1
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Yang Z, Feng R, Zhao H. Cuproptosis and Cu: a new paradigm in cellular death and their role in non-cancerous diseases. Apoptosis 2024:10.1007/s10495-024-01993-y. [PMID: 39014119 DOI: 10.1007/s10495-024-01993-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/18/2024]
Abstract
Cuproptosis, a newly characterized form of regulated cell death driven by copper accumulation, has emerged as a significant mechanism underlying various non-cancerous diseases. This review delves into the complex interplay between copper metabolism and the pathogenesis of conditions such as Wilson's disease (WD), neurodegenerative disorders, and cardiovascular pathologies. We examine the molecular mechanisms by which copper dysregulation induces cuproptosis, highlighting the pivotal roles of key copper transporters and enzymes. Additionally, we evaluate the therapeutic potential of copper chelation strategies, which have shown promise in experimental models by mitigating copper-induced cellular damage and restoring physiological homeostasis. Through a comprehensive synthesis of recent advancements and current knowledge, this review underscores the necessity of further research to translate these findings into clinical applications. The ultimate goal is to harness the therapeutic potential of targeting cuproptosis, thereby improving disease management and patient outcomes in non-cancerous conditions associated with copper dysregulation.
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Affiliation(s)
- Zhibo Yang
- Department of Neurosurgery, 3201 Hospital of Xi'an Jiaotong University Health Science Center, Hanzhong, 723000, Shaanxi, China
| | - Ridong Feng
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU), 79 Qingchun Rd., Shangcheng District, Hangzhou, 330100, Zhejiang, China
| | - Hai Zhao
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266005, Shandong, China.
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2
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Kluge A, Iranzo A. Biofluid Detection of Pathological α-Synuclein in the Prodromal Phase of Synucleinopathies. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230429. [PMID: 38995801 DOI: 10.3233/jpd-230429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Synucleinopathies are disorders characterized by the aggregation and deposition of pathological α-synuclein conformers. The underlying neurodegenerative processes begin years or decades before the onset of cardinal motor symptoms. This prodromal phase may manifest with various signs or symptoms. However, there are no current standardized laboratory tests to ascertain the progression and conversion of prodromal conditions such as mild cognitive impairment, isolated REM sleep behavior disorder or pure autonomic failure. The aim of this systematic review was to evaluate the diagnostic possibilities using human biofluids as source material to detect pathological α-synuclein in the prodromal phase of synucleinopathies. Our review identified eight eligible studies, that investigated pathological α-synuclein conformers using cerebrospinal fluid from patients with prodromal signs of synulceinopathies to differentiate this patient group from non-synucleinopathies, while only one study investigated this aspect using blood as medium. While previous studies clearly demonstrated a high diagnostic performance of α-synuclein seed amplification assays for differentiating synucleinopathies with Lewy bodies from healthy controls, only few analyses were performed focussing on individuals with prodromal disease. Nevertheless, results for the early detection of α-synuclein seeds using α-synuclein seed amplification assays were promising and may be of particular relevance for future clinical trials and clinical practice.
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Affiliation(s)
- Annika Kluge
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Kiel University, Germany
| | - Alex Iranzo
- Sleep Unit, Neurology Service, Hospital Clínic Barcelona, Barcelona University, IDIBAPS, CIBERNED, Spain
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3
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Straumann N, Combes BF, Dean Ben XL, Sternke-Hoffmann R, Gerez JA, Dias I, Chen Z, Watts B, Rostami I, Shi K, Rominger A, Baumann CR, Luo J, Noain D, Nitsch RM, Okamura N, Razansky D, Ni R. Visualizing alpha-synuclein and iron deposition in M83 mouse model of Parkinson's disease in vivo. Brain Pathol 2024:e13288. [PMID: 38982662 DOI: 10.1111/bpa.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
Abnormal alpha-synuclein (αSyn) and iron accumulation in the brain play an important role in Parkinson's disease (PD). Herein, we aim to visualize αSyn inclusions and iron deposition in the brains of M83 (A53T) mouse models of PD in vivo. The fluorescent pyrimidoindole derivative THK-565 probe was characterized by means of recombinant fibrils and brains from 10- to 11-month-old M83 mice. Concurrent wide-field fluorescence and volumetric multispectral optoacoustic tomography (vMSOT) imaging were subsequently performed in vivo. Structural and susceptibility weighted imaging (SWI) magnetic resonance imaging (MRI) at 9.4 T as well as scanning transmission x-ray microscopy (STXM) were performed to characterize the iron deposits in the perfused brains. Immunofluorescence and Prussian blue staining were further performed on brain slices to validate the detection of αSyn inclusions and iron deposition. THK-565 showed increased fluorescence upon binding to recombinant αSyn fibrils and αSyn inclusions in post-mortem brain slices from patients with PD and M83 mice. Administration of THK-565 in M83 mice showed higher cerebral retention at 20 and 40 min post-intravenous injection by wide-field fluorescence compared to nontransgenic littermate mice, in congruence with the vMSOT findings. SWI/phase images and Prussian blue indicated the accumulation of iron deposits in the brains of M83 mice, presumably in the Fe3+ form, as evinced by the STXM results. In conclusion, we demonstrated in vivo mapping of αSyn by means of noninvasive epifluorescence and vMSOT imaging and validated the results by targeting the THK-565 label and SWI/STXM identification of iron deposits in M83 mouse brains ex vivo.
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Affiliation(s)
- Nadja Straumann
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Benjamin F Combes
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Xose Luis Dean Ben
- Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | | | - Juan A Gerez
- Laboratory of Physical Chemistry, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Ines Dias
- Neurology Department, University Hospital Zurich, Zurich, Switzerland
| | - Zhenyue Chen
- Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Benjamin Watts
- Photon Science Division, Paul Scherrer Institute, Villigen, Switzerland
| | - Iman Rostami
- Microscopic Anatomy and Structural Biology, University of Bern, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Jinghui Luo
- Department of Biology and Chemistry, Paul Scherrer Institute, Villigen, Switzerland
| | - Daniela Noain
- Neurology Department, University Hospital Zurich, Zurich, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Daniel Razansky
- Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Ruiqing Ni
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
- Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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4
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Okubadejo NU, Okun MS, Jankovic J. Tapping the Brakes on New Parkinson Disease Biological Staging. JAMA Neurol 2024:2820441. [PMID: 38976240 DOI: 10.1001/jamaneurol.2024.2054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
This Viewpoint cautions against the premature adoption and implementation of biological definitions for Parkinson disease proposed in February 2024.
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Affiliation(s)
- Njideka U Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Idi Araba, Nigeria
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida Health, Gainesville
- Associate Editor, JAMA Neurology
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas
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5
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Zarkali A, Thomas GEC, Zetterberg H, Weil RS. Neuroimaging and fluid biomarkers in Parkinson's disease in an era of targeted interventions. Nat Commun 2024; 15:5661. [PMID: 38969680 PMCID: PMC11226684 DOI: 10.1038/s41467-024-49949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 06/19/2024] [Indexed: 07/07/2024] Open
Abstract
A major challenge in Parkinson's disease is the variability in symptoms and rates of progression, underpinned by heterogeneity of pathological processes. Biomarkers are urgently needed for accurate diagnosis, patient stratification, monitoring disease progression and precise treatment. These were previously lacking, but recently, novel imaging and fluid biomarkers have been developed. Here, we consider new imaging approaches showing sensitivity to brain tissue composition, and examine novel fluid biomarkers showing specificity for pathological processes, including seed amplification assays and extracellular vesicles. We reflect on these biomarkers in the context of new biological staging systems, and on emerging techniques currently in development.
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Affiliation(s)
- Angeliki Zarkali
- Dementia Research Centre, Institute of Neurology, UCL, London, UK.
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Rimona S Weil
- Dementia Research Centre, Institute of Neurology, UCL, London, UK
- Department of Advanced Neuroimaging, UCL, London, UK
- Movement Disorders Centre, UCL, London, UK
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6
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Schaeffer E, Yilmaz R, St Louis EK, Noyce AJ. Ethical Considerations for Identifying Individuals in the Prodromal/Early Phase of Parkinson's Disease: A Narrative Review. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230428. [PMID: 38995800 DOI: 10.3233/jpd-230428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
The ability to identify individuals in the prodromal phase of Parkinson's disease has improved in recent years, raising the question of whether and how those affected should be informed about the risk of future disease. Several studies investigated prognostic counselling for individuals with isolated REM sleep behavior disorder and have shown that most patients want to receive information about prognosis, but autonomy and individual preferences must be respected. However, there are still many unanswered questions about risk disclosure or early diagnosis of PD, including the impact on personal circumstances, cultural preferences and specific challenges associated with different profiles of prodromal symptoms, genetic testing or biomarker assessments. This narrative review aims to summarize the current literature on prognostic counselling and risk disclosure in PD, as well as highlight future perspectives that may emerge with the development of new biomarkers and their anticipated impact on the definition of PD.
