munoz DP. Classification and staging of Parkinson's disease using video-based eye tracking. Parkinsonism Relat Disord 2023; 110:105316. [PMID: 36822878 DOI: 10.1016/j.parkreldis.2023.105316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/11/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION 83% of those diagnosed with Parkinson's Disease (PD) eventually progress to PD with mild cognitive impairment (PD-MCI) followed by dementia (PDD) - suggesting a complex spectrum of pathology concomitant with aging. Biomarkers sensitive and specific to this spectrum are required if useful diagnostics are to be developed that may supplement current clinical testing procedures. We used video-based eye tracking and machine learning to develop a simple, non-invasive test sensitive to PD and the stages of cognitive dysfunction. METHODS From 121 PD (45 Cognitively Normal/45 MCI/20 Dementia/11 Other) and 106 healthy controls, we collected video-based eye tracking data on an interleaved pro/anti-saccade task. Features of saccade, pupil, and blink behavior were used to train a classifier to predict confidence scores for PD/PD-MCI/PDD diagnosis. RESULTS The Receiver Operator Characteristic Area Under the Curve (ROC-AUC) of the classifier was 0.88, with the cognitive-dysfunction subgroups showing progressively increased AUC, and the AUC of PDD being 0.95. The classifier reached a sensitivity of 83% and a specificity of 78%. The confidence scores predicted PD motor and cognitive performance scores. CONCLUSION Biomarkers of saccade, pupil, and blink were extracted from video-based eye tracking to create a classifier with high sensitivity to the landscape of PD cognitive and motor dysfunction. A complex landscape of PD is revealed through a quick, non-invasive eye tracking task and our model provides a framework for such a task to be used as a supplementary screening tool in the clinic.
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Affiliation(s)
- Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Heidi C Riek
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Rachel Yep
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Jeff Huang
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Brian Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - Corson Areshenkoff
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | - David Grimes
- Ottawa Hospital, uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada.
| | - Mandar Jog
- PF Centre of Excellence, London Movement Disorders Centre, Lawson Health Research Institute, London, ON, Canada.
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease, University Health Network and the Department of Medicine, Division of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Connie Marras
- Toronto Western Hospital Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, University of Toronto, Toronto, ON, Canada.
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Medicine (Neurology), Toronto, ON, Canada.
| | - Paula McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Nova Scotia Health, Halifax, NS, Canada; Department of Psychology and Neuroscience, Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada.
| | - Alicia Peltsch
- Faculty of Engineering and Applied Science, Queen's University, Kingston, ON, Canada.
| | - Angela Roberts
- School of Communication Sciences and Disorders, Department of Computer Science, University of Western Ontario, London, ON, Canada.
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.
| | - Derek Beaton
- Data Science & Advanced Analytics (DSAA), St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Richard Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre; Faculty of Medicine, Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.
| | | | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
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5
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Okubadejo NU, Okunoye O, Ojo OO, Arabambi B, Akinyemi RO, Osaigbovo GO, Abubakar SA, Iwuozo EU, Wahab KW, Agabi OP, Agulanna U, Imarhiagbe FA, Abiodun OV, Achoru CO, Adebowale AA, Adeniji O, Akpekpe JE, Ali MW, Ani-Osheku I, Arigbodi O, Balarabe SA, Bello AH, Ekenze OS, Erameh CO, Farombi TH, Fawale MB, Komolafe MA, Nwani PO, Nwazor EO, Nyandaiti Y, Obehighe EE, Obiabo YO, Odeniyi OA, Odiase FE, Ojini FI, Onwuegbuzie GA, Osemwegie N, Oshinaike OO, Otubogun FM, Oyakhire SI, Taiwo FT, Williams UE, Ozomma S, Zubair Y, Hernandez D, Bandres-Ciga S, Blauwendraat C, Singleton A, Houlden H, Hardy J, Rizig M. APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease. NPJ Parkinsons Dis 2022; 8:155. [PMID: 36371506 PMCID: PMC9653490 DOI: 10.1038/s41531-022-00411-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/11/2022] [Indexed: 11/15/2022] Open
Abstract
The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD.
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Affiliation(s)
- Njideka U Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria.
