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Yacoubian TA, Fang YHD, Gerstenecker A, Amara A, Stover N, Ruffrage L, Collette C, Kennedy R, Zhang Y, Hong H, Qin H, McConathy J, Benveniste EN, Standaert DG. Brain and Systemic Inflammation in De Novo Parkinson's Disease. Mov Disord 2023; 38:743-754. [PMID: 36853618 PMCID: PMC11403348 DOI: 10.1002/mds.29363] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To assess the presence of brain and systemic inflammation in subjects newly diagnosed with Parkinson's disease (PD). BACKGROUND Evidence for a pathophysiologic role of inflammation in PD is growing. However, several key gaps remain as to the role of inflammation in PD, including the extent of immune activation at early stages, potential effects of PD treatments on inflammation and whether pro-inflammatory signals are associated with clinical features and/or predict more rapid progression. METHODS We enrolled subjects with de novo PD (n = 58) and age-matched controls (n = 62). Subjects underwent clinical assessments, including the Movement Disorder Society-United Parkinson's Disease rating scale (MDS-UPDRS). Comprehensive cognitive assessment meeting MDS Level II criteria for mild cognitive impairment testing was performed. Blood was obtained for flow cytometry and cytokine/chemokine analyses. Subjects underwent imaging with 18 F-DPA-714, a translocator protein 18kd ligand, and lumbar puncture if eligible and consented. RESULTS Baseline demographics and medical history were comparable between groups. PD subjects showed significant differences in University of Pennsylvania Smell Identification Test, Schwab and England Activities of Daily Living, Scales for Outcomes in PD autonomic dysfunction, and MDS-UPDRS scores. Cognitive testing demonstrated significant differences in cognitive composite, executive function, and visuospatial domain scores at baseline. Positron emission tomography imaging showed increased 18 F-DPA-714 signal in PD subjects. 18 F-DPA-714 signal correlated with several cognitive measures and some chemokines. CONCLUSIONS 18 F-DPA-714 imaging demonstrated increased central inflammation in de novo PD subjects compared to controls. Longitudinal follow-up will be important to determine whether the presence of inflammation predicts cognitive decline. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Talene A Yacoubian
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yu-Hua Dean Fang
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Amy Amara
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Natividad Stover
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lauren Ruffrage
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher Collette
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard Kennedy
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yue Zhang
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Huixian Hong
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Hongwei Qin
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Etty N Benveniste
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David G Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Shalash A, Okubadejo NU, Doumbe J, Ojo OO, Hamid E, Kuate C, Calvo S, Helmi A, Agabi OP, Essam M, Aguado L, Elrassas H, Roushdy T, Tanner CM, Cubo E. Translation, Validation, Diagnostic Accuracy, and Reliability of Screening Questionnaire for Parkinsonism in Three African Countries. JOURNAL OF PARKINSON'S DISEASE 2021; 10:1113-1122. [PMID: 32568112 DOI: 10.3233/jpd-202040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Availability of validated Parkinson's disease (PD) questionnaires in languages spoken in Africa will enable the conduct of epidemiological studies. OBJECTIVE The aims of the current study were to develop cross-cultural translated and validated Arabic and French versions of a PD screening questionnaire, and determine its diagnostic accuracy for recognition of parkinsonism in early and moderate-advanced PD in three countries (Cameroon (French), Egypt (Arabic), and Nigeria (English)). METHODS This cross-sectional study screened 159 participants (81 PD and 78 controls) using the PD screening questionnaire. The questionnaire was translated into Arabic and French versions using standard protocols. Cognitive function was assessed using the Montreal Cognitive Assessment and the Identification and Intervention for Dementia in Elderly Africans cognitive screen. Co-morbidity burden was documented using the Charlson Comorbidity Index. PD severity and stage were evaluated using the MDS Unified Parkinson Disease Rating Scale and the Hoehn and Yahr scale respectively. RESULTS Both PD patients and controls were matched regarding age, gender, education, and co-morbidity burden. The PD screening questionnaire scores were significantly higher in PD (median 8.0, IQR 6.0-10.0) in contrast to controls (0.0, IQR 0.0-0.0) (p < 0.0001), with a similar pattern and level of significance across all country sites. In ROC analysis, the questionnaire demonstrated high diagnostic accuracy for PD overall, with an AUC of 0.992 (95% CI 0.981-1.002). CONCLUSION The Arabic, French, and English versions of this PD screening questionnaire are valid and accurate screening instruments for recognition of Parkinsonism. This paves the way for conducting epidemiological studies in many African countries.
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Affiliation(s)
- Ali Shalash
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Njideka U Okubadejo
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Jacques Doumbe
- Department of Neurology, University of Douala, Douala, Cameroon
| | - Oluwadamilola O Ojo
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos & Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Eman Hamid
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Callixte Kuate
- Department of Neurology, University of Douala, Douala, Cameroon
| | - Sara Calvo
- Neurology Department, University Hospital, Burgos, Spain
| | - Asmaa Helmi
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Osigwe P Agabi
- Neurology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - Mohamed Essam
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Laura Aguado
- Neurology Department, University Hospital, Burgos, Spain
| | - Hanan Elrassas
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Roushdy
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Caroline M Tanner
- Department of Neurology, Weill Institute for Neurosciences, University of California - San Francisco, San Francisco, CA, USA
| | - Esther Cubo
- Neurology Department, University Hospital, Burgos, Spain
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Yan Z, Yang W, Wei H, Dean MN, Standaert DG, Cutter GR, Benveniste EN, Qin H. Dysregulation of the Adaptive Immune System in Patients With Early-Stage Parkinson Disease. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/5/e1036. [PMID: 34301818 PMCID: PMC8299515 DOI: 10.1212/nxi.0000000000001036] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/05/2021] [Indexed: 01/25/2023]
Abstract
Objective To determine the activation status and cytokine profiles of CD4+ T cells, CD8+ T cells, and CD19+ B cells from patients with early-stage Parkinson disease (PD) compared with healthy controls (HCs). Methods Peripheral blood samples from 41 patients with early-stage PD and 40 HCs were evaluated. Peripheral blood mononuclear cells were analyzed by flow cytometry for surface markers and intracellular cytokine production. Correlations of immunologic changes and clinical parameters were analyzed. Results Adaptive immunity plays a role in the pathogenesis of PD, yet the contribution of T cells and B cells, especially cytokine production by these cells, is poorly understood. We demonstrate that naive CD4+ and naive CD8+ T cells are significantly decreased in patients with PD, whereas central memory CD4+ T cells are significantly increased in patients with PD. Furthermore, IL-17–producing CD4+ Th17 cells, IL-4–producing CD4+ Th2 cells, and IFN-γ–producing CD8+ T cells are significantly increased in patients with PD. Regarding B cells, we observed a decrease in naive B cells and an increase in nonswitched memory and double-negative B cells. As well, TNF-α–producing CD19+ B cells were significantly increased in patients with PD. Notably, some of the changes observed in CD4+ T cells and B cells were associated with clinical motor disease severity. Conclusions These findings suggest that alterations in the adaptive immune system may promote clinical disease in PD by skewing to a more proinflammatory state in the early-stage PD patient cohort. Our study may shed light on potential immunotherapies targeting dysregulated CD4+ T cells, CD8+ T cells, and CD19+ B cells in patients with PD.
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Affiliation(s)
- Zhaoqi Yan
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Wei Yang
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Hairong Wei
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Marissa N Dean
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - David G Standaert
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Gary R Cutter
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Etty N Benveniste
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham
| | - Hongwei Qin
- From the Department of Cell, Developmental and Integrative Biology (Z.Y., W.Y., H.W., E.N.B., H.Q.), Department of Neurology (M.N.D., D.G.S.), and Department of Biostatistics (G.R.C.), University of Alabama at Birmingham.
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Sex-based differences in the activation of peripheral blood monocytes in early Parkinson disease. NPJ PARKINSONS DISEASE 2021; 7:36. [PMID: 33850148 PMCID: PMC8044127 DOI: 10.1038/s41531-021-00180-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/17/2021] [Indexed: 12/12/2022]
Abstract
Increasing evidence supports the role of brain and systemic inflammation in the etiology of Parkinson disease (PD). We used gene expression profiling to examine the activation state of peripheral blood monocytes in 18 patients with early, untreated PD and 16 healthy control (HC) subjects. Monocytes were isolated by negative selection, and gene expression studied by RNA-seq and gene set enrichment analysis. A computational model that incorporated case/control status, sex, and the interaction between case/control status and sex was utilized. We found that there was a striking effect of sex on monocyte gene expression. There was inflammatory activation of monocytes in females with PD, with enrichment of gene sets associated with interferon gamma stimulation. In males, the activation patterns were more heterogeneous. These data point to the importance of systemic monocyte activation in PD, and the importance of studies which examine the differential effects of sex on pathophysiology of the disease.
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Litvan I, Proudfoot JA, Martin ER, Standaert D, Riley D, Hall D, Marras C, Bayram E, Dubinsky RM, Bordelon Y, Reich S, Shprecher D, Kluger B, Cunningham C, Schellenberg GD, Jankovic J. Gene-Environment Interactions in Progressive Supranuclear Palsy. Front Neurol 2021; 12:664796. [PMID: 33897612 PMCID: PMC8062875 DOI: 10.3389/fneur.2021.664796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022] Open
Abstract
Several genetic and environmental factors have been reported in progressive supranuclear palsy (PSP), although none were identified as a definitive cause. We aimed to explore potential gene-environment interactions in PSP. Two hundred and ninety two PSP cases and 292 controls matched for age, sex, and race from the ENGENE-PSP were analyzed to determine the association between PSP and minor alleles of 5 single nucleotide polymorphisms (SNPs) in 4 genes (MAPT, MOBP, EIF2AK3, and STX6), which were previously associated with PSP risk. Interactions between these SNPs and environmental factors, including previously reported occupational and agricultural risk factors for PSP, were assessed for PSP odds and age of symptom onset. Minor alleles of MAPTrs242557 and EIF2AK3rs7571971 were individually associated with increased odds; MAPTrs8070723 minor alleles were associated with lower PSP odds. There were several gene-environment interactions for PSP odds and age of symptom onset, however, they did not remain significant after FDR-correction. Larger scale studies are required to determine potential interactions.
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Affiliation(s)
- Irene Litvan
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, La Jolla, CA, United States
| | - James A. Proudfoot
- Clinical and Translational Research Institute, University of California, San Diego, La Jolla, CA, United States
| | - Eden R. Martin
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - David Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - David Riley
- InMotion, Warrensville Heights, OH, United States
| | - Deborah Hall
- Department of Neurological Sciences, Rush University, Chicago, IL, United States
| | - Connie Marras
- Morto and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Ece Bayram
- Department of Neurosciences, Parkinson and Other Movement Disorders Center, University of California, San Diego, La Jolla, CA, United States
| | - Richard M. Dubinsky
- Department of General Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Stephen Reich
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - David Shprecher
- Banner Sun Health Research Institute, Sun City, AZ, United States
- Department of Neurology, University of Utah, Salt City, UT, United States
| | - Benzi Kluger
- Department of Neurology, University of Colorado, Denver, CO, United States
| | - Christopher Cunningham
- Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, United States
| | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, United States
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York MK, Benge JF, Hunter C, Jankovic J. A validation of a self-administered screening test for Parkinson's disease. J Neurol Sci 2020; 418:117116. [DOI: 10.1016/j.jns.2020.117116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022]
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Goldenberg MDF, Huang X, Chen H, Kong L, Postolache TT, Stiller JW, Ryan KA, Pavlovich M, Pollin TI, Shuldiner AR, Mailman RB, Mitchell BD. Parkinson's Disease-Related Motor and Nonmotor Symptoms in the Lancaster Amish. Neuroepidemiology 2020; 54:392-397. [PMID: 32739915 DOI: 10.1159/000509394] [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: 04/14/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Previous research has suggested that the Amish may experience a relatively high prevalence of Parkinson's disease (PD) and/or parkinsonian motor signs. METHODS In a large sample from the Amish community in Lancaster County, Pennsylvania, age ≥18 years, we assessed the prevalence of self-reported PD diagnosis. For those without self-reported PD diagnosis, we assessed the frequency of PD-related motor symptoms using a 9-item questionnaire that was designed by the PD Epidemiology Research Group. Lastly, we queried study participants for the presence of 2 nonmotor symptoms that have been commonly linked to PD: bowel movement frequency and daytime sleepiness. RESULTS Among 2,025 subjects who answered the PD questionnaire, 430 were older than 60 years. Of 430 participants ≥60 years, 5 (1.2%) reported a PD diagnosis. Of those without a PD diagnosis, 10.5% reported ≥1 and 1.2% ≥ 4 motor symptoms for the 9-item PD screening questionnaire. Of the 3,789 subjects who answered the question about bowel movement frequency, 0.7% reported ≤3 bowel movements per week. Among 1,710 subjects who answered the question about daytime sleepiness, 8.1% of the participants reported "always" sleepy during the day. DISCUSSION These data neither support a markedly higher PD prevalence in the older Lancaster Amish nor do they show dramatically higher motor and/or selected nonmotor symptoms than the general population. Future studies that employ more rigorous procedures for case identification and PD-specific preclinical symptoms/tests are needed to determine the potential differences and similarities among different Amish populations and between Amish and non-Amish populations.
