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Samanci B, Tan S, Michielse S, Kuijf ML, Temel Y. Habenula volume change in Parkinson's disease: A 7T MRI study. Brain Res Bull 2024; 215:111002. [PMID: 38871257 DOI: 10.1016/j.brainresbull.2024.111002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/08/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by motor and early non-motor symptoms. The habenula is implicated in the pathophysiology of depression. This study investigates habenular volume in PD patients without clinical depression to show the changes in PD unrelated to depression. METHODS The study used high-resolution 7 Tesla MRI data from the TRACK-PD study involving 104 PD patients and 44 healthy controls (HCs). The habenula was manually segmented, and volumes were measured, considering demographic data and depression scores via the Beck Depression Inventory (BDI). RESULTS No significant correlation was found between habenular volume and BDI scores in PD patients or HCs. However, the PD group exhibited a significantly larger mean and right habenular volume than HCs. Although PD patients showed higher BDI scores, indicating more subthreshold depression, these did not correlate with the habenular volume. CONCLUSION The results suggest that while the habenula may be involved in the symptoms of PD, its role in depression within this cohort is unclear. The changes might be related to the role of the habenula in motor symptoms. This study provides a new perspective on the role of the habenula in PD, but future research could lead to a greater understanding of the neuroanatomical features of the habenula in PD.
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Affiliation(s)
- Bedia Samanci
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sonny Tan
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Stijn Michielse
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Yasin Temel
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
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Dhureja M, Deshmukh R. Impact of alogliptin on lipopolysaccharide-induced experimental Parkinson's disease: Unrevealing neurochemical and histopathological alterations in rodents. Eur J Pharmacol 2024; 975:176635. [PMID: 38734296 DOI: 10.1016/j.ejphar.2024.176635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/04/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Degeneration of the nigrostriatal dopaminergic pathway has been seen as a significant cause of movement disability in Parkinson's disease (PD) patients. However, the exact reason for these degenerative changes has remained obscure. In recent years, incretins have been neuroprotective in various pathologies. In the current study, we have investigated the neuroprotective potential of alogliptin (Alo), a dipeptidyl peptidase-IV (DPP-IV) inhibitor, in a lipopolysaccharide (LPS) induced experimental model of PD. EXPERIMENTAL APPROACH LPS (5μg/5 μl) was infused intranigrally to induce PD in experimental rats. Post-LPS infusion, these animals were treated with Alo for 21 days in three successive dosages of 10, 20, and 40 mg/kg/day/per oral. The study is well supported with the determinations of motor functions biochemical, neurochemical, and histological analysis. KEY RESULTS Intranigral infusion of LPS in rats produced motor deficit. It was accompanied by oxidative stress, elevation in neuroinflammatory cytokines, altered neurochemistry, and degenerative changes in the striatal brain region. While Alo abrogated LPS-induced biochemical/neurochemical alterations, improved motor functions, and preserved neuronal morphology in LPS-infused rats. CONCLUSION The observed neuroprotective potential of Alo may be due to its antioxidant and anti-inflammatory actions and its ability to modulate monoaminergic signals. Nonetheless, current findings suggest that improving the availability of incretins through DPP-IV inhibition is a promising strategy for treating Parkinson's disease.
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Affiliation(s)
- Maanvi Dhureja
- Department of Pharmaceutical Sciences & Technology, MRSPTU, Bathinda, India
| | - Rahul Deshmukh
- Department of Pharmaceutical Sciences & Technology, MRSPTU, Bathinda, India; Department of Pharmacology, Central University of Punjab, Ghudda, Bathinda, India.
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3
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Wang Q, Gu X, Yang L, Jiang Y, Zhang J, He J. Emerging perspectives on precision therapy for Parkinson's disease: multidimensional evidence leading to a new breakthrough in personalized medicine. Front Aging Neurosci 2024; 16:1417515. [PMID: 39026991 PMCID: PMC11254646 DOI: 10.3389/fnagi.2024.1417515] [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: 04/15/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
PD is a prevalent and progressive neurodegenerative disorder characterized by both motor and non-motor symptoms. Genes play a significant role in the onset and progression of the disease. While the complexity and pleiotropy of gene expression networks have posed challenges for gene-targeted therapies, numerous pathways of gene variant expression show promise as therapeutic targets in preclinical studies, with some already in clinical trials. With the recognition of the numerous genes and complex pathways that can influence PD, it may be possible to take a novel approach to choose a treatment for the condition. This approach would be based on the symptoms, genomics, and underlying mechanisms of the disease. We discuss the utilization of emerging genetic and pathological knowledge of PD patients to categorize the disease into subgroups. Our long-term objective is to generate new insights for the therapeutic approach to the disease, aiming to delay and treat it more effectively, and ultimately reduce the burden on individuals and society.
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Affiliation(s)
- Qiaoli Wang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xuan Gu
- Department of Trauma center, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Le Yang
- Department of Endocrinology, The People’s Hospital of Jilin Province, Changchun, China
| | - Yan Jiang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jiao Zhang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jinting He
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
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Samanci B, Tan S, Michielse S, Kuijf ML, Temel Y. The habenula in Parkinson's disease: Anatomy, function, and implications for mood disorders - A narrative review. J Chem Neuroanat 2024; 136:102392. [PMID: 38237746 DOI: 10.1016/j.jchemneu.2024.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/07/2024] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Abstract
Parkinson's disease (PD), a widespread neurodegenerative disorder, often coexists with mood disorders. Degeneration of serotonergic neurons in brainstem raphe nuclei have been linked to depression and anxiety. Additionally, the locus coeruleus and its noradrenergic neurons are among the first areas to degenerate in PD and contribute to stress, emotional memory, motor, sensory, and autonomic symptoms. Another brain region of interest is habenula, which is especially related to anti-reward processing, and its function has recently been linked to PD and to mood-related symptoms. There are several neuroimaging studies that investigated role of the habenula in mood disorders. Differences in habenular size and hemispheric symmetry were found in healthy controls compared to individuals with mood disorders. The lateral habenula, as a link between the dopaminergic and serotonergic systems, is thought to contribute to depressive symptoms in PD. However, there is only one imaging study about role of habenula in mood disorders in PD, although the relationship between PD and mood disorders is known. There is little known about habenula pathology in PD but given these observations, the question arises whether habenular dysfunction could play a role in PD and the development of PD-related mood disorders. In this review, we evaluate neuroimaging techniques and studies that investigated the habenula in the context of PD and mood disorders. Future studies are important to understand habenula's role in PD patients with mood disorders. Thus, new potential diagnostic and treatment opportunities would be found for mood disorders in PD.
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Affiliation(s)
- Bedia Samanci
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sonny Tan
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Stijn Michielse
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Yasin Temel
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
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5
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Reyes-Pérez P, García-Marín LM, Aman AM, Antar T, Flores-Ocampo V, Mitchell BL, Medina-Rivera A, Rentería ME. Investigating the Shared Genetic Etiology Between Parkinson's Disease and Depression. JOURNAL OF PARKINSON'S DISEASE 2024; 14:483-493. [PMID: 38457145 DOI: 10.3233/jpd-230176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Background Depression is a common symptom in Parkinson's disease (PD), resulting from underlying neuropathological processes and psychological factors. However, the extent to which shared genetic risk factors contribute to the relationship between depression and PD is poorly understood. Objective To examine the effects of common genetic variants influencing the etiology of PD and depression risk at the genome-wide and local genomic regional level. Methods We comprehensively investigated the genetic relationship between PD and depression using genome-wide association studies data. First, we estimated the genetic correlation at the genome-wide level using linkage-disequilibrium score regression, followed by local genetic correlation analysis using the GWAS-pairwise method and functional annotation to identify genes that may jointly influence the risk for both traits. Also, we performed Latent Causal Variable, Latent Heritable Confounder Mendelian Randomization, and traditional Mendelian Randomization analyses to investigate the potential causal relationship. Results Although the genetic correlation between PD and depression was not statistically significant at the genome-wide level, GWAS-pairwise analyses identified 16 genomic segments associated with PD and depression, implicating nine genes. Further analyses revealed distinct patterns within individual genes, suggesting an intricate pattern. These genes involve various biological processes, including neurotransmitter regulation, senescence, and nucleo-cytoplasmic transport mechanisms. We did not observe genetic evidence of causality between PD and depression. Conclusions Our findings did not support a genome-wide genetic correlation or a causal association between both conditions. However, we identified genomic segments but identified genomic segments linked to distinct biological pathways influencing their etiology.Further research is needed to understand their functional consequences.