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
| | - Olaitan Okunoye
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
| | - Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Babawale Arabambi
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Rufus O Akinyemi
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Sani A Abubakar
- Department of Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Emmanuel U Iwuozo
- Neurology Unit, Benue State University & Benue State University Teaching Hospital, Makurdi, Benue State, Nigeria
| | - Kolawole W Wahab
- Department of Medicine, University of Ilorin & University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Osigwe P Agabi
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Uchechi Agulanna
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Frank A Imarhiagbe
- University of Benin & University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | | | | | - Akintunde A Adebowale
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | | | | | | | - Ifeyinwa Ani-Osheku
- Asokoro District Hospital, Asokoro, Abuja, Federal Capital Territory, Nigeria
| | - Ohwotemu Arigbodi
- Department of Internal Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | - Salisu A Balarabe
- Department of Medicine, College of Health Sciences, Usmanu Danfodiyo University & Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Abiodun H Bello
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Oluchi S Ekenze
- Neurology Unit, Department of Medicine, Faculty of Medical Sciences, University of Nigeria & University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
| | | | - Temitope H Farombi
- Chief Tony Anenih Geriatrics Center, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Michael B Fawale
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Morenikeji A Komolafe
- Neurology Unit, Department of Medicine, Obafemi Awolowo University & Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Paul O Nwani
- Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Ernest O Nwazor
- Department of Medicine, Madonna University College of Medical Sciences, Elele, Rivers State & Federal Medical Center, Owerri, Imo State, Nigeria
| | - Yakub Nyandaiti
- University of Maiduguri & University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | | | - Yahaya O Obiabo
- Department of Internal Medicine, Delta State University & Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | | | - Francis E Odiase
- University of Benin & University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Francis I Ojini
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos State, Nigeria
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria
| | - Gerald A Onwuegbuzie
- University of Abuja & University of Abuja Teaching Hospital, Gwagwalada, Abuja, Federal Capital Territory, Nigeria
| | - Nosakhare Osemwegie
- University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Olajumoke O Oshinaike
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | | | - Shyngle I Oyakhire
- Department of Internal Medicine, National Hospital, Abuja, Federal Capital Territory, Nigeria
| | - Funlola T Taiwo
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Uduak E Williams
- Department of Internal Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross Rivers State, Nigeria
| | - Simon Ozomma
- Department of Internal Medicine, University of Calabar/University of Calabar Teaching Hospital, Calabar, Cross Rivers State, Nigeria
| | - Yusuf Zubair
- Department of Internal Medicine, National Hospital, Abuja, Federal Capital Territory, Nigeria
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Sara Bandres-Ciga
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
- Center For Alzheimer's and Related Dementias, NIA, NIH, Bethesda, MD, USA
| | - Henry Houlden
- Department of Neuromuscular Disease, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
- Neurogenetics Laboratory, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - John Hardy
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
| | - Mie Rizig
- Department of Molecular Neuroscience, University College London Institute of Neurology, Queen Square, London, UK
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Dulski J, Uitti RJ, Ross OA, Wszolek ZK. Genetic architecture of Parkinson’s disease subtypes – Review of the literature. Front Aging Neurosci 2022; 14:1023574. [PMID: 36337703 PMCID: PMC9632166 DOI: 10.3389/fnagi.2022.1023574] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
The heterogeneity of Parkinson’s disease (PD) has been recognized since its description by James Parkinson over 200 years ago. The complexity of motor and non-motor PD manifestations has led to many attempts of PD subtyping with different prognostic outcomes; however, the pathophysiological foundations of PD heterogeneity remain elusive. Genetic contributions to PD may be informative in understanding the underpinnings of PD subtypes. As such, recognizing genotype-phenotype associations may be crucial for successful gene therapy. We review the state of knowledge on the genetic architecture underlying PD subtypes, discussing the monogenic forms, as well as oligo- and polygenic risk factors associated with various PD subtypes. Based on our review, we argue for the unification of PD subtyping classifications, the dichotomy of studies on genetic factors and genetic modifiers of PD, and replication of results from previous studies.