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Affiliation(s)
- Michael D F Goldenberg
- Department of Neurology, Penn State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Xuemei Huang
- Department of Neurology, Penn State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA,
| | - Honglei Chen
- Department of Epidemiology, Michigan State University, East Lansing, Michigan, USA
| | - Lan Kong
- Department of Public Health Sciences, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, Rocky Mountain Mental Illness, Research Education and Clinical Center, Denver, Colorado, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado, USA.,VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, Maryland, USA
| | - John W Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, Rocky Mountain Mental Illness, Research Education and Clinical Center, Denver, Colorado, USA.,St. Elizabeth's Hospital, Neurology Consultation Service, Washington, District of Columbia, USA
| | - Katherine A Ryan
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, Maryland, USA
| | - Mary Pavlovich
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Toni I Pollin
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Alan R Shuldiner
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Richard B Mailman
- Department of Neurology, Penn State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.,Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Braxton D Mitchell
- Program for Personalized and Genomic Medicine, Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland, USA
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Reedijk M, Huss A, Verheij RA, Peeters PH, Vermeulen RCH. Parkinson's disease case ascertainment in prospective cohort studies through combining multiple health information resources. PLoS One 2020; 15:e0234845. [PMID: 32609766 PMCID: PMC7329061 DOI: 10.1371/journal.pone.0234845] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 06/03/2020] [Indexed: 01/15/2023] Open
Abstract
Epidemiological evidence from prospective cohort studies on risk factors of Parkinson's disease (PD) is limited as case ascertainment is challenging due to a lack of registries and the disease course of PD. The objective of this study was to create a case ascertainment method for PD within two prospective Dutch cohorts based on multiple sources of PD information. This method was validated using clinical records from the general practitioners (GPs). Face validity of the case ascertainment was tested for three etiological factors (smoking, sex and family history of PD). In total 54825 participants were included from the cohorts AMIGO and EPIC-NL. Sources of PD information included self-reported PD, self-reported PD medication, a 9 item screening questionnaire (Tanner), electronical medical records, hospital discharge data and mortality records. Based on these sources we developed a likelihood score with 4 categories (no PD, unlikely PD, possible PD, likely PD). For the different sources of PD information and for the likelihood score we present the agreement with GP-validated cases. Risk of PD for established factors was studied by logistic regression as exact diagnose dates were not always available. Based on the algorithm, we assigned 346 participants to the likely PD category. GP validation confirmed 67% of these participants in EPIC-NL, but only 12% in AMIGO. PD was confirmed in only 3% of the participants with a possible PD classification. PD case ascertainment by mortality records (91%), EMR ICPC (82%) and self-reported information (62-69%) had the highest confirmation rates. The Tanner PD screening questionnaire had a lower agreement (18%). Risk estimates for smoking, family history and sex using all likely PD cases were comparable to the literature for EPIC-NL, but not for smoking in AMIGO. Using multiple sources of PD evidence in cohorts remains important but challenging as performance of sources varied in validity.
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Affiliation(s)
- Marije Reedijk
- University of Utrecht, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Anke Huss
- University of Utrecht, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
| | - Robert A. Verheij
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Petra H. Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Roel C. H. Vermeulen
- University of Utrecht, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
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Burstyn I, LaCroix AZ, Litvan I, Wallace RB, Checkoway H. Occupation and Parkinson disease in the Women's Health Initiative Observational Study. Am J Ind Med 2019; 62:766-776. [PMID: 31328814 DOI: 10.1002/ajim.23022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION There is a lack of consistent study findings on associations between workplace exposures and the risk of Parkinson disease (PD) and a paucity of such data on women. We assessed PD risk among occupational groups to derive insights about potential occupation-specific exposures in a large cohort of women. METHODS The Women's Health Initiative Observational Study (WHI-OS) is a prospective cohort that enrolled 91 627 postmenopausal women, 50 to 79 years of age, from 01 October 1993 through 31 December 1998, at 40 clinical centers across the United States, with average follow-up interval of 11 years. These women reported up to three paid jobs, held the longest since age 18; these jobs were coded and duration of employment calculated. We defined a case by self-report of doctor-diagnosed PD (at baseline or follow-up), death attributed to PD, or taking medication consistent with PD. RESULTS Among 2590 PD cases, we found evidence of excess risk among "counselors, social workers, and other community and social service specialists," and there was a suggestion of increased in risk among postsecondary teachers, and "building and grounds cleaning and maintenance" workers. There was also evidence of a deficit in risk among women who worked in sales. Results according to ever-employed and job duration were similar, except for evidence of excess risk among "health technologists and technicians" with more than 20 years of employment. Longer duration of life on a farm was associated with higher risk. CONCLUSION Our findings paint a largely reassuring picture of occupational risks for PD among US women.
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Affiliation(s)
- Igor Burstyn
- Department of Environmental and Occupational HealthDrexel University Philadelphia Pennsylvania
| | - Andrea Z. LaCroix
- Department of Family Medicine and Public HealthUniversity of California San Diego California
| | - Irene Litvan
- Department of Neurosciences, Altman Clinical Translational Research InstituteUniversity of California San Diego California
| | - Robert B. Wallace
- Department of EpidemiologyUniversity of Iowa College of Public Health Iowa City Iowa
| | - Harvey Checkoway
- Department of Family Medicine and Public HealthUniversity of California San Diego California
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10
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Rabadia SV, Litvan I, Juncos J, Bordelon Y, Riley DE, Standaert D, Reich SG, Hall DA, Kluger B, Shprecher D, Marras C, Jankovic J. Hypertension and progressive supranuclear palsy. Parkinsonism Relat Disord 2019; 66:166-170. [PMID: 31420308 DOI: 10.1016/j.parkreldis.2019.07.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The epidemiologic evidence of whether hypertension is associated with Progressive Supranuclear Palsy (PSP) is inconsistent. The ENGENE-PSP case-control study determined various PSP risk factors including whether hypertension preceded PSP onset. METHODS Incident PSP cases per NINDS-PSP criteria and age-, sex-, race- matched controls were recruited from similar North American geographic areas. All study participants were administered standardized interviews to obtain data on demographics, medical history and medications. STATISTICS We used univariate and multivariate conditional logistic regression models to measure the associations between PSP and the following predictor variables: education level, hypertension, comorbid vascular conditions (diabetes mellitus and hyperlipidemia), and classes of anti-hypertensive medications using odds ratios and 95% confidence intervals. RESULTS There were significant associations seen between PSP and hypertension (OR: 1.569; 95% CI 1.129-2.181; p-value = 0.007), education level (OR: 0.733; 95% CI 0.637-0.843; p-value<0.001) and beta-blocker use (OR: 2.000; 95% CI 1.053-3.799; p-value = 0.034). However, in the multi-variate analysis hypertension (OR: 1.492; 95% CI 1.045-2.129; p-value = 0.027) and education level (OR: 0.730; 95% CI 0.633-0.841; p-value<0.001) were the only significant associations. CONCLUSION These results suggest that there is a modest, yet significant association between hypertension and PSP. Further studies will be needed to better understand the pathophysiological basis for this finding.
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Affiliation(s)
- Soniya V Rabadia
- University of California San Diego Department of Neurosciences, USA
| | - Irene Litvan
- University of California San Diego Department of Neurosciences, USA.
| | | | | | | | | | | | | | | | - David Shprecher
- University of Utah, USA; Banner Sun Health Research Institute, USA
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, USA
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11
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Lee HJ, Jung KW, Chung SJ, Hong SM, Kim J, Lee JH, Hwang SW, Ryu HS, Kim MJ, Lee HS, Seo M, Park SH, Yang DH, Ye BD, Byeon JS, Choe J, Jung HY, Yang SK, Myung SJ. Relation of Enteric α-Synuclein to Gastrointestinal Dysfunction in Patients With Parkinson's Disease and in Neurologically Intact Subjects. J Neurogastroenterol Motil 2018; 24:469-478. [PMID: 29969861 PMCID: PMC6034677 DOI: 10.5056/jnm17141] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/19/2018] [Accepted: 04/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background/Aims α-Synucleinopathy in the brain is the neuropathological hallmark of Parkinson’s disease (PD). However, the functional impact of α-synucleinopathy in the enteric nervous system remains unknown. We aim to evaluate the association between gastrointestinal (GI) dysfunction and α-synuclein (αSYN) pathology in the stomach and colon of PD patients and controls, as well as to investigate the association between the αSYN pathology in GI tract and future PD risk. Methods A total of 35 PD patients and 52 neurologically intact subjects were enrolled in this study. Endoscopic biopsies were performed, and then immunohistochemical staining for αSYN was performed. All subjects completed the validated Rome III questionnaire for the assessment of GI symptoms. The association between GI symptoms and the αSYN pathology in GI mucosa was evaluated. Incident PD cases were assessed during a median follow-up of 46 months. Results The proportion of self-reported constipation and functional constipation through the Rome III questionnaire was significantly higher in PD patients than in controls (P < 0.001 and P = 0.015). However, no significant association was found between the αSYN pathology in the stomach and colon mucosa and constipation, as well as other GI symptoms including dyspepsia symptoms and abdominal discomfort or pain, regardless of the presence or absence of clinical PD (P > 0.05). No incident PD cases were diagnosed during study period. Conclusions Our present study suggests that the deposition of αSYN in the mucosal enteric nervous system may not be reflected by functional impairment of the affected segment of the gut.
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Affiliation(s)
- Hyo Jeong Lee
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Juyeon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Sung Ryu
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Jung Kim
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Su Lee
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - Myeongsook Seo
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
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12
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Factors associated with dream enacting behaviors among US farmers. Parkinsonism Relat Disord 2018; 57:9-15. [PMID: 30007509 DOI: 10.1016/j.parkreldis.2018.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/27/2018] [Accepted: 07/07/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Dream enacting behavior (DEB) during REM sleep is a characteristic feature of REM sleep behavior disorder (RBD), the most specific prodromal symptom for Parkinson's disease (PD) and related synucleinopathies. METHODS We screened for DEB among 20,591 male farmers in 2013-2015 using a validated question, and examined its association with pesticide uses and other potential risk factors reported about twenty years ago in 1993-1997. We reported odds ratios (OR) and 95% confidence intervals (CI) from multivariable logistic regression models. RESULTS A total of 1623 (7.9%) farmers reported having had DEB. Farmers with DEB were more likely to report other nonmotor and motor symptoms of PD with age-adjusted ORs ranging from 1.9 to 3.0. DEB prevalence varied little by age, but was significantly associated with current smoking (adjusted OR: 1.4, 95%CI: 1.2, 1.6), daily alcohol drinking (OR: 1.4, 95%CI: 1.1, 1.6), a history of head injury (OR: 1.3, 95%CI: 1.2, 1.5), and being married (OR: 1.4, 95%CI: 1.1, 1.7). We identified significant associations for several pesticides, especially cyclodiene organochlorines and pyrethroids, with adjusted ORs ranging from 1.2 to 1.5. The results were similar after excluding PD cases or when farmers with at least three DEB episodes in life were considered as DEB cases. CONCLUSIONS This study suggests that DEB are not rare among male farmers. Findings on potential risk factors for DEB are intriguing, and given the close link between RBD and PD, these associations should be further investigated.