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Affiliation(s)
- Paula Reyes-Pérez
- Laboratorio Internacional de Investigación Sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, Querétaro, México
| | - Luis M García-Marín
- Laboratorio Internacional de Investigación Sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, Querétaro, México
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Asma M Aman
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Tarek Antar
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Victor Flores-Ocampo
- Laboratorio Internacional de Investigación Sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, Querétaro, México
- Licenciatura en Ciencias Genómicas, Escuela Nacional de Estudios Superiores Unidad Juriquilla, Universidad Nacional Autónoma de México, Querétaro, México
| | - Brittany L Mitchell
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Alejandra Medina-Rivera
- Laboratorio Internacional de Investigación Sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, Querétaro, México
| | - Miguel E Rentería
- Mental Health and Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD,Australia
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6
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Bonassi G, Lagravinese G, Bove M, Bisio A, Botta A, Putzolu M, Cosentino C, Mezzarobba S, Pelosin E, Avanzino L. How Music Moves Us: Music-induced Emotion Influences Motor Learning. Neuroscience 2023; 526:246-255. [PMID: 37437801 DOI: 10.1016/j.neuroscience.2023.06.023] [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: 02/22/2023] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023]
Abstract
Music is an important tool for the induction and regulation of emotion. Although learning a sequential motor behaviour is essential to normal motor function, to our knowledge, the role of music-induced emotion on motor learning has not been explored. Our experiment aimed to determine whether listening to different emotional music could influence motor sequence learning. We focused on two sub-components of motor sequence learning: the acquisition of the order of the elements in the sequence (the "what"), and the ability to carry out the sequence, combining the elements in a single, skilled action (the "how"). Twenty subjects performed a motor sequence-learning task with a digitizing tablet in three different experimental sessions. In each session they executed the task while listening to three different musical pieces, eliciting fearful, pleasant, and neutral mood. Eight targets were presented in a pre-set order and subjects were asked to learn the sequence while moving. Music-induced pleasure had an impact on movement kinematics with onset time and peak velocity decreasing and movement time increasing more with respect to neutral music session. Declarative learning, verbal recall of the sequence order, was improved under emotional manipulation, but only for fear-condition. Results suggest that music-induced emotion can influence both sub-components of motor learning in a different way. Music-induced pleasure may have improved motor components of sequence learning by means of increased striatal dopamine availability whereas music-induced fear may facilitate the recruitment of attentional circuits, thus acting on declarative knowledge of the sequence order.
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Affiliation(s)
- Gaia Bonassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Giovanna Lagravinese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marco Bove
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Viale Benedetto XV 3, Genoa, 16132, Italy
| | - Ambra Bisio
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Viale Benedetto XV 3, Genoa, 16132, Italy
| | | | | | - Carola Cosentino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Susanna Mezzarobba
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Viale Benedetto XV 3, Genoa, 16132, Italy; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy
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Fehér M, Márton Z, Szabó Á, Kocsa J, Kormos V, Hunyady Á, Kovács LÁ, Ujvári B, Berta G, Farkas J, Füredi N, Gaszner T, Pytel B, Reglődi D, Gaszner B. Downregulation of PACAP and the PAC1 Receptor in the Basal Ganglia, Substantia Nigra and Centrally Projecting Edinger-Westphal Nucleus in the Rotenone model of Parkinson's Disease. Int J Mol Sci 2023; 24:11843. [PMID: 37511603 PMCID: PMC10380602 DOI: 10.3390/ijms241411843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Numerous in vitro and in vivo models of Parkinson's disease (PD) demonstrate that pituitary adenylate cyclase-activating polypeptide (PACAP) conveys its strong neuroprotective actions mainly via its specific PAC1 receptor (PAC1R) in models of PD. We recently described the decrease in PAC1R protein content in the basal ganglia of macaques in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) model of PD that was partially reversed by levodopa therapy. In this work, we tested whether these observations occur also in the rotenone model of PD in the rat. The rotarod test revealed motor skill deterioration upon rotenone administration, which was reversed by benserazide/levodopa (B/L) treatment. The sucrose preference test suggested increased depression level while the open field test showed increased anxiety in rats rendered parkinsonian, regardless of the received B/L therapy. Reduced dopaminergic cell count in the substantia nigra pars compacta (SNpc) diminished the dopaminergic fiber density in the caudate-putamen (CPu) and decreased the peptidergic cell count in the centrally projecting Edinger-Westphal nucleus (EWcp), supporting the efficacy of rotenone treatment. RNAscope in situ hybridization revealed decreased PACAP mRNA (Adcyap1) and PAC1R mRNA (Adcyap1r1) expression in the CPu, globus pallidus, dopaminergic SNpc and peptidergic EWcp of rotenone-treated rats, but no remarkable downregulation occurred in the insular cortex. In the entopeduncular nucleus, only the Adcyap1r1 mRNA was downregulated in parkinsonian animals. B/L therapy attenuated the downregulation of Adcyap1 in the CPu only. Our current results further support the evolutionarily conserved role of the PACAP/PAC1R system in neuroprotection and its recruitment in the development/progression of neurodegenerative states such as PD.
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Affiliation(s)
- Máté Fehér
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Department of Neurosurgery, Kaposi Mór Teaching Hospital, Tallián Gy. u. 20-32, H-7400 Kaposvár, Hungary
| | - Zsombor Márton
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Ákos Szabó
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - János Kocsa
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Viktória Kormos
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Ágnes Hunyady
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - László Ákos Kovács
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Balázs Ujvári
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Gergely Berta
- Department of Medical Biology and Central Electron Microscopic Laboratory, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - József Farkas
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Nóra Füredi
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Tamás Gaszner
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Bence Pytel
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Dóra Reglődi
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- ELKH-PTE PACAP Research Group, Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
| | - Balázs Gaszner
- Department of Anatomy, Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
- Research Group for Mood Disorders, Centre for Neuroscience, University Medical School, University of Pécs, Szigeti út 12, H-7624 Pécs, Hungary
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Ahmad MH, Rizvi MA, Ali M, Mondal AC. Neurobiology of depression in Parkinson's disease: Insights into epidemiology, molecular mechanisms and treatment strategies. Ageing Res Rev 2023; 85:101840. [PMID: 36603690 DOI: 10.1016/j.arr.2022.101840] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 12/25/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023]
Abstract
Parkinson's disease (PD) is characterized mainly by motor dysfunctions due to the progressive loss of dopaminergic neurons. However, PD patients experience a multitude of debilitating non-motor symptoms, including depression, which may have deleteriously detrimental effects on life. Depression is multifactorial and exhibits a bimodal progression in PD, but its underlying molecular mechanisms are poorly understood. Studies demonstrating the pathophysiology of depression in PD and the specific treatment strategies for depression-like symptoms in PD patients are largely lacking, often underrated, under-recognized and, consequently, inadequately/under-treated. Nevertheless, reports suggest that the incidence of depression is approximately 20-30% of PD patients and may precede the onset of motor symptoms. Diagnosing depression in PD becomes difficult due to the clinical overlap in symptomatology between the two diseases, and the nigrostriatal dysfunction alone is insufficient to explain depressive symptoms in PD. Therefore, the current study provides an overview of the molecular mechanisms underlying the development of depression in PD and new insights into developing current antidepressant strategies to treat depression in PD. This review will identify and understand the molecular pathological mechanisms of depression in PD that will fundamentally help tailoring therapeutic interventions for depressive symptoms in PD.
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Affiliation(s)
- Mir Hilal Ahmad
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India; Genome Biology Lab, Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Moshahid Alam Rizvi
- Genome Biology Lab, Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mansoor Ali
- Cancer Biology Laboratory, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Amal Chandra Mondal
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India.
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Premotor, nonmotor and motor symptoms of Parkinson's Disease: A new clinical state of the art. Ageing Res Rev 2023; 84:101834. [PMID: 36581178 DOI: 10.1016/j.arr.2022.101834] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022]
Abstract
Parkinson's Disease (PD) is a neurodegenerative disorder that affects dopaminergic neurons in the mesencephalic substantia nigra, causing a progressive clinical course characterized by pre-motor, non-motor and motor symptoms, which negatively impact the quality of life of patients and cause high health care costs. Therefore, the present study aims to discuss the clinical manifestations of PD and to make a correlation with the gut-brain (GB) axis, approaching epidemiology and therapeutic perspectives, to better understand its clinical progression and identify symptoms early. A literature review was performed regarding the association between clinical progression, the gut-brain axis, epidemiology, and therapeutic perspectives, in addition to detailing pre-motor, non-motor symptoms (neuropsychiatric, cognitive, autonomic, sleep disorders, sensory abnormalities) and cardinal motor symptoms. Therefore, this article addresses a topic of extreme relevance, since the previously mentioned clinical manifestations (pre-motor and non-motor) can often act as prodromal markers for the early diagnosis of PD and may precede it by up to 20 years.
