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Dumurgier J, Tzourio C. Epidemiology of neurological diseases in older adults. Rev Neurol (Paris) 2020; 176:642-648. [PMID: 32145981 DOI: 10.1016/j.neurol.2020.01.356] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/20/2019] [Accepted: 01/28/2020] [Indexed: 02/07/2023]
Abstract
Neurological diseases refer to the diseases that target the nervous system (brain, spine or nerves). They are the second leading cause of death, and the first cause of severe long-term disability in the world. The prevalence of most neurological diseases increases sharply with age, and age also modulates the impact of risk factors, clinical presentation and the natural course of these diseases. Longitudinal population-based studies provide useful insights for a better understanding of the specificities of neurological diseases in older adults by assessment of a wide range of risk factors. Rapid population aging, especially in low-income countries, presents challenges in terms of health and social care. A multidisciplinary approach is necessary to find solutions to tackle the burden of neurological diseases in older adults.
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Affiliation(s)
- J Dumurgier
- Cognitive Neurology Center, Saint-Louis - Lariboisière - Fernand-Widal Hospital, AP-HP, université de Paris, Paris, France; Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, université de Paris, Paris, France.
| | - C Tzourio
- Bordeaux Population Health Research Center, UMR1219, université de Bordeaux, Bordeaux, France
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Brudek T, Winge K, Folke J, Christensen S, Fog K, Pakkenberg B, Pedersen LØ. Autoimmune antibody decline in Parkinson's disease and Multiple System Atrophy; a step towards immunotherapeutic strategies. Mol Neurodegener 2017; 12:44. [PMID: 28592329 PMCID: PMC5463400 DOI: 10.1186/s13024-017-0187-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Parkinson’s’ disease (PD) and Multiple System Atrophy (MSA) are progressive brain disorders characterized by intracellular accumulations of α-synuclein and nerve cell loss in specific brain areas. This loss causes problems with movement, balance and/or autonomic functions. Naturally occurring autoantibodies (NAbs) play potentially an important role in clearing or/and blocking circulating pathological proteins. Little is known about the functional properties of anti-α-synuclein NAbs in PD and MSA, and there have been opposing reports regarding their plasma concentrations in these disorders. Methods We have investigated the apparent affinity of anti-α-synuclein NAbs in plasma samples from 46 PD patients, 18 MSA patients and 41 controls using competitive enzyme-linked immunosorbent assay (ELISA) and Meso Scale Discovery (MSD) set-ups. Results We found that the occurrence of high affinity anti-α-synuclein NAbs in plasma from PD patients is reduced compared to healthy controls, and nearly absent in plasma from MSA patients. Also, levels of α-synuclein/NAbs immunocomplexes is substantially reduced in plasma from both patient groups. Further, cross binding of anti-α-synuclein NAbs with β- and γ-synuclein monomers suggest, the high affinity anti-α-synuclein plasma component, seen in healthy individuals, is directed mainly against C-terminal epitopes. Furthermore, we also observed reduced occurrence of high affinity anti-phosphorylated-α-synuclein NAbs in plasma from PD and MSA patients. Conclusions One interpretation implies that these patients may have impaired ability to clear and/or block the effects of pathological α-synuclein due to insufficient/absent concentration of NAbs and as such provides a rationale for testing immune-based therapeutic strategies directed against pathological α-synuclein. Following this interpretation, we can hypothesize that high affinity autoantibodies efficiently bind and clear potentially pathological species of α-synuclein in healthy brain, and that this mechanism is impaired or absent in PD and MSA patients.
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Affiliation(s)
- Tomasz Brudek
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark. .,Bispebjerg Movement Disorders Biobank, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark.
| | - Kristian Winge
- Department of Neurology, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark.,Bispebjerg Movement Disorders Biobank, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark
| | - Jonas Folke
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark
| | | | - Karina Fog
- , H. Lundbeck A/S, Ottiliavej 9, DK-2500 Valby, Copenhagen, Denmark
| | - Bente Pakkenberg
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, Copenhagen University Hospital, Bispebjerg, Bispebjerg Bakke 23, DK-2400, Copenhagen N, Denmark.,Institute of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
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