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Kelley KD, Checkoway H, Hall DA, Reich SG, Cunningham C, Litvan I. Traumatic Brain Injury and Firearm Use and Risk of Progressive Supranuclear Palsy Among Veterans. Front Neurol 2018; 9:474. [PMID: 29973911 PMCID: PMC6020251 DOI: 10.3389/fneur.2018.00474] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/31/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Progressive supranuclear palsy (PSP) is a tauopathy that has a multifactorial etiology. Numerous studies that have investigated lead exposure and traumatic brain injury (TBI) as risk factors for other tauopathies, such as Alzheimer's disease, but not for PSP. Objective: We sought to investigate the role of firearm usage, as a possible indicator of lead exposure, and TBI as risk factors for PSP in a population of military veterans. Methods: We included participants from a larger case-control study who reported previous military service. Our sample included 67 PSP cases and 68 controls. Participants were administered a questionnaire to characterize firearm use in the military and occurrence of TBI. Results: Cases were significantly less educated than controls. In unadjusted analyses, the proportion of PSP cases (80.6%) and controls (64.7%) who reported use of firearms as part of their military job was positively associated with PSP, odds ratio (OR) 2.2 (95% CI: 1-5.0). There were no significant case-control differences in mean service duration. There was only a weak association with history of TBI, OR 1.6 (95% CI: 0.8-3.4). In multivariate models, firearm usage (OR 3.7, 95% CI: 1.5, 9.8) remained significantly associated with PSP. Conclusions: Our findings show a positive association between firearm usage and PSP and an inverse association between education and PSP. The former suggests a possible etiologic role of lead. Further studies are needed to confirm the potential etiologic effects of metals on PSP. The study was registered in clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT00431301.
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Affiliation(s)
- Kristen D. Kelley
- School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Harvey Checkoway
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Deborah A. Hall
- Department of Neurology, Rush University Medical Center, Chicago, IL, United States
| | - Stephen G. Reich
- Department of Neurology, University of Maryland, Baltimore, MD, United States
| | - Chris Cunningham
- Clinical Trials Unit, University of Louisville, Louisville, KY, United States
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
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14
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Park HK, Ilango S, Charriez CM, Checkoway H, Riley D, Standaert DG, Bordelon Y, Shprecher DR, Reich SG, Hall D, Kluger B, Marras C, Jankovic J, Dubinsky R, Litvan I. Lifetime exposure to estrogen and progressive supranuclear palsy: Environmental and Genetic PSP study. Mov Disord 2018; 33:468-472. [PMID: 29460982 PMCID: PMC5840026 DOI: 10.1002/mds.27336] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/10/2017] [Accepted: 01/11/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Studies suggesting a protective effect of estrogen in neurodegenerative diseases prompted us to investigate this relationship in progressive supranuclear palsy (PSP). METHODS This case-control study evaluated the self-reported reproductive characteristics and estrogen of 150 women with PSP and 150 age-matched female controls who participated in the Environmental Genetic-PSP study. Conditional logistic regression models were generated to examine associations of PSP with estrogen. RESULTS There was no association between years of estrogen exposure duration and PSP. There was a suggestion of an inverse association between composite estrogen score and PSP that did not reach statistical significance (P = .06). Any exposure to estrogen replacement therapy halved the risk of PSP (odds ratio = 0.52; 95% confidence interval = 0.30-0.92; P = .03). Among PSP cases, earlier age at menarche was associated with better performance on Hoehn and Yahr stage (β = -0.60; SE = 0.26; P = .02) and Unified Parkinson's Disease Rating Scale II score (β = -5.19; SE = 2.48; P = .04) at clinical examination. CONCLUSIONS This case-control study suggests a protective role of lifetime estrogen exposure in PSP. Future studies will be needed to confirm this association. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Hee Kyung Park
- Department of Neurology, Inje University Ilsan-Paik Hospital, Goyang, Korea
- Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Sindana Ilango
- Graduate School of Public Health, San Diego State University
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | - Christina M. Charriez
- Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Harvey Checkoway
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA
| | | | - David G. Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yvette Bordelon
- Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - David R. Shprecher
- Banner Sun Health Research Institute, Sun City, AZ
- Department of Neurology, University of Arizona College of Medicine, Phoenix, AZ
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Stephen G. Reich
- Department of Neurology, University of Maryland, Baltimore, Maryland, USA
| | - Deborah Hall
- Department of Neurological Sciences, Rush University, Chicago, Illinois, USA
- Department of Neurology, University of Colorado, Denver, Colorado, USA
| | - Benzi Kluger
- Department of Neurology, University of Colorado, Denver, Colorado, USA
| | - Connie Marras
- Morto and Gloria Shulman Movement Disorders Centre and the Edmond J. Saftra Program in Parkinson’s Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, USA
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine
| | | | - Irene Litvan
- Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
- Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucky, USA
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15
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Pipeline to gene discovery - Analysing familial Parkinsonism in the Queensland Parkinson's Project. Parkinsonism Relat Disord 2018; 49:34-41. [PMID: 29329938 DOI: 10.1016/j.parkreldis.2017.12.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/19/2017] [Accepted: 12/29/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Family based study designs provide an informative resource to identify disease-causing mutations. The Queensland Parkinson's Project (QPP) has been involved in numerous genetic screening studies; however, details of the families enrolled into the register have not been comprehensively reported. This article characterises the families enrolled in the QPP and summarises monogenic forms of hereditary Parkinsonism found in the register. METHOD The presence of pathogenic point mutations and copy number variations (CNVs) were, generally, screened in a sample of over 1000 PD patients from the total of 1725. Whole exome sequencing (WES) was performed on eighteen probands from multiplex families. RESULTS The QPP contains seventeen incidences of confirmed monogenic forms of PD, including LRRK2 p.G2019S, VPS35 p.D620N, SNCA duplications and PARK2 p.G430D (hom) & exon 4 deletion (hom). Of these seventeen, five belong to multi-incident families, while another eight have a family history of at least one other case of PD. In additional families, WES did not identify known forms of monogenic Parkinsonism; however, three heterozygous mutations in PARK2, p.R275W, p.Q34fs, and a 40bp deletion in exon 3 were identified. Of these three mutations, only the 40bp deletion segregated with disease in a dominant inheritance pattern. CONCLUSION Eighteen probands have screened negative for known CNVs and mutations that cause clear monogenic forms of PD. Each family is a candidate for further genetic analysis to identify genetic variants segregating with disease. The families enrolled in the QPP provide a useful resource to aid in identifying novel forms of monogenic PD.
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16
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Marras C, Cunningham CR, Hou J, Proudfoot J, Standaert DG, Juncos J, Riley D, Reich SG, Hall D, Kluger B, Bordelon Y, Shprecher DR, Litvan I. Anti-inflammatory drug use and progressive supranuclear palsy. Parkinsonism Relat Disord 2017; 48:89-92. [PMID: 29307562 DOI: 10.1016/j.parkreldis.2017.11.346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Anti-inflammatory drug use, particularly ibuprofen, has been associated with a lower risk of Parkinson's disease. Microglial activation and inflammatory cytokine expression have been shown to be pathological features of progressive supranuclear palsy. We examined the association between NSAID use and risk of PSP, disease severity and age at onset. METHODS The ENGENE-PSP multicenter case-control study recruited incident PSP cases who met the NINDS-PSP Society diagnostic criteria and age-, sex- and race-matched controls primarily from the same geographical areas. All subjects underwent standardized interviews to obtain data on demographics, residential history, medication history and lifetime occupational history. NSAID use was specifically queried by telephone interview using a standardized questionnaire. RESULTS Information was obtained on anti-inflammatory drug exposure in 276 cases and 278 controls. No association was found between NSAID exposure and risk of PSP, age at onset or rate of change of UPDRS motor subscale, PSP Rating Scale or Mattis Dementia Rating Scale scores. This lack of association persisted when NSAID exposure was measured considering any NSAIDs, ibuprofen only, ASA only or non-ibuprofen, non-aspirin NSAIDs. CONCLUSIONS These results do not suggest an important association between NSAID use and PSP occurrence or expression. Despite the large size of our study, confidence intervals were wide. To rule out small associations, very large sample sizes will be required.
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17
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Gwinn K, David KK, Swanson-Fischer C, Albin R, Hillaire-Clarke CS, Sieber BA, Lungu C, Bowman FD, Alcalay RN, Babcock D, Dawson TM, Dewey RB, Foroud T, German D, Huang X, Petyuk V, Potashkin JA, Saunders-Pullman R, Sutherland M, Walt DR, West AB, Zhang J, Chen-Plotkin A, Scherzer CR, Vaillancourt DE, Rosenthal LS. Parkinson's disease biomarkers: perspective from the NINDS Parkinson's Disease Biomarkers Program. Biomark Med 2017; 11:451-473. [PMID: 28644039 PMCID: PMC5619098 DOI: 10.2217/bmm-2016-0370] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/11/2017] [Indexed: 11/21/2022] Open
Abstract
Biomarkers for Parkinson's disease (PD) diagnosis, prognostication and clinical trial cohort selection are an urgent need. While many promising markers have been discovered through the National Institute of Neurological Disorders and Stroke Parkinson's Disease Biomarker Program (PDBP) and other mechanisms, no single PD marker or set of markers are ready for clinical use. Here we discuss the current state of biomarker discovery for platforms relevant to PDBP. We discuss the role of the PDBP in PD biomarker identification and present guidelines to facilitate their development. These guidelines include: harmonizing procedures for biofluid acquisition and clinical assessments, replication of the most promising biomarkers, support and encouragement of publications that report negative findings, longitudinal follow-up of current cohorts including the PDBP, testing of wearable technologies to capture readouts between study visits and development of recently diagnosed (de novo) cohorts to foster identification of the earliest markers of disease onset.