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10
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Xiao B, Tan EK. Thalamic pathways mediating motor and non-motor symptoms in a Parkinson's disease model. Trends Neurosci 2023; 46:1-2. [PMID: 36207171 DOI: 10.1016/j.tins.2022.09.004] [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: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 12/28/2022]
Abstract
In a recent study, Zhang, Roy, and colleagues have shown that neurons in the parafascicular (PF) thalamus project to three distinct neural structures in the basal ganglia. The neural circuits identified in the study were associated with specific motor and non-motor symptoms in a Parkinson's disease (PD) mouse model. The findings provide potential actionable therapeutic targets for this disease.
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Affiliation(s)
- Bin Xiao
- Department of Neurology, National Neuroscience Institute, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore; Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore.
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11
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Ramanzini LG, Camargo LFM, Silveira JOF, Bochi GV. Inflammatory markers and depression in Parkinson's disease: a systematic review. Neurol Sci 2022; 43:6707-6717. [PMID: 36040559 DOI: 10.1007/s10072-022-06363-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Parkinson's disease (PD) patients experience non-motor symptoms (NMS), which may appear before motor manifestations. The most common NMS is depression, affecting about 30-40% of PD patients. Both PD and depression are associated with an increased inflammatory burden, with studies showing elevation of diverse inflammatory markers in patients with both conditions. METHODS A systematic review was conducted in PubMed and PsycINFO databases to investigate what inflammatory markers are associated with PD depression (PDD). Only studies in English that measured inflammatory markers and analyzed against depression scores in PD patients were included. RESULTS A total of 1132 articles were retrieved, and 14 entries were found to be eligible. Twelve were cross-sectional studies, one was a cohort, and one was a non-randomized controlled trial. IL-17A was the only marker strongly associated with PDD, while studies assessing sIL-2R and serum amyloid A found a moderate correlation. C-reactive protein, IL-10, tumor necrosis factor-α, monocyte chemoattractant protein-1, and IL-6 yielded conflicting results. Their possible roles in PDD are discussed. PDD was also related to longer disease duration and other NMS, such as anxiety, fatigue, dementia, REM sleep behavior disorder, and autonomic dysfunction. CONCLUSION We suggest that these markers may be used for distinguishing isolated depression from that related to neurodegeneration, especially in individuals that concurrently present with other known prodromal symptoms of PD and other α-synucleinopathies. However, future prospective studies are warranted to confirm this hypothesis.
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Affiliation(s)
- Luis Guilherme Ramanzini
- Department of Physiology and Pharmacology, Federal University of Santa Maria, 1000 Roraima Avenue, Building 21, Santa Maria, Rio Grande do Sul, Brazil.
| | - Luís Fernando Muniz Camargo
- Department of Physiology and Pharmacology, Federal University of Santa Maria, 1000 Roraima Avenue, Building 21, Santa Maria, Rio Grande do Sul, Brazil
| | | | - Guilherme Vargas Bochi
- Department of Physiology and Pharmacology, Federal University of Santa Maria, 1000 Roraima Avenue, Building 21, Santa Maria, Rio Grande do Sul, Brazil
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12
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Hou M, Hou X, Qiu Y, Wang J, Zhang M, Mao X, Wu X. Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson's Disease. Front Aging Neurosci 2022; 14:884506. [PMID: 35875803 PMCID: PMC9301002 DOI: 10.3389/fnagi.2022.884506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson’s disease (PD). Methods A total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject. Results Cognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis. Conclusion CSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.
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Affiliation(s)
- Miaomiao Hou
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Hou
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yiqing Qiu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jiali Wang
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mingyang Zhang
- Department of Chemistry, University of Utah, Salt Lake City, UT, United States
| | - Xiaowei Mao
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xi Wu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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13
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Kratter IH, Jorge A, Feyder MT, Whiteman AC, Chang YF, Henry LC, Karp JF, Richardson RM. Depression history modulates effects of subthalamic nucleus topography on neuropsychological outcomes of deep brain stimulation for Parkinson's disease. Transl Psychiatry 2022; 12:213. [PMID: 35624103 PMCID: PMC9142573 DOI: 10.1038/s41398-022-01978-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 11/09/2022] Open
Abstract
Patients with psychiatric symptoms, such as depression, anxiety, and visual hallucinations, may be at increased risk for adverse effects following deep brain stimulation of the subthalamic nucleus for Parkinson's disease, but there have been relatively few studies of associations between locations of chronic stimulation and neuropsychological outcomes. We sought to determine whether psychiatric history modulates associations between stimulation location within the subthalamic nucleus and postoperative affective and cognitive changes. We retrospectively identified 42 patients with Parkinson's disease who received bilateral subthalamic nucleus deep brain stimulation and who completed both pre- and postoperative neuropsychological testing. Active stimulation contacts were localized in MNI space using Lead-DBS software. Linear discriminant analysis identified vectors maximizing variance in postoperative neuropsychological changes, and Pearson's correlations were used to assess for linear relationships. Stimulation location was associated with postoperative change for only 3 of the 18 neuropsychological measures. Variation along the superioinferior (z) axis was most influential. Constraining the analysis to patients with a history of depression revealed 10 measures significantly associated with active contact location, primarily related to location along the anterioposterior (y) axis and with worse outcomes associated with more anterior stimulation. Analysis of patients with a history of anxiety revealed 5 measures with location-associated changes without a predominant axis. History of visual hallucinations was not associated with significant findings. Our results suggest that a history of depression may influence the relationship between active contact location and neuropsychological outcomes following subthalamic nucleus deep brain stimulation. These patients may be more sensitive to off-target (nonmotor) stimulation.
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Affiliation(s)
- Ian H Kratter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA.
| | - Ahmed Jorge
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michael T Feyder
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ashley C Whiteman
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Yue-Fang Chang
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Luke C Henry
- Brain Modulation Laboratory, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jordan F Karp
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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14
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Austgen G, Marsh L. Cognitive dysfunction and neuropsychiatric aspects of Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:59-90. [PMID: 35248207 DOI: 10.1016/bs.pbr.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Movement abnormalities, by definition, and cognitive changes, to varying extents, affect every patient with Parkinson's disease (PD) and are attributed to the underlying neurodegenerative disease. Various psychiatric disorders occur in most patients at some point over the course of PD, including in the prodromal phase. Even though psychiatric disturbances tend to aggravate motor and cognitive deficits, they are under-recognized and under-treated, and the role of the underlying neurological disease is often minimized. To provide an integrated approach to understanding neuropsychiatric aspects of PD, this chapter reviews how cognitive changes in PD relate to the common psychiatric disturbances in PD along with the prevalence, phenomenology, pathophysiology, and treatment of each.
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Affiliation(s)
- Gabriela Austgen
- Behavioral Neurology & Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Laura Marsh
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Professor, Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences and Department of Neurology, Baylor College of Medicine, Houston, TX, United States.
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15
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Ujvári B, Pytel B, Márton Z, Bognár M, Kovács LÁ, Farkas J, Gaszner T, Berta G, Kecskés A, Kormos V, Farkas B, Füredi N, Gaszner B. Neurodegeneration in the centrally-projecting Edinger-Westphal nucleus contributes to the non-motor symptoms of Parkinson's disease in the rat. J Neuroinflammation 2022; 19:31. [PMID: 35109869 PMCID: PMC8809039 DOI: 10.1186/s12974-022-02399-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The neuropathological background of major depression and anxiety as non-motor symptoms of Parkinson's disease is much less understood than classical motor symptoms. Although, neurodegeneration of the Edinger-Westphal nucleus in human Parkinson's disease is a known phenomenon, its possible significance in mood status has never been elucidated. In this work we aimed at investigating whether neuron loss and alpha-synuclein accumulation in the urocortin 1 containing (UCN1) cells of the centrally-projecting Edinger-Westphal (EWcp) nucleus is associated with anxiety and depression-like state in the rat. METHODS Systemic chronic rotenone administration as well as targeted leptin-saporin-induced lesions of EWcp/UCN1 neurons were conducted. Rotarod, open field and sucrose preference tests were performed to assess motor performance and mood status. Multiple immunofluorescence combined with RNAscope were used to reveal the functional-morphological changes. Two-sample Student's t test, Spearman's rank correlation analysis and Mann-Whitney U tests were used for statistics. RESULTS In the rotenone model, besides motor deficit, an anxious and depression-like phenotype was detected. Well-comparable neuron loss, cytoplasmic alpha-synuclein accumulation as well as astro- and microglial activation were observed both in the substantia nigra pars compacta and EWcp. Occasionally, UCN1-immunoreactive neuronal debris was observed in phagocytotic microglia. UCN1 peptide content of viable EWcp cells correlated with dopaminergic substantia nigra cell count. Importantly, other mood status-related dopaminergic (ventral tegmental area), serotonergic (dorsal and median raphe) and noradrenergic (locus ceruleus and A5 area) brainstem centers did not show remarkable morphological changes. Targeted partial selective EWcp/UCN1 neuron ablation induced similar mood status without motor symptoms. CONCLUSIONS Our findings collectively suggest that neurodegeneration of urocortinergic EWcp contributes to the mood-related non-motor symptoms in toxic models of Parkinson's disease in the rat.