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Affiliation(s)
- Eva Schaeffer
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Kiel University, Kiel, Germany
| | - Rezzak Yilmaz
- Department of Neurology, Ankara University School of Medicine, Ankara, Turkey
- Ankara University Brain Research Center, Ankara, Turkey
| | - Erik K St Louis
- Mayo Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic Health System Southwest Wisconsin, La Crosse, WI, USA
| | - Alastair J Noyce
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
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7
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Ketchum FB, Chin NA. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:659. [PMID: 38876734 DOI: 10.1016/s1474-4422(24)00217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Fred B Ketchum
- University of Wisconsin Madison School of Medicine and Public Health, Madison, WI 53705, USA.
| | - Nathaniel A Chin
- University of Wisconsin Madison School of Medicine and Public Health, Madison, WI 53705, USA
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8
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Filippi M, Margoni M, Rocca MA. Multiple sclerosis diagnosis: a biologically driven perspective. Lancet Neurol 2024; 23:668-669. [PMID: 38876743 DOI: 10.1016/s1474-4422(24)00207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Monica Margoni
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
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9
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Kobayashi R, Iwata-Endo K, Fujishiro H. Clinical presentations and diagnostic application of proposed biomarkers in psychiatric-onset prodromal dementia with Lewy bodies. Psychogeriatrics 2024; 24:1004-1022. [PMID: 38837629 DOI: 10.1111/psyg.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
Research criteria for the diagnosis of prodromal dementia with Lewy bodies (DLB) include three clinical subtypes: mild cognitive impairment with Lewy bodies (MCI-LB), delirium-onset prodromal DLB, and psychiatric-onset prodromal DLB. Late-onset psychiatric manifestations are at a higher risk of developing dementia, but its relation to prodromal DLB remains unclear. In addition to the risk of severe antipsychotic hypersensitivity reactions, accurate discrimination from non-DLB cases is important due to the potential differences in management and prognosis. This article aims to review a rapidly evolving psychiatric topic and outline clinical pictures of psychiatric-onset prodromal DLB, including the proposed biomarker findings of MCI-LB: polysomnography-confirmed rapid eye movement sleep behaviour disorder, cardiac [123I]metaiodobenzylguanidine scintigraphy, and striatal dopamine transporter imaging. We first reviewed clinical pictures of patients with autopsy-confirmed DLB. Regarding clinical reports, we focused on the patients who predominantly presented with psychiatric manifestations and subsequently developed DLB. Thereafter, we reviewed clinical studies regarding the diagnostic applications of the proposed biomarkers to patients with late-onset psychiatric disorders. Clinical presentations were mainly late-onset depression and psychosis; however, other clinical manifestations were also reported. Psychotropic medications before a DLB diagnosis may cause extrapyramidal signs, and potentially influences the proposed biomarker findings. These risks complicate clinical manifestation interpretation during the management of psychiatric symptoms. Longitudinal follow-up studies with standardised evaluations until conversion to DLB are needed to investigate the temporal trajectories of core features and proposed biomarker findings. In patients with late-onset psychiatric disorders, identification of patients with psychiatric-onset prodromal DLB provides the opportunity to better understanding the distinct prognostic subgroup that is at great risk of incident dementia. Advances in the establishment of direct biomarkers for the detection of pathological α-synuclein may encourage reorganising the phenotypic variability of prodromal DLB.
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Affiliation(s)
- Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Kuniyuki Iwata-Endo
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshige Fujishiro
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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10
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Soto C. α-Synuclein seed amplification technology for Parkinson's disease and related synucleinopathies. Trends Biotechnol 2024; 42:829-841. [PMID: 38395703 PMCID: PMC11223967 DOI: 10.1016/j.tibtech.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Synucleinopathies are a group of neurodegenerative diseases (NDs) associated with cerebral accumulation of α-synuclein (αSyn) misfolded aggregates. At this time, there is no effective treatment to stop or slow down disease progression, which in part is due to the lack of an early and objective biochemical diagnosis. In the past 5 years, the seed amplification technology has emerged for highly sensitive identification of these diseases, even at the preclinical stage of the illness. Much research has been done in multiple laboratories to validate the efficacy and reproducibility of this assay. This article provides a comprehensive review of this technology, including its conceptual basis and its multiple applications for disease diagnosis, as well for understanding of the disease biology and therapeutic development.
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Affiliation(s)
- Claudio Soto
- Mitchell Center for Alzheimer's Disease and Related Brain Disorders, Department of Neurology, University of Texas McGovern Medical School, Houston, TX77030, USA.
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11
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Lang AE, Höglinger GU, Adler CH, Berg D, Klein C, Outeiro TF, Poewe W, Postuma R, Stoessl AJ. Concerns with the new biological research criteria for synucleinopathy - Authors' reply. Lancet Neurol 2024; 23:666-668. [PMID: 38876742 DOI: 10.1016/s1474-4422(24)00212-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Anthony E Lang
- University Health Network's Krembil Brain Institute, Edmond J Safra Program in Parkinson's Disease and the Rossy PSP Centre, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada.
| | - Günter U Höglinger
- Department of Neurology, University Hospital, LudwigMaximilians-University (LMU) and German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Daniela Berg
- Christian Albrechts University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lüebeck, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Werner Poewe
- Medical University Innsbruck, Innsbruck, Austria
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and Parkinson's Foundation Centre of Excellence, University of British Columbia, BC, Canada
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12
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Goldman JG, Boeve BF, Galasko D, Galvin JE, Leverenz JB, Taylor JP. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:660-661. [PMID: 38876736 DOI: 10.1016/s1474-4422(24)00225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/15/2024] [Accepted: 05/14/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Jennifer G Goldman
- Barrow Neurological Institute, Department of Neurology, Phoenix, AZ 85013, USA; JPG Enterprises, Chicago, IL, USA.
| | | | - Doug Galasko
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurologic Institute Cleveland Clinic, Cleveland, OH, USA
| | - John-Paul Taylor
- Mental Health, Dementia and Neurodegeneration Theme, Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
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13
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Simuni T, Chahine LM, Weintraub D, Poston KM, Kopil CM, Dunn B, Marek K. Concerns with the new biological research criteria for synucleinopathy - Authors' reply. Lancet Neurol 2024; 23:663-666. [PMID: 38876741 DOI: 10.1016/s1474-4422(24)00233-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/24/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Tanya Simuni
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
| | - Lana M Chahine
- Department of Neurology, University of Pittsburgh, PA, USA
| | - Daniel Weintraub
- University of Pennsylvania and the Parkinson's Disease and Mental Research, Education and Clinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Kathleen M Poston
- Department of Neurology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Catherine M Kopil
- Michael J Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Billy Dunn
- Michael J Fox Foundation for Parkinson's Research, New York, NY, USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
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14
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Reis J, Tranchant C, Lucchini RG, Spencer PS. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:663. [PMID: 38876740 DOI: 10.1016/s1474-4422(24)00215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Jacques Reis
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France; Association RISE, Oberhausbergen 67205, France.
| | - Christine Tranchant
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Roberto G Lucchini
- Environmental Health Sciences, Florida International University, Miami, FL, USA; University of Modena and Reggio Emilia, Modena, Italy
| | - Peter S Spencer
- Department of Neurology, School of Medicine, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
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15
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Boeve BF, Davis AA, Ju YE, Kantarci K, Singer W, Videnovic A. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:659-660. [PMID: 38876735 DOI: 10.1016/s1474-4422(24)00213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
| | - Albert A Davis
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Yo-El Ju
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Kejal Kantarci
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Wolfgang Singer
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Aleks Videnovic
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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16
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Carli G, Roytman S, Bohnen NI. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:661. [PMID: 38876737 DOI: 10.1016/s1474-4422(24)00222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/13/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Giulia Carli
- Department of Neurology, University of Michigan, Ann Arbor, MI 48106, USA; Morris K Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI 48106, USA.
| | - Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, MI 48106, USA
| | - Nicolaas Ida Bohnen
- Department of Neurology, University of Michigan, Ann Arbor, MI 48106, USA; Morris K Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI 48106, USA; Department of Radiology, University of Michigan, Ann Arbor, MI 48106, USA; Parkinson's Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48106, USA; Neurology Service and Geriatric Research Education and Clinical Center, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
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17
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Arnaldi D, Pardini M, Chincarini A, Garibotto V, Morbelli S. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:662-663. [PMID: 38876738 DOI: 10.1016/s1474-4422(24)00211-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Dario Arnaldi
- Department of Neuroscience, University of Genoa, Genoa 16132, Italy; Division of Clinical Neurophysiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Matteo Pardini
- Department of Neuroscience, University of Genoa, Genoa 16132, Italy; Clinical Neurology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, University Hospitals of Geneva, Faculty of Medicine, University of Geneva, CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | - Silvia Morbelli
- Nuclear Medicine Unit, AOU Città Della Salute e Della Scienza di Torino, University of Turin, Turin, Italy
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18
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Escamilla-Sevilla F, Freire-Alvarez E, Martínez Castrillo JC, Sánchez Ferro Á, Santos-García D. Concerns with the new biological research criteria for synucleinopathy. Lancet Neurol 2024; 23:662. [PMID: 38876739 DOI: 10.1016/s1474-4422(24)00214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- Francisco Escamilla-Sevilla
- Movement Disorders Unit, Neurology Service, Virgen de las Nieves University Hospital, Instituto de Investigación Biosanitaria (IBS Granada), Granada 18013, Spain.
| | - Eric Freire-Alvarez
- Hospital General Universitario de Elche, Imed Hospital, Elche, Alicante, Spain
| | - Juan C Martínez Castrillo
- Movement Disorders Unit, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Diego Santos-García
- Movement Disorders Unit, Department of Neurology, A Coruña University Hospital Center, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
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19
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Jack CR, Andrews JS, Beach TG, Buracchio T, Dunn B, Graf A, Hansson O, Ho C, Jagust W, McDade E, Molinuevo JL, Okonkwo OC, Pani L, Rafii MS, Scheltens P, Siemers E, Snyder HM, Sperling R, Teunissen CE, Carrillo MC. Revised criteria for diagnosis and staging of Alzheimer's disease: Alzheimer's Association Workgroup. Alzheimers Dement 2024. [PMID: 38934362 DOI: 10.1002/alz.13859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 06/28/2024]
Abstract
The National Institute on Aging and the Alzheimer's Association convened three separate work groups in 2011 and single work groups in 2012 and 2018 to create recommendations for the diagnosis and characterization of Alzheimer's disease (AD). The present document updates the 2018 research framework in response to several recent developments. Defining diseases biologically, rather than based on syndromic presentation, has long been standard in many areas of medicine (e.g., oncology), and is becoming a unifying concept common to all neurodegenerative diseases, not just AD. The present document is consistent with this principle. Our intent is to present objective criteria for diagnosis and staging AD, incorporating recent advances in biomarkers, to serve as a bridge between research and clinical care. These criteria are not intended to provide step-by-step clinical practice guidelines for clinical workflow or specific treatment protocols, but rather serve as general principles to inform diagnosis and staging of AD that reflect current science. HIGHLIGHTS: We define Alzheimer's disease (AD) to be a biological process that begins with the appearance of AD neuropathologic change (ADNPC) while people are asymptomatic. Progression of the neuropathologic burden leads to the later appearance and progression of clinical symptoms. Early-changing Core 1 biomarkers (amyloid positron emission tomography [PET], approved cerebrospinal fluid biomarkers, and accurate plasma biomarkers [especially phosphorylated tau 217]) map onto either the amyloid beta or AD tauopathy pathway; however, these reflect the presence of ADNPC more generally (i.e., both neuritic plaques and tangles). An abnormal Core 1 biomarker result is sufficient to establish a diagnosis of AD and to inform clinical decision making throughout the disease continuum. Later-changing Core 2 biomarkers (biofluid and tau PET) can provide prognostic information, and when abnormal, will increase confidence that AD is contributing to symptoms. An integrated biological and clinical staging scheme is described that accommodates the fact that common copathologies, cognitive reserve, and resistance may modify relationships between clinical and biological AD stages.