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Affiliation(s)
- Katrina Gwinn
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Karen K David
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christine Swanson-Fischer
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roger Albin
- Neurology Service & GRECC, VAAAHS, UM Udall Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Beth-Anne Sieber
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - F DuBois Bowman
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University, New York, NY, USA
| | - Debra Babcock
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ted M Dawson
- Neuroregeneration & Stem Cell Programs, Institute for Cell Engineering, Solomon H Snyder Department of Neuroscience, Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard B Dewey
- Department of Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tatiana Foroud
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Vlad Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Judith A Potashkin
- Department of Cellular & Molecular Pharmacology, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel & Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sutherland
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - David R Walt
- Department of Chemistry, Tufts University, Medford, MA, USA
| | - Andrew B West
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Clemens R Scherzer
- Department of Neurology, Harvard Medical School, Brigham & Women's Hospital, Cambridge, MA, USA
| | - David E Vaillancourt
- Departments of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Fereshtehnejad SM, Rahmani A, Shafieesabet M, Soori M, Delbari A, Motamed MR, Lökk J. Prevalence and associated comorbidities of restless legs syndrome (RLS): Data from a large population-based door-to-door survey on 19176 adults in Tehran, Iran. PLoS One 2017; 12:e0172593. [PMID: 28212408 PMCID: PMC5315310 DOI: 10.1371/journal.pone.0172593] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/07/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Discrepancies have been reported in the prevalence rate of restless legs syndrome (RLS) among different ethnic groups and geographic populations. Furthermore, there are disagreements on determinant factors and associated comorbidities of RLS. We aimed to estimate prevalence of RLS and investigate its associated comorbid conditions and risk factors in a large population-based door-to-door survey. METHODS Following a multistage random sampling from the households lived in 22 urban districts of Tehran, Iran, 19176 participants with ≥30 years of age were recruited. Trained surveyors filled study checklist consisting of baseline characteristics, risk factors and comorbidity profile and the International RLS Study Group (IRLSSG) diagnostic criteria through face-to-face interviews. RESULTS In total, 1580 individuals were positively screened for RLS resulting in a standardized prevalence rate of 60.0/1000. There was a gradual increase in RLS prevalence by advancing age, however, sex difference disappeared after adjustment. Parkinsonism [adjusted odds' ratio (adj-OR) = 7.4 (95% CI: 5.3-10.4)], peripheral neuropathy [adj-OR = 3.7 (95% CI: 3.3-4.1)], subjective cognitive impairment (SCI) [adj-OR = 3.1 (95% CI: 2.7-3.4)], acting out dreams [adj-OR = 2.8 (95% CI: 2.5-3.2)], hyposmia [adj-OR = 2.5 (95% CI: 2.2-2.9)], active smoking [adj-OR = 1.5 (95% CI: 1.3-1.9)] and additional number of cardiometabolic diseases associated with higher risk of RLS [adj-OR = 1.6 (95% CI: 1.2-2.3)]. CONCLUSION Our findings showed that neuro-cognitive co-morbidities such as parkinsonism, peripheral neuropathy, SCI, acting out dreams and hyposmia as well as cardio-metabolic risk factors and diseases were independent determinants of RLS. It is recommended to screen individuals with either these comorbid conditions for RLS or the ones with RLS for the accompanying diseases.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Division of Clinical geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal General Hospital, Montreal, Québec, Canada
- Firoozgar Clinical Research Development Center (FCRDC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Arash Rahmani
- Medical Student Research Committee (MSRC), Mental Health Research Center, Tehran Psychiatry Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdiyeh Shafieesabet
- Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahshid Soori
- Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Delbari
- Division of Clinical geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Mohammad Reza Motamed
- Firoozgar Clinical Research Development Center (FCRDC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
- Neurology Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Johan Lökk
- Division of Clinical geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
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Fraser KB, Rawlins AB, Clark RG, Alcalay RN, Standaert DG, Liu N, West AB. Ser(P)-1292 LRRK2 in urinary exosomes is elevated in idiopathic Parkinson's disease. Mov Disord 2016; 31:1543-1550. [PMID: 27297049 PMCID: PMC5053851 DOI: 10.1002/mds.26686] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/30/2016] [Accepted: 05/04/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Mutations in Leucine-rich repeat kinase 2 (LRRK2) enhance levels of the autophosphorylated LRRK2 protein and are the most common known cause of inherited Parkinson's disease (PD). LRRK2 has been further implicated in susceptibility to idiopathic PD in genetic association studies. OBJECTIVE The objective of this study was to compare autophosphorylated Ser(P)-1292 LRRK2 levels from biobanked urine samples with clinical data in PD patients and controls. METHODS Ser(P)-1292 LRRK2 levels were measured from urine exosome fractions from 79 PD patients and 79 neurologically healthy controls enrolled in the Parkinson Disease Biomarker Program at the University of Alabama at Birmingham. RESULTS Ser(P)-1292 LRRK2 levels were higher in men than women (P < .0001) and elevated in PD patients when compared with controls (P = .0014). Ser(P)-1292 LRRK2 levels were higher in PD cases with worse cognition and correlated with poor performance in MoCA (r = -0.2679 [-0.4628 to -0.0482]), MDS-UPDRS subscales 1 and 2 (r = 0.2239 [0.0014-0.4252], 0.3404 [0.1276-0.5233], respectively), Epworth Sleepiness Scale (r = 0.3215 [0.1066-0.5077]), and Modified Schwab and England Activities of Daily Living Scales (r = -0.4455 [-0.6078 to -0.2475]). Ser(P)-1292 LRRK2 levels predicted those with worse cognitive impairment in PD patients with some success (c = 0.73). CONCLUSIONS Urinary exosome Ser(P)-1292 LRRK2 levels are elevated in idiopathic PD and correlated with the severity of cognitive impairment and difficultly in accomplishing activities of daily living. These results implicate biochemical changes in LRRK2 in idiopathic PD. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kyle B Fraser
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ashlee B Rawlins
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rachel G Clark
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University, New York City, New York, USA
| | - David G Standaert
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nianjun Liu
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrew B West
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Foki T, Vanbellingen T, Lungu C, Pirker W, Bohlhalter S, Nyffeler T, Kraemmer J, Haubenberger D, Fischmeister FPS, Auff E, Hallett M, Beisteiner R. Limb-kinetic apraxia affects activities of daily living in Parkinson's disease: a multi-center study. Eur J Neurol 2016; 23:1301-7. [PMID: 27132653 DOI: 10.1111/ene.13021] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Impaired dexterity (fine hand movements) is often present in Parkinson's disease (PD), even at early to moderate disease stages. It has a detrimental impact on activities of daily living (ADL) such as buttoning, contributing to reduced quality of life. Limb-kinetic apraxia, a loss of the ability to make precise, independent but coordinated finger and hand movements, may contribute to impaired dexterity even more than bradykinesia per se. However, the impact of limb-kinetic apraxia on ADL remains controversial. Our aim was to identify the strongest predictor of buttoning and unbuttoning in PD. It was hypothesized that coin rotation (a surrogate of limb-kinetic apraxia) represents the most important determinant. METHODS Sixty-four right-handed, early to moderate PD patients were recruited from three movement disorder centers (Hoehn andYahr stages 1-3). Buttoning, unbuttoning and coin rotation (right and left hand) represented the target tasks. Motor impairment was assessed according to the Unified Parkinson's Disease Rating Scale. RESULTS Multiple linear regression analysis showed that coin rotation with the right hand was the only significant predictor of buttoning (P < 0.001) and unbuttoning (P = 0.002). Notably, measures of bradykinesia or overall motor impairment did not represent significant predictors. CONCLUSIONS Constituting the novel key finding, limb-kinetic apraxia seems to be particularly relevant for ADL requiring dexterity skills in PD, even at early to moderate disease stages. Our results prompt research into the pathophysiological background and therapeutic options to treat limb-kinetic apraxia. The simple coin rotation test provides valuable information about ADL-related dexterity skills.
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Affiliation(s)
- T Foki
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
| | - T Vanbellingen
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - C Lungu
- Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - W Pirker
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - S Bohlhalter
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - T Nyffeler
- Perception and Eye Movement Laboratory, Departments of Neurology and Clinical Research, Inselspital, University Hospital Bern, Bern, Switzerland.,Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Luzern, Switzerland
| | - J Kraemmer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - D Haubenberger
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - F Ph S Fischmeister
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
| | - E Auff
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - R Beisteiner
- Department of Neurology, Medical University of Vienna, Vienna, Austria.,MR Center of Excellence, Medical University of Vienna, Vienna, Austria
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21
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Brody DM, Litvan I, Warner S, Riley DE, Hall DA, Kluger BM, Shprecher DR, Cunningham CR. Relationship between uric acid levels and progressive supranuclear palsy. Mov Disord 2016; 31:663-7. [PMID: 26890571 DOI: 10.1002/mds.26535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 10/29/2015] [Accepted: 11/29/2015] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The pathophysiology of both PD and PSP is characterized by a pro-oxidant state. Uric acid is an oxidative stress marker. High uric acid blood levels have been associated with a reduced risk of PD and a decreased rate of disease progression. We investigated whether a low serum concentration of uric acid is also associated with PSP. METHODS We measured serum uric acid concentrations in a subsample of the ENGENE PSP Cohort that included 75 cases and 75 frequency-matched-by-sex healthy controls (69 spouses, 6 in-laws) from four centers willing to participate (Case Western, Rush University, University of Utah, and University of Louisville). Case severity was characterized using the total PSP-Rating Scale, UPDRS, and Mattis Dementia Rating Scale. Unconditional logistic regression, Pearson's chi-squared test, and analysis of variance were used, as appropriate. RESULTS The mean uric acid level among cases (4.0 mg/dL) was not significantly lower than that of controls (4.1 mg/dL). When controlling for sex, there were no between-group statistical differences in uric acid levels. Uric acid levels were not correlated with disease severity. CONCLUSIONS The results of this study do not provide evidence of uric acid having a protective role in PSP, even if oxidative injury is important in the pathophysiology of this disorder. The lack of statistical significance suggests that there is no direct association between uric acid levels and PSP. However, a small inverse association cannot be excluded. © 2016 Movement Disorder Society.
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Affiliation(s)
- David M Brody
- Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Irene Litvan
- Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA.,Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | | | | | - Deborah A Hall
- Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Benzi M Kluger
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Christopher R Cunningham
- Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucky, USA
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22
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Litvan I, Lees PSJ, Cunningham CR, Rai SN, Cambon AC, Standaert DG, Marras C, Juncos J, Riley D, Reich S, Hall D, Kluger B, Bordelon Y, Shprecher DR. Environmental and occupational risk factors for progressive supranuclear palsy: Case-control study. Mov Disord 2016; 31:644-52. [PMID: 26854325 DOI: 10.1002/mds.26512] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The cause of progressive supranuclear palsy (PSP) is largely unknown. Based on evidence for impaired mitochondrial activity in PSP, we hypothesized that the disease may be related to exposure to environmental toxins, some of which are mitochondrial inhibitors. METHODS This multicenter case-control study included 284 incident PSP cases of 350 cases and 284 age-, sex-, and race-matched controls primarily from the same geographical areas. All subjects were administered standardized interviews to obtain data on demographics, residential history, and lifetime occupational history. An industrial hygienist and a toxicologist unaware of case status assessed occupational histories to estimate past exposure to metals, pesticides, organic solvents, and other chemicals. RESULTS Cases and controls were similar on demographic factors. In unadjusted analyses, PSP was associated with lower education, lower income, more smoking pack-years, more years of drinking well water, more years living on a farm, more years living 1 mile from an agricultural region, more transportation jobs, and more jobs with exposure to metals in general. However, in adjusted models, only more years of drinking well water was significantly associated with PSP. There was an inverse association with having a college degree. CONCLUSIONS We did not find evidence for a specific causative chemical exposure; higher number of years of drinking well water is a risk factor for PSP. This result remained significant after adjusting for income, smoking, education and occupational exposures. This is the first case-control study to demonstrate PSP is associated with environmental factors. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Irene Litvan
- Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucy, USA.,Movement Disorder Center, Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Peter S J Lees
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Christopher R Cunningham
- Division of Movement Disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, Kentucy, USA
| | - Shesh N Rai
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - Alexander C Cambon
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - David G Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Connie Marras
- Morto and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jorge Juncos
- Department of Neurology, Emory University, Atlanta, Georgia, USA
| | | | - Stephen Reich
- Department of Neurology, University of Maryland, Baltimore, Maryland, USA
| | - Deborah Hall
- Department of Neurological Sciences, Rush University, Chicago, Illinois, USA.,Department of Neurology, University of Colorado, Denver, Colorado, USA
| | - Benzi Kluger
- Department of Neurology, University of Colorado, Denver, Colorado, USA
| | - Yvette Bordelon
- Department of Neurology, University of California Los Angeles, California, USA
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Khan S, Nabi G, Naeem M, Ali L, Silburn PA, Mellick GD. A door-to-door survey to estimate the prevalence of Parkinsonism in Pakistan. Neuropsychiatr Dis Treat 2016; 12:1499-506. [PMID: 27382292 PMCID: PMC4922770 DOI: 10.2147/ndt.s86329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Parkinson's disease (PD) occurs in all races and cultures, and population-related differences in frequency may provide etiological clues. The present study was designed to explore the prevalence of PD and Parkinsonism in Pakistan, the world's sixth most populous country, for which no published prevalence data are available. METHODS We conducted a three-phase door-to-door survey in two districts of the Khyber Pakhtunkhwa province of Pakistan, to assess the prevalence of PD and Parkinsonism in a sample of 4,000 individuals aged 50 years and above. RESULTS We identified 14 cases of Parkinsonism, eleven with a diagnosis of idiopathic PD. The overall prevalence estimates were 1.7/100 (95% confidence interval [CI]: 0.9-2.46) for Parkinsonism and 1.28/100 (95% CI: 0.6-1.94) for PD in persons aged 65 years and above. The age-standardized prevalence of PD (aged 65 years and above), normalized to the USA population in 2000, was 1.33/100, which is similar to that observed in other human populations. Of the total 14 cases, five were newly diagnosed and four had a family history of PD. CONCLUSION The estimated prevalence rates in Pakistan are similar to those observed in other human populations. The frequency of familial Parkinsonism is also equivalent to previous estimates.