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Affiliation(s)
- Balázs Ujvári
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary.,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary
| | - Bence Pytel
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary
| | - Zsombor Márton
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary
| | - Máté Bognár
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary
| | - László Ákos Kovács
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary.,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary
| | - József Farkas
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary.,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary
| | - Tamás Gaszner
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary.,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary
| | - Gergely Berta
- Department of Medical Biology, Medical School, University of Pécs, 7624, Pecs, Hungary
| | - Angéla Kecskés
- Department of Pharmacology and Pharmacotherapy, Medical School & Szentágothai Research Centre, Molecular Pharmacology Research Group, University of Pécs, 7624, Pecs, Hungary
| | - Viktória Kormos
- Department of Pharmacology and Pharmacotherapy, Medical School & Szentágothai Research Centre, Molecular Pharmacology Research Group, University of Pécs, 7624, Pecs, Hungary
| | - Boglárka Farkas
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary
| | - Nóra Füredi
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary.,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary
| | - Balázs Gaszner
- Department of Anatomy, Research Group for Mood Disorders, Medical School, University of Pécs, Szigeti út 12., 7624, Pecs, Hungary. .,Centre for Neuroscience, University of Pécs, 7624, Pecs, Hungary.
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16
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Bhome R, Zarkali A, Thomas GEC, Iglesias JE, Cole JH, Weil RS. Thalamic white matter macrostructure and subnuclei volumes in Parkinson's disease depression. NPJ Parkinsons Dis 2022; 8:2. [PMID: 35013327 PMCID: PMC8748828 DOI: 10.1038/s41531-021-00270-y] [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: 08/01/2021] [Accepted: 12/20/2021] [Indexed: 12/04/2022] Open
Abstract
Depression is a common non-motor feature of Parkinson's disease (PD) which confers significant morbidity and is challenging to treat. The thalamus is a key component in the basal ganglia-thalamocortical network critical to the pathogenesis of PD and depression but the precise thalamic subnuclei involved in PD depression have not been identified. We performed structural and diffusion-weighted imaging (DWI) on 76 participants with PD to evaluate the relationship between PD depression and grey and white matter thalamic subnuclear changes. We used a thalamic segmentation method to divide the thalamus into its 50 constituent subnuclei (25 each hemisphere). Fixel-based analysis was used to calculate mean fibre cross-section (FC) for white matter tracts connected to each subnucleus. We assessed volume and FC at baseline and 14-20 months follow-up. A generalised linear mixed model was used to evaluate the relationship between depression, subnuclei volume and mean FC for each thalamic subnucleus. We found that depression scores in PD were associated with lower right pulvinar anterior (PuA) subnucleus volume. Antidepressant use was associated with higher right PuA volume suggesting a possible protective effect of treatment. After follow-up, depression scores were associated with reduced white matter tract macrostructure across almost all tracts connected to thalamic subnuclei. In conclusion, our work implicates the right PuA as a relevant neural structure in PD depression and future work should evaluate its potential as a therapeutic target for PD depression.
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Affiliation(s)
- R Bhome
- Dementia Research Centre, University College London, London, UK.
| | - A Zarkali
- Dementia Research Centre, University College London, London, UK
| | - G E C Thomas
- Dementia Research Centre, University College London, London, UK
| | - J E Iglesias
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Cambridge, USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, USA
| | - J H Cole
- Dementia Research Centre, University College London, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - R S Weil
- Dementia Research Centre, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Movement Disorders Consortium, National Hospital for Neurology and Neurosurgery, London, UK
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17
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Laux G. Parkinson and depression: review and outlook. J Neural Transm (Vienna) 2022; 129:601-608. [PMID: 34982207 DOI: 10.1007/s00702-021-02456-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/19/2021] [Indexed: 01/06/2023]
Abstract
Depression in Parkinson's Disorder (DPD) has been estimated to appear in up to 40% of people with PD and negatively impacts quality of life, motor and cognitive deficits and functional disability. Knowledge of the pathophysiology of DPD is unclear, DPD may be related to dysfunction in subcortical nuclei and the prefrontal cortex, striatal-thalamic-prefrontal and basotemporal limbic circuits, brainstem monoamine, and indolamine (i.e. dopamine, serotonin, and norepinephrine) systems. DPD is characterized by sadness, loss of interest, increased exhaustibility, feelings of helplessness, reduced drive, dysphoria, irritability, and pessimism about future. The diagnosis is complicated by overlap with PD symptoms, Detection of depression in PD should be made by psychometric depression scales. DPD is underrecognized and undertreated in clinical practice. Treatment mainly includes antidepressive medications and behavioral interventions as psychotherapy. Dopamine agonists showed some antidepressant effects, there are no sufficient numbers of RCTs. Important randomized clinical trials (RCTs) are summarized. SSRIs and SNRIs have a satisfying efficacy in DPD. TCAs are also good for improving depression. Side effects of different antidepressants (e.g. TCAs, SSRIs, SNRIs, bupropion, MAOIs) and potential interactions should be considered. In existing guidelines so far no statements, algorithms and recommendations are given for diagnosis and treatment of DPD. Methodologically adequate designed RCTs and comparative studies (NIS) which offer evidence-based results are urgently needed having the impact of DPD in mind.
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Affiliation(s)
- Gerd Laux
- Institute of Psychological Medicine (IPM), Soyen, Germany. .,MVZ Waldkraiburg of Muehldorf Clinics/Hospital, Center of Neuropsychiatry, Waldkraiburg, Germany. .,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, Germany.
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18
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Jellinger KA. The pathobiological basis of depression in Parkinson disease: challenges and outlooks. J Neural Transm (Vienna) 2022; 129:1397-1418. [PMID: 36322206 PMCID: PMC9628588 DOI: 10.1007/s00702-022-02559-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Depression, with an estimated prevalence of about 40% is a most common neuropsychiatric disorder in Parkinson disease (PD), with a negative impact on quality of life, cognitive impairment and functional disability, yet the underlying neurobiology is poorly understood. Depression in PD (DPD), one of its most common non-motor symptoms, can precede the onset of motor symptoms but can occur at any stage of the disease. Although its diagnosis is based on standard criteria, due to overlap with other symptoms related to PD or to side effects of treatment, depression is frequently underdiagnosed and undertreated. DPD has been related to a variety of pathogenic mechanisms associated with the underlying neurodegenerative process, in particular dysfunction of neurotransmitter systems (dopaminergic, serotonergic and noradrenergic), as well as to disturbances of cortico-limbic, striato-thalamic-prefrontal, mediotemporal-limbic networks, with disruption in the topological organization of functional mood-related, motor and other essential brain network connections due to alterations in the blood-oxygen-level-dependent (BOLD) fluctuations in multiple brain areas. Other hypothetic mechanisms involve neuroinflammation, neuroimmune dysregulation, stress hormones, neurotrophic, toxic or metabolic factors. The pathophysiology and pathogenesis of DPD are multifactorial and complex, and its interactions with genetic factors, age-related changes, cognitive disposition and other co-morbidities awaits further elucidation.
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Affiliation(s)
- Kurt A. Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150 Vienna, Austria
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19
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Goelman G, Dan R, Růžička F, Bezdicek O, Jech R. Asymmetry of the insula-sensorimotor circuit in Parkinson's disease. Eur J Neurosci 2021; 54:6267-6280. [PMID: 34449938 DOI: 10.1111/ejn.15432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Patients with Parkinson's disease (PD) experience motor and non-motor symptoms, suggesting alterations of the motor and/or limbic system or more probably of their communications. We hypothesized that the communication between the insula (part of the limbic system) and sensorimotor cortex in PD is altered and hemispheric asymmetric. Furthermore, that this asymmetry relates to non-motor symptoms, and specifically, that apathy-related asymmetry is unique to PD. To test these hypotheses, we used a novel multivariate time-frequency analysis method applied to resting-state functional magnetic resonance imaging (MRI) data of 28 controls and 25 participants with PD measured in their OFF medication state. The analysis infers directionality of coupling, that is, afferent or efferent, among four anatomical regions, thus defining directed pathways of information flow, which enables the extension of symmetry measures to include directionality. A major right asymmetry reduction of the dorsal-posterior insula efferent and a slight bilateral increase of insula afferent pathways were observed in participants with PD versus controls. Between-group pathways that correlated with mild cognitive impairments combined the central-executive and default-mode networks through the right insula. Apathy-correlated pathways of the posterior insula in participants with PD versus controls exhibited reduced right efferent and increased left afferent. Because apathy scores were comparable between the groups and effects of the other motor and non-motor symptoms were statistically removed by the analysis, the differences in apathy-correlated pathways were suggested as unique to PD. These pathways could be predictors in the pre-symptomatic phase in patients with apathy.