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Affiliation(s)
- Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - J Scott Andrews
- Global Evidence & Outcomes, Takeda Pharmaceuticals Company Limited, Cambridge, Massachusetts, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Teresa Buracchio
- Office of Neuroscience, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Billy Dunn
- The Michael J. Fox Foundation for Parkinson's Research, New York, New York, USA
| | - Ana Graf
- Novartis, Neuroscience Global Drug Development, Basel, Switzerland
| | - Oskar Hansson
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Lund, Sweden
| | - Carole Ho
- Development, Denali Therapeutics, South San Francisco, California, USA
| | - William Jagust
- School of Public Health and Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California, USA
| | - Eric McDade
- Department of Neurology, Washington University St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Jose Luis Molinuevo
- Department of Global Clinical Development H. Lundbeck A/S, Experimental Medicine, Copenhagen, Denmark
| | - Ozioma C Okonkwo
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA
| | - Luca Pani
- University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute (ATRI), Keck School of Medicine at the University of Southern California, San Diego, California, USA
| | - Philip Scheltens
- Amsterdam University Medical Center (Emeritus), Neurology, Amsterdam, the Netherlands
| | - Eric Siemers
- Clinical Research, Acumen Pharmaceuticals, Zionsville, Indiana, USA
| | - Heather M Snyder
- Medical & Scientific Relations Division, Alzheimer's Association, Chicago, Illinois, USA
| | - Reisa Sperling
- Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charlotte E Teunissen
- Department of Laboratory Medicine, Amsterdam UMC, Neurochemistry Laboratory, Amsterdam, the Netherlands
| | - Maria C Carrillo
- Medical & Scientific Relations Division, Alzheimer's Association, Chicago, Illinois, USA
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20
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Lleó A, Alcolea D. What Can Blood Biomarkers Tell Us About Patients With Lewy Body Dementia? Neurology 2024; 102:e209505. [PMID: 38830183 DOI: 10.1212/wnl.0000000000209505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Affiliation(s)
- Alberto Lleó
- From the Department of Neurology, Hospital Sant Pau, Barcelona
| | - Daniel Alcolea
- From the Department of Neurology, Hospital Sant Pau, Barcelona
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21
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Iranzo A, Cochen De Cock V, Fantini ML, Pérez-Carbonell L, Trotti LM. Sleep and sleep disorders in people with Parkinson's disease. Lancet Neurol 2024:S1474-4422(24)00170-4. [PMID: 38942041 DOI: 10.1016/s1474-4422(24)00170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/02/2024] [Accepted: 04/16/2024] [Indexed: 06/30/2024]
Abstract
Sleep disorders are common in people with Parkinson's disease. These disorders, which increase in frequency throughout the course of the neurodegenerative disease and impair quality of life, include insomnia, excessive daytime sleepiness, circadian disorders, obstructive sleep apnoea, restless legs syndrome, and rapid eye movement (REM) sleep behaviour disorder. The causes of these sleep disorders are complex and multifactorial, including the degeneration of the neural structures that modulate sleep, the detrimental effect of some medications on sleep, the parkinsonian symptoms that interfere with mobility and comfort in bed, and comorbidities that disrupt sleep quality and quantity. The clinical evaluation of sleep disorders include both subjective (eg, questionnaires or diaries) and objective (eg, actigraphy or video polysomnography) assessments. The management of patients with Parkinson's disease and a sleep disorder is challenging and should be individualised. Treatment can include education aiming at changes in behaviour (ie, sleep hygiene), cognitive behavioural therapy, continuous dopaminergic stimulation at night, and specific medications. REM sleep behaviour disorder can occur several years before the onset of parkinsonism, suggesting that the implementation of trials of neuroprotective therapies should focus on people with this sleep disorder.
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Affiliation(s)
- Alex Iranzo
- Sleep Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain; IDIBAPS, Universitat de Barcelona, Barcelona, Spain; CIBERNED, Universitat de Barcelona, Barcelona, Spain.
| | - Valerie Cochen De Cock
- Sleep and Neurology Department, Beau Soleil Clinic, Montpellier, France; EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
| | - María Livia Fantini
- Neurophysiology Unit, Neurology Department, Université Clermont Auvergne, CNRS, Institut Pascal, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Laura Pérez-Carbonell
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK
| | - Lynn Marie Trotti
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Emory Sleep Center, Emory University School of Medicine, Atlanta, GA, USA
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22
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Brendel M, Guedj E, Yakushev I, Morbelli S, Höglinger GU, Tolboom N, Verger A, Albert NL, Cecchin D, Fernandez PA, Fraioli F, Traub-Weidinger T, Van Weehaeghe D, Barthel H. Neuroimaging biomarkers in the biological definition of Parkinson's disease and dementia with Lewy bodies - EANM position on current state, unmet needs and future perspectives. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06803-w. [PMID: 38907856 DOI: 10.1007/s00259-024-06803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Affiliation(s)
- Matthias Brendel
- Department of Nuclear Medicine, LMU Hospital, Ludwig-Maximilians-University of Munich, Marchioninstraße 15, 81377, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
| | - Eric Guedj
- Département de Médecine Nucléaire, Aix Marseille Univ, APHM, CNRS, Centrale Marseille, Institut Fresnel, Hôpital de La Timone, CERIMED, Marseille, France
| | - Igor Yakushev
- Department of Nuclear Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Silvia Morbelli
- Nuclear Medicine Unit, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, LMU Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging, Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Allée du Morvan, 54500, Nancy, France
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU Hospital, Ludwig-Maximilians-University of Munich, Marchioninstraße 15, 81377, Munich, Germany
| | - Diego Cecchin
- Department of Medicine, Unit of Nuclear Medicine, University Hospital of Padova, Padua, Italy
| | - Pablo Aguiar Fernandez
- CIMUS, Universidade Santiago de Compostela & Nuclear Medicine Department, Univ. Hospital IDIS, Santiago de Compostela, Spain
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Tatjana Traub-Weidinger
- Department of Diagnostic and Therapeutic Nuclear Medicine, Clinic Donaustadt, Vienna Health Care Group, Vienna, Austria
| | - Donatienne Van Weehaeghe
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000, Ghent, Belgium
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
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23
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Hällqvist J, Bartl M, Dakna M, Schade S, Garagnani P, Bacalini MG, Pirazzini C, Bhatia K, Schreglmann S, Xylaki M, Weber S, Ernst M, Muntean ML, Sixel-Döring F, Franceschi C, Doykov I, Śpiewak J, Vinette H, Trenkwalder C, Heywood WE, Mills K, Mollenhauer B. Plasma proteomics identify biomarkers predicting Parkinson's disease up to 7 years before symptom onset. Nat Commun 2024; 15:4759. [PMID: 38890280 PMCID: PMC11189460 DOI: 10.1038/s41467-024-48961-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/20/2024] [Indexed: 06/20/2024] Open
Abstract
Parkinson's disease is increasingly prevalent. It progresses from the pre-motor stage (characterised by non-motor symptoms like REM sleep behaviour disorder), to the disabling motor stage. We need objective biomarkers for early/pre-motor disease stages to be able to intervene and slow the underlying neurodegenerative process. Here, we validate a targeted multiplexed mass spectrometry assay for blood samples from recently diagnosed motor Parkinson's patients (n = 99), pre-motor individuals with isolated REM sleep behaviour disorder (two cohorts: n = 18 and n = 54 longitudinally), and healthy controls (n = 36). Our machine-learning model accurately identifies all Parkinson patients and classifies 79% of the pre-motor individuals up to 7 years before motor onset by analysing the expression of eight proteins-Granulin precursor, Mannan-binding-lectin-serine-peptidase-2, Endoplasmatic-reticulum-chaperone-BiP, Prostaglaindin-H2-D-isomaerase, Interceullular-adhesion-molecule-1, Complement C3, Dickkopf-WNT-signalling pathway-inhibitor-3, and Plasma-protease-C1-inhibitor. Many of these biomarkers correlate with symptom severity. This specific blood panel indicates molecular events in early stages and could help identify at-risk participants for clinical trials aimed at slowing/preventing motor Parkinson's disease.
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Affiliation(s)
- Jenny Hällqvist
- UCL Institute of Child Health and Great Ormond Street Hospital, London, UK.
- UCL Queen Square Institute of Neurology, Clinical and Movement Neurosciences, London, UK.
| | - Michael Bartl
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany.
- Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Goettingen, Goettingen, Germany.
| | - Mohammed Dakna
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Paolo Garagnani
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | | | - Chiara Pirazzini
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Kailash Bhatia
- National Hospital for Neurology & Neurosurgery, Queen Square, WC1N3BG, London, UK
| | | | - Mary Xylaki
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Sandrina Weber
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Marielle Ernst
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Friederike Sixel-Döring
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurology, Philipps-University, Marburg, Germany
| | - Claudio Franceschi
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Ivan Doykov
- UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Justyna Śpiewak
- UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Héloїse Vinette
- UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
- UCL: Food, Microbiomes and Health Institute Strategic Programme, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Wendy E Heywood
- UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Kevin Mills
- UCL Queen Square Institute of Neurology, Clinical and Movement Neurosciences, London, UK
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
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24
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Pérez-Carbonell L, Iranzo A. REM sleep and neurodegeneration. J Sleep Res 2024:e14263. [PMID: 38867555 DOI: 10.1111/jsr.14263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
Several brainstem, subcortical and cortical areas are involved in the generation of rapid eye movement (REM) sleep. The alteration of these structures as a result of a neurodegenerative process may therefore lead to REM sleep anomalies. REM sleep behaviour disorder is associated with nightmares, dream-enacting behaviours and increased electromyographic activity in REM sleep. Its isolated form is a harbinger of synucleinopathies such as Parkinson's disease or dementia with Lewy bodies, and neuroprotective interventions are advocated. This link might also be present in patients taking antidepressants, with post-traumatic stress disorder, or with a history of repeated traumatic head injury. REM sleep likely contributes to normal memory processes. Its alteration has also been proposed to be part of the neuropathological changes occurring in Alzheimer's disease.
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Affiliation(s)
- Laura Pérez-Carbonell
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, UK
| | - Alex Iranzo
- Neurology Service, Sleep Disorders Centre, Hospital Clínic de Barcelona, IDIBAPS, CIBERNED, University of Barcelona, Barcelona, Spain
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25
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Hoy CW, Chiong W. The Ethical Landscape of Prodromal Parkinson Disease: Considerations for Shared Decision-Making and Health Equity. Neurology 2024; 102:e209522. [PMID: 38759135 PMCID: PMC11175642 DOI: 10.1212/wnl.0000000000209522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/03/2024] [Indexed: 05/19/2024] Open
Affiliation(s)
- Colin W Hoy
- From the UCSF Weill Institute for Neurosciences, San Francisco, CA
| | - Winston Chiong
- From the UCSF Weill Institute for Neurosciences, San Francisco, CA
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26
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Fox SH. Outcome Selection for Research Studies in Movement Disorders. Mov Disord Clin Pract 2024. [PMID: 38828689 DOI: 10.1002/mdc3.14087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 04/02/2024] [Indexed: 06/05/2024] Open
Affiliation(s)
- Susan H Fox
- University of Toronto, Movement Disorder Clinic, Edmond J Safra Program in Parkinson Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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27
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Lázaro DF, Lee VMY. Navigating through the complexities of synucleinopathies: Insights into pathogenesis, heterogeneity, and future perspectives. Neuron 2024:S0896-6273(24)00364-7. [PMID: 38861985 DOI: 10.1016/j.neuron.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/13/2024]
Abstract
The aggregation of alpha-synuclein (aSyn) represents a neuropathological hallmark observed in a group of neurodegenerative disorders collectively known as synucleinopathies. Despite their shared characteristics, these disorders manifest diverse clinical and pathological phenotypes. The mechanism underlying this heterogeneity is thought to be due to the diversity in the aSyn strains present across the diseases. In this perspective, we will explore recent findings on aSyn strains and discuss recent discoveries about Lewy bodies' composition. We further discuss the current hypothesis for aSyn spreading and emphasize the emerging biomarker field demonstrating promising results. A comprehension of these mechanisms holds substantial promise for future clinical applications. This understanding can pave the way for the development of personalized medicine strategies, specifically targeting the unique underlying causes of each synucleinopathy. Such advancements can revolutionize therapeutic approaches and significantly contribute to more effective interventions in the intricate landscape of neurodegenerative disorders.
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Affiliation(s)
- Diana F Lázaro
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Medicine, University of Pennsylvania, Perelman School of Medicine at University of Pennsylvania, 3600 Spruce Street, 3 Maloney Building, Philadelphia, PA 19104, USA.
| | - Virginia M-Y Lee
- Department of Pathology and Laboratory Medicine, Institute on Aging and Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Medicine, University of Pennsylvania, Perelman School of Medicine at University of Pennsylvania, 3600 Spruce Street, 3 Maloney Building, Philadelphia, PA 19104, USA.
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28
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Outeiro TF, Kalia LV, Bezard E, Ferrario J, Lin CH, Salama M, Standaert DG, Taiwo L, Takahashi R, Vila M, Mollenhauer B, Svenningsson P. Basic Science in Movement Disorders: Fueling the Engine of Translation into Clinical Practice. Mov Disord 2024; 39:929-933. [PMID: 38576081 DOI: 10.1002/mds.29802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024] Open
Abstract
Basic Science is crucial for the advancement of clinical care for Movement Disorders. Here, we provide brief updates on how basic science is important for understanding disease mechanisms, disease prevention, disease diagnosis, development of novel therapies and to establish the basis for personalized medicine. We conclude the viewpoint by a call to action to further improve interactions between clinician and basic scientists. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany
- Max Planck Institute for Multidisciplinary Sciences, Göttingen, Germany
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Scientific employee with an honorary contract at Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Göttingen, Germany
| | - Lorraine V Kalia
- Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Erwan Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre National de la Recherche Scientifique Unité Mixte de Recherche 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Juan Ferrario
- Universidad de Buenos Aires, Facultad de Ciencias Exactas y Naturales, Instituto de Biociencias, Biotecnología y Biología traslacional (iB3) and CONICET, Buenos Aires, Argentina
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, The American University in Cairo, Cairo, Egypt
- Faculty of Medicine, Mansoura University, Dakahleya, Egypt
| | - David G Standaert
- Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lolade Taiwo
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Miquel Vila
- Neurodegenerative Diseases Research Group, Vall d'Hebron Research Institute (VHIR), Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Autonomous University of Barcelona (UAB), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, Maryland, USA
| | - Brit Mollenhauer
- Scientific employee with an honorary contract at Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Göttingen, Germany
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, Maryland, USA
- Paracelsus-Elena-Klinik, Kassel, Germany; University Medical Center Goettingen, Institute of Neurology, Goettingen, Germany
| | - Per Svenningsson
- Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, Maryland, USA
- Department of Clinical Neuroscience and Neurology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Basic and Clinical Neuroscience, King's College London, London, UK
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29
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Outeiro TF, Antonini A, Ferreira JJ. Reply to: "Rethinking Parkinson's Disease: A Syndromic Perspective". Mov Disord 2024; 39:1080-1081. [PMID: 38924135 DOI: 10.1002/mds.29832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/28/2024] Open
Affiliation(s)
- Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany
- Max Planck Institute for Multidisciplinary Sciences, Goettingen, Germany
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Study Center for Neurodegenerative Diseases (CESNE), Department of Neuroscience, University of Padua, Padova, Italy
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS-Campus Neurológico, Torres Vedras, Portugal
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30
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Arnaldi D, Mattioli P, Raffa S, Pardini M, Massa F, Iranzo A, Perissinotti A, Niñerola-Baizán A, Gaig C, Serradell M, Muñoz-Lopetegi A, Mayà G, Liguori C, Fernandes M, Placidi F, Chiaravalloti A, Šonka K, Dušek P, Zogala D, Trnka J, Boeve BF, Miyagawa T, Lowe VJ, Miyamoto T, Miyamoto M, Puligheddu M, Figorilli M, Serra A, Hu MT, Klein JC, Bes F, Kunz D, De Cock VC, de Verbizier D, Plazzi G, Antelmi E, Terzaghi M, Bossert I, Kulcsárová K, Martino A, Giuliani A, Pagani M, Nobili F, Morbelli S. Presynaptic Dopaminergic Imaging Characterizes Patients with REM Sleep Behavior Disorder Due to Synucleinopathy. Ann Neurol 2024; 95:1178-1192. [PMID: 38466158 PMCID: PMC11102309 DOI: 10.1002/ana.26902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To apply a machine learning analysis to clinical and presynaptic dopaminergic imaging data of patients with rapid eye movement (REM) sleep behavior disorder (RBD) to predict the development of Parkinson disease (PD) and dementia with Lewy bodies (DLB). METHODS In this multicenter study of the International RBD study group, 173 patients (mean age 70.5 ± 6.3 years, 70.5% males) with polysomnography-confirmed RBD who eventually phenoconverted to overt alpha-synucleinopathy (RBD due to synucleinopathy) were enrolled, and underwent baseline presynaptic dopaminergic imaging and clinical assessment, including motor, cognitive, olfaction, and constipation evaluation. For comparison, 232 RBD non-phenoconvertor patients (67.6 ± 7.1 years, 78.4% males) and 160 controls (68.2 ± 7.2 years, 53.1% males) were enrolled. Imaging and clinical features were analyzed by machine learning to determine predictors of phenoconversion. RESULTS Machine learning analysis showed that clinical data alone poorly predicted phenoconversion. Presynaptic dopaminergic imaging significantly improved the prediction, especially in combination with clinical data, with 77% sensitivity and 85% specificity in differentiating RBD due to synucleinopathy from non phenoconverted RBD patients, and 85% sensitivity and 86% specificity in discriminating PD-converters from DLB-converters. Quantification of presynaptic dopaminergic imaging showed that an empirical z-score cutoff of -1.0 at the most affected hemisphere putamen characterized RBD due to synucleinopathy patients, while a cutoff of -1.0 at the most affected hemisphere putamen/caudate ratio characterized PD-converters. INTERPRETATION Clinical data alone poorly predicted phenoconversion in RBD due to synucleinopathy patients. Conversely, presynaptic dopaminergic imaging allows a good prediction of forthcoming phenoconversion diagnosis. This finding may be used in designing future disease-modifying trials. ANN NEUROL 2024;95:1178-1192.