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Affiliation(s)
- Suliman Khan
- Clinical Neuroscience Group, Eskitis Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia
| | | | - Muhammad Naeem
- Department of Biotechnology, Quaid-i-azam University, Islamabad
| | - Liaqat Ali
- Saidu Medical College, Saidu Sharif Swat Khyber Pakhtunkhwa, Pakistan
| | - Peter A Silburn
- Clinical Neuroscience Group, Eskitis Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia; The University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia
| | - George D Mellick
- Clinical Neuroscience Group, Eskitis Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia
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Chung SJ, Kim J, Lee HJ, Ryu HS, Kim K, Lee JH, Jung KW, Kim MJ, Kim MJ, Kim YJ, Yun SC, Lee JY, Hong SM, Myung SJ. Alpha-synuclein in gastric and colonic mucosa in Parkinson's disease: Limited role as a biomarker. Mov Disord 2015; 31:241-9. [DOI: 10.1002/mds.26473] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/17/2015] [Accepted: 10/07/2015] [Indexed: 01/14/2023] Open
Affiliation(s)
- Sun Ju Chung
- Department of Neurology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Juyeon Kim
- Department of Neurology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
- Department of Neurology; Metro hospital; Anyang South Korea
| | - Hyo Jeong Lee
- Department of Gastroenterology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
- Health Screening and Promotion Center, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Ho-Sung Ryu
- Department of Neurology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Kiju Kim
- Department of Neurology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Jeong Hoon Lee
- Department of Gastroenterology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Kee Wook Jung
- Department of Gastroenterology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Mi Jung Kim
- Department of Neurology; Bobath Memorial Hospital; Seongnam Republic of Korea
| | - Mi-Jung Kim
- Health Screening and Promotion Center, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Young Jin Kim
- Department of Neurology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Sung-Cheol Yun
- Division of Biostatistics, Center for Medical Research and Information, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Joo-Yong Lee
- Asan Institute for Life Sciences, Asan Medical Center; Seoul South Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center; University of Ulsan College of Medicine; Seoul South Korea
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25
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Wang L, Evatt ML, Maldonado LG, Perry WR, Ritchie JC, Beecham GW, Martin ER, Haines JL, Pericak-Vance MA, Vance JM, Scott WK. Vitamin D from different sources is inversely associated with Parkinson disease. Mov Disord 2014; 30:560-6. [PMID: 25545356 DOI: 10.1002/mds.26117] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 10/17/2014] [Accepted: 10/23/2014] [Indexed: 01/23/2023] Open
Abstract
An inverse association between Parkinson disease (PD) and total vitamin D levels has been reported, but whether vitamin D from different sources, that is, 25(OH)D2 (from diet and supplements) and 25(OH)D3 (mainly from sunlight exposure), all contribute to the association is unknown. Plasma total 25(OH)D, 25(OH)D2, and 25(OH)D3 levels were measured by liquid chromatography-tandem mass spectrometry in PD patients (n = 478) and controls (n = 431). Total 25(OH)D was categorized by clinical insufficiency or deficiency; 25(OH)D2 and 25(OH)D3 were analyzed in quartiles. Vitamin D deficiency (total 25[OH]D < 20 ng/mL) and vitamin D insufficiency (total 25[OH]D < 30 ng/mL) are associated with PD risk (odds ratio [OR] = 2.6 [deficiency] and 2.1 [insufficiency]; P < 0.0001), adjusting for age, sex, and sampling season. Both 25(OH)D2 and 25(OH)D3 levels are inversely associated with PD (P(trend) < 0.0001). The association between 25(OH)D2 and PD risk is largely confined to individuals with low 25(OH)D3 levels (P(trend) = 0.0008 and 0.12 in individuals with 25[OH]D3 < 20 ng/mL and 25[OH]D3 ≥ 20 ng/mL, respectively). Our data confirm the association between vitamin D deficiency and PD, and for the first time demonstrate an inverse association of 25(OH)D2 with PD. Given that 25(OH)D2 concentration is independent of sunlight exposure, this new finding suggests that the inverse association between vitamin D levels and PD is not simply attributable to lack of sunlight exposure in PD patients with impaired mobility. The current study, however, cannot exclude the possibility that gastrointestinal dysfunction, a non-motor PD symptom, contributes to the lower vitamin D2 levels in PD patients.
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Affiliation(s)
- Liyong Wang
- John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, Florida, USA; Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, Florida, USA
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Slottje P, Yzermans CJ, Korevaar JC, Hooiveld M, Vermeulen RCH. The population-based Occupational and Environmental Health Prospective Cohort Study (AMIGO) in The Netherlands. BMJ Open 2014; 4:e005858. [PMID: 25428630 PMCID: PMC4248092 DOI: 10.1136/bmjopen-2014-005858] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Occupational and environmental exposures remain important modifiable risk factors of public health. Existing cohort studies are often limited by the level of detail of data collected on these factors and health. It is also often assumed that the more healthy group is over-represented in cohort studies, which is of concern for their external validity. In this cohort profile, we describe how we set up the population-based Occupational and Environmental Health Cohort Study (AMIGO) to longitudinally study occupational and environmental determinants of diseases and well-being from a multidisciplinary and life course point of view. Reviewed by the Medical Ethics Research Committee of the University Medical Center Utrecht (protocol 10-268/C). All cohort members participate voluntarily and gave informed consent prior to their inclusion. PARTICIPANTS 14,829 adult cohort members (16% of those invited) consented and filled in the online baseline questionnaire. Determinants include chemical, biological, physical (eg, electromagnetic fields), and psychosocial factors. Priority health outcomes include cancer, neurological, cardiovascular and respiratory diseases and non-specific symptoms. Owing to the recruitment strategy via general practitioners of an established network, we also collect longitudinal data registered in their electronic medical records including symptoms, diagnosis and treatments. Besides the advantage of health outcomes that cannot be easily captured longitudinally by other means, this created a unique opportunity to assess health-related participation bias by comparing general practitioner-registered prevalence rates in the cohort and its source population. FINDINGS TO DATE We found no indications of such a systematic bias. The major assets of the AMIGO approach are its detailed occupational and environmental determinants in combination with the longitudinal health data registered in general practice besides linkage to cancer and mortality registries and self-reported health. FUTURE PLANS We are now in the phase of prospective follow-up, with the aim of continuing this for as long as possible (20+ years), pending future funding. Findings will be disseminated through scientific conferences and peer-reviewed journals, and through newsletters and the project website to participants, stakeholders and the wider public.
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Affiliation(s)
- Pauline Slottje
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - C Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Joke C Korevaar
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Mariëtte Hooiveld
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
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Nuytemans K, Bademci G, Kohli MM, Beecham GW, Wang L, Young JI, Nahab F, Martin ER, Gilbert JR, Benatar M, Haines JL, Scott WK, Züchner S, Pericak-Vance MA, Vance JM. C9ORF72 intermediate repeat copies are a significant risk factor for Parkinson disease. Ann Hum Genet 2013; 77:351-63. [PMID: 23845100 PMCID: PMC3815478 DOI: 10.1111/ahg.12033] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 06/04/2013] [Indexed: 12/11/2022]
Abstract
We set out to determine whether expansions in the C9ORF72 repeat found in
amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) families are associated with
Parkinson disease (PD). We determined the repeat size in a total of 889 clinically ascertained
patients (including PD and essential tremor plus Parkinsonism (ETP)) and 1144 controls using a
repeat-primed PCR assay. We found that large C9ORF72 repeat expansions (>30
repeats) were not contributing to PD risk. However, PD and ETP cases had a significant increase in
intermediate (>20 to 30+) repeat copies compared to controls. Overall, 14 cases (13
PD, 1 ETP) and three controls had >20 repeat copies (Fisher's exact test
p = 0.002). Further, seven cases and no controls had >23 repeat
copies (p = 0.003). Our results suggest that intermediate copy numbers of
the C9ORF72 repeat contribute to risk for PD and ETP. This also suggests that PD,
ALS and FTD share some pathophysiological mechanisms of disease. Further studies are needed to
elucidate the contribution of the C9ORF72 repeat in the overall PD population and
to determine whether other common genetic risk factors exist between these neurodegenerative
disorders.
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Affiliation(s)
- Karen Nuytemans
- University of Miami, Miller School of Medicine, John P. Hussman Institute for Human Genomics, Biomedical Research building, 1501 NW 10th Ave, Miami, FL, 33136, USA
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Dahodwala N, Kubersky L, Siderowf A. Can a screening questionnaire accurately identify mild Parkinsonian signs? Neuroepidemiology 2012; 39:171-5. [PMID: 22948126 DOI: 10.1159/000341409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 06/21/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mild parkinsonian signs (MPS) are early features that, when present, increase the risk of neurodegenerative disease and mortality. Current methods to identify MPS are limited to neurological examination. Our objective was to assess the ability of a 9-item Parkinson's Disease Screening Questionnaire (PDSQ), which has high sensitivity in the detection of overt Parkinson's disease (PD), to detect MPS. METHODS Measures including the PDSQ, Unified Parkinson's Disease Rating Scale and University of Pennsylvania Smell Identification Test were administered to 267 participants without neurodegenerative disease. Two published definitions of MPS were used to classify cases. RESULTS PDSQ scores were higher for cases compared to controls (p < 0.001 for the first case definition and 0.07 for the second). However, the questionnaire had low sensitivity (47 and 59%) and specificity (62 and 63%) in the detection of MPS. Adding factors such as age, gender and smell test score to the questionnaire in a predictive model only marginally improved the test characteristics. CONCLUSION The results show the screening questionnaire does not accurately identify MPS. More accurate tests are needed to improve the detection of this early syndrome which can lead to motor disability, neurodegenerative disease and mortality.
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Affiliation(s)
- Nabila Dahodwala
- Parkinson's Disease and Movement Disorders Center, Pennsylvania Hospital, 330 South Ninth Street, Philadelphia, PA 19107, USA.