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Affiliation(s)
- Gadi Goelman
- Department of Neurology, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rotem Dan
- Department of Neurology, Hadassah Hebrew University Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.,Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Filip Růžička
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
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20
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Chan YLE, Chen MH, Bai YM, Li CT, Chen TJ, Su TP. Treatment response and age of onset as risk indicators for parkinson disease in patients with major depressive disorder: A nationwide longitudinal study. J Affect Disord 2021; 283:329-334. [PMID: 33578346 DOI: 10.1016/j.jad.2021.01.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/28/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) have a higher risk of developing Parkinson disease (PD). This study investigated whether response to treatment with antidepressants for MDD can determine patients at risk of developing PD later in life. METHODS We enrolled 3303 patients with newly-diagnosed MDD and 13,212 controls between 2002 and 2004 using Taiwan's Nationwide Health Insurance Research Database. We stratified patients with MDD according to the number of antidepressant regimens prescribed to them and the age at MDD onset and followed all participants until the end of 2013. During follow-up, we evaluated patients for the possibility of developing PD. RESULTS Patients with MDD had a greater likelihood of developing PD than controls. Patients with difficult-to-treat (DTT) MDD had a higher risk of developing PD than the other MDD subgroups (hazard ratio [HR] = 3.44, 95% confidence interval [95% CI]: = 1.99-5.95). When stratified by age (<50, 50-65, >65 years), DTT patients with middle-age or late-onset MDD exhibited elevated risks of developing PD (50-65 years: HR: 7.03, 95% CI: 2.95-16.76; >65 years: HR: 2.89, 95% CI: 1.26-6.65). DISCUSSION Patients with MDD and an onset age of >50 years who responded poorly to antidepressant treatment have an associated higher risk of subsequently developing PD. Therefore, when treating patients with MDD, clinicians should provide intensive antidepressant treatment and evaluations for PD so that risk-prevention measures can be implemented upon MDD diagnosis.
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Affiliation(s)
- Yee-Lam E Chan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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21
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Agüera-Ortiz L, García-Ramos R, Grandas Pérez FJ, López-Álvarez J, Montes Rodríguez JM, Olazarán Rodríguez FJ, Olivera Pueyo J, Pelegrín Valero C, Porta-Etessam J. Focus on Depression in Parkinson's Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics. PARKINSON'S DISEASE 2021; 2021:6621991. [PMID: 33628415 PMCID: PMC7884180 DOI: 10.1155/2021/6621991] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/07/2021] [Accepted: 01/22/2021] [Indexed: 12/26/2022]
Abstract
Major and minor forms of depression are significant contributors to Parkinson's disease morbidity and caregiver burden, affecting up to 50% of these patients. Nonetheless, symptoms of depression are still underrecognized and undertreated in this context due to scarcity of evidence and, consequently, consistent clinical guideline recommendations. Here, we carried out a prospective, multicentre, 2-round modified Delphi survey with 49 questions about the aetiopathological mechanisms of depression in Parkinson's disease (10), clinical features and connections with motor and nonmotor symptoms (10), diagnostic criteria (5), and therapeutic options (24). Items were assessed by a panel of 37 experts (neurologists, psychiatrists, and a geriatrist), and consensus was achieved in 81.6% of them. Depressive symptoms, enhanced by multiple patient circumstances, were considered Parkinson's disease risk factors but not clinical indicators of motor symptom and disease progression. These patients should be systematically screened for depression while ruling out both anhedonia and apathy symptoms as they are not necessarily linked to it. Clinical scales (mainly the Geriatric Depression Scale GDS-15) can help establishing the diagnosis of depression, the symptoms of which will require treatment regardless of severity. Efficacious and well-tolerated pharmacological options for Parkinson's comorbid depression were selective serotonin reuptake inhibitors (especially sertraline), dual-action serotonin and norepinephrine reuptake inhibitors (venlafaxine, desvenlafaxine, and duloxetine), multimodal (vortioxetine, bupropion, mirtazapine, and tianeptine), and anti-Parkinsonian dopamine agonists (pramipexole, ropinirole, and rotigotine). Tricyclic antidepressants and combining type B monoamine oxidase inhibitors with serotonergic drugs have serious side effects in these patients and therefore should not be prescribed. Electroconvulsive therapy was indicated for severe and drug-refractory cases. Cognitive behavioural therapy was recommended in cases of mild depression. Results presented here are useful diagnostic and patient management guidance for other physicians and important considerations to improve future drug trial design.
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Affiliation(s)
- Luis Agüera-Ortiz
- Servicio de Psiquiatría, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Rocío García-Ramos
- Movement Disorders Unit, Servicio de Neurología, Hospital Clínico San Carlos, Complutense University, Madrid, Spain
| | | | - Jorge López-Álvarez
- Servicio de Psiquiatría, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | - Jesús Porta-Etessam
- Service of Neurology, Instituto de Neurociencias, Hospital Clínico San Carlos, San Carlos, IdISSC, Madrid, Spain
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Chen H, Wan H, Zhang M, Liu G, Wang X, Wang Z, Ma H, Pan Y, Feng T, Wang Y. Cerebral small vessel disease may worsen motor function, cognition, and mood in Parkinson's disease. Parkinsonism Relat Disord 2021; 83:86-92. [PMID: 33493785 DOI: 10.1016/j.parkreldis.2020.12.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 11/07/2020] [Accepted: 12/22/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Emerging evidence has suggested that cerebral small vessel disease (CSVD) may worsen motor function and cognition in Parkinson's disease (PD). However, the effect of CSVD on anxiety and depression in patients with PD remains unknown. This study explored the multi-dimensional effects of CSVD on PD outcomes (motor, cognition, and depression/anxiety). METHODS This cross-sectional study included 431 patients with PD from Beijing Tiantan Hospital from May 2016 to August 2019. CSVD imaging markers were assessed and the four-point CSVD burden score was calculated. Motor function (MDS-UPDRS III score and subscores), cognition (MMSE, MoCA), anxiety (HAMA), and depression (HAMD) were assessed in these patients. The associations of CSVD with these outcomes were analyzed using the Spearman's correlation and multivariable linear regression models. RESULTS Motor dysfunction, cognitive impairment, depression, and anxiety were significantly worse in patients with severe CSVD than in those with mild CSVD. Multivariable linear regression showed that CSVD burden was significantly associated with motor dysfunction (MDS-UPDRS III score and rigidity and bradykinesia subscores), impaired cognition, and high levels of depression and anxiety. A marginally significant association was observed between CSVD burden and gait/postural instability in multivariable regression analysis. Among the CSVD imaging markers, white matter hyperintensity, number of lacunes, and microbleeds were positively correlated with the severity of motor, cognitive, and emotional impairments, while the perivascular space in the basal ganglia was only correlated with cognitive impairments. CONCLUSIONS Comorbid CSVD may affect multiple functional domains in patients with PD. Management of cerebrovascular disease may improve PD outcomes.
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Affiliation(s)
- Huimin Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China; Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Huijuan Wan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China; Department of Neurology, First Affiliated Hospital, Xiamen University, Xiamen, China
| | - Meimei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Genliang Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Zhan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Huizi Ma
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China
| | - Tao Feng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China.
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China; Advanced Innovation Center for Human Brain Projection, Capital Medical University, Beijing, China.
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23
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Hypomania, Depression, Euthymia: New Evidence in Parkinson's Disease. Behav Neurol 2020; 2020:5139237. [PMID: 33294055 PMCID: PMC7718041 DOI: 10.1155/2020/5139237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/26/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
The field related to mood disorders in Parkinson's disease (PD) is fragmented. The aim of this cohort observational study was to evaluate whether the episodes of mood alteration could appear in different disease stages and to verify how nonmotor symptoms were led off into different stages. We enrolled 93 PD outpatients (three groups: drug naive—DN; not exhibiting motor fluctuations—n-MF; and exhibiting motor fluctuations—MF) and 50 healthy controls. Mood state was assessed through the Internal State Scale (ISS) while depressive symptoms were evaluated through the Beck Depression Inventory-II (BDI-II), nonmotor symptoms by means of the Non-Motor Symptoms Scale (NMSS), and the presence of impulse control disorders (ICDs) with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP). Clinical and pharmacological data have also been recorded. No significant differences in mood state distribution between groups were observed. Nevertheless, as regards the mood state distribution within groups, in n-MF (47.6%) and MF patients (50%), (hypo)mania presence was significantly higher than other symptoms. In DN patients, hypomania showed a prevalence of 38.1% although it was not significant. At least one ICD was reported in 29.3% of n-MF and 50% of MF patients. In the MF group, a moderate positive correlation between ISS ACTivation subscale scores and the presence of ICDs and compulsive medication use emerged. Finally, MF patients reported higher BDI-II total scores than DN. Our results show that mood alterations in PD, considering both depressive symptoms and mood elevation, are related to the advanced stages of the disease as well as the presence of ICDs, and dopaminergic therapy would not always be able to restore a normal mood condition.