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Affiliation(s)
- Dario Arnaldi
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Mattioli
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Stefano Raffa
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alex Iranzo
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Andres Perissinotti
- Nuclear Medicine Service, Hospital Clínic Barcelona, Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Aida Niñerola-Baizán
- Nuclear Medicine Service, Hospital Clínic Barcelona, Biomedical Research Networking Centre of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), ISCIII, Barcelona, Spain
| | - Carles Gaig
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Monica Serradell
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Amaia Muñoz-Lopetegi
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Gerard Mayà
- Neurology Service, Sleep Disorder Centre, Hospital Clínic Barcelona, Universitat de Barcelona, IDIBAPS, CIBERNED: CB06/05/0018-ISCIII, Barcelona, Spain
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Sleep Medicine Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Karel Šonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jiri Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota USA
| | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Masayuki Miyamoto
- Center of Sleep Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Monica Puligheddu
- Sleep Disorder Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Michela Figorilli
- Sleep Disorder Center, Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Alessandra Serra
- Nuclear Medicine Unit, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Michele T. Hu
- Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Johannes C. Klein
- Division of Neurology, Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Frederik Bes
- Clinic of Sleep & Chronomedicine, St. Hedwig-Hospital, Berlin Germany
- Institute of Physiology, Sleep Research & Clinical Chronobiology, Charité–Universitätsmedizin Berlin, Germany
| | - Dieter Kunz
- Clinic of Sleep & Chronomedicine, St. Hedwig-Hospital, Berlin Germany
- Institute of Physiology, Sleep Research & Clinical Chronobiology, Charité–Universitätsmedizin Berlin, Germany
| | - Valérie Cochen De Cock
- Sleep and neurology department, Beau Soleil Clinic, Montpellier, France
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | | | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
| | - Elena Antelmi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Terzaghi
- Sleep Medicine and Epilepsy Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Bossert
- Nuclear Medicine Unit, ICS Maugeri SpA SB IRCCS, Pavia, Italy
| | - Kristína Kulcsárová
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Alessio Martino
- Department of Business and Management, LUISS University, Rome, Italy
| | - Alessandro Giuliani
- Department of Environment and Health, Istituto Superiore di Sanità (Italian National Institute of Health), Rome, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy
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31
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Wyman-Chick KA, Chaudhury P, Bayram E, Abdelnour C, Matar E, Chiu SY, Ferreira D, Hamilton CA, Donaghy PC, Rodriguez-Porcel F, Toledo JB, Habich A, Barrett MJ, Patel B, Jaramillo-Jimenez A, Scott GD, Kane JPM. Differentiating Prodromal Dementia with Lewy Bodies from Prodromal Alzheimer's Disease: A Pragmatic Review for Clinicians. Neurol Ther 2024; 13:885-906. [PMID: 38720013 PMCID: PMC11136939 DOI: 10.1007/s40120-024-00620-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
This pragmatic review synthesises the current understanding of prodromal dementia with Lewy bodies (pDLB) and prodromal Alzheimer's disease (pAD), including clinical presentations, neuropsychological profiles, neuropsychiatric symptoms, biomarkers, and indications for disease management. The core clinical features of dementia with Lewy bodies (DLB)-parkinsonism, complex visual hallucinations, cognitive fluctuations, and REM sleep behaviour disorder are common prodromal symptoms. Supportive clinical features of pDLB include severe neuroleptic sensitivity, as well as autonomic and neuropsychiatric symptoms. The neuropsychological profile in mild cognitive impairment attributable to Lewy body pathology (MCI-LB) tends to include impairment in visuospatial skills and executive functioning, distinguishing it from MCI due to AD, which typically presents with impairment in memory. pDLB may present with cognitive impairment, psychiatric symptoms, and/or recurrent episodes of delirium, indicating that it is not necessarily synonymous with MCI-LB. Imaging, fluid and other biomarkers may play a crucial role in differentiating pDLB from pAD. The current MCI-LB criteria recognise low dopamine transporter uptake using positron emission tomography or single photon emission computed tomography (SPECT), loss of REM atonia on polysomnography, and sympathetic cardiac denervation using meta-iodobenzylguanidine SPECT as indicative biomarkers with slowing of dominant frequency on EEG among others as supportive biomarkers. This review also highlights the emergence of fluid and skin-based biomarkers. There is little research evidence for the treatment of pDLB, but pharmacological and non-pharmacological treatments for DLB may be discussed with patients. Non-pharmacological interventions such as diet, exercise, and cognitive stimulation may provide benefit, while evaluation and management of contributing factors like medications and sleep disturbances are vital. There is a need to expand research across diverse patient populations to address existing disparities in clinical trial participation. In conclusion, an early and accurate diagnosis of pDLB or pAD presents an opportunity for tailored interventions, improved healthcare outcomes, and enhanced quality of life for patients and care partners.
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Affiliation(s)
- Kathryn A Wyman-Chick
- Struthers Parkinson's Center and Center for Memory and Aging, Department of Neurology, HealthPartners/Park Nicollet, Bloomington, USA.
| | - Parichita Chaudhury
- Cleo Roberts Memory and Movement Center, Banner Sun Health Research Institute, Sun City, USA
| | - Ece Bayram
- Parkinson and Other Movement Disorders Center, University of California San Diego, San Diego, USA
| | - Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, USA
| | - Elie Matar
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Shannon Y Chiu
- Department of Neurology, Mayo Clinic Arizona, Phoenix, USA
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Solna, Sweden
- Department of Radiology, Mayo Clinic Rochester, Rochester, USA
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas, Spain
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Jon B Toledo
- Nantz National Alzheimer Center, Stanley Appel Department of Neurology, Houston Methodist Hospital, Houston, USA
| | - Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Solna, Sweden
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Matthew J Barrett
- Department of Neurology, Parkinson's and Movement Disorders Center, Virginia Commonwealth University, Richmond, USA
| | - Bhavana Patel
- Department of Neurology, College of Medicine, University of Florida, Gainesville, USA
- Norman Fixel Institute for Neurologic Diseases, University of Florida, Gainesville, USA
| | - Alberto Jaramillo-Jimenez
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- School of Medicine, Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Gregory D Scott
- Department of Pathology and Laboratory Services, VA Portland Medical Center, Portland, USA
| | - Joseph P M Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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32
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Hattori N. Towards the era of biological biomarkers for Parkinson disease. Nat Rev Neurol 2024; 20:317-318. [PMID: 38454092 DOI: 10.1038/s41582-024-00950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
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33
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Grippe T, Shamli-Oghli Y, Darmani G, Nankoo JF, Raies N, Sarica C, Arora T, Gunraj C, Ding MYR, Rinchon C, DiLuca DG, Pichardo S, Cardoso F, Lozano AM, Chen R. Plasticity-Induced Effects of Theta Burst Transcranial Ultrasound Stimulation in Parkinson's Disease. Mov Disord 2024. [PMID: 38787806 DOI: 10.1002/mds.29836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Low-intensity transcranial ultrasound stimulation (TUS) is a noninvasive brain stimulation (NIBS) technique with high spatial specificity. Previous studies showed that TUS delivered in a theta burst pattern (tbTUS) increased motor cortex (MI) excitability up to 30 minutes due to long-term potentiation (LTP)-like plasticity. Studies using other forms of NIBS suggested that cortical plasticity may be impaired in patients with Parkinson's disease (PD). OBJECTIVE The aim was to investigate the neurophysiological effects of tbTUS in PD patients off and on dopaminergic medications compared to healthy controls. METHODS We studied 20 moderately affected PD patients in on and off dopaminergic medication states (7 with and 13 without dyskinesia) and 17 age-matched healthy controls in a case-controlled study. tbTUS was applied for 80 seconds to the MI. Motor-evoked potentials (MEP), short-interval intracortical inhibition (SICI), and short-interval intracortical facilitation (SICF) were recorded at baseline, and at 5 minutes (T5), T30, and T60 after tbTUS. Motor Unified Parkinson's Disease Rating Scale (mUPDRS) was measured at baseline and T60. RESULTS tbTUS significantly increased MEP amplitude at T30 compared to baseline in controls and in PD patients on but not in PD patients off medications. SICI was reduced in PD off medications compared to controls. tbTUS did not change in SICI or SICF. The bradykinesia subscore of mUPDRS was reduced at T60 compared to baseline in PD on but not in the off medication state. The presence of dyskinesia did not affect tbTUS-induced plasticity. CONCLUSIONS tbTUS-induced LTP plasticity is impaired in PD patients off medications and is restored by dopaminergic medications. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Talyta Grippe
- Department of Neurology, Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Canada
- Neuroscience Graduate Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
- University Health Network, Toronto, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
| | | | | | | | | | - Can Sarica
- University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Tarun Arora
- University Health Network, Toronto, Canada
- Division of Clinical Neuroscience, Department of Neurology, Oslo University Hospital, Oslo, Norway
| | | | - Mandy Yi Rong Ding
- University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Cricia Rinchon
- University Health Network, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Daniel G DiLuca
- Department of Neurology, Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Canada
- University Health Network, Toronto, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Samuel Pichardo
- Cumming School of Medicine, Department of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Canada
| | - Francisco Cardoso
- Neuroscience Graduate Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Andres M Lozano
- University Health Network, Toronto, Canada
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Canada
| | - Robert Chen
- Department of Neurology, Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Canada
- University Health Network, Toronto, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
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Bartl M, Nilsson J, Dakna M, Weber S, Schade S, Xylaki M, Fernandes Gomes B, Ernst M, Muntean ML, Sixel-Döring F, Trenkwalder C, Zetterberg H, Brinkmalm A, Mollenhauer B. Lysosomal and synaptic dysfunction markers in longitudinal cerebrospinal fluid of de novo Parkinson's disease. NPJ Parkinsons Dis 2024; 10:102. [PMID: 38760408 PMCID: PMC11101466 DOI: 10.1038/s41531-024-00714-1] [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: 11/24/2023] [Accepted: 04/19/2024] [Indexed: 05/19/2024] Open
Abstract
Lysosomal and synaptic dysfunctions are hallmarks in neurodegeneration and potentially relevant as biomarkers, but data on early Parkinson's disease (PD) is lacking. We performed targeted mass spectrometry with an established protein panel, assessing autophagy and synaptic function in cerebrospinal fluid (CSF) of drug-naïve de novo PD, and sex-/age-matched healthy controls (HC) cross-sectionally (88 PD, 46 HC) and longitudinally (104 PD, 58 HC) over 10 years. Multiple markers of autophagy, synaptic plasticity, and secretory pathways were reduced in PD. We added samples from prodromal subjects (9 cross-sectional, 12 longitudinal) with isolated REM sleep behavior disorder, revealing secretogranin-2 already decreased compared to controls. Machine learning identified neuronal pentraxin receptor and neurosecretory protein VGF as most relevant for discriminating between groups. CSF levels of LAMP2, neuronal pentraxins, and syntaxins in PD correlated with clinical progression, showing predictive potential for motor- and non-motor symptoms as a valid basis for future drug trials.