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29
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Feldman AL, Johansson ALV, Gatz M, Flensburg M, Petzinger GM, Widner H, Lew MF, Pedersen NL, Wirdefeldt K. Accuracy and sensitivity of Parkinsonian disorder diagnoses in two Swedish national health registers. Neuroepidemiology 2012; 38:186-93. [PMID: 22472568 DOI: 10.1159/000336356] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 01/11/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Swedish population-based national health registers are widely used data sources in epidemiological research. Register-based diagnoses of Parkinson's disease have not been validated against clinical information. METHODS Parkinson's disease (PD) and other parkinsonian disorder diagnoses were ascertained in two registers, i.e. the National Patient Register (NPR) and the Cause of Death Register (CDR). Diagnoses were validated in terms of accuracy (positive predictive value) and sensitivity against data from a population-based study of PD in 1998-2004 that screened more than 35,000 persons and identified 194 cases of parkinsonian disorders including 132 PD cases (the gold standard for the purposes of this study). RESULTS Accuracy for any parkinsonian disorder diagnoses was 88.0% in the NPR and 94.4% in the CDR. Accuracy of PD diagnoses was 70.8% in the NPR and 66.7% in the CDR. Misclassification between differential parkinsonian diagnoses was common. The accuracy of PD diagnoses in the NPR improved to 83.0% by restricting the definition to primary diagnoses only. The sensitivity of PD diagnoses in the NPR and CDR combined was 83.1%, with a mean time to detection of 6.9 years. CONCLUSIONS Population-based national health registers are valid data sources in epidemiological studies of PD or parkinsonian disorder etiology but are less suitable in studies of incidence or prevalence.
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Affiliation(s)
- Adina L Feldman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Dahodwala N, Siderowf A, Baumgarten M, Abrams A, Karlawish J. Screening questionnaires for parkinsonism: a systematic review. Parkinsonism Relat Disord 2011; 18:216-24. [PMID: 21930414 DOI: 10.1016/j.parkreldis.2011.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 09/02/2011] [Accepted: 09/05/2011] [Indexed: 10/17/2022]
Abstract
Parkinson's disease (PD) is a common, treatable movement disorder that often remains undiagnosed despite clinically manifest symptoms. Screening for parkinsonism could lead to improved detection and earlier treatment, and facilitate research studies of PD prevalence. In order to determine the feasibility of screening, this study evaluated the validity of previously developed screening questionnaires. We systematically searched online databases PubMed and EMBASE for English-language studies published between 1980 and 2009. In each database a "Parkinson(s) disease" or "parkinsonism" term was combined with a screening term ("screening instrument," "screening questionnaire," "screen" or "prevalence survey") and a validity term ("validation," "sensitivity" and "specificity"). Included studies reported the psychometric properties of at least one self-report questionnaire for parkinsonism. Twenty-seven studies met the inclusion criteria. From these studies, 9 screening questionnaires were identified. Sensitivity and specificity estimates varied widely. Sensitivity estimates were as high as 100% when questionnaires were tested among previously diagnosed PD patients and included a high number of parkinsonism specific items, but were as low as 48% when tested among early cases in a community-based sample. Specificity estimates were lower, ranging from 22 to 100%. An older sample, presence of multiple co-morbid conditions and lower literacy led to lower specificity estimates. Higher specificity estimates were seen when the screening questionnaires were administered by a physician. Screening questionnaires can detect symptomatic parkinsonism. However, the performance of these questionnaires varied based on the individual items, study sample, and method of administration. The performance of screening questionnaires in the detection of early or mild parkinsonism was modest.
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Biernacka JM, Armasu SM, Cunningham JM, Ahlskog JE, Chung SJ, Maraganore DM. Do interactions between SNCA, MAPT, and LRRK2 genes contribute to Parkinson's disease susceptibility? Parkinsonism Relat Disord 2011; 17:730-6. [PMID: 21816655 DOI: 10.1016/j.parkreldis.2011.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 06/21/2011] [Accepted: 07/01/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Polymorphisms in SNCA, MAPT and LRRK2 genes have recently been confirmed as risk factors for Parkinson's disease (PD), although with small individual attributable risk. Here we investigated the association of PD with interactions between variants of these genes. METHODS As part of a previous study of PD susceptibility genes 119 SNCA, MAPT, and LRRK2 haplotype tagging single nucleotide polymorphisms (SNPs) and two variable number tandem repeats (VNTRs) were genotyped in 1098 PD cases from the upper Midwest, USA and 1098 matched controls. Twenty-six of these SNPs were selected for SNP-SNP (or SNP-VNTR or VNTR-VNTR) interaction analysis (256 interaction pairs). Case-control analyses were performed to study association of pairwise SNP interactions with PD susceptibility. RESULTS Out of the 256 interaction pairs investigated, 10 had uncorrected p-values <0.05. These represented six SNCA-LRRK2 pairs, three SNCA-MAPT pairs, and one MAPT-LRRK2 pair. However, none of these pairwise interactions were significant after correction for multiple testing. Secondary analyses in strata defined by type of control (sibling or unrelated), sex, or age at onset of the case also did not reveal any significant interactions after accounting for multiple testing. CONCLUSIONS This study provides no statistically significant evidence of gene-gene interaction effects for the three confirmed genetic susceptibility loci for PD. However, this does not exclude the possibility that other genomic loci or environmental risk factors interact with these genes.
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Affiliation(s)
- Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55095, USA
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Moisan F, Gourlet V, Mazurie JL, Dupupet JL, Houssinot J, Goldberg M, Imbernon E, Tzourio C, Elbaz A. Prediction model of Parkinson's disease based on antiparkinsonian drug claims. Am J Epidemiol 2011; 174:354-63. [PMID: 21606234 DOI: 10.1093/aje/kwr081] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Drug claims databases are increasingly available and provide opportunities to investigate epidemiologic questions. The authors used computerized drug claims databases from a social security system in 5 French districts to predict the probability that a person had Parkinson's disease (PD) based on patterns of antiparkinsonian drug (APD) use. Clinical information for a population-based sample of persons using APDs in 2007 was collected. The authors built a prediction model using demographic variables and APDs as predictors and investigated the additional predictive benefit of including information on dose and regularity of use. Among 1,114 APD users, 320 (29%) had PD and 794 (71%) had another diagnosis as determined by study neurologists. A logistic model including information on cumulative APD dose and regularity of use showed good performance (c statistic = 0.953, sensitivity = 92.5%, specificity = 86.4%). Predicted PD prevalence (among persons aged ≥18 years) was 6.66/1,000; correcting this estimate using sensitivity/specificity led to a similar figure (6.04/1,000). These data demonstrate that drug claims databases can be used to estimate the probability that a person is being treated for PD and that information on APD dose and regularity of use improves models' performances. Similar approaches could be developed for other conditions.
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Harris MA, Koehoorn M, Teschke K. Ongoing challenges to finding people with Parkinson’s disease for epidemiological studies: A comparison of population-level case ascertainment methods. Parkinsonism Relat Disord 2011; 17:464-9. [DOI: 10.1016/j.parkreldis.2011.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 02/25/2011] [Accepted: 04/08/2011] [Indexed: 10/18/2022]
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Chung SJ, Armasu SM, Biernacka JM, Lesnick TG, Rider DN, Cunningham JM, Maraganore DM. Variants in estrogen-related genes and risk of Parkinson's disease. Mov Disord 2011; 26:1234-42. [PMID: 21469201 DOI: 10.1002/mds.23604] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 11/24/2010] [Accepted: 11/29/2010] [Indexed: 11/09/2022] Open
Abstract
Incidence rates of Parkinson's disease are higher in men than in women at all ages, and these differences may be a result of the neuroprotective effects of estrogen on the nigrostriatal pathway. We investigated the association of common variants in 4 estrogen-related genes with Parkinson's disease. Tagging single-nucleotide polymorphisms in the CYP19A1, ESR1, ESR2, and PRDM2 genes were selected from the International Haplotype Map and genotyped in 1103 Parkinson's disease cases from the upper Midwest of the United States and in 1103 individually matched controls (654 unaffected siblings, and 449 unrelated controls from the same region). Of 137 informative single-nucleotide polymorphisms, 2 PRDM2 single-nucleotide polymorphisms were significantly associated with an increased risk of Parkinson's disease at the Bonferroni-corrected significance level of 0.0004 (rs2744690: OR, 1.54; SE(logOR), .109; 99.96% CI, 1.05-2.26; uncorrected P = .0001; rs2744687: OR, 1.53; SE(logOR), .113; 99.96% CI, 1.03-2.29, uncorrected P = .0002); the association was significant in the women-only stratum but not in the men-only stratum. An additional 6 single-nucleotide polymorphisms in PRDM2, 2 in ESR1, 1 in ESR2, and 1 in CYP19A1 had significant P values in the overall sample before Bonferroni correction. None of the single-nucleotide polymorphisms were significantly associated with age at onset of Parkinson's disease after Bonferroni correction. Our results confirm the association of PRDM2 variants with Parkinson's disease susceptibility, especially in women.
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Affiliation(s)
- Sun Ju Chung
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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Bademci G, Edwards TL, Torres AL, Scott WK, Züchner S, Martin ER, Vance JM, Wang L. A rare novel deletion of the tyrosine hydroxylase gene in Parkinson disease. Hum Mutat 2011; 31:E1767-71. [PMID: 20809526 PMCID: PMC3025121 DOI: 10.1002/humu.21351] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Tyrosine hydroxylase (TH) enzyme is a rate limiting enzyme in dopamine biosynthesis. Missense mutation in both alleles of the TH gene is known to cause dopamine-related phenotypes, including dystonia and infantile Parkinsonism. However, it is not clear if single allele mutation in TH modifies the susceptibility to the adult form of Parkinson disease (PD). We reported a novel deletion of entire TH gene in an adult with PD. The deletion was first identified by copy number variation (CNV) analysis in a genome-wide association study using Illumina Infinium BeadChips. After screening 635 cases and 642 controls, the deletion was found in one PD case but not in any control. The deletion was confirmed by multiple quantitative PCR (qPCR) assays. There is no additional exonic single nucleotide variant in the one copy of TH gene of the patient. The patient has an age-at-onset of 54 years, no evidence for dystonia, and was responsive to L-DOPA. This case supports the importance of the TH gene in PD pathogenesis and raises more attention to rare variants in candidate genes being a risk factor for Parkinson disease. © 2010 Wiley-Liss, Inc.
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Affiliation(s)
- Güney Bademci
- University of Miami, Miller School of Medicine, John P. Hussman Institute for Human Genomics Miami, FL 33136, USA
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Chung SJ, Armasu SM, Biernacka JM, Lesnick TG, Rider DN, Lincoln SJ, Ortolaza AI, Farrer MJ, Cunningham JM, Rocca WA, Maraganore DM. Common variants in PARK loci and related genes and Parkinson's disease. Mov Disord 2010; 26:280-8. [PMID: 21412835 DOI: 10.1002/mds.23376] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 06/08/2010] [Accepted: 07/05/2010] [Indexed: 01/06/2023] Open
Abstract
Rare mutations in PARK loci genes cause Parkinson's disease (PD) in some families and isolated populations. We investigated the association of common variants in PARK loci and related genes with PD susceptibility and age at onset in an outbred population. A total of 1,103 PD cases from the upper Midwest, USA, were individually matched to unaffected siblings (n = 654) or unrelated controls (n = 449) from the same region. Using a sequencing approach in 25 cases and 25 controls, single nucleotide polymorphisms (SNPs) in species-conserved regions of PARK loci and related genes were detected. We selected additional tag SNPs from the HapMap. We genotyped a total of 235 SNPs and two variable number tandem repeats in the ATP13A2, DJ1, LRRK1, LRRK2, MAPT, Omi/HtrA2, PARK2, PINK1, SNCA, SNCB, SNCG, SPR, and UCHL1 genes in all 2,206 subjects. Case-control analyses were performed to study association with PD susceptibility, while cases-only analyses were used to study association with age at onset. Only MAPT SNP rs2435200 was associated with PD susceptibility after correction for multiple testing (OR = 0.74, 95% CI = 0.64-0.86, uncorrected P < 0.0001, log additive model); however, 16 additional MAPT variants, seven SNCA variants, and one LRRK2, PARK2, and UCHL1 variants each had significant uncorrected P-values. There were no significant associations for age at onset after correction for multiple testing. Our results confirm the association of MAPT and SNCA genes with PD susceptibility but show limited association of other PARK loci and related genes with PD.