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24
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Ushakova VM, Morozova AY, Reznik AM, Kostyuk GP, Chekhonin VP. Molecular Biological Aspects of Depressive Disorders: A Modern View. Mol Biol 2020. [DOI: 10.1134/s0026893320050118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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25
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Grigoruţă M, Martínez-Martínez A, Dagda RY, Dagda RK. Psychological Stress Phenocopies Brain Mitochondrial Dysfunction and Motor Deficits as Observed in a Parkinsonian Rat Model. Mol Neurobiol 2020; 57:1781-1798. [PMID: 31836946 PMCID: PMC7125028 DOI: 10.1007/s12035-019-01838-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022]
Abstract
Psychological distress is a public health issue as it contributes to the development of human diseases including neuropathologies. Parkinson's disease (PD), a chronic, progressive neurodegenerative disorder, is caused by multiple factors including aging, mitochondrial dysfunction, and/or stressors. In PD, a substantial loss of substantia nigra (SN) neurons leads to rigid tremors, bradykinesia, and chronic fatigue. Several studies have reported that the hypothalamic-pituitary-adrenal (HPA) axis is altered in PD patients, leading to an increase level of cortisol which contributes to neurodegeneration and oxidative stress. We hypothesized that chronic psychological distress induces PD-like symptoms and promotes neurodegeneration in wild-type (WT) rats and exacerbates PD pathology in PINK1 knockout (KO) rats, a well-validated animal model of PD. We measured the bioenergetics profile (oxidative phosphorylation and glycolysis) in the brain by employing an XF24e Seahorse Extracellular Flux Analyzer in young rats subjected to predator-induced psychological distress. In addition, we analyzed anxiety-like behavior, motor function, expression of antioxidant enzymes, mitochondrial content, and neurotrophic factors brain-derived neurotrophic factor (BDNF) in the brain. Overall, we observed that psychological distress diminished up to 50% of mitochondrial respiration and glycolysis in the prefrontal cortex (PFC) derived from both WT and PINK1-KO rats. Mechanistically, the level of antioxidant proteins, mitochondrial content, and BDNF was significantly altered. Finally, psychological distress robustly induced anxiety and Parkinsonian symptoms in WT rats and accelerated certain symptoms of PD in PINK1-KO rats. For the first time, our collective data suggest that psychological distress can phenocopy several aspects of PD neuropathology, disrupt brain energy production, as well as induce ataxia-like behavior.
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Affiliation(s)
- Mariana Grigoruţă
- Department of Pharmacology, Reno School of Medicine, University of Nevada, Reno, NV, 89557, USA
- Departamento de Ciencias Químico Biológicas, Universidad Autónoma de Ciudad Juárez, Anillo envolvente Pronaf y Estocolmo s/n, 32310, Ciudad Juarez, Mexico
| | - Alejandro Martínez-Martínez
- Departamento de Ciencias Químico Biológicas, Universidad Autónoma de Ciudad Juárez, Anillo envolvente Pronaf y Estocolmo s/n, 32310, Ciudad Juarez, Mexico.
| | - Raul Y Dagda
- Department of Pharmacology, Reno School of Medicine, University of Nevada, Reno, NV, 89557, USA
| | - Ruben K Dagda
- Department of Pharmacology, Reno School of Medicine, University of Nevada, Reno, NV, 89557, USA.
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26
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Ren J, Hua P, Pan C, Li Y, Zhang L, Zhang W, Xu P, Zhang M, Liu W. Non-Motor Symptoms of the Postural Instability and Gait Difficulty Subtype in De Novo Parkinson's Disease Patients: A Cross-Sectional Study in a Single Center. Neuropsychiatr Dis Treat 2020; 16:2605-2612. [PMID: 33173298 PMCID: PMC7646450 DOI: 10.2147/ndt.s280960] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/08/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Little is known about non-motor symptoms (NMSs) associated with the postural instability and gait difficulty (PIGD) phenotype, especially in de novo Parkinson's disease (PD) patients. The aims of this study were to compare NMSs between the tremor dominant (TD) and PIGD phenotypes in de novo PD patients and to determine factors that are associated with the PIGD subtype. PATIENTS AND METHODS In a cross-sectional study conducted at our single center, 226 de novo PD patients with a median disease duration of 2 years were recruited. Data, including comprehensive demographics, motor subtypes and NMSs were obtained. Motor subtypes were classified as PIGD and non-PIGD (TD and indeterminate) by Jankovic's method. NMSs were evaluated by the non-motor symptoms questionnaire (NMSQuest). RESULTS We identified 73 (32.3%), 34 (15.0%) and 119 (52.7%) patients with TD, intermediate and PIGD subtypes, respectively. Patients with the PIGD subtype had poorer ADL, motor, depression, anxiety, sleep, and non-motor scores compared with those with the TD subtype. In the NMSQuest, the prevalence of cardiovascular, sleep, mood/cognitive and miscellaneous domains was increased in patients with the PIGD subtype compared with patients with the TD subtype. Multivariable forward stepwise logistic regression revealed that the Hamilton Depression Scale (HAMD) [odds ratio (OR), 1.059; 95% confidence interval (CI), 1.016-1.104, p = 0.007] and pain (OR, 3.175; 95% CI, 1.695-5.947, p < 0.001) exhibit significant discriminative power in differentiating PIGD and non-PIGD groups. CONCLUSION The PIGD group had more severe cardiovascular symptoms, sleep impairments, mood disturbances and pain. We demonstrated for the first time that pain was associated with the PIGD phenotype. Prompt detection and early treatment of NMSs related to the PIGD phenotype may improve patient outcomes.
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Affiliation(s)
- Jingru Ren
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Ping Hua
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Chenxi Pan
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuqian Li
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Li Zhang
- Department of Geriatrics, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Wenbin Zhang
- Department of Neurosurgery, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Pingyi Xu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Weiguo Liu
- Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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27
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Galts CP, Bettio LE, Jewett DC, Yang CC, Brocardo PS, Rodrigues ALS, Thacker JS, Gil-Mohapel J. Depression in neurodegenerative diseases: Common mechanisms and current treatment options. Neurosci Biobehav Rev 2019; 102:56-84. [DOI: 10.1016/j.neubiorev.2019.04.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/22/2019] [Accepted: 04/02/2019] [Indexed: 12/19/2022]
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28
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Specketer K, Zabetian CP, Edwards KL, Tian L, Quinn JF, Peterson-Hiller AL, Chung KA, Hu SC, Montine TJ, Cholerton BA. Visuospatial functioning is associated with sleep disturbance and hallucinations in nondemented patients with Parkinson's disease. J Clin Exp Neuropsychol 2019; 41:803-813. [PMID: 31177941 DOI: 10.1080/13803395.2019.1623180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Cognitive impairment is a common symptom of Parkinson's disease (PD) associated with reduced quality of life and a more severe disease state. Previous research has shown an association between visuospatial dysfunction and worse disease course; however, it is not clear whether this is separable from executive dysfunction and/or dementia. This study sought to determine whether distinct cognitive factors could be measured in a large PD cohort, and if those factors were differentially associated with other PD-related features, specifically to provide insight into visuospatial dysfunction. Methods: Non-demented participants with PD from the Pacific Udall Center were enrolled (n = 197). Co-participants (n = 104) completed questionnaires when available. Principal components factor analysis (PCFA) was utilized to group the neuropsychological test scores into independent factors by considering those with big factor loading (≥.40). Linear and logistic regression analyses were performed to examine the relationship between the cognitive factors identified in the PCFA and other clinical features of PD. Results: Six factors were extracted from the PCFA: 1) executive/processing speed, 2) visual learning & memory/visuospatial, 3) auditory working memory, 4) contextual verbal memory, 5) semantic learning & memory, and 6) visuospatial. Motor severity (p = 0.001), mood (p < 0.001), and performance on activities of daily living scores (informant: p < 0.001, patient: p = 0.009) were primarily associated with frontal and executive factors. General sleep disturbance (p < 0.006) and hallucinations (p = 0.002) were primarily associated with visuospatial functioning and visual learning/memory. Conclusions: Motor symptoms, mood, and performance on activities of daily living were primarily associated with frontal/executive factors. Sleep disturbance and hallucinations were associated with visuospatial functioning and visual learning/memory only, over and above executive functioning and regardless of cognitive disease severity. These findings support that visuospatial function in PD may indicate a more severe disease course, and that symptom management should be guided accordingly.