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Affiliation(s)
- Michael Bartl
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany.
- Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Goettingen, Goettingen, Germany.
| | - Johanna Nilsson
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Mohammed Dakna
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Sandrina Weber
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Mary Xylaki
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Bárbara Fernandes Gomes
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Marielle Ernst
- Institute of Diagnostic and Interventional Neuroradiology, University Medical Center Goettingen, Goettingen, Germany
| | | | - Friederike Sixel-Döring
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurology, Philipps-University, Marburg, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Ann Brinkmalm
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
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Stige KE, Kverneng SU, Sharma S, Skeie GO, Sheard E, Søgnen M, Geijerstam SA, Vetås T, Wahlvåg AG, Berven H, Buch S, Reese D, Babiker D, Mahdi Y, Wade T, Miranda GP, Ganguly J, Tamilselvam YK, Chai JR, Bansal S, Aur D, Soltani S, Adams S, Dölle C, Dick F, Berntsen EM, Grüner R, Brekke N, Riemer F, Goa PE, Haugarvoll K, Haacke EM, Jog M, Tzoulis C. The STRAT-PARK cohort: A personalized initiative to stratify Parkinson's disease. Prog Neurobiol 2024; 236:102603. [PMID: 38604582 DOI: 10.1016/j.pneurobio.2024.102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/15/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
The STRAT-PARK initiative aims to provide a platform for stratifying Parkinson's disease (PD) into biological subtypes, using a bottom-up, multidisciplinary biomarker-based and data-driven approach. PD is a heterogeneous entity, exhibiting high interindividual clinicopathological variability. This diversity suggests that PD may encompass multiple distinct biological entities, each driven by different molecular mechanisms. Molecular stratification and identification of disease subtypes is therefore a key priority for understanding and treating PD. STRAT-PARK is a multi-center longitudinal cohort aiming to recruit a total of 2000 individuals with PD and neurologically healthy controls from Norway and Canada, for the purpose of identifying molecular disease subtypes. Clinical assessment is performed annually, whereas biosampling, imaging, and digital and neurophysiological phenotyping occur every second year. The unique feature of STRAT-PARK is the diversity of collected biological material, including muscle biopsies and platelets, tissues particularly useful for mitochondrial biomarker research. Recruitment rate is ∼150 participants per year. By March 2023, 252 participants were included, comprising 204 cases and 48 controls. STRAT-PARK is a powerful stratification initiative anticipated to become a global research resource, contributing to personalized care in PD.
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Affiliation(s)
- Kjersti Eline Stige
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway; The Department of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Neurology and Clinical Neurophysiology, St Olav's University Hospital, Trondheim 7006, Norway
| | - Simon Ulvenes Kverneng
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Soumya Sharma
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Geir-Olve Skeie
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Erika Sheard
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Mona Søgnen
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Solveig Af Geijerstam
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Therese Vetås
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Anne Grete Wahlvåg
- Department of Neurology and Clinical Neurophysiology, St Olav's University Hospital, Trondheim 7006, Norway
| | - Haakon Berven
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Sagar Buch
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - David Reese
- Imaging Research Laboratories, Robarts Research Institute, Ontario, London N6A 5B7, Canada
| | - Dina Babiker
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Yekta Mahdi
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Trevor Wade
- Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, Ontario, London N6A 6B7, Canada
| | - Gala Prado Miranda
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Jacky Ganguly
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Yokhesh Krishnasamy Tamilselvam
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada; Department of Electrical and Computer Engineering, Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario (UWO), Ontario, London, Canada
| | - Jia Ren Chai
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Saurabh Bansal
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Dorian Aur
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Sima Soltani
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Scott Adams
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada; School of Communication Sciences & Disorders, Faculty of Health Sciences, Western University, Canada
| | - Christian Dölle
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Fiona Dick
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Erik Magnus Berntsen
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim 7006, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Renate Grüner
- Department of Physics and Technology, University of Bergen, Bergen 5007, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Post Office Box 1400, Bergen 5021, Norway
| | - Njål Brekke
- Department of Physics and Technology, University of Bergen, Bergen 5007, Norway; Radiology Department, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Frank Riemer
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Post Office Box 1400, Bergen 5021, Norway
| | - Pål Erik Goa
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim 7006, Norway; Department of Physics, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Kristoffer Haugarvoll
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - E Mark Haacke
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mandar Jog
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Charalampos Tzoulis
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway.
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Yuan Y, Wang Y, Liu M, Luo H, Liu X, Li L, Mao C, Yang T, Li S, Zhang X, Gao Y, Xu Y, Yang J. Peripheral cutaneous synucleinopathy characteristics in genetic Parkinson's disease. Front Neurol 2024; 15:1404492. [PMID: 38751879 PMCID: PMC11094647 DOI: 10.3389/fneur.2024.1404492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Background Cutaneous phosphorylated alpha-synuclein (p-α-syn) deposition is an important biomarker of idiopathic Parkinson's disease (iPD). Recent studies have reported synucleinopathies in patients with common genetic forms of PD. Objective This study aimed to detect p-α-syn deposition characteristic in rare genetic PD patients with CHCHD2 or RAB39B mutations. Moreover, this study also aimed to describe peripheral alpha-synuclein prion-like activity in genetic PD patients, and acquire whether the cutaneous synucleinopathy characteristics of genetic PD are consistent with central neuropathologies. Methods We performed four skin biopsy samples from the distal leg (DL) and proximal neck (C7) of 161 participants, including four patients with CHCHD2 mutations, two patients with RAB39B mutations, 16 patients with PRKN mutations, 14 patients with LRRK2 mutations, five patients with GBA mutations, 100 iPD patients, and 20 healthy controls. We detected cutaneous synucleinopathies using immunofluorescence staining and a seeding amplification assay (SAA). A systematic literature review was also conducted, involving 64 skin biopsies and 205 autopsies of genetic PD patients with synucleinopathy. Results P-α-syn was deposited in the peripheral cutaneous nerves of PD patients with CHCHD2, LRRK2, or GBA mutations but not in those with RAB39B or PRKN mutations. There were no significant differences in the location or rate of α-syn-positive deposits between genetic PD and iPD patients. Peripheral cutaneous synucleinopathy appears to well represent brain synucleinopathy of genetic PD, especially autosomal dominant PD (AD-PD). Cutaneous α-synuclein SAA analysis of iPD and LRRK2 and GBA mutation patients revealed prion-like activity. Conclusion P-α-syn deposition in peripheral cutaneous nerves, detected using SAA and immunofluorescence staining, may serve as an accurate biomarker for genetic PD and iPD in the future.
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Affiliation(s)
- Yanpeng Yuan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Yangyang Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Minglei Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Haiyang Luo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, Henan, China
| | - Xiaojing Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Lanjun Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Chengyuan Mao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, Henan, China
| | - Ting Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Shuo Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaoyun Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, Henan, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, Henan, China
| | - Jing Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Disease, Zhengzhou, Henan, China
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Espay AJ, Lees AJ. Loss of monomeric alpha-synuclein (synucleinopenia) and the origin of Parkinson's disease. Parkinsonism Relat Disord 2024; 122:106077. [PMID: 38461037 DOI: 10.1016/j.parkreldis.2024.106077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/11/2024]
Abstract
These facts argue against the gain-of-function synucleinopathy hypothesis, which proposes that Lewy pathology causes Parkinson's disease: (1) most brains from people without neurological symptoms have multiple pathologies; (2) neither pathology type nor distribution correlate with disease severity or progression in Parkinson's disease; (3) aggregated α-synuclein in the form of Lewy bodies is not a space-occupying lesion but the insoluble fraction of its precursor, soluble monomeric α-synuclein; (4) pathology spread is passive, occurring by irreversible nucleation, not active replication; and (5) low cerebrospinal fluid α-synuclein levels predict brain atrophy and clinical disease progression. The transformation of α-synuclein into Lewy pathology may occur as a response to biological, toxic, or infectious stressors whose persistence perpetuates the nucleation process, depleting normal α-synuclein and eventually leading to Parkinson's symptoms from neuronal death. We propose testing the loss-of-function synucleinopenia hypothesis by evaluating the clinical and neurodegenerative rescue effect of replenishing the levels of monomeric α-synuclein.