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Affiliation(s)
- Sun Ju Chung
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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Bower JH, Grossardt BR, Maraganore DM, Ahlskog JE, Colligan RC, Geda YE, Therneau TM, Rocca WA. Anxious personality predicts an increased risk of Parkinson's disease. Mov Disord 2010; 25:2105-13. [PMID: 20669309 PMCID: PMC3089895 DOI: 10.1002/mds.23230] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We studied the association of three personality traits related to neuroticism with the subsequent risk of Parkinson's disease (PD) using a historical cohort study. We included 7,216 subjects who resided within the 120-mile radius centered in Rochester, MN, at the time they completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965. We considered three MMPI personality scales (pessimistic, anxious, and depressive traits). A total of 6,822 subjects (94.5%) were followed over four decades either actively or passively. During follow-up, 227 subjects developed parkinsonism (156 developed PD). An anxious personality was associated with an increased risk of PD [hazard ratio (HR), 1.63; 95% confidence interval (CI), 1.16-2.27]. A pessimistic personality trait was also associated with an increased risk of PD but only in men (HR = 1.92; 95% CI = 1.20-3.07). By contrast, a depressive trait was not associated with increased risk. Analyses combining scores from the three personality scales into a composite neuroticism score showed an association of neuroticism with PD (HR = 1.54; 95% CI = 1.10-2.16). The association with neuroticism remained significant even when the MMPI was administered early in life (ages 20-39 years). By contrast, none of the three personality traits was associated with the risk of non-PD types of parkinsonism grouped together. Our long-term historical cohort study suggests that an anxious personality trait may predict an increased risk of PD developing many years later.
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Affiliation(s)
- James H Bower
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Arabia G, Grossardt BR, Colligan RC, Bower JH, Maraganore DM, Ahlskog JE, Geda YE, Rocca WA. Novelty seeking and introversion do not predict the long-term risk of Parkinson disease. Neurology 2010; 75:349-57. [PMID: 20660865 DOI: 10.1212/wnl.0b013e3181ea15fd] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE It has been suggested that people who develop Parkinson disease (PD) may have a characteristic premorbid personality. We tested this hypothesis using a large historical cohort study with long follow-up. METHODS We conducted a historical cohort study in the region including the 120-mile radius centered in Rochester, MN. We recruited 7,216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 through 1965 and we considered 5 MMPI scales to measure sensation seeking, hypomania, positive emotionality, social introversion, and constraint. A total of 6,822 subjects (94.5% of the baseline sample) were followed over 4 decades either actively (via interview and examination) or passively (via medical records). RESULTS During follow-up, 227 subjects developed parkinsonism (156 developed PD). The 3 MMPI scales that we selected to measure the extroverted personality construct (sensation seeking, hypomania, and positive emotionality) did not show the expected pattern of higher scores associated with reduced risk of PD. Similarly, the 2 MMPI scales that we selected to measure the introverted personality construct (social introversion and constraint) did not show the expected pattern of higher scores associated with increased risk of PD. However, higher scores for constraint were associated with an increased risk of all types of parkinsonism pooled together (hazard ratio 1.39; 95% CI 1.06-1.84; p = 0.02). CONCLUSIONS We suggest that personality traits related to introversion and extroversion do not predict the risk of PD.
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Affiliation(s)
- G Arabia
- Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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Hennecke G, Scherzer CR. RNA biomarkers of Parkinson's disease: developing tools for novel therapies. Biomark Med 2010; 2:41-53. [PMID: 20477362 DOI: 10.2217/17520363.2.1.41] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
By 2030 the number of individuals with Parkinson's disease (PD) will nearly double to approximately 9.3 million because of aging populations. No medications have been approved that address the progressive neurodegeneration that underlies the disease and existing symptomatic treatments are only partially effective. Reliance on insensitive and confounded clinical assessments has obstructed the development of novel therapeutics designed to prevent, delay or slow the disease. While PD symptoms reflect preferential neuronal death, DNA, RNA and biochemical traits of the disease are detectable in blood cells. To systematically search for lead RNA biomarkers of PD, genome-wide expression changes in the blood of patients with early-stage PD and controls have been probed by microarray. This scan identified a candidate gene signature, as well as lead single gene biomarkers associated with PD. Efforts are underway to refine and develop these hits into biomarkers that will enable risk-modifying therapies. This development process will progress through discovery, cross-sectional and prospective clinical biomarker studies, to Phase III clinical trials.
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Affiliation(s)
- Gerrit Hennecke
- Harvard Medical School and Brigham and Women's Hospital, Laboratory for Neurogenomics, Center for Neurologic Diseases, 65 Landsdowne Street, Cambridge, MA 02139, USA
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Edwards TL, Scott WK, Almonte C, Burt A, Powell EH, Beecham GW, Wang L, Züchner S, Konidari I, Wang G, Singer C, Nahab F, Scott B, Stajich JM, Pericak-Vance M, Haines J, Vance JM, Martin ER. Genome-wide association study confirms SNPs in SNCA and the MAPT region as common risk factors for Parkinson disease. Ann Hum Genet 2010; 74:97-109. [PMID: 20070850 DOI: 10.1111/j.1469-1809.2009.00560.x] [Citation(s) in RCA: 360] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Parkinson disease (PD) is a chronic neurodegenerative disorder with a cumulative prevalence of greater than one per thousand. To date three independent genome-wide association studies (GWAS) have investigated the genetic susceptibility to PD. These studies implicated several genes as PD risk loci with strong, but not genome-wide significant, associations. In this study, we combined data from two previously published GWAS of Caucasian subjects with our GWAS of 604 cases and 619 controls for a joint analysis with a combined sample size of 1752 cases and 1745 controls. SNPs in SNCA (rs2736990, p-value = 6.7 x 10(-8); genome-wide adjusted p = 0.0109, odds ratio (OR) = 1.29 [95% CI: 1.17-1.42] G vs. A allele, population attributable risk percent (PAR%) = 12%) and the MAPT region (rs11012, p-value = 5.6 x 10(-8); genome-wide adjusted p = 0.0079, OR = 0.70 [95% CI: 0.62-0.79] T vs. C allele, PAR%= 8%) were genome-wide significant. No other SNPs were genome-wide significant in this analysis. This study confirms that SNCA and the MAPT region are major genes whose common variants are influencing risk of PD.
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Affiliation(s)
- Todd L Edwards
- John P. Hussman Institute for Human Genomics, University of Miami, FL 33136, USA
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Wong KT, Grove JS, Grandinetti A, Curb JD, Yee M, Blanchette P, Ross GW, Rodriguez BI. Association of fibrinogen with Parkinson disease in elderly Japanese-American men: a prospective study. Neuroepidemiology 2009; 34:50-4. [PMID: 19940513 DOI: 10.1159/000260070] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 07/24/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of this prospective study was to examine whether fibrinogen level is associated with Parkinson disease (PD) for both prevalent and incident cases. METHODS The Honolulu Asia-Aging Study is a longitudinal study of Japanese-American men based on the Honolulu Heart Study birth cohort. The original cohort consisted of 8,006 participants with selective service records who were living on the island of Oahu, Hawaii, in 1965. For this analysis, baseline was defined as the 1991-1993 examination (n = 3,845) when men were aged 71-93 years old. Multivariate logistic regression and Cox proportional hazards models were used, adjusting for potential confounders. RESULTS We identified 61 prevalent cases and 61 incident cases of PD during the follow-up. High fibrinogen level (presence in the top quintile) was associated with higher frequency of PD for both prevalent (OR = 2.07, 95% CI = 1.10-3.88, p = 0.024) and incident cases (HR = 3.05, 95% CI = 1.34-6.97, p = 0.008) among men aged 76-93 years, after adjusting for age, smoking, and low-density lipoprotein cholesterol. CONCLUSIONS These results suggest high fibrinogen level is associated with increased risk of PD among men over 75 years.
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Affiliation(s)
- K T Wong
- Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
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Sutherland GT, Halliday GM, Silburn PA, Mastaglia FL, Rowe DB, Boyle RS, O'Sullivan JD, Ly T, Wilton SD, Mellick GD. Do polymorphisms in the familial Parkinsonism genes contribute to risk for sporadic Parkinson's disease? Mov Disord 2009; 24:833-8. [PMID: 19224617 DOI: 10.1002/mds.22214] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Recent whole genome association studies provided little evidence that polymorphisms at the familial Parkinsonism loci influence the risk for Parkinson's disease (PD). However, these studies are not designed to detect the types of subtle effects that common variants may impose. Here, we use an alternative targeted candidate gene approach to examine common variation in 11 genes related to familial Parkinsonism. PD cases (n = 331) and unaffected control subjects (n = 296) were recruited from three specialist movement disorder clinics in Brisbane, Australia and the Australian Electoral Roll. Common genetic variables (76 SNPs and 1 STR) were assessed in all subjects and haplotype, genotype, and allele associations explored. Modest associations (uncorrected P < 0.05) were observed for common variants around SNCA, UCHL1, MAPT, and LRRK2 although none were of sufficient magnitude to survive strict statistical corrections for multiple comparisons. No associations were seen for PRKN, PINK1, GBA, ATP13A2, HTRA2, NR4A2, and DJ1. Our findings suggest that common genetic variables of selected PD-related loci contribute modestly to PD risk in Australians.
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Affiliation(s)
- Greg T Sutherland
- Eskitis Institute for Cell and Molecular Therapies, School of Biomolecular and Physical Sciences, Griffith University, Brisbane, Queensland, Australia
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A Swedish family with de novo alpha-synuclein A53T mutation: evidence for early cortical dysfunction. Parkinsonism Relat Disord 2009; 15:627-32. [PMID: 19632874 DOI: 10.1016/j.parkreldis.2009.06.007] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 05/22/2009] [Accepted: 06/19/2009] [Indexed: 11/20/2022]
Abstract
A de novo alpha-synuclein A53T (p.Ala53 Th; c.209G > A) mutation has been identified in a Swedish family with autosomal dominant Parkinson's disease (PD). Two affected individuals had early-onset (before 31 and 40 years), severe levodopa-responsive PD with prominent dysphasia, dysarthria, and cognitive decline. Longitudinal clinical follow-up, EEG, SPECT and CSF biomarker examinations suggested an underlying encephalopathy with cortical involvement. The mutated allele (c.209A) was present within a haplotype different from that shared among mutation carriers in the Italian (Contursi) and the Greek-American Family H kindreds. One unaffected family member carried the mutation haplotype without the c.209A mutation, strongly suggesting its de novo occurrence within this family. Furthermore, a novel mutation c.488G > A (p.Arg163His; R163H) in the presenilin-2 (PSEN2) gene was detected, but was not associated with disease state.
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Facheris MF, Schneider NK, Lesnick TG, de Andrade M, Cunningham JM, Rocca WA, Maraganore DM. Coffee, caffeine-related genes, and Parkinson's disease: a case-control study. Mov Disord 2009; 23:2033-40. [PMID: 18759349 DOI: 10.1002/mds.22247] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
An inverse association between coffee and Parkinson's disease (PD) has been reported. However, it remains uncertain why some but not all coffee drinkers are less susceptible to PD. We considered the possibility of a pharmacogenetic effect. In our study, we included 1,208 subjects (446 case-unaffected sibling pairs and 158 case-unrelated control pairs) recruited from an ongoing study of the molecular epidemiology of PD in the Upper Midwest (USA). We collected information on lifetime coffee drinking and we studied two genes: ADORA2A, which encodes the major receptor activity of caffeine in the brain (variants rs5751876 and rs3032740), and CYP1A2, which encodes the major rate-limiting step of caffeine metabolism (variants rs35694136 and rs762551). We did not observe significant associations of coffee drinking or of the genetic variants with PD susceptibility, either independently or jointly, in the sample overall and in most strata. Our study neither supports the hypothesis that coffee protects against PD nor provides evidence for a pharmacogenetic effect.