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Affiliation(s)
- Krista Specketer
- a Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System , Seattle , WA , USA
| | - Cyrus P Zabetian
- a Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System , Seattle , WA , USA.,b Department of Neurology, University of Washington School of Medicine , Seattle , WA , USA
| | - Karen L Edwards
- c Department of Epidemiology, University of California, Irvine, School of Medicine , Irvine , CA , USA
| | - Lu Tian
- d Department of Biomedical Data Science, Stanford University School of Medicine , Palo Alto , CA , USA
| | - Joseph F Quinn
- e Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Medical Center , Portland , OR , USA.,f Department of Neurology, Oregon Health and Science University , Portland , OR , USA
| | - Amie L Peterson-Hiller
- e Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Medical Center , Portland , OR , USA.,f Department of Neurology, Oregon Health and Science University , Portland , OR , USA
| | - Kathryn A Chung
- e Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Medical Center , Portland , OR , USA.,f Department of Neurology, Oregon Health and Science University , Portland , OR , USA
| | - Shu-Ching Hu
- a Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System , Seattle , WA , USA.,b Department of Neurology, University of Washington School of Medicine , Seattle , WA , USA
| | - Thomas J Montine
- g Department of Pathology, Stanford University School of Medicine , Palo Alto , CA , USA
| | - Brenna A Cholerton
- g Department of Pathology, Stanford University School of Medicine , Palo Alto , CA , USA
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29
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Ryan M, Eatmon CV, Slevin JT. Drug treatment strategies for depression in Parkinson disease. Expert Opin Pharmacother 2019; 20:1351-1363. [DOI: 10.1080/14656566.2019.1612877] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Melody Ryan
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Courtney V. Eatmon
- Mental Health Clinical Pharmacy Specialist, Lexington Veterans Affairs Healthcare System, Lexington, KY, USA
| | - John T. Slevin
- Departments of Neurology and Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
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30
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Pantall A, Suresparan P, Kapa L, Morris R, Yarnall A, Del Din S, Rochester L. Postural Dynamics Are Associated With Cognitive Decline in Parkinson's Disease. Front Neurol 2018; 9:1044. [PMID: 30568629 PMCID: PMC6290334 DOI: 10.3389/fneur.2018.01044] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/19/2018] [Indexed: 11/25/2022] Open
Abstract
Early features of Parkinson's disease (PD) include both motor and cognitive changes, suggesting shared common pathways. A common motor dysfunction is postural instability, a known predictor of falls, which have a major impact on quality of life. Understanding mechanisms of postural dynamics in PD and specifically how they relate to cognitive changes is essential for developing effective interventions. The aims of this study were to examine the changes that occur in postural metrics over time and explore the relationship between postural and cognitive dysfunction. The study group consisted of 35 people (66 ± 8years, 12 female, UPDRS III: 22.5 ± 9.6) diagnosed with PD who were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation—PD Gait (ICICLE-GAIT) study. Postural and cognitive assessments were performed at 18, 36, and 54 months after enrolment. Participants stood still for 120 s, eyes open and arms by their side. Postural dynamics were measured using metrics derived from a single tri-axial accelerometer (Axivity AX3, York, UK) on the lower back. Accelerometry metrics included jerk (derivative of acceleration), root mean square, frequency, and ellipsis (acceleration area). Cognition was evaluated by neuropsychological tests including the Montreal Cognitive Assessment (MoCA) and digit span. There was a significant decrease in accelerometry parameters, greater in the anteroposterior direction, and a decline in cognitive function over time. Accelerometry metrics were positively correlated with lower cognitive function and increased geriatric depression score and negatively associated with a qualitative measure of balance confidence. In conclusion, people with PD showed reduced postural dynamics that may represent a postural safety strategy. Associations with cognitive function and depression, both symptoms that may pre-empt motor symptoms, suggest shared neural pathways. Further studies, involving neuroimaging, may determine how these postural parameters relate to underlying neural and clinical correlates.
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Affiliation(s)
- Annette Pantall
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom
| | - Piriya Suresparan
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom
| | - Leanne Kapa
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom.,Department of Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Alison Yarnall
- The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Silvia Del Din
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle upon Tyne, United Kingdom.,The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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31
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Cova I, Priori A. Diagnostic biomarkers for Parkinson's disease at a glance: where are we? J Neural Transm (Vienna) 2018; 125:1417-1432. [PMID: 30145631 PMCID: PMC6132920 DOI: 10.1007/s00702-018-1910-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/24/2018] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder whose aetiology remains unclear: degeneration involves several neurotransmission systems, resulting in a heterogeneous disease characterized by motor and non-motor symptoms. PD causes progressive disability that responds only to symptomatic therapies. Future advances include neuroprotective strategies for use in at-risk populations before the clinical onset of disease, hence the continuing need to identify reliable biomarkers that can facilitate the clinical diagnosis of PD. In this evaluative review, we summarize information on potential diagnostic biomarkers for use in the clinical and preclinical stages of PD.
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Affiliation(s)
- Ilaria Cova
- Neurology Unit, L. Sacco University Hospital, Milan, Italy
| | - Alberto Priori
- Department of Health Sciences, "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan and ASST Santi Paolo e Carlo, Milan, Italy.
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32
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Vecchia DD, Kanazawa LKS, Wendler E, de Almeida Soares Hocayen P, Bruginski E, Campos FR, Stern CAJ, Vital MABF, Miyoshi E, Wöhr M, Schwarting RK, Andreatini R. Effects of ketamine on vocal impairment, gait changes, and anhedonia induced by bilateral 6-OHDA infusion into the substantia nigra pars compacta in rats: Therapeutic implications for Parkinson’s disease. Behav Brain Res 2018; 342:1-10. [DOI: 10.1016/j.bbr.2017.12.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/31/2017] [Indexed: 12/22/2022]
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33
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Dallé E, Mabandla MV. Early Life Stress, Depression And Parkinson's Disease: A New Approach. Mol Brain 2018; 11:18. [PMID: 29551090 PMCID: PMC5858138 DOI: 10.1186/s13041-018-0356-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 02/27/2018] [Indexed: 12/20/2022] Open
Abstract
This review aims to shed light on the relationship that involves exposure to early life stress, depression and Parkinson's disease (PD). A systematic literature search was conducted in Pubmed, MEDLINE, EBSCOHost and Google Scholar and relevant data were submitted to a meta-analysis . Early life stress may contribute to the development of depression and patients with depression are at risk of developing PD later in life. Depression is a common non-motor symptom preceding motor symptoms in PD. Stimulation of regions contiguous to the substantia nigra as well as dopamine (DA) agonists have been shown to be able to attenuate depression. Therefore, since PD causes depletion of dopaminergic neurons in the substantia nigra, depression, rather than being just a simple mood disorder, may be part of the pathophysiological process that leads to PD. It is plausible that the mesocortical and mesolimbic dopaminergic pathways that mediate mood, emotion, and/or cognitive function may also play a key role in depression associated with PD. Here, we propose that a medication designed to address a deficiency in serotonin is more likely to influence motor symptoms of PD associated with depression. This review highlights the effects of an antidepressant, Fluvoxamine maleate, in an animal model that combines depressive-like symptoms and Parkinsonism.
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Affiliation(s)
- Ernest Dallé
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
| | - Musa V. Mabandla
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000 South Africa
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Khan AR, Kroenke CD, Wiborg O, Chuhutin A, Nyengaard JR, Hansen B, Jespersen SN. Differential microstructural alterations in rat cerebral cortex in a model of chronic mild stress depression. PLoS One 2018; 13:e0192329. [PMID: 29432490 PMCID: PMC5809082 DOI: 10.1371/journal.pone.0192329] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 01/22/2018] [Indexed: 01/17/2023] Open
Abstract
Chronic mild stress leads to depression in many cases and is linked to several debilitating diseases including mental disorders. Recently, neuronal tracing techniques, stereology, and immunohistochemistry have revealed persistent and significant microstructural alterations in the hippocampus, hypothalamus, prefrontal cortex, and amygdala, which form an interconnected system known as the stress circuit. Most studies have focused only on this circuit, however, some studies indicate that manipulation of sensory and motor systems may impact genesis and therapy of mood disorders and therefore these areas should not be neglected in the study of brain microstructure alterations in response to stress and depression. For this reason, we explore the microstructural alterations in different cortical regions in a chronic mild stress model of depression. The study employs ex-vivo diffusion MRI (d-MRI) to assess cortical microstructure in stressed (anhedonic and resilient) and control animals. MRI is followed by immunohistochemistry to substantiate the d-MRI findings. We find significantly lower extracellular diffusivity in auditory cortex (AC) of stress groups and a significantly higher fractional anisotropy in the resilient group. Neurite density was not found to be significantly higher in any cortical ROIs in the stress group compared to control, although axonal density is higher in the stress groups. We also report significant thinning of motor cortex (MC) in both stress groups. This is in agreement with recent clinical and preclinical studies on depression and similar disorders where significant microstructural and metabolic alterations were found in AC and MC. Our findings provide further evidence that the AC and MC are sensitive towards stress exposure and may extend our understanding of the microstructural effects of stress beyond the stress circuit of the brain. Progress in this field may provide new avenues of research to help in diagnosis and treatment intervention for depression and related disorders.