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Affiliation(s)
- Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.
| | - Andrew J Lees
- The National Hospital, Queen Square and Reta Lila Weston Institute for Neurological Studies University College London, London, UK
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Plastini MJ, Abdelnour C, Young CB, Wilson EN, Shahid-Besanti M, Lamoureux J, Andreasson KI, Kerchner GA, Montine TJ, Henderson VW, Poston KL. Multiple biomarkers improve diagnostic accuracy across Lewy body and Alzheimer's disease spectra. Ann Clin Transl Neurol 2024; 11:1197-1210. [PMID: 38436140 DOI: 10.1002/acn3.52034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/20/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE More than half of neurodegenerative disease patients have multiple pathologies at autopsy; however, most receive one diagnosis during life. We used the α-synuclein seed amplification assay (αSyn-SAA) and CSF biomarkers for amyloidosis and Alzheimer's disease (AD) neuropathological change (ADNC) to determine the frequency of co-pathologies in participants clinically diagnosed with Lewy body (LB) disease or AD. METHODS Using receiver operating characteristic analyses on retrospective CSF samples from 150 participants determined αSyn-SAA accuracy, sensitivity, and specificity for identifying clinically defined LB disease and predicting future change in clinical diagnosis. CSF biomarkers helped determine the frequency of concomitant Lewy body pathology, ADNC, and/or amyloidosis in participants with LB disease and AD, across clinical spectra. RESULTS Following a decade-long follow-up, the clinically or autopsy-defined diagnosis changed for nine participants. αSyn-SAA demonstrated improved accuracy (91.3%), sensitivity (89.3%), and specificity (93.3%) for identifying LB disease compared to all non-LB disease, highlighting the limitations of clinical diagnosis alone. When examining biomarkers of co-pathology, amyloidosis was present in 18%, 48%, and 71% (χ2(2) = 13.56, p = 0.001) and AD biomarkers were present in 0%, 8.7%, and 42.9% (χ2(2) = 18.44, p < 0.001) of LB disease participants with different stages of cognitive impairment respectively. Co-occurring biomarkers for αSyn-SAA and amyloidosis were present in 12% and 14% of AD compared to 43% and 57% LB disease participants with different stages of cognitive impairment (χ2(3) = 13.87, p = 0.003). INTERPRETATION Our study shows that using a combination of αSyn-SAA and AD biomarkers can identify people with αSyn, ADNC, and co-pathology better and earlier than traditional clinical diagnostic criteria alone.
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Affiliation(s)
- Melanie J Plastini
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Christina B Young
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Edward N Wilson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | - Marian Shahid-Besanti
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
| | | | - Katrin I Andreasson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Chan Zuckerberg Biohub, San Francisco, California, 94158, USA
| | - Geoffrey A Kerchner
- Pharma Research and Early Development, F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - Thomas J Montine
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Victor W Henderson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California, USA
- Knight Initiative for Brain Resilience, Stanford University, Stanford, California, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, California, USA
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Mulroy E, Erro R, Bhatia KP, Hallett M. Refining the clinical diagnosis of Parkinson's disease. Parkinsonism Relat Disord 2024; 122:106041. [PMID: 38360507 PMCID: PMC11069446 DOI: 10.1016/j.parkreldis.2024.106041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
Our ability to define, understand, and classify Parkinson's disease (PD) has undergone significant changes since the disorder was first described in 1817. Clinical features and neuropathologic signatures can now be supplemented by in-vivo interrogation of genetic and biological substrates of disease, offering great opportunity for further refining the diagnosis of PD. In this mini-review, we discuss the historical perspectives which shaped our thinking surrounding the definition and diagnosis of PD. We highlight the clinical, genetic, pathologic and biologic diversity which underpins the condition, and proceed to discuss how recent developments in our ability to define biologic and pathologic substrates of disease might impact PD definition, diagnosis, individualised prognostication, and personalised clinical care. We argue that Parkinson's 'disease', as currently diagnosed in the clinic, is actually a syndrome. It is the outward manifestation of any array of potential dysfunctional biologic processes, neuropathological changes, and disease aetiologies, which culminate in common outward clinical features which we term PD; each person has their own unique disease, which we can now define with increasing precision. This is an exciting time in PD research and clinical care. Our ability to refine the clinical diagnosis of PD, incorporating in-vivo assessments of disease biology, neuropathology, and neurogenetics may well herald the era of biologically-based, precision medicine approaches PD management. With this however comes a number of challenges, including how to integrate these technologies into clinical practice in a way which is acceptable to patients, promotes meaningful changes to care, and minimises health economic impact.
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Affiliation(s)
- Eoin Mulroy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, (SA), Italy
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
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Janssen Daalen JM, Gerritsen A, Gerritse G, Gouman J, Meijerink H, Rietdijk LE, Darweesh SKL. How Lifetime Evolution of Parkinson's Disease Could Shape Clinical Trial Design: A Shared Patient-Clinician Viewpoint. Brain Sci 2024; 14:358. [PMID: 38672010 PMCID: PMC11048137 DOI: 10.3390/brainsci14040358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Parkinson's disease (PD) has a long, heterogeneous, pre-diagnostic phase, during which pathology insidiously accumulates. Increasing evidence suggests that environmental and lifestyle factors in early life contribute to disease risk and progression. Thanks to the extensive study of this pre-diagnostic phase, the first prevention trials of PD are being designed. However, the highly heterogenous evolution of the disease across the life course is not yet sufficiently taken into account. This could hamper clinical trial success in the advent of biological disease definitions. In an interdisciplinary patient-clinician study group, we discussed how an approach that incorporates the lifetime evolution of PD may benefit the design of disease-modifying trials by impacting population, target and outcome selection. We argue that the timepoint of exposure to risk and protective factors plays a critical role in PD subtypes, influencing population selection. In addition, recent developments in differential disease mechanisms, aided by biological disease definitions, could impact optimal treatment targets. Finally, multimodal biomarker panels using this lifetime approach will likely be most sensitive as progression markers for more personalized trials. We believe that the lifetime evolution of PD should be considered in the design of clinical trials, and that such initiatives could benefit from more patient-clinician partnerships.
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Affiliation(s)
- Jules M. Janssen Daalen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, 6525 GA Nijmegen, The Netherlands; (J.M.J.D.); (A.G.)
| | - Aranka Gerritsen
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, 6525 GA Nijmegen, The Netherlands; (J.M.J.D.); (A.G.)
| | - Gijs Gerritse
- Dutch Parkinson’s Patient Association, P.O. Box 46, 3980 CA Bunnik, The Netherlands; (G.G.); (J.G.); (H.M.); (L.E.R.)
| | - Jan Gouman
- Dutch Parkinson’s Patient Association, P.O. Box 46, 3980 CA Bunnik, The Netherlands; (G.G.); (J.G.); (H.M.); (L.E.R.)
| | - Hannie Meijerink
- Dutch Parkinson’s Patient Association, P.O. Box 46, 3980 CA Bunnik, The Netherlands; (G.G.); (J.G.); (H.M.); (L.E.R.)
| | - Leny E. Rietdijk
- Dutch Parkinson’s Patient Association, P.O. Box 46, 3980 CA Bunnik, The Netherlands; (G.G.); (J.G.); (H.M.); (L.E.R.)
| | - Sirwan K. L. Darweesh
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, 6525 GA Nijmegen, The Netherlands; (J.M.J.D.); (A.G.)
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Hatano T, Okuzumi A, Matsumoto G, Tsunemi T, Hattori N. α-Synuclein: A Promising Biomarker for Parkinson's Disease and Related Disorders. J Mov Disord 2024; 17:127-137. [PMID: 38589016 PMCID: PMC11082597 DOI: 10.14802/jmd.24075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 03/30/2024] [Accepted: 04/09/2024] [Indexed: 04/10/2024] Open
Abstract
Mutations in the SNCA gene, which encodes α-synuclein (α-syn), play a key role in the development of genetic Parkinson's disease (PD). α-Syn is a major component of Lewy bodies in PD and glial cytoplasmic inclusions in multiple system atrophy (MSA). Rapid eye movement sleep behavior disorder patients often progress to PD, dementia with Lewy bodies, or MSA, which are collectively known as α-synucleinopathies. The loss of dopaminergic neurons with Lewy bodies precedes motor dysfunction in these diseases, but the mechanisms of neurodegeneration due to α-syn aggregation are poorly understood. Monitoring α-syn aggregation in vivo could serve as a diagnostic biomarker and help elucidate pathogenesis, necessitating a simple and accurate detection method. Seed amplification assays (SAAs), such as real-time quaking-induced conversion and protein misfolding cyclic amplification, are used to detect small amounts of abnormally structured α-syn protofibrils, which are central to aggregation. These methods are promising for the early diagnosis of α-synucleinopathy. Differences in α-syn filament structures between α-synucleinopathies, as observed through transmission electron microscopy and cryo-electron microscopy, suggest their role in the pathogenesis of neurodegeneration. SAAs may differentiate between subtypes of α-synucleinopathy and other diseases. Efforts are also being made to identify α-syn from blood using various methods. This review introduces body fluid α-syn biomarkers based on pathogenic α-syn seeds, which are expected to redefine α-synucleinopathy diagnosis and staging, improving clinical research accuracy and facilitating biomarker development.
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Affiliation(s)
- Taku Hatano
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Ayami Okuzumi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Gen Matsumoto
- Department of Histology and Cell Biology, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Taiji Tsunemi
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Neurodegenerative Disorders Collaboration Laboratory, RIKEN Center for Brain Science, Saitama, Japan
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Orso B, Brosse S, Frasnelli J, Arnaldi D. Opportunities and Pitfalls of REM Sleep Behavior Disorder and Olfactory Dysfunction as Early Markers in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230348. [PMID: 38517805 DOI: 10.3233/jpd-230348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
During its pre-motor stage, Parkinson's disease (PD) presents itself with a multitude of non-motor symptoms with different degrees of specificity and sensitivity. The most important among them are REM sleep behavior disorder (RBD) and olfactory dysfunction. RBD is a parasomnia characterized by the loss of REM sleep muscle atonia and dream-enacting behaviors. Olfactory dysfunction in individuals with prodromal PD is usually described as hyposmia (reduced sense of smell) or anosmia (complete loss of olfactory function). These symptoms can precede the full expression of motor symptoms by decades. A close comprehension of these symptoms and the underlying mechanisms may enable early screening as well as interventions to improve patients' quality of life. Therefore, these symptoms have unmatched potential for identifying PD patients in prodromal stages, not only allowing early diagnosis but potentially opening a window for early, possibly disease-modifying intervention. However, they come with certain challenges. This review addresses some of the key opportunities and pitfalls of both RBD and olfactory dysfunction as early markers of PD.