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Brighina L, Schneider NK, Lesnick TG, de Andrade M, Cunningham JM, Mrazek D, Rocca WA, Maraganore DM. Alpha-synuclein, alcohol use disorders, and Parkinson disease: a case-control study. Parkinsonism Relat Disord 2009; 15:430-4. [PMID: 19196539 DOI: 10.1016/j.parkreldis.2008.11.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Revised: 11/06/2008] [Accepted: 11/13/2008] [Indexed: 10/21/2022]
Abstract
Collaborative pooled analyses demonstrated that allele length variability of the dinucleotide repeat sequence within the alpha-synuclein gene promoter (SNCA REP1) is associated with Parkinson disease (PD) worldwide. Other studies demonstrated that variability in the SNCA promoter is also associated with alcohol use disorders, but not consistently. Yet other studies demonstrated that alcohol use disorders are inversely associated with PD, but not consistently. The aim of this study was to clarify the patterns of association between REP1 genotype, alcohol use disorders, and PD. Cases were recruited from the Department of Neurology of the Mayo Clinic in Rochester, MN. The controls included unaffected siblings and unrelated controls. We assessed alcohol use via a structured telephone interview and screened for alcohol use disorders using the CAGE questionnaire. REP1 genotyping was performed using an ABI 3730XL platform. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using conditional logistic regression models. We recruited 893 case-control pairs. There was an increasing risk of PD with increasing SNCA REP1 allele length (OR 1.18 for each REP1 genotype score unit, 95% CI 1.02-1.35; p=0.02). There was a decreasing risk of PD with increasing CAGE score (p=0.01). The association of REP1 score with PD remained significant after adjusting for CAGE score, and the association of CAGE score with PD remained significant after adjusting for REP1 score. There were no pairwise interactions. Our findings suggest that SNCA REP1 genotype and alcohol use disorders are independently associated with PD.
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Affiliation(s)
- Laura Brighina
- Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Monza, Italy
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Wirdefeldt K, Gatz M, Bakaysa SL, Fiske A, Flensburg M, Petzinger GM, Widner H, Lew MF, Welsh M, Pedersen NL. Complete ascertainment of Parkinson disease in the Swedish Twin Registry. Neurobiol Aging 2007; 29:1765-73. [PMID: 17532098 PMCID: PMC2662365 DOI: 10.1016/j.neurobiolaging.2007.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Revised: 03/09/2007] [Accepted: 04/07/2007] [Indexed: 10/23/2022]
Abstract
This report describes the ascertainment of Parkinson disease (PD) in all individuals aged 50 years or older (49,814 individuals) from the Swedish Twin Registry. In phase one of the study, all twins were screened for PD using telephone interviews, with a response rate of 72.7%. In phase two, twins with suspected PD were re-contacted to exclude anyone from follow-up who reported parkinsonian symptoms due to diseases other than PD. In the third phase, in-person clinical evaluations were completed for twins who were still considered PD suspects after phase two and for a sample of co-twins. During the clinical evaluations, we also collected blood samples and information about a variety of environmental exposures. Overall prevalence rate for PD was 496 per 100,000 individuals. Among the 132 PD cases identified, there were only three concordant twin pairs. In total 7.2% of PD cases reported a first degree relative with PD.
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Affiliation(s)
- Karin Wirdefeldt
- Department of Medical Epidemiology and Biostatistics, Box 281, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Margaret Gatz
- Department of Medical Epidemiology and Biostatistics, Box 281, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Psychology, University of Southern California, Los Angeles, California 90089-1061, USA
| | - Stephanie L. Bakaysa
- Department of Medical Epidemiology and Biostatistics, Box 281, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Amy Fiske
- Department of Psychology, West Virginia University, PO Box 6040, Morgantown, West Virginia 26506, USA
| | - Måns Flensburg
- Department of Medical Epidemiology and Biostatistics, Box 281, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Giselle M. Petzinger
- Department of Neurology, Keck/University of Southern California School of Medicine, 1520 San Pablo Suite 3000, Los Angeles, California 90033, USA
| | - Håkan Widner
- Department of Clinical Neurosciences, Section for Neurology, Lund University Hospital, 221 85, Lund, Sweden
| | - Mark F. Lew
- Department of Neurology, Keck/University of Southern California School of Medicine, 1520 San Pablo Suite 3000, Los Angeles, California 90033, USA
| | - Mickie Welsh
- Department of Neurology, Keck/University of Southern California School of Medicine, 1520 San Pablo Suite 3000, Los Angeles, California 90033, USA
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Box 281, Karolinska Institutet, SE-171 77 Stockholm, Sweden
- Department of Psychology, University of Southern California, Los Angeles, California 90089-1061, USA
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47
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Brighina L, Okubadejo NU, Schneider NK, Lesnick TG, de Andrade M, Cunningham JM, Farrer MJ, Lincoln SJ, Rocca WA, Maraganore DM. Beta-synuclein gene variants and Parkinson's disease: a preliminary case-control study. Neurosci Lett 2007; 420:229-34. [PMID: 17556099 PMCID: PMC1978171 DOI: 10.1016/j.neulet.2007.05.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 03/30/2007] [Accepted: 05/05/2007] [Indexed: 12/11/2022]
Abstract
Aggregation and fibrillization of the alpha-synuclein protein, which is the main component of Lewy bodies, may represent important processes in the pathogenesis of Parkinson's disease (PD). Several in vivo and in vitro studies suggest that beta-synuclein may be a natural negative regulator of alpha-synuclein aggregation and fibrillization. The goal of the present study was to investigate the association of two polymorphisms (rs35035889 and rs1352303) in the beta-synuclein (SNCB) gene with PD. Our case-control study included a total of 370 case-unaffected sibling pairs and 168 case-unrelated control pairs (538 pairs total). The subjects were recruited from an ongoing study of the molecular epidemiology of PD in the Upper Midwest (USA). We employed a liberalization of the sibling transmission disequilibrium test to study the main effects of the gene variants for subjects overall and for strata defined by age at study, gender, ethnicity, clinical diagnostic certainty, dementia, and family history of PD (adjusted for age at study and gender as appropriate). The analyses were conducted for each SNCB variant separately, and also for two-locus haplotypes using score tests. Neither of the SNCB SNPs examined were associated with PD overall or in strata, and haplotype analyses were negative as well. However, one of the two SNPs (rs1352303) was associated with a delayed age at onset of PD in women. The results of this preliminary study suggest that the SNCB locus, though not a susceptibility gene for PD, might modify the age at onset of PD.
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Affiliation(s)
- Laura Brighina
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Njide U. Okubadejo
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Nicole K. Schneider
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Timothy G. Lesnick
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Mariza de Andrade
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Julie M. Cunningham
- Department of Laboratory Medicine, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Matthew J. Farrer
- Department of Neuroscience, Mayo Clinic College of Medicine, Jacksonville, FL USA
| | - Sarah J. Lincoln
- Department of Neuroscience, Mayo Clinic College of Medicine, Jacksonville, FL USA
| | - Walter A. Rocca
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN USA
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN USA
| | - Demetrius M. Maraganore
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN USA
- *Corresponding author. Department of Neurology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905. Tel.: 507 538 1038; fax: 507 284 3665. E-mail address: (D. Maraganore)
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48
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Smiley-Oyen AL, Lowry KA, Kerr JP. Planning and control of sequential rapid aiming in adults with Parkinson's disease. J Mot Behav 2007; 39:103-14. [PMID: 17428756 DOI: 10.3200/jmbr.39.2.103-114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Eight people with Parkinson's disease (PD), 8 age-matched older adults, and 8 young adults executed 3-dimensional rapid aiming movements to 1, 3, 5, and 7 targets. Reaction time, flight time, and time after peak velocity to the 1st target indicated that both neurologically healthy groups implemented a plan on the basis of anticipation of upcoming targets, whereas the PD group did not. One suggested reason for the PD group's deficiency in anticipatory control is the greater variability in their initial force impulse. Although the PD group scaled peak velocity and time to peak velocity similarly to the other groups, their coefficients of variation were greater, making consistent prediction of the movement outcome difficult and thus making it less advantageous to plan too far in advance. A 2nd finding was that the PD group exhibited increased slowing in time after peak velocity in the final segments of the longest sequence, whereas the other 2 groups did not. The increased slowing could be the result of a different movement strategy, increased difficulty modulating the agonist and antagonist muscle groups later in the sequence, or both. The authors conclude that people with PD use more segmented planning and control strategies than do neurologically healthy older and young adults when executing movement sequences and that the locus of increased bradykinesia in longer sequences is in the deceleration phase of movement.
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Affiliation(s)
- A L Smiley-Oyen
- Motor Control and Learning Research Laboratory, Department of Health and Human Performance, Iowa State University, Ames 50011, USA.
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49
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Scherzer CR, Eklund AC, Morse LJ, Liao Z, Locascio JJ, Fefer D, Schwarzschild MA, Schlossmacher MG, Hauser MA, Vance JM, Sudarsky LR, Standaert DG, Growdon JH, Jensen RV, Gullans SR. Molecular markers of early Parkinson's disease based on gene expression in blood. Proc Natl Acad Sci U S A 2007; 104:955-60. [PMID: 17215369 PMCID: PMC1766335 DOI: 10.1073/pnas.0610204104] [Citation(s) in RCA: 338] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) progresses relentlessly and affects five million people worldwide. Laboratory tests for PD are critically needed for developing treatments designed to slow or prevent progression of the disease. We performed a transcriptome-wide scan in 105 individuals to interrogate the molecular processes perturbed in cellular blood of patients with early-stage PD. The molecular multigene marker here identified is associated with risk of PD in 66 samples of the training set comprising healthy and disease controls [third tertile cross-validated odds ratio of 5.7 (P for trend 0.005)]. It is further validated in 39 independent test samples [third tertile odds ratio of 5.1 (P for trend 0.04)]. Insights into disease-linked processes detectable in peripheral blood are offered by 22 unique genes differentially expressed in patients with PD versus healthy individuals. These include the co-chaperone ST13, which stabilizes heat-shock protein 70, a modifier of alpha-synuclein misfolding and toxicity. ST13 messenger RNA copies are lower in patients with PD (mean +/- SE 0.59 +/- 0.05) than in controls (0.96 +/- 0.09) (P = 0.002) in two independent populations. Thus, gene expression signals measured in blood can facilitate the development of biomarkers for PD.
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Affiliation(s)
- Clemens R Scherzer
- Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA.
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50
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Rocca WA, Bower JH, Ahlskog JE, Elbaz A, Grossardt BR, McDonnell SK, Schaid DJ, Maraganore DM. Increased risk of essential tremor in first-degree relatives of patients with Parkinson's disease. Mov Disord 2007; 22:1607-14. [PMID: 17546668 DOI: 10.1002/mds.21584] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We conducted a historical cohort study of 981 first-degree relatives of 162 patients with Parkinson's disease (PD) and of 838 first-degree relatives of 147 controls representative of the population of Olmsted County, Minnesota. In addition, we studied 2,684 first-degree relatives of 411 patients with PD referred to the Mayo Clinic. Relatives were interviewed and screened for tremor either directly or through a proxy, and those who screened positive were examined or copies of their medical records were obtained to confirm the diagnosis of essential tremor (ET). We also obtained ET information from a medical records-linkage system (family study method). In the population-based sample, the risk of ET was significantly increased for relatives of patients with onset of PD<or=66 years (first tertile; hazard ratio [HR]=2.24; 95% confidence interval [95% CI]=1.26-3.98; P=0.006). In the referral-based sample, the risk of ET among relatives increased with younger onset of PD in patients (linear trend; P=0.001), and was higher in relatives of PD patients with the tremor-predominant or mixed form when compared with relatives of patients with the akinetic-rigid form, and in men compared with women. These findings suggest that PD and ET may share familial susceptibility factors.
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Affiliation(s)
- Walter A Rocca
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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