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Affiliation(s)
- Ahmad Raza Khan
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Christopher D. Kroenke
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Ove Wiborg
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Andrey Chuhutin
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Jens R. Nyengaard
- Core Center for Molecular Morphology, Section for Stereology and Microscopy, Centre for Stochastic Geometry and Advanced Bioimaging, Aarhus University, Aarhus, Denmark
| | - Brian Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Sune Nørhøj Jespersen
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
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Trojano L, Papagno C. Cognitive and behavioral disorders in Parkinson's disease: an update. II: behavioral disorders. Neurol Sci 2017; 39:53-61. [PMID: 29038946 DOI: 10.1007/s10072-017-3155-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Patients with Parkinson's disease (PD) can experience several behavioral symptoms, such as apathy, agitation, hypersexuality, stereotypic movements, pathological gambling, abuse of antiparkinsonian drugs, and REM sleep behavioral disorders. Psychoses and hallucinations, depression and anxiety disorders, and difficulties in recognizing and experiencing emotions also impair behavior and can cause severe psychosocial problems in patients with PD. Symptoms can be present since early stages of the disease, sometimes even before the appearance of classical motor symptoms, likely in relation to dopamine depletion in basal ganglia and/or to dysfunctions of other neurotrasmitter systems, and others can develop later, in some cases in relation to dopaminergic treatment. In this paper, we review recent literature, with particular attention to the last 5 years, on the main behavioral and emotional disturbances described in PD patients as well as the hypothesized neurofunctional substrate of such impairments. Finally, we provide some suggestions on the most suitable instruments to check and assess PD-associated behavioral defects over time.
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Affiliation(s)
- Luigi Trojano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100, Caserta, Italy.
- ICS Maugeri, IRCCS, Telese Terme, Italy.
| | - Costanza Papagno
- CIMeC, University of Trento, Trento, Italy.
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy.
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Jellinger KA. Neuropathology of Nonmotor Symptoms of Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:13-62. [PMID: 28802920 DOI: 10.1016/bs.irn.2017.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD), a multiorgan neurodegenerative disorder associated with α-synuclein deposits throughout the nervous system and many organs, is clinically characterized by motor and nonmotor features, many of the latter antedating motor dysfunctions by 20 or more years. The causes of the nonmotor manifestations such as olfactory, autonomic, sensory, neuropsychiatric, visuospatial, sleep, and other disorders are unlikely to be related to single lesions. They are mediated by the involvement of both dopaminergic and nondopaminergic systems, and diverse structures outside the nigrostriatal system that is mainly responsible for the motor features of PD. The nonmotor alterations appear in early/prodromal stages of the disease and its further progression, suggesting a topographical and chronological spread of the lesions. This lends further support for the notion that PD is a multiorgan proteinopathy, although the exact relationship between presymptomatic and later developing nonmotor features of PD and neuropathology awaits further elucidation.
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Non-human primate models of PD to test novel therapies. J Neural Transm (Vienna) 2017; 125:291-324. [PMID: 28391443 DOI: 10.1007/s00702-017-1722-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/04/2017] [Indexed: 12/13/2022]
Abstract
Non-human primate (NHP) models of Parkinson disease show many similarities with the human disease. They are very useful to test novel pharmacotherapies as reviewed here. The various NHP models of this disease are described with their characteristics including the macaque, the marmoset, and the squirrel monkey models. Lesion-induced and genetic models are described. There is no drug to slow, delay, stop, or cure Parkinson disease; available treatments are symptomatic. The dopamine precursor, L-3,4-dihydroxyphenylalanine (L-Dopa) still remains the gold standard symptomatic treatment of Parkinson. However, involuntary movements termed L-Dopa-induced dyskinesias appear in most patients after chronic treatment and may become disabling. Dyskinesias are very difficult to manage and there is only amantadine approved providing only a modest benefit. In this respect, NHP models have been useful to seek new drug targets, since they reproduce motor complications observed in parkinsonian patients. Therapies to treat motor symptoms in NHP models are reviewed with a discussion of their translational value to humans. Disease-modifying treatments tested in NHP are reviewed as well as surgical treatments. Many biochemical changes in the brain of post-mortem Parkinson disease patients with dyskinesias are reviewed and compare well with those observed in NHP models. Non-motor symptoms can be categorized into psychiatric, autonomic, and sensory symptoms. These symptoms are present in most parkinsonian patients and are already installed many years before the pre-motor phase of the disease. The translational usefulness of NHP models of Parkinson is discussed for non-motor symptoms.
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Dupont AC, Largeau B, Santiago Ribeiro MJ, Guilloteau D, Tronel C, Arlicot N. Translocator Protein-18 kDa (TSPO) Positron Emission Tomography (PET) Imaging and Its Clinical Impact in Neurodegenerative Diseases. Int J Mol Sci 2017; 18:ijms18040785. [PMID: 28387722 PMCID: PMC5412369 DOI: 10.3390/ijms18040785] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/31/2017] [Accepted: 04/04/2017] [Indexed: 02/06/2023] Open
Abstract
In vivo exploration of activated microglia in neurodegenerative diseases is achievable by Positron Emission Tomography (PET) imaging, using dedicated radiopharmaceuticals targeting the translocator protein-18 kDa (TSPO). In this review, we emphasized the major advances made over the last 20 years, thanks to TSPO PET imaging, to define the pathophysiological implication of microglia activation and neuroinflammation in neurodegenerative diseases, including Parkinson’s disease, Huntington’s disease, dementia, amyotrophic lateral sclerosis, multiple sclerosis, and also in psychiatric disorders. The extent and upregulation of TSPO as a molecular biomarker of activated microglia in the human brain is now widely documented in these pathologies, but its significance, and especially its protective or deleterious action regarding the disease’s stage, remains under debate. Thus, we exposed new and plausible suggestions to enhance the contribution of TSPO PET imaging for biomedical research by exploring microglia’s role and interactions with other cells in brain parenchyma. Multiplex approaches, associating TSPO PET radiopharmaceuticals with other biomarkers (PET imaging of cellular metabolism, neurotransmission or abnormal protein aggregates, but also other imaging modalities, and peripheral cytokine levels measurement and/or metabolomics analysis) was considered. Finally, the actual clinical impact of TSPO PET imaging as a routine biomarker of neuroinflammation was put into perspective regarding the current development of diagnostic and therapeutic strategies for neurodegenerative diseases.
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Affiliation(s)
- Anne-Claire Dupont
- CHRU Tours, 2 Boulevard Tonnellé, 37044 Tours, France.
- Institut National de la Santé et de la Recherche Médicale U930, 10 Boulevard Tonnellé, 37032 Tours, France.
| | | | - Maria Joao Santiago Ribeiro
- CHRU Tours, 2 Boulevard Tonnellé, 37044 Tours, France.
- Institut National de la Santé et de la Recherche Médicale U930, 10 Boulevard Tonnellé, 37032 Tours, France.
| | - Denis Guilloteau
- CHRU Tours, 2 Boulevard Tonnellé, 37044 Tours, France.
- Institut National de la Santé et de la Recherche Médicale U930, 10 Boulevard Tonnellé, 37032 Tours, France.
| | - Claire Tronel
- Institut National de la Santé et de la Recherche Médicale U930, 10 Boulevard Tonnellé, 37032 Tours, France.
| | - Nicolas Arlicot
- CHRU Tours, 2 Boulevard Tonnellé, 37044 Tours, France.
- Institut National de la Santé et de la Recherche Médicale U930, 10 Boulevard Tonnellé, 37032 Tours, France.
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Who Can Diagnose Parkinson's Disease First? Role of Pre-motor Symptoms. Arch Med Res 2017; 48:221-227. [DOI: 10.1016/j.arcmed.2017.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/24/2017] [Indexed: 01/15/2023]
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