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Affiliation(s)
- Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
| | - Sarah Brosse
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Research Center, Sacré-Coeur Hospital of Montreal, Montréal, Québec, Canada
| | - Johannes Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Research Center, Sacré-Coeur Hospital of Montreal, Montréal, Québec, Canada
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
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Kulcsarova K, Skorvanek M, Postuma RB, Berg D. Defining Parkinson's Disease: Past and Future. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230411. [PMID: 38489197 DOI: 10.3233/jpd-230411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Parkinson's disease (PD) is the second most common still relentlessly progressive neurodegenerative disorder with a long period in which the pathophysiological process is already spreading but cardinal motor symptoms are not present. This review outlines the major developments and milestones in our understanding of PD that have shaped the way we define this disorder. Past criteria and definitions of PD have been based on clinical motor manifestations enabling diagnosis of the disease only in later symptomatic stages. Nevertheless, with advancing knowledge of disease pathophysiology and aim of early disease detection, a major shift of the diagnostic paradigm is being advocated towards a biological definition similar to other neurodegenerative disorders including Alzheimer's disease and Huntington's disease, with the ultimate goal of an earlier, disease course modifying therapy. We summarize the major pillars of this possible approach including in vivo detection of neuronal α-synuclein aggregation, neurodegeneration and genetics and outline their possible application in different contexts of use in the frame of biological PD definition.
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Affiliation(s)
- Kristina Kulcsarova
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic
- Department of Clinical Neurosciences, University Scientific Park MEDIPARK, P. J. Safarik University, Kosice, Slovak Republic
| | - Matej Skorvanek
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic
- Department of Neurology, L. Pasteur University Hospital, Kosice, Slovak Republic
| | - Ronald B Postuma
- Department of Neurology, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Daniela Berg
- Department of Neurology, Kiel University and University Medical Center Schleswig-Holstein, Kiel, Germany
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Mahlknecht P, Poewe W. Pharmacotherapy for Disease Modification in Early Parkinson's Disease: How Early Should We Be? JOURNAL OF PARKINSON'S DISEASE 2024:JPD230354. [PMID: 38427503 DOI: 10.3233/jpd-230354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Slowing or halting progression continues to be a major unmet medical need in Parkinson's disease (PD). Numerous trials over the past decades have tested a broad range of interventions without ultimate success. There are many potential reasons for this failure and much debate has focused on the need to test 'disease-modifying' candidate drugs in the earliest stages of disease. While generally accepted as a rational approach, it is also associated with significant challenges around the selection of trial populations as well as trial outcomes and durations. From a health care perspective, intervening even earlier and before at-risk subjects have gone on to develop overt clinical disease is at the heart of preventive medicine. Recent attempts to develop a framework for a biological definition of PD are aiming to enable 'preclinical' and subtype-specific diagnostic approaches. The present review addresses past efforts towards disease-modification, including drug targets and reasons for failure, as well as novel targets that are currently being explored in disease-modification trials in early established PD. The new biological definitions of PD may offer new opportunities to intervene even earlier. We critically discuss the potential and challenges around planning 'disease-prevention' trials in subjects with biologically defined 'preclinical' or prodromal PD.
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Affiliation(s)
- Philipp Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Vaughan DP, Fumi R, Theilmann Jensen M, Georgiades T, Wu L, Lux D, Obrocki R, Lamoureux J, Ansorge O, Allinson K, Warner TT, Jaunmuktane Z, Misbahuddin A, Leigh PN, Ghosh B, Bhatia KP, Church A, Kobylecki C, Hu M, Rowe JB, Blauwendraat C, Morris HR, Jabbari E. Evaluation of cerebrospinal fluid alpha-synuclein seed amplification assay in PSP and CBS. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.28.24303478. [PMID: 38529496 PMCID: PMC10962751 DOI: 10.1101/2024.02.28.24303478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background Seed amplification assay (SAA) testing has become an important biomarker in the diagnosis of alpha-synuclein related neurodegenerative disorders. Objectives To assess the rate of alpha-synuclein SAA positivity in progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), and analyse the clinical and pathological features of SAA positive and negative cases. Methods 106 CSF samples from clinically diagnosed PSP (n=59), CBS (n=37) and indeterminate parkinsonism cases (n=10) were analysed using alpha-synuclein SAA. Results Three cases (1 PSP, 2 CBS) were Multiple System Atrophy (MSA)-type SAA positive. 5/59 (8.5%) PSP cases were Parkinson's disease (PD)-type SAA positive, and these cases were older and had a shorter disease duration compared with SAA negative cases. In contrast, 9/35 (25.7%) CBS cases were PD-type SAA positive. Conclusions Our results suggest that PD-type seeds can be detected in PSP and CBS using a CSF alpha-synuclein SAA, and in PSP this may impact on clinical course.
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Höglinger GU, Adler CH, Berg D, Klein C, Outeiro TF, Poewe W, Postuma R, Stoessl AJ, Lang AE. A biological classification of Parkinson's disease: the SynNeurGe research diagnostic criteria. Lancet Neurol 2024; 23:191-204. [PMID: 38267191 DOI: 10.1016/s1474-4422(23)00404-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 01/26/2024]
Abstract
With the hope that disease-modifying treatments could target the molecular basis of Parkinson's disease, even before the onset of symptoms, we propose a biologically based classification. Our classification acknowledges the complexity and heterogeneity of the disease by use of a three-component system (SynNeurGe): presence or absence of pathological α-synuclein (S) in tissues or CSF; evidence of underlying neurodegeneration (N) defined by neuroimaging procedures; and documentation of pathogenic gene variants (G) that cause or strongly predispose to Parkinson's disease. These three components are linked to a clinical component (C), defined either by a single high-specificity clinical feature or by multiple lower-specificity clinical features. The use of a biological classification will enable advances in both basic and clinical research, and move the field closer to the precision medicine required to develop disease-modifying therapies. We emphasise the initial application of these criteria exclusively for research. We acknowledge its ethical implications, its limitations, and the need for prospective validation in future studies.
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Affiliation(s)
- Günter U Höglinger
- Department of Neurology, University Hospital, Ludwig-Maximilians-University (LMU) and German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Daniela Berg
- Christian Albrechts University and University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lüebeck, Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Göttingen, Göttingen, Germany; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Werner Poewe
- Medical University Innsbruck, Innsbruck, Austria
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal Neurological Institute, Montreal, QC, Canada
| | - A Jon Stoessl
- Pacific Parkinson's Research Centre and Parkinson's Foundation Centre of Excellence, University of British Columbia, BC, Canada
| | - Anthony E Lang
- University Health Network's Krembil Brain Institute, Edmond J Safra Program in Parkinson's Disease and the Rossy PSP Centre, Toronto Western Hospital, Toronto, ON, Canada.
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Darweesh SKL, Sampaio C, Bloem BR. Has the time come to redefine Parkinson's disease? Lancet Neurol 2024; 23:130-133. [PMID: 38267174 DOI: 10.1016/s1474-4422(23)00503-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Sirwan K L Darweesh
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen 6500, Netherlands
| | | | - Bastiaan R Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson and Movement Disorders, Nijmegen 6500, Netherlands.
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Obeso JA, Calabressi P. Parkinson's disease is a recognisable and useful diagnostic entity. Lancet Neurol 2024; 23:133-134. [PMID: 38267175 DOI: 10.1016/s1474-4422(23)00512-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Jose A Obeso
- HM CINAC Neurocenter, Fundación HM Hospitales, HM Puerta del Sur, Universidad San Pablo CEU, Madrid 28938, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.
| | - Paolo Calabressi
- Neurologia, Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy; Unità Complessa di Neurologia, Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Jack CR. Criteria for a biological definition of neuronal α-synuclein disease-a major conceptual step forward. Lancet Neurol 2024; 23:129-130. [PMID: 38267173 DOI: 10.1016/s1474-4422(23)00456-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 01/26/2024]
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50
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Keavney JL, Mathur S, Schroeder K, Merrell R, Castillo-Torres SA, Gao V, Crotty GF, Schwarzschild MA, Poma JM. Perspectives of People At-Risk on Parkinson's Prevention Research. JOURNAL OF PARKINSON'S DISEASE 2024; 14:399-414. [PMID: 38489198 DOI: 10.3233/jpd-230436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
The movement toward prevention trials in people at-risk for Parkinson's disease (PD) is rapidly becoming a reality. The authors of this article include a genetically at-risk advocate with the LRRK2 G2019 S variant and two patients with rapid eye movement sleep behavior disorder (RBD), one of whom has now been diagnosed with PD. These authors participated as speakers, panelists, and moderators in the "Planning for Prevention of Parkinson's: A Trial Design Forum" hosted by Massachusetts General Hospital in 2021 and 2022. Other authors include a young onset person with Parkinson's (PwP) and retired family physician, an expert in patient engagement in Parkinson's, and early career and veteran movement disorders clinician researchers. Several themes emerged from the at-risk participant voice concerning the importance of early intervention, the legitimacy of their input in decision-making, and the desire for transparent communication and feedback throughout the entire research study process. Challenges and opportunities in the current environment include lack of awareness among primary care physicians and general neurologists about PD risk, legal and psychological implications of risk disclosure, limited return of individual research study results, and undefined engagement and integration of individuals at-risk into the broader Parkinson's community. Incorporating the perspectives of individuals at-risk as well as those living with PD at this early stage of prevention trial development is crucial to success.
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Affiliation(s)
- Jessi L Keavney
- Parkinson's Foundation, Parkinson's Advocates in Research Program, Pendergrass, GA, USA
| | | | - Karlin Schroeder
- Parkinson's Foundation, Associate Vice President of Community Engagement, New York, NY, USA
| | | | - Sergio A Castillo-Torres
- Edmond J. Safra Fellow in Movement Disorders, Servicio de Movimientos Anormales, Fleni, Buenos Aires, Argentina
| | - Virginia Gao
- Movement Disorders Fellow, Columbia University Irving Medical Center and Weill Cornell Medicine, New York, NY, USA
| | - Grace F Crotty
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael A Schwarzschild
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John M Poma
- Parkinson's Foundation, People with Parkinson's Advisory Council, Glen Allen, VA, USA
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