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Affiliation(s)
- Jarosław Dulski
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
- Division of Neurological and Psychiatric Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
- Department of Neurology, St. Adalbert Hospital, Copernicus PL Ltd., Gdańsk, Poland
| | - Ryan J. Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, United States
| | - Zbigniew K. Wszolek
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
- *Correspondence: Zbigniew K. Wszolek,
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7
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Saposnik G, Ismail Z, Rivard AM, Knifton D, Bromfield G, Terzaghi M, Montoya A, Menard MC. Decision making under uncertainty in the diagnosis and management of Alzheimer's Disease in primary care: A study protocol applying concepts from neuroeconomics. Front Med (Lausanne) 2022; 9:997277. [DOI: 10.3389/fmed.2022.997277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe current management of patients with Dementia, primarily with Alzheimer's Disease (AD) is rapidly evolving. However, limited information is available about the current gaps and decision-making in primary care.ObjectivesTo evaluate factors associated with gaps, risk preferences regarding diagnostic and therapeutic choices in the management of patients with AD by primary care physicians (PCP) from across Canada.MethodsWe propose a non-interventional, cross-sectional pilot study involving 120 primary care physicians referred from the College of Family Physicians of Canada to assess diagnostic and therapeutic decisions in the management of ten simulated AD-related case-scenarios commonly encountered in clinical practice. We initially describe the current landscape and gaps regarding diagnostic and therapeutic challenges in the management of patients with AD in primary care. Then, we provide concepts from behavioral economics and neuroeconomics applied to medical decision-making. Specifically, we include standardized tests to measure risk aversion, physicians' reactions to uncertainty, and questions related to risk preferences in different domains. Finally, we summarize the protocol to be implemented to address our goals. The primary study outcome is the proportion of participants that elect to defer initial investigations to the specialist and the associated factors. Secondary outcomes include the proportion of PCP willing to order cerebral spinal fluid studies, PET scans, or initiate treatment according to the simulated case-scenarios. The study will be conducted in English and French.ConclusionsThe study findings will contribute a better understanding of relevant factors associated with diagnostic and therapeutic decisions of PCP in the management of AD, identifying participant's preferences and evaluating the role of behavioral aspects such tolerance to uncertainty, aversion to ambiguity, and therapeutic inertia.
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Laudanski K. Persistence of Lipoproteins and Cholesterol Alterations after Sepsis: Implication for Atherosclerosis Progression. Int J Mol Sci 2021; 22:ijms221910517. [PMID: 34638860 PMCID: PMC8508791 DOI: 10.3390/ijms221910517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Sepsis is one of the most common critical care illnesses with increasing survivorship. The quality of life in sepsis survivors is adversely affected by several co-morbidities, including increased incidence of dementia, stroke, cardiac disease and at least temporary deterioration in cognitive dysfunction. One of the potential explanations for their progression is the persistence of lipid profile abnormalities induced during acute sepsis into recovery, resulting in acceleration of atherosclerosis. (2) Methods: This is a targeted review of the abnormalities in the long-term lipid profile abnormalities after sepsis; (3) Results: There is a well-established body of evidence demonstrating acute alteration in lipid profile (HDL-c ↓↓, LDL-C -c ↓↓). In contrast, a limited number of studies demonstrated depression of HDL-c levels with a concomitant increase in LDL-C -c in the wake of sepsis. VLDL-C -c and Lp(a) remained unaltered in few studies as well. Apolipoprotein A1 was altered in survivors suggesting abnormalities in lipoprotein metabolism concomitant to overall lipoprotein abnormalities. However, most of the studies were limited to a four-month follow-up and patient groups were relatively small. Only one study looked at the atherosclerosis progression in sepsis survivors using clinical correlates, demonstrating an acceleration of plaque formation in the aorta, and a large metanalysis suggested an increase in the risk of stroke or acute coronary event between 3% to 9% in sepsis survivors. (4) Conclusions: The limited evidence suggests an emergence and persistence of the proatherogenic lipid profile in sepsis survivors that potentially contributes, along with other factors, to the clinical sequel of atherosclerosis.
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Affiliation(s)
- Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA; ; Tel.: +1-215-662-8200
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute of Healthcare Economics, Philadelphia, PA 19104, USA
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